Residency salaries

[biogirl215]

Hi,
I'm not a med. student nor a resident, but I hope you don't mind me posting here. I often hear residents say that they can barely live on resident salaries, yet these salaries are about twice as much as what most loan companies will give you for "living expenses" in med. school (about 20k vs. 40k, from what I've seen). What makes living during residency so much more costly? Is it a matter of having to pay back student loans?, Is it that residents are more likely to have families to support? Something else?

Thanks!

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[yadayadadude]

For one thing, the difference isn't as large as you suggest, because loan money isn't taxed, but residents' salaries are ... so the real difference is more like $20K vs. $30K.

 

[mlw03]

any or all of the above can contribute. plus, another thing is that a lot of med students have roommates, but by residency people are at an age where they'd rather live alone (i'm an exception - i'd prefer a roommate to lower my cost of living until i'm married). however in many cities, the residency salary is significantly higher and allows for a more comfortable living.

 

[MR1]

The big difference I think is cost of living, the ~40k in the South goes a lot farther than ~50K in NY or CA. I live in the south, pay a mortgage and one car payment, and support my wife and 2 small children just fine. Now don't get me wrong, it is tight and we don't have things like cable tv or eat out much. It makes things easier to know that my salary will increase significantly in a few years because I wouldn't want to live like this forever.

 

[DrDawg]

Resident salaries are certainly enough to live on, and I'm not stuck eating PB&J or ramen all the time. I think most gripes are more related to pay vs hours, pay vs level of education, pay vs debt, and lack of things such as 401k's at many programs. Also as more residents move onto specialty training they may not be able to defer their government loans (typically 3 years), or private loans (typically 4 years). Also as a group when tend to be complainers.

 

[Leforte]

Also as a group when tend to be complainers.

I tend to agree with this statement. Physicians tend to overvalue their worth in residency. As a PGY-4, I make somewhere aroung $43k a year, bring home ~1300 every 2 weeks. We own our house, make a car payment (own the other bomb) and my wife and child stay at home. We don't eat out often, don't have cable (but do have Netflix) and spend little for ourselves. We do have good vacations, however. In short, we are doing fine.

I occasionally hear about how our wage compares with the hours we work. Personally, I don't tend to view it that way. I consider residency a paid apprenticeship, much like a post-doc for the PhDs (which, mind you we get paid a heck of a lot more than they do). The time I am in conference, in surgery, etc are training times - no different than med school or college, but I am getting paid instead of paying.

If finances are a worry for you when residency time comes - choose places that are more affordable to live. While it would be nice to be in NYC, Seattle, Chicago, San Diego etc for some - I prefer to be at a place with good training, and affordable for the income I make. Others prefer different things.

 

[TheWowEffect]

Seriously, I can't imagine NOT having cable

Now back to topic.....I think a lot of it is subjective. This will clearly show in the responses posted in this thread.

 

[Hernandez]

Hi,
I'm not a med. student nor a resident, but I hope you don't mind me posting here. I often hear residents say that they can barely live on resident salaries, yet these salaries are about twice as much as what most loan companies will give you for "living expenses" in med. school (about 20k vs. 40k, from what I've seen). What makes living during residency so much more costly? Is it a matter of having to pay back student loans?, Is it that residents are more likely to have families to support? Something else?

Thanks!

Look at it from this perspective, most of us are 26 plus, many with families, trying to pay living expenses, 401ks, health insurance, food, and have 150K plus student loan debt breathing down our necks collecting interest. And that doesn't even begin to talk about if our crappy med school cars are falling apart, or if we want to have a hobby or two. According to my logs, I work an average of 76 hours a week and am only making the pay of a single full time job, that's a big part of my disgruntlement with the pay.

 

[medicinesux]

Physicians tend to overvalue their worth in residency.

When nurses are making three to four times more per hour than a resident, you say that we tend to "overvalue our worth". What a crock! If all residents decided to have a one day national sick out, we'll see exactly how "undervalued" we are. Oh and by the way, most jobs require one to sit in bull**** meetings and conferences. If they were so great, why do pharm companies have to bribe us with free lunches .....oh and don't forget to sign the "sign in sheet"!

