Starting salary 180-190K Low?

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Thaitanium

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Talked with a friend of mine who told me starting salaries for a few private practice jobs he was at started at 180-190K (Southeast and Midwest). I wouldn’t say these were that desirable of locations. Is this a lowball starting salary guys?
 
For private practice that is 100% lowball especially if not East/West coast. That is what I would expect starting in academics in Midwest. Should be 225 minimum with 3 year max partner track with incremental raises each each until partner.
 
That is definitely low. I guess depending on the type of environment. But even small hospital employee pathologist jobs are higher than that.
 
Zero student loan debt? That 44% approximates what I believe is the % of FMGs in Pathology.

Foreign grads have very little debt because in other countries, med school tuition is cheap. Some FMGs didn’t have to pay any tuition because they worked in government hospitals (something along those lines).

Those numbers I cited were for a practice in the Midwest, not a desirable city. Pay increases to 240-250 after three years from bonuses . No partnership.

It’s not just those people that have no debt that accept them. It’s new grads who have no choice but to accept them. The jobs are limited (“slim pickings” was the word my friend used) and you have to take what you can get especially as a first job.
 
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jkdoctor said:
Yes. And you have to compete for jobs with many residents who have no debt.
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Most foreign grads are on J1 visas so their job prospects become much slimmer unless the employer is willing to sponsor them. So you don’t have to compete with them for jobs unless the employer is willing to sponsor those on visas.

Why the probationary status?
 
jkdoctor said:
Over 90% of residents on J-1 visas permanently stay in the USA after finishing their residency program. There are many visa waiver programs and you will certainly have to compete with them in the job market.
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From what I’ve heard from my fellow FMG friends is that if you get the waiver you have to work in an underserved area. There are limited number of positions per state which are handed to primary care fields first. They’ve told me it’s hard, but the FMGs I know get jobs mostly in academics.

If you don’t get a waiver, you have to go back to your home country for two years.
 
That is a low-ball offer, but they'll find someone to take it. More importantly than the absurdly low salary is to know what the nature of the work is. How many cases is a pathologist in this setting supposed to see per day, what are the benefits, and how much vacation time is in the contract?
 
Thaitanium said:
Talked with a friend of mine who told me starting salaries for a few private practice jobs he was at started at 180-190K (Southeast and Midwest). I wouldn’t say these were that desirable of locations. Is this a lowball starting salary guys?
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I hope these are severe 3rd SD outliers.I also would expect higher offers in those areas versus more competitive regions.
 
jkdoctor said:
Over 90% of residents on J-1 visas permanently stay in the USA after finishing their residency program. There are many visa waiver programs and you will certainly have to compete with them in the job market.
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Where this "90%..." information is coming from? This might be true statement for a primary care, but in no way for pathology.

jkdoctor said:
There are many visa waiver programs and you will certainly have to compete with them in the job market.
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You can't "compete" with the waiver program🙂 since it is not a job by itself, but rather legal tool to overcome a J1 visa issue AFTER you received a job offer.
Why should particular agency (hospital, government, PP group, etc) consider a pathologist on J1 visa who is subject to waiver if there are multiple "normal" candidates for every position advertised? To sponsor a waiver employer has to pay all the legal fees, hire an attorney, fill in tons of paperwork, and follow the specific timeline which is typically longer then a year?
 
Impossible to say if that is low-ball without knowing other specifics - expected signout volume, other away-from-the-scope responsibilities, call, partnership track, vacation, benefits, QOL, COL, etc... However, that's about the number I would expect for an academic salary (and on the low end of that), depending on location - but again your mileage may vary (void where prohibited).
 
Members of private groups hate the idea of a new hire getting something better than they did.
If the partner got hired at 180k in 1994, then that will likely remain the starting salary.
There is no need to consider inflation for a few reasons:
1. there are plenty of lemmings to take the job at that salary or even lower regardless of geography. The reward of the Midwest or the South is lower cost of living and free parking in the hospital lot, not necessarily hirer salary for the imaginary hardship of living in that **** locale.
2. inflation seems ridiculous to consider when many pathologists earned more in the 1970's and 1980's than pathologists do today in unadjusted dollars.
 
This doesn’t sound all that low too me.
depends on where you are and time to full partner take.

