Am I Under-/Overpaid?

[Hash Slinging Slasher]

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Hey everyone,

Was hoping to get some insight about my salary and whether or not I should be content with it.

I graduated residency this year and accepted an academic psychiatry position straight out of residency at my state medical school in the Southeast along the Atlantic. The medical school partners with community / state organizations to deliver care which I help fulfill. My mornings are spent managing a cohort of about 8-10 inpatients myself at the state psychiatric hospital. In the afternoon depending on the weekday, I supervise 2 resident clinics (including a ketamine and outpatient clinic), teach medical students for a half-day, manage a cohort of 8-10 juvenile detention patients (half-day by myself), do ECT (8 patients / half-day myself), and or do TMS (myself doing motor mappings). If an inpatient colleague takes vacation, then in the mornings, I'll manage my cohort of inpatients AND also assume responsibility for their cohorts which can vary anywhere from 14-22 patients depending on how busy the state hospital is and then come to afternoon clinics with colleague's residents managing things on the inpatient side while I do my afternoon obligations. Same with other outpatient providers' resident clinics or ECT/TMS obligations.

I make 220K/yr (base). To supplement the income, I make an additional 70K/yr from internal moonlighting by working x2 12-hr shifts/month and x1 4hr afternoon shift every week. In-person call supervising residents at hospital once every 3 months but leave after patients are all seen. Out of everything I do, about 0.3 FTEs are considered "RVU-generating" with the rest of the obligations being "contract"/flat-fee contracts with community partners. So for me, if I earn a collected wRVU threshold valued above 66K in a year, then ~$58/wRVU is paid out as a non-pension-contributing bonus. I get about 20 CME days, a $5000 yearly CME stipend, and accrue sick and annual leave at 8 and 12hrs respectively so there's def other benefits that possibly make up for the lower salary.

The biggest draws to me accepting a state academic position was teaching, state benefits/pension (requires 10 years of employment to become vested), and sovereign immunity overring protection from malpractice. However, with state budget issues, I'm not likely to get a raise next year (meaning I'll be making less after inflation), and the work has been keeping me very busy. Obvs, comparison is the thief of joy but wage but so is working under the value of what you bring. I'm seeing some of my former co-residents working in academics are making >275-300K in other parts of the country and I'm wondering if I hastily accepted too low of a salary or if I should be content where I'm at.

Question: Is my base salary reasonable / fair for what I do?

Would welcome any thoughts you all had

 

[Cath Up]

All told how many hours a week are you at work on average?

 

[psydocc]

Question: Is my base salary reasonable / fair for what I do?

Do you feel fairly compensated for the work you do? I think that's all that ultimately matters regardless of the actual salary. If your answer is "no" then it's just a matter of time until resentment and/or burnout sets in. I didn't feel fairly compensated for my work until I crossed the $600k mark.

 

[Stagg737]

All told how many hours a week are you at work on average?

In addition to this, how many patient encounters per day?

I’m Midwest academic making 260k-280k/yr seeing 8-10 patients most days with call q7-8 weekends on what’s basically a 3 week on/1 week off schedule. What OP is describing sounds like low pay for the amount of work, but that’s academia…

One thing I find a bit crazy is that it’s 10 years to full vestment in benefits. I hope that’s 10 years to obtain the full pension with other retirement accounts fully vested before that, which isn’t horrible if that’s the state plan. Otherwise yikes to those golden handcuffs. Im fully vested at 5 years and I don’t love waiting that long.

 

[comp1]

20 CME days? A paid month off for CME every year? That is a huge benefit. Overall the pay seems fine, particularly for the South.. Personally, I don't like it when inpatient and outpatient are split like you have it some days, but I guess other people do. I think you make it all too complicated with RVUs, number of patients and call, etc. Just add up the total salary and benefits and the hours you work per week (accounting for all that leave.)

 

[Hash Slinging Slasher]

All told how many hours a week are you at work on average?

Not including moonlighting, I work about 50hrs / week

 

[Hash Slinging Slasher]

20 CME days? A paid month off for CME every year? That is a huge benefit. Overall the pay seems fine, particularly for the South.. Personally, I don't like it when inpatient and outpatient are split like you have it some days, but I guess other people do. I think you make it all too complicated with RVUs, number of patients and call, etc. Just add up the total salary and benefits and the hours you work per week (accounting for all that leave.)

Yes with expenses up to $5000/yr. After accounting for registration, airfare, hotels, etc it seems like it would cover about 1.5 conferences but not much beyond. If I foot the bill afterwards, then yes, I can still use the time to do CMEs

Not sure if that's standard or unusual in academia, but I'd love to hear your thoughts

 

[Hash Slinging Slasher]

In addition to this, how many patient encounters per day?

