What is the difference between individuals who earn an income in the 300s and those who earn closer to 500K?

[Anotherwin]

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I am still in residency and trying to learn more about the differences in earnings when it comes to the field of psychiatry. My only frame of reference so far is individuals working in academics, which I know is only a small part of the overall picture. Would like to learn more about whether it is a difference an hours worked, job structuring, risk tolerance, or other possible factors.

 

[Atreides]

200k

 

[kelminak]

From what I've read and looked into, it's generally just private practice with good business sense. You can have a cash pay practice charging enough to clear that with high enough rates or hire a ton of midlevels and skim money off of them (or do both). You can also take employed positions and work yourself to death too. Some of the doctors at my hospital would cover 3 service lines which netted them a tremendous amount of RVUs. Whether they could ethically supervise that many patients/residents is a different question.

 

[AD04]

Not too much difference between $300k and $500k. Hustle a bit harder and you can reach the latter.

Frankly, making earned income in medicine is just math, assuming you’re not salaried.

Hours billed * hourly rate = take-home pay.

If you’re not creative, work harder and increase hours billed. If you are creative, increase hourly rate.

If you can work harder, and if you are creative, you can earn more than that.

 

[comp1]

I assume the difference is the impact it has on the rest of their life. I think the bigger question for the OP is why $500k might be a goal?

 

[Merovinge]

You hit 500k in psychiatry by either cobbling together multiple jobs (e.g. rounding on an inpatient unit then going to a nursing home, clinic, PHP/IOP/RTC in the afternoon) OR by having your own practice and charging an appropriate rate (e.g. $500-600/hour) and being mostly full. There are assuredly some niche cases, but the above scenarios probably captures 90% of psychiatrists making 500k/year.

 

[randomdoc1]

Work really hard or work really smart. Or both. In my PP I can clear over 600k a year if desired. I prefer to work smarter. Keep gaps out of your schedule. Make all your time on the clock count with paid encounters. PP has the higher ceiling. Higher earning potential per hour but higher risk. Or take lower risk in other settings and increase work volume.

 

[mistafab]

300k is around median for psychiatry.

Doing more work, job cobbling, and private practice are the easiest ways to go beyond the median. Just realize most people in private practice are doing more work than those clocking in/ clocking out - at least at the start.

I am job cobbling.

 

[randomdoc1]

300k is around median for psychiatry.

Doing more work, job cobbling, and private practice are the easiest ways to go beyond the median. Just realize most people in private practice are doing more work than those clocking in/ clocking out - at least at the start.

I am job cobbling.

wise words.
yes, the non PP settings pay more in the start although I feel like the earning ceiling is lower. Many of my colleagues 5-10 years out are now burned out in non PP settings.

PP is more work and less pay up front. But play it well and the sky is the limit. On the other hand, there are some providers that just aren't cut out for it. Nothing wrong with that. That's where the other gigs are a better fit.

imho, physicians are way too risk averse. If we step up our game and increase a little risk tolerance, there are big rewards literally and figuratively. Not enough folks give it a chance. More are capable of it than they think. PP = higher risk but highest potential gain. other settings, lower risk but lower potential gain.

 

[Merovinge]

wise words.
yes, the non PP settings pay more in the start although I feel like the earning ceiling is lower. Many of my colleagues 5-10 years out are now burned out in non PP settings.

PP is more work and less pay up front. But play it well and the sky is the limit. On the other hand, there are some providers that just aren't cut out for it. Nothing wrong with that. That's where the other gigs are a better fit.

imho, physicians are way too risk averse. If we step up our game and increase a little risk tolerance, there are big rewards literally and figuratively. Not enough folks give it a chance. More are capable of it than they think. PP = higher risk but highest potential gain. other settings, lower risk but lower potential gain.

Docs are risk adverse by selection process because when we make risks at work and they go bad, people die and it is a field notorious for being able to always have a good/high paying job in regardless of economic conditions.

Then you add on the 6 figure debt most docs have which adds to risk aversion with starting a practice. Then you select for psychiatrists who are possibly the most risk adverse subspecialty and it's no wonder the field looks as it does.

 

[FatherPsychiatry]

I assume the difference is the impact it has on the rest of their life. I think the bigger question for the OP is why $500k might be a goal?

MO MONEY MO __________ ?

