Are these clinical instructor salary numbers from AAMC accurate?

[brokeasshemonc]

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Note: this is slightly modified from a post I made on the hem/onc forum. I've slightly changed some details about myself to preserve anonymity.

I'm a hem/onc research fellow at a solid but not upper echelon program in the Midwest, widely considered T25 but not T5. I was looking to continue as a clinical instructor for a few years before applying for tenure-track research positions. I was expecting this to pay about $130k per year (as was the case in prior years), but due to the current funding crisis, this has been slashed to the resident/fellow pay scale at my institution.

I don't have a K award, but I do have a Damon Runyon Postdoctoral Fellowship and an ASCO YIA.

From the 2024 AAMC Faculty Salary Report for FY2023, stats for clinical instructors in hem/onc were as follows:

• Count: 114
• 10th Percentile: $135,476
• 25th Percentile: $181,800
• Median: $242,822
• 75th Percentile: $274,310
• 90th Percentile: $334,500
• Mean: $245,802

These were much higher figures than I expected for clinical instructors, not assistant professors, and I can't figure out anything in the survey methodology to suggest why they would skew higher than expected. I also recognize that these are self-reported numbers, but I don't have any reason to believe clinical instructors would be more inclined to self-report favorable numbers than other positions.

If these are accurate, my compensation as a clinical instructor would be 1/3 of the reported median/mean of clinical instructors, a subset of academically oriented physician scientists who were already inclined to take lower compensation, despite the fact that I would be able to fully fund my external research effort. I can't justify continuing like this. On the other hand, if these numbers are completely skewed by a factor of 2-3x, then I would have to seriously contemplate what's important to me.

 

[tr]

What % FTE will you have for research and how will that be covered? Departmental funds, internal career development grant, or external funding?

Research time is generally compensated at a much lower rate than patient care time. However the institution has to settle on a single salary number for you.

If you will be doing mostly clinical work you can argue for a clinical level salary. If you will be doing mostly research it is harder to make that case.

Some institutions handle this issue by setting the salary at the research rate and then providing a "clinical supplement" that is prorated to the %clinical FTE. If this is the case your salary will look low on paper but your take-home will be closer to reasonable.

 

[brokeasshemonc]

What % FTE will you have for research and how will that be covered? Departmental funds, internal career development grant, or external funding?

Research time is generally compensated at a much lower rate than patient care time. However the institution has to settle on a single salary number for you.

If you will be doing mostly clinical work you can argue for a clinical level salary. If you will be doing mostly research it is harder to make that case.

Some institutions handle this issue by setting the salary at the research rate and then providing a "clinical supplement" that is prorated to the %clinical FTE. If this is the case your salary will look low on paper but your take-home will be closer to reasonable.

80% research protected. I'm not sure "how it will be covered" because the math makes no sense. The external funding + internal sources already exceed the salary they're offering me, even without my 20% clinical effort. This is what prompted me to check what other clinical instructors were being paid.

 

[solitude]

ask your chair and get an offer that more clearly states the conditions leading to your actual income in writing. Being paid on the PGY scale is unacceptable.

 

[Neuronix]

I'm a hem/onc research fellow at a solid but not upper echelon program in the Midwest, widely considered T25 but not T5. I was looking to continue as a clinical instructor for a few years before applying for tenure-track research positions. I was expecting this to pay about $130k per year (as was the case in prior years), but due to the current funding crisis, this has been slashed to the resident/fellow pay scale at my institution.

So you're looking at about what, 75k? That's basically post-doc level. The idea has always been that the 20% clinical effort is good for another 50-60k on top of a post-doc research-only salary to get you to that ~130k/year salary that is classic for physician-scientist instructor.

My initial impression is that they don't have any funding for post-docs and are having you self-fund your position with the 20% clinical effort and extramural funding. If so, they're basically creating a position for you, but they're not committing any resources to you. Without skin in the game on their side, there's no incentive on their side to help you build an academic career.

From the 2024 AAMC Faculty Salary Report for FY2023, stats for clinical instructors in hem/onc were as follows:

• Count: 114
• 10th Percentile: $135,476
• 25th Percentile: $181,800
• Median: $242,822
• 75th Percentile: $274,310
• 90th Percentile: $334,500
• Mean: $245,802

These were much higher figures than I expected for clinical instructors, not assistant professors, and I can't figure out anything in the survey methodology to suggest why they would skew higher than expected. I also recognize that these are self-reported numbers, but I don't have any reason to believe clinical instructors would be more inclined to self-report favorable numbers than other positions.

Many clinical instructor positions have much more clinical effort. I wouldn't compare to these numbers if you're 80% research, at least without a significant, independent grant.

80% research protected. I'm not sure "how it will be covered" because the math makes no sense. The external funding + internal sources already exceed the salary they're offering me, even without my 20% clinical effort. This is what prompted me to check what other clinical instructors were being paid.

