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Nurses making more than residents?
Started by DrDarce
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Residency is optional for dentists, they get paid $150,000+ straight out of dental school..my friend is making $200,000 plus incentives in private practice working 8-5pm straight out of school. After 4 years of pre-med hell, 4 years of med school hell, we still can't practice unless we finish at least all 3 years of residency hell..you don't see anything wrong with that? We are the only doctorate degree where we can't practice unless we finish every year of the required post-doctorate training. And I know you can "technically" work after 1 year of residency in primary care but no hospital or insurance will pay you because these days you now also need to be board certified by an independent organization within your field (i.e. ABIM for internal med) before you get hired and have credentials to practice..and in order to be board certified need to complete every single year of residency in your field..another money making scheme that makes physicians go through ridiculous $1,500+ testing every few years in order to remain board cerified even after we have completed 4 licensing exams (Step 1, 2 CK, 2CS, 3)..while NPs can legally practice independently with their online degrees and 900 hrs of clinical shadowing (equivalent to ~10 wks of residency)..it's a messed up system and we let them abuse us..I don't know about you but I see a lot wrong..
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deleted393595
Apples to oranges.
Please never ever go into hospital admin or business. Your shift-worker mentality would make you terrible for those kinds of jobs that require more chutzpah.
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Lol
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Dentists also have a much more finite area of practice that they specifically train for for two years during dental school. Regardless, you are a trainee, that's the thing. If you want to bring standards down so that we're on the level of NPs or whatever, go ahead and advocate for that, but don't be surprised if salaries come down with it. Can't see where your complaint is with training that grants full benefits and a salary. US medical training is pretty consistent with GME across the globe, so it's not like we're uniquely screwed compared to other physicians.
That's some wonderful complete failure to defend your position and ad hominem you've got there, could I have some more?
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deleted393595
Sure. Frankly, I don't want to ever work with you because you're going to play the good little-boy who does whatever hospital admin and the System tells him to. Speaking up for patients? Nah. Trying to fix the system? Nah. And someone like you makes for a very dangerous physician (heck - you'd still be a danger in any other profession too) because I know your type, and there is no extent to how far you will go to please your superiors - even if it means throwing your patients and fellow peers under the bus.
Thats my point..the current educational and training system as it is now is highly inefficient..we don't need 4 years of pre med besides for adding another $100,000+ of debt plus interest and getting drunk and having fun it doesn't add anything to the actual training of becoming a doctor..or make med school 3 years..4th year isn't needed it's a waste and basic sciences can be condensed into 1-1.5 years..or allow physicians to actually enter primary care without restrictions if they complete 1 year of residency..our training as it is now does not have to be as long as it is currently..other nations have a much more efficient system of training of their doctors
I got blasted here as being a naive med student for saying that... You don't need to be a genius to see the system will not crumble if med school is (3+3+2+ residency)... But I am a lowly med student. What do I know?
>Pre-med telling a guy that spent over 12,000 hours working in healthcare prior to med school what kind of patient advocate and physician he'll be
I was actually recognized multiple times in my hospital for process improvement (I won an award for a plan to improve the process by which we handle high flight risk patients that are a danger to themselves and/or others), patient safety (multiple recognitions), and patient advocacy (dozens of letters from attendings and patient families to administration). I've got a proven track record of being a quality provider of care. And you've got, what, exactly? An attitude and a bunch of preconceived notions about life with no personal experience to back them up?
We're one of the only nations where medical school is 4 years instead of 6. They are only more efficient because they cut out undergrad, and simply have two years of undergraduate sciences tacked on to the 4 year typical medical education. We've also got some of the shortest postgraduate training period requirements in the world- In many countries, you can't be a consultant/attending until 5-6 years after medical school in specialties that we certify in 3-4. And subspecialties- don't even get me started. Most 2-3 year fellowships in the US last between 4 and 7 years in the UK, for instance. We've got extremely efficient GME compared to most of the world. Yeah, we could probably do for more six year BS/MD programs, but other than that, things are pretty good.
@Mad Jack you can not deny that LCME or schools do a poor job in designing med school curriculum... So many inefficiency in a system that cost student 50k-80k...
There's three year curriculums out there. I think they could be more broadly utilized. But I really do feel that there's a place for the four year curriculum, particularly for those students that don't really know what exactly it is they want to do like myself. Many of the fields I'm interested in I can't rotate in until fourth year to even see if I'll like them.
Come on now..our med school is actually 8 years compared to other nations 6 years because we are required to get a bachelor's which isn't required in most other nations..traditionally the medical degree is the bachelor's hence other nations including UK use MBBS (Bachelors of Medicine, Bachelors of Surgery)..residency is considered the graduate portion of medical training hence we still use terms like GME (Graduate Medical Education) for residency..so we are technically forced to get what's really equivalent to 2 bachelor's since our doctorate doesn't allow us to do anything and the MBBS gets converted to MD once people apply for ECFMG certification to apply for residency in US (yes their bachelor's gets converted to a doctorate..how nice)..and in other nations they can do just 1 year of what they call "house job" and can become a general practioner
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In the UK, it's 2 years minimum for a medical license and 3 years to become a GP after two foundation years (their equivalent of internship) (http://www.rcgp.org.uk/training-exams/~/link.aspx?_id=BF9B9CB2D566448D92840496DB367159&_z=z). In Australia, it's 3 years to be certified as a GP via the Vocational pathway or 4 years via the Experience pathway. The only English-speaking country I can find with a shorter path to GP/FP is Canada, which has 2 year FM residencies, which leave many FM residents feeling undertrained (http://futureoffamilymedicine.blogspot.com/2013/04/family-medicine-in-canada.html).