 

[Anotherwin]

I assume the difference is the impact it has on the rest of their life. I think the bigger question for the OP is why $500k might be a goal?

That is a good question and one I do not have a great answer too. I have a fair bit of debt from medical school and college, and also have family members that are growing older who need financial support. I figured 500K would put me in a place where I can pay off my debts faster, develop a solid foundation for retirement long term, and also take care of the people who took care of me. I will also admit that I do not yet have the greatest financial sense and cannot conceptualize what 300K looks like after tax and how far that much income would go.

 

[Merovinge]

That is a good question and one I do not have a great answer too. I have a fair bit of debt from medical school and college, and also have family members that are growing older who need financial support. I figured 500K would put me in a place where I can pay off my debts faster, develop a solid foundation for retirement long term, and also take care of the people who took care of me. I will also admit that I do not yet have the greatest financial sense and cannot conceptualize what 300K looks like after tax and how far that much income would go.

If you are young/single which it sounds like you are, then you should be looking to cobble together multiple jobs and/or locum/shift work where you can be properly reimbursed for going over 1.0 FTE. There's nothing wrong with hustling for a few years to pay off debt and ideally learn enough psychiatry to figure out a sustainable pathway for the rest of your career. There is plenty of demand for psychiatrists looking to do this type of work.

 

[MedMan80]

It's doable, but you're probably not going to work 30/h a day and see 10 patients a day to hit 500k. You're prob at that 20 encounters a day range, with a good amount of hustle. Probably close to 45+ hours a week, most shrinks want to work less..

 

[FatherPsychiatry]

It's doable, but you're probably not going to work 30/h a day and see 10 patients a day to hit 500k. You're prob at that 20 encounters a day range, with a good amount of hustle. Probably close to 45+ hours a week, most shrinks want to work less..

Agreed... the closest thing I can think of for 30-40h a week with low work load is middle of nowhere prisons in CA where rates were $300+ a year or two ago (I heard one place was offering $400 for short term locums for a bit), but last I heard, those gigs are drying up. Dunno if its due to budget issues or people are actually starting to fill those positions (ie, employees), but probably a mix of those.

 

[MedMan80]

Agreed... the closest thing I can think of for 30-40h a week with low work load is middle of nowhere prisons in CA where rates were $300+ a year or two ago (I heard one place was offering $400 for short term locums for a bit), but last I heard, those gigs are drying up. Dunno if its due to budget issues or people are actually starting to fill those positions (ie, employees), but probably a mix of those.

Locums in boonies in NYS were 300/h 2-3 years ago

 

[FlowRate]

For the people in private practice managing to fill with high rates, there's probably also some sort of specific draw that they've cultivated. They could be extremely good with patients while maintaining high standards of care (which means saying "no" in many cases.) They could have made a name locally/regionally as an expert in a particular diagnosis or diagnostic category (couple of frequent forum contributors fall into this category.) They could be willing to see more severely ill/risky patients than the typical outpatient PP doc. They could diagnose everyone with whatever they want to be diagnosed with and fall just barely on the line of not technically being a pill mill.

I know that it's important to me to maintain very high standards of care and to try and push back some on the diagnostic bloat trend, which means (often figuratively more than literally) saying "no" to patients sometimes. When you combine that with the the idea that I'm probably average with worried well patients, when compared to other psychiatrists, but not extremely good, it means I would not have as good a chance with the easiest side of high-earning PP (in terms of workload.) I'm not naturally effusive/highly emotive, which many of the worried well patients seem to want, but I'm best with patients who have serious problems and who need/want a serious, invested, respectful psychiatrist. So, if I ever wanted to aim for a higher-earning PP, I'd probably need to target specialized or severely ill populations. Meanwhile, I think that makes me a good fit for an employed generalist job, where my primary incentives align toward providing the best quality care possible and only secondarily align with patient satisfaction.

 

[Merovinge]

For the people in private practice managing to fill with high rates, there's probably also some sort of specific draw that they've cultivated. They could be extremely good with patients while maintaining high standards of care (which means saying "no" in many cases.) They could have made a name locally/regionally as an expert in a particular diagnosis or diagnostic category (couple of frequent forum contributors fall into this category.) They could be willing to see more severely ill/risky patients than the typical outpatient PP doc. They could diagnose everyone with whatever they want to be diagnosed with and fall just barely on the line of not technically being a pill mill.

