What Job offers are current residents getting?

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Silent Cool said:
@bronx43 , you remind me of Peter Schiff :)
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Haha... not sure that's a good thing. I think he holds some interesting beliefs, and may ultimately be right about certain things that he predicts, but he lacks a coherent understanding of global macroeconomics and finance. I'm more in line with the views of anti-neoclassical economists like Yanis Varoufakis and Steve Keen. They are somewhere in between the dominant neoclassical crowd and the Austrian faction.
 
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dr doze said:
Someone once said, "the world is always going to hell in a hand basket, but it never quite gets there".
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It never quite gets there? Not sure who added the latter part, but I'm not sure I agree with that statement - depending on your definition of hell.
 
bronx43 said:
It never quite gets there? Not sure who added the latter part, but I'm not sure I agree with that statement - depending on your definition of hell.
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WW1: 37 million dead
The Great Depression
WW2: 60 million dead
The cold war with US and the Soviets aiming thousands of nukes at each other
Riots of the 1960s, etc.

Other than global warming (if you believe it) today's problems don't quite compare.
 
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dr doze said:
WW1: 37 million dead
The Great Depression
WW2: 60 million dead
The cold war with US and the Soviets aiming thousands of nukes at each other
Riots of the 1960s, etc.

Other than global warming (if you believe it) today's problems don't quite compare.
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Lol, yeah this was actually gonna be my point. We get to hell quite often. The problem is trying to guess where on the cyclical nature of history we are. Are we in the early 20th century right before the war, or are we at some great moderation of a millennium of peace?
 
dr doze said:
WW1: 37 million dead
The Great Depression
WW2: 60 million dead
The cold war with US and the Soviets aiming thousands of nukes at each other
Riots of the 1960s, etc.

Other than global warming (if you believe it) today's problems don't quite compare.
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Those sound like huge numbers.

However, to put in perspective, there are 109 million people on welfare benefits in the US.
 
$300k minimum, about $350k this year

Graduated within the past few years
Los Angeles suburb
1099 independent contractor
Average 100 hr/month (hours physically in hospital, not necessarily doing cases the whole time)
Call from home, one weekday per week, one weekend 72hr Fri 7am-Mon 7am call per month
Call is usually light, cases end by 3-5pm most of the time, occasional after-hours epidural, C-section, lap appy
Post-call off
OB not in house for running epidurals
Bread and butter cases of all ages, usually no kids below 2yo
Hours don't vary too much, most weeks barely 20hr, week that include weekend call never reach 40h
4 weeks vacation

I have enough free time to look for a second per diem job, but I enjoy my time off too much.

My friends in the Midwest make 50% more than me and get lots of benefits (retirement, profit sharing, malpractice insurance, health insurance, CME reimbursement, sign-on bonus, student loan repayment, etc, such that they can earn double). I have to swallow the cost of living/working here, but not sure there's anything one can do about it but move.
 
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Yeah, average 20-25h a week. My last weekend call I worked a total of 6h between Fri morning and Mon morning. The rest of the time I was doing errands and chores and meeting up with friends. There are some weekday or weekend calls that I work 22h straight, but those are very rare like 2-3x per year.
 
Around here I've heard it can be either way depending on hospital, stay in house or home while epidural is running.
 
Wow, 25 hrs/wk @ 350k/yr in LA? Gas on, guys!
 
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Making 190k for 25hrs a week in a fairly nice area plus light call is better than 400k for 60 hrs and frequent call in a boring area for many if not most people. Depends on spouse, kids, etc. but sounds amazing.
 
We go home with our epidurals running.... I think it's because the hospital doesn't want to pay to put in a proper call room
 
We go home with running epidurals. I think it's fairly common in smaller hospital settings to have no one in house with running epidurals. It's considered analgesia not anesthesia with an epidural
 
BLADEMDA said:
$350K in LA? as a 1099 he is taking home maybe $250K and still paying high taxes on top of living in LA. I'd say $350K 1099 in LA is like $190K 1099 living in most other areas of the country.
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Blade. Most peeps in California sock a lot of money in tax deferred plans. My brother socks $100k plus into his defined benefit plans per year.

