Hourly income per specialty

[efle]

There's a lot of resources out there for yearly income by specialty, and a few resources that try to show the typical hours per specialty. I hadn't seen such a nice list where the income, hours, and adjusted hourly $$ were nicely put together like this before.

Bonus fun chart with the USMLE correlation.

Spoiler: Large images:

Source (found on Reddit): http://www.rimed.org/rimedicaljournal/2018/10/2018-10-50-cont-eltorai.pdf

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[slowthai]

There's a lot of resources out there for yearly income by specialty, and a few resources that try to show the typical hours per specialty. I hadn't seen such a nice list where the income, hours, and adjusted hourly $$ were nicely put together like this before.

Bonus fun chart with the USMLE correlation.

Spoiler: Large images:

View attachment 279864
View attachment 279865

Source (found on Reddit): http://www.rimed.org/rimedicaljournal/2018/10/2018-10-50-cont-eltorai.pdf

It would be great if they updated the article to this year. The MGMA data is from 2012.

 

[efle]

It would be great if they updated the article to this year. The MGMA data is from 2012.

I've also got the MGMA data from 2015-2016 and it's pretty similar. There's been some USMLE score creep at the upper end (~250 now for Derm, Plastics, Ortho, ENT, etc) and some overall increases in income, but nothing drastic I can see.

 

[WedgeDawg]

I want to know who all these surgeons working <60 hours per week are and whether they can hook me up

 

[Lawpy]

The @efle charts and analyses have returned!

 

[nimbus]

I want to know who all these surgeons working <60 hours per week are and whether they can hook me up

I know many. Some by choice but more often because they don’t get many referrals.

 

[libertyyne]

An interesting analysis would incorporating additional training time to even become an attending .

 

[7331poas]

An interesting analysis would incorporating additional training time to even become an attending .

The report where he got those charts does have that analysis

 

[efle]

An interesting analysis would incorporating additional training time to even become an attending .

I imagine your total years worked/age of retirement tends to be more impactful than your training time though. Like derm trains shorter than ortho but I bet derm also retires younger.

 

[7331poas]

I imagine your total years worked/age of retirement tends to be more impactful than your training time though. Like derm trains shorter than ortho but I bet derm also retires younger.

True, and your source also has that data as well.

 

[libertyyne]

True, and your source also has that data as well.

Thank I didnt look at that at first. It does not seem to indicate that the analysis incorporates opportunity cost or difference in income as a result of having less time to invest.

I imagine your total years worked/age of retirement tends to be more impactful than your training time though. Like derm trains shorter than ortho but I bet derm also retires younger.

That is good point, i wonder if specialties that are physically taxing retire at an earlier age compared to less physically demanding specialties. Investment outcomes do change by time of first investment theoretically.

This is obviously exaggerated. But those numbers are close, and the cost of not paying up loans also tends to continue to accrue.

 

[efle]

Thank I didnt look at that at first. It does not seem to indicate that the analysis incorporates opportunity cost or difference in income as a result of having less time to invest.

That is good point, i wonder if specialties that are physically taxing retire at an earlier age compared to less physically demanding specialties. Investment outcomes do change by time of first investment theoretically.
View attachment 280144
This is obviously exaggerated. But those numbers are close, and the cost of not paying up loans also tends to continue to accrue.

I'm pretty sure one of the tables shows that time in training and loan interest accrual is factored into the net worth at retirement numbers

 

[You shall know the Truth]

Thank I didnt look at that at first. It does not seem to indicate that the analysis incorporates opportunity cost or difference in income as a result of having less time to invest.

That is good point, i wonder if specialties that are physically taxing retire at an earlier age compared to less physically demanding specialties. Investment outcomes do change by time of first investment theoretically.
View attachment 280144
This is obviously exaggerated. But those numbers are close, and the cost of not paying up loans also tends to continue to accrue.

Let’s say Joey began investing 20k per month at 45 yo. Does he come out in the end

 

[You shall know the Truth]

It’s crap that vascular works so many more hours and retires middle of the road

 

[efle]

It’s crap that vascular works so many more hours and retires middle of the road

Yeah man, there's a reason it's the only surgical subspecialty with average board scores. You work insane hours like a neurosurgeon, deal with a lot of "difficult" patient population and get paid a lot less than the other surgical specialists.

