UPMC boosting starting wages to $15/hr.

[GlowInTheDark]

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Members do not see this ad.

Soon residents will be the cheapest labor per hour labor in the hospital!

http://www.wpxi.com/news/pennsylvan...tarting-wages-to-15-an-hour-by-2021/185426541

 

[DrDarce]

 

[shoal]

lookz like many residents already are. min wage of 11.25 already. pretty sure neurosurg is making less then that

Sent from my VS986 using Tapatalk

 

[mimelim]

I make less than the baggers at the local grocery store if you calculate my hourly wage.

 

[NotAProgDirector]

I make less than the baggers at the local grocery store if you calculate my hourly wage.

But would you really want to bag groceries for 70 hours a week for the rest of your life?

 

[pulmoblast]

But would you really want to bag groceries for 70 hours a week for the rest of your life?

Wouldn't you want your residents to be paid more than those who bag groceries? Even if it is just for 3/4 years..


Sent from my iPhone using SDN mobile app

 

[NotAProgDirector]

Feel free to check my post history, but I have always agreed with paying residents a fair salary. At at my home institution, I always push as much as I can.

But, to at least point out the other side of the coin, some of the time residents spend in my program doesn't really help me or the institution. Research electives. 3 months in Botswana or Haiti. All clinical elective time. All of the interview time for fellowships and jobs (which we consider "career development" and hence count as paid days). If I paid residents $15/hr for all the useful rotations they do, and then pay them nothing for these other rotations that are "useless" to me and the institution, you might be better off with current salaries.

 

[mimelim]

But would you really want to bag groceries for 70 hours a week for the rest of your life?

Feel free to check my post history, but I have always agreed with paying residents a fair salary. At at my home institution, I always push as much as I can.

But, to at least point out the other side of the coin, some of the time residents spend in my program doesn't really help me or the institution. Research electives. 3 months in Botswana or Haiti. All clinical elective time. All of the interview time for fellowships and jobs (which we consider "career development" and hence count as paid days). If I paid residents $15/hr for all the useful rotations they do, and then pay them nothing for these other rotations that are "useless" to me and the institution, you might be better off with current salaries.

I think that it is absurd to pay your residents the same as ours. Our clinical duties push 80+/week. We have research, academic and administrative responsibilities that while not mandated or required are a standard part of what most of our residents do. We have research years with mandatory production requirements and clear expectations. We do not have research or clinical electives. Every rotation that is not on our home service is funded via FTE position at that other program or hospital. Interview time for fellowship/jobs must be done on your PTO time.

I am not naive. I understand this system and why it functions the way that it does having spent quite a bit of time on GME committees. I am not a fool. There are dozens of residents and other MDs that would line up to take my spot in my specialty at my hospital. That doesn't mean that residents are treated differently than virtually every other employee in the US. It is staggering what hospitals can get away with when it comes to when to treat residents as true employees and then when to retreat into, "well, you aren't really an employee". For example, I have 500+ hours of excess PTO accrued and I am half way through my program. I can't use it except for specific times and in limited quantities. I can't participate in the PTO share/buy that other employees can. And unlike every other employees, when my contract is terminated at the end of my residency, I can not cash out the balance. I don't think that residents in different specialties at the same hospital should be paid the same amount. I don't like not having the standard labor force protection that most employees have. *shrug* I would keep going, have more to say, but I just got home and need to be back at the hospital in 7 hours and am going to sleep.

 

[rokshana]

I think that it is absurd to pay your residents the same as ours. Our clinical duties push 80+/week. We have research, academic and administrative responsibilities that while not mandated or required are a standard part of what most of our residents do. We have research years with mandatory production requirements and clear expectations. We do not have research or clinical electives. Every rotation that is not on our home service is funded via FTE position at that other program or hospital. Interview time for fellowship/jobs must be done on your PTO time.

