Salary

Started by yalla22
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yalla22

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I'm wondering what salary ranges are for psychiatrists when they first graduate from residency and over time w greater experience. I know this varies depending on inpatient, outpatient and location but I think it would be informative to go through the general ranges depending on these factors. I'm interested in psych but I really don't know much about it's financial compensation. Given the hundreds and thousands of dollars of loans I have, I definetly want to make an informed decision about specialty choice. Any ideas or advice?
 
I'm wondering what salary ranges are for psychiatrists when they first graduate from residency and over time w greater experience. I know this varies depending on inpatient, outpatient and location but I think it would be informative to go through the general ranges depending on these factors. I'm interested in psych but I really don't know much about it's financial compensation. Given the hundreds and thousands of dollars of loans I have, I definetly want to make an informed decision about specialty choice. Any ideas or advice?

We do well--usually better than primary care in a given area, not as well as interventional medical specialities, not as well as surgical types. However, if you're not doing a field you enjoy, you will be in the wrong field--regardless of your compensation plan. So...choose wisely.
 
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the variations between psych subspecialties are not large enough to justify a decision based on financial concerns, really. just pick a field you like. if you like it enough to work hard at it and become immensely successful, then you can be a biedermann (child), or a resnick (forensic), or a brizendine (general). untold riches and glory await.
 
the variations between psych subspecialties are not large enough to justify a decision based on financial concerns, really. just pick a field you like. if you like it enough to work hard at it and become immensely successful, then you can be a biedermann (child), or a resnick (forensic), or a brizendine (general). untold riches and glory await.

another possibility is you can rent yourself out for pharm talks. at several thousand a pop, youll be on your way to trimming the debt in no time.
 
Well the reason I ask is I have varied things. I do think I like psychiatry a lot. But I also know that if I am going to struggle to pay back my ridiculous amount of loans, can't afford kids and a basic life for a while after I graduate, no matter how much I "like" my work, I may not be happy. I know someone in internal medicine who is making about $140k a year, she loves her work, but is really exhausted/tired/stressed by the hours, demands and mostly poor compensation. I want to do something I like but I also want to raise a family and be able to meet their needs. Between my husband and I, we will have around 500k in loans (yes ridiculous I know) and so if I find that I love psychiatry but there is something that I like less but pays much more, then maybe I will just have to sacrifice what I love...I don't know...just thinking out loud. Any thoughts?
 
True or false: pharma rep + academic psychiatrist don't mix?

It is exceedingly rare to find an academic psychiatrist/researcher who does not have ties to industry. Especially the prominent ones.

-AT.
 
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A few things I learned being an attending for one year, going back to training (in fellowship) and now considering my job prospects after June.

1) Several jobs will offer to pay off a large portion of your debt. Many of these jobs are with the government--e.g. the state government, federal or the military.

2) Follow OPD's advice. If you don't like your job, the money won't matter much.

3) Going hand in hand with #2--> Consider that a typical psychiatric job differs from residency in this very important aspect: You have to do the same thing everyday. This is not like residency where if you don't like a rotation, you'll be off of it in a few weeks to months.

4) Pay varies with the locality. It's typical supply and demand. Several areas are in much more need of psychiatrists than others.
 
Between my husband and I, we will have around 500k in loans

My Mrs. and I (both in med school) will be close to 550k with her undergraduate debt!

So, I understand your concern. I was about to take an NHSC scholarship before someone gave me the best advice...

Make an appointment with your financial aid office! You'll find out things like: (a) you're not the only one, (b) plenty of jobs offer loan forgiveness, and whether or not you get that as part of your benefits, (c) most couples pay off loans of that size in 10-12 years and still live well. The counselor we met with gave us data from actual couples who had our level of debt and showed that they were living fine. The couple's specialties: one was a pediatrician, the other was an internist.

My wife and I think of it like this: a decade after we finish residency, we'll get a 20-25% pay raise

I find that I love psychiatry but there is something that I like less but pays much more, then maybe I will just have to sacrifice what I love

Life is too short and med school too long to do something you dislike. Rethink your strategy!
 
