Canadian Hospitalist Salaries?

[whyyou]

I was informed that hospitalist in Canada make about $300,000 by an American physician but I can't find proof of this. What is the average starting salary for a hospitalist? Academic or not?

I did not realize Canadians were better compensated than American physicians. People constantly make the opposing argument.

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[Kadava Reviva]

I was informed that hospitalist in Canada make about $300,000 by an American physician but I can't find proof of this. What is the average starting salary for a hospitalist? Academic or not?

I did not realize Canadians were better compensated than American physicians. People constantly make the opposing argument.

It's not about the pay!




That being said, who the hell wants to do that for only $300K?

 

[leviathan]

300k is about average from what I've seen. Just look at any provincial billings database if you know the name of specific internists. It's all public information.

 

[drongo]

Absolutely true, the average hospitlast salary at least in GTA area is around 300 K. However the set-up is different. Most Canadian hospitalist are Family medicine trained, most don't do ICU work. Provincial billing databases do not reflect hospitalist salaries, as its not considered a medical sub-specialty and its not OHIP billings cumulative, but a stipend(salary) - most hospitalists in the province are employed as contractors, many are incorporated.

 

[MontereyMD]

You have to remember that salary is Gross.

The Canadian Federal/Provincial tax rate so far is 42% and could increase. So that leaves you with about $160K after tax! This is the same take home as a regular GP.

Also there is no Hospitalist speciality in Canada so Hospitalists are GP's. In order to keep your GP Registration or licence current by the College of each Province you have to keep your outpatient GP skills active. So most Hospitalists in Canada also work outpatient GP's at walk in clinics a couple of times a month.

 

[Arb]

For Internal Medicine Hospitalist/General Internist:

There is no separate tax bracket for IM and GP (family medicine clinic doctors). If a GP makes as much as an general internalist then the GP's gross earnings was the same which is possible but takes much more work/hours. You make more as an internist than a GP controlling for location and hours.

Again, marginal tax rates people. 300K marginal 42% tax rate in Ontario = ~$193K take home pay. I recommend people understand the tax structure ESPECIALLY if you incorporate. People keep throwing around incorporation but don't understand it and thinks their corporation will pay for their Porsche or mortgage just like that...Most pay income tax at the same marginal rates.

General internal medicine (GIM) has been the most sought after subspecialty fellowship for the past 3 years. Endocrinology as well. Yes that's compared to Cardio and GI. Average earnings is approximately $14K/5 days as a general internist at an academic centre. Various structures exist.

 

[septoplasty]

This discussion brought up a question I've wanted to ask for a long time.

Are there any specific skill sets(NALS/ATLS etc.) or licensing requirements in Ontario if an American trained (AAFP Licensed) family physician wanted to pursue the hospitalist route in Ontario?

Also, is it better to go the AAFP route or ABIM route if I wanted to do a mix of outpatient/hospitalist/ER work?

I'm trying to keep options open come September (applying for IM/FM).

Now I know ER might be a long stretch especially in the GTA, but what about areas that are under served? Can a physician licensed in IM/FM work in the ER? I know it wouldn't be so much of a problem w/ hospitalist or outpatient practice.

 

[jnuts]

Again this subject is hugely province and specialty dependent.

Physicians in Ontario can personally incorporate dropping their effective tax burden to 24%.

Physician salaries are very difficult to figure out. There are lots of different practice models and physicians often have income sources outside of OHIP. Billings don't give you very much information.

Just thought I'd mention.

Also, graduated tax brackets change your net rate of taxation. If your net income is in the top tax bracket you only pay the top rate on money made in that bracket. For example, your first 30,000 is tax free if you make only 30,000 or 300,000.

 

[MontereyMD]

problem is with the Canadians and their CCFP/RCPSC.
In Canada FM training is 2 years and IM training is 4 years.
You can get the Canadian CCFP after getting the ABFM boards as the CCFP recognizes the ABFM as equivalent.
The RCPSC is different as they don't recognize ABIM as equivalent. You have to do another year somewhere to get the Canadian IM or RCPSC.
Believe it or not the Canadians are so obsessed with the process that for licensing purposes if you were board certified in Hospitalist IM by the ABIM you could NOT get a license to practice in the Province however if you were board certified in FM by the ABFM you could. Eventually you could get a license being IM but you would have to do another year and get approved by the RCPSC.

 

[septoplasty]

problem is with the Canadians and their CCFP/RCPSC.
In Canada FM training is 2 years and IM training is 4 years.
You can get the Canadian CCFP after getting the ABFM boards as the CCFP recognizes the ABFM as equivalent.
The RCPSC is different as they don't recognize ABIM as equivalent. You have to do another year somewhere to get the Canadian IM or RCPSC.
Believe it or not the Canadians are so obsessed with the process that for licensing purposes if you were board certified in Hospitalist IM by the ABIM you could NOT get a license to practice in the Province however if you were board certified in FM by the ABFM you could. Eventually you could get a license being IM but you would have to do another year and get approved by the RCPSC.

Okay, that makes sense. Thank you so much for clarifying.

 

[Arb]

Yes and no. There are many American IM docs practicing in Canada it's really not an issue.

Core IM in Canada is 3 years just like in the US. Years 4 and onwards are fellowship years (geriatrics, endo, general internal etc.). Everyone does a fellowship and general internal medicine, starting in 2013, is for all intents and purposes a 2yr fellowship. Those with fellowship training in the US will be recognized by the Royal College and are allowed to write the exam. IM is not a 4 year program in Canada. Those who do not match into a fellowship and work in certain community settings are able to sit the Royal College exam for Internal medicine with basically 3yrs of training. There's no reason why Canada should recognize US training as the training is different. It goes the other way too.

