Pediatric Salaries

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Why would a nurse work to take care of a child who is dying when they could get the same pay to have a MA collect all their vitals and when something remotely is amiss, transfer the patient out of their care to lighten their burden?

All that being said, requiring a hospitalist fellowship with a board certification is a complete misunderstanding of the true issue. I don't think the ABP has any real understanding of the practice of pediatrics...

The answer to your question, which I suspect you know, is that some nurses, like physicians and others, would rather be in a critical care setting because that's what they like doing and they feel added value to their lives when working in that environment, even though it is more difficult. Perhaps, they should get a differential pay or other similar benefits, but that doesn't stop lots of nurses from working there. A lack of recognition that critical care nurses do get burned out, need some more help when it is busy, etc does cause high turnover and real problems. But the issue isn't just money, or, necessarily primarily money that is the problem with high turnover in critical care units that I have worked within. YMMV.

As far as fellowships for hospitalists, I think it might be best to see exactly what is proposed before being sure it must be a mistake. I am doubtful that boarding for hospitalists will make it impossible for non-boarded hospitalists to work in entirely non-academic settings.

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The answer to your question, which I suspect you know, is that some nurses, like physicians and others, would rather be in a critical care setting because that's what they like doing and they feel added value to their lives when working in that environment, even though it is more difficult. Perhaps, they should get a differential pay or other similar benefits, but that doesn't stop lots of nurses from working there. A lack of recognition that critical care nurses do get burned out, need some more help when it is busy, etc does cause high turnover and real problems. But the issue isn't just money, or, necessarily primarily money that is the problem with high turnover in critical care units that I have worked within. YMMV.

As far as fellowships for hospitalists, I think it might be best to see exactly what is proposed before being sure it must be a mistake. I am doubtful that boarding for hospitalists will make it impossible for non-boarded hospitalists to work in entirely non-academic settings.

Yes, lots of nurses work there, but they are almost all fresh graduates. They become charge and senior nurses after 2 years because of attrition. And we still have to close beds and have the unit covered by float pool due to understaffing. I suspect that there is burnout, but I find it hard to believe that after being a nurse for 2 years, one gets burned out, but I admit that maybe I don't understand the problem. I do know that after 2 years, they can apply for CRNA school and go work in the PACU 9-5 with no weekends and get equal or better. Granted, I don't walk in their shoes, but this is just what they tell me.

I suppose I'm just jaded seeing fellows being forced to go through scholarly project when they clearly have no interest in it. I hear people say "well maybe they aren't interested because they haven't been exposed". That maybe, but that hasn't been my experience. If they had been interested in scholarship, they would have pursued it earlier and not wait until they are 30. The inflexibility in training and and assuming everyone is going to graduate to become an academician, it seems misguided.
 
Yes, lots of nurses work there, but they are almost all fresh graduates.

Really? This is not my experience. Although undoubtedly critical care nursing (NICU/PICU/CVICU) appeals to new grads, they are not "almost all" of the nurses I've seen. I think that a large number of nurses who burn out do so early on and the remainder tend to stay for a while (5-10 years or so). None of this isn't to say there is a real problem with keeping veteran nurses in these settings, but I think that improving the quality of their life is at least as important as resolving salary issues.
 
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Really? This is not my experience. Although undoubtedly critical care nursing (NICU/PICU/CVICU) appeals to new grads, they are not "almost all" of the nurses I've seen. I think that a large number of nurses who burn out do so early on and the remainder tend to stay for a while (5-10 years or so). None of this isn't to say there is a real problem with keeping veteran nurses in these settings, but I think that improving the quality of their life is at least as important as resolving salary issues.

Almost all might be an exaggeration but in trying to recall the number of nurses who work in my current unit who were there 3 years ago, I would estimate that it is only 20 to 30%. The rest are new graduates or new hires. There are typically 3 to 4 new graduates per semester who do their nursing residency in the unit and are hired afterwards. So that is about 8 new nurses per year. I don't do that much service so maybe my estimation is inaccurate, but it certainly seems that way.
 
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Almost all might be an exaggeration but in trying to recall the number of nurses who work in my current unit who were there 3 years ago, I would estimate that it is only 20 to 30%. The rest are new graduates or new hires. There are typically 3 to 4 new graduates per semester who do their nursing residency in the unit and are hired afterwards. So that is about 8 new nurses per year. I don't do that much service so maybe my estimation is inaccurate, but it certainly seems that way.

