Why do residents get paid so little and have to work so hard?

[Fumoffu]

Forgive me for being a bit clueless on how the medical education system works but...

I've read numbers ranging anywhere from 35k to 45k being the starting and even ending salaries of residents. Yet I've been reading that residents work anywhere from 80 to 120 hours a week!

To me this doesn't really make sense. Tons of college graduates make CONSIDERABLY more than 35k. Heck some make even more than 60k! And I'm willing to bet almost none of them are putting in 80 hours a week (except maybe i-bankers). Residents obviously have a higher degree...but make less than secretaries? What the heck?

Are the responsibilities of a resident that different from the attending? I've seen what residents do and even though they're supervised, it doesn't seem like the responsibilities are THAT "far below" to warrant a salary that's more than 5 times lower than a regular physician's salary.

The "work so hard" part makes sense since you're still learning as a resident, but the compensation part boggles me especially since we'll all be in heavy debt by the time we graduate (well over 200k for me...).

Can anyone explain this to me?

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[IllinoisStudent]

quit medicine if u think you are not going to be paid enough. Although, I agree that residents are underpaid, I just don't feel like bit*hing about it.

*Edit - I m sorry Fumofu and fighterdoc. I just was losing my nerves trying to explain kinetic that AA is good. But it wasn't working. I guess I took it out somewhere else. I know its not a good excuse. Sorry *

 

[Garuda]

Residency is for chumps. You should just start practicing after you get out of med school. No one will know the difference.

 

[Thearchitect]

This is the manifestation of classism again, a dirty little thing that we don't like to talk about in the USA. You see, the years of making next to nothing are there to scare those incredibly talented low socioeconomic whites/Asians away from going into medicine, making it an almost necessity to have a mommy and daddy's bankroll to get you out of the red before the interest eats you alive on your peanuts salary.

 

[flighterdoc]

Forgive me for being a bit clueless on how the medical education system works but...

I've read numbers ranging anywhere from 35k to 45k being the starting and even ending salaries of residents. Yet I've been reading that residents work anywhere from 80 to 120 hours a week!

To me this doesn't really make sense. Tons of college graduates make CONSIDERABLY more than 35k. Heck some make even more than 60k! And I'm willing to bet almost none of them are putting in 80 hours a week (except maybe i-bankers). Residents obviously have a higher degree...but make less than secretaries? What the heck?

Are the responsibilities of a resident that different from the attending? I've seen what residents do and even though they're supervised, it doesn't seem like the responsibilities are THAT "far below" to warrant a salary that's more than 5 times lower than a regular physician's salary.

The "work so hard" part makes sense since you're still learning as a resident, but the compensation part boggles me especially since we'll all be in heavy debt by the time we graduate (well over 200k for me...).

Can anyone explain this to me?

First of all, pardon the post from illinoisstudent.

Residents technically don't get paid, they get a "stipend". The reason it's so little is because the AMA and AAMC and the hospitals and Medicare (which funds most residency slots) can get away with it.

You're also right, you have a LOT of debt, but you also get a LOT of payoff on the back end. By the time you graduate (assuming you're entering school this year) even a low-paying physician will make close to $200k a year (the low end specialties now get around $130K to start). So, a $200K debt isn't that bad.

 

[IndyZX]

The reason: because they can and will work for peanuts.

It's about cheap labor, and hospitals will exploit it.

 

[stinkycheese]

Medicine is all about paying dues. Wearing the short coat in med school, doing scut throughout med school and residency, taking q3/q4 call throughout the entire three-five years of training, etc, etc, etc... it's a grueling profession and a grueling training, and making no money is just a part of that. It will never get better, either, as each successive generation of physicians looks back and thinks, "i had to go through that-- so does the next batch."

 

[nina512]

Forgive me for being a bit clueless on how the medical education system works but...

I've read numbers ranging anywhere from 35k to 45k being the starting and even ending salaries of residents. Yet I've been reading that residents work anywhere from 80 to 120 hours a week!

To me this doesn't really make sense. Tons of college graduates make CONSIDERABLY more than 35k. Heck some make even more than 60k! And I'm willing to bet almost none of them are putting in 80 hours a week (except maybe i-bankers). Residents obviously have a higher degree...but make less than secretaries? What the heck?