I’m Midwest academic making 260k-280k/yr seeing 8-10 patients most days with call q7-8 weekends on what’s basically a 3 week on/1 week off schedule. What OP is describing sounds like low pay for the amount of work, but that’s academia…

One thing I find a bit crazy is that it’s 10 years to full vestment in benefits. I hope that’s 10 years to obtain the full pension with other retirement accounts fully vested before that, which isn’t horrible if that’s the state plan. Otherwise yikes to those golden handcuffs. Im fully vested at 5 years and I don’t love waiting that long.

Yes, it's 10 years to become vested/eligible for the pension. You also have to be 60+ in age before it pays out (or earlier with penalty if still 10+ years of service)

 

[Hash Slinging Slasher]

Do you feel fairly compensated for the work you do? I think that's all that ultimately matters regardless of the actual salary. If your answer is "no" then it's just a matter of time until resentment and/or burnout sets in. I didn't feel fairly compensated for my work until I crossed the $600k mark.

I guess that was one of the reasons for me coming here to ask hahaha

I don't really know if my salary is truly "fair" since I can't compare to other places as I'm sticking around at the same place I trained

I like what I do for sure. But if my salary/work was low-balled, then I don't want to feel like a sucker whose new grad naivety got taken advantage of. I also don't want to be an ingrate either, because if I've got a good thing going, I'll roll with the punches and be grateful for what I have

I guess I'm asking based on your all's collective experiences, what would you feel about my current salary/work situation...

 

[psydocc]

I guess that was one of the reasons for me coming here to ask hahaha

I don't really know if my salary is truly "fair" since I can't compare to other places as I'm sticking around at the same place I trained

I like what I do for sure. But if my salary/work was low-balled, then I don't want to feel like a sucker whose new grad naivety got taken advantage of. I also don't want to be an ingrate either, because if I've got a good thing going, I'll roll with the punches and be grateful for what I have

I guess I'm asking based on your all's collective experiences, what would you feel about my current salary/work situation...

$290k for 50hrs/week is underpaid, however you're in academia so being underpaid comes with the territory. I'm sure academia has its perks, but financial fairness is not typically one of them. You're doing inpatient, outpatient, ketamine, TMS, ECT, resident supervision, and two 12hr weekend shifts per month? I would demand $1MM/year for the workload you described, but I guess that's why I'm not in academia.

 

[TexasPhysician]

This is very low for private practice, but I’d call it normal for academia. 20 CME days is amazing and better than average. Often that number is 5 days. Many academic jobs have matching retirement contributions that vest in 5 years, but a true pension is a nice benefit that isn’t typical. That level of vacation 1 year out is also pretty good. I expect it increases at certain intervals.

I’d say the salary is a little low for academia, but your benefits are above average which evens things out. As you gain seniority, the goal would be to supervise more resident clinics and do more RVU bonusing half-days instead of the contract position days with no bonus.

You can theoretically take an entire 1 month off in conference cities every year without touching your vacation days. Academia often isn’t too strict on those days, meaning “attending” a Germany psychiatry conference and then an Italian conference could likely happen.

 

[finalpsychyear]

I guess that was one of the reasons for me coming here to ask hahaha

I don't really know if my salary is truly "fair" since I can't compare to other places as I'm sticking around at the same place I trained

I like what I do for sure. But if my salary/work was low-balled, then I don't want to feel like a sucker whose new grad naivety got taken advantage of. I also don't want to be an ingrate either, because if I've got a good thing going, I'll roll with the punches and be grateful for what I have

I guess I'm asking based on your all's collective experiences, what would you feel about my current salary/work situation...

How much PTO do you get? You mentioned 20 CME days. So for 50 hrs you are including all the moonlighting averaged out i hope and your about 300k then. I was offered a 160-170k base about 10 years ago before leaving residency.

Just to give you perspective if you were doing PP or some side contract work and doing 50 hours of patient care you would be getting at least 50% more than you current gross including the moonlighting but not necessarily counting all the perks like pto, free insurance, pension, sick days, cme etc that you are also getting in academia which can definitely add up on.

 

[Hash Slinging Slasher]

How much PTO do you get? You mentioned 20 CME days. So for 50 hrs you are including all the moonlighting averaged out i hope and your about 300k then. I was offered a 160-170k base about 10 years ago before leaving residency.

Just to give you perspective if you were doing PP or some side contract work and doing 50 hours of patient care you would be getting at least 50% more than you current gross including the moonlighting but not necessarily counting all the perks like pto, free insurance, pension, sick days, cme etc that you are also getting in academia which can definitely add up on.

I accrue PTO (12hrs) and sick leave (8hrs) monthly but don't get a lump sum at the beginning of the fiscal year. The 50hrs/wk is after averaging all my moonlighting out, yes. I will say that medical/dental/vision and pension contribution along with maxed out 403b and 457b (totaling $47K) are all pre-tax which is really nice

 

[comp1]

So in addition to calculating benefits and malpractice, when saying 50 hours/week you have to be subtracting out the leave hours (including your massive CME) to get an accurate comparison to PP. You get slightly lower than I might expect in terms of vacation leave (but maybe it goes up over time?) That said...your CME blows the average straight out of the water, so that more than makes up for it. $5k reimbursement is quite normal, although it definitely beats the $1k at federal facilities. It's only an issue because of the huge number of days they give you. I stand by this being a fair/pretty good pay for an academic facility in the South.

