Starting Salaries

[robberbaron]

Hey all,

Did anyone else hear widely varying accounts of psych starting salaries on the interview trail? At some of the more competitive programs I interviewed at (U.S. News top 10) I was told by PDs and faculty that some of the grads were being offered "absurd" sums of money for private practice in the NE and on the West Coast (i.e.250-300K+). However at strong, though less-renowned programs, I heard about starting salaries that were only around 100K. Are there any current residents or PDs out there that can provide a bit of insight into the role which residency prestige plays in starting compensation?

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[Doc Samson]

None whatsoever. Residencies with academic prestige are useful only for landing jobs with academic prestige - which usually pay like @#$%.

 

[maranatha]

None whatsoever. Residencies with academic prestige are useful only for landing jobs with academic prestige - which usually pay like @#$%.

Some actually have good training, too. Doc Samson, aren't you at a prestigious academic program ?

 

[Doc Samson]

Some actually have good training, too. Doc Samson, aren't you at a prestigious academic program ?

Yup, but I've always known that I want to stay in academia... if I wanted to make money I'd be doing a forensics fellowship instead of a consult fellowship.

 

[sasevan]

Yup, but I've always known that I want to stay in academia... if I wanted to make money I'd be doing a forensics fellowship instead of a consult fellowship.

I'm undecided between forensics and c & l (psychosomatic); what do you anticipate will be the difference in salary and benefits between these two sub-specialties?

 

[jjbmsiv]

I'm pretty curious about starting c&l and emergency psych salaries, too. Preferably in the northeast, but, any info helps!

 

[Chianti]

I know a consultation-liasion psychiatrist who did not complete a consultation-liasion fellowship but is working as a C&L psychiatrist fresh out of residency in north New Jersey (right across from Staten Island). He works 8 AM - 4 PM M-F and his salary is $210,000. Not bad. Did his residency at a very "average" program.

 

[Doc Samson]

CL and forensics both have the opportunity to make money, but in very different venues.

CL is almost always a salaried position. Many insurances reimburse very little or nothing at all for psychiatric consultation on the medically ill, so the "value" to the hospital comes from decreasing length of stay. Some private hospitals may be willing to pay in the $200k plus range for a CL psychiatrist, but this is extremely unusual, and would likely entail a full-time commitment (i.e. no private practice on the side). In academia, CL psychiatrists are paid the same as any other faculty of similar rank, which in Boston means somewhere in the $110k-$130k range starting out of training.

Forensics allows you the opportunity to "bill like a lawyer", i.e. billing for every hour spent working on the case, not just the face time with the evaluee (they're not your patient). The financial scale works in reverse to that of any other subspecialty (like CL where the big money is in the private world), since to really be considered an expert, and earn the $500+ hourly fees, you pretty much have to be an academic with lots of publishing. Lawyers want the fanciest looking CV to present to the jury, so if you went to brand X residency, are now in private practice, and haven't really published, you're going to be less attractive that Dr. Ivy residency - Ivy professor- mores than 200 chapters and articles.

 

[psyjake]

CL and forensics both have the opportunity to make money, but in very different venues.

Doc Samson,

Thanks for your input on this. While I'm just at the point where I'm waiting on my match results for PGY-I, I'm trying to draw up long term plans on where I want to go with my education and training.

My top choice program (which I hope I get) has forensics and child fellowships up and running with a C-L program in the wings (should be ready by the time I'm eligible to apply). Also addiction and geriatrics programs are in the long term plan of the program.

Right now I'm leaning toward C-L simply because of my particular interests but I suppose some day I'll need to consider more seriously the practical aspects of it as well.

Thanks again. I hope to hear more about your experience.

 

[sasevan]

CL and forensics both have the opportunity to make money, but in very different venues.
QUOTE]

Thank you; that was a good explanation.....argh...why do my professional passions pay so little...lol
I'm just starting out so I have a long way to go and may well change my mind but my passion right now is CL; I see it as an ideal way to deepen my medical knowledge while being a psychiatrist.
Has it been your experience that my assumption is accurate or are there other more financially rewarding avenues to get the same results (deepened med knowledege)?

 

[Doc Samson]

CL is the most medically involved of all subspecialties, and is pretty much the only one that allows access to the general hospital setting. The only limit on earning potential is if you stay in academia... contracting with private hospitals can bring pretty good money.

 

[maranatha]

or are there other more financially rewarding avenues to get the same results (deepened med knowledege)?

The Geri Psychiatrists that I know have to keep up on their medicine and use that knowledge all the time. Of course, I'm not sure the pay is much better then C&L...

 

[sasevan]

Thanks all for the info.

 

[whopper]

None whatsoever. Residencies with academic prestige are useful only for landing jobs with academic prestige - which usually pay like @#$%.

I've heard the same about academia from the attendings at my own program.

I have though heard from the PGY IVs that there has been some good variability with general clinical psyche, but the depending factor seemed to be the geographic location and their demand for psychiatrists. One guy told me there was a position to be a psychiatrist in a hospital system in a southern state that was paying > $200,000. However he also told me that there were no psychiatrists in the area, and if you took the job, you were going to be expected to work very hard hours to fill that gap.

I have gotten some job offers in other areas where there is a severe shortage of psychiatrists. They all offer great pay, but when I looked at the schedule I could tell they weren't going to be easy...e.g. being on call Q3!

 

[Solideliquid]

...but it's home call, right? (famous last words?) lol

 

[outofhere]

Here is a new thought: these numbers that PDs quote are essentially meaningless. Hear me out. It is difficult to compare benefit packages: your actual salary, health benefit (for you, or anyone you're related to), disability, retirement, how many vacation days, sick days...etc, all these are factors. Say, if you get retirement, is it a pension plan? Or is it a 401(K)? And how do they calculate the pension? Is it the average of your annual salary over your entire career, or the last five years of your career? These numbers can VARY SO VERY MUCH! For instance, at Kaiser (since there is a thread about that at the moment) they offer adult psychiatrists perhaps about $180,000 annually, give or take, depending how difficult it is to recruit someone...etc. They offer health insurance for the entire family for free, for life (or something like that) and even parents (which may be worth a LOT to you if your parents have no insurance other than MediCare), they also have both 401(K) and a pension plan. Some say, that these benefits actually amount to another 30% in value, in addition to the annual salary. So, actually, this psychiatrists makes $240,000. However, even this $240,000 isn't hard and fast for everyone: you have to factor in your current age: no sense in counting on being there to collect your pension if you're 30 y/o and may very well want to do private practice in your 40's. Whereas, someone in private practice may make $300,000 annually in gross income, but then you factor in health insurance, disability, vacation time, sick time, the emotional toll of always covering for your patients, the pain of finding someone to cover when you're in Europe for vacation...blah, blah, blah, maybe the net worth of the Kaiser psychiatrist is more.
All in all, too many factors, don't even both asking. Just know that if you're a good psychiatrist, you can make a comfortable living. Then again, let me not get started the WIDE variation of 'comfortable living.'