Can someone explain how academic pediatricians are paid?

[pigsinacloth]

3rd year medical student who has always been interested in academic medicine and pediatrics. Going into medical school I figured I would do peds and the do a fellowship in something (Cardio, GI, Pulm, Neph). At this point I have done most of my rotations minus IM and I am still leaning towards peds, but I am worried about actually finding a job and being able to pay off my med school debt (most likely $400k+ when I graduate). I would also like to be in Chicago as that is where my girlfriend's family is from.

So how does the salary structure work in academics and is there anyway for me to make more through research grants and stuff if I am hoping on splitting my time 80/20 clinic/research?

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[GoSpursGo]

If you're 80/20 clinic/research, then likely you will not be dependent on getting any grants to support your research/admin time. You'll need to have some sort of publishing output (more than case reports) to make your division chief and department chair happy and to help you when it's time to go up for promotion, but it shouldn't be a high bar.

In terms of salary, you'll likely get paid a base salary which will be pretty low because you're in academia and it also sounds like you'll be in a desirable location. You will be able to earn a bonus based on the number of patients you see and RVUs you generate. You would make likely about half to 2/3 of what you would make as an adult subspecialist--still very comfortable, but there's no way around it that you're leaving money on the table to choose to work with kids. Obviously it's a decision we all made and all those surveys that show that pediatricians are the most satisfied in their jobs would tend to back up that there are nonmonetary benefits, but this is something you have to make your own peace with.

You should definitely learn more about the job market for peds subspecialties before deciding on your specialty. I can only comment on my own specialty, heme/onc, but the job market has been very tight lately and led to a massive decrease in applicants this year with many programs not filling. Since many peds subspecialties exist almost exclusively in academic medical centers, whether or not there is a clinical position open at any given time when you finish fellowship may be somewhat luck of the draw.

 

[pigsinacloth]

If you're 80/20 clinic/research, then likely you will not be dependent on getting any grants to support your research/admin time. You'll need to have some sort of publishing output (more than case reports) to make your division chief and department chair happy and to help you when it's time to go up for promotion, but it shouldn't be a high bar.

In terms of salary, you'll likely get paid a base salary which will be pretty low because you're in academia and it also sounds like you'll be in a desirable location. You will be able to earn a bonus based on the number of patients you see and RVUs you generate. You would make likely about half to 2/3 of what you would make as an adult subspecialist--still very comfortable, but there's no way around it that you're leaving money on the table to choose to work with kids. Obviously it's a decision we all made and all those surveys that show that pediatricians are the most satisfied in their jobs would tend to back up that there are nonmonetary benefits, but this is something you have to make your own peace with.

You should definitely learn more about the job market for peds subspecialties before deciding on your specialty. I can only comment on my own specialty, heme/onc, but the job market has been very tight lately and led to a massive decrease in applicants this year with many programs not filling. Since many peds subspecialties exist almost exclusively in academic medical centers, whether or not there is a clinical position open at any given time when you finish fellowship may be somewhat luck of the draw.

Thank you so much! is it common for hospitals to hire directly out of their fellowship/ie train with the intent to have at least some of the fellows stay on or is it completely a game of chance?

Also would it be ok if I PM you with some more specific questions?

 

[GoSpursGo]

Thank you so much! is it common for hospitals to hire directly out of their fellowship/ie train with the intent to have at least some of the fellows stay on or is it completely a game of chance?

Also would it be ok if I PM you with some more specific questions?

It depends on the specialty and institution.

 

[GonnaBeADoc2222]

You'll likely be paid 150k or less unless you go into PICU (200k ish) or NICU (where there are private practice opportunities).

You will be dependent on government intervention to clear your loans (PSLF).

You're much better off choosing psych, derm, rads or a surg subspecialty and doing a child fellowship.

 

[SurfingDoctor]

You'll likely be paid 150k or less unless you go into PICU (200k ish) or NICU (where there are private practice opportunities).

You will be dependent on government intervention to clear your loans (PSLF).

You're much better off choosing psych, derm, rads or a surg subspecialty and doing a child fellowship.

That is not accurate at all at face value.

A lot of variables go into compensation.

 

[GoSpursGo]

You'll likely be paid 150k or less unless you go into PICU (200k ish) or NICU (where there are private practice opportunities).

You will be dependent on government intervention to clear your loans (PSLF).

You're much better off choosing psych, derm, rads or a surg subspecialty and doing a child fellowship.

