Fellowship vs residency salaries

[doc.Junior]

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I assume this varies with specialties, of course, but can anyone perhaps lend insight on what the difference is between salary in residency vs fellowship is like please? Does it get better? 🙂

 

[GotToGetThatGPAUp]

It doesn't vary with specialty. It's based off PGY-X salary for whatever year you are at that institution.

For example, if you were a first year cardiology fellow you'd be a PGY-4 (3 years IM + first year fellowship) and be paid whatever the GME wide PGY-4 salary is at that institution

 

[mistafab]

It is usually up, but can go down.

If you go to a lower paying institution after residency, you may be taking a pay cut even though you are a pay grade higher.

 

[Dral]

Both above. It can change based on the institution. I think I made more during residency in NYC than my rural area fellowship.

And within an institution, it's based on PGY year. so just think of all pre-attending training considered as PGY year pay. So to expand on what GotToGetThatGPAUp said, a first year cards fellow would typically be paid the same as a 4th year surgery resident (both PGY-4s).

 

[sloop]

There may be exceptions, but every institution I have experience with works pretty much the same way.

Within an institution, there is a salary schedule based on PGY. A PGY-4 cardiology fellow will be paid the same as a PGY-4 psychiatry resident at the same institution. Different institutions, even within the same region, may pay slightly differently though. Because the raises from year to year in residency are typically not enormous, there can easily be situations where you might take a pay cut if you go to a new institution for fellowship. This would happen if the PGY-5 pay at the new institution is lower than the PGY-4 pay at the prior institution.

In general, you can expect modest raises (somewhere in the range of $2-4K before cost of living adjustment) each year as you progress through training, regardless of whether you are a resident or a fellow.

 

[doc.Junior]

Thanks a lot for the 411 all.

So, what I'm hearing is: (a) fellowship is basically like additional years of residency, finance-wise, (b) all specialties are paid the same by year (PGY-X), but (c) there is some difference based on region and institution?

So is it that institutions have to pay a certain minimum based on their location (high-cost urban vs low-cost rural) and that, atop that, some institutions (i.e., your big name places) have more $ to sprinkle on top of the required minimums?

 

[DOVinciRobot]

atop that, some institutions (i.e., your big name places) have more $ to sprinkle on top of the required minimums

Lol no. You aren’t getting more at Harvard just because it’s Harvard.

 

[mrbreakfast]

So is it that institutions have to pay a certain minimum based on their location (high-cost urban vs low-cost rural) and that, atop that, some institutions (i.e., your big name places) have more $ to sprinkle on top of the required minimums?

If you are asking how hospitals determine the specific number to pay residents that work there, that is complicated. However, you can think of it as "a decent wage in that city" (e.g. seems to track well with the median household income) + a little extra for high COL cities.

PGY1 salary at my midwestern med school in a LCOL city: $58k
PGY1 salary at my big-name, HCOL residency: $70K

There are programs that offer a salary supplement because rents near the hospitals are so high.

 

[sloop]

So is it that institutions have to pay a certain minimum based on their location (high-cost urban vs low-cost rural) and that, atop that, some institutions (i.e., your big name places) have more $ to sprinkle on top of the required minimums?

They don’t really have to pay a certain minimum (legally speaking), but programs in higher cost areas seem to generally try to adjust their salaries to keep their residents out of abject poverty. That said, your quality of life is not guaranteed to be better if you’re living in NYC and making 10-15K more than a program would pay you in a lower cost area.

Bigger name places are not guaranteed to pay you more than other programs. It just depends on the individual institutions.

 

[Lost in Translation]

Thanks a lot for the 411 all.

So, what I'm hearing is: (a) fellowship is basically like additional years of residency, finance-wise, (b) all specialties are paid the same by year (PGY-X), but (c) there is some difference based on region and institution?

So is it that institutions have to pay a certain minimum based on their location (high-cost urban vs low-cost rural) and that, atop that, some institutions (i.e., your big name places) have more $ to sprinkle on top of the required minimums?

It's more tied to COL. For example, a PGY5 fellow in NYC makes around $100k pre-tax. But rent in NYC is north of $3k per mo (if not in institutional-subsidized housing) so the realistic pay is more like $64k which is more in line with what others are being paid around the country.

 

[operaman]

For acgme accredited fellowships, Generally tracks pgy year according to each institutions pay scale. Housing bonuses and whatnot are also institution specific and usually associated with high COL areas.

For non accredited fellowships it’s the Wild West. Most places also track the local pgy scale. Since you’re a fully licensed attending in these programs, many offer moonlighting or extra call opportunities that can quickly add up ( full faculty at my shop often paid fellows a couple thousand bucks to cover their weekend or extended holiday calls). There are some places that do offer higher base salaries - I know one Harvard-based ENT fellowship always bragged in written advertising about paying their fellows $120k+ a number of years ago. There are also some places - private practice facial plastics in particular - that pay a LOT less, like <$50k.

Generally it’s a little better but not a lot better. I think I made $75k salary for that one year and another $10-15k from call/moonlighting within my institution. It tends to be plenty to live on and even save a bit unless you’re talking a super high COL area.

 

[GotToGetThatGPAUp]

Lol no. You aren’t getting more at Harvard just because it’s Harvard.

Tbf sometimes you are

They have more money to throw at stipends (for example 10k housing stipend and 10k disadvantaged student stipend though they're taxed differently and would benefit the trainee more if they were baked into the salary) however there are rural community programs that entice people by throwing more money at them as well (plus much lower COL)

But yeah it can go both ways. Some cities the ivory tower institutions have the highest pay (usually if there are other ivory towers to help compete) and in others they're the lowest paying (no competition, they know people will come anyways)

 

[DarkBluMage]

I assume this varies with specialties, of course, but can anyone perhaps lend insight on what the difference is between salary in residency vs fellowship is like please? Does it get better? 🙂

You can check the websites of the programs you’re interested in. They usually have the salary listed

 

[doc.Junior]

Very comprehensive, thanks community! I waited and all questions I had were answered 🙂