money after residency

[tls]

---

Members do not see this ad.

I read the FAQ and looked at the websites offered regarding compensation after residency.
I was wondering if residents who are currently looking for jobs could respond to what the compensation is like for private practice in the midwest when first coming out of residency? Then, how does it change >2 years.
I feel that the websites give huge ranges.
I currently live in Cincinnati, if that helps to narrow it down.
Thanks for any responses. 🙂

 

[Andrew_Doan]

I read the FAQ and looked at the websites offered regarding compensation after residency.
I was wondering if residents who are currently looking for jobs could respond to what the compensation is like for private practice in the midwest when first coming out of residency? Then, how does it change >2 years.
I feel that the websites give huge ranges.
I currently live in Cincinnati, if that helps to narrow it down.
Thanks for any responses. 🙂

Previous residents from Iowa were being offered ~$120K-$140K/year starting from Mid-West practices. After 2 years, the income is dependent on how much one bills per year. Overhead is often around 50%; so if you bill $400K, then a physician earns $200K.

 

[jkin]

Andrew,
The FP that was my M2 clinical mentor in WI was in his first year of practice. His initial salary guarantee was higher than that and he was expecting to be over 200,000 by year 2. Has general Ophthalmology salary dropped recently or is it just that the first year salary is much lower than the 3rd year and beyond?

 

[yagmd]

Andrew,

Are the salary numbers you're quoting guaranteed base salary or do they include bonuses and incentives?

Thanks!

BTW, as another source of comparison, Hospitalists (after 3 yrs of Internal Med residency with no fellowship) typically start at $150K and up.

 

[Andrew_Doan]

Andrew,

Are the salary numbers you're quoting guaranteed base salary or do they include bonuses and incentives?

Thanks!

BTW, as another source of comparison, Hospitalists (after 3 yrs of Internal Med residency with no fellowship) typically start at $150K and up.

These are guaranteed base salaries. Some practices will offer bonuses and incentives too.

BTW, if you're in medicine for the $$$, then go be a hospitalist or FP with the higher starting salaries. I'd be bored personally. 😴

In private practice, you can make as much as you're willing to work. No one is going to hand you a $200,000/year salary if you're not going to earn it. It takes time to build a practice and surgical volume. If you stink as a surgeon, then you'll never build a decent surgical practice. However, if you work hard and have good hands, then there is no salary cap with ophthalmology. There are practices in the Mid-West where physicians are billing millions of dollars per year. These physicians are doing high volume refractive and/or cataract surgeries (~100 refractive surgeries/month and ~100 cataracts/month). The going rate for refractive surgeries is $1500/eye around here and cataract $$$ is $650/eye.

Do the math:
$1.8 million/year for refractive surgery, and $780K/year for cataract surgery if you assume the above volume. Refractive surgery reimbursements are going down, but good surgeons are still receiving $1500/eye. Some ads advertise $299/eye, but that's for the first 1.00D of correction. The price quickly goes up if you're a -6.00 D myope.

Clearly, no practice is going to start a new physician with this kind of volume. You have to build up your practice. Money won't be handed to you. You'll have to be a wise business person.

Personally, I don't think money is an issue. If I really wanted to make millions as an ophthalmologist, then I think I could figure a way to do it. For me, I'm happy with an academic salary of $150K/year as long as I enjoy what I do.

Don't worry about the money. Concentrate on finding an area of medicine you love. If you hate what you do, then your salary will be this shackle that binds you to the job you hate.

 

[oldandtired]

"Personally, I don't think money is an issue. If I really wanted to make millions as an ophthalmologist, then I think I could figure a way to do it. For me, I'm happy with an academic salary of $150K/year as long as I enjoy what I do."


Money is a very important issue. Especially for those with > 150,000 in loans, families, credit card debt, etc. Being in your early to mid 30s before you start making significant cash flow sucks. Making 100,000 as an associate somewhere aint gonna cut it.

The field of Opthalmology is terribly saturated in most places. That is the real reason salaries are pathetically low.

I agree that you must enjoy what you do. But there are many options in medicine, one must choose wisely taking everything into consideration. Ignore medical school propaganda.

 

[vanelo]

Money is a very important issue. Especially for those with > 150,000 in loans, families, credit card debt, etc. Being in your early to mid 30s before you start making significant cash flow sucks. Making 100,000 as an associate somewhere aint gonna cut it.

The field of Opthalmology is terribly saturated in most places. That is the real reason salaries are pathetically low.

