Why do residents get paid so little?

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wlee43

wlee43

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50 K for working 60-90 hours a week

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I say 70-100K seems about fair for the amount of work and stress that goes into it. some entry jobs in other fields dont usually pay this much but then again they dont work this much either
 
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wlee43 said:
I say 70-100K seems about fair for the amount of work and stress that goes into it. some entry jobs in other fields dont usually pay this much but then again they dont work this much either
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The average salary in the United States is $26K. And just be happy you don't have to pay tuition for residency.
 
be happy you're not paying tuition? lol I'm all for making the best of crappy things but residents get paid what averages out to something like minimum wage. Yeah I don't see anything wrong with that.
 
^I agree. and why would we even consider tuition and residency. Residency is not a school
 
ohioguy said:
be happy you're not paying tuition? lol I'm all for making the best of crappy things but residents get paid what averages out to something like minimum wage. Yeah I don't see anything wrong with that.
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There's been talk of charging tuition for residency, and it's still not completely out of the question.

Keep in mind 90% of people already think doctors make too much money, so complaining about your temporary 3-4 year salary sounds entitled and arrogant.
 
UnclePhil said:
Because residency programs are training programs and it costs a hospital resources and money to train a physician.
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Actually the hospital is prob making money off the residents bc they get ~50K per resident per year they trained plus a resident (in my opinion) is better than a midlevel they could hire for 90K.

The real reason why residents dont make more is medicare is broke...for the most part resident training is funded by medicare. Also residents really dont have a strong lobby in the politics of the funding of medicare, so when there are extra government funds they never get allocated to resident training.
 
link2swim06 said:
Actually the hospital is prob making money off the residents bc they get ~50K per resident per year they trained plus a resident (in my opinion) is better than a midlevel they could hire for 90K.

The real reason why residents dont make more is medicare is broke...for the most part resident training is funded by medicare. Also residents really dont have a strong lobby in the politics of the funding of medicare, so when there are extra government funds they never get allocated to resident training.
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The counter argument I hear is the time spent by attendings to teach and check the work of the residents is nearly equivalent to the value of the resident's work + wage.
 
ohioguy said:
Residents get paid what averages out to something like minimum wage.
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Resident pay doesn't average out to minimum wage until you're at >90 hours per week. Minimum wage at 55-65 hours per week (i.e. many residency programs) comes to a meager $26-32K/year.

Bottom line: It's not that bad unless you're in a demanding program like general surgery.
 
There are fairly significant costs involved in training a resident. You have administrative costs, attending time use, malpractice costs. It's less a job and more of an apprentice training system. The amount paid by the government exceeds the costs plus salary, but not by that much. When you factor in the fact that residents probably only start becoming profitable to the hospital a couple of years into their training and yet many residencies end after 3-4 years, you realize that if the government didnt fund residencies, a lot of hospitals wouldnt do them. They could be training midlevels who wouldn't leave after 3 years.
 
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Charles Darwin said:
There's been talk of charging tuition for residency, and it's still not completely out of the question.
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I'd like to see some articles about this supposed "talk". Your argument sounds like "yeah things are bad but there's a slight chance they could be worse so.....just be happy they're not worse". Physicians are already some of the most disorganized groups politically. Who knows, maybe this complacent attitude is prevalent and one of the reasons that nothing has been changed.

Charles Darwin said:
Keep in mind 90% of people already think doctors make too much money, so complaining about your temporary 3-4 year salary sounds entitled and arrogant.
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And 20% of Americans think that the Earth is the center of the solar system.
 
ohioguy said:
I'd like to see some articles about this supposed "talk". Your argument sounds like "yeah things are bad but there's a slight chance they could be worse so.....just be happy they're not worse"....
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I think you can probably find them in other boards on SDN -- this topic was raised a few months back. It won't likely happen, but does give you a sense of how some value residents.
 
Cms pays hospitals 100k per year per resident.
 
