How much $$ do a surgeon really make?

[tjmDO]

Hello, I am a 3rd year and I am torn between EM and Surgery. Mainly becaus of the lifestyle differences. I am currently on my Gen Surg rotation and I love it. We went to the ER yesterday for a central line placement and man the ER was nuts!!! My surgeon doesn't seem to have a horrible lifestyle and if I could make a good deal of $ with his work schedule I would chose surgery over EM. Can anyone tell me what the average surgeon really makes. I have heard the EM docs make anywhere between 200K-300K without difficulty. How about surgery, and I have looked at the salary surveys and they say EM after 3 years = 216K and G. surg after 3 years = 291K. Not that big of a difference here. Can anyone help. Thanks

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[Fermata]

It all depends on what you do and how many hours you work.

Just like every other specialty.

 

[avgjoe]

Hello, I am a 3rd year and I am torn between EM and Surgery. Mainly becaus of the lifestyle differences. I am currently on my Gen Surg rotation and I love it. We went to the ER yesterday for a central line placement and man the ER was nuts!!! My surgeon doesn't seem to have a horrible lifestyle and if I could make a good deal of $ with his work schedule I would chose surgery over EM. Can anyone tell me what the average surgeon really makes. I have heard the EM docs make anywhere between 200K-300K without difficulty. How about surgery, and I have looked at the salary surveys and they say EM after 3 years = 216K and G. surg after 3 years = 291K. Not that big of a difference here. Can anyone help. Thanks

From hearing a few docs' salaries, i'm really starting to wonder how accurate those surveys are. The Gsurg attendings I've talked to make between 150-200 a few years after residency, the obgyns 140-190 in private practice or hmo, and fps 100-120. this is in the Bay Area (northern california). These figures are all way below the 'average' quoted on those surveys, and this is an area with an incredibly high cost of living!

 

[Fermata]

From hearing a few docs' salaries, i'm really starting to wonder how accurate those surveys are. The Gsurg attendings I've talked to make between 150-200 a few years after residency, the obgyns 140-190 in private practice or hmo, and fps 100-120. this is in the Bay Area (northern california). These figures are all way below the 'average' quoted on those surveys, and this is an area with an incredibly high cost of living!

California is notorious for low physician salaries(excluding Beverly Hills plastic surgeons).

 

[Pilot Doc]

It all depends on what you do and how many hours you work. Just like every other specialty.

C'mon - I know this post reappears in some form every month, but that's not a very helpful reply

In terms of pay/hr, ER wins hands down. In terms of overall pay, I suspect surgeons have the edge. The salary surveys are really hard to interpret. It truly does vary wildly with practice setting, volume and location.

It's hard to answer the original poster's question. What is "a good deal of $" to you? From what I can gather, EM and gsurg (no fellowship) are fairly similarly reimbursed - I suspect the 216:291 ratio you quoted is reasonable. Base your decision on what you'd rather spend your life doing.

 

[surg4me]

Also keep in mind that regional salaries differ greatly, even within states. A family physician in a small town in CA can make as much as a EM doc in LA; or a general surgeon in the mid-West can generally make more than a GS in CA, although the cost of living is greater in CA in general. There are many factors besides this, such as the type of practice that you have: in general, academic physician tend to make much less than a 100% private attending.

 

[dry dre]

A standard for bargaining pusposes in many areas is the MGMS data, a small portion of which is at:

http://www.merritthawkins.com/mgma.cfm

In general, Merrit-Hawkins provides the best general info on physician $ numbers in different areas including salary, bonuses, recruiting data, etc.

You (and all med student/residents) would be well served to talk to one of the physician recruiters at your hospital to discuss career/job finding practices. *NOTE* I said your hospital's recruiter, not an outside recruiter. And don't sign anything, ever, when talking to these guys unless several senior physicians whom you trust says that it's a good idea.

It may be a few steps down the road, but knowing how NOT to be screwed by medical recruiters is a good skill to have. Asking your hospital's recruiter the "ins and outs" of job finding and salaries may financially be the best ~15 minutes you spend in training.

 

[Hudson]

From hearing a few docs' salaries, i'm really starting to wonder how accurate those surveys are. The Gsurg attendings I've talked to make between 150-200 a few years after residency, the obgyns 140-190 in private practice or hmo, and fps 100-120. this is in the Bay Area (northern california). These figures are all way below the 'average' quoted on those surveys, and this is an area with an incredibly high cost of living!