Are the responsibilities of a resident that different from the attending? I've seen what residents do and even though they're supervised, it doesn't seem like the responsibilities are THAT "far below" to warrant a salary that's more than 5 times lower than a regular physician's salary.

The "work so hard" part makes sense since you're still learning as a resident, but the compensation part boggles me especially since we'll all be in heavy debt by the time we graduate (well over 200k for me...).

Can anyone explain this to me?

Because in residency...you're still in "training." Why should a 1st year resident get paid as much as someone with 10+years of work experience?

Don't worry, you can defer payment of your loans while you're in residency. And when your finished with residency, the salary will still be several times higher than what most people make in this country.

 

[Alexander99]

Residency is for chumps. You should just start practicing after you get out of med school. No one will know the difference.

Damn. I thought I was the only one with that idea. The secret's out now. Residencies are optional. If you want to make good money right away, just skip your residency (really important for specialities with long residencies like surgery.)

 

[gizmoduck]

The reason: because they can and will work for peanuts.

It's about cheap labor, and hospitals will exploit it.

Yep, it's like a fraternity hazing. They know that we're all naive and don't have much choice in the matter as we come out of med school so we all get to do the elephant walk.

 

[!dr_nick!]

Yep, it's like a fraternity hazing. They know that we're all naive and don't have much choice in the matter as we come out of med school so we all get to do the elephant walk.

And just remember, one day you can turn around and do the sadistic hazing to others. Man i love perpetuating painful cycles.

 

[juddson]

Don't worry, you can defer payment of your loans while you're in residency. And when your finished with residency, the salary will still be several times higher than what most people make in this country.

this is mostly not true, right? I thought that all you could really get during residency is "hardship" forbearance, which is income dependant and not necessarily available for most single residents in the US.

Somebody help me out on this.

Judd

 

[HollyJ]

Residency is for chumps. You should just start practicing after you get out of med school. No one will know the difference.

Forget that -- med school schmed school. Just get yourself a van and a sharp knife.

 

[ASDIC]

remember residency is education and training..and it costs them to train a resident.

So, instead of paying you $85000 a year...they take out $40000 as training fees and give the rest as your salary

 

[theprizefighter]

Hello,

I think we all have to keep in mind that as advanced as medicine has become in technology and treatments, it is still very much a profession based on tradition. One tradition is that the residents get their asses worked to the bone. Residents used to be just that: they lived in the hospital. A hundred years ago, your typical resident slept in the hospital, got his (no female docs back then) meals paid for, and got a uniform. That was it. No separate salary, no place of their own to live and A LOT of discouragment about getting married (can't exactly start a family if you are living in the hospital).

Today, some older docs who were young enough to train under physicians who went thru that would say that current residents are too pampered, especially with the eighty hour limit. Part of it is psychology. There's the whole, "If we worked 120 hrs as residents why don't the new ones today do it?" Think about this for a minute. Can you as a new med student starting out imagine what you'd feel if med schools dropped the o-chem requirement? You'd be furious! In much the same way, some older docs genuinely believe that working 100+ hours a week for peanuts makes you into a better doctor because they argue that it teaches you endurance, dedication to your patients, and it cuts down on your total residency training time because you see more cases as a result of more hours on the wards.

I don't necessarily agree with any of this logic and neither should you. It's important, though to understand it because it's the institutional mentality that keeps such grueling residency training measures in place. On one level, it's very dangerous for patients. I certainly wouldn't want to do a potentially life and death medical procedure after being up for 20 odd hours straight. Wanting to practice medicine, so much, though, I know that that may have to happen. We are all going to have to prepare in our own way for when that sort of situation arises in our medical training because it probably will.

theprizefighter

Pitt Med '08

"You're gonna eat lightening and crap thunder!" - Mickey, Rocky II

 

[Fumoffu]

Thanks for the insightful posts guys.

I don't disagree with the hours that residents need to put in because they are still learning.