The most common rationale I've heard is that you're getting as much from the hospital as they're getting from you. You can't go on to be a practicing physician without their training, and they can't afford to hire as many attendings/mid-levels to cover the number of patients they have. Whether or not you agree, this is what I hear the most.
 
Wasn't there talk about reducing the amount of hours residents work because the accident rates were high due to fatigue? Or is this wishful thinking? 🙂
 
ohioguy said:
I'd like to see some articles about this supposed "talk". Your argument sounds like "yeah things are bad but there's a slight chance they could be worse so.....just be happy they're not worse". Physicians are already some of the most disorganized groups politically. Who knows, maybe this complacent attitude is prevalent and one of the reasons that nothing has been changed.
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"Tens of billions of dollars in cuts to some Medicare reimbursements and hospital payments are now on the table as part of the deficit-reduction talks between the White House and Congressional Republicans, and cuts in at least one area would affect the $9.5 billion Medicare pays to teaching hospitals each year, The New York Times reported Tuesday. Whether the cuts will become law depends on the outcome of the negotiations, but the Accreditation Council for Graduate Medical Education, as well as a coalition of hospital lobbyists that includes the Association of American Medical Colleges, has sounded the alarm.

In an open letter, the Accreditation Council for Graduate Medical Education, which accredits residency programs, laid out its concerns about the changes. Medicare payments compose the majority of funding for training medical residents and fellows, the council wrote. Losing the Medicare payments would mean that the small, often rural health-care providers that make up about half of the group's 681 accredited programs might have to stop offering residencies. Larger providers might turn to industry sponsorship or ask residents to pay tuition. "Abrupt and dramatic reductions in Medicare [graduate medical education] funding will have a significant and adverse impact on both the number of residents educated and trained, and the quality of that education," the group wrote. "This will challenge the profession's responsibility as a public trust to produce the next generation of physicians to serve the needs of the American public through the provision of excellent, innovative, safe and affordable care."
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http://forums.studentdoctor.net/showthread.php?t=836988

ohioguy said:
And 20% of Americans think that the Earth is the center of the solar system.
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Cool story, bro. Still doesn't address the fact that many people, including those with political power, believe doctors make too much money.
 
DrOMG said:
Wasn't there talk about reducing the amount of hours residents work because the accident rates were high due to fatigue? Or is this wishful thinking? 🙂
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They did. Its 80 hour/week max (if the program has a culture of compliance). Interns can't work more than 16 hours straight.
 
The end product is what you see. However, that salary is much higher but liability insurance, medical insurance, etc. are taken from the pot that Medicare pays per resident. Our IM program has one or two residents that aren't guarenteed via Medicare and the hospital is outright paying for them because it's cheaper than getting a mid-level (d/t efficiency/hours worked) or hiring another couple practitioners. I believe the hospital is roughly spending $110,000 out of pocket per resident.
 
DrOMG said:
It's because 80 hours a week is still ridiculous
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You cut the work week any more and we're going to be seeing residencies extended in length. Say it was a 60 hour week, thats 20hours X 45 weeks (generous) X 3 years for internal medicine = 2700 training hours lost.

Now, I don't know where those hours would go besides additional years. I don't want that. You don't want that (trust me) and the government doesn't want that because its not cost effective.
 
DrOMG said:
It's because 80 hours a week is still ridiculous
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That's the norm if you want to be successful. If you want to make partner in a law firm, be ready for 100+ hours/week until that happens. If you want to have a succesfull business, you'll put in 100+ hours a week. Want to be a top accountant or MBA or whatever? Same story.

Bottom line is that to be highly successful in any career requires a lengthy, abusive training period in order to get where you want to be. If you don't, go enroll in DeVry, train to be a car mechanic and be happy with your 60-70k/year job working 8am-6pm.
 
notbobtrustme said:
That's the norm if you want to be successful. If you want to make partner in a law firm, be ready for 100+ hours/week until that happens. If you want to have a succesfull business, you'll put in 100+ hours a week. Want to be a top accountant or MBA or whatever? Same story.

