What kind of salary do NHSC physicians typically have? I know it depends a lot on location, and that the salaries offered are "locally competitive", but it would be nice to have a more concrete idea of what doctors earn while working with underserved populations. If anyone can please share specific examples that they have come across and wouldn't mind including a few details (such as type of clinic, specialty, region, urban/rural), that would be great. Mainly, I would just like some reassurance that by accepting an NHSC scholarship I won't be ripped off when it comes time to get a job.
NHSC Salaries
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I would also really like to find out about salaries for the NHSC. CTR, have you been offered an award? I got a finalist email at the very end of August, submitted the required docs but haven't heard anything since.
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I'm a year out on my first job after being lucky enough to receive an NHSC scholarship. As a PA though, I had offers across the spectrum from crappy (American Samoa) to several offers well above the nat'l average. I work in a clinic/hosp/ED coverge with call 7 nights per month and I make great money living in a rural community. Of course, I started job hunting about a year out from finishing my training.
Thank you for your comments, cableguy. Although I didn't ask for PA salaries, your input is indeed valuable. It helps to give me a rough idea of what I might expect when I get out.
If anyone else out there would like to contribute this conversation, please do! Even if this thread doesn't see much activity for a while, I certainly wouldn't mind if others shared their knowledge here from time to time. I still have about four years before I can even think about applying for one of these jobs, and besides that, I believe other students may benefit from reading this thread sometime in the future.
If anyone else out there would like to contribute this conversation, please do! Even if this thread doesn't see much activity for a while, I certainly wouldn't mind if others shared their knowledge here from time to time. I still have about four years before I can even think about applying for one of these jobs, and besides that, I believe other students may benefit from reading this thread sometime in the future.
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I emailed a number of job postings at NHSC approved sites around the southwest/northwest regarding salary, work hours, benefits, etc. just a few weeks ago. Most of the sites that I got a response from reported $120-130K as their starting salary for new grads. Most of these were CHCs and rural clinics.
Thank you for your post, MedMan25. I happen to be from the Northwest, so that information is just what I'm looking for. Emailing various clinic sites was actually my next plan of action, too, so I appreciate the fact that you have already done that and shared your findings. Did any of them tell you about their work hours and benefits? Another thing I would be curious about if you happen to know is call schedule.
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Most of the sites I heard back from said the typical schedule is M-F, 8-5 with most docs keeping pretty close to a 40 hour work week. Call is usually taken from home with issues being handled over the phone. I think the call schedule was 1 week out of 4 for most. Benefits included malpractice coverage, 401K, 3-4 weeks of paid vacation, CME reimbursement and productivity bonuses.
I didn't limit my search to the HRSA sites that only a scholar would qualify for though since I'm not a NHSC scholar. I imagine sites with a higher HRSA score could be more demanding with longer work hours, I don't know.
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Some background on myself, since location, specialty, and whatnot matter so very much in discussions of this nature.
- Family Medicine PGY-3. Currently in a program about 10 miles outside of a major metropolitan area in the northeast part of the country (think NYC-Philly-DC area). Will graduate this coming June.
- NHSC scholar; 2 year commitment.
- Seriously looked for jobs mainly in the NYC-Philly-DC area, as well as the Southeast. Ended up accepting a job in an urban area in the southeastern part of the country - no OB, no in-patient, no nursing home duties. Strictly outpatient.
The jobs that I looked at in the southeast paid a little less than the national average, which I would guesstimate to be ~$150K. In the rural areas (ex: Florida panhandle, Alabama, Mississippi, South Carolina), the salaries were as high as $140K. Didn't see anything that dipped below $110K. If it did, I doubt that they'd be able to get anyone to join them. Anything below $100K for family medicine, even in an underserved area, is...well, let's just say that there are a LOT of better offers out there. Even for NHSC scholars.
$140K is really not bad, considering that this is your first job as an attending, and you'll be working in a community health center-type setting. That's actually much higher than what I would get if I took a job with the suburban hospital where I am currently doing my residency.
If you tack on any kind of procedures (i.e. if you do FM-OB), you can expect to get paid much more. Of course, your call schedule will be significantly worse as well.
Work hours at the job where I am looking were fairly standard - 8AM-5PM, 4-4.5 days a week, possibly one or two weekend mornings a month, with home call for one week at a time only.
Benefits were also pretty standard - retirement fund, 2 weeks paid vacation, 1.5 weeks for holidays, CME allowance, etc.
Keep in mind that if you work at a Federally Qualified Health Center (FQHC), federal law mandates that the government pays for your malpractice insurance; it does not come out of your pocket.
