pay tuitions for residency training

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The vice president of our school recently predicted that, in five to eight years, residents will have to pay for their training instead of getting paid modestly.

No wonder that US healthcare system is broken. Without medical residents, most of hospitals could not exist.

 

[Joe Joe on da Radio]

well, if hospitals cannot function w/out residents (and they can't), what are they going to do if all residents decide to "walk out," in defiance of such a policy?

 

[pathstudent]

they will hire FMGs.

Good thing I am going to be done in 5 to 8 years.

That would be so degrading to be a resident and have to pay.

 

[SunnyS81]

That is an infeasible. Most medical school students have enough debt coming out between undergrad and medical school that additional debt would crush them for life. A large chunk (if not most) wouldn't enter medicine anymore. For something like a surgical residency, it would cause the person to finish with a debt of $200k in principle. With interest compounded it would be over $500k. There would be a sudden flood of M.D.'s going into research.

Yeah, they could get FMG's, but where are FMG's going to get the money? Remember that after currency conversation, FMG's aren't in a position to drop a load of cash.

 

[Winged Scapula]

Moving to General Residency Issues...

 

[Madjimbo1]

Sorry, but what's an FMG ?

(I got into med school through a series of amazing clerical errors)

 

[Winged Scapula]

Originally posted by Madjimbo1
Sorry, but what's an FMG ?

(I got into med school through a series of amazing clerical errors)

FMG = foreign medical grad

 

[Madjimbo1]

🙂

 

[edinOH]

If this happened, residencies would still find themselves competing for top U.S. grads. I think ultimately you would see programs undercutting each other in terms of tuition charged to the point that programs would offer candidates "free tuition" or living expense "scholarships" in exchange for attending their programs. This would help out the top students or less desirable programs but the majority of residents would still be left with a tuition bill. Plus, how would this affect hospital and attending liability? It seems that liability would be shifted to the hospitals and attendings more than it already is since the resident might still technically be a "student" in the strictest sense. Not to mention the difficulties the programs would have controlling moonlighting since the resident wouldn't actually be a contractually obligated employee.

In the end I doubt it will happen.

 

[random_fool]

I have never heard of this rumor before and I would definitely not put much credibilty in it. Think about it, this would essentially mean that medical school would be extended to 7-11 years, resulting in impossible costs. The first residency program to even hint at charging their residents tuition will lose all their applicants.

Oh and concerning FMG replacement of US grads, why would you expect FMG's to accept this any more than US grads? Most FMG's are certainly not in any financial position to pay for residency. If anything, this policy would effectively end all FMG participation in US healthcare.

 

[tussy]

I'm a surgery resident in Canada. I pay tuition! All residencies in Canada are university based, and therefore, the university considers us "post graduate medical students" and as such charges us tuition. We are paid by the hospitals in which we work, and we have a collective agreement negotiated with the hospital in which we work. In our last contract negotiation we managed to get the hospital to pay most of our tuition for us which was a huge victory.

 

[womansurg]

Originally posted by tussy
I'm a surgery resident in Canada. I pay tuition

Sheeeeeeyaaaaaat....I can't imagine. We get 40k/year, free health insurance, unlimited free food in the hospital cafeteria, and free covered parking in the hospital garage. And I still feel reamed.

One of the local FP residencies gets all the above, plus free housing in this adorable, park-like complex right near the hospital, including paid utilities. It's funny to see their interns tootling around in expensive sports cars and SUVs. Why not? They don't have anything else to put their money into 🙂 .

 

[BellKicker]

They pay for residency in Canada?!?

I was going to scroll down this thread and laugh at the notion of paying for residency but if they pay in Canada, who knows?

My view on this is that they already pay US residents ridiculously low salaries compared to (some) other countries. So I would think there'd be a riot or something - or at least some serious unionizing among graduating MDs. But then again, I didn't know about Canada. Is that really true?

I guess people would pay the tuition, though, What else would they do? Perhaps medicine as a profession would be less sought after.