Sure state income taxes suck out there. But you can shield a lot until you figure what to do with the money.

Cost of living is higher if you live near the coast. Prices aren't too bad once you move away in land.

But it California. Weather is great 80-90% of the time in Southern California. Weather is great probably only 50% of time in Florida (I prefer November-March in Florida).
 
aneftp said:
Blade. Most peeps in California sock a lot of money in tax deferred plans. My brother socks $100k plus into his defined benefit plans per year.

Sure state income taxes suck out there. But you can shield a lot until you figure what to do with the money.

Cost of living is higher if you live near the coast. Prices aren't too bad once you move away in land.

But it California. Weather is great 80-90% of the time in Southern California. Weather is great probably only 50% of time in Florida (I prefer November-March in Florida).
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How does he sock 100k into his defined benefit plans? Max limit per individual 401k is 52k per year, backdoor Roths for physician and spouse adds another 11k per year, HSA account adds another 6150 per year, where's the rest going? Does he have a secondary 1099 job to contribute to a secondary 401k account for another 52k per year? Are you referring to him putting money into just an IRA because not much tax benefit in that.

Red
 
amyl said:
We go home with our epidurals running.... I think it's because the hospital doesn't want to pay to put in a proper call room
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God girl, every time you post, your job sounds worse and worse. Congrats on having the courage to leave and try something new. Several negative Nancy posters to this forum would be much happier if they followed your lead. Maybe they would make less money, but life's too short to have so much negativity caused by a job. Good luck in the quest for a better gig. It shouldn't be too hard to find one better than your current shop. ;)
 
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RedAnesthesia said:
How does he sock 100k into his defined benefit plans? Max limit per individual 401k is 52k per year, backdoor Roths for physician and spouse adds another 11k per year, HSA account adds another 6150 per year, where's the rest going? Does he have a secondary 1099 job to contribute to a secondary 401k account for another 52k per year? Are you referring to him putting money into just an IRA because not much tax benefit in that.

Red
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"Get this: A 52-year-old entrepreneur netting $300,000 could use a one-person defined-benefit pension plan combined with a solo 401(k) to shelter a total of $169,800 from current income taxes, calculates Karen Shapiro, chief executive of Dedicated Defined Benefit Services in Oakland, Calif."

http://www.forbes.com/sites/ashleae...an-get-big-tax-breaks-for-retirement-savings/

Just one of many ways
 
Wow. Good for you guys. I couldn't imagine being able to leave with running epidurals. They barely like us not here with laboring patients. But we do have a call room so we kind of have no excuse
 
RedAnesthesia said:
How does he sock 100k into his defined benefit plans? Max limit per individual 401k is 52k per year, backdoor Roths for physician and spouse adds another 11k per year, HSA account adds another 6150 per year, where's the rest going? Does he have a secondary 1099 job to contribute to a secondary 401k account for another 52k per year? Are you referring to him putting money into just an IRA because not much tax benefit in that.
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401K is a defined-contribution plan. Defined benefit plans are completely different.

I suggest you peruse this document.
 
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aimedicine said:
Yes but the difference is, in 1996 student loans was no where near 220k average thar it is today, so with 100k student loans and wrking 40hrs a week with lots ofvacation i can see myself doing anesthesia. BUT in 2015, with avg loan 220k+ plus, 5yrs of residency, inherent risk of job, and increasing hrs...no one in their right sense will go into anesthesia for 165k salary....which is lower than FP. If this country hope to continue to produce doctor anesthesiologist, they dare not do that.
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Well since we have increasing USMD graduates every year SOMEBODY will take it if its the difference between getting a residency or not getting a residency.

Also FMGs typically have little/no student loans
 
qwerty89 said:
Well since we have increasing USMD graduates every year SOMEBODY will take it if its the difference between getting a residency or not getting a residency.

