maranatha

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At my training institution, C&A researchers and academic attendings make about 10 to 20K more then those in adult.

Was wondering if:
1. Any one is aware if this is true in most academic centers
2. What is an average salary for academic C&A attendings (I know this is highly variable, but just thought I'd ask)
3. What are the differences between working at a "more well known academic" institution like Hopkins, Yale, or one of the Harvard programs vs. more "mid level" institutions.
4. Does anyone know specifically what attendings at Hopkins make?

I'm strongly leaning toward an academic career after I finish my fellowship, but want to make sure I can pay off my loans...:(
 
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interesting questions. is there any child/adolescent psychiatrist in here? thru Google search, average seem to be around 210k in an nonacademic setting. I wonder if that is the truth average future and how low is it in an academic setting?
 

MDchouette

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I don't know about C&A, but I have heard from a reasonably good source that starting salaries for fresh-out-of-residency psychiatrists at Harvard this year were around $80K.
 

TexasPhysician

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I don't know about C&A, but I have heard from a reasonably good source that starting salaries for fresh-out-of-residency psychiatrists at Harvard this year were around $80K.
Interesting.....since the average salary of the general psychiatrists leaving my school's program (not a top 50 program) is $180,000+
 

OldPsychDoc

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I don't know about C&A, but I have heard from a reasonably good source that starting salaries for fresh-out-of-residency psychiatrists at Harvard this year were around $80K.
Interesting.....since the average salary of the general psychiatrists leaving my school's program (not a top 50 program) is $180,000+
And therein lies the story of academia vs. clinical practice...
 

strangeglove

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In some places, you are allowed to start a private practice along with your academic work. This usually provides the real income, especially if you are doing cash-only and charging fees that reflect the "quality" of your academic affiliation.
 

atsai3

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At my training institution, C&A researchers and academic attendings make about 10 to 20K more then those in adult.

Was wondering if:
1. Any one is aware if this is true in most academic centers
2. What is an average salary for academic C&A attendings (I know this is highly variable, but just thought I'd ask)
3. What are the differences between working at a "more well known academic" institution like Hopkins, Yale, or one of the Harvard programs vs. more "mid level" institutions.
4. Does anyone know specifically what attendings at Hopkins make?

I'm strongly leaning toward an academic career after I finish my fellowship, but want to make sure I can pay off my loans...:(
Can't speak for child, but for general adult psychiatry in the Bay Area, you can make much more in the community than you can in academic practice. Starting staff salaries at UCSF are about in the 130s, San Francisco General inpatient or county outpatient 180s, and Kaiser in the 220s.

-AT.
 

maranatha

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In some places, you are allowed to start a private practice along with your academic work. This usually provides the real income, especially if you are doing cash-only and charging fees that reflect the "quality" of your academic affiliation.
Yeah, I've heard about this as well. I wonder if this is true at some of the places such as Harvard and Hopkins who are notorious for not paying much. Does anyone else know about this? I can't imagine anyone with student loans could make it on 80K a year. There must be some other source of income.

I know at my institution that at least one new C/A academic attending doing research started around 130K and this went up top 150K in just a few years. Considering they have a pretty cushy life style and spend most to their time doing research, I think this is a pretty nice starting salary, i.e. don't have to worry about insurance, overhead, dealing with hiring staff, etc. The child attendings who have been here for a while make just over 200K. And again, these are folks doing research with some patient care. Also, there are other perks such as health insurance and support for retirement. I wonder if this is unusual...
 
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maranatha

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Can't speak for child, but for general adult psychiatry in the Bay Area, you can make much more in the community than you can in academic practice. Starting staff salaries at UCSF are about in the 130s, San Francisco General inpatient or county outpatient 180s, and Kaiser in the 220s.

-AT.
That's probably true around here as well for the Adult folks (the child attendings move up much faster and ultimately average a good 20K more after a few years). But the cost of living in my neck of the woods is much less. That makes a BIG difference when you're offered 130K in the San Fran area versus a midwest city.
 

