Is a resident's salary too high, too low or just right?

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

carlosc1dbz

Full Member
15+ Year Member
Joined
Jan 29, 2007
Messages
306
Reaction score
23
I do not know much about the history of residents salary, but my impression is that for the most part is has been in the low 40K for a long time. I am sure 40K could go a long way at one time, but in my opinion, after taxes, it doesnt go very far at all. Inflation at its best right? Anyway, what do you all think about current residency salaries. Should they even get a salary at all, since many argue its still part of their education? Maybe they should still pay tuition.
 
I do not know much about the history of residents salary, but my impression is that for the most part is has been in the low 40K for a long time. I am sure 40K could go a long way at one time, but in my opinion, after taxes, it doesnt go very far at all. Inflation at its best right? Anyway, what do you all think about current residency salaries. Should they even get a salary at all, since many argue its still part of their education? Maybe they should still pay tuition.

I understand the interns getting paid that little but after that, especially in fellowship, you should get paid more.
 
Resident salary have been slowly going upward every year (not sure if it kept pace with inflation or not)

When I was premed in college, the typical resident salaries were low 30s. Now they are in the 40s (and every year, it seems to be adjusted slightly higher for the same PGY level by a few hundred dollars)

As far as fellowship, your typical fellowship salary will only be slightly higher than residency, but that's more due to your higher PGY year than advance training. A first year cardiology fellow will get paid the same as a fourth year surgical resident at the same institution since they are both PGY4.

As to whether a resident's salary is too high, too low, or just right - well, that's for another debate 🙄
 
First question -- relative to what? Compared to a nurse -- maybe, probably. Compared to a UAW worker? Definitely. Compared to an attending ped/IM/FP/rheum/ID/Ob-Gyn? Nope. Everything is relative, and the last group on the list have been getting a much larger shaft for a longer time than PGYs.

When I finished residency training in 2005, my PGY-4 salary did not crack 40k. Three years later (when my BIL started residency) interns made more.
 
I think it's about right for a post-doctoral trainee. If you look at other fields, post-doctoral researchers typically make $35k-$55k-- just in line with a resident.
 
I think it's too low, and that's why so many residents look for moonlighting opportunities. When you're getting paid less than nurses, your suppressed frustrations may come out in your words and actions.
 
I think it's about right for a post-doctoral trainee. If you look at other fields, post-doctoral researchers typically make $35k-$55k-- just in line with a resident.

Do post-doc researchers also work 80 hour weeks and take q3 call?
 
I don't understand how you can accurately gauge whether or not residents' pay is fair or adequate. For all intents and purposes, residents are still in their medical education process. They have no choice in doing a residency. Hospitals can't bill for residents' work, therefore their value add to the hospital is derived solely from their labor, which the hospital doesn't pay for.
So, residents' compensation isn't subject to the same cost/supply curve as any other job in a capitalist market. There's really no reason Medicare can't get away with heavy-handedly cutting residency funding.
 
Do post-doc researchers also work 80 hour weeks and take q3 call?

Some of them work 80+ hours. Most of them don't, I imagine. I didn't realize we were working for hourly wages.
 
I'm not trying to be argumentative, I just get irritated when people say that residents are well paid because we make more than the national average. We actually work the equivalent of 2 full time jobs. Also, most jobs offer overtime for workers to work >40hr/nights/weekends. If our paychecks reflected overtime, our base salary would be somewhere around 18k, which I personally think kinda sucks after 8 years of education.

I know we're professionals and not salaried workers, but most professionals make significantly more than 40k. My wife is a first year associate at a law firm and she makes >80k. I'm also sure NPs and PAs make significantly more than 40k at their first job after graduation.
 
I don't understand how you can accurately gauge whether or not residents' pay is fair or adequate. For all intents and purposes, residents are still in their medical education process. They have no choice in doing a residency. Hospitals can't bill for residents' work, therefore their value add to the hospital is derived solely from their labor, which the hospital doesn't pay for.
So, residents' compensation isn't subject to the same cost/supply curve as any other job in a capitalist market. There's really no reason Medicare can't get away with heavy-handedly cutting residency funding.

