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I don't care for your slant on all this but I agree 100% on your conclusion. Truthfully, I wouldn't mind a few of you banding together and putting me on ignore. 🙂 And then I can applaud you.
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ROAD specialties not as appealing anymore?
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Nope, ophtho. The whole point is that it's the ROAD to happiness. Lifestyle.
Also, ortho has been taking hits left and right. While they certainly aren't being knocked down to where a lot if lesser paying specialties are, many spine procedures, for instance, are no longer billed on a "per level" basis. A multilevel laminectomy now pays ~the same as a single level, I believe.
Eyes are amazing though.......you can see with them and stuff.
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Hey, Anastamoses is a kind man, bee nice to him.
As for Ophtho, I agree with Frazier that some people are just crazy fascinated with eyes for some reason. More power to them, though. At least they're not crazy fascinated with Neurosurgery.
As for Ophtho, I agree with Frazier that some people are just crazy fascinated with eyes for some reason. More power to them, though. At least they're not crazy fascinated with Neurosurgery.
Thank you Arkangeloid
I have a very hard time believing that number. That whole article seems like a giant enticement to get physicians to take hospital employed jobs. Maybe it was written by someone in the Obama Admin...
Those numbers are so laughably high that they shouldn't be taken seriously for even half a second. Way higher than even the inflated MGMA numbers. Try half that for non-invasive cards, optho, and take $100-200k off of the others.
Surgical specialists in well run practices can make very high income, including in academia if they have incentive compensation based on productivity. None of those numbers are far fetched.
When I was in the .mil, some of the neurosurgeons would take pager call from home for the local group for $3000 a night, $5000 flat rate if they came in. The 4 surgeons splitting call equally would make an additional $270k minimum just for call coverage. And if they were paying an outsider that much, I suspect they got even more.
When I was in the .mil, some of the neurosurgeons would take pager call from home for the local group for $3000 a night, $5000 flat rate if they came in. The 4 surgeons splitting call equally would make an additional $270k minimum just for call coverage. And if they were paying an outsider that much, I suspect they got even more.
The US spends more and gets less than every other country out there.
Canadian doctors make as much or more than US doctors and work less for it. They also have cheaper medical school and cheaper undergraduate.
Gross maybe. Net seems unlikely.
High wage earners can pay ~50% in taxes in Canada (when you combine their federal and state/provincial taxes).
Also isn't everything more expensive in Canada anyhow?
Yeah there is this misconception that since Canada is "socialist" the doctors are making less and everything is worse but from what I can see they make bank. The problem is that the jobs are not spread out through the country and certain subspecialists can't find jobs.
some specialists may make bank but there aren't a lot of specialists to begin with, the spots are very limited and high controlled..many more graduates end up in primary care..and as you said, the specialists cant find jobs..i wouldnt use canada as a model system we should strive for..although media loves to compare US vs. Canda, once again tuition in Canada is pennies when compared to US tuition
I'm not saying we should strive for the Canadian system. The culture of the two countries are not the same and it's hard to imagine Americans appropriating the whole system. I'm saying the idea that Canadian physicians are underpaid is ludicrous, even though the government is essentially setting prices.
EDIT: Actually this article makes it seem like the tax rates for physicians because of physician-specific tax laws is the same or less as it would be for US physicians: http://www.theglobeandmail.com/life...uch-are-canadian-doctors-paid/article7750697/ Let's not forget they work fewer hours--because in every other country the doctors work fewer hours.
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sure, so what? You don't have to pay for your kids college/private school (since public schools are very good), you don't have to pay for health insurance, you don't have much loans to pay back, and COA in Canadian cities is comparable to major US cities. Overall, you probably bring in more money in Canada than in the US, while working less and without having to deal with the craziness that comes with our system (eg insurance not paying for procedures).
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Let's be honest here. If PCP were paid 300k-400k for 40 hrs/week, FM/IM would be the most competitive residencies to get into. Specialties are so competitive because they pay more for less work.
Also despite these high salaries, midlevel creep is not the serious problem that it is here. There isn't this same kind of push to have midlevels practice independently, so astonishingly, those 300k family medicine jobs appear safe.
ROAD is for lifestyle specialties. Ortho is not a lifestyle specialty.
Funny that it's better to be a doc in Canada than America for the average doctor (excluding our top 10% of earners).
The 50th percentile doc in Canada is thriving in Canada and sinking in America.
The 50th percentile doc in Canada is thriving in Canada and sinking in America.
Anastomoses is a girl.
I'm sure you're right, but every Canadian physician I've spoken with has, with great tact, painted a bleak picture of medical practice there, and the Canadians in my class are all sitting the Step. They claim it's a backup since it's easier to get into the States than Canada as an IMG, which is certainly true, but they're spending far more time in preparing for the Step than for their own boards.
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That's because everyone has the "grass is greener" mentality. Canadians don't understand our system and they would burn out extremely fast, both due to the high workload and due to the culture of American healthcare.
I agree with your point about the grass being greener, but I think the rest is hubris. Paperwork, slave-driving, and profit margins are hardly unique to the Land of the Free and the Brave. Don't mind me, I'm contrary during blocks. I'm sure you all know what you're talking about. I only have anecdotal evidence.
