PSLF + Side gigs/jobs

[Ellomate]

Hi! I"m a PGY1 Psych, with >300k loans

I consolidated my loans to stay on track for PSLF.

What's it like out there in the real world in terms of PSLF-eligible gigs? (in terms of salary, responsibilities, hours, etc)

Are they mostly low-paying academic jobs 200-250k, or can you find decent PSLF-eligile gigs +300k? (I'm in the Northeast region)

Anyone out here working a PSLF eligible job for <40 hours AND working another part time job? If so, what setting is your part time (e.g telepsych, extrashift, consult, calls, TMS/ECT, addiction clinic, or even real estate). And what is the schedule like for your full time that allows time to fit in your part time?

Is it easy to keep track of PSLF monthly payments as the income rises with a side-gig or can it get pretty complicated?

Anyone tempted out of PSLF due to better offers? What's a reasonable offer to jump out of PSLF for you?

Thanks!

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[ObsequiousAplomb]

My wife went straight from residency to a job as a psychiatrist at a state hospital, which is obviously PSLF eligible. This is her second year there (started in July 2022). She is paid something like $350k a year.
She on paper works 40 hours a week. Realistically, she shares a 22 bed unit with another psychiatrist. He doesn't work Mondays and she doesn't work Fridays because they cross-cover for each other to make that happen. He has a private practice he runs on Mondays.

Once a month she is the "on duty" psychiatrist during the workday so she is covering for whoever is out (among 30 doctors in the pool). There is no mandatory after-hours call but there is optional in-house call (attending sleeps while resident who is also in-house runs the show except for restraint and seclusion evaluations). 13 paid holidays, 3 that she has to work (we've been lucky with some doctors there who prefer to work the holidays she prefers not to, vice versa).
13 sick days per year, 20 days annual leave.
No weekends except if she were to volunteer.
I don't know what the call shifts pay because she's never shown any interest, to the point that she never asked.

She could do some part-time work as a side-job if she wanted to, but why? I even have a private practice she could see patients one or two hours a month if she wanted to. She does want to at some point, but she's enjoying the first few years out of residency in a nice job where she can focus on one thing at a time for a while.

 

[annoyedpsychiatrist]

many jobs are eligible because it just needs to be not for profit which is the majority of health systems. Typically youd work for the state, community health center, or not for profit hospital system, or VA. Basically you wouldnt work for the private clinics. I have nearly 6.5/10 years of pslf and I work for a not for profit health system and my salary is in line with psych average. Good quality of life too

 

[Ellomate]

My wife went straight from residency to a job as a psychiatrist at a state hospital, which is obviously PSLF eligible. This is her second year there (started in July 2022). She is paid something like $350k a year.
She on paper works 40 hours a week. Realistically, she shares a 22 bed unit with another psychiatrist. He doesn't work Mondays and she doesn't work Fridays because they cross-cover for each other to make that happen. He has a private practice he runs on Mondays.

Once a month she is the "on duty" psychiatrist during the workday so she is covering for whoever is out (among 30 doctors in the pool). There is no mandatory after-hours call but there is optional in-house call (attending sleeps while resident who is also in-house runs the show except for restraint and seclusion evaluations). 13 paid holidays, 3 that she has to work (we've been lucky with some doctors there who prefer to work the holidays she prefers not to, vice versa).
13 sick days per year, 20 days annual leave.
No weekends except if she were to volunteer.
I don't know what the call shifts pay because she's never shown any interest, to the point that she never asked.

She could do some part-time work as a side-job if she wanted to, but why? I even have a private practice she could see patients one or two hours a month if she wanted to. She does want to at some point, but she's enjoying the first few years out of residency in a nice job where she can focus on one thing at a time for a while.

Wow that sounds like a great gig!
Grew up in an immigrant family, so would def like to retire my parents, get them business class flights to visit home county to see their family, and also hoping to be able to fund 2-3 children in the future.
Thanks for sharing, it's insightful and helpful!

many jobs are eligible because it just needs to be not for profit which is the majority of health systems. Typically youd work for the state, community health center, or not for profit hospital system, or VA. Basically you wouldnt work for the private clinics. I have nearly 6.5/10 years of pslf and I work for a not for profit health system and my salary is in line with psych average. Good quality of life too

I know that the VA & academic gets a pay cut. What has your experiencing been regarding PSLF-eligible jobs? What's a good salary range to expect right out of residency.
Do you have any regrets not doing private practice? Thanks!

 

[psych_0]

I know several people who work PSLF inpatient jobs in the morning and have cash-pay clinics in the afternoon. I also rotated with 2 in the same boat way back in medical school. All of them are doing very well.

 

[BiscoDisco]

I have a PSLF job but I make two much at jobs 2 and 3 so I would end up paying back the entirety of my 290k loan before PSLF would take care of the rest. For me, I'm stretching the loan out over 25 years and investing the difference. I've run the numbers and I should end up +100k over the life of the payoff period this way.