Maybe for interns, but what about residents in their last year of training? They have a greater deal of autonomy, but still make ridiculous wages.
 
Maybe for interns, but what about residents in their last year of training? They have a greater deal of autonomy, but still make ridiculous wages.

I'm not trying to make a subjective conclusion on the validity of resident salaries, because it doesn't play a substantial role in this strictly regulated system. Would I like to make more as a resident? Absolutely. But, at the same time, I realize that this isn't a free market and I shouldn't expect my resident wages to be reflective of such.
Like I said, no one in their right state of mind would choose to forgo a residency(thus forfeiting their right to ever practice) even if they were compensated $30k/year.
 
Actually, I know of several places that pay you per hour based on 80 hours every week.

I'd be surprised if many places did this, because it would require them to strictly adhere to the 80 hour work week. If you went over, you'd have to earn overtime, which would be evidence that they were violating the law. Most places like to have a little wiggle room in case you go over a few hours. If you are a salaried worker they don't have to track your hours so closely.
 
I'd be surprised if many places did this, because it would require them to strictly adhere to the 80 hour work week. If you went over, you'd have to earn overtime, which would be evidence that they were violating the law. Most places like to have a little wiggle room in case you go over a few hours. If you are a salaried worker they don't have to track your hours so closely.

The 80 hours is NOT a strict, ever week has to be under 80 hours. 80 Hours is an average over 4 weeks, meaning I could work 85 one week, 82 the next, 74 the next, and 79 the next, and I would be compliant with work hours.
 
The 80 hours is NOT a strict, ever week has to be under 80 hours. 80 Hours is an average over 4 weeks, meaning I could work 85 one week, 82 the next, 74 the next, and 79 the next, and I would be compliant with work hours.

Should residents get paid at all? Why did residents start getting a stipend in the first place? Also some of you guys are right, residency is like working 2 full time jobs. So 40K for 2 full time jobs. Thats 20K per job. lol
 
Should residents get paid at all? Why did residents start getting a stipend in the first place? Also some of you guys are right, residency is like working 2 full time jobs. So 40K for 2 full time jobs. Thats 20K per job. lol

And I'm sure that some parents would say that raising kids is a full time job. And they don't get paid.... certainly not $45k/yr.

Residency is a post-doctoral training period. $45k is about the middle of the range for post-doctoral positions in other fields. Talking about hours worked is a slippery slope--- if my program is q3 and another program is q7, if I work 80 hours and another program 60, should I complain about call schedules or hours worked?
 
I concede that any post-doc who makes 45k and is forced to work 80 hour weeks and makes life and death decisions on a regular basis is underpaid. This doesn't change the fact that residents are also underpaid. Just about every other profession I can think of from lawyers to Walmart greeters pay their trainees a reasonable wage that is not a fraction of that of a non-trainee.

Also, the argument that residents deserve low pay because we can't bill for our services makes no sense. How do the janitors, rad techs, and phlebotomists earn their salaries?

I'm pretty sure a nanny who raises kids full time would get paid more per hour than a resident, even a trainee. 😉
 
Last edited:
I concede that any post-doc who makes 45k and is forced to work 80 hour weeks and makes life and death decisions on a regular basis is underpaid. This doesn't change the fact that residents are also underpaid. Just about every other profession I can think of from lawyers to Walmart greeters pay their trainees a reasonable wage that is not a fraction of that of a non-trainee.

Also, the argument that residents deserve low pay because we can't bill for our services makes no sense. How do the janitors, rad techs, and phlebotomists earn their salaries?

I'm pretty sure a nanny who raises kids full time would get paid more per hour than a resident, even a trainee. 😉
The billing law wasn't an argument for or against resident raises. I brought it up simply to demonstrate the source of difference between attending compensation and resident compensation.

