Compensation Report 2014

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BestDoctorEver said:
But when you just finished residency and you look at that big loan that you have to pay back, I guess some people might want to work more hours so they can pay off that loan. I would not mind working an extra 10 hours/wk so I can pay back my loan in a faster time.... I am looking to be 250k in the red after med school...Boy! I think I should start crying now! I wonder if psych has these 30k/year in loan repayment jobs like FM/Peds/OBGYN if one works in an underserved area and/or for a CHC... I would not mind taking a 140k-150k salary if I can find a deal like that....
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Yes. Psych is part of the Public Health Service programs.
 
Very true, I can definitely understand working extra hours to pay back student loans. I was more referring to a career-long pursuit of extra hours for extra gross income as being mostly self-defeating. Once the loans are paid off, extra income beyond six figures is not likely to contribute much to you or your family's happiness or quality of life. There are a bunch of studies on this but I don't feel like Googling them right now. 😉
 
SteinUmStein said:
Very true, I can definitely understand working extra hours to pay back student loans. I was more referring to a career-long pursuit of extra hours for extra gross income as being mostly self-defeating. Once the loans are paid off, extra income beyond six figures is not likely to contribute much to you or your family's happiness or quality of life. There are a bunch of studies on this but I don't feel like Googling them right now. 😉
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I completely agree.

I wanted to compare oranges with oranges. So 60 hour psych vs. 60 hour gen surgeon.

Happiness and job satisfaction is an entirely different argument. My question (which you guys have addressed) is how much can a 60 hour psych generate. Straight Up.

It appears 350K is a safe estimate for 60 hour psych. Which if I'm not mistaken, is the avg. gen surgeon income (320k?).

So really, psych is quite impressive from a financial reimbursement point of view.

P.S - Your 2 cents on doing fellowships to strengthen private practice?
 
I see Blitz, that makes sense. I think they are comparable on an hourly basis, although gen surg is not known for being the greatest financial deal. Other surgical subspecialties like ENT, ortho, and urology do better than psych when correcting for hours worked, but they also have longer and more grueling training programs.
 
Sporadicus said:
I think the reason no one knows is because hardly anyone works that many hours in psych.

Example: earlier this year my current hospital was advertising openings to work part time in the psych ED, 8 hour shifts paying $140/hr. I asked an attending about said rate, the reality was that you could get a flat rate of $100/hr regardless of how busy it gets, or you can get $75/hr + $65 for every H&P you generate. Assuming there are beds available and it is busy enough that you can generate one admission per hour, that's theoretically $140/hr. It is a lot more likely that you will never hit that number, and will opt for the flat rate. Some days you will work every single minute and stay an hour afterwards to return phone calls and wrap things up for the new shift. This will not be compensated time.

Do a shift every Tuesday afternoon and again Saturday morning and you will have hit an extra 16 hours per week for an extra $1600 in income.

Do that every single week, 52 weeks per year, and you will have added $83,200 to your salary. At a base of 220, that is $303,200 for 56 compensated hours of work. After progressive federal and state taxes remove $0.40 per dollar earned over $186,000 you will actually pocket an additional $957 per week- that's $136 more per day, working 6 days a week, missing Saturday afternoon and getting home every Tuesday night at about 2 AM - you will likely be burned out and very unhappy all the time. You will be a surgeon.
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Nice number crunching.

I know this is not a surgery forum, but to play devil's advocate, can a surgeon not choose to work 40 hours if they want? (ie - purely elective stuff like gall bladders and hernias)?
 
SteinUmStein said:
I see Blitz, that makes sense. I think they are comparable on an hourly basis, although gen surg is not known for being the greatest financial deal. Other surgical subspecialties like ENT, ortho, and urology do better than psych when correcting for hours worked, but they also have longer and more grueling training programs.
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Right. I don't expect psych to touch ENT/Ortho/Urology/Plastics

I am comparing with gen surg/cards/gastro/optho/derm/rads

More gruelling hours yes, but they are 4 years like psych right?
 
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Not typically, except for derm and ophtho-

cards = 7 years (3 IM + 3 cards + 1 interventional cards)
gen surg = 6 years (5 + 1 for fellowship which 90% of them do)
gastro = 6 years (3 IM + 3 GI, possible 5 total if you fasttrack)
ophtho = 4 years (1 prelim + 3 ophtho)
derm = 4 years (1 prelim +3 derm)
 
Sporadicus said:
Not typically, except for derm and ophtho-

cards = 7 years (3 IM + 3 cards + 1 interventional cards)
gen surg = 6 years (5 + 1 for fellowship which 90% of them do)
gastro = 6 years (3 IM + 3 GI, possible 5 total if you fasttrack)
ophtho = 4 years (1 prelim + 3 ophtho)
derm = 4 years (1 prelim +3 derm)
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Oh yeah I knew that obviously. I was referring to stein's example of Urology/ENT....
 
Urology is 5 I believe.
ENT is 5 as well.