GmailQueen

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If you're planning on staying in academics and will spend 30+ hours/week working for a non-profit (most academic centers qualify, although it depends upon where your paycheck comes from), you should really look into income-based loan repayment with public service forgiveness. You're only required to pay back an amount equivalent to 15% of your salary above the federal poverty level (might be above 150% of the federal poverty level). After 120 payments, your remaining debt is forgiven. I believe you qualify for IBR as long as your repayment under IBR is less than what you'd be paying with standard repayment.

Also, if you're going to be doing research, look into the NIH loan repayment option.

Good luck!
 

sluox

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I don't know about C&A, but I have heard from a reasonably good source that starting salaries for fresh-out-of-residency psychiatrists at Harvard this year were around $80K.
I'm PRETTY sure this is an inaccurate number and is not nearly as scary as it sounds. What he/she probably meant was that a position (likely part-time inpatient) pays 80k at some harvard affiliate. This thus gives a steady source of income, along with health insurance and retirement. However, the doc is likely able to set up an outpatient somewhere in the afternoon.

The usual arrangement is 50% inpatient, 50% out, or 20%/80% etc. As you can see, it's very easy to at least double this quoted number--and the salary is higher in outpatient with less charity care. Often as the outpatient clients get developed, the inpatient responsibility gets phased out. It seemed to me to be very hard to recruit long term attendings in the inpatient units--ever notice how these units are mostly staffed with fresh attendings? People who like being inpatient attendings end up becoming unit directors in their mid 30s. It's not bad.

As far as research goes, the numbers I heard for T32 fellowship is ~100k. Most FELLOWS are getting paid close to 80k if you count moonlighting for fellow-calls. I wouldn't worry about not paying off your student loans if you go into psychiatry, especially if you go to a Harvard program. I have NEVER heard of any practicing psychiatrist, even full time academicians who complain about salary. The usual comment is, "I don't want to go back to fellowship because I'm too used to attending salary now." And I know multiple academic psychiatrists (indeed, one was such a lowly research fellow) at highly prestigious institutions with 2-3 kids living in nice areas of the most expensive cities in the US. They've not disclosed their salaries to me, but knowing the real estate market I'm pretty sure they are buying million dollar condos (though perhaps faculties have mortgage assistance from the school?) and sending kids to private schools. You'll be fine. Don't worry! What's more likely to happen is that when you get done with your fellowship you'll get recruited as a C&A with a much higher salary (>$250k) in private practice, then it'll be super hard to stay in academia rather than to jump ship--which is why almost no good research is done in C&A. I was very worried about these things going in, but after talking to a few faculties and fellows candidly about job prospects, my fears are pretty assuaged. People are very often getting more than a few job offers (though perhaps this reflects the quality of the residency program?). The best people to ask are the new faculties etc., and I'm sure they will tell you.
 
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maranatha

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If you're planning on staying in academics and will spend 30+ hours/week working for a non-profit (most academic centers qualify, although it depends upon where your paycheck comes from), you should really look into income-based loan repayment with public service forgiveness. You're only required to pay back an amount equivalent to 15% of your salary above the federal poverty level (might be above 150% of the federal poverty level). After 120 payments, your remaining debt is forgiven. I believe you qualify for IBR as long as your repayment under IBR is less than what you'd be paying with standard repayment.

Also, if you're going to be doing research, look into the NIH loan repayment option.

Good luck!
Thanks! I'll look into those options.
 

st2205

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I'd take loan forgiveness as a nice perk, but I certainly would not plan as if it were certain. When Washington finds they can't keep stable with everything that's being spent (at the rate it's going this may not happen, however) an easy place to cut costs is people there is no obligation with (not that an obligation would mean much to begin with). There's no way that program can sustain itself.
 

maranatha

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I'm PRETTY sure this is an inaccurate number and is not nearly as scary as it sounds. What he/she probably meant was that a position (likely part-time inpatient) pays 80k at some harvard affiliate. This thus gives a steady source of income, along with health insurance and retirement. However, the doc is likely able to set up an outpatient somewhere in the afternoon.