Also FMGs typically have little/no student loans
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Not if there are better alternatives...why go into anesthesia for 160k with all the stress and longer training when you can go into family medicine, peds, psych, PMR, radiology (and if your board scores are high enough...there is derm, uro, optho, ortho, and IM subspec.) etc...it just doesn't make sense...no one is and should be that desperate to be anesthesiologist....medical students are many things, but stupid is not one of it because that is what i would call someone who would borrow 200k in loans, do 5 years of residency, endure the risk and stress of anesthesia, just to be the lowest compensated physician....because at 160k, anesthesia would be lowest compensated field.

now should anesthesia compensation dip to 160k, you're correct, it would be filled with desperate FMG/IMG and bottom 10% of USMD/DO schools...basically the torch of the field would be carried by CRNA and the worst medical school graduates.....this would effectively be the end of the field.
 
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aimedicine said:
Not if there are better alternatives...why go into anesthesia for 160k with all the stress and longer training when you can go into family medicine, peds, psych, PMR, radiology (and if your board scores are high enough...there is derm, uro, optho, ortho, and IM subspec.) etc...it just doesn't make sense...no one is and should be that desperate to be anesthesiologist....medical students are many things, but stupid is not one of it because that is what i would call someone who would borrow 200k in loans, do 5 years of residency, endure the risk and stress of anesthesia, just to be the lowest compensated physician....because at 160k, anesthesia would be lowest compensated field.

now should anesthesia compensation dip to 160k, you're correct, it would be filled with desperate FMG/IMG and bottom 10% of USMD/DO schools...basically the torch of the field would be carried by CRNA and the worst medical school graduates.....this would effectively be the end of the field.
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The bottom of the heap has been going into internal medicine, pediatrics, neurology etc. for quite some time... Those fields aren't ending.
 
Carbocation1 said:
The bottom of the heap has been going into internal medicine, pediatrics, neurology etc. for quite some time... Those fields aren't ending.
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Yes but those fields are low risk, 3 yr residency, and they pay more than 160k.
 
aimedicine said:
Not if there are better alternatives...why go into anesthesia for 160k with all the stress and longer training when you can go into family medicine, peds, psych, PMR, radiology (and if your board scores are high enough...there is derm, uro, optho, ortho, and IM subspec.) etc...it just doesn't make sense...no one is and should be that desperate to be anesthesiologist....medical students are many things, but stupid is not one of it because that is what i would call someone who would borrow 200k in loans, do 5 years of residency, endure the risk and stress of anesthesia, just to be the lowest compensated physician....because at 160k, anesthesia would be lowest compensated field.

now should anesthesia compensation dip to 160k, you're correct, it would be filled with desperate FMG/IMG and bottom 10% of USMD/DO schools...basically the torch of the field would be carried by CRNA and the worst medical school graduates.....this would effectively be the end of the field.
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I know many FMGs personally and I don't think you people understand how desperate many of them are. Its not all about the money for them. Many, from places like India, simply want their children to grow up in the U.S. and will do ANYTHING for that to happen. No to mention the prestige of being a specialist (ever wonder why FMGs bother to sub-specialize in Nephrology when US grads all run away from it like the plague?). Not to mention that applying for a greencard takes forever, but getting a residency to sponsor a VISA? Much easier. (Residencies love their cheap labor!)

I know FMGs that have left India for the US and spend years working in factories, dry-cleaners, etc while studying for their USMLEs.