 

[septoplasty]

Yes and no. There are many American IM docs practicing in Canada it's really not an issue.

Core IM in Canada is 3 years just like in the US. Years 4 and onwards are fellowship years (geriatrics, endo, general internal etc.). Everyone does a fellowship and general internal medicine, starting in 2013, is for all intents and purposes a 2yr fellowship. Those with fellowship training in the US will be recognized by the Royal College and are allowed to write the exam. IM is not a 4 year program in Canada. Those who do not match into a fellowship and work in certain community settings are able to sit the Royal College exam for Internal medicine with basically 3yrs of training. There's no reason why Canada should recognize US training as the training is different. It goes the other way too.

But it doesn't make sense, so a hospitalist (ABIM), who wants to work in a hospitalist setting in Canada, needs to do an additional year of "training", so that he can do his job as a hospitalist better?

So essentially, ABIM licensed internist/hospitalists aren't competent according to RC? lol.

Ah, my home and native land, you make me mad sometimes.

 

[Arb]

Didn't say anything about competence. I'm sure a doctor from Saudi Arabia, France, Taiwan, etc. can walk into a hospital here and do fine as a hospitalist but I bet you would be against that. This is an accreditation issue that is in place in every country and for good reason.

I can tell right away you haven't compared Royal College with ABIM. In the US, 50% of IM training is ambulatory primary care. In Canada maybe 5% and IM docs can't do primary care at all. Huge difference and some of the training focuses are different as well. In Canada there is a minimum 5 months of critical care rotations (ICU/CCU). Not so in the US (1-2). So a hospital would hire you (ABIM) expecting you to have more than double the acute critical care training that you actually don't have if there was no accreditation process in place.

 

[septoplasty]

Didn't say anything about competence. I'm sure a doctor from Saudi Arabia, France, Taiwan, etc. can walk into a hospital here and do fine as a hospitalist but I bet you would be against that. This is an accreditation issue that is in place in every country and for good reason.

I can tell right away you haven't compared Royal College with ABIM. In the US, 50% of IM training is ambulatory primary care. In Canada maybe 5% and IM docs can't do primary care at all. Huge difference and some of the training focuses are different as well. In Canada there is a minimum 5 months of critical care rotations (ICU/CCU). Not so in the US (1-2). So a hospital would hire you (ABIM) expecting you to have more than double the acute critical care training that you actually don't have if there was no accreditation process in place.

So is the 1 year difference made up by an ABIM certified hospitalist by working in an American hospital for 1 year? Are they eligible for the RC exam?

Essentially, you are getting this "experience".

This is weird, because GP's (FM certified) can work as hospitalists (As I understood from the above posts), no problem, but the guy whos speciality is designed for hospitalist work isn't allowed to because of the fact that he lacks "experience".

Also, i'm sure the training in Saudi Arabia/France/Taiwan is good, but it holds no reciprocity with the North American training vs. an ABIM certified hospitalist who can go work anywhere in the world (except Canada I guess), without much effort.

 

[Arb]

Every country is like this. US trained ABIM certified can NOT go to anywhere in the world and land a job. Just ask all those that tried to get attending/consultancy jobs in the UK, Australia and the rest of the EU and you will find that it's difficult/almost impossible and not worth the effort. There was a peds attending here who had to do go back into residency training in Ireland and STILL could not get an attending job.

Things are changing with FRCP. You can sit the exam with 4 years training however what you call yourself may be different.

General internal medicine specialist applying for a hospitalist position:
US = 3yrs post-grad training + ABIM
Canada = 5yrs post-grad training + FRCP
I'm not sure you would be able to call yourself a general internist coming from the US but I would ask the Royal College on that one.

 

[septoplasty]

Every country is like this. US trained ABIM certified can NOT go to anywhere in the world and land a job. Just ask all those that tried to get attending/consultancy jobs in the UK, Australia and the rest of the EU and you will find that it's difficult/almost impossible and not worth the effort. There was a peds attending here who had to do go back into residency training in Ireland and STILL could not get an attending job.

Things are changing with FRCP. You can sit the exam with 4 years training however what you call yourself may be different.

General internal medicine specialist applying for a hospitalist position:
US = 3yrs post-grad training + ABIM
Canada = 5yrs post-grad training + FRCP
I'm not sure you would be able to call yourself a general internist coming from the US but I would ask the Royal College on that one.

Hmm okay, so which is the better, shorter way of getting into an hospitalist position than? FM?

 

[firetown]

You have to remember that salary is Gross.

The Canadian Federal/Provincial tax rate so far is 42% and could increase. So that leaves you with about $160K after tax! This is the same take home as a regular GP.

Also there is no Hospitalist speciality in Canada so Hospitalists are GP's. In order to keep your GP Registration or licence current by the College of each Province you have to keep your outpatient GP skills active. So most Hospitalists in Canada also work outpatient GP's at walk in clinics a couple of times a month.

Wrong, Canada has a progressive tax system. This website can give you your after tax income depending in where you live http://www.ey.com/CA/en/Services/Tax/Tax-Calculators-2012-Personal-Tax

 

[jnuts]

And again, physicians can pay the corporate tax rate and have other income sources outside of billings.

 

[abuhawraa]

Well, if you check the Australian Medical Council, you will find that any one have the ECFMG certificate with step 3 and 2 years residency can apply for AMC certificate without doing any test. After that you need to have 12 month supervised work either outpatient (GP) or inpatient setting. You will get paid around 200 thousand dollars. If you done the 12 month then you be eligible to sit for GP test which is much easier than ABIM. If you become GP then you will make between 300-350 thousand dollars a year