The usual arrangement is 50% inpatient, 50% out, or 20%/80% etc. As you can see, it's very easy to at least double this quoted number--and the salary is higher in outpatient with less charity care. Often as the outpatient clients get developed, the inpatient responsibility gets phased out. It seemed to me to be very hard to recruit long term attendings in the inpatient units--ever notice how these units are mostly staffed with fresh attendings? People who like being inpatient attendings end up becoming unit directors in their mid 30s. It's not bad.

As far as research goes, the numbers I heard for T32 fellowship is ~100k. Most FELLOWS are getting paid close to 80k if you count moonlighting for fellow-calls. I wouldn't worry about not paying off your student loans if you go into psychiatry, especially if you go to a Harvard program. I have NEVER heard of any practicing psychiatrist, even full time academicians who complain about salary. The usual comment is, "I don't want to go back to fellowship because I'm too used to attending salary now." And I know multiple academic psychiatrists (indeed, one was such a lowly research fellow) at highly prestigious institutions with 2-3 kids living in nice areas of the most expensive cities in the US. They've not disclosed their salaries to me, but knowing the real estate market I'm pretty sure they are buying million dollar condos (though perhaps faculties have mortgage assistance from the school?) and sending kids to private schools. You'll be fine. Don't worry! What's more likely to happen is that when you get done with your fellowship you'll get recruited as a C&A with a much higher salary (>$250k) in private practice, then it'll be super hard to stay in academia rather than to jump ship--which is why almost no good research is done in C&A. I was very worried about these things going in, but after talking to a few faculties and fellows candidly about job prospects, my fears are pretty assuaged. People are very often getting more than a few job offers (though perhaps this reflects the quality of the residency program?). The best people to ask are the new faculties etc., and I'm sure they will tell you.
Thanks. My program is a little inbreed and, since I'm planning on leaving eventually, they don't know what other places are like.

A job offer for >250K would be tempting. However, although I love patient care and that is what drives me, I'm not sure I'm cut out to see patients 8 to 5, Mon-Fri, plus call. The idea of being able to think deeply about a problem I see in my patients and then implementing a research idea based on my clinical work is very appealing. Besides, as you implied, there aren't too many going into C&A research and there are so many cool questions that need to be answered--it's a wide open field and very exciting. I don't need that much money and think the researchers at my institution do very well. I'm just curious if that is typical in other places since I plan on not staying.

Are you in research?
 
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masterofmonkeys

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If you're planning on staying in academics and will spend 30+ hours/week working for a non-profit (most academic centers qualify, although it depends upon where your paycheck comes from), you should really look into income-based loan repayment with public service forgiveness. You're only required to pay back an amount equivalent to 15% of your salary above the federal poverty level (might be above 150% of the federal poverty level). After 120 payments, your remaining debt is forgiven. I believe you qualify for IBR as long as your repayment under IBR is less than what you'd be paying with standard repayment.

Also, if you're going to be doing research, look into the NIH loan repayment option.

Good luck!
Given that you do not sign a contract at the beginning of this program, color me skeptical. You are going to pay IBR, build lots of interest, and then hope and pray that the govt comes through for you 10 years from now? LOL.

I considered that option and then s***-canned it. Bottom line was given the way the govt has chosen to treat us so far, I have no reason to place any faith in them on what amounts to a verbal promise. Residents have been specifically exempted from almost all labor laws, yet pay into social security. Medicare and medicaid rates, when corrected for inflation, trended down absurdly over the past 10 years, and then they failed to
abort SGR just a few days ago. And they refuse to try us by a jury of our peers in malpractice cases. Not to mention the ripping off involved in medical and DEA licensure. And I'm supposed to think they'll come through for me on this? Hell no.