 

[DisorderedDoc417]

Hey everyone,

Was hoping to get some insight about my salary and whether or not I should be content with it.

I graduated residency this year and accepted an academic psychiatry position straight out of residency at my state medical school in the Southeast along the Atlantic. The medical school partners with community / state organizations to deliver care which I help fulfill. My mornings are spent managing a cohort of about 8-10 inpatients myself at the state psychiatric hospital. In the afternoon depending on the weekday, I supervise 2 resident clinics (including a ketamine and outpatient clinic), teach medical students for a half-day, manage a cohort of 8-10 juvenile detention patients (half-day by myself), do ECT (8 patients / half-day myself), and or do TMS (myself doing motor mappings). If an inpatient colleague takes vacation, then in the mornings, I'll manage my cohort of inpatients AND also assume responsibility for their cohorts which can vary anywhere from 14-22 patients depending on how busy the state hospital is and then come to afternoon clinics with colleague's residents managing things on the inpatient side while I do my afternoon obligations. Same with other outpatient providers' resident clinics or ECT/TMS obligations.

I make 220K/yr (base). To supplement the income, I make an additional 70K/yr from internal moonlighting by working x2 12-hr shifts/month and x1 4hr afternoon shift every week. In-person call supervising residents at hospital once every 3 months but leave after patients are all seen. Out of everything I do, about 0.3 FTEs are considered "RVU-generating" with the rest of the obligations being "contract"/flat-fee contracts with community partners. So for me, if I earn a collected wRVU threshold valued above 66K in a year, then ~$58/wRVU is paid out as a non-pension-contributing bonus. I get about 20 CME days, a $5000 yearly CME stipend, and accrue sick and annual leave at 8 and 12hrs respectively so there's def other benefits that possibly make up for the lower salary.

The biggest draws to me accepting a state academic position was teaching, state benefits/pension (requires 10 years of employment to become vested), and sovereign immunity overring protection from malpractice. However, with state budget issues, I'm not likely to get a raise next year (meaning I'll be making less after inflation), and the work has been keeping me very busy. Obvs, comparison is the thief of joy but wage but so is working under the value of what you bring. I'm seeing some of my former co-residents working in academics are making >275-300K in other parts of the country and I'm wondering if I hastily accepted too low of a salary or if I should be content where I'm at.

Question: Is my base salary reasonable / fair for what I do?

Generally speaking, running an inpatient practice (10-12 beds with some overnight call, some weekends here and there) and doing *something else* whether it be clinic, ketamine/sprayvato clinic, TMS, ECT, heck even forensic work should put you well into the 500-600k+ gross range. I wouldn't even entertain it for less. You can always be a guest lecturer or let a med school know you would host students....I don't see the need to yield 50% of your income for it.

 

[comp1]

Where are these salaried psychiatry jobs that advertise $600k or heck, $500k? I'd really like to see them. Heck, maybe I'd want one! The OP's job sounds like it is being paid exactly right. It's super nice that some of you cobble together a bunch of 1099's and apparently make a lot of money, but that is not the OP's situation.

 

[DisorderedDoc417]

Where are these salaried psychiatry jobs that advertise $600k or heck, $500k? I'd really like to see them. Heck, maybe I'd want one! The OP's job sounds like it is being paid exactly right. It's super nice that some of you cobble together a bunch of 1099's and apparently make a lot of money, but that is not the OP's situation.

You're never salaried for one job for 600k... as you later point out. I guess one positive is that if you're okay doing 6 different jobs all under the umbrella of one low-ish average salary, you will have job-security and the hospital probably loves you... And hopefully some "prestige" and a very nice plaque when you hit retirement.

 

[FatherPsychiatry]

My mornings are spent managing a cohort of about 8-10 inpatients myself at the state psychiatric hospital.

You could probably make more just being "full time" in the state hospital, probably having a similar case / work load in the morning that you do now, with no real afternoon obligations, while also still getting the pension, benefits, similar CME (or other PTO) time etc. You have an amazing skill-set (how many people can do ECT these days?) and work ethic. Do not sell yourself short. Yes its not all about money, but money is a big part and you are definitely not getting what you're worth IMO.

 

[DisorderedDoc417]

You could probably make more just being "full time" in the state hospital, probably having a similar case / work load in the morning that you do now, with no real afternoon obligations, while also still getting the pension, benefits, similar CME (or other PTO) time etc. You have an amazing skill-set (how many people can do ECT these days?) and work ethic. Do not sell yourself short. Yes it’s not all about money, but money is a big part and you are definitely not getting what you're worth IMO.

 

[DisorderedDoc417]

Agree with this sentiment. This is a fantastic skill set and work ethic. All that’s left is to let the market pay what that’s worth.