 

[PikminOC]

Is this what hospitals use for renumeration? I have seen that pediatricians usually make less.

 

[Gurby]

Yeah man, there's a reason it's the only surgical subspecialty with average board scores. You work insane hours like a neurosurgeon, deal with a lot of "difficult" patient population and get paid a lot less than the other surgical specialists.

Is this due to their bread and butter operations having fewer RVU's for some reason, or is there some other factor at play to cause this?

 

[efle]

Interesting to see IM all the way down there. I thought hospitalists made comparable to neurologists, pm&r, nephrologists etc.

They probably can make the same if they put in tons more hours. The guys who want big money in IM go for cardio or GI fellowships though

 

[PhillyMed777]

Interesting to see IM all the way down there. I thought hospitalists made comparable to neurologists, pm&r, nephrologists etc.

A huge draw for hospitalist work is time off. It's common to have 26-28 weeks off a year.

 

[efle]

A huge draw for hospitalist work is time off. It's common to have 26-28 weeks off a year.

Why does it say they work so much on average? I know EM docs can work 12 shifts/month if they want to, but they're one of the low hours in this paper.

 

[Tenk]

Why does it say they work so much on average? I know EM docs can work 12 shifts/month if they want to, but they're one of the low hours in this paper.

I know almost no EM doc attendings who work 185 hours a month. That’s a pretty insane shift load for EM and is certainly well above the average for full time which is usually somewhere in the ballpark of 120-140 a month on average. Since this paper lists 46.4 as the average that means a large portion of people are doing MORE than 185 a month which is insane. I’ve only know a handful of docs who do this over the years and they all had no life and too many ex wives. Pretty sure this number is grossly inaccurate.

 

[WhereMyLiberalsAt]

too many ex wives.

I can’t say this enough... We should all strive for the right amount of ex-wives!

 

[Tenk]

I can’t say this enough... We should all strive for the right amount of ex-wives!

Yeah, zero.

 

[efle]

I know almost no EM doc attendings who work 185 hours a month. That’s a pretty insane shift load for EM and is certainly well above the average for full time which is usually somewhere in the ballpark of 120-140 a month on average. Since this paper lists 46.4 as the average that means a large portion of people are doing MORE than 185 a month which is insane. I’ve only know a handful of docs who do this over the years and they all had no life and too many ex wives. Pretty sure this number is grossly inaccurate.

Wow, some of these values in this paper are a little higher than other sources, but I don't think I've ever seen anything saying 30 hrs/week !

 

[Tenk]

Wow, some of these values in this paper are a little higher than other sources, but I don't think I've ever seen anything saying 30 hrs/week !

Almost all the full time jobs I get offered are somewhere in the ballpark of 120-140 or so. I have never seen a minimum full time job for 185. Ever.

My job is 126/month.

 

[efle]

Almost all the full time jobs I get offered are somewhere in the ballpark of 120-140 or so. I have never seen a minimum full time job for 185. Ever.

My job is 126/month.

Are the pay values also inflated or are EM docs really out here making 300k for 32hrs/week? If so, where do I sign up

 

[Dr. Doctor MD]

Are the pay values also inflated or are EM docs really out here making 300k for 32hrs/week? If so, where do I sign up

EM makes $375k for 32-36 hours per week. Maybe less on the East Coast, but likely closer to $450k+ in the Midwest or less desirable locations.

And they deserve every bit of it!

 

[nimbus]

Are the pay values also inflated or are EM docs really out here making 300k for 32hrs/week? If so, where do I sign up

That’s $200/hr. You can do as well or better in almost every specialty.

 

[Tenk]

Are the pay values also inflated or are EM docs really out here making 300k for 32hrs/week? If so, where do I sign up

Depends on where you work and who you work for. If you work in a big city or highly desired area for a CMG, expect to make around that $/hr quoted there. I once had an offer for a job in Hawaii for only $110/hr. No thanks. If you work in a less desirable area for a small group that spreads itself thin, you can make over double that quoted amount per hour.

 

[WhereMyLiberalsAt]

Depends on where you work and who you work for. If you work in a big city or highly desired area for a CMG, expect to make around that $/hr quoted there. I once had an offer for a job in Hawaii for only $110/hr. No thanks. If you work in a less desirable area for a small group that spreads itself thin, you can make over double that quoted amount per hour.