 

[Stagg737]

I know that the VA & academic gets a pay cut. What has your experiencing been regarding PSLF-eligible jobs? What's a good salary range to expect right out of residency.

Unless you take an academic job you should not be making less than $250k/y, but beyond that, variance will be significant. Even some academic positions make more. My position is at an academic center and after bonuses and call pay I'll likely end 2023 somewhere around $260k for the year.

 

[docksan]

I know that the VA & academic gets a pay cut. What has your experiencing been regarding PSLF-eligible jobs? What's a good salary range to expect right out of residency.
Do you have any regrets not doing private practice? Thanks!

VA systems probably have the most stable pay because it's tied to federal increases with incentives and step bonuses.

Academic psychiatrists should still be earning more than academic primary care unless they're purely academic, which some are, but you'll still be earning a comfortable living. The mean psychiatrist salary is like $250k, and fluctuates more on the high end than low.

 

[annoyedpsychiatrist]

Wow that sounds like a great gig!
Grew up in an immigrant family, so would def like to retire my parents, get them business class flights to visit home county to see their family, and also hoping to be able to fund 2-3 children in the future.
Thanks for sharing, it's insightful and helpful!

I know that the VA & academic gets a pay cut. What has your experiencing been regarding PSLF-eligible jobs? What's a good salary range to expect right out of residency.
Do you have any regrets not doing private practice? Thanks!

community health setting: see the sickest of the sick patients, often with very little support, was super stressful. But mine was run poorly. Perhaps theres otheres out there that are run better.

hospital outpatient: for me more relaxed. They dont view psych as a money maker, and make money off their procedural departments. Psych is viewed as a way for overwhelmed other providers to get their patients seen so the emphasis is less about RVU/numbers and i get 30 min f/us as a result. Has its pros and cons. I really cant complain though and the more I think about it objectively my complaints wouldnt be related to the job but moreso the nuances of outpatient: lots of BPD, lots of tik tok autism/adhd, lots of drug seeking, etc.

private clinic: havent taken a job yet thats a private clinic. The jobs i had interviewed for that were private clinic they all tended to pay well but you were a workhorse. One job they only gave you 15 minute follow ups which is complete crap. I feel rushed at times with 20 min f/us in my last job, especially when theyd often arrive late, but 15 min f/u is a joke. Interviewed at another private clinic place offer was >335k a year 4 days a week 10 hours a day, but one week out of the month id be on clinic call to where if patient had problem NP would take the call, and if they had issues then id get called. 7 days a month is too much to me. And then id go back to NP supervision. So honestly didnt seem right. The worst private clinic i interviewed right out residency about 2.5 years ago was in a super rural city. 300k offer but they were seeing absurd numbers of patients, like 20-23 a day. It was just an RVU mill

 

[annoyedpsychiatrist]

VA systems probably have the most stable pay because it's tied to federal increases with incentives and step bonuses.

Academic psychiatrists should still be earning more than academic primary care unless they're purely academic, which some are, but you'll still be earning a comfortable living. The mean psychiatrist salary is like $250k, and fluctuates more on the high end than low.

im going to be that annoying persistent guy who is still skeptical (forgive me) because ive went through the job search process twice in the past 2.5 years- there were some jobs around 250k but those were mostly in states with no state tax and even those werent common. I had multiple 300k offers for outpatient. One was a pretty cush IOP type setup, but it was for teens and i decided to focus moreso on adults, otherwise job seemed nice.

 

[docksan]

and how much work are you expected to do to make those numbers?

 

[annoyedpsychiatrist]

and how much work are you expected to do to make those numbers?

my current job is outpatient no call and i make >300k with average patient load of 10-12 patients a day which is very reasonable. Had a job offer in another state that was basically same setup and that was for 330k, same patient load. I think hospital systems are often less about numbers/rvus again, given they draw in money from other more profitable specialties. Really the workload at my current job is extremely reasonable.

 

[Ellomate]

I know several people who work PSLF inpatient jobs in the morning and have cash-pay clinics in the afternoon. I also rotated with 2 in the same boat way back in medical school. All of them are doing very well.

Attendings in my hospital can't seem to leave before 4pm. They usually stay till 4:50pm.
If working in academic centers, are you obliged to stay till 5pm as you have to teach/attest residents notes?

 

[Ellomate]

I have a PSLF job but I make two much at jobs 2 and 3 so I would end up paying back the entirety of my 290k loan before PSLF would take care of the rest. For me, I'm stretching the loan out over 25 years and investing the difference. I've run the numbers and I should end up +100k over the life of the payoff period this way.

I guess with 100% subsidy on the new SAVE plan, the 25 years stretch shouldn't be too bad in terms of your interest accuring!
Also, how do you maintain 3 jobs? Are you clocking in like 60-80hours/week? Any time for family and/or travel? What is your motivation on working so much at this time?