I am not naive. I understand this system and why it functions the way that it does having spent quite a bit of time on GME committees. I am not a fool. There are dozens of residents and other MDs that would line up to take my spot in my specialty at my hospital. That doesn't mean that residents are treated differently than virtually every other employee in the US. It is staggering what hospitals can get away with when it comes to when to treat residents as true employees and then when to retreat into, "well, you aren't really an employee". For example, I have 500+ hours of excess PTO accrued and I am half way through my program. I can't use it except for specific times and in limited quantities. I can't participate in the PTO share/buy that other employees can. And unlike every other employees, when my contract is terminated at the end of my residency, I can not cash out the balance. I don't think that residents in different specialties at the same hospital should be paid the same amount. I don't like not having the standard labor force protection that most employees have. *shrug* I would keep going, have more to say, but I just got home and need to be back at the hospital in 7 hours and am going to sleep.

wow...you really believe that you are just that much better? 😱you cut, you sew...rinse repeat...eventually when you are a pgy 37, you do get paid more

 

[mimelim]

wow...you really believe that you are just that much better? 😱you cut, you sew...rinse repeat...eventually when you are a pgy 37, you do get paid more

Can you link me to where I said anything about someone being better than someone else? While you may like to demean and disparage another specialty and what they do, I respect what each of the specialties do. I am specifically responding to the non-work parts of other residencies and how if they were subtracted out and people were paid hourly, they would be paid less than they currently are. Not all residencies function like this and it doesn't make a whole lot of sense to pay people the same for doing completely different volumes of work (for example leaving the system for 3 months).

 

[Goro]

And baggers don't get sued for malpractice either!

Being a grad student and post-doc at one time, I can sympathize, colleague. I didn't even get a salary...I got a "stipend".

I make less than the baggers at the local grocery store if you calculate my hourly wage.

 

[thehundredthone]

Can you link me to where I said anything about someone being better than someone else? While you may like to demean and disparage another specialty and what they do, I respect what each of the specialties do. I am specifically responding to the non-work parts of other residencies and how if they were subtracted out and people were paid hourly, they would be paid less than they currently are. Not all residencies function like this and it doesn't make a whole lot of sense to pay people the same for doing completely different volumes of work (for example leaving the system for 3 months).

While I don't deny that your hours are probably busier in the broad sense, I think it's a misplaced focus on the fact that you don't get paid proportionately more than other specialty residents. The bureaucracy sends the program money, the program dispenses it. The more compelling issue is, why does your program make you work the way it does?

 

[mimelim]

While I don't deny that your hours are probably busier in the broad sense, I think it's a misplaced focus on the fact that you don't get paid proportionately more than other specialty residents. The bureaucracy sends the program money, the program dispenses it. The more compelling issue is, why does your program make you work the way it does?

I understand how and why residents are paid the way they are. My point is simply that not all residents work the same amount, more in response to @aProgDirector than a global opinion.

Why does my program make us work as much as we do? Two fold, #1 Because it is impossible to produce competent vascular surgeons working the hours and months that other residencies do (as described in this thread). #2 There are patients to take care of.

There is a lot to learn and limited time to do it in. Excessive scut is bad. But, even outside of scut, there is a lot of work to do. It is time consuming to train surgeons. Could things been more streamlined? Of course. But the reality is that in order to get enough cases and foundation to go into practice, you need to work the hours and if you are going to limit those hours each week, the only way to make it back is to continue to extend training.

 

[Obnoxious Dad]

I understand how and why residents are paid the way they are. My point is simply that not all residents work the same amount, more in response to @aProgDirector than a global opinion.

Why does my program make us work as much as we do? Two fold, #1 Because it is impossible to produce competent vascular surgeons working the hours and months that other residencies do (as described in this thread). #2 There are patients to take care of.

There is a lot to learn and limited time to do it in. Excessive scut is bad. But, even outside of scut, there is a lot of work to do. It is time consuming to train surgeons. Could things been more streamlined? Of course. But the reality is that in order to get enough cases and foundation to go into practice, you need to work the hours and if you are going to limit those hours each week, the only way to make it back is to continue to extend training.

You chose this specialty. You weren't conscripted. You knew or at least should have known it was going to be awful. Now you are complaining after taking a slot someone else would have loved. If you wanted something easy and short you should have and probably could have gone into some other specialty.

 

[mimelim]

You chose this specialty. You weren't conscripted. You knew or at least should have known it was going to be awful. Now you are complaining after taking a slot someone else would have loved. If you wanted something easy and short you should have and probably could have gone into some other specialty.

Link to where I said I was conscripted.

Link to where I said anything was awful.

Link to where I said that I didn't love what I am doing.

I mean Jesus your reading comprehension is terrible. Or you are just angry.

 

[Obnoxious Dad]

Link to where I said I was conscripted.

Link to where I said anything was awful.

Link to where I said that I didn't love what I am doing.

I mean Jesus your reading comprehension is terrible. Or you are just angry.

I've passed two bar exams, how's your reading comprehension? It's not the words you choose, it's your whiny tone.