I know that it's important to me to maintain very high standards of care and to try and push back some on the diagnostic bloat trend, which means (often figuratively more than literally) saying "no" to patients sometimes. When you combine that with the the idea that I'm probably average with worried well patients, when compared to other psychiatrists, but not extremely good, it means I would not have as good a chance with the easiest side of high-earning PP (in terms of workload.) I'm not naturally effusive/highly emotive, which many of the worried well patients seem to want, but I'm best with patients who have serious problems and who need/want a serious, invested, respectful psychiatrist. So, if I ever wanted to aim for a higher-earning PP, I'd probably need to target specialized or severely ill populations. Meanwhile, I think that makes me a good fit for an employed generalist job, where my primary incentives align toward providing the best quality care possible and only secondarily align with patient satisfaction.

Good self-reflection, my practice style is very similar to that as well. I do see folks do well in PP that are known for really high quality care without one specific niche, but they have cultivated a reputation over a long time. It's certainly not the easiest path to a lucrative PP (i.e. the serious, well read, invested, and respectful psychiatrist with relatively low expressed emotion), but can be done.

 

[clozareal]

For the people in private practice managing to fill with high rates, there's probably also some sort of specific draw that they've cultivated. They could be extremely good with patients while maintaining high standards of care (which means saying "no" in many cases.) They could have made a name locally/regionally as an expert in a particular diagnosis or diagnostic category (couple of frequent forum contributors fall into this category.) They could be willing to see more severely ill/risky patients than the typical outpatient PP doc. They could diagnose everyone with whatever they want to be diagnosed with and fall just barely on the line of not technically being a pill mill.

My rates are on the higher end but not the highest for my area. I lean more toward seeing more severely ill patients, especially children/teenagers, whose parents are the ones who can afford those rates and are willing to pay for high quality care for their sick kids. I've had parents tell me "I'll pay whatever if you can help because there are no other child psychiatrists in this area who has availability." I often tell patients that they don't have ADHD/autism if that's their clinical question and I don't think they do, and some I don't see again because of it (good riddance). I do about 6-8 hours of psychotherapy per week, mostly psychodynamic and family/parent therapy. The worried well don't stick around for long except for in psychotherapy — as per Jonathan Shedler, I think successful psychotherapy should not only relieve symptoms (i.e. get rid of something) but also foster the positive presence of psychological capacities and resources (i.e., adding something good).

 

[Marasmus1]

The difference for me is peace of mind.

I make around 300k in academia. Majority of the work is clinician educator, covering different resident service lines. Have couple of faculty clinic patients I see weekly. Typically in by 9 AM and out by 4:30 PM. Getting approximately 9 weeks off a year. Will need much more than 500k to feel motivated for a change of setup. However, I can see somebody else hating my setup and grinding day/night to hit 500k. Not for me

 

[FlowRate]

The difference for me is peace of mind.

I make around 300k in academia. Majority of the work is clinician educator, covering different resident service lines. Have couple of faculty clinic patients I see weekly. Typically in by 9 AM and out by 4:30 PM. Getting approximately 9 weeks off a year. Will need much more than 500k to feel motivated for a change of setup. However, I can see somebody else hating my setup and grinding day/night to hit 500k. Not for me

That sounds like a particularly nice faculty setup, great job. How much call coverage?

 

[Stagg737]

That sounds like a particularly nice faculty setup, great job. How much call coverage?

These academic jobs are out there. I make $260-270k/yr as a consult attending and my days are basically 10-4ish in terms of actually staffing with residents in what is essentially a 3 on/1 off schedule. So 13 weeks "off"/admin per year. I have a call week every 6-7 weeks where I'm on overnight call for 7 days (have gotten 3 calls total in 3 years, never after midnight; so I don't even really consider this call) and staff on the weekend which I am paid extra for ($1k/day + wRVUs). I also have other benefits that adds to total compensation and puts it over that $300k mark pretty easily.

 

[jbomba]

Large groups out here in the land of milk and honey have negotiated rates which generate 450-500/hr for their providers AFTER the groups 40% cut. This is assuming once full and doing two 99214 and 90833 per hour.

So 700s for 32 hours a week with 6 weeks off.

 

[Atreides]

Large groups out here in the land of milk and honey have negotiated rates which generate 450-500/hr for their providers AFTER the groups 40% cut. This is assuming once full and doing two 99214 and 90833 per hour.