I mean, it takes 5 years to become a general internist or ER physician in Canada, 5 years to be a GP in the UK, nearly a DECADE to become a surgeon in the UK- we've got pretty fast training compared to most of the first world.
New system (Modernising Medical Careers)
Year 1+2: Foundation Doctor (FY1 and FY2) - 2 years
Year 3: Specialty Registrar (SpR)
in a hospital speciality:
minimum six years
Specialty Registrar (GPST)
in general practice:
three years
Years 3-5: General practitioner
total time in training:
5 years
Years 3-10:Consultant
total time in training:
minimum 8 years
Optional Training may be extended by pursuing
medical research (usually two-three years),
usually with clinical duties as well Training is competency based, times shown are a minimum.
Training may be extended by obtaining an Academic Clinical
Fellowship for research or by dual certification in another speciality.
You forgot your /s tag on this one. Must have left it under that tin foil hat.
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deleted393595
Why so bitter today? Girlfriend dumped you because she realized what a loser you are?
Don't bothering arguing logic with MJ on this topic, he's of the mentality that he can happily live on 55k a year for the rest of his life and that his expenses will never increase and he doesn't care about any of it.
Wow. What's next, mom jokes?
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deleted393595
Lol! Yea, sure, you've done all those things, but it's frankly embarrassing to see someone like you - who as a non-trad should be greatly more mature than us - still stepping down to lick the boots of the healthcare system. Hospitals colluding to fix your salary as a future resident? "Nah bro, 50K is good enough for me". You're going to be making 50K working 80 hours a week? "Bro, we're better off than everyone else! Stop complaining." As I said before, you're frankly going to be happy with whatever the system hands you, and you're going to attack your colleagues who try to question it. Aka, the "good ol' boy"/shift-worker mentality.
And you know nothing about me, or what I'm doing so please stop 😉 It's people like me trying to fix the system who keep on being dragged down by people like you.
I'm just saying it's not nearly as bad as everyone bitches about it being, whether we compare ourselves to other fields in this country or our physician colleagues abroad, and it's certainly far better than things were 50 or even 20 years ago, when resident salaries where either nonexistent or half of what they are today. That's just what I view to be a reasonable assessment of the situation- would getting paid more be nice? Sure. Is it going to happen? Probably not, but feel free to join a program that has a resident's union if you want to force some change in administrative policy. Quite frankly I don't care much about what amounts to a small period of my training (and one during which I can moonlight if I feel like I need more cash). Now, pay after I'm BC/BE... That's a different matter entirely.
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Solutions please? You think residents should be paid what then? Otherwise you sound like just another allo board poster barking at the vacuum.
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Personally I think medical school costs need to come back down to earth. Getting paid nearly the same resident salary as 20 years ago but paying 5-10x more in tuition is not exactly something most of you would've argued in favor of, but here we are.
The ~$50k training salary would be a lot easier to accept if people weren't otherwise crippled with debt+ridiculous interest rates.
Some of my younger attendings who finished residency around 2000-2002 have occasionally complained about their ~$100k debt at 1-2% interest they started with upon Med school graduation. Most current /recent grads would kill for that.
How do you know? How many days of residency have you completed?
We're talking about the pay, not the conditions, of residency. I've experienced the salary in question and it was hardly awful.
You can't moonlight legally every state. In the states where it is legal, some will not allow you to do so until 3rd year. And finally, some residency programs themselves don't allow moonlighting regardless of state/local laws.
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Yeah- that's my big complaint. The salary itself isn't a problem, but the enormous debt (which isn't the fault of residencies) and the loss of any loan interest subsidies (thanks federal government) are a serious problem. It'll be hard for me to justify pursuing a fellowship with the debt levels I'm going to have, as compound interest will be absolutely brutal on the principle.
Lol. Dental school cost almost 400k. Which is why I'm not an indentured underpaid servant to my father
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I think we can all agree with that (my college roommate went to a school with an OOS of 50k but only for the first year before falling into the 20s after residency could be claimed and we all thought how insane that one year cost was back then. My cousin went to the same school as me and when he was there his 30k tuition was in the top 15 schools in the country for tuition. It was ~40k per year when I went there 5-9 years ago). Unfortunately the costs to the schools are rising with our tuitions as well. Taxpayers sadly are less and less willing to subsidize education, particularly for those who can make six figures in their 30s.
...though it appears that @ElCapone is talking about resident compensation.
I'm hardly a lone wolf, but you are correct, I don't need a lot of money to survive. And I wouldn't say my friends are poor- they're middle class (40-60k incomes), which puts them firmly in the $25,500 to $76,500 middle 50% of household incomes.