Unless you take an academic job you should not be making less than $250k/y, but beyond that, variance will be significant. Even some academic positions make more. My position is at an academic center and after bonuses and call pay I'll likely end 2023 somewhere around $260k for the year.

Thanks so much for your transparency regarding salary. Is there a particular reason why you are staying with your current job since it seems you can find jobs somewhat easily >300k? Are you hoping to find administrative position? PD, APD, medical director, etc? If so, do you need fellowhsip?

 

[Ellomate]

im going to be that annoying persistent guy who is still skeptical (forgive me) because ive went through the job search process twice in the past 2.5 years- there were some jobs around 250k but those were mostly in states with no state tax and even those werent common. I had multiple 300k offers for outpatient. One was a pretty cush IOP type setup, but it was for teens and i decided to focus moreso on adults, otherwise job seemed nice.

What are some inpatient offers you've seen? Will I be contacted during PGY4 somehow via email from recruiters? How are people hearing about these offers? Thanks!

 

[jbomba]

I guess with 100% subsidy on the new SAVE plan, the 25 years stretch shouldn't be too bad in terms of your interest accuring!
Also, how do you maintain 3 jobs? Are you clocking in like 60-80hours/week? Any time for family and/or travel? What is your motivation on working so much at this time?

Whats this deal about the subsidy? I have a lot of loans and not sure what to do about payback.

 

[Stagg737]

Attendings in my hospital can't seem to leave before 4pm. They usually stay till 4:50pm.
If working in academic centers, are you obliged to stay till 5pm as you have to teach/attest residents notes?

Wasn't directed at me, but it may vary. Where I'm at I can leave at 2pm most of the week and most of the attendings on our consult team leave before 4. On the inpatient side they often leave before 3 and some of the previous attendings regularly left before 1. YMMV.

Thanks so much for your transparency regarding salary. Is there a particular reason why you are staying with your current job since it seems you can find jobs somewhat easily >300k? Are you hoping to find administrative position? PD, APD, medical director, etc? If so, do you need fellowhsip?

The work-life balance is solid. Main part of my job is in the ER, probably average about 3 patients per day there for my shift. I also only do 6 hours of outpatient per week, which I really don't enjoy but it pads my RVUs. I get to do ECT, staff a resident outpatient clinic a few times per month, and help cover consults in the hospital. I really enjoy the variety without being overloaded. I also get to teach medical students directly and supervise residents in a few settings, which is nice because I'm more passionate about teaching than medicine itself. I have a few research partners here, and the kind of research we're doing would be extremely difficult to do in PP without the database we have. I would like to have some involvement on the administrative side with education as well and where I'm at has several positions I'll likely try and pursue, but not looking to be a department chair or med director.

Yes, I could easily find something that pays >$300k and apply today, but I hate outpatient and most high paying positions either involve outpatient work or high patient volume, neither of which I find particularly appealing. Additionally, my job responsibilities will likely be shift in the next few months and hopefully add about $25k/yr to my income while doing something I enjoy more. Benefits are also pretty great and I probably get an extra$30-40k in retirement benefits from the hospital without any further contributions on my own, so my total compensation is well above my base salary. I also live in a low COL area and afford a pretty nice lifestyle with what I make. If I lived somewhere that was HCOL I might feel differently, but where I'm at I make more than enough to live more comfortably than I thought I'd be able to when I was younger.

What are some inpatient offers you've seen? Will I be contacted during PGY4 somehow via email from recruiters? How are people hearing about these offers? Thanks!

Go to some job fairs, they have plenty online, and recruiters will start spamming you. Some recruiters will get your info from a general database but those jobs are almost all terrible. Cold call places you want to work. It was said in another thread, but most "great" jobs are made through negotiating up from decent offers. No one is going to just offer you something great.

 

[Ellomate]

Wasn't directed at me, but it may vary. Where I'm at I can leave at 2pm most of the week and most of the attendings on our consult team leave before 4. On the inpatient side they often leave before 3 and some of the previous attendings regularly left before 1. YMMV.

I hear different things online so I can't wait to see the actual offers that are out there.

The work-life balance is solid. Main part of my job is in the ER, probably average about 3 patients per day there for my shift. I also only do 6 hours of outpatient per week, which I really don't enjoy but it pads my RVUs

Hardest thing about ER Psych is dispo... I get anxiety on my decision making bc having to force INVOL is something that's tough for me in my level of training.

Yes, I could easily find something that pays >$300k and apply today, but I hate outpatient and most high paying positions either involve outpatient work or high patient volume

I thought the general rule was that inpatient $$ > outpatient $

Go to some job fairs, they have plenty online, and recruiters will start spamming you. Some recruiters will get your info from a general database but those jobs are almost all terrible. Cold call places you want to work. It was said in another thread, but most "great" jobs are made through negotiating up from decent offers. No one is going to just offer you something great.

Any legitamte job fairs you can share here?

Thank you so much!