The salaries that janitors and dietary staff get paid are perfectly irrelevant to your situation. Read an economics book. Resident salaries and work hours have been beaten to death on SDN. You knew exactly what you were in for. You could see it as a third year medical student. You talked to class mates, attending physicians, faculty etc. You knew that as a resident you were going to be paid between $52,000 and $60,000 per year and you knew that you would work 80 hours a week. You knew that this prison sentence would last seven years. You probably have some idea what the lifestyle and compensation of vascular surgeons will be when you get through this ordeal.

The American public already spends 18% of the GDP on health care. Various groups want to cut residency funding. There is no money to pay you more. Got it?

 

[mimelim]

I've passed two bar exams, how's your reading comprehension? It's not the words you choose, it's your whiny tone.

The salaries that janitors and dietary staff get paid are perfectly irrelevant to your situation. Read an economics book. Resident salaries and work hours have been beaten to death on SDN. You knew exactly what you were in for. You could see it as a third year medical student. You talked to class mates, attending physicians, faculty etc. You knew that as a resident you were going to be paid between $52,000 and $60,000 per year and you knew that you would work 80 hours a week. You knew that this prison sentence would last seven years. You probably have some idea what the lifestyle and compensation of vascular surgeons will be when you get through this ordeal.

The American public already spends 18% of the GDP on health care. Various groups want to cut residency funding. There is no money to pay you more. Got it?

Arguing is easy when you make up what the other person says. Nothing you say is remotely related to what has been put in this thread. Obvious troll is obvious. And maybe work on your reading comprehension skills. Clearly you need some work.

 

[CopaceticOne]

@Obnoxious Dad - just go away already.

 

[Goro]

I detected not a molecule of whining in Mimelim's posts, just astute observations.

MCAT VR section would kill you.

I've passed two bar exams, how's your reading comprehension? It's not the words you choose, it's your whiny tone.

The salaries that janitors and dietary staff get paid are perfectly irrelevant to your situation. Read an economics book. Resident salaries and work hours have been beaten to death on SDN. You knew exactly what you were in for. You could see it as a third year medical student. You talked to class mates, attending physicians, faculty etc. You knew that as a resident you were going to be paid between $52,000 and $60,000 per year and you knew that you would work 80 hours a week. You knew that this prison sentence would last seven years. You probably have some idea what the lifestyle and compensation of vascular surgeons will be when you get through this ordeal.

The American public already spends 18% of the GDP on health care. Various groups want to cut residency funding. There is no money to pay you more. Got it?

 

[thehundredthone]

I understand how and why residents are paid the way they are. My point is simply that not all residents work the same amount, more in response to @aProgDirector than a global opinion.

Does this comparison work within specialties as well? Should busier surgery programs pay their residents more than comparatively less busy ones?

There is a lot to learn and limited time to do it in. Excessive scut is bad. But, even outside of scut, there is a lot of work to do. It is time consuming to train surgeons. Could things been more streamlined? Of course. But the reality is that in order to get enough cases and foundation to go into practice, you need to work the hours and if you are going to limit those hours each week, the only way to make it back is to continue to extend training.

So there is a quantum of learning that needs to happen, which you say needs to happen a certain way and within a certain time. The hands on specialties are somewhat disadvantaged when it comes to this arrangement for many reasons including those you brought up. But all this relates to volume of work, which must be fit into the limited time allowance (however artificial or farcical that may be). The ACGME set the 80 hour limit, and certain specialties don't reach it (and some possibly never did before either), but I don't think that's justification for differential pay. Because with that kind of reasoning, residents could argue that they work 80+ hours "just like anyone else" to justify their pay, same as programs (could) argue that their residents never cross the 80 hour limit to avoid paying them as much. The system evolves based on what the soft and hard limits turn out to be.

 

[azhrei]

In a medical system where new PAs can make twice as much, there should be a solution for residency pay.

Yes we all know what we are signing up for, and we did it anyways. Does that mean we shouldn't strive for change or for improving the system? I think not.

Accepting the status quo is like asking attendings to sit and take abuse from the federal government and hospital administration. It shouldn't be acceptable to eliminate free market competition and we should work to change existing law.

In addition, to change our current work environment, we should be advocating for more student billable interactions. It doesn't make sense that M2s can't do the work of medical assistants and that M4s can't do any of the work of a newly minted PA.