Arguing that residents should receive more money based on whatever duties they have isn't going to get you far. Residents have no leverage. They have no choice but to complete their training. Therefore, the question of whether or not they are underpaid can only be met with subjective perspectives. And these arguments have little to no bearing, as there is no free market upon which to make an assessment. Like I said, if they cut resident funding by 50%, who in their right mind would forgo residency?
 
I can't speak about other fields, but general surgery residents are underpaid in my opinion. General surgery residents work 70-90 hours a week, and as junior residents, a lot of the work is low-level scut. Education consists of 1 hr of M&M conference, 1 hr basic science, and maybe 1 hr of grand rounds. That's 3 hrs per week. On top of that you get some teaching in the OR if you are lucky enough to get a case, which is infrequent as junior residents. The teaching on the floor is done by upper level residents, mid-levels, the social worker, pharmacist, and whoever else you seek information from.

A junior surgery resident earns about 50k for 80 hrs per week.
A surgery PA or NP earns about 80k for 40 hrs per week.

To put it another way, a surgery mid-level earns about 3.2x per hour more than the junior surgery resident, while working better hours with no overnight call. Extrapolate a mid-level salary to resident hours, and you are looking at 160k, without accounting for any over-time or weekend adjustment.

I think it is reasonable to say that by at least 4-6 months into internship, most residents can do a pretty similar job to experienced mid-levels in terms of scut and logistics of the hospital. So we provide equal (and probably greater) value to the hospital compared to a mid-level at this point.

In other words, one can say that you are looking at a "tuition" of 110k per year, for 3 hours of education per week. Things become more complex the further you go in training, because our management complexity and skill begin to distance themselves from that of a mid-level, but our education in the OR also increase significantly. Upper levels also have greater responsibility for teaching junior residents and medical students, which is not reimbursed. But looking at internship and maybe PGY2, we are very underpaid.
 
I can't speak about other fields, but general surgery residents are underpaid in my opinion. General surgery residents work 70-90 hours a week, and as junior residents, a lot of the work is low-level scut. Education consists of 1 hr of M&M conference, 1 hr basic science, and maybe 1 hr of grand rounds. That's 3 hrs per week. On top of that you get some teaching in the OR if you are lucky enough to get a case, which is infrequent as junior residents. The teaching on the floor is done by upper level residents, mid-levels, the social worker, pharmacist, and whoever else you seek information from.

A junior surgery resident earns about 50k for 80 hrs per week.
A surgery PA or NP earns about 80k for 40 hrs per week.

To put it another way, a surgery mid-level earns about 3.2x per hour more than the junior surgery resident, while working better hours with no overnight call. Extrapolate a mid-level salary to resident hours, and you are looking at 160k, without accounting for any over-time or weekend adjustment.

I think it is reasonable to say that by at least 4-6 months into internship, most residents can do a pretty similar job to experienced mid-levels in terms of scut and logistics of the hospital. So we provide equal (and probably greater) value to the hospital compared to a mid-level at this point.

In other words, one can say that you are looking at a "tuition" of 110k per year, for 3 hours of education per week. Things become more complex the further you go in training, because our management complexity and skill begin to distance themselves from that of a mid-level, but our education in the OR also increase significantly. Upper levels also have greater responsibility for teaching junior residents and medical students, which is not reimbursed. But looking at internship and maybe PGY2, we are very underpaid.

All we need now is some FMG from Germany or something telling us that we are lucky.
 
The billing law wasn't an argument for or against resident raises. I brought it up simply to demonstrate the source of difference between attending compensation and resident compensation.

Arguing that residents should receive more money based on whatever duties they have isn't going to get you far. Residents have no leverage. They have no choice but to complete their training. Therefore, the question of whether or not they are underpaid can only be met with subjective perspectives. And these arguments have little to no bearing, as there is no free market upon which to make an assessment. Like I said, if they cut resident funding by 50%, who in their right mind would forgo residency?

I don't like this argument. You're basically throwing up your hands and saying, I have no power anyway so I'll just take what they give me. This legitimizes our abusive system in which residency programs have all the power and residents have none. This is akin to indentured servitude. I also don't like being called a student, no other profession I'm aware of classifies their "trainee" employees as students. There was another thread on here that showed the high cost associated with losing residents at a certain hospital, yet we are always being told the lie that resident's are a drain on the resources of our hospitals. I personally feel it's more an issue of fairness and respect than one of money.
 
