Anyone else having trouble stomaching low starting salaries?

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docdoc2012

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In the thick of the job hunt right now...
Seeing bases in the high 100's, low 200s has been pretty disheartening after working this hard to get into ophtho, learning to be a microsurgeon and going through a fellowship...especially watching internal med colleagues finding jobs that almost double that working only half the year

I don't want this to be a woe is me thread...rather, I would love to hear from the senior guys on here 5 to 10 years in...when does it start getting better? It seems even after the associate period you are still working at a financial loss due to partnership buy ins, and building your rep seems tough when everyone wants to get worked on by the most experienced surgeon...how did you guys deal with these issues?
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If anyone feels the need to provide a "your hard work doesn't entitle you to anything" lecture, please spare us.


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Is this primarily an issue you've found in "saturated" areas or is this everywhere?
 
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anywhere withing a 2-2.5 hour range of a big city or in the suburbs of a mid-sized city . There has always been some excuse or another- the mid sized city practices say that the bases are low because the cost of living is lower, so that justifies it. Saturated areas the practices say that there is so much competition that they can't take a risk with a new associate because they might not be able to even generate their base.
 
Hi ophtholove92, my sibling also just signed as a hospitalist for 265 in a mid-sized city, works 1 week on 1 week off. I think there is a large variability across starts for internal medicine fields, less so for ophtho.
once again, not meant to be a 'let's all sit and talk about how bad we have it' thread.
I think I and I'm sure many of the people on this thread are wondering what the first few years after the low base look like, when it starts to get better and how those building years are tackled. In other words, when do you truly feel like you've made it?
 
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Not sure what your expectations were but 200kbase plus productivity is pretty decent starting salary for a first year associate. There's a high ceiling and if you hustle and ramp up quickly this will increase rapidly.
 
I have been saying this for years and years. Search my previous posts. Ophthalmology IS NOT like other specialities. Our procedures have been slashed and cut to the bone. Why? For example, cataract surgery is the most performed surgical procedure in the US, out of all specialities. Cutting $5 of cataract surgery is more cost effective than cutting brain surgery or whatever. We are now down to what? $600/cataract? And it keeps going. What are other reasons- hospitals do not need us. No reason to create an expensive ophtho department, they can function without us. Anything emergent ophtho is shipped out to academic centers or private guys. On the other hand, hospitals can't function without Hospitalists, general surgeons, ER, anesthesia, etc. Yes, we have cash procedures- lasik, premium lenses, but good luck carving out that market in competitive area. Is it possible? Yes. Is it nearly impossible- yes! Don't let anyone tell you otherwise. Here is another interesting tidbit- there is a HUGE shortage of primary care physicians EVERYWHERE. I am in So Cal and starting salaries are higher at So Cal Kaiser for PCPs as compared to ophtho. Last I heard they had 80 PCP positions open in LA proper. You know how many positions are open in ophtho within the same area? ZERO. In any ophtho subspecialty.

You will eventually see someone come on this forum and claim they making 7 figures working 4 days per week and getting their monthly checks from surgery center and optical. But they are usually in the middle of nowhere where such opportunities still exist. Trust me, you have more chances of getting struck by a lightening than getting into a situation like that in LA, SF, NY, etc.

I love what I do, I would never trade off doing cataract surgery for anything. But we are generally in a low paying surgical specialty now, probably one of the lowest. Unless you are super business savvy or in a very low competition area, you will likely not make as much as other surgical colleagues.


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Ophthalmology has a wider range of salaries than most other specialities. I see many doing very well in comprehensive (500 K+) in small, non-competitive areas, but then I also have friends who tried to set up shop in a crowded market, were making 100K, and had to give up and go move somewhere else after a few years.

The starting salaries are depressing. If we are honest, our speciality is as competitive to get into as Derm, Rads, Anesthesia, Ortho. The majority of them have starting salaries over 300K, many over 400K.

We definitely have the best job out there, but if money is your main goal then hit up a higher paying speciality on average. If you want to hit it rich in ophtho, you're going to have to bust your butt and get a bit of luck. All you have to do to hit it rich in ortho is become an employee somewhere and make 600K. If you want to become an employee at somewhere like Kaiser you'll be making 225 K your entire career.
 
I sit on compensation committee of a large multi hospital health care system. I know what all specialities make and averages for our area, which is ultra competitive. You guys underestimate what employed surgical specialities make. Our Orthos working 4 days a week make well north of 700k on average. Urology, ENT about the same. Our cardiologists and oncologists make 7 (!) figures while being employed and carrying no private practice risk and having had no buy in. So yeah, you do the math. Ophtho doesn't even have an option for similar employed position (I am very lucky I guess).


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corneainterviewseason said:
Ophthalmology has a wider range of salaries than most other specialities. I see many doing very well in comprehensive (500 K+) in small, non-competitive areas, but then I also have friends who tried to set up shop in a crowded market, were making 100K, and had to give up and go move somewhere else after a few years.

The starting salaries are depressing. If we are honest, our speciality is as competitive to get into as Derm, Rads, Anesthesia, Ortho. The majority of them have starting salaries over 300K, many over 400K.