Plus allow time for a research year (or two) or another degree in there somewhere if you aren't competitive for these. It's not a given that you'll match into any program in something like derm or ENT or urology these days, and it's getting more competitive every application cycle.

Re: surgeon choosing their own hours - depends on the specialty and the employer. I know some ophthos/ENTs/plastics will buy into a group practice or work up to partner and then set their own hours with perhaps some small amount of shared coverage but minimal weekends/nights. Other specialties have more difficulty with this, like gen surg or cards, and you should expect a decent amount of call & coverage for most of your career. It all comes down to how your group/hospital wants to cover that ruptured appendix at 3 am on Saturday morning or the STEMIs on Sunday night. Asking these questions may get good responses on the surgical boards, I'm just repeating what I've heard from surgery residents and classmates going into these fields.
 
Blitz2006 said:
Nice number crunching.

I know this is not a surgery forum, but to play devil's advocate, can a surgeon not choose to work 40 hours if they want? (ie - purely elective stuff like gall bladders and hernias)?
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Probably not. Anyway, judging from your previous posts, you are an IMG who applied in gen surg for a couple cycles before landing a psych residency. Back then you worried about gen surg $$ and lifestyle, $$ in surgery, gen surg $$ vs plastics, job outlook in surg, some more about $$, and then a few more times about $$...just relax, we are paid very well for what we do. You will do okay.
 
Sporadicus said:
Probably not. Anyway, judging from your previous posts, you are an IMG who applied in gen surg for a couple cycles before landing a psych residency. Back then you worried about gen surg $$ and lifestyle, $$ in surgery, gen surg $$ vs plastics, job outlook in surg, some more about $$, and then a few more times about $$...just relax, we are paid very well for what we do. You will do okay.
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Well I like to be well informed before I go into something. I applied once to gen surg in canada, and withdrew because I was unsure about the job market and prospects.

being well informed and reading this forum is a major factor for me deciding on psych and coming to the states.

so while relaxed, still will do my researching
 
Ibn Alnafis MD said:
Reading this thread made me realize that psychiatry is the best hidden secret in medicine.
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And rheumatology. But a warning sign is that psych is definitely not for everyone. It's a world of its own away from medicine.
 
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Sporadicus said:
I think it is safe to say our hourly wage after expenses is about $120/hr, based on an 8 hour day and 48 week year, which puts us close to the average for most specialties.

Just do the math: seeing 3 outpatients per hour billing $100/visit and assuming 60% collections gives us $60/visit or $180 in revenue/hr, of which we will keep roughly 67% after overhead. This would be the typical job advertised on indeed.com, taking into account joining an already established practice booked out weeks ahead with fixed overhead and room to grow.

My own estimation which comes from cold calling psych recruiters last year is that a fresh out of residency graduate could expect roughly $220,000 for a 40 hour week, seeing 16 to 24 outpatients or rounding on 8 to 12 inpatients each day.

Some places start at < $200,000 if they are in very desirable places or have academic responsibilities that take time away from billing. Hospitals typically have some sort of RVU bonus that rewards you with a percentage of revenue from billing over your minimum expected billing. These bonuses can increase salary by about 25% but have a lot of hoops and require very efficient medicine.

90% of the offers fell into the $220,000 - $260,000 range. The median was $240,000. Most offered more for weekends/consults/ED coverage.

The places that advertise anything over $275,000 to start require you to generate well over $400,000 in billing and will come with some sort of catch which usually entails a combination of unfavorable hours/weekday call/covering a sister facility many miles away, but those jobs are also out there.
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90% of the offers fell into the $220,000 - $260,000 range.
Is this what a starting residents make or what seasoned psychs make at peak career?

Blitz2006 said:
Right. I don't expect psych to touch ENT/Ortho/Urology/Plastics

I am comparing with gen surg/cards/gastro/optho/derm/rads

More gruelling hours yes, but they are 4 years like psych right?
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I think comparing to derm and cards is still a bit of a stretch. Anyone known how the psych numbers compare to neuro? They're the two I'm torn between.
 
If you're torn between neuro and psych, spend some more time in both on electives if you can. The daily work is very, very different despite the common focus on the CNS (although neuro does a ton with the PNS as well). The mystery patient exercise helped me -if there was a patient with an unknown chief complaint behind a door, would you be prefer for it to be a patient with epilepsy or a patient with schizophrenia? Recovering alcoholic or recovering stroke patient? Blown pupil or acutely suicidal? The two specialties are more different than similar when you look at their daily routine and what they are thinking about during a typical patient encounter.
 
Starting.

If you scroll up and see merritt hawkins website you can see that 300k is quite doable after a few years of pp.

I believe another poster said miami psych making 300k for 40 hours after 15 yrs experience.

I think hours plays a major role. 40 hour week is probably hard to hit 300, but doable in some areas.

I have a fam friend who is finishing residency this year, and she is getting offers 250 to 300k. BUT this is for texas.
I suspect in the northeast it will more likely be around 240 to 250.

stein gave you good advice. but if you are torn between the 2, consider neuropsychiatry...



vanfanal said:
90% of the offers fell into the $220,000 - $260,000 range.
Is this what a starting residents make or what seasoned psychs make at peak career?