I do disagree with the magnitude of consecutive hours though. For example, 20 hours a day every other day, alternated with 12 hours a day doesn't seem too bad or unreasonable, but I read an article about a John Hopkins surgery resident working 60+ consecutive hours while doing 120+ hours a week, with nothing but cat naps during the 60+ hour shift. I don't know about the rest of you, but the longest I stayed awake consecutively was for 53 hours and I was hearing voices and hugging my Mt. Dew bottle by the 45th hour. Mistakes happen this way.

Also it seems sort of stupid to pay residents peanuts just to cling on to some tradition of "hazing" the new generation of physicians. A 5th year general surgery resident getting paid like 48,000 a year while working 120+ hours a week? That sounds a bit cruel. Heck my brother is starting at 55,000 a year working 40 hours a week, with only an undergraduate degree!

I guess I'm starting to see why a lot of pre-meds and med students have this sort of "martyr" attitude because they really are sacrificing a LOT to become a physician. Sure it's a rewarding and challenging career where you get to heal your fellow man, gain people's trust, and be a source of comfort, but on the flip side, you have to sacrifice a lot too - namely time - which in essence means sacrificing family time, social life, romantic life, etc... and increasingly likely as I read more on this forum, it looks like you'll be sacrificing financial security (with malpractice premiums and trivial lawsuits).

Don't get me wrong, I would never change my decision of career choice, just that the situation seems unfair to me.

*end rant*

 

[TTSD]

Well, new laws state that a resident is not allowed to work more than 80 hours a week after a tragic accident involving a carload of people and a resident who fell asleep behind the wheels. As to whether or not that law is a good thing or not has yet to be seen. I wonder how that affects such residences like neurosurgery or various other intensive specialties where previous residents were worked like dogs to know everything inside and out.

But as to why residents are paid so little, it's because they're still learning. It's basically like a work-study program. They get further training, but are working at the same time and get a little stipend. So God help you if you end up in a residency in an expensive neighborhood and residency salaries are all pretty much the same amount.

I don't think it really has much to do with "hazing" as there are other ways to haze new naive residents. Maybe most old timers do see it as a rite of passage, "Dammit, I spent my nights at Duke falling asleep collecting CSF so you sit there and hold this tube while it drips for the next hour!! and we're doing this all night!"

But also, the more you're exposed to your field the more ingrained it becomes for you. The more possible encounters met, the better prepared you are when you get out there, and best be done under supervision by those who have already been there. And if you're worked like a dog, night calls, long days, all the crap that comes with being a doctor becomes more bearable and less prone to psychotic episodes.

It's kind of like studying for anything else. The more you study it, the easier it becomes.

 

[JohnnyJ]

The official line is that residency is a time of educational training and youre learning on the job so residents are paid almost nothing on a per hour basis. I remember someone computing that its less than minumum wage but I dont remember where I saw it.

The unoffical line is that hospital economics is for the most part phucked up and they need sources of revenue to cover the money holes like the ER, the poor reimburesement rates and the no pays. Medicare pays x amount per year to train residents so the hospital gives you a quarter of that amount per year and they use the rest to cover their budget deficits.

 

[pjm]

Slightly related to the salary debate is the question of the Match; does a system that forces residents to go to where the computer says keep salaries artificially low?

A class-action lawsuit was filed in May 2002 to reform the Match. The AMA and various other orgs say (among other things) that if resident salaries went up, that would be the End Of Medicine As We Know It because the hospital cost structure can't accommodate higher salaries for trainees. (like JohnnyJ says.)

The plantiffs say that "wages are likely to increase and dangerously long work hours decrease as hospitals start to compete to attract and keep residents" if a "Voluntary Match" is instituted.

http://www.ama-assn.org/ama/pub/category/8231.html
http://www.savetheresidents.com/

Residents allegedly typically log workweeks of more than 80 or 90 hours and are paid an average of just under $ 40,000. The plaintiffs allege that the conspiracy deprives medical students of any choice of where they will work as residents.

....
It is quite possible, therefore, that a judgment for the entire plaintiff class could be enormous and seriously impair the continued viability of the remaining defendants which carry out the existing system of graduate medical education in the U.S.