But I also know that if I am going to struggle to pay back my ridiculous amount of loans, can't afford kids and a basic life for a while after I graduate, no matter how much I "like" my work, I may not be happy.

Sorry for the double post, but I forgot to mention this:

There is a limit as to how much of your loans you're required to pay back every year. It's something like 20% of your income, but you should look that up. Anyway, the limit (whatever it is) is a function of your income, so regardless of how much you owe, you will never be required to make loan repayments that total more than 20% of your yearly income.

So, I think your fears of not being able to afford children or a 'basic life' is unfounded. Let's give a worst case scenario where you pick the lowest paying specialty and job: your both pick peds and work charity care for the NHSC and earn a combined $160k. Every two every years the NHSC would forgive $100k of your combined debt. You'll be paying $32k for loan repayment for a number of years, but you'll have about $130k before taxes for your household. That is more than enough to raise a family.

Good luck
 
does anyone know how much the nhsc sites usually give as an annual salary? just bc i keep hearing it mentioned, but if they pay $100,000 a year, it doesnt sound like their $25,000 yearly loan repayment would do much help...
 
True or false: pharma rep + academic psychiatrist don't mix?
More and more true. Also Psychiatric "research" and academia are more and more intertwined (for the paid studies) and separated (as independent researchers have difficulty getting drug studies off the ground).

I see several reps, they bring samples and coupons (and wisely not anything else), and don't bother me with "information" of practices that I am already doing.

But the words of my medschool pharm teacher still ring in my ears:
"Drug reps bring you samples and nice stuff. But if you ever change anything you do for a patient, based on what they tell you, you will rot in Hell forever.":laugh:
 
...and so if I find that I love psychiatry but there is something that I like less but pays much more, then maybe I will just have to sacrifice what I love...I don't know...just thinking out loud. Any thoughts?
You will be sorry forever. More and more sorry every year until you become a bitter old geezer who hate your patients and therefore they leave you anyway.

I can't stress enough: Go with what you like. Frankly, physicians don't go broke, we live comfortably. But if it all about the money, you better go into banking instead. That will be as exciting as working in a medical field you don't really like.
 
Whenever I hear conversations like this among my classmates I really can't help but be dumbstruck. I have a single mom who works as a librarian making around $50,000/year. With that salary she supported 4 children, in California, and I never felt all that poor and never went hungry. Even if you only make $140,000/year, and you have $250,000 in loans (or more, in my case), you are still going to have plenty of money to afford kids and have a basic life. 🙄
 
Whenever I hear conversations like this among my classmates I really can't help but be dumbstruck. I have a single mom who works as a librarian making around $50,000/year. With that salary she supported 4 children, in California, and I never felt all that poor and never went hungry. Even if you only make $140,000/year, and you have $250,000 in loans (or more, in my case), you are still going to have plenty of money to afford kids and have a basic life. 🙄
Agreed. But keep in mind that most folks who get as far as medical school do not come from working class families. A large majority come from upper-middle class or above. That can give you the viewpoint of $140K being "nothing."

Also, folks tend not to do the math. A $140K salary with a $250K loan works out to be a lot more money than a $100K salary and no loan. Would anyone cry in their cheerio's about how a $100K salary is "no money"? Maybe...
 
Ahh the cost of a MD today versus back when it was a mere 20k total
 
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Also, folks tend not to do the math. A $140K salary with a $250K loan works out to be a lot more money than a $100K salary and no loan. Would anyone cry in their cheerio's about how a $100K salary is "no money"? Maybe...

I would say it's a little closer to a wash (i.e. $100k with no loan nets you just about the same as $150K with $250k in loans)

$250,000 6.8%
Loan Term......Mo. Pymt
10 years........$2877
20 years........$1908

Gross.........Net.........Mo. Net.....Mo. Net minus Student Loans
$100,000....$64,000....$5,333......$5,333
$150,000....$94,000....$7,833......$4,956 to $5,925 (10 to 20 years)

But, as I've come to realize, it's still doable on $100,000/year - you'll just be living much more of an upper-middle class lifestyle than a "wealthy" life-style (e.g. maybe a nice new Camry instead of a Lexus).