I'm pretty sure a nanny who raises kids full time would get paid more per hour than a resident, even a trainee. 😉

Fine. if you don't like my parenting analogy, how about an airline pilot analogy? A starting pilot (who requires a certain number of certified flight hours that they most likely have to pay for themselves before they can even apply for a job), will work for a regional airline and make around $20k/yr. They are only paid for the hours that they're actually in the air (imagine the 80 hour work rule with a clock that runs only while the patient is open in the OR).

Oh, and if they screw up, they kill 50 people, not 1.

Look, this is an argument we can continue ad nauseum. Residents complain that they are underpaid. Med students complain that they don't get paid. Attendings complain that they work too hard for their pay. Teachers don't get paid well enough, period. Lawyers -- yes, lawyers -- complain that their pay is too low while they bill their clients $500/hr to write grammatically correct but logically indecipherable English.

The fact of the matter is, once we complete our training, we will most likely be well compensated in our careers. What's a little bit more delayed gratification in the grand scheme of things?
 
I certainly wouldn't mind making more money, but the completion of a residency has an economic value well in excess of the completion of other post-doctoral programs.
 
The promise of future income/economic value shouldn't preclude residents from being compensated appropriately for the service they provide while in training.

I agree, that argument is pure rhetoric. I was watching a documentary yesterday about the companies that benefit from the war in the middle east. Its hard to believe how much our government is willing to spend, and pay private contractors, but wants to be stingy when it comes to things like education and health care reimbursement, and resident "stipend."
 
I don't like this argument. You're basically throwing up your hands and saying, I have no power anyway so I'll just take what they give me. This legitimizes our abusive system in which residency programs have all the power and residents have none. This is akin to indentured servitude. I also don't like being called a student, no other profession I'm aware of classifies their "trainee" employees as students. There was another thread on here that showed the high cost associated with losing residents at a certain hospital, yet we are always being told the lie that resident's are a drain on the resources of our hospitals. I personally feel it's more an issue of fairness and respect than one of money.

Then go do something about it. Go lobby for increased Medicare funding of residency training, while your attending superiors are clamoring for increased reimbursement of their services. You can bargain with every ounce of your... I forgot what leverage you think you have.
Actually, it isn't as much bargaining as holding your hand out saying "please sir, may I have some more?"
 
I agree, that argument is pure rhetoric. I was watching a documentary yesterday about the companies that benefit from the war in the middle east. Its hard to believe how much our government is willing to spend, and pay private contractors, but wants to be stingy when it comes to things like education and health care reimbursement, and resident "stipend."

Stingy is an entirely relative term. Just because private military contractors are given large absolute sums of money doesn't mean they can't make the exact same argument you just did. No one. And I mean no one thinks they are being paid adequately.

"It's hard to believe how much our government is willing to spend, and pay wealthy doctors, but wants to be stingy when it comes to things like national security, maintenance of freedom, and the well being of our brave soldiers."

Subjective arguments with regards to compensation, in the absence of a free market, fail on all levels.
 
Stingy is an entirely relative term. Just because private military contractors are given large absolute sums of money doesn't mean they can't make the exact same argument you just did. No one. And I mean no one thinks they are being paid adequately.

"It's hard to believe how much our government is willing to spend, and pay wealthy doctors, but wants to be stingy when it comes to things like national security, maintenance of freedom, and the well being of our brave soldiers."

Subjective arguments with regards to compensation, in the absence of a free market, fail on all levels.

Hey bronx, you overlooked one tiny thing in your analysis: contractors operate in a bid-placing environment whereby they actually propose what they are willing to work for. When making the comparison to healthcare funding that is not exactly apples to apples....
 
The only way things like this work are if air traffic controllers organize as a group, 20,000 strong which will never happen. IF it did happen and air traffic controllers chose to strike, you can bet funding would come quickly because air travel would grind to a halt if no air traffic controllers were around and customers would suffer.