Bottom line is that to be highly successful in any career requires a lengthy, abusive training period in order to get where you want to be. If you don't, go enroll in DeVry, train to be a car mechanic and be happy with your 60-70k/year job working 8am-6pm.
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I should have learned this from the military...
 
Frazier said:
I remember a physician discussion on the forum where residents were referred to as quite profitable for hospitals.
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I'd imagine so since hospitals pay pretty much nothing out of their pocket to pay for residents, who do a large amount of the work for the hospital. It seems like free labor to me o_o
 
tiedyeddog said:
Hey, has there actually been a study on it? I'd very interested to see the results.
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Not going to bother to look it up now, but I remember reading a study basically showing no significant decline in error rates. A couple reasons were proposed. one was that built in redundancy and oversight caught a lot of the mistakes made by tired residents, and another was that the increased number of handoffs increases medical errors to compensate for reduced fatigue induced error.
 
DrOMG said:
Wasn't there talk about reducing the amount of hours residents work because the accident rates were high due to fatigue? Or is this wishful thinking? 🙂
Click to expand...

DrOMG said:
It's because 80 hours a week is still ridiculous
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God, I hope work hours don't decrease any further. I don't want residencies to become longer than they currently are, especially when studies suggest that the work hour rules haven't really shown any benefit for patient care.

Also, it's not 80 hrs/week. It's 80 hrs/week averaged over 4 weeks, if I remember correctly.

tiedyeddog said:
Hey, has there actually been a study on it? I'd very interested to see the results.
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Yea, there have been. I haven't looked recently but the ones I looked at suggested that after the work hour rules were instituted, there either hasn't been any significant decrease in mistakes or that there actually has been an increase in mistakes. This seems to be due to the fact that decreased hours = increased handoffs = increased errors. I think even the ACGME pointed out recently that the work hour rules haven't shown any benefit for patient safety.
 
notbobtrustme said:
That's the norm if you want to be successful. If you want to make partner in a law firm, be ready for 100+ hours/week until that happens. If you want to have a succesfull business, you'll put in 100+ hours a week. Want to be a top accountant or MBA or whatever? Same story.

Bottom line is that to be highly successful in any career requires a lengthy, abusive training period in order to get where you want to be. If you don't, go enroll in DeVry, train to be a car mechanic and be happy with your 60-70k/year job working 8am-6pm.
Click to expand...

The average mechanic does not make near this, especially out of school, try about half that. The ones who do have seniority at a sizable dealership which takes at least 5 years to work towards, and they make 50-100k depending on what type of work they do. The whole time they also have to purchase equipment which eats away at their income, many get a tool allowance but it doesn't cover the ~5k it tools to get started or much of the other 10-30k of tools you'll need as the years progress.

60k+ with a bachelors out of school is actually quite the minority unless you live in a high cost of living part of the country, have solid connections, or are an engineer. Even then most grads are just happy to have a job these days.
 
Kaushik said:
God, I hope work hours don't decrease any further. I don't want residencies to become longer than they currently are, especially when studies suggest that the work hour rules haven't really shown any benefit for patient care.

Also, it's not 80 hrs/week. It's 80 hrs/week averaged over 4 weeks, if I remember correctly.
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Yes, it is averaged. I looked it up. 🙂 I didn't realize it was either work 80hours a week for x many years, or work 50 hours a week for x many years + 1 additional year. I guess it is one of those 'what would you rather do...' questions.
 
Charles Darwin said:
There's been talk of charging tuition for residency, and it's still not completely out of the question.
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ohioguy said:
I'd like to see some articles about this supposed "talk".
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thought i'd google and i found this:

pxz said:
The vice president of our school recently predicted that, in five to eight years, residents will have to pay for their training instead of getting paid modestly.