...
Q--Is there any evidence that salaries would increase if the "Match" were eliminated?

A--Currently, there have not been any studies demonstrating that salaries would go up. However, a study published in the September 3, 2003 issue of JAMA suggested that the "Match" system does not suppress salaries and that salaries would not be expected to rise if the "Match" was dissolved. By comparing fellowships that utilized the "Match" with those that did not, researchers found that salaries were not significantly different for programs that used the "Match" compared with those that did not. Fellows had the choice of going into higher-paying practices, but fellowship salaries did not rise to make the positions more attractive. This suggests that the matching process is unrelated to the level of salaries involved.

There are several advantages to the Voluntary Match. Among other things (1) replacing coercion with choice will increase compliance with antitrust law and will give young doctors more choice; (2) discrimination against United States medical school students under the current NRMP rules will end; (3) the discriminatory impact on minorities under the current NRMP system will end; (4) wages are likely to increase and dangerously long work hours decrease as hospitals start to compete to attract and keep residents; (5) patients are likely to receive better care from well-rested residents; and (6) hospitals are likely to enjoy cost-savings as expensive medical mistakes are avoided.

 

[medic170]

Well, After 8 years of working my ass off and being dirt poor, I will be HAPPY to pull in 40 grand a year. At least I can finally get a new car, my 91 saturn already has 210,000 mile on it

 

[Allygator89]

This is what I was told at one of the local hospitals.

You are in the hospital 80 hours/week. Of those 80 hours:

You only work 40
They spend 40 hours teaching you.

Think about it this way. There are people that feel that residents should PAY to be a resident. Yup, that's right. You should pay to work..

Just be happy they are paying you anything at all. It could be worse..

 

[ltdanp21]

Simple. SUPPLY AND DEMAND. The best residency programs have something apart from money that the best students want. But once you're a physician, the only thing hospitals have to draw physicians to them is a salary higher than the next hospital so you're paid what you're worth in the market.

 

[SarahGM]

Medicine is all about paying dues. Wearing the short coat in med school, doing scut throughout med school and residency, taking q3/q4 call throughout the entire three-five years of training, etc, etc, etc... it's a grueling profession and a grueling training, and making no money is just a part of that. It will never get better, either, as each successive generation of physicians looks back and thinks, "i had to go through that-- so does the next batch."

And as my ever-astute boyfriend pointed out, "That mentality sounds a lot like fraternity hazing."

 

[Gerg]

Hazing is illegal in most states, and every NFC Fraternity I know of frowns upon it.

 

[OnMyWayThere]

If sweat shops were legal, I am willing to bet more than half of the stuff we use and wear would be made in sweat shops.

I believe the reason why residents get paid so little for their time and education is because it's legal.

There is someone always willing to work for less, heck there are some unfunded residencies that you get paid $0.00/hr.

 

[velo]

If sweat shops were legal, I am willing to bet more than half of the stuff we use and wear would be made in sweat shops.

I believe the reason why residents get paid so little for their time and education is because it's legal.

There is someone always willing to work for less, heck there are some unfunded residencies that you get paid $0.00/hr.

Um...check your tags. Well over half your stuff is made in a sweat shop....but this is WAY off topic, just wanted to chime in, please don't let this start a thread hi-jacking.

To get things back on track...I'd like it if residents got paid more....but we knew what we were in for when we signed up for this. Residents past and present have managed to get by within this system...and they all still say "don't worry about loans, you can pay them off and live comfortably." If they can all do it I'm sure we'll find a way as well.

 

[Gerg]

It was only recently that I learned that a residency was a paid position, and not just more schooling that we pay for. You're still in school and you're getting paid. How many people are volunteering currently at hospitals/clinics to get patient interaction. As a resident, you get paid, you get lots of learning, and you get to have that patient interaction. How great is that???

 

[dmoney41]

You're still in school and you're getting paid.

The school of what, hard knocks? Life? You've got an MD after your name and a piece of paper on the wall that says you're a doctor. You're getting on the job training, not schooling.

I think the residency pay system is fine, though. Personally, I think paying residents more is the first step in justifying cutting doctor's salaries on the road to paying doctors like they do in socialist systems (now let's give you free med school -- now let's take away 75% of your salary). I'll take a few years getting paid peanuts for the long term payoff.

