Salary

[nm825]

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I'm a new third-year. First rotation has been psychiatry, and I like it a ton. I never really seriously considered it before, but I've really loved this rotation so far.

My biggest concern is salary. I have a TON of loans, like a TON more than the average med student. I only got into one MD school, and it's one of the most expensive in America. I know if im making low 200s, it's going to be a lot harder paying off loans, so I have some concerns about psych. Can I make 250k in psych?

 

[F0nzie]

In most cases you will need to put in more than 40 hours to make 250k. Maybe around 50 hours. Watch out for mental burnout though. Procedural specialties like anesthesia are great for putting in long hours and you won't have any problems making 400-500k. In psych you will need to be very creative or willing to eat massive amounts of s*** to make that much 🙂


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[hamstergang]

Can I make 250k in psych?

Location can make a huge difference in the answer to this.

 

[TexasPhysician]

If you are flexible in any of location, call, or hours, finding 250k jobs are easy.

 

[J ROD]

Salary seems to be increasing overall it appears to me. I know all those that graduated my program got offers > 250K. Now, if you want < 40 hr/wk, no call, no weekends.......expect to make no money. Got to work some of those times. Can also do Telepsych on the side to make some extra cash.

 

[Shikima]

I see 275k for 4-5 day work weeks with no call and outpt only routinely along with the usual benefits including loan repayment.

 

[SteinUmStein]

Agreed, you don't necessarily have to work call/weekends/holidays to make a robust salary. Especially if you are willing to go to a rural/semi-rural area, or do work that is in higher demand (child, inpatient, corrections, higher census, shorter outpatient visits, etc). You can make well over 250k in high-demand areas with no call. In popular/urban areas you will likely make less than 250k without call/weekends/holidays or longer hours - at least for employed work with benefits. That's my observation at least, YMMV.

 

[J ROD]

Yeah, if you take less desirable places, jobs.......it pays more. As demand continues to grow, I expect salaries to continue to increase.

 

[splik]

You should choose a residency program where you will be able to moonlight early and there a good opportunities for well paying moonlighting gigs so you can start to pay off your loans. Some people will put on 60 hours or so working one or multiple jobs for a few years after residency, doing this you would be making 450k+/yr and can live frugally. Then once you are done with paying down your debt you can choose what kind of job you really want to have and the lifestyle that you want to live. It's increasingly common for med students to end up with a ton of debt, and it's totally doable to pay it off reasonably quickly if you are willing to put in the extra hours and live a modest lifestyle for a few more years. One good thing about psych is the hours are less intense at most programs during residency, so you would have more time to moonlight than in other specialties. some residency programs allow their residents to start seeing private practice patients in their PGY-4 year too which is unheard of in other specialties.

 

[swifteagle43]

I'm a new third-year. First rotation has been psychiatry, and I like it a ton. I never really seriously considered it before, but I've really loved this rotation so far.

My biggest concern is salary. I have a TON of loans, like a TON more than the average med student. I only got into one MD school, and it's one of the most expensive in America. I know if im making low 200s, it's going to be a lot harder paying off loans, so I have some concerns about psych. Can I make 250k in psych?

You will make money doing what you love. If you choose a field you love, you will be okay with working extra hours or weekends. 250k salary is very realistic salary in many parts of the country. However, MANY of the people I know make between $280k-$340k. Work is not work if you are having fun.

 

[surfguy84]

Salary seems to be increasing overall it appears to me. I know all those that graduated my program got offers > 250K. Now, if you want < 40 hr/wk, no call, no weekends.......expect to make no money. Got to work some of those times. Can also do Telepsych on the side to make some extra cash.

What is telepsych paying these days?

 

[TexasPhysician]

What is telepsych paying these days?

$120-170/hr based on how desperate they are or about $220k with benefits in my experience.

 

[surfguy84]

$120-170/hr based on how desperate they are or about $220k with benefits in my experience.

Thanks for your response. Could one realistically fill up 40-50 hours a week, every week, with telepsych, and assume an average of 140/hr? i.e. can you pull mid 300's doing strictly telepsych?

I like the idea of trying to get my own private practice going after residency but doing telepsych concurrently. Not sure how feasible this is in the real world.

 

[splik]

Telepsychiatry is basically regular psychiatry but done via video, so yes of course you can work 40-50 hours a week doing so (or more). Particularly if you are happy to work nights as many emergency rooms are now using telepsychiatry overnight. btw some people even offer telepsychiatry as part of their private practice. This is the latest turn in telepsych is to offer remote services to selected patients who'd rather not come into the office or live father away for most or all visits and there are several app services that do this (for example ginger.io and lyrahealth.com) etc. Lots of telepsych in corrections too.