 

[comp1]

It's going to be close. The corrections pay range for the Southeast is well within what the OP is making. What it definitely will not be is $500-600k. Remember the OP is a brand new grad and will be salaried accordingly. Here's a job from Virginia, since the OP didn't tell us which specific state they are in. Personally, I would not want to do corrections all day (you're still going to be physically sitting in prison even if you aren't "working" in the afternoon), and be without residents, for what would likely be a small difference in pay, but to each their own. Psychiatrist #00597 : Nottoway Correctional Center - Nottoway, Virginia, United States

 

[Orgone]

Another way to look at OP's numbers: accumulates annually 6 weeks combined annual/sick leave, and get 4 weeks CME leave. If that is the only leave time, that makes for working 42 weeks per year; OP says working 50 hours a week before moonlighting (ugh), so multiply to 2,100 hours per year. For a base of 220k/year, and 5,000 CME allowance. If those numbers are correct, that makes your hourly rate 225,000/2,100 or .... $107/hour.

I was getting paid about that much 10 years ago, moonlighting as a resident. Granted that was 1099 income, and maybe OP will get a hefty RVU bonus, and maybe there's some other compensation OP didn't mention, but I doubt any of those will raise that hourly rate to something that doesn't sound terrible.

 

[Stagg737]

Another way to look at OP's numbers: accumulates annually 6 weeks combined annual/sick leave, and get 4 weeks CME leave. If that is the only leave time, that makes for working 42 weeks per year; OP says working 50 hours a week before moonlighting (ugh), so multiply to 2,100 hours per year. For a base of 220k/year, and 5,000 CME allowance. If those numbers are correct, that makes your hourly rate 225,000/2,100 or .... $107/hour.

I was getting paid about that much 10 years ago, moonlighting as a resident. Granted that was 1099 income, and maybe OP will get a hefty RVU bonus, and maybe there's some other compensation OP didn't mention, but I doubt any of those will raise that hourly rate to something that doesn't sound terrible.

I'd still want to know how many patients seen per day on average. Hourly pay is fine to calculate, but if OP is only seeing 4-6 patients per day then the hourly compensation isn't really representative of work done.

 

[jbomba]

Hey everyone,

Was hoping to get some insight about my salary and whether or not I should be content with it.

I graduated residency this year and accepted an academic psychiatry position straight out of residency at my state medical school in the Southeast along the Atlantic. The medical school partners with community / state organizations to deliver care which I help fulfill. My mornings are spent managing a cohort of about 8-10 inpatients myself at the state psychiatric hospital. In the afternoon depending on the weekday, I supervise 2 resident clinics (including a ketamine and outpatient clinic), teach medical students for a half-day, manage a cohort of 8-10 juvenile detention patients (half-day by myself), do ECT (8 patients / half-day myself), and or do TMS (myself doing motor mappings). If an inpatient colleague takes vacation, then in the mornings, I'll manage my cohort of inpatients AND also assume responsibility for their cohorts which can vary anywhere from 14-22 patients depending on how busy the state hospital is and then come to afternoon clinics with colleague's residents managing things on the inpatient side while I do my afternoon obligations. Same with other outpatient providers' resident clinics or ECT/TMS obligations.

I make 220K/yr (base). To supplement the income, I make an additional 70K/yr from internal moonlighting by working x2 12-hr shifts/month and x1 4hr afternoon shift every week. In-person call supervising residents at hospital once every 3 months but leave after patients are all seen. Out of everything I do, about 0.3 FTEs are considered "RVU-generating" with the rest of the obligations being "contract"/flat-fee contracts with community partners. So for me, if I earn a collected wRVU threshold valued above 66K in a year, then ~$58/wRVU is paid out as a non-pension-contributing bonus. I get about 20 CME days, a $5000 yearly CME stipend, and accrue sick and annual leave at 8 and 12hrs respectively so there's def other benefits that possibly make up for the lower salary.

The biggest draws to me accepting a state academic position was teaching, state benefits/pension (requires 10 years of employment to become vested), and sovereign immunity overring protection from malpractice. However, with state budget issues, I'm not likely to get a raise next year (meaning I'll be making less after inflation), and the work has been keeping me very busy. Obvs, comparison is the thief of joy but wage but so is working under the value of what you bring. I'm seeing some of my former co-residents working in academics are making >275-300K in other parts of the country and I'm wondering if I hastily accepted too low of a salary or if I should be content where I'm at.

Question: Is my base salary reasonable / fair for what I do?

Would welcome any thoughts you all had

Am I reading this correctly? You work ~42 moonlighting hours a month and for that effort you make 70k? That's 140/hr. I don't know how that is in your neck of the woods but around here that's below NP or resident moonlighting pay.

 

[TexasPhysician]

Am I reading this correctly? You work ~42 moonlighting hours a month and for that effort you make 70k? That's 140/hr. I don't know how that is in your neck of the woods but around here that's below NP or resident moonlighting pay.

NP’s are not making anywhere near $140/hr near me.

 

[Hash Slinging Slasher]

I'd still want to know how many patients seen per day on average. Hourly pay is fine to calculate, but if OP is only seeing 4-6 patients per day then the hourly compensation isn't really representative of work done.