I think you're both right. The Canadian system probably has all of our same problems. The difference here is they aren't working nearly as much (probably < 50 hrs week), they don't pay for school, and Family docs earn 300-400k compared to 180k. You have to admit that earning 300-400k without accruing any debt as a general practitioner is nice. Our average family doc has 200k in debt and earns less than or around 200k per year.
You know this how, exactly? Read some stuff on the internet and think you know everything? Hurts your feels somehow? Are you saying they just made those numbers up? For what it's worth, those numbers are right in line with MGMA, not "way higher" as you claim. 75% percentile optho w/retina is $775k. Cards non-invasive is $540k. Invasive is only 100k or so more.
Why are they in-line with the MGMA data? Because if you read the article, they are using the MGMA data for those numbers. Way to go.
Why are you being so defensive towards him?
He takes issue with the fact that you clearly framed those numbers as what the "average ophtho" is making per year:
...The point is that 75th percentile RETINA salaries are far from the "average ophtho's" reality.
I'm sure you appreciate that fact.
The figure they give for 50th% general ophtho (Ophthalmology: $628,260) is the 90th% on MGMA...90th% in any specialty makes high figures.
It is really nothing worth arguing over today -- as in 6-10 years, when we practice, much will have changed across all fields. Relax and enjoy the weekend.
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Yeah, I'm not even sure if those are 2013 MGMA #'s.
Anyway, yeah - this is about 10 years from now.
Good pro tip on the weekend!
As an IMG? thats probably why
Canadian students who train in Canada or the US MD schools don't take boards before their match. Only students who train in foreign schools or US DO schools have to take a Step 1 like exam before interview season.
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Not in med school yet (hopefully next year) , but I am Canadian. We don't pay for school? What? I know it's less than what you guys pay but my "state" med school tuition is 22 000...
Also, the less than 50 hours a week is a bit off. There's a bunch of documents somewhere that details hours worked by specialty, (Google Canadian medical specialty profiles, or something). It was under 50 for very few specialties.
Other than that though, your points are all valid. Doctors have it pretty good up here.
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Wait, but that's not possible. A man once told me that on the internet, all "women" are men, all "men" are kids, and all "kids" are undercover cops.
Average ophtho salary is $350-400k. Average starting is $150-200k. They say it takes 3-5 years to build up your practice and that point are at the average. Retina makes a lot more and averages like $600k, but they also have a 2-year fellowship and generally do not have the typical ophtho lifestyle because they have extremely busy practices and most ocular emergencies are retinal in nature. Oculoplastics also makes bank compared to the rest of ophtho but those docs also work their butt off. The ones who can potentially make a ridiculous amount while working easy hours are the refractive surgeons. Unfortunately, that area is very saturated and only a few actually dominate that market. The typical ophtho working 4.5-5 days per week with little call and making $350-400k sounds great to me, though. Especially considering all the awesome things you do, including a great mix of surgery and clinic (using cool instruments).
Ophtho continues to get more competitive unfortunately. The average Step 1 score typically went up 1 point each year but increased by 3 this year to 242. Match rate last year was 78% and this year was 75%. The Step 1 national average didn't even increase much between this year's 4th year class and the one before it but ophtho still went up 3. There was a 3 point increase in the average Step 1 with the current M3s, so I'd expect it to jump another 3+ next year.
Ophtho continues to get more competitive unfortunately. The average Step 1 score typically went up 1 point each year but increased by 3 this year to 242. Match rate last year was 78% and this year was 75%. The Step 1 national average didn't even increase much between this year's 4th year class and the one before it but ophtho still went up 3. There was a 3 point increase in the average Step 1 with the current M3s, so I'd expect it to jump another 3+ next year.
No girls on the internet, bro.
From 2010 MGMA:
75% general optho: 456k
75% corneal optho: 542k
75% retinal optho: 772k
75% peds optho: 354k
Clearly the article did not specify "retina" even thought that is the data it is using. However, 456k is nothing to scoff at, and I certainly wouldn't call it "far from the average optho's reality."
When somebody comes along and says that the MGMA averages are sky high and nobody makes that much, well, you have to remember that this is an internet forum and a single voice can reach millions. Also, 50% of physicians are going to see that data and be pissed because they are making less than average. Of course those in the bottom half are going to take issue with it. Nobody likes to believe they are making less than their peers. Tough, but somebody's got to be at the bottom. 25%tile general optho is 250k. 75% of opthos are making more than that.
Optho is one of the few ultra-competitive specialties where it's still possible to get in with lower step 1 scores (rad onc being the other). Derm, ortho, plastics, anything less than 230 and you can't get any interviews without connections. 220-230 step 1 is doable for optho. At least it was a few years ago.
22k a year or 22k overall?
Either way, that's like 1/5th - 1/10th of what we pay in the US.
I'm sure he was exaggerating when he said Canadians don't pay for school..and I believe your numbers..but the tuition at McGill (a world-renowned university) is $6,728 for residents of the province. Yes it's higher for non-residents and there are some Canadian schools whose tuition is in the low $20,000s but still....
