Lower offer with fellowship?

[Itsarainbow]

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Spoke with a buddy who is stroke fellowship trained and recieved offer for 260k for stroke position while another hospital in the same region was offering 280k for a neurohospitalist job. Region is the northeast. I would have expected the opposite. Besides, isn't this low for both positions? I think MGMA average for stroke was around 440k and for neurohospitalist I would imagine atleast >300k. Would you counter offer with the MGMA data?

 

[ProReduction]

Stroke fellowship trained and recieved offer for 260k for stroke position while another hospital in the same region was offering 280k for a neurohospitalist job. Region is the northeast. I would have expected the opposite. Besides, isn't this low for both positions? I think MGMA average for stroke was around 440k and for neurohospitalist I would imagine atleast >300k. How do I counter the offer? Do I just quote MGMA?

Northeast consistently has the worst pay in the country, by far. Many academic stroke jobs in the NE do not crack 200k to start.

 

[Telamir]

They know what they're offering is low, and are unlikely to increase their offer by 100k.

There seem to be a lot of people here who think that the same exact job will pay differently if you have a stroke fellowship vs not. They don't. They pay the same.

 

[Postictal Raiden]

Both jobs pay ****

 

[Itsarainbow]

Northeast consistently has the worst pay in the country, by far. Many academic stroke jobs in the NE do not crack 200k to start.

Is there a reason for that?

 

[Itsarainbow]

They know what they're offering is low, and are unlikely to increase their offer by 100k.

There seem to be a lot of people here who think that the same exact job will pay differently if you have a stroke fellowship vs not. They don't. They pay the same.

I get that part but why doesn't MGMA reflect that? I would it's rare to find pure stroke positions outside of medicine.

 

[Itsarainbow]

Both jobs pay ****

Yes very much. I would atleast expect 350k and even then it might be on the lower side. There are CRNA making 250k working 40 hours/week

 

[CnsCrit]

You'll eventually learn that lots of CRNAs, NPs, and PAs make more than attendings. $440 is way too high for a northeast stroke salary. I doubt there are any desirable first stroke attending jobs anywhere paying that. I would say $260 is above average, probably either community or privademic.

 

[HemeOncHopeful19]

Is there a reason for that?

A lot of people (or their spouses) are afraid to live anywhere outside the Northeast or LA.

 

[neophyte2008]

I trained in North East, if its academic it makes sense and is actually better than most places , most private places outside cities were offering 350k. when you think about it, if you only see stroke and not other things then you probably are less useful to the hospital system.

 

[ProffesorOakDO]

Why does vascular neurology appear to make 60K more on MGMA than other neurology specialties. The consensus on the boards that i've been is that fellowship training does not affect compensation that much.

 

[deleted1139416]

Is there a reason for that?

Neurology shortfall to worsen by 2025 | MDedge

www.mdedge.com

The northeast has the highest concentration of neurologists in the country relative to population

 

[Itsarainbow]

Why does vascular neurology appear to make 60K more on MGMA than other neurology specialties. The consensus on the boards that i've been is that fellowship training does not affect compensation that much.

Same exact question I have. Why is the MGMA data off?

 

[NeuroHopeful1]

Why does vascular neurology appear to make 60K more on MGMA than other neurology specialties. The consensus on the boards that i've been is that fellowship training does not affect compensation that much.

id guess because more vascular neurologists work neurohospitalist and take stroke call which carries higher compensation vs general neurologists who may just do outpatient at a higher proportion

or it could be neuroendovascular surgery is listed under vascular neuro?

 

[Aldertonghen]

Same exact question I have. Why is the MGMA data off?

Stroke director position pays more ($30k or so in the Midwest) without increasing clinical time (but adds admin stuff), and many also initially do a few days of telestroke on their weeks off. But to be comprehensive stroke centers, many up and coming places need a vascular neurologist, and are willing to pay more for a director position. Gen neuro also includes outpatient (which brings their average down relative to stroke)- as right now outpatient pays less than neuro hospitalist, whereas stroke is mostly inpatient.

NeuroIR compensation is under IR, and pain compensation is under pain non anesthesia. These are much much higher than neurology subspecialties (not included under stroke).

 

[deleted1139416]

Stroke director position pays more ($30k or so in the Midwest) without increasing clinical time (but adds admin stuff), and many also initially do a few days of telestroke on their weeks off. But to be comprehensive stroke centers, many up and coming places need a vascular neurologist, and are willing to pay more for a director position. Gen neuro also includes outpatient (which brings their average down relative to stroke)- as right now outpatient pays less than neuro hospitalist, whereas stroke is mostly inpatient.

NeuroIR compensation is under IR, and pain compensation is under pain non anesthesia. These are much much higher than neurology subspecialties (not included under stroke).

I thought neuro, across the board, was having higher salary compensation, no?

 

[Aldertonghen]

I thought neuro, across the board, was having higher salary compensation, no?

Yes that’s true, but inpatient NH still pays a little more than outpatient, and stroke directorship pays a little more than inpatient neurohospitalist. Since there are more outpatient than inpatient neurologists, the mgma data for gen neuro skews towards outpatient, making it look like vascular neurologists earn $60k more, whereas in reality they don’t earn a lot more than NH.

In a Midwest city, straight out of residency/fellowship, gen neuro outpatient is $300-325k, inpatient 7 on 7 off is around $350-360k, and a 7 on 7 off stroke directorship position that our fellow picked up was $400k. Whereas the neuroIR fellow was getting offers of $600-750k plus bonuses. This lines up with the MGMA findings. Salaries will be lower in the west coast and NE.