Calculators used:
http://www.finaid.org/calculators/loanpayments.phtml
https://secure.gtmassociates.com/calculator.aspx
 
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I would say it's a little closer to a wash
Maybe I'm reading it wrong, but with your numbers, after 10 or 20 years of somewhat comparable salaries, the loan is paid off and the $150K is bringing in $50K/year the other isn't. For another 10 or 30 years. I'm not sure how that's a wash. Then again, I'm no accountant.
But, as I've come to realize, it's still doable on $100,000/year - you'll just be living much more of an upper-middle class lifestyle than a "wealthy" life-style (e.g. maybe a nice new Camry instead of a Lexus).
Agreed. Becoming wealthy via psychiatry probably isn't the wisest strategy. But if folks are worried about scraping by, the issue might be more with what they consider scraping than the actual number of zeroes on their paycheck.
 
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I've heard from psychiatrists, read, researched
A. A salaried psychiatrist, somewhere between 150-200
B. Private practice, somewhere between 200-400 (200 for a simpler, mostly outpatient practice....400 if you do high volume, inpatient plus out patient high patient volume)
 
isn't there some pending legislation that's supposed to boost mental health compensation to be more equivalent to "traditional" medical compensation? positive effect on future psych salaries?
 
isn't there some pending legislation that's supposed to boost mental health compensation to be more equivalent to "traditional" medical compensation? positive effect on future psych salaries?

Parity was passed in the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008. It mandates that if U.S. health insurance companies provide coverage for mental health and substance abuse, the coverage must be equal for conditions such as psychological disorders, alcoholism, and drug addiction.

It's only going to apply if people actually a) have insurance, and b) it covers these diagnoses; and only mandates that it pay on an equal basis to other medical conditions. So if you have crappy insurance, it will now be crappy for mental health care as well. Never mind that it's fairly difficult for people with chronic mental illness to get and keep insurance--unless they live in a fairly generous state that is not having major budget issues right now...

So bottom line--parity is a basic social justice issue that was necessary to have passed into law, but is going to have very little direct effect on our salaries under the current systems of health care payment in this country.
 
Parity was passed in the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008. It mandates that if U.S. health insurance companies provide coverage for mental health and substance abuse, the coverage must be equal for conditions such as psychological disorders, alcoholism, and drug addiction.
Is there any concern for an unintended consequence of more insurance companies just deciding to not offer coverage for mental health?
 
Unless a private practice psychiatrist has subspecialty certification in a lucrative field such as sleep medicine, the typical income range would be $185,000-255,000.

Yes, thank you for the clarification.

The 400K (and you never know for sure) was from someone seeing around 40-50 patients a day, with a LPC and Psychologist working for him also. That also included maybe 5-10 hospitalized patients per day. Personally, after seeing his practice, I wouldn't like to work that way. But he said he liked it.
 
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Maybe I'm reading it wrong, but with your numbers, after 10 or 20 years of somewhat comparable salaries, the loan is paid off and the $150K is bringing in $50K/year the other isn't. For another 10 or 30 years. I'm not sure how that's a wash. Then again, I'm no accountant.

You are quite right. Over the long run, the $150K gives you far more (~1 million if you work another 20 years). I was just focusing on the initial 10 years in practice post-residency, where about 1/3 of your income is going to loans payments.
 
You are quite right. Over the long run, the $150K gives you far more (~1 million if you work another 20 years). I was just focusing on the initial 10 years in practice post-residency, where about 1/3 of your income is going to loans payments.
Ah, gotcha. You're right. Trying to pay off a big fat loan quickly, there's definitely going to be a delayed gratification.

It's no fun righting out checks to your alma mater for a lot of years, but it would be hard to come up with too many better return-on-investments than medical school.
 
I just wanted to note that under [FONT=arial, helvetica]the College Cost Reduction and Access Act of 2007, student loan debt is discharged after 10 years of employment in a "public service" occupation. I haven't dug too far into the specifics of this legislation, but there are several scenarios in which it could benefit psychiatrists.