I have a question about the location/pay of EM... I thought EM was the one specialty were pay was positively correlated with population. I really like EM but my wife and I are not interested in larger cities (and like your above comment, the right amount of ex-wives = zero 🙂.... I know one option is FM and just work in an ED.... But what population size earns a 300-325k for "normal" work hours?

 

[efle]

I have a question about the location/pay of EM... I thought EM was the one specialty were pay was positively correlated with population. I really like EM but my wife and I are not interested in larger cities (and like your above comment, the right amount of ex-wives = zero 🙂.... I know one option is FM and just work in an ED.... But what population size earns a 300-325k for "normal" work hours?

I thought the rule was the opposite, you make more in the middle of nowhere?

 

[Tenk]

I have a question about the location/pay of EM... I thought EM was the one specialty were pay was positively correlated with population. I really like EM but my wife and I are not interested in larger cities (and like your above comment, the right amount of ex-wives = zero 🙂.... I know one option is FM and just work in an ED.... But what population size earns a 300-325k for "normal" work hours?

Pretty much any ED with around 10,000 annual visits or more can offer that pretty readily unless it’s a highly sought after location because then whoever is pulling the strings will sell to whoever takes the lowest offer.

Just because you have a hospital with increased annual visits doesn't mean you make tons more due to payer base (insured vs uninsured, medicare%, etc), overhead cost, and number of people you are splitting the pot with. Also, it depends on if your group is doing the billing or being paid by another entity doing the billing for you.

Every place will be different. To break it down into one sentence: it's pretty easy to make that much outside of big cities and places where everyone wants to live.

 

[PhillyMed777]

That applies for Neurologists too though right? Neurohospitalists have 7 on 7 off schedules. Although I'm not sure how common it is.

I'm unsure about neuro...
I'm basing hospitalist gig data from my buddies at a large academic medicine program from where I did my prelim at.

 

[KeikoTanaka]

Wow Table 2. Internal Medicine: 855$/hr. Sign me up

 

[WhereMyLiberalsAt]

I thought the rule was the opposite, you make more in the middle of nowhere?

If you go out too far you’ll start seeing FM docs in the ED. The county I lived in before (a place I wouldn’t mind practicing) didn’t have a EM doc. It was solely staffed by FM/IM. It was a revenue booster for the FM guys but the hospital really wouldn’t pay an EM doc 300k to staff it.

 

[efle]

If you go out too far you’ll start seeing FM docs in the ED. The county I lived in before (a place I wouldn’t mind practicing) didn’t have a EM doc. It was solely staffed by FM/IM. It was a revenue booster for the FM guys but the hospital really wouldn’t pay an EM doc 300k to staff it.

Hmm, but then again 200k out there probably buys more than 400k in the nearest 1mil+ city

 

[CherryRedDracul]

Wow Table 2. Internal Medicine: 855$/hr. Sign me up

For 5 hours a week!

How do I switch into Table 2 IM?

 

[JoaoMoutinho]

Pretty much any ED with around 10,000 annual visits or more can offer that pretty readily unless it’s a highly sought after location because then whoever is pulling the strings will sell to whoever takes the lowest offer.

Just because you have a hospital with increased annual visits doesn't mean you make tons more due to payer base (insured vs uninsured, medicare%, etc), overhead cost, and number of people you are splitting the pot with. Also, it depends on if your group is doing the billing or being paid by another entity doing the billing for you.

Every place will be different. To break it down into one sentence: it's pretty easy to make that much outside of big cities and places where everyone wants to live.

By "less desirable" do you mean anywhere outside of NYC/Boston/SF/LA/etc, or do you mean Nome AK/Blanding UT/Greenville AL?

 

[MSTP18]

FML, my specialty isn't even included.

Here We Go Again, Pathology Was Left Out of Another Article | GomerBlog

GOMERBLOG HQ - Whoops. We really screwed up this time: Pathology was left out of another Gomerblog article. To be specific, THIS ARTICLE. We sat

gomerblog.com

 

[efle]

FML, my specialty isn't even included.

Here We Go Again, Pathology Was Left Out of Another Article | GomerBlog

GOMERBLOG HQ - Whoops. We really screwed up this time: Pathology was left out of another Gomerblog article. To be specific, THIS ARTICLE. We sat

gomerblog.com

Maybe you basement-dwellers don't get a steady web connection down there and miss the survey emails 😉

 

[CidHighwind]

I think the big takeaway is that as much as EM makes per hour, there are 14 other specialties that make even more.