Paying back on extended, non-income based, and paying at least a little principal every month. Maybe in 10 years I'll have been proven wrong (i'm 100% set on academics in some way shape or form). I still believe this is the more prudent way to go.

p.s. don't forget that 'forgiven' debt is treated as income. I.e., when the government 'forgives' 80k, you're going to pay 40% (at least) right back to the govt.
 
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is it my imagination or is it my imagination? I saw some of locum tenens advertisements. They hire pcp for 70-80d/hr while hiring adult psych for 100-110d/hr? is that typically or rare occasion?
 

GmailQueen

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Given that you do not sign a contract at the beginning of this program, color me skeptical. You are going to pay IBR, build lots of interest, and then hope and pray that the govt comes through for you 10 years from now? LOL.

I considered that option and then s***-canned it. Bottom line was given the way the govt has chosen to treat us so far, I have no reason to place any faith in them on what amounts to a verbal promise. Residents have been specifically exempted from almost all labor laws, yet pay into social security. Medicare and medicaid rates, when corrected for inflation, trended down absurdly over the past 10 years, and then they failed to
abort SGR just a few days ago. And they refuse to try us by a jury of our peers in malpractice cases. Not to mention the ripping off involved in medical and DEA licensure. And I'm supposed to think they'll come through for me on this? Hell no.

Paying back on extended, non-income based, and paying at least a little principal every month. Maybe in 10 years I'll have been proven wrong (i'm 100% set on academics in some way shape or form). I still believe this is the more prudent way to go.

p.s. don't forget that 'forgiven' debt is treated as income. I.e., when the government 'forgives' 80k, you're going to pay 40% (at least) right back to the govt.
Sure, it may not be the best option for everyone. But for those of us who have the options of IBR vs. forbearance, IBR is clearly the better option.

You can also be on the IBR repayment plan and pay more than your required payment every month. So, assuming that you're on an extended repayment plan, you could pay the same amount under IBR as you would on your extended repayment plan... and in 10 years, if the public service forgiveness is still in effect, hey, the rest of your loans are gone. If not, well you're not any worse off than you would be on the extended repayment schedule. Again, it differs for everyone, but as someone who is single, just finished medical school, and has no savings, having flexibility with my income right now to put money into savings and retirement is more important to me than paying back my debt, esp when there are currently a few different options that I can use for debt repayment (NIH loan repayment, NHSC, etc).

And, as for your last point - we just had our exit interview and were told that that is NOT the case. The money is forgiven and is not considered disposable income. Again, this may change in 10 years, but right now you don't have to pay taxes on it.

Also, since this plan is only ~1 year old, the government *may* not realize what a disaster they created for themselves until 10 years from now, when the first group wants their loans forgiven. Which may mean that those that jump on board now *may* just squeeze through before the government takes it away (b/c I agree - this plan is not going to last long).
 

michaelrack

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academic salaries are complex. Typically you would get a base salary from the medical school ($80,000 is fairly typical for an asst prof). You might get some type of supplement from your department. If your are director of a ward, you would probably get a medical director stipend from the hospital. In addition, you would typically get a % of the income generated from seeing patients (sometimes this will apply to all the patients you see, sometimes only to the patients you see in a "private" clinic).
The situation is even more complex if you do FUNDED research.
 

Sneezing

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I'm not counting on the government either. To expect them to hold up their deal for at least 10 years? LOL. They are already realizing they won't be able to cover all the pensions for government workers.

Oh, and don't forget if you do see the IBR through completion, when they pay off your remainder, it is considered taxable income for that year.

The government will get their's some how.
 

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Sneezing

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Correct, public service loan forgiveness is not taxable, but if you are involved with IBR or Income contigent repayment without public service it would be taxable.
 

GmailQueen

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Correct, public service loan forgiveness is not taxable, but if you are involved with IBR or Income contigent repayment without public service it would be taxable.
Without public service, you'd also be paying off your loans for 25 years, not 10; based on your post it seemed like that was what you were talking about.
 

masterofmonkeys

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Sure, it may not be the best option for everyone. But for those of us who have the options of IBR vs. forbearance, IBR is clearly the better option.