If, for example, you completed both your residency and first 6 years of post-residency practice at a non-profit institution, you would certainly qualify for loan forgiveness. That means, if you used an income-based repayment (IBR) plan and made loan payments during residency, your loans would be forgiven 6 years after residency. IBR requires you to pay only 15% of your annual income that exceeds the poverty level ((Adjusted Gross Income - poverty level) * .15). Thus, someone earning $50,000 as a resident would only be required to repay about $325/month. The payment amount under IBR is capped at the amount you would pay under a standard 10-year repayment. So, when you take that post-residency position, you'd be paying no more than $3,000 on a $250k loan for the remaining 6 years until the loan is forgiven. If you run the numbers, you'd end up only repaying about $230k of the $250k loan over a 10-year period. If you calculate the amount of interest you would otherwise pay over these 10 years, there is the potential for savings of over $250k under this program. This is an unbelievable deal if you can take advantage of it. Just something to think about.
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I just wanted to note that under [FONT=arial, helvetica]the College Cost Reduction and Access Act of 2007, student loan debt is discharged after 10 years of employment in a "public service" occupation. I haven't dug too far into the specifics of this legislation, but there are several scenarios in which it could benefit psychiatrists.

If, for example, you completed both your residency and first 6 years of post-residency practice at a non-profit institution, you would certainly qualify for loan forgiveness. That means, if you used an income-based repayment (IBR) plan and made loan payments during residency, your loans would be forgiven 6 years after residency. IBR requires you to pay only 15% of your annual income that exceeds the poverty level ((Adjusted Gross Income - poverty level) * .15). Thus, someone earning $50,000 as a resident would only be required to repay about $325/month. The payment amount under IBR is capped at the amount you would pay under a standard 10-year repayment. So, when you take that post-residency position, you'd be paying no more than $3,000 on a $250k loan for the remaining 6 years until the loan is forgiven. If you run the numbers, you'd end up only repaying about $230k of the $250k loan over a 10-year period. If you calculate the amount of interest you would otherwise pay over these 10 years, there is the potential for savings of over $250k under this program. This is an unbelievable deal if you can take advantage of it. Just something to think about.
.

Would you take a "pay cut" by working in this setting though? Or does it suck to work in these settings? I mean, how attractive is this really...almost sounds too good to be true.
 
What does sleep get up to??

Highly variable.
As a psychiatrist, it can be tough. Academia pays little but pays more if you do sleep (also easier to become professor etc).

In the community the bigger towns and cities are taken by the pulmonologists and neurologists. I am not saying that you couldn't find a bunch of internists/FPs or psychiatrists and get them to hire you but its not that easy.

However, you could make 500,000 if you have your own lab, are 100 percent sleep and stay busy. There are sleep docs making much more with multiple labs, DME etc. Thats more a business model than just the sleep practice and you don't have to be a sleep physician to have the DME or sleep lab.
 
Highly variable.
As a psychiatrist, it can be tough. Academia pays little but pays more if you do sleep (also easier to become professor etc).

In the community the bigger towns and cities are taken by the pulmonologists and neurologists. I am not saying that you couldn't find a bunch of internists/FPs or psychiatrists and get them to hire you but its not that easy.

However, you could make 500,000 if you have your own lab, are 100 percent sleep and stay busy. There are sleep docs making much more with multiple labs, DME etc. Thats more a business model than just the sleep practice and you don't have to be a sleep physician to have the DME or sleep lab.

what's "DME"?
 
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I just wanted to note that under [FONT=arial, helvetica]the College Cost Reduction and Access Act of 2007, student loan debt is discharged after 10 years of employment in a "public service" occupation. I haven't dug too far into the specifics of this legislation, but there are several scenarios in which it could benefit psychiatrists.

