why it sucks being an academic attending

[countingdays]

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I guess academics as well as PP has its disadvantages. However, I am wondering if there will be a shift towards graduates taking more jobs in academics given the direction the economy and government are going. To some, it may seem to be a more secure job to be in a university-based setting or other academic setting.

What do you all think about job security in academics v private practice ACT model? I mean, I would think that academics is as secure as it gets, but how often do private practice guys actually have to pack up and move because the job was not secure enough? Most private practices I've seen have people who have been there for 20 years or more.

 

[cchoukal]

What do you all think about job security in academics v private practice ACT model? I mean, I would think that academics is as secure as it gets, but how often do private practice guys actually have to pack up and move because the job was not secure enough? Most private practices I've seen have people who have been there for 20 years or more.

I would guess that there would be less pressure from AMCs in the academic arena. At the end of the day, though, most academic jobs are paid for with clinical revenue and hospital subsidies (true), just like in the private world. If revenue/volume goes down, jobs would be in jeopardy. In the same way that in PP it helps to have extra skills, so it is in academics. It's probably harder to get rid of the subspecialty people and those who have roles in the department (program directors, vice chairs, etc.). Of course, after awhile, most department members have some sort of extra title/role, BS or otherwise. The most secure would probably be the people whose income is derived from non-clinical funds (and those same people are generally really desirable people to keep for other reasons, as their income is derived from industry or grants, which make them very attractive).

 

[deleted50478]

So am I to assume that you represent the majority of SRNAs out there? You are likely the exception, at least where I trained you would be.

For you academic guys, how much does your salary go up over time without becoming chair or anything leading to a big bump? Does you get a yearly increase or only with advancement in rank? If it goes up yearly, is it just keeping pace with inflation or are you getting real raises?

 

[2win]

Ok, this is not a private practice is better than academics thread. What this is is my perspective on the parts about being in academic medicine I did not like for those of you considering it. I did academics for a year, and now am in private practice which has its own negatives.

1) Some days are really boring when you have good residents covering easy cases. I always thought I could read books or whatever during that time, but it's still just boring.

2) Residents who whine all the time. Some just complain and whine about how late they work EVERYDAY, how unfair it is, how others get to go home before them ALL THE TIME, how it's basically a conspiracy to keep them late. Suck it up.

3) Watching a resident flail on a procedure which you know you can do in 30 seconds while the surgeon is pushing you to hurry up. Patience is a virtue.

4) Trying to make constructive criticisms to the resident who gets very defensive without making them defensive. For example, I suggested to a resident to tape the eyes before intubation after I clearly saw him poke the patient in the eye with the endotracheal tube before intubating the pt while he concentrated on getting a view (he accidentally flipped the eyelid open and scraped the eyeball with the tube). He proceeded to argue with me that he didn't poke him in the eye. Christ.

5) Walking into a room to check on how a case was going just to find that the resident took the initiative to do something stupid. Like moving the BP cuff to the side with the fresh AV fistula, or running 0.2 of sevo alone (with rocuronium) on a healthy pt for the past 45 mins because her BP was low ("don't worry, I gave scopolamine") Christ.

6) Having other attendings try to dump their work on you or try to get you to rewrite their papers without giving you credit or try to take advantage of you in everyway possible. Though that happens too in private practice but less.

7) Dealing with lazy, disrespectful OR nurses who want to blame others rather than working together to make the system work. Private practice was such a huge refreshing change in this respect.

8) The worst: having your license on the line for trainees who by definition are training and will make mistakes when you are not in the room. I had a colleague get sued because something a resident did that was completely out of my colleague's control. Now that lawsuit follows him everywhere.

That's not to say academics was horrible; it has a lot of positives and fun things to it as well. Just wore me out.

I just thought that this post has to be updated.

 

[IlDestriero]

For you academic guys, how much does your salary go up over time without becoming chair or anything leading to a big bump? Does you get a yearly increase or only with advancement in rank? If it goes up yearly, is it just keeping pace with inflation or are you getting real raises?