The number of patients per day that they expect their physicians to see is roughly about what the attendings in our residency clinic see - about 20 minutes per patient, 15 for same day sick walk-ins. (Yes, I know this sounds INCREDIBLY daunting if you're a pre-med or a med student; as a resident, that's what we're expected to do now. Some private practices at non-NHSC sites require that their physicians see patients every 10 minutes.)
Other benefits that some people look for are not there, of course. Because these are community health centers, there are no productivity bonuses, and frequently no sign-on bonus. This didn't particularly bother me, since I don't have any loans to pay off, but some people may not like this.
There are also no opportunities to make partner in the practice. Again, not a problem for me (partly why I signed up to do the NHSC in the first place), but for some people, this is a big issue. Just something to look out for, if you're the kind of person who was hoping to buy a portion of the practice that you join.
Hope this helps.
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My experience talking to several scholars is equiv to SMQ's post. The exceptions would be IHS (slightly higher $140k and up depending on what they do with bonuses, your salary increases with years in, so that goes up as you stay) and California prison system, where they are currently spending a fortune thanks to a very high-profile federal lawsuit regarding medical care of inmates.
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Make sure you really want this scholarship. Yes, they give you a lot of money, but you are giving up A LOT in order to get this scholarship....don't forget that. You're giving up a significant amount; more than a lot of people realize.
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From what I understand (in the process of applying), they pay for your education (4 years) and you work (with pay of course) for 4 years right after graduation. If you couldn't find an opening, they could assign a working site for you with decent starting salary for a new grad. Can you clarify the part "giving up A LOT... more than a lot of people realize"?
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From what I understand (in the process of applying), they pay for your education (4 years) and you work (with pay of course) for 4 years right after graduation. If you couldn't find an opening, they could assign a working site for you with decent starting salary for a new grad. Can you clarify the part "giving up A LOT... more than a lot of people realize"?
I think that the money blinds people a lot. Yes, it's a lot of money, and the prospect of being debt free is attractive, but, like I said, it's not without sacrifice.
- If you're in medical school, and you haven't done rotations yet, you really don't know which specialties you'll like, so you don't really truly understand how much of a luxury freedom of choice is. I loved surgery, but I couldn't seriously pursue it because of the scholarship. I don't think it was the wrong choice (I don't think that I could do surgery as a career), but again....freedom of choice is huge.
Pre-meds and MS1s don't get this, because it's really hard to know what a specialty REALLY entails until you rotate through it. If you had asked me, as a pre-med, what I thought of derm, I would have wrinkled my nose and told you that it's a useless specialty for vain patients. But, after rotating through it as a resident, I really enjoyed it. The dermatologist took care of a ton of people with skin cancer, there are a lot of cool, non-cosmetic procedures, and I really liked it. Not enough to do it for a lifetime, but I liked it more than I ever imagined I would.
- If you're young, single, and without any geographic ties, then you don't understand how important it is to be able to choose where you end up.
For example, let's say that you go to school in NY. For now, you're single with no kids. But at the end of school (or at the end of residency), that could be different - you could have a steady girlfriend/boyfriend, or you could even be married. You might have a child or two. Let's say, for the sake of argument, that your gf/bf/spouse can't leave NY (which is fairly common).
There are no NHSC physician jobs in New York, that I could find. The nearest job was a crappy job in Baltimore, that didn't pay well and had very...strange...stipulations. (PM me if you want to know exactly what those were). The nearest "good" job that I would consider going to was South Carolina.
So, now what? No matter how you look at it, it's going to be a long distance relationship for 4 years. Do you really want to spend 4 years in a crappy job that you don't like, to be 4 hours away from your gf/bf/spouse/baby? Long distance relationships are hard to maintain in the best of circumstances; this is hardly the best of circumstances. If you hadn't taken the scholarship you could have easily found a good job that you liked in NY...but, at least you're debt free...I guess.
It's definitely a trade off. Don't make the mistake of underestimating the freedom of choice.
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Thank very much for this. Those are some wise words.
This is an excellent post. I agree 100% with how valuable having freedom of choice can be. I accepted the scholarship as an MS2, before I had done any rotations. I admit that I did have an interest in various fields, including PM&R, Neurology, Radiology, and others that weren't allowed by the NHSC. I was willing to do what was allowed by the NHSC, though, so I gave up my wishes for anything else and just focused on these five specialties (FM, IM, Peds, OB/Gyn, Psych). To be honest, when I signed my life away, I was still more interested in Neurology than anything else, but my spouse was extremely terrified at the prospect of not taking the scholarship and the likelihood of graduating with around $300K in loans.