So 700s for 32 hours a week with 6 weeks off.

Idk about that. My friends in the Bay Area who have joined large private practice groups tell me they get about $400/hour after the groups 30% cut, seeing three 99214 and 90833's per hour. By your math, these groups are getting over $400 per appointment from insurance, so about 2x CMS. I have not seen that in the Bay Area.

 

[throw-away-go-away]

Large groups out here in the land of milk and honey have negotiated rates which generate 450-500/hr for their providers AFTER the groups 40% cut. This is assuming once full and doing two 99214 and 90833 per hour.

So 700s for 32 hours a week with 6 weeks off.

HCOL are or LCOL area? Or just in general where, lol

 

[Mad Jack]

You should also keep in mind that it isn't what you make, it's what you keep. 500k in a high tax state with HCOL may be worth less than 300k in a low tax state with LCOL. I'm in the mid-300s doing academic work in a moderate cost of living area and I'm far better off than people I know in California or NYC that make far more than me

 

[Marasmus1]

That sounds like a particularly nice faculty setup, great job. How much call coverage?

negligible. I am on call on the paper over 2 weekends a month covering ED over the phone. ED is staffed by a resident 24/7 who discusses the case with the ER attending and child fellow who sign the admission or discharge order. once every three months or so I may receive a call about a kid who is dumped in the ED with nobody knowing whereabouts of family but that`s pretty much what call entails. I give in-service child psychiatry emergencies course to ED attendings/residents two times a year, which saves me 10s of unnecessary calls if not 100s.

I strongly believe that the next 3-5 years will see strong relapse of interest in academic employment at facilities with GME programs. It is not because academia salaries are taking off. They are not and They won`t. It is simply because academia remains one of the few places where APP encroachment stays minimal (and even if they are there, the boundaries with physicians/residents are much stricter) and you still have an immediate physician boss (instead of an MBA who is a puppet of corporate interests). With the insane market share of VC backed telehealth companies, start ups and poorly regulated initiatives of AI assisted mental healthcare delivery, opening a private practice is becoming more and more like opening a neighborhood grocery store within the 0.5 mile radius of Costco, Sam`s club and Whole Foods. Sure you can still create a brand but you would need to put much more work than you would have done before. And it is rather clear that average Joe won`t be clearing big bucks by offering primarily ''pharmacotherapy'' practice in very near future. One can google ''adderall doctor'' or ''order antidepressant'' , click one of those advertised telehealth start ups, sign up, answer ''symptom questionnaire'' and receive a script with free delivery within 24 to 48 hours for approximately 25 dollars a month (some even have started augmenting partial response with abilify).

Some may still prefer corporate employment with clear check in and check out times and potential to make big bucks. However, it is worth noting that the role of a psychiatrist is being reduced to ''provider'' or even worse ''medication manager'' day by day. In fact, one of those tele health start ups which primarily provide employee behavioral health services has recently approached me for a part time gig. Their website clearly states they have two types of behavioral health providers ; ''counselors'' and ''medication managers'', under which you can see the names of board certified MD`s/DO`s.

A role of a psychiatrist has been becoming more and more of a ''medication manager'' middle man within the complex wrap around behavioral health services. We have been approaching the last days of a romantic era in which the psychiatrist was the leader of a treatment team.

 

[randomdoc1]

You should also keep in mind that it isn't what you make, it's what you keep. 500k in a high tax state with HCOL may be worth less than 300k in a low tax state with LCOL. I'm in the mid-300s doing academic work in a moderate cost of living area and I'm far better off than people I know in California or NYC that make far more than me

Yes, even more potent than making money is managing money. It's good to invest, invest a lot and early on. First get rid of debt fast as you can though. Indexing is great. I've been dabbling in individual stocks, PLTR and NVDA. It's been boosting me further than the SP500 alone (but also a risk I'm well aware I am taking).
Max out your 401k, IRA, HSA. Powerful wealth building tools.

That and how to optimize your taxes. Tax deductions.

Once you eventually in life hopefully hit the multimillions--you basically hold the key to generational wealth. Compounding interest is an exponential function--without having to lift an extra finger. It's wild.