 

[Gerg]

I see what you mean by on the job training, but as a resident, I'd imagine you are under an attending physician at a hospital that is associated with a Medical School, but I could be wrong.

 

[Gleevec]

The thing is, in most other professions, on-the-job-training pays WAY the heck better.

Do non-partner lawyers make 30k a year for 80 hours a week? No.

Do non-CEO MBAs make 30k a year for 80 hours a week? No.

In each of those cases, you could consider fresh law and business grads as getting on the job training, yet they make way the heck more than residents. And dont even get started on fellows. And generally starting JD and MBA offers are way way way higher than 30k. Yet each professional degree plan ends up with similar debt-- its just that MBAs and JDs can pay it off sooner.

Seriously, for the amount of work residents and fellows do for such little pay, med school should cost $0. I think that would be a valid compromise between paying residents and fellows what they're worth (probably around 100k or so, though Im just making that figure up kinda) and maintaining the current "education" moniker that residency and fellowship training have.

 

[pauleuglis]

Wow. This thread really makes you want to think twice before going into medicine. I guess I'm already stuck!

 

[JohnnyJ]

Do non-partner lawyers make 30k a year for 80 hours a week? No.

Do non-CEO MBAs make 30k a year for 80 hours a week? No.

True but those people dont work for money losing nonprofit institutions. I dont get why people get so worked up over the comparison. Its not like this fact is concealed when you sign on the dotted line that your Ibanking/law firm associate buddy is going to make more than you during those years.

If med school tuition was subsidized as it is in euro countries (i.e. FREE), then medicine would have be fully socialized and it would go down the ****ter for doctors to make any serious bank. That might be fine for some but I wouldnt do it.

I would be more pissed at some residency programs taking away the chance to moonlight than pining for an extra 10-15k a year.

 

[Gleevec]

True but those people dont work for money losing nonprofit institutions. I dont get why people get so worked up over the comparison. Its not like this fact is concealed when you sign on the dotted line that your Ibanking/law firm associate buddy is going to make more than you during those years.

If med school tuition was subsidized as it is in euro countries (i.e. FREE), then medicine would have be fully socialized and it would go down the ****ter for doctors to make any serious bank. That might be fine for some but I wouldnt do it.

I would be more pissed at some residency programs taking away the chance to moonlight than pining for an extra 10-15k a year.

Subsidized med school tuition does not necessarily mean socialized medicine. Residency "salary" is provided by the government as well, and we are most definitely not a socialized medical state.

 

[OneStrongBro]

Quite Simply it is paying your dues. Furthermore, if you are in medicine for money, the residency experience will be horrible because your focus will be on the lack of compensation. This is one of the reasons why Doctors have one of the highest drug use, alcohol use, divorce rate, and depression. They realized after 4 years of medical school, that they still have 4 more to go at peanuts pay. On the other hand, if you have a passion for medicine, money doesn't really matter, job security does. Medicine has that.

Actually, it is good that you are already thinking about it. You'll be surprised how many 1st year medical students and pre-meds really know about pay. I bet if more people knew about the pay than less people would go into medicine for the wrong reasons (rather than paying for their own consequences i.e. alcoholism, drug use, depression, divorce rate etc).

Just remember, you may fool the admission's committee, MCAT, Step 1, Residency Directors etc. However, you cannot fool yourself. Your true motivation will be exposed when you went through the INFERNO aka medical school, and you still have 4-5 years of slave labor afterwards at about $8.00 to $9.00 an hour. This is why it is so important to be honest with yourself.

 

[Jeff3614]

Quite Simply it is paying your dues, and learning on the job. Furthermore, if you are in medicine for money, the residency experience will be horrible because your focus will be on the lack of compensation. This is one of the reasons why Doctors have one of the highest drug use, alcohol use, divorce rate, and depression. They realized after 4 years of medical school, that they still have 4 more to go at peanuts pay. On the other hand, if you have a passion for medicine, money doesn't really matter, job security does. Medicine has that.

