The "exploitation" of residents is a very long tradition and it is slowly receding.
I realize I'm old school, but I have trouble reconciling $40K/year with long hours for four years followed by a $150K-$350K/year job for life as what pops into my head when I think "exploitation."
I definitely have bad days, but when I take a deep breath, I just can't get outraged about low resident wages. Unlike the case of gibits (autocorrect off), which by his description sounds like a sandbagging with regards to his ability to moonlight, we all knew
exactly what we were getting into. In fact, we had pretty good insight into hours and salary
8 years in advance, which is pretty unheard of outside the military or the most civil of service. The only difference between the job I have now and the one I expected when I started medical school is that residents earn more money and work less hours now than they did when I started.
It flat out sucks to be an intern sometimes. Most of us have had rotations where we worked well over 80 hours per week. This happens for about six months max. The other half of intern year, the 60 hour week is the exception to the rule for most. Beyond intern year, average hours seem to be 40-50 hours for the easier programs, around 50 hours/week for many programs, and pushing 60 at the hardest of programs. Even at the programs that have the reputation for being true workhorses, I doubt many of them would have a 60 hour workweek if you averaged PGY2-4. But again, it isn't hard getting visibility into which program is which with a little initiative and research.
Though it sure feels like a lot when you're doing it, 50 hours per week is on the
light side for a professional career. Lawyers would kill for this. Programmers would kill children for this. Business consultants would wipe out entire cultures. Dentists, granted, would call it a real grinder.
The counter-argument to any reassessment of the hours always is the money, but again, this is something we knew from day 1. It's
incredibly tough to get off of a 60 or 70 hour workweek (which ended on Sunday mid-morning) and realize that although you have a day(ish) off, you don't have enough money to go see a (matinee) movie. That truly sucks. It's particularly hard without a sense of delayed gratification. It's worth remembering that one of the
lowest performing residents from one of the
lowest regarded residency programs in psychiatry still has a $150K/year job waiting for him, if he is so inclined. The lowest performing law student from one of the lowest regarded law schools? He's now a barrista. The lowest performing business student from one of the lowest regarded business schools? She's
interning to become a barrista.
And that's just cash, a huge motivator for some.
For others, there's the fact that psychiatry is one of the few fields of medicine you can still set up a shingle for yourself in many markets without a huge cash outlay and a sense of sheer masochism.
For others, there's the fact that you can throw a dart at a map of the United States and feel fairly confident you can find (or create) a job within a livable commute of wherever it lands (the middle of the Great Lakes doesn't count).
For others, there's the fact that your basic psychiatry residency can open the door to a world of practice opportunities. Private practice psychotherapy or psychopharmacology. Inpatient public sector. Outpatient public outreach. Hospital-based consulting. Addiction. Prisons. Veterans. Etc. etc. etc.
For others yet, there's the very tangible benefit of after a long hard day knowing that you weren't making widgets, you weren't selling potato chips, and you weren't moving zeroes on a spreadsheet. At the end of each day there's a particular satisfaction coming from either having helped people or (on the bad ones) at least having had the opportunity to.
Residency can be sucky. It can be particularly exploitive and sucky at the malignant programs. But at the end of the day, the prospects are far greater for every psych resident than for most. Earning $43K/year sounds like absolute peanuts (though it's actually the average U.S. working wage), and it can be demoralizing to do the math and figure out your hourly when you're crushing 70 hour weeks ($22 an hour or somesuch?). But for mental health-sake, it needs to be viewed as what it is, which is an
investment. And it's one that pays off higher and more reliably than almost any other use of four years. And if you truly want to become a psychiatrist, it's all to do the best job out there.
No one likes coughing up the down-payment on a house either, but it beats the $hit out of renting the rest of your life. Hang in there, everybody. As they say, it gets better.