 

[libertyyne]

I think the big takeaway is that as much as EM makes per hour, there are 14 other specialties that make even more.

The real takeaway is that vascular surgeons are insane.

 

[efle]

The real takeaway is that vascular surgeons are insane.

It's something I didn't understand until my surgery rotation, but on a Sunday evening some people would literally rather be in the OR dealing with their 1000th AAA than lounging around at home. They're not crazy like I thought. It's just that the dopamine kick I get from a cold IPA and a good kung fu movie, they get that kick from the OR.

I'm envious of them, in a way. Louis CK said "I wish I loved anything the way kids love bubbles." Grown up version is, I wish I loved anything as much as those hardcore surgeons love doing surgery.

 

[Tenk]

By "less desirable" do you mean anywhere outside of NYC/Boston/SF/LA/etc, or do you mean Nome AK/Blanding UT/Greenville AL?

The first one but also doesn’t have to be a big city, can just be a super desirable area like Hawaii, the west coast, really good vacation destinations, etc

 

[TypeADissection]

It’s crap that vascular works so many more hours and retires middle of the road

Is this due to their bread and butter operations having fewer RVU's for some reason, or is there some other factor at play to cause this?

I think the answer is combination of a lot of different factors. Academics generally makes less than private practice so if it's taking into account all comers, then it makes sense that it would depress the salaries. Regional differences in salary can also be quite significant. My wife and I are both from New England and it's been interesting to see the offers we're getting there to be much less while the cost of living is much more. As of now, we've both signed to join a mid-sized city in the Midwest that we just kind of fell in love with in terms of location and practice setup. We also know that we will also be able to have some modicum of work-life balance while making a very good living. I have buddies who are vascular surgeons and have been in practice 3-5 years and are all doing well financially, not walking around miserable and depressed, and overall quite happy with their choices. It's definitely a self-selecting group but it's not all doom and gloom as these surveys seem to suggest, at least not from my vantage point. Then again, I've been dead on the inside for years now so that probably helps...

The real takeaway is that vascular surgeons are insane.

Shhh. Dude. You're embarrassing me in front of the wizards.

It's something I didn't understand until my surgery rotation, but on a Sunday evening some people would literally rather be in the OR dealing with their 1000th AAA than lounging around at home. They're not crazy like I thought. It's just that the dopamine kick I get from a cold IPA and a good kung fu movie, they get that kick from the OR.

I'm envious of them, in a way. Louis CK said "I wish I loved anything the way kids love bubbles." Grown up version is, I wish I loved anything as much as those hardcore surgeons love doing surgery.

I've said this before and I'll say it again. I f**king love vascular surgery. It's the perfect field for me as an intersection point where so many different interests meet and I'm very fortunate that I get to do this for a living. Having said all that, it's still just a job. The day after I retire someone else is going to be in the same OR that I had been in and will be doing the same operations that I had been doing, and probably even better. The one job that is truly unique to me is being a husband and a father. I won't go to my deathbed wishing I had done another aortic operation. So as much as I love this, the main driving factor for me in choosing a place to work was: strong senior mentors, good variety of cases and some semblance of work-life balance. The bonus is that I also will be well paid. Because as much as I love doing aneurysms and carotids; I equally look forward to coaching my kids super sh*tty tee ball team. I just hope everyone finds whatever their passion is in medicine and just works to be the best at it. The money will be there.

PS - Except pediatric nephrology. Don't do that. You'll be hungry forever.

 

[MSTP18]

Maybe you basement-dwellers don't get a steady web connection down there and miss the survey emails 😉

I'll have you know I sit in a windowless room on the top floor of the building thank you very much!

 

[Bacchus]

That FM value is laughable, based on personal experience.

 

[NecFasc92]

That FM value is laughable, based on personal experience.

Too low?

 

[Bacchus]

Too low?

Yes. At my office based on duties and experiences 95-120. 40 hours a week (doing work thru lunch) with maybe an additional unpaid 5-6 hours at most.

 

[efle]

That FM value is laughable, based on personal experience.

But even the Bureau of Labor says $212,000 average for general and family practice ?

Maybe you're just way above the average!