National nursing turnover goals, including children's hospitals and to the best of my knowledge, acute care settings are generally 12-14% per year. If yours is > 20% per year there may be a local issue. Regardless, there are strategies focusing on support related to the stress in these settings that can be helpful. My only point is that it isn't just money or necessarily mostly money, that is involved.
 
I suppose I'm just jaded seeing fellows being forced to go through scholarly project when they clearly have no interest in it. I hear people say "well maybe they aren't interested because they haven't been exposed". That maybe, but that hasn't been my experience. If they had been interested in scholarship, they would have pursued it earlier and not wait until they are 30. The inflexibility in training and and assuming everyone is going to graduate to become an academician, it seems misguided.

Just to clarify, I believe that the most widely advocated program for a hospitalist fellowship leading to board certification would be for two years. This would be different than other pediatric fellowships. In planning those two years, it is expected that many of the fellows will focus on an advanced degree, not necessarily an MPH, and/or things like advocacy or more formal education or business training. Some may do a classic scholarly project, but it is not expected to be the same as that required in other areas that are 3 year fellowships. Now, I suspect your real complaint is that 3 year fellowships with a scholarly project of 1/2 or more of that time is unreasonable for everyone. I agree. I am old and trained before the change in neo from 2 to 3 years but it is safe to say I had nothing to do with the change and think the issue should urgently be reconsidered.
 
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Just to clarify, I believe that the most widely advocated program for a hospitalist fellowship leading to board certification would be for two years. This would be different than other pediatric fellowships. In planning those two years, it is expected that many of the fellows will focus on an advanced degree, not necessarily an MPH, and/or things like advocacy or more formal education or business training. Some may do a classic scholarly project, but it is not expected to be the same as that required in other areas that are 3 year fellowships. Now, I suspect your real complaint is that 3 year fellowships with a scholarly project of 1/2 or more of that time is unreasonable for everyone. I agree. I am old and trained before the change in neo from 2 to 3 years but it is safe to say I had nothing to do with the change and think the issue should urgently be reconsidered.

I think my residency training better prepared for hospitalists positions than private practice. Long time ago so things might be different now but I also don't see the need for a fellowship.


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National nursing turnover goals, including children's hospitals and to the best of my knowledge, acute care settings are generally 12-14% per year. If yours is > 20% per year there may be a local issue. Regardless, there are strategies focusing on support related to the stress in these settings that can be helpful. My only point is that it isn't just money or necessarily mostly money, that is involved.

Maybe it is local. I don't know. It certainly seems higher than at the previous institute but that maybe just my peripheral perception. I'm also not a nurse and can't speak for what leads to the turnover, but I do know money is mentioned more frequently than any other topic.

Just to clarify, I believe that the most widely advocated program for a hospitalist fellowship leading to board certification would be for two years. This would be different than other pediatric fellowships. In planning those two years, it is expected that many of the fellows will focus on an advanced degree, not necessarily an MPH, and/or things like advocacy or more formal education or business training. Some may do a classic scholarly project, but it is not expected to be the same as that required in other areas that are 3 year fellowships. Now, I suspect your real complaint is that 3 year fellowships with a scholarly project of 1/2 or more of that time is unreasonable for everyone. I agree. I am old and trained before the change in neo from 2 to 3 years but it is safe to say I had nothing to do with the change and think the issue should urgently be reconsidered.

That's fine if someone wants to pursue a MPH or higher degree, but I don't quite understand why one would need more clinical inpatient training which is usually a part of fellowship training. Residency, at least in my opinion, should graduate trainees who are ready to practice independently in a private practice and inpatient hospital medicine. If not, then the issues with residency training should be addressed. I admit, I don't know the details of what this fellowship entail, but it sounds like the general pediatric academic fellowship, which is really an attending physician who is getting protected scholarship time to practice solely in an academic setting. I guess that is a fellowship. If you know more about the details, I'd be interested to hear. The general pediatric academic fellowship is not boarded from my understanding, which makes sense because how can you be double boarded in the same thing.. ie general pediatrics. If they make hospitalist fellows maintain board certification in hospitalist medicine and general pediatrics, it again sounds like being boarded in the same thing. But I admit my lack of knowledge regarding the subject. Maybe the details are more clear and defined on how the clinical practice of a hospitalist really requires an additional board certification to differentiate it from general pediatrics.
 