We get annual 2-4% raises and bump ~$25k w/ promotions. They review academic salary data annually and keep us competitive. My last academic job reevaluated salary every 7-8 years. No annual raises, that sucks. They also only adjusted to what was deemed appropriate for the previous year, so you were already behind when you got the raise.:mad. The current job also pays an annual bonus that is loosely related to individual productivity and departmental profits. The division chiefs all get a significant bonus and the chair makes a killing.

 

[okayplayer]

Do any academic institutions have the reputation of paying better for new grads than others? I know at my home institution (west coast major university) they start non fellowship trained clinical track attendings at 270k or so with some bonuses that are easily attained. Seems low. I have a few years left but am interested in academics (mostly because I am drawn to teaching residents) but not bench research. I also have to weigh having some fat student loans in the equation too.

 

[MrBurns10]

Do any academic institutions have the reputation of paying better for new grads than others? I know at my home institution (west coast major university) they start non fellowship trained clinical track attendings at 270k or so with some bonuses that are easily attained. Seems low.

You think that seems low? Just starting out I'd say that's incredibly good. Granted my home institution is in a city with cheaper cost of living than on the west coast, but recent grads here start out much, much lower. Just based on things I've heard, academic salaries vary considerably from institution to institution, not just based on location but also on things like prestige so look around. Also, if you're interested in teaching but not research, look into the private/community hospitals with residency programs as there's not nearly as much emphasis on research.

 

[ssmallz]

Do any academic institutions have the reputation of paying better for new grads than others? I know at my home institution (west coast major university) they start non fellowship trained clinical track attendings at 270k or so with some bonuses that are easily attained. Seems low. I have a few years left but am interested in academics (mostly because I am drawn to teaching residents) but not bench research. I also have to weigh having some fat student loans in the equation too.

270k isn't too bad b/c it probably comes w/fully benies like malpractice insurance, healthcare, and some retirement incentives. All told that adds about another 30k or so making the starting salary equivalent to a 300k 1099 position. You also need to consider amount of call, weekends, and total hours worked before you compare 1 job to another.

 

[Tuohy]

You all are forgetting one BIG advantage to academic medicine. TUITION BENEFITS for children (and spouses too!). Something that private practice guys "usually" don't get...

 

[BLADEMDA]

You all are forgetting one BIG advantage to academic medicine. TUITION BENEFITS for children (and spouses too!). Something that private practice guys "usually" don't get...

If you have 3 kids that could mean $360,000 or more in tuition benefits.

 

[scudrunner]

If you have 3 kids that could mean $360,000 or more in tuition benefits.

IF your children can get in and IF they will go there.

 

[proman]

IF your children can get in and IF they will go there.

Some institutions pay 1/2 of the tuition rate for their undergrad, applied to any undergrad.

 

[IlDestriero]

IF your children can get in and IF they will go there.

Based on the fact that nearly all of the senior faculty in my department have sent one or more kids to my most competitive parent university, there is clearly some consideration made for undergrad admissions.
It's a generous tuition benefit currently worth up to $70k or $125k per child, depending on if they attend my university or another. As it's based on the cost of my university's (ridiculously high) tuition and fees, it's only going to be worth more when I need it. I would expect it to be at least $100/$180k when I'm done using it. I don't see tuition freezes on the horizon at elite private schools. When it's been changed in the past, faculty were grandfathered into the old plan, so I'm not worried about it being worth any less. Multiply that by 2 or 3 kids and it's a very significant benefit, even if the kids go to a different school.
I'm at a private university and the tuition benefits apply to any accredited school. I looked at jobs at a couple of state universities, their tuition benefit was not as generous and only applied to other state schools. If you're looking at a faculty position, find out what the rules are for their tuition reimbursement benefit. They're all a bit different, and require a different duration of time on faculty before you are eligible. (2-5 years). One university also limited you to 24 semesters. (3 kids)

 

[Doctor4Life1769]

IF your children can get in and IF they will go there.

when it comes to med school, there is a thing called nepotism, and it works full-force.