 

[NotAProgDirector]

I think that it is absurd to pay your residents the same as ours. Our clinical duties push 80+/week. We have research, academic and administrative responsibilities that while not mandated or required are a standard part of what most of our residents do. We have research years with mandatory production requirements and clear expectations. We do not have research or clinical electives. Every rotation that is not on our home service is funded via FTE position at that other program or hospital. Interview time for fellowship/jobs must be done on your PTO time.

I am not naive. I understand this system and why it functions the way that it does having spent quite a bit of time on GME committees. I am not a fool. There are dozens of residents and other MDs that would line up to take my spot in my specialty at my hospital. That doesn't mean that residents are treated differently than virtually every other employee in the US. It is staggering what hospitals can get away with when it comes to when to treat residents as true employees and then when to retreat into, "well, you aren't really an employee". For example, I have 500+ hours of excess PTO accrued and I am half way through my program. I can't use it except for specific times and in limited quantities. I can't participate in the PTO share/buy that other employees can. And unlike every other employees, when my contract is terminated at the end of my residency, I can not cash out the balance. I don't think that residents in different specialties at the same hospital should be paid the same amount. I don't like not having the standard labor force protection that most employees have. *shrug* I would keep going, have more to say, but I just got home and need to be back at the hospital in 7 hours and am going to sleep.

I agree, at least on some level. We have decided (in general), that all residents are paid the same regardless of how many hours they work based on PGY level. So, in IM, a PGY-4 Endocrine fellow gets paid the same as a PGY-4 Cardiology fellow -- despite the fact that the latter probably puts many more hours in. We have very reasonable data about how many hours residents work due to duty hour logging -- I think we can assume that the busier specialties may under report, but even with that we see many more hours in those fields. In GME we have discussions about whether this is "fair" or not and the same debate ensues -- some people think residents in different fields should be paid based on (average) hours worked. Others feel it should be even across the board (the current status quo) and think that the busier specialties "work out" in the end because those people tend to make higher salaries when trained, or that they "chose" it, or that it will send the message that surgical residents are "more important" than other residents. Yet others (just a few, luckily), think that the "hot" fields should pay less per resident because the demand is high, so that's capitalism. Pick your poison and drink it.

And I agree that minelim's response is completely reasonable.

Obnoxious Dad remains concerned about the overall cost of medical care/training in this country -- also a very reasonable concern. If paying more for surgery residents cost medicare more money, then this would be a big problem. But it won't -- the amount medicare pays programs is independent of what we pay in salaries. Any hospital that paid their surgical residents more would have a small increase in costs, and perhaps that might lead the hospital to increase prices, but honestly the difference would be so small it's not worth worrying about. If we want to decrease the cost of healthcare in this country (or the cost of healthcare training), there are much bigger changes to be made.

 

[rokshana]

I understand how and why residents are paid the way they are. My point is simply that not all residents work the same amount, more in response to @aProgDirector than a global opinion.

Why does my program make us work as much as we do? Two fold, #1 Because it is impossible to produce competent vascular surgeons working the hours and months that other residencies do (as described in this thread). #2 There are patients to take care of.

There is a lot to learn and limited time to do it in. Excessive scut is bad. But, even outside of scut, there is a lot of work to do. It is time consuming to train surgeons. Could things been more streamlined? Of course. But the reality is that in order to get enough cases and foundation to go into practice, you need to work the hours and if you are going to limit those hours each week, the only way to make it back is to continue to extend training.

so then by your rationale, the upper level should be paid less...since the juniors no doubt work the bulk of hours.

 

[mimelim]

so then by your rationale, the upper level should be paid less...since the juniors no doubt work the bulk of hours.

That is incorrect. Most seniors work more hours than interns or pgy2s. I'd say that PGY3 is our "light" year. You don't leave cases that are going. It is not atypical at 8pm for 3 ORs to be going with seniors scrubbed in all of them and the rest of the day team gone.

You are expected to run your service and operate. There is far more work as a senior than an intern. Never mind that you are expected to do the bulk of the conference presentations, run and prepare M&M, run and prepare journal club, run and prepare junior mock orals. Then there is the fact that most seniors have more established research projects owing to having already spent time in the lab.

 

[calvnandhobbs68]

I think that it is absurd to pay your residents the same as ours. Our clinical duties push 80+/week. We have research, academic and administrative responsibilities that while not mandated or required are a standard part of what most of our residents do. We have research years with mandatory production requirements and clear expectations. We do not have research or clinical electives. Every rotation that is not on our home service is funded via FTE position at that other program or hospital. Interview time for fellowship/jobs must be done on your PTO time.