If, for example, you completed both your residency and first 6 years of post-residency practice at a non-profit institution, you would certainly qualify for loan forgiveness. That means, if you used an income-based repayment (IBR) plan and made loan payments during residency, your loans would be forgiven 6 years after residency. IBR requires you to pay only 15% of your annual income that exceeds the poverty level ((Adjusted Gross Income - poverty level) * .15). Thus, someone earning $50,000 as a resident would only be required to repay about $325/month. The payment amount under IBR is capped at the amount you would pay under a standard 10-year repayment. So, when you take that post-residency position, you'd be paying no more than $3,000 on a $250k loan for the remaining 6 years until the loan is forgiven. If you run the numbers, you'd end up only repaying about $230k of the $250k loan over a 10-year period. If you calculate the amount of interest you would otherwise pay over these 10 years, there is the potential for savings of over $250k under this program. This is an unbelievable deal if you can take advantage of it. Just something to think about.
.

From what I can tell the disadvantages to this program are:
#1 - it might not be around in 10 years, so if you're barely paying off your interest with those minimal payments and then the program disappears, you're still stuck with a lot of debt that you might have made more payments on otherwise.
#2 - Whatever amount is forgiven after 10 years is considered income, and you are taxed on that amount, so you have to prepare in advance to pay a large lump sum when your 10 years are up.

I don't know a ton about the program so I'm not sure if there is some kind of safety net for #1 (ie, if you start the program you are guaranteed that they will pay off your loans in 10 years even if the program is eliminated at some point). It still seems like a great deal though, if you can appropriately save for #2 (and especially if you are planning on doing a fellowship or having an academic career).
 
Would you take a "pay cut" by working in this setting though? Or does it suck to work in these settings? I mean, how attractive is this really...almost sounds too good to be true.

The settings to which this loan forgiveness program would apply are pretty varied. I don't know the exact number, but I would assume something like 75% of hospitals in the US are either non-profit or government run. Physician salaries at such institutions tend to be competitive with other employers in the area. In addition, most, if not all, academic positions would qualify for the program; however, as I'm sure you know, academic positions tend to be lower paying and are usually chosen for lifestyle/prestige/research interest reasons.

I am just making people aware of the program to assuage some of the concerns expressed on this thread regarding relatively low salaries in psychiatry and large debt burdens.
 
From what I can tell the disadvantages to this program are:
#1 - it might not be around in 10 years, so if you're barely paying off your interest with those minimal payments and then the program disappears, you're still stuck with a lot of debt that you might have made more payments on otherwise.
#2 - Whatever amount is forgiven after 10 years is considered income, and you are taxed on that amount, so you have to prepare in advance to pay a large lump sum when your 10 years are up.

I don't know a ton about the program so I'm not sure if there is some kind of safety net for #1 (ie, if you start the program you are guaranteed that they will pay off your loans in 10 years even if the program is eliminated at some point). It still seems like a great deal though, if you can appropriately save for #2 (and especially if you are planning on doing a fellowship or having an academic career).

#1 is a valid point. However, I would anticipate some sort of phase-out rather than an abrupt ending of this program if it came to that. Civil servants make up a significant portion of those benefiting from this program and they are not a population that Congress is particularly fond of jerking around. I would also mention that a lot of people plan to take a hardship deferral during residency anyway, so paying a little each month in an income-based repayment would actually help them keep their principal balance lower.

I don't believe #2 is accurate. Typically, loan forgiveness programs that require a multiple-year commitment prior to forgiveness are not taxable. The theory being 1) that the "income" was actually earned over several years and would properly be claimed only by amending prior year returns, and 2) these forgiveness programs are established to advance some public policy concern and it is not in the public's interest to "punish" people with a large tax burden in the year of forgiveness.
 
The settings to which this loan forgiveness program would apply are pretty varied. I don't know the exact number, but I would assume something like 75% of hospitals in the US are either non-profit or government run. Physician salaries at such institutions tend to be competitive with other employers in the area. In addition, most, if not all, academic positions would qualify for the program; however, as I'm sure you know, academic positions tend to be lower paying and are usually chosen for lifestyle/prestige/research interest reasons.

I am just making people aware of the program to assuage some of the concerns expressed on this thread regarding relatively low salaries in psychiatry and large debt burdens.

Good to know. I'll have to keep this in mind...
 
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