I don't really buy into this justification and I don't recall anywhere where it says you can't demand a higher salary and still be passionate about your career. This has nothing to do with dedication. The only reason residents get paid so little is because it's a closed system that only competes with itself. The only way things could change would be if residents went on strike and demanded a higher compensation.

-J

 

[fullefect1]

Forget that -- med school schmed school. Just get yourself a van and a sharp knife.

I like this guys mindset.

 

[finnpipette]

You're also right, you have a LOT of debt, but you also get a LOT of payoff on the back end. By the time you graduate (assuming you're entering school this year) even a low-paying physician will make close to $200k a year (the low end specialties now get around $130K to start). So, a $200K debt isn't that bad.

low end paying physicians don't make ~$200k/year. In your dreams. Anyhow, 40k/year isn't terrible. You don't have to pay back your loans during this period, so stop being such little whiny bitches. I know plenty of PhD's that are getting paid in the low 40s even though they went to school for 7+ years and have been working for a pretty long time. In addition, they work pretty long hours without gratitude...so deal with it. It annoys me to hear all the whiny self-absorbed premeds whining about how screwed they are and how they're sacrificing so much to go into medicine. Tell it to the cows.

 

[bearpaw]

I don't really buy into this justification and I don't recall anywhere where it says you can't demand a higher salary and still be passionate about your career. This has nothing to do with dedication. The only reason residents get paid so little is because it's a closed system that only competes with itself. The only way things could change would be if residents went on strike and demanded a higher compensation.

-J

i absolutely agree. there is nothing wrong with demanding fair compensation. i want to be a doctor, not a martyr.

 

[LuckyMD2b]

I don't really buy into this justification and I don't recall anywhere where it says you can't demand a higher salary and still be passionate about your career. This has nothing to do with dedication. The only reason residents get paid so little is because it's a closed system that only competes with itself. The only way things could change would be if residents went on strike and demanded a higher compensation.

-J

Strike? Keep dreaming.

I wish some folks decided to boycott the match when I graduate. I'd be happy to take their spot at the residency program of my dreams while getting $40K/year.

Right now in I'm making about -$40K, it'll be a welcome change for the better.

 

[Gleevec]

Strike? Keep dreaming.

I wish some folks decided to boycott the match when I graduate. I'd be happy to take their spot at the residency program of my dreams while getting $40K/year.

That's why the AMA doesnt want resident unions. Of course, Id imagine the gunner med students could care less and would take those slots anyway.

Salaries should go up or Hours should go down. Hell, I wouldnt mind splitting the difference and getting paid 50k for 50 hours a week.

 

[LuckyMD2b]

That's why the AMA doesnt want resident unions. Of course, Id imagine the gunner med students could care less and would take those slots anyway.

Salaries should go up or Hours should go down. Hell, I wouldnt mind splitting the difference and getting paid 50k for 50 hours a week.

"Gunner"

It's easy to say that you'd strike now, because it's a hypothetical. I'm just keeping it real.

Frm my POV, I don't think 40K is that bad for a couple of years.

 

[Philo Beddo]

. . .comes when you're out. I just graduated in Internal Medicine last month. We dont make much, BUT, we make a helluva lot more than residents.

I can work 3.5 twelve hour shifts and make the same pay as an entire month as a resident (night hospitalist).

Daaaaayum.

One of my anesthesia pals just found a starting job in San Fran for $350K.

Thats rediculous chaddah. Ludicrous cheddah.


Philo

hippocritis.com. Fake news by residents, for pre-med, med students and other residents.

 

[45408]

I wonder how that affects such residences like neurosurgery or various other intensive specialties where previous residents were worked like dogs to know everything inside and out.

But as to why residents are paid so little, it's because they're still learning. It's basically like a work-study program. They get further training, but are working at the same time and get a little stipend.

No doubt the residency is crucial to learning the your specialty, but I have a feeling that hospitals like to exploit the cheap labor. I realize also that they are still learning, but in what profession does someone walk out the door of college/grad school and straight to the top of their field? None, obviously. However, you can graduate law school and quickly start raking in the dollars compared to a resident, while working similar hours to a resident.