😉

 

[sevoflurane]

Based on the fact that nearly all of the senior faculty in my department have sent one or more kids to my most competitive parent university, there is clearly some consideration made for undergrad admissions.
It's a generous tuition benefit currently worth up to $70k or $125k per child, depending on if they attend my university or another. As it's based on the cost of my university's (ridiculously high) tuition and fees, it's only going to be worth more when I need it. I would expect it to be at least $100/$180k when I'm done using it. I don't see tuition freezes on the horizon at elite private schools. When it's been changed in the past, faculty were grandfathered into the old plan, so I'm not worried about it being worth any less. Multiply that by 2 or 3 kids and it's a very significant benefit, even if the kids go to a different school.
I'm at a private university and the tuition benefits apply to any accredited school. I looked at jobs at a couple of state universities, their tuition benefit was not as generous and only applied to other state schools. If you're looking at a faculty position, find out what the rules are for their tuition reimbursement benefit. They're all a bit different, and require a different duration of time on faculty before you are eligible. (2-5 years). One university also limited you to 24 semesters. (4 kids)

Never thought of this. Excellent benefit. That is free $$$ right there. Is it just tuition or do some include tuition + room/board? Either way an excellent bennie for those who have kids.

 

[partydoc]

IF your children can get in and IF they will go there.

When I was in high school it was understood that I would go to the school where my mom worked because of the tuition benefit. I wasn't given any options. In fact, I only applied to one other school.

They paid 1/2 tuition + I got some scholarships so it worked pretty well.

 

[michigangirl]

Based on the fact that nearly all of the senior faculty in my department have sent one or more kids to my most competitive parent university, there is clearly some consideration made for undergrad admissions.
It's a generous tuition benefit currently worth up to $70k or $125k per child, depending on if they attend my university or another. As it's based on the cost of my university's (ridiculously high) tuition and fees, it's only going to be worth more when I need it. I would expect it to be at least $100/$180k when I'm done using it. I don't see tuition freezes on the horizon at elite private schools. When it's been changed in the past, faculty were grandfathered into the old plan, so I'm not worried about it being worth any less. Multiply that by 2 or 3 kids and it's a very significant benefit, even if the kids go to a different school.
I'm at a private university and the tuition benefits apply to any accredited school. I looked at jobs at a couple of state universities, their tuition benefit was not as generous and only applied to other state schools. If you're looking at a faculty position, find out what the rules are for their tuition reimbursement benefit. They're all a bit different, and require a different duration of time on faculty before you are eligible. (2-5 years). One university also limited you to 24 semesters. (4 kids)

This is SO huge-- a big draw.. Add to that the retirement incentives, which are incredible-- the choice was made for me. If my kid wants to go to harvard or university of ____ state school, they can do so, and get 50% of our universities tution free or 100% free at our university. Totally makes it all wroth it. We don't have a semester limit, your kid just has to finish in 4 years, doesn't matter how many kids you have. very nice.

 

[Bertelman]

It's a generous tuition benefit currently worth up to $70k or $125k per child, depending on if they attend my university or another. As it's based on the cost of my university's (ridiculously high) tuition and fees, it's only going to be worth more when I need it. I would expect it to be at least $100/$180k when I'm done using it.

I think this is a great benefit, and I think academic anesthesia needs better salaries. But tuition benefits for children shouldn't really factor into your choice to go academic. Unless you have 10 kids, the 200k bonus in this tuition waiver can be recouped in a few years with the salary differential of private practice.

(This isn't directed @ IlD, just a general comment on the direction this thread just took.)

 

[IlDestriero]

I think this is a great benefit, and I think academic anesthesia needs better salaries. But tuition benefits for children shouldn't really factor into your choice to go academic. Unless you have 10 kids, the 200k bonus in this tuition waiver can be recouped in a few years with the salary differential of private practice.