Also if you get other bene’s with real value such as employer deposit into Sep ira at irs max (think this is ~ 50 k now) or Immediately vested match into 401k you should count this as salary.

as others have mentioned volume is also a consideration. If this group signs a reasonable volume with a good quality of life and full partner take is high 200s starting at high 100s is pretty good.

how are your other offers if you have them?
 
Had phone interviews for now. Those numbers are what my friend was offered in his first job.

Got off the phone for an interview with a group today. They have a 5 years until partnership track. That’s too long right?
 
Thaitanium said:
Had phone interviews for now. Those numbers are what my friend was offered in his first job.

Got off the phone for an interview with a group today. They have a 5 years until partnership track. That’s too long right?
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5 years until full partner, or just to get on partnership track/ladder? If just track/ladder, that sounds too long to me.
 
Thaitanium said:
Had phone interviews for now. Those numbers are what my friend was offered in his first job.

Got off the phone for an interview with a group today. They have a 5 years until partnership track. That’s too long right?
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Depends on your need for the job / income and what your alternatives are...
 
Thaitanium said:
Had phone interviews for now. Those numbers are what my friend was offered in his first job.

Got off the phone for an interview with a group today. They have a 5 years until partnership track. That’s too long right?
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5 years until partnership track? That is insane if that is what you mean. Partnership track should be from day 1. I would say 3 year track period is avg but I am not surprised by 5 years these days. Each year should give bump in pay as well until full partner.
 
sooo many variables...is the partnership a "buy in" with tangible assets? what's the overall volume? Vaca? boneses? health insurance situation? 401k contributions during this "buy in" period?
5 yrs to partner is long, particularly if it means you're just accepting a lower salary for 5 yrs and "partner" is just "equal distributions"...but also depends on partner pay...if they're pulling in 650 it's prolly worth it, but you never know how solid contacts are...

midwest non-desirable city should be at least 200, ideally 2-3 yr partnership track...but that depends on partner pay expectations too.
 
5 years is a little long but not that long. But it kind of depends on what those 5 years involve - is your salary flat for five years, no increase in benefits, vacation, etc? Or does it gradually equalize? Do you have say in the running of the group? Do all new hires progress to partnership or do people mysteriously leave after 3-4 years? Buy in? So it would not be a deal breaker for me, but it raises more questions.

In the past, 7 years was common.
 
In talking to some of my contacts around the country, starting salaries and partnership opportunities are all over the place. Some examples:

1) Two other practices in my area are 3 years to partnership, but no one who has started in either group over the past 5 years has made it to partner in either group. I have no idea what the starting salaries are, but given they hold no tangible assets (i.e. independent lab, etc.) and only billable services, I can't imagine the salaries being beyond $200K starting. One group is just plain malignant and the other is highly dysfunctional to the point of actually being counterproductive to the practice of pathology.

2) The local academic pathology program starts salaries in the $170-180K range with pay raises only every 7 years which are entirely contingent on being promoted. Full professors top out at $250-270K, but they do very little work and have good benefits and good retirement.

3) A contact of mine got an east coast job with good hours, vacation time, and benefits (I don't remember specifics, but certainly more than I have). 5 years to full equity partner is the only specific i can attest to.

4) Another contact of mine got a job in an extremely undesirable place in the arctic Midwest as I call it. Starting salary was in the $300-350K range with a minimum $150K sign-on bonus. After 5 years, the job can cap out in the $500k range. In addition, they pay all medical school debt if there for 5 or so years. The job description is great though: 30 cases/day max with great benefits and time off (I don't know those specifics). No partnership - it's an employee position with the hospital system affiliated multidisciplinary medical group. Given the amount of money for the maximum amount of work expected, the salary is no doubt supplemented through other means beyond what a pathologist there professionally bills.

5) In case anyone is wondering, my group is old school and has a 7 year to full partnership track. Great medical benefits and retirement with what some would consider below average vacation time. We have actual assets such as our own fully accredited histology lab with solid accounts and we own the building its in. Full partner salaries fluctuate depending on the amount of work we saw during the year, but they far above anything in the above 4 examples.
 
What do people mean (other than an independent histology lab) when they say tangible assets? If a group has tangible assets is that considered a better group to join (more financially stable)? Does that mean pathologists at such groups have higher incomes because of these tangible assets?

Thanks for the replies everyone.
 