Daily patient load varies

During my inpatient mornings, I'll always manage my own panel of 8-10 patients. Thankfully don't have to write daily notes on them (weekly) since those patients have been admitted for a while. If I'm covering for a colleague on the inpatient side, I'm covering my own panel plus their 14-22 patients (w/ resident supervision) which are x3 notes/week but the resident writes those

During the outpatient afternoon clinics where I'm supervising residents, it can be anywhere from 6-14 patients

During my ECT half-day, I treat 6-8 pts

 

[Hash Slinging Slasher]

NP’s are not making anywhere near $140/hr near me.

That's my understanding as well

I was told that $140/hr is pretty decent for a inpatient, state psychiatric hospital moonlighting in the South

But if you guys have data/info suggesting otherwise, I'm all ears haha

 

[FatherPsychiatry]

It's going to be close. The corrections pay range for the Southeast is well within what the OP is making. What it definitely will not be is $500-600k. Remember the OP is a brand new grad and will be salaried accordingly. Here's a job from Virginia, since the OP didn't tell us which specific state they are in.... Psychiatrist #00597 : Nottoway Correctional Center - Nottoway, Virginia, United States

Agreed that no job will offer 500k+straight up. But regarding the points about being a 'brand new grad and will be salaried accordingly', this is location and person dependent, but I think you can generally hit around 300k minimum without much effort. For the job you linked, the hiring range is $194k to $357k. You would think that a new grad will be offered the $194k because they're a new grad and all, but many places automatically start you at a higher step for whatever reasons, and you can often ask for the higher or even highest pay and they may grant it. In addition, there may be other bonuses that apply that aren't always listed on the job advertisement.

For example, for my job, the salary range is listed as $230k to $309k (which itself is from like two years ago, we've had raises since then but I'll just use those numbers for now). But there's a 20% bonus that's not reflected in the posted salary range, and also various other bonuses such as being board certified. Also, any new hires start at around $270k base, but around when I started you could show a salary you were offered by another company and then the job would automatically offer the $309k base. All in all, comes out to mid-upper 300s (now low to mid 400s), but you wouldn't know that by the information given on the job advertisement. I don't know if any of that kind of stuff applies to the job you list, but considering all the government jobs I looked into (VA, state, county) had em, I wouldn't be surprised if they did.

Long story short - try to network with psychiatrists actually working at these places to see what the work and pay is like. Recent grads from your program who work at some of these places are always a good resource IMO.

 

[comp1]

I really like the comparisons of salaried to salaried jobs above. I think that's important as opposed to comparing 1099 gigs/hourly pay. Ultimately the OP is getting around $300k with RVU bonuses and overtime (moonlighting). They're also getting (a lot) more CME time than average...and working less than average during their hours based on what is described above. And while I don't like to break things down to hourly pay when talking about salaried positions, no, NPs are not making $140 an hour. It's closer to half that. Salaried NPs are paid commensurate with their amount of training. Like MDs, they can can cobble together random 1099 work to come up with technically high hourly pay, but it's not salaried. Here's an example also from the Virginia Department of Corrections given my previous example:

Nurse Practitioner #00474 : Buckingham Correctional Center - Buckingham, Virginia, United States

Title: Nurse Practitioner #00474 : Buckingham Correctional Center State Role Title: RN III/Nurse Prct II Hiring Range: $124,984 - $176,129 Pay Band: 6 Agency: Dept of Corr - Central Admin Location: Buckingham Correctional Center Agency Website: https://www.vadoc.virginia.gov Recruitment Type...

www.jobs.virginia.gov

In terms of a new grad making on the high end of a salary range, I'm sure it happens, but it definitely would not be good for morale amongst employees and I've be very leery of taking a job that did that. You don't want people just coming in making more than people who have been there for a long time. That is the start of a death spiral. Further, most public employee's salaries are published online for transparency. Everybody knows everybody's business. Certainly in the federal sector salary isn't even close to negotiable. Time in service pay is just that (although service experience elsewhere may be transferrable) and salaries are set based on geographic averages, not individual negotiations. I'm sure there's slightly more leeway in things like state schools where the OP is, but I don't think much and I seriously doubt any academic job would consider "matching" any sort of competing offers from companies.

 

[FatherPsychiatry]

In terms of a new grad making on the high end of a salary range, I'm sure it happens, but it definitely would not be good for morale amongst employees and I've be very leery of taking a job that did that. You don't want people just coming in making more than people who have been there for a long time. That is the start of a death spiral.

Definitely happened here. There was a period a few years ago where a bunch of people bounced between corrections and the state hospital, even after working at the prior place for 4-5 years, because the new hires were starting on the maximum step whereas the people that had been there for years were only like halfway to the max, since you only get one step a year and many places started you on step 1. And there was no real way to just skip a bunch of steps while you were there. Typical government nonsense. So they'd jump for like 6 months, wait for whatever government checkboxes needed to be cleared so the hiring would be considered a new hire vs re-hire, and then jump back and now they were a new hire and starting at that high step and much higher pay than before.