As I went through my rotations, I found myself not being as interested in certain fields as I probably would have been otherwise, simply because I knew they were "off limits". Worst of all, when I finally rotated through Neurology as an MS4, I discovered that I did indeed really love Neurology more than anything else I had encountered to that point, and I probably would have made a fine neurologist, had I not accepted the NHSC scholarship. This is when I realized just how valuable FREEDOM is.
Yes, you certainly do give up a lot by taking the scholarship, and it's a gamble when you haven't rotated through anything yet. Plus you'll have 2-4 years of working in a place you might not want to live, and if you have a family with kids that could potentially be a problem.
By the way, thanks to everyone who has kept this thread going!
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The way I understand it: many people who join the NHSC are interested in community health/serving in rural areas AND want to have financial support for school.
So the important answer I need to know from the past scholarship recipients: if given the opportunity to go back in time and change, would you refuse the scholarship and tough it up with that huge debt instead?
I am weighing option between military and nhsc and I think nhsc offer much more than military. At least you won't be half way across the world for 6-month deployment. With NHSC, you still can fly out and visit your bf/gf/family on weekend, right?
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That was definitely me. I was always interested in the urban underserved, and the financial support was a nice bonus.
So the important answer I need to know from the past scholarship recipients: if given the opportunity to go back in time and change, would you refuse the scholarship and tough it up with that huge debt instead?
I might. I honestly can't say that the scholarship and being debt free is completely worth giving up freedom of location and freedom of specialty choice. I honestly don't know. Yes, being debt free is nice, but the scholarship definitely caused its fair share of angst and frustration.
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I am a third year medical student who has been on the NHS scholarship for the past three years and would like to add my thoughts in the event that it might help someone who might be considering their contract. There are so many factors that must be considered. I will share with you the factors that are important to me. I am married and have three children. My wife and I were born and raised in Arizona. Fortunately for me there are dozens of repayment sites in Arizona. So… geography is in my favor. As other posters have highlighted, some states (NY) do not have any sites and so you must seriously consider where in this great country you want to live.
Second, after signing you are OBLIGATED to enter a primary care specialty. Again, you must really consider your own personal situation. I am an average student, I have not failed any courses and ended my didactic years with a B average. My board scores were slightly below average. While my orthopedic surgery rotation was amazing and I would love a career in orthopedics (and the pay) I know my place and I am aware of the residency programs/specialties where I will be a competitive applicant. I am not down on myself at all but I know that my GPA and board scores would likely qualify me for the same specialties that the NHS scholarship stipulates anyway. If you are already in your first year and you are consistently scoring in the top 10% of your class I think you would be wise to keep your options open and not sign a contract with the NHS. The scholarships are offered in October four months into most first year medical students first year.
Lastly, I must say that the NHS has taken very good care of me. Last month I received my annual ORC payment which is intended to cover your books and other costs. This year my ORC was almost 8,000.00 in addition to the 1289.00 we receive each month. They host an annual conference where you can make great contacts. They provide health insurance as well as coverage for ALL tuition and fees. All in all this is not a bad deal in my opinion. If you have any questions please do not hesitate to leave a message here.
A pleased NHS scholar
Second, after signing you are OBLIGATED to enter a primary care specialty. Again, you must really consider your own personal situation. I am an average student, I have not failed any courses and ended my didactic years with a B average. My board scores were slightly below average. While my orthopedic surgery rotation was amazing and I would love a career in orthopedics (and the pay) I know my place and I am aware of the residency programs/specialties where I will be a competitive applicant. I am not down on myself at all but I know that my GPA and board scores would likely qualify me for the same specialties that the NHS scholarship stipulates anyway. If you are already in your first year and you are consistently scoring in the top 10% of your class I think you would be wise to keep your options open and not sign a contract with the NHS. The scholarships are offered in October four months into most first year medical students first year.
Lastly, I must say that the NHS has taken very good care of me. Last month I received my annual ORC payment which is intended to cover your books and other costs. This year my ORC was almost 8,000.00 in addition to the 1289.00 we receive each month. They host an annual conference where you can make great contacts. They provide health insurance as well as coverage for ALL tuition and fees. All in all this is not a bad deal in my opinion. If you have any questions please do not hesitate to leave a message here.
A pleased NHS scholar
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Thank you. These posts were very informative.
Am I correct in interpretating that there is no rush in applying for one of these NHSC scholarships (AKA you can apply after your second year when you have had much more experience and know better which field you will likely pursue)?
By the time I graduate and finish residency procedural medicine may not be paying nearly as well as it has in the past. PCP and FP will likely become much more attractive fields.
Any input?