 

[filter07]

Overestimate our worth... yes it's true. We are not trained to do anything worthwhile by the time we graduate from medical school. That's the problem!

Nurses are fully trained after finishing nursing school. Pharmacists are fully trained. PAs are fully trained. Nurse practioners are fully trained. Techs are fully trained. They all get paid better than residents.

I get paid a relatively comfortable amount. I have a mortgage, a car payment, and maybe a few bucks left over every month. So I'm not hurting that badly. But compare that to my friend, who has one bachelor's degree, gets paid double what I do, for half the hours, and takes sick days, overtime bonuses, 5-10% annual salary increases, and does not make any life or death decisions. She has time to go on vacations, spends freely, and contributes about 10x the amount to her 401K than I can afford. She did not study hard in high school, did not study hard in college, and does not study at all now.

So maybe I am a whiny baby for comparing myself to someone who I worked harder than for more than a decade, when I should have compared myself to a homeless crack addict who works part time at Burger King. My apologies.

 

[Hard24Get]

So maybe I am a whiny baby for comparing myself to someone who I worked harder than for more than a decade, when I should have compared myself to a homeless crack addict who works part time at Burger King. My apologies.

I think this hits the nail on the head. All of our friends we grew up with have established careers by now, nice houses, nice cars, have started a family that is living comfortably WITH cable, and have money to go to expensive restaurants and buy us nice gifts for x-mas - all while working 8-5. Meanwhile, we are comparatively quite poor and work twice the hours. Having said that, I guess this why MDs often get paid so well when they are attendings...

 

[DrDawg]

In the US your pay is only based on how much you can make someone else or your company. Teachers, social works, and residents don't make anyone else rich, as such we get paid a reasoniable salary; enough to live on, but not enough to pay our loans, build a savings, save for retirement, ect.

 

[Blade28]

Don't forget that for many of us, we'll be in our early-to-mid 30s (or later) and STILL be earning a resident's/fellow's salary.

In other words, we're guaranteed to be making less than $10/hour even into our 30s. This is not including the massive amounts of debt that we'll have to eventually pay off.

 

[Leforte]

I hear what you are all saying, but I still think that as a trainee, I am OK with the salary I get. For example - If I do ear cases with my attending, I am not really needed AT ALL for the operation. It is a 1 person case, and I am there exclusively to train. My presence slows the case down. The patient is then charged more for the anesthesia, more by the hospital for OR charges, etc. Should I then be asked to be paid a higher salary when already I am costing the system more than I am providing? Similarly with Thyroid cases - 1 surgeon and a scrub can do the operation - In fact, these are done by the private guys in 1/2 -3/4 the time. Moreover, resident participation in surgery increases the rates of complication - What then, exactly am I bringing to the table to demand a higher wage?

For those in Medicine residencies - Our hospital caps how many admissions for the med teams. Once they are reached - they rest go to the hospitalist. There are 3 residents on call for their team - and One Hospitalist by themselves- they frequently get equal hits. On the resident team, there is 2-3x the work. First the med student, then the intern, then the R2/R3 all see the Pt followed by the attending, vs just an attending on the hospitalist teams. So a resident may be 1/3 as productive as an attending (factored over their training) and they get ~1/3 that of an attending. On top of that the residents typically order more tests/imaging, etc than is needed - which the hospital eats (They get paid by DRG). So lets see, I take longer, cost more and have more complications - but I should get paid more?

As far as conferences - yes, people in other career fields (business, etc) have to go to conference, too - But they are not a daily event that you need for career advancement - a similar argument would be to say that Businesses should give their employees time off, extra pay and reimburse all tuition for advanced degrees (MBA, JD). Most do not.

So while, yes, I would love to be paid more as a resident - I am also appreciative of what I have. Training is a finite time - and, at least in my field, reimbursement is substantially higher once completed.

Personally, I think a better argument can be made for government support of all tuition expenses.

 

[undecided3yr]

Overestimate our worth... yes it's true. We are not trained to do anything worthwhile by the time we graduate from medical school. That's the problem!

Nurses are fully trained after finishing nursing school. Pharmacists are fully trained. PAs are fully trained. Nurse practioners are fully trained. Techs are fully trained. They all get paid better than residents.