We definitely have the best job out there, but if money is your main goal then hit up a higher paying speciality on average. If you want to hit it rich in ophtho, you're going to have to bust your butt and get a bit of luck. All you have to do to hit it rich in ortho is become an employee somewhere and make 600K. If you want to become an employee at somewhere like Kaiser you'll be making 225 K your entire career.
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Not true regarding Kaiser (I am not at Kaiser). SCPMG general ophtho salary tops out at 450k after 10 years of service. After at least 20 years, you get pension which is worth somewhere between 3-4 million depending how long you live. You get free medical care for life, company match, 401k on top of that. Plus after becoming a partner in 3 years you start getting paid K1 instead of W2, so you can write lots of stuff off. Just FYI.


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Eyefixer said:
Not true regarding Kaiser (I am not at Kaiser). SCPMG general ophtho salary tops out at 450k after 10 years of service. After at least 20 years, you get pension which is worth somewhere between 3-4 million depending how long you live. You get free medical care for life, company match, 401k on top of that. Plus after becoming a partner in 3 years you start getting paid K1 instead of W2, so you can write lots of stuff off. Just FYI.


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Good point re: Kaiser pension. Huge huge perk after 20 years. I was misinformed about the 225 K then, that was based off what one disgruntled Kaiser employed comprehensive guy told me.
 
No, he was right. 225k is starting salary. But with cataract incentive and annual increase it tops out at $450 after 10 years.


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Curious if anyone can elaborate more on starting salaries and mid-career pay in more rural areas for those of us who are pretty flexible in location for the right job


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Do people actually stay at Kaiser for 20 years in Ophthalmology? I have several friends at Kaiser in various Cali positions, and they all seem "ho-hum" about their jobs. Just wondering.
 
LightBox said:
Do people actually stay at Kaiser for 20 years in Ophthalmology? I have several friends at Kaiser in various Cali positions, and they all seem "ho-hum" about their jobs. Just wondering.
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Folks in that type system either stay for a couple years and get sick of the bureaucracy and leave or they stay for life. See it all the time.

To the OP: Gurantees for someone coming out of training on average are around $200K with a bonus potential. You really will start hitting the big incomes after you are fully vested in a practice.
 
This is just my opinion as a green resident, but honestly, $200,000 is a great salary compared to the vast majority of the US. Sure, hospitalists might make a bit more for working like a slave for a week (most hospitalists joke that it's just a continuation of residency, but as an attending). Seriously, the week they are on absolutely blows. 60-80 hours would not be too surprising. It's not too bad of a gig overall, but I would prefer a steady 40 over shoving 80 into one week any day. Plus, ophthalmology is fun. In the end it levels out and you are somewhere in the middle of the pack as far as compensation goes. On top of that, you have better hours and your patients actually get better. What else could you want? Comparison is one source of discontent. Wanting more than you need is another source of discontent. Being grateful for what you have will improve your sense of well-being.
 
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StupidRoo said:
This is just my opinion as a green resident, but honestly, $200,000 is a great salary compared to the vast majority of the US. Sure, hospitalists might make a bit more for working like a slave for a week (most hospitalists joke that it's just a continuation of residency, but as an attending). Seriously, the week they are on absolutely blows. 60-80 hours would not be too surprising. It's not too bad of a gig overall, but I would prefer a steady 40 over shoving 80 into one week any day. Plus, ophthalmology is fun. In the end it levels out and you are somewhere in the middle of the pack as far as compensation goes. On top of that, you have better hours and your patients actually get better. What else could you want? Comparison is one source of discontent. Wanting more than you need is another source of discontent. Being grateful for what you have will improve your sense of well-being.
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Thanks for the reply StupidRoo.

Many of my intereal medicine colleagues love their jobs as hospitalists and don't feel like slaves. And I absolutely hope they love their jobs and their chosen specialty because we have all worked too hard to get here to not enjoy what we do. Comparison does absolutely breed malcontent in life in general. Having to see the negatives in another profession is also a form of comparison, and ide much rather not be looking for the negatives in other people's choices to feel better about my own chosen profession.

I also respectfully disagree with comparison of physicians salaries to the general population. It's a can of worms that doesn't need to be opened on this thread.

As I mentioned in the original post, this is not meant to be woe is me thread, it was simply asking the senior people on the thread how they got over the reality of the job situation in our profession, when it started to get better for them and what to expect out of the next 5 to 10 years. I, and I know many others in my position are tired of getting the "hey, atleast you don't have it as bad as this guy" consolation. That's not the point. Reality is that for whatever reasons, many of which have been mentioned above, ophthalmology has been shafted as a profession. The point is figuring out how to deal with the reality and getting a general picture of what to expect from the early years
 
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To put in my experience, I'm signing with an academic position, and it is well above the average stating salary. Not posting publicly about the details though for obvious reasons.
 
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Be forward thinking. Whatever the starting salary is means very little compared to what the expected salary will be in the coming years. don't be penny wise pound foolish, that could cost you big over the course of your career
 
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