But if you think about it, let's say you put 500k in VOO. The stock return in general has averaged 9-11% for the past 100 years. It's been a consistent climb even if you include the Great Depression and 2008 crash. It's always recovered. If you are getting 10% back per year, that's just a free 50k and it grows year over year if you do not take it out!

 

[finalpsychyear]

Yes, even more potent than making money is managing money. It's good to invest, invest a lot and early on. First get rid of debt fast as you can though. Indexing is great. I've been dabbling in individual stocks, PLTR and NVDA. It's been boosting me further than the SP500 alone (but also a risk I'm well aware I am taking).
Max out your 401k, IRA, HSA. Powerful wealth building tools.

That and how to optimize your taxes. Tax deductions.

Once you eventually in life hopefully hit the multimillions--you basically hold the key to generational wealth. Compounding interest is an exponential function--without having to lift an extra finger. It's wild.

But if you think about it, let's say you put 500k in VOO. The stock return in general has averaged 9-11% for the past 100 years. It's been a consistent climb even if you include the Great Depression and 2008 crash. It's always recovered. If you are getting 10% back per year, that's just a free 50k and it grows year over year if you do not take it out!

Yes spot on. My one attending alway said the money you make the first 10 years of attending life is the most valuable then you get to take off the heavy backback and compound growth takes it over forever after that. Harness into investments and you'll fire early. If you get lost buying cars, too much house then its an uphill road.

Hoping in 2030 I'll be handing off the backback.

 

[finalpsychyear]

negligible. I am on call on the paper over 2 weekends a month covering ED over the phone. ED is staffed by a resident 24/7 who discusses the case with the ER attending and child fellow who sign the admission or discharge order. once every three months or so I may receive a call about a kid who is dumped in the ED with nobody knowing whereabouts of family but that`s pretty much what call entails. I give in-service child psychiatry emergencies course to ED attendings/residents two times a year, which saves me 10s of unnecessary calls if not 100s.

I strongly believe that the next 3-5 years will see strong relapse of interest in academic employment at facilities with GME programs. It is not because academia salaries are taking off. They are not and They won`t. It is simply because academia remains one of the few places where APP encroachment stays minimal (and even if they are there, the boundaries with physicians/residents are much stricter) and you still have an immediate physician boss (instead of an MBA who is a puppet of corporate interests). With the insane market share of VC backed telehealth companies, start ups and poorly regulated initiatives of AI assisted mental healthcare delivery, opening a private practice is becoming more and more like opening a neighborhood grocery store within the 0.5 mile radius of Costco, Sam`s club and Whole Foods. Sure you can still create a brand but you would need to put much more work than you would have done before. And it is rather clear that average Joe won`t be clearing big bucks by offering primarily ''pharmacotherapy'' practice in very near future. One can google ''adderall doctor'' or ''order antidepressant'' , click one of those advertised telehealth start ups, sign up, answer ''symptom questionnaire'' and receive a script with free delivery within 24 to 48 hours for approximately 25 dollars a month (some even have started augmenting partial response with abilify).

Some may still prefer corporate employment with clear check in and check out times and potential to make big bucks. However, it is worth noting that the role of a psychiatrist is being reduced to ''provider'' or even worse ''medication manager'' day by day. In fact, one of those tele health start ups which primarily provide employee behavioral health services has recently approached me for a part time gig. Their website clearly states they have two types of behavioral health providers ; ''counselors'' and ''medication managers'', under which you can see the names of board certified MD`s/DO`s.

A role of a psychiatrist has been becoming more and more of a ''medication manager'' middle man within the complex wrap around behavioral health services. We have been approaching the last days of a romantic era in which the psychiatrist was the leader of a treatment team.

I've been paranoid the last 8-9 years this happening but sadly it has come true. Doing the live like the resident for 5 years def saved me with all this nonsense that has come and is coming soon. I dont really enjoy the direction medicine is going and thank the gods I suffered and saved/invested till it hurt most of my career.

Edit: had a ton of pts come back and tell me that they got the adhd meds rx online when i wouldn't rx it to them so this is spot on.

 

[comp1]

So I can see that academics might be more attractive because you're primarily supervising physicians and having supervisors who are physicians. However, in a lot of cases, you will still be supervising and training NP or PA students. I'd go so far as to say most medical schools have affiliated NP, PA or both programs. Of course these do tend to be much higher quality trainees than the online programs. In terms of avoiding the (non-MD) MBAs, it's just a matter of how high you go. They're always there somewhere.