Physicians' salaries are typically much higher in areas that have lower costs of living. The Docs that make the most money practice in markets that are "monopolized" by large single specialty practices..i.e. (one large urology group(10 docs) serving a city of 200-300k people + the surrounding areas.) The same follows for other specialties. Why are these markets so profitable for docs compared to "high cost of living areas of Cali"...b/c...

1) Less competition, you do not have to compete withother docs, the patients HAVE to see you therefore the work finds you and you do not have to bust A** to get patients. The large group basically monopolizes the area, makes it very difficult for ins companies to "bring in" a new practice(other docs) b/c the hospital Loves the current practice and the service they get from the established docs.

2) Less HMO penetration. In semi-rural environments there is more private ins assuming the community is not dirt poor. When one HMO does not insure a majority patient population they LOSE bargaining power, and thereforethey lose their ability to offer "take it or leave it" rates for doc. In more metropolitan areas there is a great degree of HMO involvement and lower rate of reimbursement coupled with increased competition from other docs.

Trust me the good life is there. Find a nice sized city that is on the rise. Practice sound compassionate medicine and success will find you. Remember no matter how idealistic any of us are we are selling a product, which is our knowledge and physical ability to mange, and hopefully cure, diseases/sickness/and injuries.

Making enough money in a metropolitan area as a doc to live WELL is becoming more and more difficult. Your best bet is to be on the outskirts, but close enough to enjoy the big city amenities if that is what you want.

 

[Sessamoid]

If you did surgery and loved it, then go into surgery. Choosing something you don't like or don't like nearly as much for a few tens of thousands a year (one way or the other) is stupid. How much is your happiness worth to you?

This isn't my forum, but since you're trying to decide between my specialty and surgery, I thought I'd offer an opinion.

 

[bustbones26]

I kind of agree with sessamoid here, I mean if I tell you that EM docs make more money, why should that be a reason to dump surgery as an option or vice versa?

If you like ER and like surgery, try this one. Go into gen surg, and then plan on doing fellowship in either crit care surg or trauma surg. If you like EM and surg, you'd probably like being a trauma surgeon.

I know that a trauma surgery service is operated differently at every hospital, but at least where I am at now, they are mostly gen surgeon that are paid a very nice flat rate pay when they agree to take their turn on the trauma service.

 

[tjmDO]

Thanks a lot everyone. I am just trying to figure it all out. I was a paramedic before I went to MEd School and I originally thought EM was my gig, but I am almost equally interested in both. My wife would prefer I go into EM for obvious reasons and I am trying my best to weigh the pluses and minuses of both and it seemed as if the salary info was a bit off on the surveys. Thanks again.

 

[jdubya]

I know why physician salaries are lower than the past and why compensation is decreasing. . .because we are a bunch of economic idiots. How can you suggest that 216 and 291 are "similiar" numbers. Thats a 35% difference. If someone came up to you and you were a businessman and said: "hey, come work for me, I'll give you a 35% salary bump worth 750,000 over 10 years" you'd have to be an idiot to not consider this a significant number.

 

[Sessamoid]

Thanks a lot everyone. I am just trying to figure it all out. I was a paramedic before I went to MEd School and I originally thought EM was my gig, but I am almost equally interested in both.

Well, that makes it much tougher to decide then. This is where the question also includes, "How much is your WIFE's happiness worth to you?"

 

[Pilot Doc]

because we are a bunch of economic idiots.

Well, I agree with that in general

How can you suggest that 216 and 291 are "similiar" numbers.

Three reasons. 1) The salary surveys are not terrible reliable. Those two numbers may not be statistically different. 2) Even if those numbers were absolutely correct averages, they represent one point on bell curves that have substantial overlap. 3) If converted to an hourly wage, the difference could well evaporate, certainly to the point of statistical insignificance. (i.e. most people assume that ER docs work fewer hrs/wk and wks/yr).

If you like Surgery and ER equally, choose ER. That's easy: it's good money, a good life, etc. But the two fields are really very different, and I suspect if you really like surgery, you'll find ER an inadequate substitute. And despite the wife-scaring horror stories floating around, there are very liveable residencies and practice opportunities floating around out there. Sounds like your preceptor is in one of them. Truth be told, in the right surgical practice, you could work _MUCH_ less night/weekend/holiday time than an ER doc.

About your wife, have an honest discussion with her. Some people are congenitally unsuited to living with a surgeon, some would just prefer an easier life. Decide what you and she can handle and then (VERY IMPORTANT) clearly define and jealously guard your joint priorities.