No wonder that US healthcare system is broken. Without medical residents, most of hospitals could not exist.
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this was in a thread from 2003 ....and here we are 8.5 years later and nothing has changed, nor will anything change in the foreseeable future.
 
ohioguy said:
I'd like to see some articles about this supposed "talk". Your argument sounds like "yeah things are bad but there's a slight chance they could be worse so.....just be happy they're not worse". Physicians are already some of the most disorganized groups politically. Who knows, maybe this complacent attitude is prevalent and one of the reasons that nothing has been changed.



And 20% of Americans think that the Earth is the center of the solar system.
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Yeah, the average American salary seems HIGHER than 26K....that seem oddly low. And noone thinks doctors are paid that much...at least the non-ignorant ones, and they shouldn't have a real say to things that matter.
 
DoctwoB said:
Not going to bother to look it up now, but I remember reading a study basically showing no significant decline in error rates. A couple reasons were proposed. one was that built in redundancy and oversight caught a lot of the mistakes made by tired residents, and another was that the increased number of handoffs increases medical errors to compensate for reduced fatigue induced error.
Click to expand...

Kaushik said:
Yea, there have been. I haven't looked recently but the ones I looked at suggested that after the work hour rules were instituted, there either hasn't been any significant decrease in mistakes or that there actually has been an increase in mistakes. This seems to be due to the fact that decreased hours = increased handoffs = increased errors. I think even the ACGME pointed out recently that the work hour rules haven't shown any benefit for patient safety.
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Not gonna lie, I think this is pretty funny although I understand the seriousness of the issue. It seems like to me that the whole cap idea started because of anecdotal fear-mongering (you know, mainly because of the one physciatric death in new york) instead of being based on scientific fact. I guess that's how politics goes...
 
Why do college football players get paid 0....for arguably more work.
 
Charles Darwin said:
They get a free education. That should be payment enough for being a student-athlete.
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How much money does a 4.0 biology student on an academic scholarship bring into the school? Compare that to what McCarron brings Alabama.
 
TheProwler said:
That's $13/hour. That's more than a resident makes.


Why? It's not school. You're doing work.
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Yeah, I NEVER got that argument. Residents are workers, who have to learn on the job, but still workers. Its different than 4 years of med school, where you are merely students, as a resident, you are...well a doctor!

And I think people underestimate that 26K crap, I mean, doctors aren't making bank left and right unless people are in delusional land. Sounds cliche, but I think everyone knows if you only go to medicine solely for money, you're better off in a different career haha. I guess it's kinda lame that people who never went to medical school can decide on this stuff, they don't really have any room to say much, lol
 
Didn't read every post, but about 50k is the standard number, right?
 
TwinsFan said:
The average mechanic does not make near this, especially out of school, try about half that. The ones who do have seniority at a sizable dealership which takes at least 5 years to work towards, and they make 50-100k depending on what type of work they do. The whole time they also have to purchase equipment which eats away at their income, many get a tool allowance but it doesn't cover the ~5k it tools to get started or much of the other 10-30k of tools you'll need as the years progress.

60k+ with a bachelors out of school is actually quite the minority unless you live in a high cost of living part of the country, have solid connections, or are an engineer. Even then most grads are just happy to have a job these days.
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(Cough) nursing: 2-3 years for ADN, then 50 wks/yr @ 60 hrs/wk @ $24/hr = $72,000/yr.

One of the best majors in terms of time, difficulty, and compensation, IMO.
 
DrOMG said:
It's because 80 hours a week is still ridiculous
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Not when you realize how much there is to learn before you are ready to work without a net as an attending. Honestly as you get further along in residency, you start to realize it's kind of short in duration for what you are really trying to accomplish. It's shorter still if you shave a good chunk of hours off it. So no, 80 isn't ridiculous for a number of specialties. Going below 80 without increasing the number years probably would be.

Also bear in mind it's 80 averaged over 4 weeks. You can go above 80 in a given week.
 
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