These first sentences really have nothing to do with the rest of your argument if your argument is that you should get paid for being more productive clinically at this point. Your "research time" is just as essentially worthless to the hospital system that would be paying you as it would be for any other resident, whatever "production requirements" or whatever you have. In terms of running a lab, you could pay a lab tech half your salary (or a med student next to nothing for a year lol) and get the same brute force work out of it. In terms of the hospital system...you're worth nothing during that time. You are producing 0 dollars and 0 cents. It's not like you're running your own lab or getting an R01 for the university.

The last sentence also has nothing to do with anything you're arguing for. So you're getting paid out of other GME funds from some other program? Why does that somehow justify that you should get paid more?

 

[rokshana]

These first sentences really have nothing to do with the rest of your argument if your argument is that you should get paid for being more productive clinically at this point. Your "research time" is just as essentially worthless to the hospital system that would be paying you as it would be for any other resident, whatever "production requirements" or whatever you have. In terms of running a lab, you could pay a lab tech half your salary (or a med student next to nothing for a year lol) and get the same brute force work out of it. In terms of the hospital system...you're worth nothing during that time. You are producing 0 dollars and 0 cents. It's not like you're running your own lab or getting an R01 for the university.

The last sentence also has nothing to do with anything you're arguing for. So you're getting paid out of other GME funds from some other program? Why does that somehow justify that you should get paid more?

because he is a very special flower...

 

[mimelim]

These first sentences really have nothing to do with the rest of your argument if your argument is that you should get paid for being more productive clinically at this point. Your "research time" is just as essentially worthless to the hospital system that would be paying you as it would be for any other resident, whatever "production requirements" or whatever you have. In terms of running a lab, you could pay a lab tech half your salary (or a med student next to nothing for a year lol) and get the same brute force work out of it. In terms of the hospital system...you're worth nothing during that time. You are producing 0 dollars and 0 cents. It's not like you're running your own lab or getting an R01 for the university.

The last sentence also has nothing to do with anything you're arguing for. So you're getting paid out of other GME funds from some other program? Why does that somehow justify that you should get paid more?

In all seriousness, you really should get your reading comprehension checked. Did I argue anywhere that anything but our clinical hours are beneficial to the hospital system? Did I argue anywhere that we are producing any money? Our research time is funded like most from outside sources (like virtually every program with dedicated research time), it obviously does not come from standard GME funds. Clearly, given that I quoted a post, I was responding to that. It is pretty clear that I was comparing two programs to make the claim "It is absurd to pay your residents the same as ours." Something that the person I quoted, "Agrees with on some level." Again, if you make **** up, what is the point in having a discussion?

This isn't exactly rocket science. In a given year:

Resident 1: 80 hours/week for 12 months of clinical duties on home service
Resident 2: 60 hours/week for 8-9 months of clinical duties on home service

Both are paid the same. To me, that doesn't make a ton of sense. If that does to you, I don't really know what to tell you. Clearly, I understand why it happens that way since I sit on our GME because I understand how residency funding works. I am simply saying that residents as a group are not treated like every other employee in the hospital and not all residents work nearly the same amount and that a strong argument can be made to pay them differently. If you can't even acknowledge those differences, I don't really know what to tell you.

 

[Obnoxious Dad]

In all seriousness, you really should get your reading comprehension checked. Did I argue anywhere that anything but our clinical hours are beneficial to the hospital system? Did I argue anywhere that we are producing any money? Our research time is funded like most from outside sources (like virtually every program with dedicated research time), it obviously does not come from standard GME funds. Clearly, given that I quoted a post, I was responding to that. It is pretty clear that I was comparing two programs to make the claim "It is absurd to pay your residents the same as ours." Something that the person I quoted, "Agrees with on some level." Again, if you make **** up, what is the point in having a discussion?

This isn't exactly rocket science. In a given year:

Resident 1: 80 hours/week for 12 months of clinical duties on home service
Resident 2: 60 hours/week for 8-9 months of clinical duties on home service

Both are paid the same. To me, that doesn't make a ton of sense. If that does to you, I don't really know what to tell you. Clearly, I understand why it happens that way since I sit on our GME because I understand how residency funding works. I am simply saying that residents as a group are not treated like every other employee in the hospital and not all residents work nearly the same amount and that a strong argument can be made to pay them differently. If you can't even acknowledge those differences, I don't really know what to tell you.

It doesn't make any sense to you because you don't understand economics. Economics should not be concerned with administering every facet of the economy based on the subjective opinions of some self important jamoke. It's about people maximizing their wealth and income and making rational decisions based on the information available.