There, I fixed that for you.

Seriously folks, this isn't a battle we want to expend our effort fighting. There are plenty of more important things-- DNPs, SGRs, etc.
 
If not this battle then what. I'm not sure whether you are an attending whose so far gone that they don't remember what it was like or a med student/pre-med who hasn't been into the fire yet but you're misguided.

If we as resident physicians can't stand up and unify to fight for issues pertinent to residents how are we as attendings supposed to unite to fight the bigger issues you cite (DNP. SGR, etc.). Further, showing those in power that the 80,000 residents in training and the attendings they will become can unite into a strong voting block would be a powerful message.

While penny ante to you, an improved residency salary would make life better for residents who dedicate their lives for a few years to an institution and often have to moonlight on top of their job to make ends meet.

I'm about to start residency. I'm 5-7 years away from being an attending. I think it's foolhardy to start complaining about pay in the middle of an economic crisis, when the rest of physician-world is being beleaguered on all sides. We have a PR battle to fight against the nurses and against the politicians. Do you really think we're going to be well served by arguments saying, "hey, we make above average money, but we don't get enough of it."

It's hard enough for physicians to get organized to do anything. Why do we want to waste our precious time and resources on low pay... there are plenty of professions that are paid less with similar responsibilities and with similar concerns over work hours-- commercial pilots, for one.

Seriously, the public is not going to have sympathy for a bunch of doctors saying that they're underpaid, when they're going to be well-compensated in a few years. Let's not fuel the fire for those that want to call us greedy.
 
I've often wondered why hospitals aren't allowed to forgo Medicare funds, have interns as a sunk cost and once they get licensed after PGY-1, let them bill. Even if take home was only 1/3 of collections residents would still be doing better. The Labor Relations Board says residents are employees, not students and as we all know no "student" is given the level of responsibility and forced to work as much.
 
Hey bronx, you overlooked one tiny thing in your analysis: contractors operate in a bid-placing environment whereby they actually propose what they are willing to work for. When making the comparison to healthcare funding that is not exactly apples to apples....

Oh yeah, forgot about that. Thanks for pointing it out. I guess that comparison is better applied to armed forces, instead of contractors.
 
It's not about screaming about being underpaid but rather showing those in power that when compared to what the health care system is paying for midlevel providers residents are not being compensate for the skill, knowledge, and responsibility the have. You may think your pay is above average but when you divide it by the number of hours you are working, the pay isn't that much better than minimum wage (At 50,000/year and 80 hours around 11 dollars an hour). Further, when you factor in what resident generate in income, the proof is there.

You have some fixation on commercial pilots. The reason they're not paid as well as they don't have the education level, becoming a pilot does not take the 13-20 years it does to become a physician. Further, their work hours are not in the range of a resident either.

People love to talk about how residents are going to be making good money in a few years but it's not that simple. You can't underpay someone because of what they're going to make.

My "fixation" with commercial pilots is because no one has adequately countered my argument. There are plenty of instances where the media and/or NTSB has suggested pilot fatigue as a factor in incidents and accidents. Just because their cap is lower than 80 hrs a week doesn't mean that they aren't overworked. There's plenty of discussion that because of their low pay, they can't afford adequate rest before their shifts, have to take red eye flights across country to make it to their stations, etc. Is there any evidence that residents don't perform well because they aren't paid well (but still, above the national average)?

Listen, we as physicians have a lot of battles to fight. Like I said, this makes us sound greedy.... and PUBLIC PERCEPTION IS GOING TO BE VERY IMPORTANT. And especially in a time where there's a great deal of scrutiny on health care costs, demanding more money is going to be counterproductive.
 
Oh yeah, forgot about that. Thanks for pointing it out. I guess that comparison is better applied to armed forces, instead of contractors.

Yeah.... one little thing about that as well: that is an example of an employed position. While that may work for the world of the PGY, it still does not translate to the greater healthcare provider sector.