 

[brosa]

Everyone is talking about the CME, but can OP actually use it?

I have often seen a pushback in academia to use PTO, like you have to find your own coverage, you need approval X months before, you need XYZ, making it harder to actually use it. It is a great running scam, you can post 100 CME days and make them close to impossible to being used.

Regarding OPs compensation, why not just get a remote position? Any big company will pay you 250-300+. There are certainly better options out there, but if for some reason you are stuck geographically, it is a great option. I've seen a huge variation in salary per location. Around here, resident's moonlight pay around $50-80/h. Sometimes it is something very low like $30 per patient or something.

 

[comp1]

Definitely second the question as to whether the OP can use the CME time. It's such a crazy high amount, I am also interested in hearing.

 

[Hash Slinging Slasher]

Definitely second the question as to whether the OP can use the CME time. It's such a crazy high amount, I am also interested in hearing.

I am able to use the CME days though I have to arrange my own coverage, which means that I have to plan my CME out 6 to 12 months in advance. That hasn't been too terribly difficult thankfully since I have a pretty good crew of colleagues, but since I work in several different locations, it ends up being several different colleagues I have to concurrently get buy-in from

The limiting factor honestly has been the $5,000 per year cap. I realize it's above average, but considering how expensive registration fees, flight / hotel, etc is, Even if I took all my CME days, only a fourth would end up being funded through that allotment and rest of the bill would be mine personally to foot

If do some 1099 moonlighting work on the side doing VA disability evals, though it's peanuts compared to internal moonlighting pay (which is why didn't I include it in original post) but I guess I could write off the additional CME expenses not covered by the department as a business expense under my 1099 LLC?

Please do let me know if that sounds doable or if I'm WAY off the mark here though...

 

[splik]

Definitely second the question as to whether the OP can use the CME time. It's such a crazy high amount, I am also interested in hearing.

I think it is unusual to get "CME time" in academics since there are plenty of activities providing CMEs (e.g. grand rounds) but it is very common to have professional leave to attend conferences (often to present but not required), serve on committees, give grand rounds at other institutions etc etc. When I was in academics we were allowed up to 48 days per year (the idea was it was basically unlimited within reason). I used to do 4-5 weeks of professional leave. I also used this time to testify in court for my forensic work. I was often presenting or doing committees etc but I did just attend conferences just because as well, and was able to do the MBT training. Other colleagues did other therapy trainings, often paid for by the department on the expectation they would provide those services and supervise residents in those modalities. Our department didn't pay for conference unless you applied which was a nuisance but I often received honorary and sometimes travel expenses for giving talks.

honestly, it was much easier for me to take professional leave than actual vacation! It was definitely one of the positives of academia. Now in private practice I attend far fewer conferences and do much less committee work. But I also have more time for vacation since I can take as much as I want!

 

[FatherPsychiatry]

The limiting factor honestly has been the $5,000 per year cap. I realize it's above average, but considering how expensive registration fees, flight / hotel, etc is, Even if I took all my CME days, only a fourth would end up being funded through that allotment and rest of the bill would be mine personally to foot

LOL when I read "CME", I thought of it as vacation with another name, with the worst case scenario being having to document CME credits for which a stack of UpToDate searches should suffice. Not like, actual continuing medical education.

 

[comp1]

Yeah, the OP seems to think that using CME time necessarily involves traveling physically to a conference. That's not my concept of it at all, although maybe it is at their institution? Of course my conceptualization was also not doing court testimony.

 

[mistafab]

For academic, your salary is somewhere in the realm of normal. However, your hours per week if actually that much (50 you said) is above average for this salary. Unless your work hours are super chill and not really that strict then that is a bit of an outlier.

You should be working less to be paid less, generally. It sounds like you're somewhat working more but being paid less. Not horrible if you like the gig. Not great if you're working that hard.

 

[psydocc]

In terms of a new grad making on the high end of a salary range, I'm sure it happens, but it definitely would not be good for morale amongst employees and I've be very leery of taking a job that did that.

The high end of the salary range for the corrections job you posted is $350k which is completely normal for a new grad to receive these days. I'd be far more leery of a full time position that seriously offered a salary of only $190k to new grads. This is not 1995 anymore.

 

[Stagg737]

I accrue PTO (12hrs) and sick leave (8hrs) monthly but don't get a lump sum at the beginning of the fiscal year. The 50hrs/wk is after averaging all my moonlighting out, yes. I will say that medical/dental/vision and pension contribution along with maxed out 403b and 457b (totaling $47K) are all pre-tax which is really nice

This is mediocre and significantly problematic early on when you don't have any time accrued. Hopefully if you need to take sick leave or vacation they'll let you borrow from your future self for the first X months, otherwise this is just not good. For comparison, my academic position I get 4 hours of sick accrual and 8 hours of vacation for pay period which is every 2 weeks.