I get paid a relatively comfortable amount. I have a mortgage, a car payment, and maybe a few bucks left over every month. So I'm not hurting that badly. But compare that to my friend, who has one bachelor's degree, gets paid double what I do, for half the hours, and takes sick days, overtime bonuses, 5-10% annual salary increases, and does not make any life or death decisions. She has time to go on vacations, spends freely, and contributes about 10x the amount to her 401K than I can afford. She did not study hard in high school, did not study hard in college, and does not study at all now.

So maybe I am a whiny baby for comparing myself to someone who I worked harder than for more than a decade, when I should have compared myself to a homeless crack addict who works part time at Burger King. My apologies.

We may not be fully trained but law students, a similar level of education, get paid similar to lawyers while on internship. Why? because there is competition to get the into firms and we have a monopoly called the match controlling our market.

PA's may be "fully trained" did you know what a PA needs to do to be trained? essentiallay a 1yr taste of the basic sciences excluding things like neuro and then the equivilent to a 3rd yr medicine clerkship. Now they're "trained" and paid very well to have a physician oversee them and make sure they dont kill people. How is that so different from our situation?

 

[undecided3yr]

bump

 

[Winged Scapula]

bump

Why the bump? Did you have a question that was not answered?

 

[filter07]

PA: 40 hrs, 80k salary
Resident: 80 hrs, 40k salary

If residents worked as many hours as PAs, we would be making about 160 thousand dollars. I understand we are still in training, so let me ask everyone this:

Is our training worth 120 thousand dollars of "tuition" a year?

 

[Doowai]

As a 46 year old male the hours are somewhat oppressive. My first real career job had me working 72 hours per week (8-8 Mon - sat), but then after many years of working 15-30 hours per week for 6 figures spoiled me. As an intern next year I will be working twice as much as the average male and almost as much as a single mother - its just not right.

People can live on residents salaries. The worst intern salary I saw was $42K, plus meals (worth about 3,000 a month), and reduced cost for health insurance.

The best intern salary I saw was $52K, plus 11% paid into a retirement account annually (so about $15-20K saved by the end of residency), plus $850 first year for CME, plus $3000 moving expenses, plus meals (~$3,000 benefit), plus PDA. So somewhere around $62K in salary and benefits the first year. In a very low cost of living area. If a single person cannot live on that anywhere (Chicago and NY included) then they have absolutely no money management skills and no self-discipline.

 

[mgdsh]

Currently the average hourly wage across the US is $17.55 an hour. Most residents make far less then that and you could easily get a job making $17.55 an hour after graduating just high school.

You do the math...

 

[DrDawg]

Moreover, resident participation in surgery increases the rates of complication

This struck me before Absite and I didn't have time to search it. I disagreed but had no proof. So I did a quick medline

Gulbins et al. Safety of a cardiac surgical training program over a twelve-year period. Thoracic Cardiovascular Surgery. Dec 2007

- Compared Resident cases (1925) to attending cases (13000+) over a twelve year period. Overall mortality for residents was 0.5% compared to 2% for staff. This was significant. Further the reexpolaration rate was also lower for residents. This was also significant.

Salim et al. Impact of the 80 hour work week on patient care at a Level 1 trauma center. Archives of Surgery. August 2007.

-not related entirely but did show an increase in complications and preventiable deaths after 80's.
- may "suggest" that residents improve patient outcomes

Koulas et al. Laproscopic Cholecystectomy performed by surgical trainees.

- Trend toward longer times, and complications for trainees did not reach significance. Staff had higher incidence of major complications (bowel, and duct injury) but also not significant.

Obviously I didn't review all the lit, but these studies seem to imply that, at least surgical residents don't increase morbity and mortality significantly. I didn't review any of the lit on medical residencies. Sorry.

 

[medicinesux]

Another way of looking at it:

40 k for working 80 hrs a week = 20 k for working a normal 40 hr week. So essentially we are "really" making 20 k a year.

 

[sunlioness]

I am ok with my salary though understandably looking forward to making more than I do now. The thing that really makes me hyperventilate though is not being able to make loan payments. Especially since my three years of "economic hardship" deferral just ran out and I have to be in forebearance until I graduate and can afford to pay $800/mo to Sallie Mae.