 

[OneStrongBro]

This isn't justification. It is reality. Do you honestly think 4 years of medical school gives you the skills to be an effective clinician?

Residents are paid peanuts because they don't have the competence that physicians do that already have the training. The number of years in medical school does not ENTITLE you to a high salary, it is all about practicality from the hospital's point of view. A person's salary is dependant upon what the hospital thinks that person is worth. Sadly, a person out of medical school does not have the skills to justify paying that person 100K a year.


Medical school & Residency is a journey. A means to an end. Once you are a competent board certified physician within your expertise, than you have the bargaining power to test the open market for you salary. Until than, residency is still an educational endeavor.

As an astute poster mentioned earlier, in residency you are paid a STIPEND not a Salary. There is a big difference. Residency is an educational extension.

I don't really buy into this justification and I don't recall anywhere where it says you can't demand a higher salary and still be passionate about your career. This has nothing to do with dedication. The only reason residents get paid so little is because it's a closed system that only competes with itself. The only way things could change would be if residents went on strike and demanded a higher compensation.



-J

 

[OneStrongBro]

I agree 100%

The sense of entitlement of some pre-med students is ridiculous. The bottomline is what SKILLS can a newly minted resident bring to the table to justify a $60,000+ stipend?

The only argument one can make is 4 years of college and 4 years of medical school. This does not hold water. Knowledge does not equate to clinical competency and skills.

Sure, some of you will be $200,000 dollar in debt. However, that comes with the territory to realize your dream. Once you step on the wards, and realize how much little you know compared to everyone else in a hospital, you will see how foolish you are to want a higher salary in residency.

The bottomline is money. One of my favorite lines is if you have to ask the price of something, you can't afford it. Similarly, if you have to complain about money than you are not motivated for the right reasons.

The money will be there once the training is over. Relax.

low end paying physicians don't make ~$200k/year. In your dreams. Anyhow, 40k/year isn't terrible. You don't have to pay back your loans during this period, so stop being such little whiny bitches. I know plenty of PhD's that are getting paid in the low 40s even though they went to school for 7+ years and have been working for a pretty long time. In addition, they work pretty long hours without gratitude...so deal with it. It annoys me to hear all the whiny self-absorbed premeds whining about how screwed they are and how they're sacrificing so much to go into medicine. Tell it to the cows.

 

[redstorm]

yeah but back then when you finished residency, you actually were autonomous and called your own shots and hours and nobody said or could say anything about it.. Now youwork for somebody namely the hmo or the hospital and they call your shots and you have no say over it plus they pay you a **** salary.. so I say it wont change until the medical school applications dwindle to the point where they have to change.. Then amount of bull**** involved in the process is un believable.. trust me.. i graduated already

 

[dmoney41]

Residents are paid peanuts because they don't have the competence that physicians do that already have the training. The number of years in medical school does not ENTITLE you to a high salary, it is all about practicality from the hospital's point of view.

Completely wrong. A useful comparison is law graduates. They are even less experienced at their job than medical graduates: they usually have one summer of "job experience" that mostly consisted of going to parties and doing tiny amounts of irrelevant work, and their coursework was almost completely tangential to their daily job. But they start off at a salary (at good firms) at least two or three times that of residents despite the fact that they're even more unprepared. Why? Market forces - firms will pay the most for the best.

Residents don't get paid low amounts because they need training, they get paid low amounts because it's an artificially closed system where market forces can't kick in and raise. The benefit is security: without the artificially closed system, the HMS grads would be making bank and the (insert low ranked school) grads would be making maybe even less than now, and probably with a much more competitive, cutthroat matching system.

You can say the current system is right or wrong but it's just bizarre to claim that residents have extremely low pay because they still require training. Other jobs are simply not like that and there is no real reason medicine has to be, it's just the way things are.

Personally, I'm of the opinion that, at least after intern year, residents contribute significantly more than they cost the hospital. I mean, considering the medicare payment (80k a year or so per resident), who really thinks 3 residents do less work and make the hospital less money than 1 PA? So I think in a "fair" world they would probably make more than 40k, but in the current environment a raise in resident pay is probably going to lead to doctors taking a hit somewhere else so I'm okay with the current system.

