That is depressing. Why on earth did your friend take this job when he could pull down 3-4X that in private practice? Are people that afraid of living west of the Mississippi River that they accept **** pay to stay on the east coast? So long as institutions (in all specialties) can find quality applicants willing to take jobs at such low salaries, there is no market pressure for the salaries to come up. The NYC ME's office has posted ads in the last few years starting well under 150K, which is very low in the context of NYC/Manhattan CoL index.