Also there has been a trend in China/India of increasing patient unrest. Patients their see their docs as greedy parasites (sounds familiar...) and have increasingly physically attacked doctors (and no the local drunk swinging at at doc/nurse in the ED is not the same).

http://time.com/15185/chinas-doctors-overworked-underpaid-attacked/
http://zeenews.india.com/news/delhi...ting-against-attack-on-colleague_1553850.html
http://www.dailyrounds.org/blog/sto...t-in-return-for-trying-to-revive-his-patient/

and the most recent one (3 days ago)

http://www.bbc.com/news/blogs-trending-32815816
 
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qwerty89 said:
I know many FMGs personally and I don't think you people understand how desperate many of them are. Its not all about the money for them. Many, from places like India, simply want their children to grow up in the U.S. and will do ANYTHING for that to happen. No to mention the prestige of being a specialist (ever wonder why FMGs bother to sub-specialize in Nephrology when US grads all run away from it like the plague?). Not to mention that applying for a greencard takes forever, but getting a residency to sponsor a VISA? Much easier. (Residencies love their cheap labor!)

I know FMGs that have left India for the US and spend years working in factories, dry-cleaners, etc while studying for their USMLEs.

Also there has been a trend in China/India of increasing patient unrest. Patients their see their docs as greedy parasites (sounds familiar...) and have increasingly physically attacked doctors (and no the local drunk swinging at at doc/nurse in the ED is not the same).

http://time.com/15185/chinas-doctors-overworked-underpaid-attacked/
http://zeenews.india.com/news/delhi...ting-against-attack-on-colleague_1553850.html
http://www.dailyrounds.org/blog/sto...t-in-return-for-trying-to-revive-his-patient/

and the most recent one (3 days ago)

http://www.bbc.com/news/blogs-trending-32815816
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now should anesthesia compensation dip to 160k, you're correct, it would be filled with desperate FMG/IMG and bottom 10% of USMD/DO schools...basically the torch of the field would be carried by CRNA and the worst medical school graduates.....this would effectively be the end of the field.
 
aimedicine said:
now should anesthesia compensation dip to 160k, you're correct, it would be filled with desperate FMG/IMG and bottom 10% of USMD/DO schools...basically the torch of the field would be carried by CRNA and the worst medical school graduates.....this would effectively be the end of the field.
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1. It didn't happen in the 90's. The world didn't end.
2. Nobody really cares what will happen to "the field". The leadership is relatively old and all they care about is the 10 years till retirement.
3. FMGs are not the worst medical school graduates, not by far. Not while there is a big supply of them and the US medical programs can cherry-pick the best. Even for $160k. As somebody pointed out on another thread, there will always be a ton of FMGs from developing countries, willing to come to the US for a better life (even at the average US household salary, I would add).
 
FFP said:
1. It didn't happen in the 90's. The world didn't end.
2. Nobody really cares what will happen to "the field". The leadership is relatively old and all they care about is the 10 years till retirement.
3. FMGs are not the worst medical school graduates, not by far. Not while there is a big supply of them and the US medical programs can cherry-pick the best. Even for $160k. As somebody pointed out on another thread, there will always be a ton of FMGs from developing countries, willing to come to the US for a better life (even at the average US household salary, I would add).
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when i say the end of the field, i don't mean the field will end literally. I mean it would be the end of the field as we currently know it.
 
There are extremely few Crnas willing to work 55 hours full call with little or no opportunity for overtime for say $200k. Why do that when they can work 3-4 days a week no calls no nights for 160k easily in many parts of the country.

So for md compensation to get as low as $200k full time with call, u will see a big drop in Crna income as well.

The aana knows there aren't enough bodies to replace md. That's why the push for collaborate model forcing more acute cases on MDs while protecting the Crnas. Aana won't come out and say that. But we all know that is the plan.
 
Can you guys explain what you mean when you say "risk" of doing an anethesiology residency compared to say, an IM residency? I'm not sure what you guys mean
 
dgu334 said:
Can you guys explain what you mean when you say "risk" of doing an anethesiology residency compared to say, an IM residency? I'm not sure what you guys mean
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I think they mean the risk of practicing the specialty. As in it is much more difficult to put someone out in IM, Peds, FM, etc as opposed to anesthesia, where you are practicing acute care medicine, and patients can die in minutes. This translates to job stress which anesthesiologists deserve to be handsomely compensated for.
 
is CC a good fellowship to consider if/when **** hits the fan in anesthesia?
 
chaingangdx said:
is CC a good fellowship to consider if/when **** hits the fan in anesthesia?
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1. Peds
2. Pain
3. Cardiac
4. Critical Care

For academics Critical Care is a great fellowship and I highly recommend it. A good Critical Care Fellowship will prepare you for the majority of Private Practice jobs where you will do hearts. That said, if you want strictly private practice the top 3 listed are all in demand.

