Worst salary for a psychiatrist?

[nancysinatra]

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Ok, I am looking for a lowball estimate here. Let's say I go into geriatric academic psychiatry and work in a struggling county hospital, in a depressed region of the country that also happens to be very close to a thriving major city with a psychiatrist glut, and assuming I will take every form of insurance including medicaid and medicare, am not allowed to see private practice patients on the side and that my contract negotiating skills are not on the sharp side, what is the lower end estimate on what my salary might be?

Let me add that maybe I'd get half a day a week devoted to research on "systems" issues where I wouldn't see any patients at all.

This is for someone working 40 hours per week. I'm just asking to round things out, because so often, people want to know what the most they could make will be. But someone's got to make the least...

 

[OldPsychDoc]

Ok, I am looking for a lowball estimate here. Let's say I go into geriatric academic psychiatry and work in a struggling county hospital, in a depressed region of the country that also happens to be very close to a thriving major city with a psychiatrist glut, and assuming I will take every form of insurance including medicaid and medicare, am not allowed to see private practice patients on the side and that my contract negotiating skills are not on the sharp side, what is the lower end estimate on what my salary might be?

Let me add that maybe I'd get half a day a week devoted to research on "systems" issues where I wouldn't see any patients at all.

This is for someone working 40 hours per week. I'm just asking to round things out, because so often, people want to know what the most they could make will be. But someone's got to make the least...

$85k?

 

[PikminOC]

I think your contract negotiating skills will be sharp.

Are benefits included?

 

[toothless rufus]

$85k?

Wow, is that really a possibilty?! PAs make more than that.

I am resigned to taking a paycut after residency, I fear.

 

[nancysinatra]

$85k?

Ok a person could live on that. I'm not saying I could pay off my Peugeot all in one swipe on a salary like that, but I could eat.

Now let's say on top of the less than ideal salary situation, that I am also a less than ideal doctor, and my malpractice rates are higher than usual due to a losing lawsuit or two... And let's say I live in a state with high income taxes and high licensing fees--I wonder what my expenses might come to?

 

[nancysinatra]

Are benefits included?

Major medical, although you have to go to the struggling county hospital. Dental includes annual cleaning. They have a 401K plan and death/dismemberment.

At 85K I would be tempted to dismember myself.

 

[nancysinatra]

I am resigned to taking a paycut after residency, I fear.

I am printing this out and taking it to my department chair as proof that I need a raise. Do you really make >85K as a resident??

 

[toothless rufus]

I am printing this out and taking it to my department chair as proof that I need a raise. Do you really make >85K as a resident??

Haha! Not. Even. Close. I just meant that I am afeared that my starting salary as a bona fide psychiatrist after residency will be less than what I currently make as a resident. Which is far, far less than 85K!

 

[nancysinatra]

Haha! Not. Even. Close. I just meant that I am afeared that my starting salary as a bona fide psychiatrist after residency will be less than what I currently make as a resident. Which is far, far less than 85K!

Ok I may be really dense but I thought the 85K estimate was the low end of what a "bona fide psychiatrist after residency" would make in the worst of circumstances, i.e. geri psych, academic, overserved area, dedication to the public sector and a zeal for unpaid research. If you make far, far less than that as a RESIDENT, then you can still expect a raise, even if it might not be huge!

 

[st2205]

The military just started a new incentive for residents that they'll pay them 75k/yr (in addition to your salary) if you sign on with them year for year +1. In that scenario you would take a paycut. A rather significant one, too.

 

[Doctor Bagel]

Wow, is that really a possibilty?! PAs make more than that.

I am resigned to taking a paycut after residency, I fear.

Entirely 3rd hand, but I heard about an attending here who was making $80k doing a research/patient care type of mix. He's now left.

 

[billypilgrim37]

Entirely 3rd hand, but I heard about an attending here who was making $80k doing a research/patient care type of mix. He's now left.

Salary support for a K award is only about 90k. People supplement with clinical here and there, but early career researchers certainly aren't in it for the money.

 

[notdeadyet]

The military just started a new incentive for residents that they'll pay them 75k/yr (in addition to your salary) if you sign on with them year for year +1. In that scenario you would take a paycut. A rather significant one, too.

Nope. 75k for the military FAP program plus say 50k for residency is 125k which is less than what a board eligible military psychiatrist makes.

 

[F0nzie]

I think my happiness asymptotes at around 50k-100k (without student loans) when I can pay for basic living expenses and then some. Since I'm not all that crazy about blowing a fuse working, I can't think of a better scenario than working as a part-time psychiatrist making 100k for the county or a private organization. Unfortunately part-time academics will only get me a resident's salary. My other thoughts are that hourly rate after-tax dollars will drop anywhere between 10 to 20 percent (depending on state) for being in a higher tax bracket. So the more I work, the less I get paid by the hour to where I might just want to do something else with my time.

 

[st2205]

Nope. 75k for the military FAP program plus say 50k for residency is 125k which is less than what a board eligible military psychiatrist makes.

Are you sure? I don't know much about the military but from all the numbers I've ever seen it hovers around 90-115k.

 

[F0nzie]

I just remembered several months ago I was offered 95k for a full-time staff Psychiatrist position with the Airforce which is even lower than the 105k for academics. Those are the two lowest figures I've seen for full-time positions.

 

[notdeadyet]

Are you sure? I don't know much about the military but from all the numbers I've ever seen it hovers around 90-115k.