22 per year. And come on, 110 000/ year, just for tuition? AAMC says the most expensive last year was Tufts at 60 000.
I never said it wasn't cheaper, but it's not pennies.
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Quebec is a special case. It's like Texas (tuition wise)
McGill is the only school non French speaking people can even apply to, and they take ~5 non residents per year.
Also, apparently, McGill is riding on the coat tails of its reputation, and the med school isn't very good. But that's a different story.
The cheapest realistic example is probably Calgary, at 15 000.
I know he was exaggerating, but just saying.
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Really? How so? I'm not doubting you because I haven't investigated this field but everyone at our school that goes into rad onc have step 1's >260, have written the equivalent of a textbook in rad onc, do 50 aways, and worry about even getting interviews.
Again, not doubting you but the stigma at our school is that rad onc is super competitive.
it's about the whole package. one of the rad onc resident didn't get a stellar >260 score, but he stood out b/c he had a few patents. step score isn't the only factor
nono, i was extrapolating out to 4 years. In the US, it's basically a 200-250k expenditure because tuition isn't the only thing medical students need to borrow. We also need to borrow for cost of living, so tack on another 15-20k/year.
Us too, ahah. We may have universal healthcare, but not housing and groceries. 😉
I figure it's going to cost me about about 200 000 for four years.
Anyways, your tuition is crazy high, that sucks. Sorry for the derail!
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Still, the quoted poster said lower step 1 scores. Did they have <235? Again, I don't know about rad onc but I do know of 2 MD/PhD AMG students that both had patents and both had average step 1 scores (220-230); one didn't match in derm and one matched at a very subpar program in radiology. Both had very pleasant personalities and were well-liked in the student body, can't imagine they botched their interviews too bad. Is there something special about rad onc and patents that would make their situation different had they chosen to pursue that field?
Again, still curious at the quoted poster's statement that one can get into rad onc with a lower step 1 score.
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Research is king in rad-onc. Programs prefer applicants with >240, and most applicants do have >240, but an applicant with 215-225 step 1 can still get enough interviews to match if he has a solid c.v. and LORs, whereas that applicant would get auto-screened in a lot of other fields. In general it is my impression that most programs would prefer a 225 step 1 applicant with a PhD and 3-4 first author rad-onc pubs vs. a 265 step 1 applicant with zero pubs who decided on rad-onc last minute.
i mean yea its not the only factor. connection matters too. where they applied matters.
Cool deal, thanks. I was just curious.
I'm applying to rad onc for next weeks match (fingers crossed!). There is definitely a possibility to go unmatched if you have sub-par Step scores and clinical grades as an MD/PhD. Some call it the "MD/PhD trap."
A large proportion of the radiation oncology residency programs in the US are very clinically oriented without much (if any) research opportunity. These programs look at applicants with a PhD and say "They want research. Not good fit for our program... no interview for you!" I have a PhD with two first author rad onc pubs and two other first author cancer pubs. My Step 1 score was in the 240s. I didn't get a single offer from any of these programs.
The radiation oncology residency programs that have ample research opportunity are typically at very prestigious institutions. Due to their prestige... they demand high Step 1 scores and good clinical grades (AOA preferred). These programs look at applicants with mediocre scores and say "They scores too low. Not good fit for our program... no interview for you!" I managed to get enough interviews at mid-tier institutions with a Step 1 score >240... but didn't get a single offer from "top-tier" radiation oncology programs.
So if you have a PhD and mediocre scores/grades... you could definitely have trouble matching in rad onc (or other competitive specialties for that matter). I bet the applicant with Step 1 260, AOA, no PhD but with a couple published abstracts or manuscripts in radiation oncology would get the most interview offers. Someone who has great scores but zero pubs might have trouble since they want to see that you have some genuine interest in radiation oncology and didn't decide at the last minute because we don't work weekends.
Students can definitely still match if they have low scores as long as they have taken other measures. Doing away rotations at institutions that are a good fit for you and busting your tail; getting great letters; taking that year off to do rad onc research; applying widely (i.e. everywhere); contacting the program coordinator to get your application looked at rather than being screened out; and of course... having connections.
A major irony of the field of radiation oncology is that despite the strong preference for applicants with research heavy backgrounds... the reality is that most of these applicants who become faculty will end up never doing biomedical research. There are actually very few physician-scientists in the field. An article published last year highlights the dearth of funding from the NIH that goes to support basic science research for radiation oncology departments:
http://www.ohsu.edu/xd/education/sc...d/NIH-funding-radonc_Steinberg_et_al_2013.pdf
Most faculty will still do the standard retrospective clinical research, but as you can see... the vast majority of NIH awards given to radiation oncology departments are concentrated at 5 institutions. So if you want to be a physician-scientist... you better be willing to move for the opportunity. Not everyone is willing or able to move to just anywhere... so for them its "Get in the clinic and make us some money!"
CAVEAT: I am still just a med student and not faculty... so maybe not the best source on this. But this has been my experience.
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