You can also be on the IBR repayment plan and pay more than your required payment every month. So, assuming that you're on an extended repayment plan, you could pay the same amount under IBR as you would on your extended repayment plan... and in 10 years, if the public service forgiveness is still in effect, hey, the rest of your loans are gone. If not, well you're not any worse off than you would be on the extended repayment schedule. Again, it differs for everyone, but as someone who is single, just finished medical school, and has no savings, having flexibility with my income right now to put money into savings and retirement is more important to me than paying back my debt, esp when there are currently a few different options that I can use for debt repayment (NIH loan repayment, NHSC, etc).

And, as for your last point - we just had our exit interview and were told that that is NOT the case. The money is forgiven and is not considered disposable income. Again, this may change in 10 years, but right now you don't have to pay taxes on it.

Also, since this plan is only ~1 year old, the government *may* not realize what a disaster they created for themselves until 10 years from now, when the first group wants their loans forgiven. Which may mean that those that jump on board now *may* just squeeze through before the government takes it away (b/c I agree - this plan is not going to last long).
Oh, I think IBR is better than forbearance for sure. I am a tightwad so making the payments and still enjoying myself isn't hard. But I recognize that for others it might be different.
 
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is it my imagination or is it my imagination? I saw some of locum tenens advertisements. They hire pcp for 70-80d/hr while hiring adult psych for 100-110d/hr? is that typically or rare occasion?
OK I am over in the UK and Ireland, so maybe I don't know what's going on there in the US, but I don't think it's much different here.

Salaries for psychiatry here vary hugely. Here there are people on part time government jobs making 70k/year, and people in private practice making 500k+. I saw the same for Switzerland, where the average salary for psychiatrists was around CHF 200k (almost the same as dollars), but that was at an average working week of 22hrs, because a huge amount of people are in psych part-time, or are women with families, etc., .

I was looking at the US once, and it struck me to be the exact same thing, as I saw government jobs for US$90-100k in institutions, and also 300k+ jobs being advertised on the internet. It's so variable that you will make plenty of money if you enjoy the job - forget about it as I am sure you will do fine, and enjoy psychiatry!

Most people in surgical jobs are working full time, 50-60hr weeks, AFAIK on both sides of the Atlantic. Quoted salaries are therefore in a more tight spread. I know as many psychiatry residents here making €50k a year as I do others making €120k. You can't look at average salary quotes, it's all negotiable, and if you enjoy it and work at it, you will have no worries with paying back loans.
 

trophyhusband

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Oh, I think IBR is better than forbearance for sure. I am a tightwad so making the payments and still enjoying myself isn't hard. But I recognize that for others it might be different.
You're not the only one. We've budgeted so we can live off of my wife's salary that way my entire salary can go toward paying back her loans. That way we'll pay off her $250k in loans in just under 5 years. It'll be pretty sweet having no debt when she gets her first attending job.

Thankfully the budget we'll be living on is only $400 or so less than what we live on now and we're moving to an area where our housing costs will be between $300-600 less. So just know you're not the only tightwad out there.
 

HMSPSYCH

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At my training institution, C&A researchers and academic attendings make about 10 to 20K more then those in adult.

Was wondering if:
1. Any one is aware if this is true in most academic centers
2. What is an average salary for academic C&A attendings (I know this is highly variable, but just thought I'd ask)
3. What are the differences between working at a "more well known academic" institution like Hopkins, Yale, or one of the Harvard programs vs. more "mid level" institutions.
4. Does anyone know specifically what attendings at Hopkins make?

I'm strongly leaning toward an academic career after I finish my fellowship, but want to make sure I can pay off my loans...:(
I was offerred salaries in the 230K+ at places but i ultimately chose to stick with full time research for another few years as I don't have a whole lot of med school loans (full ride). Generally, the harvard hospitals pay between 130-140K for inpatient/outpatient. Not too bad if one want to stick around and sharpen one's skills. Psychiatry is alot harder than it looks.