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Alteran said:
In talking to some of my contacts around the country, starting salaries and partnership opportunities are all over the place. Some examples:

1) Two other practices in my area are 3 years to partnership, but no one who has started in either group over the past 5 years has made it to partner in either group. I have no idea what the starting salaries are, but given they hold no tangible assets (i.e. independent lab, etc.) and only billable services, I can't imagine the salaries being beyond $200K starting. One group is just plain malignant and the other is highly dysfunctional to the point of actually being counterproductive to the practice of pathology.

2) The local academic pathology program starts salaries in the $170-180K range with pay raises only every 7 years which are entirely contingent on being promoted. Full professors top out at $250-270K, but they do very little work and have good benefits and good retirement.

3) A contact of mine got an east coast job with good hours, vacation time, and benefits (I don't remember specifics, but certainly more than I have). 5 years to full equity partner is the only specific i can attest to.

4) Another contact of mine got a job in an extremely undesirable place in the arctic Midwest as I call it. Starting salary was in the $300-350K range with a minimum $150K sign-on bonus. After 5 years, the job can cap out in the $500k range. In addition, they pay all medical school debt if there for 5 or so years. The job description is great though: 30 cases/day max with great benefits and time off (I don't know those specifics). No partnership - it's an employee position with the hospital system affiliated multidisciplinary medical group. Given the amount of money for the maximum amount of work expected, the salary is no doubt supplemented through other means beyond what a pathologist there professionally bills.

5) In case anyone is wondering, my group is old school and has a 7 year to full partnership track. Great medical benefits and retirement with what some would consider below average vacation time. We have actual assets such as our own fully accredited histology lab with solid accounts and we own the building its in. Full partner salaries fluctuate depending on the amount of work we saw during the year, but they far above anything in the above 4 examples.
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Was this contact a fresh grad?
 
Yhormthegiant12 said:
Was this contact a fresh grad?
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If you're referring to the one in example 4, yes. However, I should have emphasized that this person came from a "name-brand" pathology program where their graduates are generally considered to be well trained. I sincerely doubt that such an offer would have been extended to a fresh grad from a run of the mill program. And from what I've been told, some groups/practices (like this one) actively recruit only from these types of elite programs. They have no interest in graduates from any other program(s), won't advertise, and won't consider unsolicited applications/inquiries.

PS: For the naysayers who say that such starting salaries don't exist, I'd like to correct that record and say that they do. We tried to recruit this particular candidate, but we, or most private groups for that matter, can't compete with that type of out the gate starting salary without gaining a whole new account also. But as I said, these types of offers are rare and restricted to the best grads that the pathology market has to offer. So, in short, it does matter where you do your residency.
 
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Alteran said:
If you're referring to the one in example 4, yes. However, I should have emphasized that this person came from a "name-brand" pathology program where their graduates are generally considered to be well trained. I sincerely doubt that such an offer would have been extended to a fresh grad from a run of the mill program. And from what I've been told, some groups/practices (like this one) actively recruit only from these types of elite programs. They have no interest in graduates from any other program(s), won't advertise, and won't consider unsolicited applications/inquiries.

PS: For the naysayers who say that such starting salaries don't exist, I'd like to correct that record and say that they do. We tried to recruit this particular candidate, but we, or most private groups for that matter, can't compete with that type of out the gate starting salary without gaining a whole new account also. But as I said, these types of offers are rare and restricted to the best grads that the pathology market has to offer. So, in short, it does matter where you do your residency.
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Elite program... That term gets thrown around a lot here but no one ever says which ones those are. Aside from ones that don't even need to be mentioned like Hopkins, Stanford, and the Ivies.
 
Alteran said:
So, in short, it does matter where you do your residency.
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...unless you're ok with the 'arctic midwest' gigs you refer to, which can be fairly well paying (top %) and likely rely more on "familiarity" with programs than perceived "elite" status. Most of these sorts of gigs fly under the radar...people are born, raised, educated and train "locally" and that often leads to them getting in the door to these places. Sure you have to be ok with a city that isn't a cultural mecca, but if you're willing to reach retirement 10 years earlier, it may be worth it.

...i guess that technically still implies 'where' you train matters, just in a different context...
 
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Thaitanium said:
What do people mean (other than an independent histology lab) when they say tangible assets? If a group has tangible assets is that considered a better group to join (more financially stable)? Does that mean pathologists at such groups have higher incomes because of these tangible assets?

Thanks for the replies everyone.
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yes generally a hiso lab...can be good or bad depending on the reimbursment rates, payer mix, competition (or likelihood of competition)...but for established practices with a steady stream, it's a good thing.
 