(This isn't directed @ IlD, just a general comment on the direction this thread just took.)

I don't know why you wouldn't consider it? It's, like everything, a part of the offer to consider. Since it has a real $$ amount, it's not just a perk. For me, I would value it at about $20k per year. Could you make much more in PP, yes, probably. If I'm making the equivalent of >$400 1099, I think I'm fairly paid for what I work. Maybe I'm wrong. I know that I bring in more than I'm getting, even with the benefits. Of course, if I decide to leave, I get nothing, so I'm saving for them anyway.
I don't cover 4 rooms at a time, I get to teach residents and fellows, don't train CRNAs, don't take much call, get out before 3 frequently, have large case variety, work with great surgeons, etc. All those things have value to me as well, and are also part of the package. Those are the ones that are hard to put a dollar value on.
The only thing I would really enjoy is 2 more weeks vacation, at the same income of course.😉

 

[Apollyon]

One university also limited you to 24 semesters. (4 kids)

Are kids getting their bachelor's degrees in 3 years now (honest question)? Wouldn't 24 semesters be 3 kids (8 semesters for 4 years)?

 

[IlDestriero]

Are kids getting their bachelor's degrees in 3 years now (honest question)? Wouldn't 24 semesters be 3 kids (8 semesters for 4 years)?

Typo. My math's not that bad, yet.

 

[imfrankie]

Never thought of this. Excellent benefit. That is free $$$ right there. Is it just tuition or do some include tuition + room/board? Either way an excellent bennie for those who have kids.

And for folks that would like to take coursework themselves, many institutions let the faculty do so for free. Lots of people find this a big bonus if they want to pursue an MPH, MBA, PhD, what-have-you.

Bear in mind at certain institutions the dependent's tuition is taxed as ordinary income.

 

[pgg]

Bear in mind at certain institutions the dependent's tuition is taxed as ordinary income.

Interesting ... so does the institution issue a 1099 to the employee for the $25K (or whatever) the institution "paid" itself for the kid's tuition?

Aren't universities tax exempt? What's the institution benefit to "paying" $25K to an employee vs "giving" it to the kid as an untaxable scholarship or simply "waiving" tuition? Seems like the only thing that's being accomplished is giving the employee a tax bill of ~1/3 the benefit.

 

[partydoc]

Interesting ... so does the institution issue a 1099 to the employee for the $25K (or whatever) the institution "paid" itself for the kid's tuition?

Aren't universities tax exempt? What's the institution benefit to "paying" $25K to an employee vs "giving" it to the kid as an untaxable scholarship or simply "waiving" tuition? Seems like the only thing that's being accomplished is giving the employee a tax bill of ~1/3 the benefit.

From what I understand, the tuition benefit was listed on my mom's W2.

 

[scudrunner]

Based on the fact that nearly all of the senior faculty in my department have sent one or more kids to my most competitive parent university, there is clearly some consideration made for undergrad admissions.
It's a generous tuition benefit currently worth up to $70k or $125k per child, depending on if they attend my university or another. As it's based on the cost of my university's (ridiculously high) tuition and fees, it's only going to be worth more when I need it. I would expect it to be at least $100/$180k when I'm done using it. I don't see tuition freezes on the horizon at elite private schools. When it's been changed in the past, faculty were grandfathered into the old plan, so I'm not worried about it being worth any less. Multiply that by 2 or 3 kids and it's a very significant benefit, even if the kids go to a different school.
I'm at a private university and the tuition benefits apply to any accredited school. I looked at jobs at a couple of state universities, their tuition benefit was not as generous and only applied to other state schools. If you're looking at a faculty position, find out what the rules are for their tuition reimbursement benefit. They're all a bit different, and require a different duration of time on faculty before you are eligible. (2-5 years). One university also limited you to 24 semesters. (3 kids)

Yeah, I had no idea the benefit could be applied to other universities. Very nice perk.