I agree that you must enjoy what you do. But there are many options in medicine, one must choose wisely taking everything into consideration. Ignore medical school propaganda.

Typical money-minded capitalist......

Enjoy your wealthy "happy" life.

👎 👎

 

[jkin]

I don't know how anyone could decide what to do the rest of their life without trying to get all the possible information. Asking how much money Ophthalmologists are currently making is a responsible question. I would hate to not know what I am getting into. I would never let any one part of the whole change my decision, but I want to know.

 

[Elephantitan]

The thing with money is that it's not always about what you want for yourself as much as what you want to provide for your family (or future family as the case may be). Money is a factor in choosing careers. Of course it's not the end all be all, but it's a factor. I don't want to tell my kids they can only go to certain colleges or high schools because we can't afford it. I'm a Dr and should be able to afford it. I didn't go into medicine for the money nor ophtho, but that doesn't mean I can't be concerned about the low relative compensation. The happiness money can provide doesn't necessarily come in the form of material things as much as the ability to provide for your family now and when you die. So the low salaries in ophtho is definitely concerning as it's my career. What is enough? Who knows--that's a personal decision and if 150K is enough, more power to you, but the cost of college is astronomical already and it's not bloody likely to go down. So those who say people who are concerned about money are money hungry pigs are either too short sighted to realize the realities of the cost of the world, are lying to themselves about the importance of their salary because it sounds noble, or they truly don't care a thing about it and are quite content with lower compensation as long as they are as happy as possible in their current job. If you're in the latter group, congrats-you're in the tiny minority in this country and I salute you. Personally, if money was no issue whatsoever, I'd be a ski instructor in the winter and a river guide in the summer. But alas, it will remain merely a vacation.

 

[Andrew_Doan]

Read again what I said previously. I think there is the potential to make money in ophthalmology for those who want to make it. This is how:

1) Don't live in over-saturated cities.
2) Be good with money and business.
3) Become an excellent surgeon.
4) Work-hard. I know ophthalmic surgeons who work 6 days a week, see over 60 patients a day, and maintain very busy surgical practices. Are they making good money? Yes. In fact, they are making over $1,000,000 per year. Do they see much of their family? Absolutely NOT. These surgeons work from 8 AM to 8 PM every day. They dictate until 10 PM.

However, if you don't need to make that much, and for instance, can live with $150,000/year, then work in over-saturated cities. Better yet, pursue academics because the lifestyle is better than the surgeon making a $1 million/year. Also, keep in mind that academic jobs also provide additional compensation not measurable by salary alone: 401K plans, health insurance, travel, and other benefits.

In ophthalmology, you have the option of making as much as your little heart desires. However, like I said, practices are not going to give you a nice salary if you're not producing.

On the other hand, it's difficult to make a $1 million/year in internal medicine or as an FP. There are not enough billable surgeries in IM and FP to generate $2 million/year in revenue. In contrast, good ophthalmic surgeons are not desperate for surgical volume. With the baby boomers getting older, for instance, there are going to be twice the cataract volume. A cataract surgeon in Iowa who does 100 phacos a month will bill roughly $750,000 a year for cataracts surgeries. With an overhead of 50%, the surgeon makes $375,000/year for cataract surgeries alone. Even if you only did half the volume (12-15 phacos a week), then the surgeon makes $187,500/year on cataract surgery alone. This does not include billing for clinic patients, lasers, and other procedures.

Can you make money in ophthalmology? Yes.

Is the job market over-saturated? Yes, depending on where you live.

Can you live on $150,000-$200,000/year? That's more than 95% of US citizens. I can't believe that only the 5% most wealthy families are sending their kids to college. Families who make only $80,000/year send their kids to college every day.

 

[monkeysarefunny]

i am new to ophthalmology and was just wondering... given the field of ophthalmology is over-saturated, is the academy aware of this and, if so, is it taking the steps necessary (i.e. controlling the number of residency positions available) so that the situation might improve in the future?

 

[Andrew_Doan]

i am new to ophthalmology and was just wondering... given the field of ophthalmology is over-saturated, is the academy aware of this and, if so, is it taking the steps necessary (i.e. controlling the number of residency positions available) so that the situation might improve in the future?

The AAO doesn't control residency training. The ACGME and the RRC controls the number of spots.

The field is over-saturated in major cities; however, there is a great need in less populated areas.