 

[redstorm]

Slightly related to the salary debate is the question of the Match; does a system that forces residents to go to where the computer says keep salaries artificially low?

A class-action lawsuit was filed in May 2002 to reform the Match. The AMA and various other orgs say (among other things) that if resident salaries went up, that would be the End Of Medicine As We Know It because the hospital cost structure can't accommodate higher salaries for trainees. (like JohnnyJ says.)

The plantiffs say that "wages are likely to increase and dangerously long work hours decrease as hospitals start to compete to attract and keep residents" if a "Voluntary Match" is instituted.


The match is absolutely bull ****.. It is hospital friendly and it is made to keep salaries uniform.. In this day and age money is important unless you are independently wealthy. So the average residencies will have to attract residents with money otherwise they will go unfilled.. and this would raise the miserable salaries that residents have to endure.. period.... whoever said that hospitals or the government cant afford it is fooling themselves completely..

 

[OneStrongBro]

If money means that much to you go to Law School. We need less premeds obsessed over money.

 

[hakksar]

Completely wrong. A useful comparison is law graduates. They are even less experienced at their job than medical graduates: they usually have one summer of "job experience" that mostly consisted of going to parties and doing tiny amounts of irrelevant work, and their coursework was almost completely tangential to their daily job. But they start off at a salary (at good firms) at least two or three times that of residents despite the fact that they're even more unprepared. Why? Market forces - firms will pay the most for the best.

I disagree . . . law school is not a good comparison to medical school. This is because once a lawyer passes the Bar after finishing law school they are capable of getting hired into any type of law (this may not be a good idea but it is the current situation). Residents are better compared to graduate students. Grad students in the sciences are paid stipends (just like Residents are paid stipends) and are in the process of specializing (just like residents). The difference is in the amount of undergrad education they receive prior to specialization (4 years for Grad Students and 8 years for residents) . . . however if you look at Stipend amounts it is a fair trade since Residents receive about 2 times the amount in stipends that grad students receive. Finally, both grad students and residents come out with a piece of paper that has a lot of value (a PhD for a grad student and a Board Certification for a resident). Thus, it is not market forces that keep resident stipends down but rather the nature of specialist training in general.

Personally, I'm of the opinion that, at least after intern year, residents contribute significantly more than they cost the hospital. I mean, considering the medicare payment (80k a year or so per resident), who really thinks 3 residents do less work and make the hospital less money than 1 PA? So I think in a "fair" world they would probably make more than 40k, but in the current environment a raise in resident pay is probably going to lead to doctors taking a hit somewhere else so I'm okay with the current system.

What does contribution versus cost have to do with anything? If that is what mattered RN's would make the most. This is because all the "dirty" work is done by the RN's . . . in non-academic centers they perform many of the procedures that residents perform (arterial blood gas draws, almost all IV sticks, vent adjustments etc) in addition to all the "patient care" that they perform anywhere. However, they NEVER receive the 6 figure salaries that a Physician can expect when they finish residency. If we go back to the grad school comparison the Grad student does all the real research and makes a contribution that far exceeds the compensation received. However, I do not hear many grad students complaining about an unfair pay system. Obviously, this is because compensation has nothing to do with contribution.

Residents don't get paid low amounts because they need training, they get paid low amounts because it's an artificially closed system where market forces can't kick in and raise. The benefit is security: without the artificially closed system, the HMS grads would be making bank and the (insert low ranked school) grads would be making maybe even less than now, and probably with a much more competitive, cutthroat matching system.

Why would the HMS grad make anymore than the low ranked school? Is the medical education received at Harvard superior to the education received at the lower ranked school? I am sure the LCME would not allow a huge disparity in training between schools so it would have to do with name recognition. However, does name recognition matter if you have not specialized yet? Would you prefer to hire a PhD who attended undergrad at Harvard and did not do any real research there and got their PhD at some unknown institution in the lab of an unknown scientist or a PhD who went to an unknown undergrad but went to Harvard for their PhD and worked in the lab of the top person in the field? It is pretty clear that the system is designed to make residency the deciding point as to the quality of the Physician.