That's generous. Are they including benefits? That is often looked over.

Coming out you push glass or cut meat, likely 10 to 12 hours a day. If you aren't doing that you are cheating yourself. If you have no fellowship you are even less marketable.

I've worked with all types and hired all types and I can assure you that someone who isn't bringing referral business to the practice or unique fellowship skills is a dime a dozen, don't expect a orthopod's "salary." One thing I can say is I would never hire a non fellowship trained path in this day and age, they lack skills and will rarely achieve a level of functioning above a senior resident.

If the salary is sky high be warned, you will work to earn it, likely holidays and weekends.
 
I would like to confirm that these starting salaries for fresh grads do exist. I also got an offer straight after fellowship (hospital employee) in an undesirable for most people location with a starting salary around 400k peaking at around 500k shortly afterwards. I trained at pretty solid but not elite programs and did not have any word-of-mouth leads/connections. Honestly, most partnership-track positions I interviewed for sucked balls: undesirable locations, salary in lower 200s, 4-5 years till partnership.
 
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D1b()4 said:
I would like to confirm that these starting salaries for fresh grads do exists. I also got an offer straight after fellowship (hospital employee) in an undesirable for most people location with a starting salary around 400k peaking at around 500k shortly afterwards. I trained at pretty solid but not elite programs and did not have any word-of-mouth leads/connections. Honestly, most partnership-track positions I interviewed for sucked balls: undesirable locations, salary in lower 200s, 4-5 years till partnership.
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What size hospital was this 400-500k job? How many surgicals a year? Caseload a day?
 
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Around 5k cases per pathologist. It is not a low-volume place, but also doesn't seem to be anything crazy in terms of volume per pathologist. Also, no work on holidays or weekends unless you are on call. Some of the private partnership-track positions had higher volume with crappy salary, location, and long partnership track.

Btw, have you found a position?
 
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D1b()4 said:
I would like to confirm that these starting salaries for fresh grads do exist. I also got an offer straight after fellowship (hospital employee) in an undesirable for most people location with a starting salary around 400k peaking at around 500k shortly afterwards. I trained at pretty solid but not elite programs and did not have any word-of-mouth leads/connections. Honestly, most partnership-track positions I interviewed for sucked balls: undesirable locations, salary in lower 200s, 4-5 years till partnership.
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Interesting information to share in your debut post on SDN.....
 
Unty said:
Probably the same person who said he or she got an academic position with a 150K signing bonus as a first post then disappeared for good into the black hole of SDN Path.
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No, that's not true. I have been a long-time lurker and decided to register to let people know that you can get a decent salary after just one fellowship. My other offer was 50-100k less but in a better location.
 
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D1b()4 said:
Around 5k cases per pathologist. It is not a low-volume place, but also doesn't seem to be anything crazy in terms of volume per pathologist. Also, no work on holidays or weekends unless you are on call. Some of the private partnership-track positions had higher volume with crappy salary, location, and long partnership track.

Btw, have you found a position?
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There is no way a hospital is paying a pathologist that salary. Not today. Especially not multiple pathologists. You are leaving something out. Especially with that volume.
 
Torsed said:
There is no way a hospital is paying a pathologist that salary. Not today. Especially not multiple pathologists. You are leaving something out. Especially with that volume.
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As far as I know, I am not leaving anything out. I will provide an update once I start if there are any surprises. But I don't think it is that far off. A friend of mine also got an offer around 400k for a hospital-based position. Most non-academic hospital-based positions pay in upper 200s to mid 300s.

Regardless, 180-190k is definitely low. The lowest salary offer I have heard of someone getting recently is 210k.
 
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Just floated a number FAR above this to a new jr. associate and I literally got an email mere hours later the party was absolutely not interested with no response to my follow up email..hahaha.

so yah 180 is low unless you are in rural Kansas or something.
 
D1b()4 said:
I would like to confirm that these starting salaries for fresh grads do exist. I also got an offer straight after fellowship (hospital employee) in an undesirable for most people location with a starting salary around 400k peaking at around 500k shortly afterwards. I trained at pretty solid but not elite programs and did not have any word-of-mouth leads/connections. Honestly, most partnership-track positions I interviewed for sucked balls: undesirable locations, salary in lower 200s, 4-5 years till partnership.
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starting 400? Insane. You are essentially a USELESS hunk of trash until like 6mo or even a year after fellowship in terms of efficiency.