 

[Stagg737]

You should also keep in mind that it isn't what you make, it's what you keep. 500k in a high tax state with HCOL may be worth less than 300k in a low tax state with LCOL. I'm in the mid-300s doing academic work in a moderate cost of living area and I'm far better off than people I know in California or NYC that make far more than me

Agree and same. Where I live compared to where I grew up and my parents live (Chicago suburb) are so wildly different from a CoL standpoint I could never move back. A near identical house costs $1mil more there than my current house. Estimated mortgage for the Chicago suburb house is $8.3k/mo more than we pay and property tax would be 4x higher. It's a difference of about $125k/yr just in mortgage and property tax difference and allows me to live a nice lifestyle and build a nest egg while working in academics basically 3/4 of the year vs choosing between hustling or living like a resident. Yes, I take a pay hit and potentially won't be able to FIRE as soon as I'd like, but those trade offs are well worth it to me.

So I can see that academics might be more attractive because you're primarily supervising physicians and having supervisors who are physicians. However, in a lot of cases, you will still be supervising and training NP or PA students. I'd go so far as to say most medical schools have affiliated NP, PA or both programs. Of course these do tend to be much higher quality trainees than the online programs. In terms of avoiding the (non-MD) MBAs, it's just a matter of how high you go. They're always there somewhere.

Ime the bolded isn't really accurate. Yes, a lot of these places have other health programs, but typically those students are either trained by their counterparts that are on staff (at least with NPs, PAs may get supervised by physicians more) or have to seek supervision on their own because the academic center just doesn't provide it. I've been directly e-mailed by NP students from places I never expected and which are nowhere near me (Duke and UCLA off the top of my head) asking me to supervise them. We do have NPs at our program, but none of the psychiatrists supervise them other than one and I have a specific clause in my contract stipulating I will not supervise any non-physician students unless I directly agree (and I recommend anyone who doesn't want to supervise others do the same).

 

[FlowRate]

negligible. I am on call on the paper over 2 weekends a month covering ED over the phone. ED is staffed by a resident 24/7 who discusses the case with the ER attending and child fellow who sign the admission or discharge order. once every three months or so I may receive a call about a kid who is dumped in the ED with nobody knowing whereabouts of family but that`s pretty much what call entails. I give in-service child psychiatry emergencies course to ED attendings/residents two times a year, which saves me 10s of unnecessary calls if not 100s.

I strongly believe that the next 3-5 years will see strong relapse of interest in academic employment at facilities with GME programs. It is not because academia salaries are taking off. They are not and They won`t. It is simply because academia remains one of the few places where APP encroachment stays minimal (and even if they are there, the boundaries with physicians/residents are much stricter) and you still have an immediate physician boss (instead of an MBA who is a puppet of corporate interests). With the insane market share of VC backed telehealth companies, start ups and poorly regulated initiatives of AI assisted mental healthcare delivery, opening a private practice is becoming more and more like opening a neighborhood grocery store within the 0.5 mile radius of Costco, Sam`s club and Whole Foods. Sure you can still create a brand but you would need to put much more work than you would have done before. And it is rather clear that average Joe won`t be clearing big bucks by offering primarily ''pharmacotherapy'' practice in very near future. One can google ''adderall doctor'' or ''order antidepressant'' , click one of those advertised telehealth start ups, sign up, answer ''symptom questionnaire'' and receive a script with free delivery within 24 to 48 hours for approximately 25 dollars a month (some even have started augmenting partial response with abilify).

Some may still prefer corporate employment with clear check in and check out times and potential to make big bucks. However, it is worth noting that the role of a psychiatrist is being reduced to ''provider'' or even worse ''medication manager'' day by day. In fact, one of those tele health start ups which primarily provide employee behavioral health services has recently approached me for a part time gig. Their website clearly states they have two types of behavioral health providers ; ''counselors'' and ''medication managers'', under which you can see the names of board certified MD`s/DO`s.

A role of a psychiatrist has been becoming more and more of a ''medication manager'' middle man within the complex wrap around behavioral health services. We have been approaching the last days of a romantic era in which the psychiatrist was the leader of a treatment team.

So much more chill than where I did residency. Academic gigs there were long ours, attendings were typically called at least once a night, and low pay. I like my current job, but just good to hear there are more balanced academic opportunities.