Military pay can be tricky to calculate because there are a lot of hidden bonuses that you get as a physician.

Basic pay consists of salary plus housing allowance plus food allowance. It varies by region. In a small city in non-coastal California, this comes to about $63.5k/year.

Additionally, as a board certified physician, you get the following bonuses each year:

Variable Special Pay: $5K/year
BC Pay: $2.5k/year
Incentive Special Pay: $20K/year
Additional Special Pay: $15K/year

Your salary is now: $106k/year

You are also eligible for either the Critical Warfare Skills Pay, which is $272k, spread out over 4 years. This would bring your total salary to $174k.

If you did not do FAP in residency, you would be eligible for a big signing bonus instead. You are also eligible for loan repayment programs after your commitment is done.

Military pay is further complicated by the fact that some stuff is tax exempt, making it hard to compare apples to oranges.

This is not meant to be a sales pitch, though. There are plenty of miserable physicians in the military and they make everyone around them miserable (there is nothing worse for morale than hearing literally the highest paid people in an organization moan and whine). When you join the military you are making a big sacrifice in terms of personal freedoms and liberties. Never, ever join for the money.

I just remembered several months ago I was offered 95k for a full-time staff Psychiatrist position with the Airforce which is even lower than the 105k for academics. Those are the two lowest figures I've seen for full-time positions.

I'm not sure what this means. If this was a military recruiter trying to get you to actually commission into the Air Force, they don't know what they're talking about as they're missing some pretty relevant bonuses. If this was a private recruiter filling a civilian contract physician for the military, you were wise to turn it down. Civilians typically make much more in the military. There is a $300K/year child job always floating around (somewhere in Kansas, I believe). The fact that it's always floating around probably says something about the position or locale.

 

[DD214_DOC]

When did the Critical Warfare Skills Pay come around? This is the first I have heard about it. Is this the same as MSP they use to get HPSP people to sign another contract?

I am currently in residency and make just short of $100,000 per year, most of it in bonuses or incentives because of where I am stationed, as well as for having a family. However, in the military incentives are not taxed, so I am only taxed on the $45,000 - $50,000 or so I make in basic pay.

Once I leave residency I will get a slight increase in pay, around $10,000 - $20,000 but in an area with a much lower cost of living. Although I will make considerably less than my civilian counterparts, I frontloaded my income by making considerably more money during residency in addition to what I save in both taxes and benefits such as the PX and commissary. I calculated all of this out a few years ago and found that after residency, four years is the break even point -- exactly the obligation I have. Up to that point, earning is equal to civilian counterparts. However, currently, with the additional bonuses military shrinks get they actually come out making more than their civilian counterparts.

It's really not a bad gig to do psych in the military.

 

[payme2]

It seems like you could only take one or the other between the MSP or Critical Skills Accession Bonus. The MSP for a 4 year contract pays 43,000/year for Psychiatry. Less than the Critical Skills bonus, but the MSP does give you the option of signing for a shorter term of 2 or 3 years.

Critical Skills Wartime Accession Bonus

The military services may pay wartime accession bonuses to medical and dental officers who agree to serve at least four years. During the active-duty service obligation for which they qualify for the critical wartime skills accession bonus, officers are not eligible for multiyear special or incentive pay. Bonus rates vary by medical or dental specialty; for medical specialties in 2012, the lowest bonus amount is $180,000 for aerospace medicine specialists, and the highest is $400,000 for neurosurgeons, general surgeons and vascular surgeons. For dental specialties, the bonus is $300,000 for oral and maxillofacial surgeons and specialists in comprehensive dentistry, endodontics and prosthodontics.

http://www.navytimes.com/projects/money/pay_charts/2012/medical_dental/
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[DD214_DOC]

It seems like you could only take one or the other between the MSP or Critical Skills Accession Bonus. The MSP for a 4 year contract pays 43,000/year for Psychiatry. Less than the Critical Skills bonus, but the MSP does give you the option of signing for a shorter term of 2 or 3 years.

Critical Skills Wartime Accession Bonus

The military services may pay wartime accession bonuses to medical and dental officers who agree to serve at least four years. During the active-duty service obligation for which they qualify for the critical wartime skills accession bonus, officers are not eligible for multiyear special or incentive pay. Bonus rates vary by medical or dental specialty; for medical specialties in 2012, the lowest bonus amount is $180,000 for aerospace medicine specialists, and the highest is $400,000 for neurosurgeons, general surgeons and vascular surgeons. For dental specialties, the bonus is $300,000 for oral and maxillofacial surgeons and specialists in comprehensive dentistry, endodontics and prosthodontics.

http://www.navytimes.com/projects/money/pay_charts/2012/medical_dental/
​

I assume like everything else the CSWAB does not apply to physicians currently serving back an obligation for HPSP? We only get VSP, BCP, ASP, and ISP, correct?

After reading the DFAS website, it appears that the CSWAB is only a Navy thing. Darn.

 

[zenman]

There is a $300K/year child job always floating around (somewhere in Kansas, I believe). The fact that it's always floating around probably says something about the position or locale.

Yes, at Fort Riley. Plus $25 k sign on and $20k yearly retention. Good part of Kansas too...not flat like a pancake. Rolling hills, hunting, fishing, etc.. I just started there a month ago. Great staff to work with. Might want to spread the word on this secret. New hospital to move into in 2014 and behavioral health clinic is moving in first.