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Just to clarify, I believe that the most widely advocated program for a hospitalist fellowship leading to board certification would be for two years. This would be different than other pediatric fellowships. In planning those two years, it is expected that many of the fellows will focus on an advanced degree, not necessarily an MPH, and/or things like advocacy or more formal education or business training. Some may do a classic scholarly project, but it is not expected to be the same as that required in other areas that are 3 year fellowships. Now, I suspect your real complaint is that 3 year fellowships with a scholarly project of 1/2 or more of that time is unreasonable for everyone. I agree. I am old and trained before the change in neo from 2 to 3 years but it is safe to say I had nothing to do with the change and think the issue should urgently be reconsidered.
What advanced degree would it be if not an MPH?
 
This is timely as I've recently had access to standards for salaries for pediatric cardiology. I'm not going to reproduce the entire table but will hit highlights for assistant professors since that's what people start at for the most part.

Note this is all for US academic positions only.

Numbers will be listed like this:
25%
Mean
75%

MGMA data for 2015:

Base compensation
Assistant Professor
180,000
204,054
224,811

Total compensation
Assistant Professor
192,874
233,211
257,965

Here's the AAMC data for 2015, and as a bonus I have it for PICU also.

Pediatric Cardiology
Assistant Professor
195,000
222,600
241,000

PICU
Assistant Professor
202,000
237,300
264,000

Thanks for sharing. If these are reasonably accurate, that would be wonderful

Mandating a 3 year fellowship is easily one of the biggest, misguided mistakes in medical training the ABP/ACGME has ever done. For people who want to do fellowship and go into private practice and just see patients, the 18 months of scholarship is a complete waste of time and nothing valuable is generally obtained. On the other hand, for those who want to pursue research, academics, etc., 18 months is woefully inadequate to gain the expertise (or even the foundation of knowledge) to be successful in that endeavor, and typically you need ~ 3 years of scholarship beyond the clinical time. Everyone in my group agrees with this sediment, and I know this is a frequent topic of conversation at the program director meetings for pediatric critical care. I desperately hope it will change someday, but I just don't see it happening any time soon. What I do see happening (potentially/eventually), is that as cost of education rises, so will the debt and people will avoid pediatrics or subspecialty training due to the financial disincentive. This, coupled with more private practice jobs, will force the ABP to drop the 3 year mandated training program and have a clinical 1.5 year program to fill the needs. I suspect though, this change in training and policy will only happen when the system of caring for children with subspecialty needs is on the brink of, or has had, a meltdown. Though I try to avoid policy and committees as much as possible in my academic time, the exposure I've had has taught me that when it comes to policy or system changes, people only act in a reactive manner, never in a proactive manner. Typically you need a sentinel event (or a couple) to really make administrative people want to take action.

The 3 year fellowship is a travesty. In combination with no financial incentive (typically a financial penalty) for the majority of subspecialties, it just doesn't work. The bolded is already very much happening
 
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Being a pediatrician is a lot like being a veterinarian, except the only thing that bites is the paycheck! :laugh:
 
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Being a pediatrician is a lot like being a veterinarian, except the only thing that bites is the paycheck! :laugh:

Say what? I'm guessing you have never breastfed a baby with teeth, have you? As far as the salary, most pediatricians only go to Chuck E Cheese for dinner anyway so we're cool with getting paid a buck-fifty for a well baby visit.
 
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You don't seem to take the student loans into account.

Making $150,000-$180k a year and having 2-300k (or more) in student loans isn't a good life, it is slavery, indentured servitude.

No one would argue that you cannot live well on a $150k salary, with no other debts. However, most physicians have easily reached $200k in debt if not significantly more, so that $150k after taxes and loans comes out to about the poverty line for a family.

It is pathetic to hear people defending it, to be honest. Have a calling all you want, but you won't be getting too many intelligent people who can do math in pediatrics.

The fact that women (largely) inhabit this area certainly does mean something, what exactly, I'll leave to the reader. You don't have to live in 1950 to think that the largely male hospital administration is taking advantage of the female population in pediatrics, you just have to have eyes and ears.

