Physician-Scientist Pay in Anesthesiology

[Tothepub]

---

Members don't see this ad.

Of the variety of things that are opaque in academic medicine one of the most ambiguous has been the issue of salary/compensation when one is working in a not purely clinical role. This is magnified in a field like Anesthesiology where there are not many 80-20 (or some other fraction) physician-scientists.

I was curious to know how compensation works for these types of roles at different institutions. Is the pay cut dramatic since the clinical side of anesthesia reimburses so well? Do departments supplement pay up to clinical base for a few years while new faculty try and get early career awards? How does this change if trained in a non-OR subspecialty (i.e. Chronic Pain, ICU)?

I suspect the answers are complicated but any anecdotes are helpful.

 

[NICMAN]

It is not a great time for researchers who get abrupt notices from NIH that their grant is cancelled and then a pink slip from their university because their salary and benefits were paid out of the institutional portion of their RO1.

Also, it is hard to be a great clinician and also a great basic science researcher.

 

[DesiredMemberName?]

Also, it is hard to be a great clinician and also a great basic science researcher.

Hard agree. The most academically productive attendings in my training program were comically inept in the OR. They were invariably assigned upper level residents. In general, there was a negative correlation between academic productivity and clinical competence.

To answer your question, they usually had similar compensation but with reduced clinical obligations. How much of a reduction depended on how much research money they were bringing in for the department.

Also, climbing the leadership hierarchy further augmented compensation and reduced clinical service obligations. The academically productive were typically more likely to ascend the ladder.

 

[sevo00]

 

[cchoukal]

Of the variety of things that are opaque in academic medicine one of the most ambiguous has been the issue of salary/compensation when one is working in a not purely clinical role. This is magnified in a field like Anesthesiology where there are not many 80-20 (or some other fraction) physician-scientists.

I was curious to know how compensation works for these types of roles at different institutions. Is the pay cut dramatic since the clinical side of anesthesia reimburses so well? Do departments supplement pay up to clinical base for a few years while new faculty try and get early career awards? How does this change if trained in a non-OR subspecialty (i.e. Chronic Pain, ICU)?

I suspect the answers are complicated but any anecdotes are helpful.

It is true that anesthesiology departments tend to have fewer grant-funded, primarily non-clinical researchers, although most departments probably wish they had more. It's a hard road in any speciality, however, as you're typically expected to become "independent," which means both functionally and financially, in the form of grants with salary support. Departments will usually take the right candidate and start them at 20% clinical in the "research" track, or whatever it's called at the given university, and if you're not showing promise (AKA, money) after a certain number of years, shift you into a primarily clinical role. University departments don't make money on your publications, they only make money on the (indirect funds from your) grants. The "right candidate" referenced above is someone who has already demonstrated not just an interest and aptitude in research, but a track-record. An MSTP/MD-PhD is neither necessary nor sufficient; you'd likely need to get grants during residency and fellowship and complete a T-32 year. Keep in mind, if the department lets you take 5 or 6 years at full salary to try to become independent, they're investing millions of dollars in you, so they want to put that money into people with a high likelihood of success.

Now, lots of academic anesthesiologists publish research and get a few grants here or there without being 20% clinical, myself included. There's lots of room between being 100% clinical and being a grant-funded researcher. It's not an all or none situation, but the 80/20 people are kind of in a world of their own.

 

[kidthor]

I’ve actually worked with a good number of people who’re both clinically excellent and also world class academic researchers. They worked HARD, were very efficient, and their lives were dedicated to academia. They love what they do and they absolutely are paid less than your average clinical anesthesiologist. The fact that grants are dissolving is a devastating blow.

You would certainly need outside grant funding to fund your non clinical time and research setup. Some places will give you internal seed funding but it’s really not much - but it gets you started and you can list it at least as a “grant”.

I would never go this super acadedemic route because it’s so much work for dwindling returns. But if you go that route I would recommend being at an academic super robust place that can provide directed mentorship on research and grant funding (this combo is very uncommon).

Also I would connect with people at FAER, which is the best meta resource within anesthesia.

 

[NICMAN]

I’ve actually worked with a good number of people who’re both clinically excellent and also world class academic researchers. They worked HARD, were very efficient, and their lives were dedicated to academia. They love what they do and they absolutely are paid less than your average clinical anesthesiologist. The fact that grants are dissolving is a devastating blow.

You would certainly need outside grant funding to fund your non clinical time and research setup. Some places will give you internal seed funding but it’s really not much - but it gets you started and you can list it at least as a “grant”.

I would never go this super acadedemic route because it’s so much work for dwindling returns. But if you go that route I would recommend being at an academic super robust place that can provide directed mentorship on research and grant funding (this combo is very uncommon).

Also I would connect with people at FAER, which is the best meta resource within anesthesia.

You forgot the biggest factor in success in basic science research: Luck/serendipity. Graduate schools are pumping out 1-2 PhDs a year per funded mentor. The supply is enormous. Finding the right mentor who has just the right network connections at just the right time is critical.

Too much left to chance in this environment where Vanderbilt and the and UW-Seattle are dropping researchers like Iranian generals.