This is concerning math. I would be looking for another institution. At a minimum you have to be well aware that this institution is not a place you can stay for the long-term. The lack of resources or salary will be a chronic problem even if you manage to get an R01-equivalent.

 

[brokeasshemonc]

This is concerning math. I would be looking for another institution. At a minimum you have to be well aware that this institution is not a place you can stay for the long-term. The lack of resources or salary will be a chronic problem even if you manage to get an R01-equivalent.

Yes, I've come to this realization. Without divulging too many details about myself or the institution (not interested in burning bridges even on the way out), this place has undergone changes at every significant place of leadership in the past year. Unfortunately, it means I haven't been able to get a straight answer about how the situation unfolded below even my lowest expectations.

 

[dl2dp2]

Yes, I've come to this realization. Without divulging too many details about myself or the institution (not interested in burning bridges even on the way out), this place has undergone changes at every significant place of leadership in the past year. Unfortunately, it means I haven't been able to get a straight answer about how the situation unfolded below even my lowest expectations.

They are paying you 80k for 1.0 FTE as a board-certified medical oncologist with 20% clinical? LOL. Academia is getting worse by the day. I thought only Dana Farber/MD Andersons of the world did this.

*I read my own writing and it's a bit too emotionally charged so let me give you some bullets instead as a R01 funded academic researcher*

- Academia is in secular decline. NIH is losing money every day.

- You should aim to make enough money to be financially independent as soon as possible, because sustaining an academic career depends on that more than anything else. Many different non-mutually exclusive ways, including:
moonlighting at an outside private practice
industry consulting
a wealthy/high earning spouse
family money - I'm not even joking. have a very serious discussion with your parents if you come from a medical or otherwise well-to-do family. do not waste time on starting a family, buying a house, etc. say that you are deciding to commit to a career in academic cancer research and it will pay relatively poorly, can they help with X Y Z. This happens ALL the time. Now that I know what's going on if I had a child who wants to pursue this I would *offer* before they ask. You cannot afford to waste your 30s on nonsense.
completely unrelated side gigs (real estate, PhD-focused consulting, etc)

- As a more midcareer person, the amount of "real science" you do actually decreases because you need to worry about personnel, strategic goals, etc.

- The 1-3 hours a week of "real science" is pretty interesting, because very few people in the world can do what you do, but the rest is tedious

- Industry is a great exit. 300k to start, 500k+ after 5 years

- If you want to stay in academia and don't want to side gig, you need to give talks outside and move around

- It is likely that you'll get competing offers in the 250k+ range in academia if you move around

- Highly unlikely that they'll give you a raise unless you bring an external offer

 

[tr]

You should apply for external jobs anyway. If you can solicit a competing offer that says 300k+, they might consider giving you a raise.

Well. If you get a competing offer, I would say you should take it.
Agree with @Neuronix that it sounds like this department is really not doing well and the sooner you are out of there, the better.
Don't hitch your wagon to a falling rock.

 

[dl2dp2]

Well. If you get a competing offer, I would say you should take it.
Agree with @Neuronix that it sounds like this department is really not doing well and the sooner you are out of there, the better.
Don't hitch your wagon to a falling rock.

lol, I had an external offer as a div chief then self-sabotaged myself by submitting a wildly unrealistic strategic plan so that they rescinded their offer. so, no, not always.

 

[brokeasshemonc]

They are paying you 80k for 1.0 FTE as a board-certified medical oncologist with 20% clinical? LOL. Academia is getting worse by the day. I thought only Dana Farber/MD Andersons of the world did this.

Technically, only board-eligible (just graduated). But to add insult to injury, the research effort for the 80k is almost exclusively covered by grants that I personally secured.

Thanks for confirming that this isn't the norm, even during a challenging funding environment.

You should aim to make enough money to be financially independent as soon as possible, because sustaining an academic career depends on that more than anything else.

I'm not quite financially independent yet, but secure enough where I was willing to sacrifice earnings (i.e. a >75% pay cut compared to private practice or industry) for the science for what I assumed would be a standard clinical instructor role. But to be asked to take an additional, steep pay cut even on top of that--with the "offer on the table" mainly contributed by my grant--has me running towards the exits.

Realistically, if I pivot now to "chase the bag" (let's say in industry), I assume the door is realistically closed on me in academia. At least as a R01-funded physician scientist with their own lab.

 

[tr]

Technically, only board-eligible (just graduated). But to add insult to injury, the research effort for the 80k is almost exclusively covered by grants that I personally secured.

Thanks for confirming that this isn't the norm, even during a challenging funding environment.


I'm not quite financially independent yet, but secure enough where I was willing to sacrifice earnings (i.e. a >75% pay cut compared to private practice or industry) for the science for what I assumed would be a standard clinical instructor role. But to be asked to take an additional, steep pay cut even on top of that--with the "offer on the table" mainly contributed by my grant--has me running towards the exits.

Realistically, if I pivot now to "chase the bag" (let's say in industry), I assume the door is realistically closed on me in academia. At least as a R01-funded physician scientist with their own lab.