Yes to all of the above, but a little perspective is in order. $150k/year easily puts you in the top 2% in terms of income. We don't live like kings and may not all drive Teslas, but it's enough to pay loans and live comfortably while still saving for retirement. It is frustrating that adult counterparts make considerably more than we do, but we have good job security, one of the highest job satisfaction rating of any specialty, and we do just fine. I suspect that over time physician salaries will even out (as is common in other countries), though I have no idea over what time frame that will play out.
 
You don't seem to take the student loans into account.

Making $150,000-$180k a year and having 2-300k (or more) in student loans isn't a good life, it is slavery, indentured servitude.

No one would argue that you cannot live well on a $150k salary, with no other debts. However, most physicians have easily reached $200k in debt if not significantly more, so that $150k after taxes and loans comes out to about the poverty line for a family.

It is pathetic to hear people defending it, to be honest. Have a calling all you want, but you won't be getting too many intelligent people who can do math in pediatrics.

The fact that women (largely) inhabit this area certainly does mean something, what exactly, I'll leave to the reader. You don't have to live in 1950 to think that the largely male hospital administration is taking advantage of the female population in pediatrics, you just have to have eyes and ears.

If you make 180k, have 250k in debt, and have a family of 4, you'll pay ~2700 a month for 10 years. Figure about 60k taxes, leaves you about 7k a month in disposable income. Show me how you're getting to "about poverty line". The hyperbole isnt helpful
 
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You don't seem to take the student loans into account.

Making $150,000-$180k a year and having 2-300k (or more) in student loans isn't a good life, it is slavery, indentured servitude.

No one would argue that you cannot live well on a $150k salary, with no other debts. However, most physicians have easily reached $200k in debt if not significantly more, so that $150k after taxes and loans comes out to about the poverty line for a family.

It is pathetic to hear people defending it, to be honest. Have a calling all you want, but you won't be getting too many intelligent people who can do math in pediatrics.

The fact that women (largely) inhabit this area certainly does mean something, what exactly, I'll leave to the reader. You don't have to live in 1950 to think that the largely male hospital administration is taking advantage of the female population in pediatrics, you just have to have eyes and ears.

1) 150K/year means a lifetime pretax earnings of more than 5 million, which is more than twice what the average college graduate will earn and 5 times what the average American will earn. 300K in debt (principal), compounding continuously through medical school, residency, and a 10 year repayment plan, leaves you paying 1.2 million of pretax earnings towards your debt. That still leaves you with twice what an average college graduate earns to live on.

2) No one is forcing you to earn 150K/year. Call free, 5 day/week clinic jobs tend to start at 200K going up to 250K mid career. Q3-Q4 nursery call combined with a 5 day/week clinic starts at 250K, going up to 300K mid career. It's perfectly possible to earn 10 million pretax over a career as a Pediatrician while working what most physcians would consider normal hours.

3) Remember, its not the $ that your profession makes, its the $/hour. Pediatrics skews towards the less hard working. The average clinic Pediatrician only works 40 hours/week. If you want surgeon money, really all you need to do is work surgeon hours.

4) Ob/Gyn also heavily skews female, they're not having salary woes.
 
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Can anybody give me a ballpark income for peds cardiology, PICU, NICU?
 
Does your school provide the aamc careers in medicine dealio? They have the mgma data for private practice and the aamc data for academic on there. The median for all three is higher than you probably think (private practice that is).

My school doesn't. Where could I get this?
 
I've been using state websites (which publish salary data) to get ballpark figures. California's website is particularly good and can give you a sense of what academic physicians in major markets (LA, SF) as well as slightly less major markets (Sacramento, Irvine, etc.).

Compensation at the University of California: Annual Wage

Just go to the UCLA/UCSF/UCSD SOM website, find the physicians in your chosen specialty (e.g. pull up the Peds Cardiology/EM department) and search their names on the salary database above. Since the websites also list how many years out of residency/fellowship each physician is, it's also helpful for getting some sense of how starting salaries compare to mid-late career salaries.
 
I have been practicing for one year as an employee of a group that only runs FQHCs in small towns/cities in Norcal; I started at 180k (+10k for CME/conferences which is just added in), now at 190k, effectively 200k. I work about 36h/week, strictly outpatient, and see on average anywhere from 18-23 pts per day. I am quite satisfied, I realize my situation is somewhat unique, and one which I am thankful for, but I figured it's another data point or an indication of what is possible.
 