 

[PistolPete]

Telepsychiatry is basically regular psychiatry but done via video, so yes of course you can work 40-50 hours a week doing so (or more). Particularly if you are happy to work nights as many emergency rooms are now using telepsychiatry overnight. btw some people even offer telepsychiatry as part of their private practice. This is the latest turn in telepsych is to offer remote services to selected patients who'd rather not come into the office or live father away for most or all visits and there are several app services that do this (for example ginger.io and lyrahealth.com) etc. Lots of telepsych in corrections too.

I don't think I'd want to see a private practice patient via telepsych who is at home due to the liability. They say they are suicidal and want to kill themselves and live alone? I'd be toast. That's why currently most telepsych is done at CMHC where there is a staff member available on-site.

 

[TexasPhysician]

I don't think I'd want to see a private practice patient via telepsych who is at home due to the liability. They say they are suicidal and want to kill themselves and live alone? I'd be toast. That's why currently most telepsych is done at CMHC where there is a staff member available on-site.

This is why we document current location at the beginning of each session.

 

[PistolPete]

This is why we document current location at the beginning of each session.

But even if you do that, I don't think that would reduce your liability that much in the event of a lawsuit, would it?

 

[TexasPhysician]

But even if you do that, I don't think that would reduce your liability that much in the event of a lawsuit, would it?

You can sue for anything in this country.

If the patient threatens suicide in your clinic and runs into traffic, will you throw yourself at him in the middle of the street and then hold him down until help arrives? What if he has a knife, will you wrestle him for it? A gun?

There is only so much that can reasonably be done to prevent self harm of others.

In high risk patients, I certainly push for live appointments though.

 

[PistolPete]

You can sue for anything in this country.

If the patient threatens suicide in your clinic and runs into traffic, will you throw yourself at him in the middle of the street and then hold him down until help arrives? What if he has a knife, will you wrestle him for it? A gun?

There is only so much that can reasonably be done to prevent self harm of others.

In high risk patients, I certainly push for live appointments though.

Yea, good point. So what % of your practice involves telepsych, if you don't mind sharing?

 

[Armadillos]

I don't think I'd want to see a private practice patient via telepsych who is at home due to the liability. They say they are suicidal and want to kill themselves and live alone? I'd be toast. That's why currently most telepsych is done at CMHC where there is a staff member available on-site.

Do you feel the same liability when you return a patients phone call?

That being said I also would not like doing telepsych for folks in their own home.

 

[PistolPete]

Do you feel the same liability when you return a patients phone call?

That being said I also would not like doing telepsych for folks in their own home.

I don't, but I suppose I shouldn't feel any differently. If they told me by phone they wanted to kill themselves, I'd call 911 and send the police to the home, but if the patient doesn't want to tell me where they are, then there's nothing I can do, and I'd just document that in the note and ask them to call 911 themselves or go to an ER.

 

[splik]

I don't think I'd want to see a private practice patient via telepsych who is at home due to the liability. They say they are suicidal and want to kill themselves and live alone? I'd be toast. That's why currently most telepsych is done at CMHC where there is a staff member available on-site.

what liability? most people in private practice screen out high risk/suicidal patients anyway. secondly, you are not responsible for what someone does in their own home. many will only offer telepsych appts after first doing an in-person intake, and others will require x number of in person visits. if someone needs hospitalization you call 911. Most people would not do telepsychiatry like this for medicaid patients, but cash paying or privately insured patients is a different story. For those who live where there are no psychiatrists, this may be the one way they can access timely care. You are 1000x more liable for a pt committing suicide on an inpt unit than in their own home.

 

[TexasPhysician]

Yea, good point. So what % of your practice involves telepsych, if you don't mind sharing?

It's small. Most prefer 100% in-person.

 

[PistolPete]

what liability? most people in private practice screen out high risk/suicidal patients anyway. secondly, you are not responsible for what someone does in their own home. many will only offer telepsych appts after first doing an in-person intake, and others will require x number of in person visits. if someone needs hospitalization you call 911. Most people would not do telepsychiatry like this for medicaid patients, but cash paying or privately insured patients is a different story. For those who live where there are no psychiatrists, this may be the one way they can access timely care. You are 1000x more liable for a pt committing suicide on an inpt unit than in their own home.

First seeing the patient in-person and requiring X number of visits is a great idea, didn't think about that!

 

[Waldeinsamkeit]

If you are flexible in any of location, call, or hours, finding 250k jobs are easy.

Is this true for psychiatrists their first year out of residency?

 

[Shikima]

Is this true for psychiatrists their first year out of residency?

Yes, they are there. Just need to look.

 

[Merovinge]

Is this true for psychiatrists their first year out of residency?

Trivial in the literal sense of the word if you are flexible on location

 

[Monocles]

OP, you should go to residency somewhere on the coasts with a good "brand name" and then do private practice afterwards. $250+ an hour cash only. You'll make your money back real quick.