Daily patient load varies

During my inpatient mornings, I'll always manage my own panel of 8-10 patients. Thankfully don't have to write daily notes on them (weekly) since those patients have been admitted for a while. If I'm covering for a colleague on the inpatient side, I'm covering my own panel plus their 14-22 patients (w/ resident supervision) which are x3 notes/week but the resident writes those

During the outpatient afternoon clinics where I'm supervising residents, it can be anywhere from 6-14 patients

During my ECT half-day, I treat 6-8 pts

That changes things significantly for that part of the job. I'd guess that position is probably state or grant funded, so won't matter but that's really only 5-6 patient encounters per day. So I'd expect lower compensation for that. The other coverage is a lot though and based on your hours and number of patients you're seeing (sounds like closer to 15-20/day) $220k is not good even for academia imo. The benefits could make it worthwhile, but that depends on how they're structured and how much much extra you're actually getting vs just being able to defer taxes on your own contributions. In general, academic programs will try and squeeze as much extra/free work out of you as possible. People like myself stick with it because the extra things I do for free are things I want to do that I otherwise wouldn't get to do in non-academic jobs (interview residents, lecture residents and med students, directly mentor pre-clinical students, etc). I get paid for all my clinical duties (RVU based) and only do administrative duties for free that I really want to do.

That's my understanding as well

I was told that $140/hr is pretty decent for a inpatient, state psychiatric hospital moonlighting in the South

But if you guys have data/info suggesting otherwise, I'm all ears haha

It's great if you're a resident but definitely well below average for an attending. Maybe that's true, but I feel like when people start adding modifiers like "for a state psych hospital in the south" that it's probably a sign that they're trying to give a reason why the pay isn't better.

I am able to use the CME days though I have to arrange my own coverage, which means that I have to plan my CME out 6 to 12 months in advance. That hasn't been too terribly difficult thankfully since I have a pretty good crew of colleagues, but since I work in several different locations, it ends up being several different colleagues I have to concurrently get buy-in from

The limiting factor honestly has been the $5,000 per year cap. I realize it's above average, but considering how expensive registration fees, flight / hotel, etc is, Even if I took all my CME days, only a fourth would end up being funded through that allotment and rest of the bill would be mine personally to foot

If do some 1099 moonlighting work on the side doing VA disability evals, though it's peanuts compared to internal moonlighting pay (which is why didn't I include it in original post) but I guess I could write off the additional CME expenses not covered by the department as a business expense under my 1099 LLC?

Please do let me know if that sounds doable or if I'm WAY off the mark here though...

And there's the catch. So you have to arrange your own coverage for multiple responsibilities any time you want to use CME. I have to do this too, but I can just block my clinic and usually our consult team is fine if someone is out, so we just cover each other. Being in multiple places in one day makes that difficult and the fact that you have to do this 6+ months in advance shows that. Imo that's not normal and a huge pain. I get 5 days of CME per year and $6k in CME/professional allowance yearly. I can use that on electronics as well as long as it's work related, so I update my phone every 2-3 years since we have a messaging system. If I were presenting at a conference or doing something else educational I'd just use my significant accrued vacation or sick leave.

 

[Stagg737]

Where are these salaried psychiatry jobs that advertise $600k or heck, $500k? I'd really like to see them. Heck, maybe I'd want one! The OP's job sounds like it is being paid exactly right. It's super nice that some of you cobble together a bunch of 1099's and apparently make a lot of money, but that is not the OP's situation.

They're rare but they're out there. Taddy posted about a medical director position for a state hospital in North Dakota paying $700k/yr with a pension a couple of months ago. Another user sent me a listing for a position in Ohio (including hospital recruiter's contact info) making $650-$750k/yr a few years ago. An alum from my residency program sent an e-mail to my class when I was a PGY-4 for a OP PP position in NYC paying $800k/yr (salary). One of my current colleagues that was in that doc's graduating class confirmed the position and pay was legit but that anyone doing it would be miserable there. I've also seen stuff in that range for locums positions, highest I saw was almost 7 figures for 6 months in Alaska when I was a resident. Catch was it involved flying back and forth on a small plane between two hospitals in different cities up there. So yea, they exist, and there's almost certainly a very good (or very bad?) reason why they pay that much.

LOL when I read "CME", I thought of it as vacation with another name, with the worst case scenario being having to document CME credits for which a stack of UpToDate searches should suffice. Not like, actual continuing medical education.

If you don't have to use the CME for actual conferences or training then why call it CME? Where I'm at we have to submit the registration forms/receipts for conferences we attend or show we were presenters. I'm sure if I tried to use CME as just a vacation I'd get in trouble with my department and they'd ask why I was using my 5 CME days for vacation when I have weeks of vacation time accrued and available, lol.

 

[FlowRate]

If you don't have to use the CME for actual conferences or training then why call it CME? Where I'm at we have to submit the registration forms/receipts for conferences we attend or show we were presenters. I'm sure if I tried to use CME as just a vacation I'd get in trouble with my department and they'd ask why I was using my 5 CME days for vacation when I have weeks of vacation time accrued and available, lol.