I guess one of the big things that always keeps me from bitching is looking at certain other professions, like veterinarians. A lot of them graduate with 250-300k in debt, and they manage to get by on 50-80k in income for the rest of their lives, so I see making 55-65k for three or four years (or five or six or seven, for those among you that are into that sort of thing), after which your income jumps by 3-8x as really not that bad of a deal in the grand scheme of things. And I'm certainly thrilled to not be paying tuition like dental specialists have to- look at the tuition at UPenn for orthodontics:
ORTHODONTIC RESIDENCY » TUITION & FEES
2015-2016 Orthodontics Residency Educational Expenses
Tuition Fee $74,974
General Fee 2,686
Instruments 7,298
Dental Clinical Fee 625
Technology Fee 878
Room and Board 19,600
Books and Supplies 1,282
Miscellaneous 5,956
Total $113,299
- See more at: http://www.dental.upenn.edu/academi...ency_program/annual_fees#sthash.yMLYQNGk.dpuf
They could charge us to be residents if they wanted to lol, if not for NRMP rules. I'm just the sort that looks on the bright side I guess, god forbid anyone do that on SDN.
ORTHODONTIC RESIDENCY » TUITION & FEES
2015-2016 Orthodontics Residency Educational Expenses
Tuition Fee $74,974
General Fee 2,686
Instruments 7,298
Dental Clinical Fee 625
Technology Fee 878
Room and Board 19,600
Books and Supplies 1,282
Miscellaneous 5,956
Total $113,299
- See more at: http://www.dental.upenn.edu/academi...ency_program/annual_fees#sthash.yMLYQNGk.dpuf
They could charge us to be residents if they wanted to lol, if not for NRMP rules. I'm just the sort that looks on the bright side I guess, god forbid anyone do that on SDN.
It was always my perspective that residents got the short end of the stick inasmuch as hospitals made money off of certain programs at the expense of residents working hours doing tasks that may not all have been relevant to their training. Since the government reimburses hospitals for direct costs/salary to the tune of 45-55k per year and indirect costs to the tune of 120k-200k per year, no hospital actually loses money on a program. In fact, most of them end up making money, because they can saddle residents with the work of other staff and thusly avoid having to hire scribes, nurses, PAs, NPs, other attendings, etc.
Now, I'm sure this is something that could vary WILDLY by specialty, hospital, location, etc. Anyone out there who can weigh in on this on more detail? I acknowledge I may be entirely wrong on this, but the above is what I've heard/read/observed.
Now, I'm sure this is something that could vary WILDLY by specialty, hospital, location, etc. Anyone out there who can weigh in on this on more detail? I acknowledge I may be entirely wrong on this, but the above is what I've heard/read/observed.
OUCH!
Considering most people live on less their entire lives, it's not exactly a far-fetched mentality. I frankly don't understand how anyone could think they need more than that amount. I can understand want because people always want more than they have, but need is more an issue of lifestyle decisions.
Arguing that a dual income household can survive for 3-6 years with one partner making 55k is hardly radical, particularly if the other person is pulling in the same or more.
Given the backgrounds of some of the people I went to med school with, I could see how living on 50k per year could be seen as horrible, horrible, hardship.
The prospect of only making 55k per year isn't at all that bad in a vaccuum. It's the fact that one will be saddled with God knows how much debt that is accruing interest over that time that will surely be the point of concern.
+ children + life + other interests and hobbies + retirement planning + smart investments
( totes in b4 the "but I don't want kids and I don't like having fun and who cares about retirement planning garbage )
My program mandated 8% into a retirement account. Was annoying not to have that money as a resident but I'm very glad to have to do it in hindsight. (of course the matching funds came in at 5 years and I was in a 4 year program, but that was a university policy that I couldn't do much about).
Exactly. Lifestyle choices. Things you want but don't need. Not to mention that there are people who make that much and are still able to afford those things.
Why is any of this relevant to us?
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The residency programs didn't give us that debt, nor did they take away our interest subsidies. Regardless, PAYE can make the payments manageable.
I know it sounds completely unfathomable to you, but there's plenty of nurses, police officers, teachers, etc, that manage to have children, a life, other interests, hobbies, and retirement contributions on 55k a year, particularly if they've got a partner that is earning similar to them. Yeah, it sucks that you can't really start doing the things you'd like to do until residency is over, but that's life. Yeah, the debt sucks. Sure, things could be better. But this is what we signed up for, and honestly, it could be a lot worse.
Because I'm saying it's all relative. Relative to most everyone else, we don't have it all that bad.
I don't know what that is
My 401k + backdoor Roth situation + what I pay for health insurance alone is nearly 55k
I guess "good" insurance is a need not a want.
Damnit. *falsifies income, applies for cheap insurance via the exchange, storms off in a huff*
I guess "good" insurance is a need not a want.
Damnit. *falsifies income, applies for cheap insurance via the exchange, storms off in a huff*
The point is that in order to safeguard things not just for myself but for my spouse and sort of for future generations, the income necessary is far above the numbers that some of you are tossing around. And this isn't even because I want them to live some shoe filled fancy life
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