 

[Lactic Folly]

I checked my calendar (catalog) - postgraduate medical education tuition is $700-800 a year.

 

[eddieberetta]

This is a touchy subject in Canada. We also earn about 45-60K (30-45US) over the 5 years. Some of the supposedly top-tier Canadian schools have decided that residents should be treated like any other university student and charged tuition (going against a long-standing tradition not to do so). There were certainly threats of provincewide walkouts as we have provinical professional associations like in the US. The current stalemate has some universities charging the tuition but it is intercepted and paid (mostly) by some other party, such as the teaching hospital, program, etc.

I think it is apalling that residents across north america are paid so little in relation to our many years of post-secondary training. This just adds further insult to injury.

WS, our benefits package and meal allowance, as well as salary is similar to US residents (i.e. pittiful salary, decent benefits).

I have no idea what would happen if the Universities had their way on this. Do you remember the people so desperate to do some specialty that they would practically pay to do it (Certain ENT, ophtho, Derm and Rads types come to mind). Well, perhapse these would be the people populating specialty programs in the brave new era of resident tuition...and undesirable programs would still be paying residents to attend.

 

[BellKicker]

Originally posted by eddieberetta
This is a touchy subject in Canada. We also earn about 45-60K (30-45US) over the 5 years.

All right, so you make the same as they do in the US but pay 700 bucks to the program? That's not so bad. I think the OP was talking about a situation where residents were paid no salary and had to pay to work at the hospital.

If nothing else, it would mark the end of non-traditional students going into medicine. Who, in their 30's with kids, would want to enter 10 years of debt-amassment with no pay?

Gaad, I hope this doesn't happen.

 

[smackdaddy]

what is the average debt load of the canadian med school graduate?

 

[edinOH]

followed up with what is the average pay of a residency trained physician in Canada?

 

[The Pill Counter]

Tussy and EddieBeretta would know for sure, but I've been told by friends that are residents in Canada that a family physician pulls in $100-175 CAN depending on how hard they worked. IM and its subspecialties $150-250 CAN, Anesthesiology, Surgery, Radiology about $250-350 CAN. The Canadian dollar is about 75 cents on the US dollar.
Remember, doctors in Canada don't chase insurers or billing matters. They have a 99% collection rate for their fees. Obviously this comes from the government.
Debt load for Canadian graduates is increasing dramatically compared to grads from 7-8 years ago due to skyrocketing increases in tuition.
I remember at University of Toronto a few years back that they tried to push tuition on residents, and they staged a mass walkout, and the administration backed down.

 

[eddieberetta]

Pill Counter summed it up well. I don't have the latest figures on debt load but it is around 70K I imagine, higher in Ontario where tuition is undergoing deregulation and is now about 18K per year (so the debt load of many of the newest cohorts will be over 100K).

Right now, for all intents, residents are not charged tuition. The "fees" levied by the university are at most a few hundred dollars and the agreement is not to revisit this decision for several years. I am fully aware, as mentioned by another poster, that the discussion of "tuition" for residents refers to a more substantial fee and / or major reduction in salary. The model in Canada is basically the same as the current US system.
However, what I wanted to say was that the universities have tried to push for significant tuition levies in Ontario. It was only through a massive effort by the resident professional association, including direct advertising to the public, that this greedy move by the Universities was stalled.

Staff physicians generally make amounts in Canadian dollars comparable to US physicians of the same specialty in US dollars. However, the buying power of a Canadian dollar is stronger than would be suggested by the conversion factor, so the over quality of life is similar. I would add to PC's figures that interventional rads and Cards can make over 400K, as do certain surgeons (ENT/Plastic/CVTS), and some motivated FM/IMs hit 350k. The system is fee-for-service (i.e. the more you do the more you are paid) but there is only one payer (the province). As PC observes, denied claims and other HMO "fraud" is a lesser issue here. Nevertheless, the potential to make about 20-30% more, coupled with lower taxes prompts many specialists here to seriously consider moving...

Cheers