A motivated Critical care Fellow should be able to pass the Basic TEE exam and be more than able to handle private practice cases. That said, there are more job opportunities with a Cardiac Fellowship with your TEE certification (advanced).
 
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BLADEMDA said:
1. Peds
2. Pain
3. Cardiac
4. Critical Care

For academics Critical Care is a great fellowship and I highly recommend it. A good Critical Care Fellowship will prepare you for the majority of Private Practice jobs where you will do hearts. That said, if you want strictly private practice the top 3 listed are all in demand.

A motivated Critical care Fellow should be able to pass the Basic TEE exam and be more than able to handle private practice cases. That said, there are more job opportunities with a Cardiac Fellowship with your TEE certification (advanced).
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A motivated resident can pass the advanced TEE test. We've had several new hires who have.
 
nimbus said:
A motivated resident can pass the advanced TEE test. We've had several new hires who have.
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Of course, I agree with you. Seinfeld and others who did CC Fellowships have passed the advanced TEE exam. My point is that most CC fellows should be able to pass at least the BASIC exam upon finishing their fellowship. Naturally, it may be in their interest to move up to the advanced exam.
 
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BLADEMDA said:
1. Peds
2. Pain
3. Cardiac
4. Critical Care

For academics Critical Care is a great fellowship and I highly recommend it.
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Thanks Blade. :) I assume the above #1-4 are for PP. But for academics, how would you rank the fellowships? Would Critical Care be #1?
 
bashwell said:
Thanks Blade. :) I assume the above #1-4 are for PP. But for academics, how would you rank the fellowships? Would Critical Care be #1?
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For Academics choose the Fellowship which most interests you. I'm not sure any of the fellowships makes you a better academician but Peds, Critical care, Cardiac and Pain are all in demand. Critical Care is certainly highly regarded in Academics.

Want to be in ultra high demand? Peds fellowship followed by Subspecialty training in Peds hearts or Peds Critical Care.
 
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Except that to do Peds Critical Care, you'd have to do a Peds residency, as well. Also, outside of dedicated childrens' hospitals and big academic centers, how many regular residency programs do Peds hearts? One is only in demand if one fills a particular niche. This is not my field, but I wouldn't think that most academic programs would find a peds cardiac attending amazingly atractive, if they don't do any.
 
Carbocation1 said:
The bottom of the heap has been going into internal medicine, pediatrics, neurology etc. for quite some time... Those fields aren't ending.
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The "bottom of the heap" (as you both so graciously put it) has been going into anesthesia for quite some time too. All you need is a pulse and a step 1 score above 200 to match somewhere (not to mention the huge amount of open transfer spots available every year). The higher end academic programs are, as for every field, competitive.
 
M
calvnandhobbs68 said:
The "bottom of the heap" (as you both so graciously put it) has been going into anesthesia for quite some time too. All you need is a pulse and a step 1 score above 200 to match somewhere (not to mention the huge amount of open transfer spots available every year). The higher end academic programs are, as for every field, competitive.
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i dunno about those with a pulse (U.S. Aamc med schools) are guaranteed spots these days anymore.

It used to be almost any aamc (those 120 plus med schools in USA) basically got a residency spot.

Because residency spots are limited because of Medicare funding. And U.S. Schools have increased slots for medical students (rom 1975-2000 ish). The only "new" aamc med school that opened was University of South Florida. (Opened in 1976 I believe)

But I believe in the past 15 years we've had 7-10 new aamc med schools open. This plus DO schools and IMG and limited residency slots means the bottom of heap isn't guaranteed a slot anymore
 
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