Seriously, I can think of no other example in our country that has a command economy like healthcare; as such, is there any question as to why it is so ****ed?
 
I find it ironic that a couple of med students are trying to tell residents and attendings that residents are well paid. Perhaps once they actually know what it's like to take q3 call, work 80 hour weeks, and have the level of responsibility residents have, all while knowing they are the lowest paid worker in the hospital, their perspective may change?
 
I find it ironic that a couple of med students are trying to tell residents and attendings that residents are well paid. Perhaps once they actually know what it's like to take q3 call, work 80 hour weeks, and have the level of responsibility residents have, all while knowing they are the lowest paid worker in the hospital, their perspective may change?

I think residents may have a few grand on the janitorial staff. 👍
 
who cares what I will make in 4-7 years. I should be paid my worth now. the hospital has deemed that the services of an NP/PA doing 40 hours a week are worth $90-110k. I as a resident will provide more hours, take care of more complex patients, and have greater overall responsibility than a PA/NP, and yet i'm only worth $47k? BS.
 
Last edited:
I can't help but think of The Three Little Bears every time I see the "too high, too little, just right" title. :laugh:



To answer the question - based upon the responsibility that a resident has, I believe the salary is too low.
 
I think residents may have a few grand on the janitorial staff. 👍

You may be right, but only by a narrow margin. What's the average hourly rate for a hospital janitor? Do they generally get overtime? Benefits?


Edit: According to salary.com, the median base salary for a janitor (doesn't delineate hospital janitors, who may actually make more) is $23,846 not including overtime or benefits. A resident who works 80 hours per week for $46k would make $23K if they worked a comparable 40 hour work week. If we assume time-and-a-half pay for >40 hours per week, that resident would make $18,400 annual base salary. So, I would definitely say we are one of, if not the, lowest paid workers in the hospital.

Just to be clear, I am in no way saying janitors are overpaid. My only point is that residents are severely underpaid for the difficulty/responsibility/hours/education required for the work we do.
 
Last edited:
Listen, we as physicians have a lot of battles to fight. Like I said, this makes us sound greedy.... and PUBLIC PERCEPTION IS GOING TO BE VERY IMPORTANT. And especially in a time where there's a great deal of scrutiny on health care costs, demanding more money is going to be counterproductive.

I disagree. I think if our patients knew that the doctor watching over them at night was being paid less than the custodian who cleans their room, they would be on our side. Just look at the public uproar over decreasing resident work hours.
 
I disagree. I think if our patients knew that the doctor watching over them at night was being paid less than the custodian who cleans their room, they would be on our side. Just look at the public uproar over decreasing resident work hours.

I think you're SIGNIFICANTLY overestimating the public's attitudes.
 
Just look at the public uproar over decreasing resident work hours.

Yes, because they are well aware that long hours decreases patient (their) safety.

do you honestly believe they're doing it from altruistic motives. I'm sure they don't give a _________ how well we're paid.
 
I personally believe, (chews gum), that public would be sympathetic to "residents" if they knew the struggles of a resident. $11 an hour is insulting the residents, and I am pretty sure that the public would be a little concerned if the person taking care of their health, their life, was paid $11 an hour.

......and the Iraq.
 
I disagree. I think if our patients knew that the doctor watching over them at night was being paid less than the custodian who cleans their room, they would be on our side. Just look at the public uproar over decreasing resident work hours.

Totally different. The public doesn't want reduced resident work hours for your sake. They want it for theirs. When they know you'll be making $150-300k post-residency, why would they give a rat's ass what you make as a resident as long as you get your sleep?
 
You guys are probably right. 🙁

I may be in the minority, but even if I wasn't a resident and happened to be a patient in a hospital, I would be deathly afraid knowing the doctor who may need to keep me alive overnight is being paid less then the janitor.
 
I disagree. I think if our patients knew that the doctor watching over them at night was being paid less than the custodian who cleans their room, they would be on our side. Just look at the public uproar over decreasing resident work hours.

I sincerely doubt that the patients give two ***** what you are paid, you evil rich doctor, you.....😉
 
Top