I think comparing to derm and cards is still a bit of a stretch. Anyone known how the psych numbers compare to neuro? They're the two I'm torn between.
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Jorje286 said:
And rheumatology. But a warning sign is that psych is definitely not for everyone. It's a world of its own away from medicine.
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It is and it isn't.

I don't think in medical school we get proper exposure to psych. I went to med school in UK and we did 5 weeks. 2 weeks of outpatient, 3 weeks of inpatient in a small mental health centre.

The outpatient was alright. Inpatient was horrible experience in a very underserviced area. what we didnt knoe as med students is that psych is chiefly an outpatient speciality if you want it to be.

Also, I think psych is great because its one of the few specialities you can tailor your interests into your practice.

you like kids? do c&a. you like working with lawyers and working in criminal cases? forensics. you like working with other specialists? cl. you enjoy neuroscience and neuroimaging? neuropsych. and the list goes on.

As a medical student, I had 0 idea of these psych subspecialties apart from c&a.

so yes. while in residency you have to deal with bread and butter psych, mood disorders, substance abuse, etc, you can then down the road find your niche and roll with it.

and as we discussed you can easily work 30 hours or 60 hours, depending on what you want. much tougher in other specialities like cards or gen surg.

so yes, I agree that psych is obv not for everyone, but I think med students write it off too quickly due to lack of adequate exposure and knowledge of the field.

just my 2 cents
 
SteinUmStein said:
If you're torn between neuro and psych, spend some more time in both on electives if you can. The daily work is very, very different despite the common focus on the CNS (although neuro does a ton with the PNS as well). The mystery patient exercise helped me -if there was a patient with an unknown chief complaint behind a door, would you be prefer for it to be a patient with epilepsy or a patient with schizophrenia? Recovering alcoholic or recovering stroke patient? Blown pupil or acutely suicidal? The two specialties are more different than similar when you look at their daily routine and what they are thinking about during a typical patient encounter.
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Haha. Really interesting game. Unfortunately, my neuro experience was poor so I don't think understand it to well. But not to worry, elective are already in the works. I have a 4-week psych elective this summer. Thanks for the advice.

Blitz2006 said:
It is and it isn't.

I don't think in medical school we get proper exposure to psych. I went to med school in UK and we did 5 weeks. 2 weeks of outpatient, 3 weeks of inpatient in a small mental health centre.

The outpatient was alright. Inpatient was horrible experience in a very underserviced area. what we didnt knoe as med students is that psych is chiefly an outpatient speciality if you want it to be.

Also, I think psych is great because its one of the few specialities you can tailor your interests into your practice.

you like kids? do c&a. you like working with lawyers and working in criminal cases? forensics. you like working with other specialists? cl. you enjoy neuroscience and neuroimaging? neuropsych. and the list goes on.

As a medical student, I had 0 idea of these psych subspecialties apart from c&a.

so yes. while in residency you have to deal with bread and butter psych, mood disorders, substance abuse, etc, you can then down the road find your niche and roll with it.

and as we discussed you can easily work 30 hours or 60 hours, depending on what you want. much tougher in other specialities like cards or gen surg.

so yes, I agree that psych is obv not for everyone, but I think med students write it off too quickly due to lack of adequate exposure and knowledge of the field.

just my 2 cents
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Completely agree with you. UK medical student here was well. I think that I was lucky to get a balance between inpatient and outpatient.
 
One thing worth noting: $200k (or any salary) is very different than $210, 220k etc in private practice, because of benefits or the lack there of.

Now some of us don't care for benefits (I already get health insurance through my wife)
 
vanfanal said:
Completely agree with you. UK medical student here was well. I think that I was lucky to get a balance between inpatient and outpatient.
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That's surprising. Based on their basketball program, I would have thought they'd have solid all-around exposure.
 
The United Kingdom. I believe England became the UK in the early 18th century under queen Anne.
 
Umm, I don't get it. What the other UK? 🤔
 
So a friend of mine is in a Child and Adolescent Psych fellowship (community program) in the Midwest and she is getting offers for 250k + bonus/loan repayment for 40 hr a week outpatient. Is this normal and what you are seeing in your neck of the woods?
 
MacDonaldTriad said:
Zaire Taylor's superb display gave Worcester Wolves their first BBL Play-off title as they beat Newcastle Eagles 90-78 at Wembley Arena.
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Hmmm....sounds like division III play there. Never heard of these schools.
 
The British Basketball League has 12 Pro teams.

Birmingham Knights
Cheshire Phoenix
Durham Wildcats
Glasgow Rocks
Leicester Riders
London Lions
Manchester Giants
Newcastle Eagles
Plymouth Raiders
Sheffield Sharks
Surrey United
Worcester Wolves

Kind of makes me wonder what Surrey’s mascot looks like.
 
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