The information concerning your work hours and the number of years it would take to become a vascular surgeon were available to you as a medical student and yet you still competed for that slot. It's common knowledge among medical students that residents at the same institution in the same year of residency get paid the same amount of money per year. If you thought that was a bad deal you should have and could have chosen a different specialty. However, you did not choose a different specialty.

You made your bed. Stop complaining.

 

[mimelim]

It doesn't make any sense to you because you don't understand economics. Economics should not be concerned with administering every facet of the economy based on the subjective opinions of some self important jamoke. It's about people maximizing their wealth and income and making rational decisions based on the information available.

The information concerning your work hours and the number of years it would take to become a vascular surgeon were available to you as a medical student and yet you still competed for that slot. It's common knowledge among medical students that residents at the same institution in the same year of residency get paid the same amount of money per year. If you thought that was a bad deal you should have and could have chosen a different specialty. However, you did not choose a different specialty.

You made your bed. Stop complaining.

And he continues to post things that are unrelated to anything in this thread. Again, obvious troll is obvious.

 

[calvnandhobbs68]

In all seriousness, you really should get your reading comprehension checked. Did I argue anywhere that anything but our clinical hours are beneficial to the hospital system? Did I argue anywhere that we are producing any money? Our research time is funded like most from outside sources (like virtually every program with dedicated research time), it obviously does not come from standard GME funds. Clearly, given that I quoted a post, I was responding to that. It is pretty clear that I was comparing two programs to make the claim "It is absurd to pay your residents the same as ours." Something that the person I quoted, "Agrees with on some level." Again, if you make **** up, what is the point in having a discussion?

This isn't exactly rocket science. In a given year:

Resident 1: 80 hours/week for 12 months of clinical duties on home service
Resident 2: 60 hours/week for 8-9 months of clinical duties on home service

Both are paid the same. To me, that doesn't make a ton of sense. If that does to you, I don't really know what to tell you. Clearly, I understand why it happens that way since I sit on our GME because I understand how residency funding works. I am simply saying that residents as a group are not treated like every other employee in the hospital and not all residents work nearly the same amount and that a strong argument can be made to pay them differently. If you can't even acknowledge those differences, I don't really know what to tell you.

So what was the point of the research stuff you brought up then? Apparently it had no point. It looks like you're the one who has trouble responding to a specific question which was...what does your "research time" have to do with anything else in your argument besides boosting your ego and helping you feel like you're better than everyone else who doesn't do a dedicated research year? If you'll look back, you were trying to include that somehow in your argument that your residents should get paid more because they work more. I was simply asking how your research time was relevant to that argument in any way.

 

[mimelim]

So what was the point of the research stuff you brought up then? Apparently it had no point. It looks like you're the one who has trouble responding to a specific question which was...what does your "research time" have to do with anything else in your argument besides boosting your ego and helping you feel like you're better than everyone else who doesn't do a dedicated research year? If you'll look back, you were trying to include that somehow in your argument that your residents should get paid more because they work more. I was simply asking how your research time was relevant to that argument in any way.

I'll repeat it for you.

I was responding to a specific post. I was comparing my program to the details provided about another by @aProgDirector. The point was that our research time is not time that takes us away from clinical duties. I think that if you re-read the post, you will see that that is what I was responding to.

Where the **** do you read that we are "better" than everyone else who doesn't do a dedicated research year? I went back, re-read all of it, I am still confused how you can get that from my post or the conversation before you showed up. We have 4 IM programs in our area. Their residents work ~60 hours/week. Which is obviously an estimation. They are loosely setup like @aProgDirector 's program with electives that take them away from home clinical duties. My argument is very simple. Residents in different specialties work different amounts. They aren't really all that close in terms of total time dedicated to their home services. It is not crazy to say that they should have different annual salaries.

I acknowledged, well before this devolved, in my original post that there are dozens of MS4s that would have been happy to take my spot. I am happy where I am. I am happy with my choices. I knew what I was getting into and it has been par for the course over the last 4 years. That doesn't mean that there aren't things that can be changed to be fairer or better. I don't know why some of you are so conservative and pro-status-quo. Do you not recognize that there are (as I have pointed out in this thread) rampant problems with how residents as a whole are reimbursed? Do you think that it is fair that residents have very few legal protections that are afforded to virtually every other employee group in the United States? Or should they all just accept it because after all, there are plenty of IMGs that would be happy to take their spots, even at probably half the pay.