The AAO has a new search engine to find the distribution of ophthalmologists:

http://aaophp.aao.org/doclocator/

 

[ncmd2005]

Dr. Doan,
I could not agree more with your statement that its crucial to find what you truly enjoy doing and are passionate about; other wise money WILL be the shackle that binds you the job you hate.
I see many people going into fields based on compensation solely.
I personally agree with you in that I'd be happier doing an academic field, esp in something like cardiology for example, and make a reasonable income and have good quality of life with a mix of clinical work, research, and teaching.
In America, we all have an intrinsic entrepreneual drive that leads to an insatiable desire for higher income so I would not be surprised if these surgeons billing millions are also unsatisfied. Plus from what I've heard, once you are making high levels of income it's difficult to scale back and easen the work load (i.e. take less pay with more time off, etc..)
Sometimes I wonder about our preceptors and mentors decision making process when they were in our shoes 30 years ago -- before all these procedural specialties boomed -- I wonder if their decisions were less obscured by income, etc.. and were purley based on interest alone.

Good luck to all applying this year.
Remember, at the end of the day, we are all physicians practiting in what is arguably the best health care system in the world for both the patient and provider.

 

[kugs10]

Previous residents from Iowa were being offered ~$120K-$140K/year starting from Mid-West practices. After 2 years, the income is dependent on how much one bills per year. Overhead is often around 50%; so if you bill $400K, then a physician earns $200K.

Do you know if these salaries included incentive plans? I was offered slightly less than $120k but with an incentive plan that pays 40% of whatever I bill over that base salary. I can never tell if the posted average salary data include incentives.

 

[kugs10]

I read the FAQ and looked at the websites offered regarding compensation after residency.
I was wondering if residents who are currently looking for jobs could respond to what the compensation is like for private practice in the midwest when first coming out of residency? Then, how does it change >2 years.
I feel that the websites give huge ranges.
I currently live in Cincinnati, if that helps to narrow it down.
Thanks for any responses. 🙂

Do you have a link to that FAQ?

Thanks!

 

[podarski]

In my theory my kids can put themselves through college, I'm doing it and so can they. In fact the first thing I will do when I'm rich is buy myself a small farm so my kids learn how to work. I know to many kids in school whos dady bought them everything and it absolutley ruined them!

 

[Andrew_Doan]

Do you know if these salaries included incentive plans? I was offered slightly less than $120k but with an incentive plan that pays 40% of whatever I bill over that base salary. I can never tell if the posted average salary data include incentives.

I'm not sure if the average salary data include incentives.

 

[PDT4CNV]

There are 2/5 of the senior residents at our program who will be entering private practice following graduation. One of them stated that the job he accepted guaranteed $200,000/year for the first 2-3 years I believe.

There have been others in the past several years who have started their own practices from scratch. The financial committment for equipment can be very expensive. One graduating resident last year moved to a less urban location where there was no ophthalmologist practicing. The local hospital agreed to pay, not only for his outstanding educational loans, but also for his office equipment and surgical equipment. He of course was obligated to practice there for a specified time.

I must disagree that the field is oversaturated. The distribution could be better in that most large to mid sized cities are oversaturated. But many smaller cities and rural areas are in desperate need. There are areas in my state where the closest general ophthalmologist is greater than 100 miles away. But, most graduating residents are not interested in moving to rural areas in this state.

There was a study done in the August "Annals of Surgery" a year or so ago which suggested that of the surgical subspecialties including Ophthalmology, CV Surgery, Urology, Gen. Surgery, Neurosurgery, Ortho, and ENT, that the demand for Ophthalmology related surgical procedures will increase the most. I believe they predicted a 15% increase by 2010, and an almost 50% increase by 2020 of Ophthalmic surgery demand. This I believe was based on survey and census data, but as a rough estimate, I think the field is still a strong choice for medical students.

My own feeling, it can take time to build up a practice and find your niche in your community, particularly if there is an abundance of subspecialty support in your practice or locally. Your salary following your training--regardless of whether it is $150,000 or $350,000, you will be happy with it because it will be so much more than you have had for the last 8-10 years during medical school and residency/fellowship.

 

[Bless]

In my theory my kids can put themselves through college, I'm doing it and so can they. In fact the first thing I will do when I'm rich is buy myself a small farm so my kids learn how to work. I know to many kids in school whos dady bought them everything and it absolutley ruined them!

There is nothing wrong with daddies buying their kids everything. My Dad buys me everything and I dont do anything bad. I don't smoke, drink or do anything like that. (My Dad is very strict, though.) I plan on being an ophthalmologist in the future and the reason I decided to do so, was because of my Dad. Your kids have to know that you love them. (I am not saying love is determined by how much money you spend on your kids.)