That's how I assume it works in academics. Our company doesn't have any requirements for using CME. The total PTO time would be really insufficient for new docs if they did.

 

[FatherPsychiatry]

If you don't have to use the CME for actual conferences or training then why call it CME? Where I'm at we have to submit the registration forms/receipts for conferences we attend or show we were presenters. I'm sure if I tried to use CME as just a vacation I'd get in trouble with my department and they'd ask why I was using my 5 CME days for vacation when I have weeks of vacation time accrued and available, lol.

Because that's how the union negotiated for us to get more vacation time without having to code vacation time on our time sheet 🕺💃

 

[comp1]

Good CME use should be a combination of vacation and training, regardless of whether you travel or not. The OP has a slightly less than average sick/vacation leave (at least compared to the federal government standard), but the CME being more than 4x the federal standard makes up for it. Coverage is indeed where the issue appears to arise.

 

[Stagg737]

Good CME use should be a combination of vacation and training, regardless of whether you travel or not. The OP has a slightly less than average sick/vacation leave (at least compared to the federal government standard), but the CME being more than 4x the federal standard makes up for it. Coverage is indeed where the issue appears to arise.

Uh, when I was getting recruited by our VA it was 54 or 57 days off per year (including holidays). OP isn't getting near that, it's 2.5 days per month. Based on what the setup sounds like the CME is there to make up for otherwise below average PTO especially since they said they can't use days until they're accrued. If OP could use CME like vacation time then I'd agree, but it's pretty clear they can't and that it's more of a "benefit" that looks more attractive on paper than the reality, which is pretty typical of a lot of academic "benefits".

Because that's how the union negotiated for us to get more vacation time without having to code vacation time on our time sheet 🕺💃

Gross. I mean, good for you and the docs, but seems icky that this is how the union and employer had to agree for you all to get the time off instead of just being straight forward and transparent. Just sounds kind of shady all around.

That's how I assume it works in academics. Our company doesn't have any requirements for using CME. The total PTO time would be really insufficient for new docs if they did.

Sure, but there's ways to accommodate until a buffer is built up. Where I'm at if someone needs sick leave or wants vacation before they've accrued it they can just borrow from their future selves for the first 4 or 6 months or some timeline like that. We also get the CME days and "discretionary days" that we can use for whatever as long as we notify the department a few weeks in advance.

"CME" is kind of pointless anyway if it isn't designated specifically for CME activities and like Splik said if it's truly limited in academia then it's pretty counterproductive to the mission of a lot of places. May as well just lump CME and vacation days together. Lots of silly bureaucracy about labeling days off that's distracting from other important aspects (like actually being able to use the time like has been mentioned).

 

[comp1]

Okay here is the breakdown of federal leave:
13 sick days per year
26 vacation days
5 CME days
10 holidays

And here is my take on the OP:
6 sick days (0.5x12)
18 vacation days (1.5x12)
20 CME days
9 holidays? (Most states don't recognize at least one of the federal holidays)

They seem about the same, but maybe my math is off. I definitely keep track of things in 2 week and not monthly blocks

 

[brosa]

To add more about range of pay, OP makes very similar money to what they pay at my city. I actually wonder if he works here, otherwise it is just a coincidence. In some places 220-270k is kinda the norm, while in others it's 300-400. Kinda crazy how it changes.

 

[Stagg737]

Okay here is the breakdown of federal leave:
13 sick days per year
26 vacation days
5 CME days
10 holidays

And here is my take on the OP:
6 sick days (0.5x12)
18 vacation days (1.5x12)
20 CME days
9 holidays? (Most states don't recognize at least one of the federal holidays)

They seem about the same, but maybe my math is off. I definitely keep track of things in 2 week and not monthly blocks

That looks accurate, but like I mentioned above it looks nice on paper but the reality is very different.

Those sick days and vacation days for the first 3-6 months before time accrues is basically nothing unless you can borrow from the future or have alternative means to take time off. Also, those 20 CME days look like a great way to make it up, but if OP is needing to request this 6-12 months in advance it looks like something that is good on paper but has significant barriers in place to minimize the actual use. Ime with the VA taking time off was never an issue for attendings and I only have to notify 2 weeks in advance for vacations at our program.

The other thing we don't know is how much of that time can accrue and roll over? I'd assume those CME days can't roll over and if you can't roll over a hefty chunk of sick or vacation days it could be even worse. I remember at the VA it was something like accruing 80 vacation days and unlimited sick days. Where I'm at vacation accrual maxes out at 38 days but sick leave accumulation is unlimited. No idea what OP's situation there is, but something for new grads to think about when looking at positions.

 

[comp1]

Yes, 85 days max accrual of vacation for federally employed physicians (much less for other workers). Unlimited sick accrual, but CME doesn't roll over. If you quit early, all vacation days are paid out in full. No reimbursement for unused sick days, but they do count towards your pension at retirement.