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There is a rush in applying for the scholarship. They pay year for year for up to four years, but do not retroactively pay for previous years. So if you wait til you have started your 3rd year, the max you'd be able to apply for is 2 years of scholarship.
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Does anyone know how the acceptance rates to this scholarship compare by intended specialty and between MD, DO, NP, PA?
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Congrats to all those that got the NHSC scholarship this year! I plan on applying for it next year when I start osteopathic medical school, and am wondering how the application process was?
Is it mainly just questions about your financial situation, or do we have to write some essays as well? I am really excited for the opportunity to apply for this scholarship, I have wanted to do rural medicine for a long time now and this is the perfect scholarship for that route!
Also, does anyone know exactly how competitive the scholarship is? I noticed that on the website and was wondering if there were stats anywhere.
Is it mainly just questions about your financial situation, or do we have to write some essays as well? I am really excited for the opportunity to apply for this scholarship, I have wanted to do rural medicine for a long time now and this is the perfect scholarship for that route!
Also, does anyone know exactly how competitive the scholarship is? I noticed that on the website and was wondering if there were stats anywhere.
When I applied a few years ago, I remember writing a few brief essay-style responses to some questions as part of the application. I don't recall discussing anything about my financial situation, but I believe they were mainly interested in my background and/or interest in serving the underserved. At that time, they said it was something like 1 in 14 applicants received the scholarship. I think it got a little easier to receive a scholarship with the Affordable Care Act because some extra money went into the program. However, now that the government is cutting back on spending in several programs due to the poor financial situation our country is in, it could possibly be more competitive than that today.
I just took a look at their website and discovered this document, which states they anticipate giving out 190 awards this year. In the last three years, they awarded 212, 253, and 210 scholarships (and there were 1373, 3200, and 1375 applicants, respectively, which roughly translates into award rates ranging from 1 in 6 to 1 in 13).
The Obgyn salaries are pathetic and far below the mean for all areas. They are supposed to have to offer better but don't. People will offer less if they find out you are an nhsc scholar in desired areas.
Yes. I haven't entered repayment as I'm in residency.
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Not always true. I gave up nothing. I'm working in exactly the clinic setting I envisioned, had my 200K med school bills paid up front (plus stipend). My salary is only slightly less than other FM docs in the area and working for a FQHC I don't have to worry about malpractice insurance.
If you desire to work in the settings that the scholarship exists for and doing primary care, if your med school is fairly pricey, then there aren't too many cons to being a NHSC scholar.
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I think one thing people arent taking into account is, your repayment years, divide the overall cost of med school by 4 and add that to your salary. Thats actually how much you are making because its money you dont have to pay back in loans you would have. So if its $150,000 tack on what $60,000 more of the loans you dont have being paid as well. Think about this as well, you will have 4 years as an attending under your belt and be able to go where you want and make the money you want while getting the experience that will make you a better candidate.
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Can any psychiatrists talk about their experience? Are NHSC psychiatrists' pay much lower than average?
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I see that a lot of people who take the NHSC scholarship do it because of the debt. But i'm trying to see if debt alone is good enough reason to take the scholarship. If you end up with 300K in debt, isn't it still better to have geographic and specialty freedom of choice? What about 10 year income based repayment plans and such. Isn't it true that if you work in public hospitals or underserved areas, you can utilize IBR and just pay a manageable monthly payment? In my opinion, with this option available, it isn't really worth it to do NHSC.
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Well, there is a lot of speculation that IBR will go away. IBR was probably meant initially for teachers or social workers, not doctors. So we'll see how long it lasts.
If you work for an underserved area, and hate it, it is better to do it only for 2-4 years than the 10 that IBR would require.
That being said, as I have said on this site many times, do NOT do NHSC just for the money.
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The way I see it, IBR allows work in public hospitals, of which many are in metropolitan areas. Overall, much more location flexibility than is allowed by NHSC I believe. Of course, that is assuming that IBR remains an option. If not, it probably won't be worth it to pursue a primary care career with the current debt load students have.
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I'd like to know this as well. 140 k, notwithstanding that it is un urban areas is still underpaid imo. What about more rural areas?
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140K still pretty average from rural locations around my area (southwest). The 150-250K positions you see posted and offered are often at large practices that can support elevated primary care provider salaries with what their specialists and procedures bring in. Many sites with HPSA scores for scholars are FQHCs or similar and only staff with primary care so cannot afford mid/high range provider salaries, unless they have you see around 30 patients per 8 hour day. The system I work for (FQHC) struggles just to get MD/DO salaries in the 140s range and we are one of the largest and definitely the most productive FQHC system in our state.