If you have funding that will cover 80% FTE (and assuming you want to stay in academia), you should run to another institution right now (assuming the funding is transferrable with you correct? should be if it is an early career foundation type award). Don't wait because you will be less of a good prospect with fewer years of funding to bring with.

Switching institutions is the only time you really have negotiating leverage, which is based on how valuable the institution expects you to be.
Once you are there, you are basically stuck with whatever they want to offer you unless you are willing to leave. Most people aren't because especially once you are past the early career stage, uprooting your spouse/family/etc becomes a really big deal.

You sound like a good deal from a chair's perspective right now. I think you should be able to negotiate something that works for you.
You might not be as much of a good deal 2-3 years down the road when you have less time left on your current awards.

Whatever they promise you, get it in writing.

 

[brokeasshemonc]

If you have funding that will cover 80% FTE (and assuming you want to stay in academia), you should run to another institution right now (assuming the funding is transferrable with you correct? should be if it is an early career foundation type award). Don't wait because you will be less of a good prospect with fewer years of funding to bring with.

Switching institutions is the only time you really have negotiating leverage, which is based on how valuable the institution expects you to be.
Once you are there, you are basically stuck with whatever they want to offer you unless you are willing to leave. Most people aren't because especially once you are past the early career stage, uprooting your spouse/family/etc becomes a really big deal.

I changed some of the details of the situation I described (including funding sources) to try to remain anonymous, but to simplify, I would probably be able to take my funding with me as a clinical instructor but not as an assistant professor. Relocating (and disrupting my science) for a "lateral move" is not the most attractive option, but it is one of many that I'm considering.

 

[dl2dp2]

Technically, only board-eligible (just graduated). But to add insult to injury, the research effort for the 80k is almost exclusively covered by grants that I personally secured.

Thanks for confirming that this isn't the norm, even during a challenging funding environment.


I'm not quite financially independent yet, but secure enough where I was willing to sacrifice earnings (i.e. a >75% pay cut compared to private practice or industry) for the science for what I assumed would be a standard clinical instructor role. But to be asked to take an additional, steep pay cut even on top of that--with the "offer on the table" mainly contributed by my grant--has me running towards the exits.

Realistically, if I pivot now to "chase the bag" (let's say in industry), I assume the door is realistically closed on me in academia. At least as a R01-funded physician scientist with their own lab.

One big lesson I've learned in the last 10 years is that there is a substantial amount of "hidden curriculum" in this world. You are presenting two alternatives (academia with 80k vs. private practice/industry 500k) that are dramatically different and require restrictive black and white thinking ("I'm 'willing' to 'sacrifice'...", "disrupting my science"). I would encourage you to think outside of the box and have calm, frank, and creative discussions with people, including your direct leadership at your institution and people from your network in industry or private practice.

You need to be starkly honest: your or anyone else's science at any particular moment is generally worthless unless there's substantial backing from NIH, ventures, big pharma, etc etc. This is also a good thing it means that there's practically no cost to pivot to move on and UP. Don't be so inflexibly wedded to generally worthless ideas to make personal sacrifices. Maybe you can make upward moves withOUT disrupting your "science". Maybe you can make upward moves and discard your science and discover even better science. Maybe you can make OUTward moves and discover better science.

In the real world, things rarely have to be 100% this, 100% that. Especially in 2025. Many extraordinary examples. Geoff Hinton, for example, discussed how he started working for Google after he realized that he'll never make enough money to support his child who had autism as a tenured academic. But he didn't drop out of his academic position at the time either. How did this happen? By talking to people and creating things that aren't in a "track" of some sort. So many examples in tech. And increasingly more examples in biopharma (George Church, Bob Langer, Tim Springer, etc etc etc).

If I followed a "track", and "prepared myself" for poverty, my life would have never worked out the way it has. The reason I am doing well now both financially and academically is because I just followed where there was no track and carved out my own niche based on what the market indicated that I can be good at. Having the flexibility and courage to believe that you can make things happen is a requisite. You don't have to believe the idea that "it's not possible to" make a lot of money as an academic "because it's just the way it is".

Also remember, soliciting offers does not mean that you need to take one immediately. Aim to be constantly on the job market. Someone like you shouldn't be moving "laterally". You should be talking to the top 5 all the time. Plus top 5 in the industry. Plus top 5 in private practice. And THEN some (VC, tech, etc.) The world is a big fat oyster for someone with MD PhD med onc fellowship. Don't yield to the unrelenting negative buzz in academia. It's so easy to do that, but it's exactly the wrong thing to do. Academia is going to the toilet, no doubt about it. It has been going to **** for 20 years. But academia is not the world, and there's plenty of opportunity and growth in your field.

Try to think creatively, talk to people, go where the market demands you, and create your own path. You don't have to do this or that, often you can do this AND that. Change your mindset from constantly making compromises and picking what's the least bad, to *designing* what's the best for YOU. I know this all sounds like chicken soup soft skills BS, but it really is the key to success.