Dont post total BS here, that is dangerous. I hope you arent merely swinging your e-peen around.

I am more than highly skeptical. I have not seen actual experienced directors with 10+ years of high volume sign outs get offers for mere employee positions at 400-500K...so where are you?
 
D1b()4 said:
Around 5k cases per pathologist. It is not a low-volume place, but also doesn't seem to be anything crazy in terms of volume per pathologist. Also, no work on holidays or weekends unless you are on call. Some of the private partnership-track positions had higher volume with crappy salary, location, and long partnership track.

Btw, have you found a position?
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I believe it. I know of peeps getting jobs like this. Will you be doing everything, ie: general AP, flow, smears,SPEP ect?
 
D1b()4 said:
General SP with AP/CP call coverage.
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wow, so you only do surg path? You dont have to do flow, peripheral smears, or spep? That’s a impressive job. Other people I know starting at that salary were doing all those other things as well.
 
LADoc00 said:
starting 400? Insane. You are essentially a USELESS hunk of trash until like 6mo or even a year after fellowship in terms of efficiency.

Dont post total BS here, that is dangerous. I hope you arent merely swinging your e-peen around.

I am more than highly skeptical. I have not seen actual experienced directors with 10+ years of high volume sign outs get offers for mere employee positions at 400-500K...so where are you?
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I am truly glad that my offer is insane. It is very high 300s if to be exact but very close to 400k first year. The location is also not desirable for most people (not a metropolitan coastal city).
 
pathslides said:
wow, so you only do surg path? You dont have to do flow, peripheral smears, or spep? That’s a impressive job. Other people I know starting at that salary were doing all those other things as well.
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Yes. The volume might be higher than I expect though, but it is all SP.

Also, I have heard of people getting 400k offers in desirable locations, but it usually involves doing everything, as you have mentioned.
 
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I saw a job ad for upper 300s for a pathologist in a not so nice area. 3 person hospital based practice. Mostly just AP, 1 bone marrow a week from what I was told.
 
Unty said:
I saw a job ad for upper 300s for a pathologist in a not so nice area. 3 person hospital based practice. Mostly just AP, 1 bone marrow a week from what I was told.
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No, no that one LOL
 
I think I need explain the economics of all this as it will put this in perspective.

If you read for example the MAXIMUM cytology allowed by law every working day with no vacations for a solid year you would gross $650,000.

If you take out malpractice, billing, payroll taxes, health benefits and a reasonable 401K plan, you are in the neighborhood now of earning $400,000 max.

400K for signing out SIXTEEN THOUSAND cytology cases a year.

Now tell me what fellows right out training can do that?

Sorry try again.

If someone is paying you 400K for signing out a tiny fraction of that load, they are losing money. I would rather than ditch biz to Quest than lose money on a millennial I also have to babysit.

Yah no, try again.
 
LADoc00 said:
I think I need explain the economics of all this as it will put this in perspective.

If you read for example the MAXIMUM cytology allowed by law every working day with no vacations for a solid year you would gross $650,000.

If you take out malpractice, billing, payroll taxes, health benefits and a reasonable 401K plan, you are in the neighborhood now of earning $400,000 max.

400K for signing out SIXTEEN THOUSAND cytology cases a year.

Now tell me what fellows right out training can do that?

Sorry try again.

If someone is paying you 400K for signing out a tiny fraction of that load, they are losing money. I would rather than ditch biz to Quest than lose money on a millennial I also have to babysit.

Yah no, try again.
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Cytology? My job is SP only.
 
D1b()4 said:
Cytology? My job is SP only.
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that was an easy example. if you read 5000 x88305-26 surgical biopsies a year, I would lose money on paying you anything more than 40.75 x 5000 = 203K gross - expense end would be roughly 120-135K.

If someone is paying you more than twice that coming out of fellowship, they are either total suckers or really really bad at basic math...


Given how utterly useless even most experienced pathologists are to me, your name would have to be Juan Rosai, Jr. for this to make any sense.

The point being is someone right out of training isnt worth even $120,000 to most groups. People are overpaying to get really expensive vacation coverage.

The reality is I can call CompHealth and get someone to cover for 800 bucks flat a day or $160,000 for entire 200-day work year..so yah you arent worth 400K buddy, nothing even remotely close to that.

If fellows are worth 400K out of training, then I would be underpaid by the tune of like 11 million+ a year! hahaha.
 
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