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I have been practicing for one year as an employee of a group that only runs FQHCs in small towns/cities in Norcal; I started at 180k (+10k for CME/conferences which is just added in), now at 190k, effectively 200k. I work about 36h/week, strictly outpatient, and see on average anywhere from 18-23 pts per day. I am quite satisfied, I realize my situation is somewhat unique, and one which I am thankful for, but I figured it's another data point or an indication of what is possible.

This doesn't seem that far off from the jobs that my friends are getting, both in pay and patient volume.
 
Hello, doc! Would you say the mgma data is an accurate representation of salaries for PP pediatrics (I would like to know your opinion on the matter)? I wanted to PM you but it won't let me. It's very hard to get a good read on this. I am going to graduate with 500k in debt and I want to do pediatrics but the debt is terrifying :(.

Don't do pediatrics with that kind of debt. You can't count on PSLF and it will be hard to pay that off with Peds.


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For those that have seen the paid for mgma report, I have come across a number of free versions with their summaries, and it seems that none of them ever have pay for peds subspecialties. Is that the norm where you have no clue, or is that just with the free stuff that floats around online? I have no problem paying for it eventually, but I am not paying that much for something that doesn't tell me anything.
 
@physicsnerd42 500k debt is no longer atypical, with undergrad + interest it will be the norm for those not getting financial help. Not everyone can be a dermatologist, you can just say avoid the vast majority of residency positions (primary care).
 
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I will have approximately 400K in debt coming out of residency. I went to a cheap undergrad state school and the cheapest medical school I got into (no state medical school). It seems the baby boomers are always insulting "stupid millennials" about debt when we never got chance for the $2,000 per year tuition and govt-subsidized interest they had but that's a side conversation.

I LOVE working with kids, but it is hard to ignore making 1.5-3X as much in other specialties or even other pediatric subspecialties (anesthesia, ortho, ENT, so on). Money is not everything but it is tough to think about essentially flushing a few million down the drain over the course of a career.

I'm not trying to offend or insult anyone at all. It is my only hesitation about going into peds. Did anyone else have similar thoughts and go with peds? Thanks.
 
Why does Doximity have peds at average 230k? Then you came here and people tell you expect 135k, crazy.
 
Why does Doximity have peds at average 230k? Then you came here and people tell you expect 135k, crazy.
Those incomes are self-reported and have a mix of private versus academic, large practice versus solo or small, city versus rural. For a median income 230K is probably out right. It's where you have to practice to get 230K that makes the difference. Some people certainly don't mind practicing in less desirable areas to make more, its a matter of choice. I suspect the lower salaries you see here are more reflective of people living in more desirable, urban areas. That is an assumption, but that has been my experience.
 
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Why does Doximity have peds at average 230k? Then you came here and people tell you expect 135k, crazy.

I was offered ~170K for a first job out of residency working in Urgent Care, and I didn't have to pay for malpractice. And this was in a city. Not NY or Cali, but a city none-the-less. The 230K includes people who have been in practice forever, and all the other iterations above. I hear one of the neos in my hospital made over a million one year, but he also works like crazy and is a partner in a very large physician group.
 
one of the neos in my hospital made over a million one year

I'd love to hear the specifics of how he did that, even if working like crazy. Since this is the peds salaries thread, I wonder how much the highest grossing general pediatrician makes and how they do it.
 
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I'd love to hear the specifics of how he did that, even if working like crazy. Since this is the peds salaries thread, I wonder how much the highest grossing general pediatrician makes and how they do it.

This is rumor, though I don't doubt he made it happen. As I said, he is one of the partners in a very large physician group, and they have a lot of bonuses that end up being distributed according, I believe, to seniority, and he's been here forever. He also is in charge of staffing all the nurseries in the area, and pays not much (compared to other gen peds positions in the area) to the people who staff those local nurseries not affiliated with NICUs. I think he may also have a few side projects not affiliated with the hospital, but I don't know that for sure.
 
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This is rumor, though I don't doubt he made it happen. As I said, he is one of the partners in a very large physician group, and they have a lot of bonuses that end up being distributed according, I believe, to seniority, and he's been here forever. He also is in charge of staffing all the nurseries in the area, and pays not much (compared to other gen peds positions in the area) to the people who staff those local nurseries not affiliated with NICUs. I think he may also have a few side projects not affiliated with the hospital, but I don't know that for sure.
The only pediatric-based subspecialites that I know have an income similar to this range is pediatrician cardiothoracic surgeons. If that is ones aspirations... go for it.
 
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