Agree with above, this is overstated. It shouldn’t shock anyone that pediatricians make less, but you’ll make more than $150k, and depending on your clinical workload and how your bonuses are calculated you can get a sizable bonus.

 

[pigsinacloth]

One of the things I was also looking into was the NIH loan repayment program. Where you do 20 hours a week of research specific work. I figured if I was already hoping to do an 80/20 split of a usual week this would just be a couple extra hours of top of that every week in exchange for 100k in loan relief over 2 years. Not sure if anyone has any knowledge of if this is super competitive or if the NIH has weird stipulations, but figured it would be a good way to help make payments towards PSLF/pay off the loans as well as keep more of my paycheck for my would be family at the time.

this is the link to the loan repayment program. There is a peds specific research heading too.

Home Page | National Institutes of Health | Division of Loan Repayment

www.lrp.nih.gov

Also based on everything that I was seeing online my initial guess would be the starting salary for a peds specialist would be around 180K base and then increase as other things increase ie faculty rank, years of experience, number of pts seen.

 

[oldbearprofessor]

One of the things I was also looking into was the NIH loan repayment program. Where you do 20 hours a week of research specific work. I figured if I was already hoping to do an 80/20 split of a usual week this would just be a couple extra hours of top of that every week in exchange for 100k in loan relief over 2 years. Not sure if anyone has any knowledge of if this is super competitive or if the NIH has weird stipulations, but figured it would be a good way to help make payments towards PSLF/pay off the loans as well as keep more of my paycheck for my would be family at the time.

this is the link to the loan repayment program. There is a peds specific research heading too.

Home Page | National Institutes of Health | Division of Loan Repayment

www.lrp.nih.gov

Also based on everything that I was seeing online my initial guess would be the starting salary for a peds specialist would be around 180K base and then increase as other things increase ie faculty rank, years of experience, number of pts seen.

I have frequently been a grant reviewer for this program over the years. It isn't designed for 80/20 primary clinical folks, it's designed for those on a tenure track or planning a tenure track appointment in academics with a substantial research commitment in their career. It has become increasingly competitive over the last 20 years although less competitive than many other grant programs from the NIH. Review has a lot to do with your mentor and long-term career plans.

 

[mvenus929]

You'll likely be paid 150k or less unless you go into PICU (200k ish) or NICU (where there are private practice opportunities).

You will be dependent on government intervention to clear your loans (PSLF).

You're much better off choosing psych, derm, rads or a surg subspecialty and doing a child fellowship.

I'm in the lowest paid specialty and I make more than 150k as my base salary, not including a stipend for working primarily at an offsite location and bonus.

Additionally, there IS a pediatric subspecialty specific loan forgiveness program, similar to the NIH and the health service corps--you just have to commit to working in an underserved area. Which is... not hard. Dunno how solvent it is since it just got funded this year, but it offers up to 100K of loan forgiveness. Fellowship training does count. Apply to the Pediatric Specialty Loan Repayment Program | Bureau of Health Workforce

But, PSLF is also a reasonable thing, and very easy to do as a peds subspecialist (theoretically, all your years of training count, so you only need 4 years as an attending).

One of the things I was also looking into was the NIH loan repayment program. Where you do 20 hours a week of research specific work. I figured if I was already hoping to do an 80/20 split of a usual week this would just be a couple extra hours of top of that every week in exchange for 100k in loan relief over 2 years. Not sure if anyone has any knowledge of if this is super competitive or if the NIH has weird stipulations, but figured it would be a good way to help make payments towards PSLF/pay off the loans as well as keep more of my paycheck for my would be family at the time.

this is the link to the loan repayment program. There is a peds specific research heading too.

Home Page | National Institutes of Health | Division of Loan Repayment

www.lrp.nih.gov

Also based on everything that I was seeing online my initial guess would be the starting salary for a peds specialist would be around 180K base and then increase as other things increase ie faculty rank, years of experience, number of pts seen.

20 hours per week is 0.5 FTE. That's what they're looking for, not someone with an 80% clinical/20% research split. Realistically, no one works a 40 hour workweek, but the 20 hours is part of your regular work week, not additional time.

 

[Stone Cold]

You'll likely be paid 150k or less unless you go into PICU (200k ish)

Unsure where you got this info from but all the graduating PICU fellows in my program landed in pretty decent gigs with the least offer being $290k

MGMA