 

[SteadyEddy]

Why do you folks act like you don't care about money. Choosing a lifelong vocation is about how you want to live. That includes your hours and how much money you make. You can talk that nonsense about how you don't care about your salary, but we could've all helped people by being social workers (extremely vital, but very underpaid!). Don't get me wrong...I absolutely love working with people in need, but I want the "big chips" too.

I kind of agree with sessamoid here, I mean if I tell you that EM docs make more money, why should that be a reason to dump surgery as an option or vice versa?

If you like ER and like surgery, try this one. Go into gen surg, and then plan on doing fellowship in either crit care surg or trauma surg. If you like EM and surg, you'd probably like being a trauma surgeon.

I know that a trauma surgery service is operated differently at every hospital, but at least where I am at now, they are mostly gen surgeon that are paid a very nice flat rate pay when they agree to take their turn on the trauma service.

 

[Sessamoid]

Why do you folks act like you don't care about money.
remainder of useless tripe snipped

Show me where I said I don't care about money. All I said (and others agreed) was that money should not be your primary reason for choosing a specialty.

 

[SteadyEddy]

Let me clarify what I'm saying for you my son. In your post it seems that you are minimizing this person's feelings about choosing a specialty based on how much money one or the other makes. He was simply asking a question that could be answered in a means other than "picking a specialty because of the money is stupid". Sorry for not being specific enough...

Show me where I said I don't care about money. All I said (and others agreed) was that money should not be your primary reason for choosing a specialty.

 

[jmattwilson]

"Let me clarify what I'm saying for you my son."

That is a classic response, I love it

 

[Sessamoid]

Let me clarify what I'm saying for you my son. In your post it seems that you are minimizing this person's feelings about choosing a specialty based on how much money one or the other makes. He was simply asking a question that could be answered in a means other than "picking a specialty because of the money is stupid". Sorry for not being specific enough...

Goodness, I hope you don't plan to speak that way to all your future attendings in residency.

 

[Celiac Plexus]

It's a great idea to consider the economic picture of the career you choose. Unfortunately there is a pervasive attitude in medicine that money is a dirty topic. Rather than discuss the economics of medicine, many physicians are silenced by peer pressure that somehow screams: "Doctors are martyrs, and we shouldn't care about reimbursement." Then you wonder why your chief resident leases a new Beemer at the beginning of his chief year.

Also, most physicians have no background in economics. Remember that for the great majority of physicians, being a physician is the first real job they every had. Compound this inexperience with the fact that they spent anywhere from 3-10 years as a resident/fellow making 40-50K/year for untold hours per week. We are conditioned to put money/pay out of our minds. If we, as residents, think about it too much we will become, ummm.... disturbed.

Some important economic considerations when picking a specialty....

1. What do you really want to do? Pathology? Surgery? Family medicine? Anesthesia? ER? It's a huge decision. But I believe that the most important driving factor should be: "Do what you think is cool, and have the most excitement/fun with." Choosing a residency is awesome because I can't think of another profession in the world where you get to choose from a wide variety of potentially fascinating jobs (residencies), in which you will work with other like-minded, highly intelligent, interesting people. Pick a field in which you will be happy to get out of bed to do when you're 70.

2. income. Yep, if you say that this is not a big factor in your thinking then you are either wealthy, naive, or not telling the truth. Medical school + residency = HUGE "opportunity cost". That means that while you were in medical school and residency for the better part of a decade making very little money, and incurring significant debt, your peers were in the workplace earning a lot more money and possibly investing it, etc. Or at least they went on some pretty cool vacations. Don't be ashamed to factor income potential into your decision algorithm. An interventional radiologist has the same degree as an FP... that's where the similarities end.

3. Lifestyle. It is VERY important. If you have a nagging husband/wife/SO that is already placing restrictions on you as far as where to do residency... this is is a bad sign. If you really love this person then factor them in too. But if you want to do surgery and you have a whiny (and you folks know what I mean even though I'm being blunt) SO, know that you are going to be in for more pain than if you have a very relaxed, supportive, devoted SO. I'm a pgy-2 GS resident, and I have already seen the good, the bad, the ugly in my own personal life, and in the lives of a few of my colleagues. If you're single, this is potentially a great advantage for the first 2-3 years of a surgery residency.

To the OP: GS and EM are very different. I am not sure why people think that there is a huge connection between the two. Maybe because as a medical student you get to sew in the ER and sew in the OR, so the idea of similarity arises. Or maybe it's because there is a big telephone/consult relationship between ER doctors and surgeons. I really don't know. But there is really very little similarity between the two fields. The money in ER is great considering how little training is required to practice. 3 year residency, and you can go out and make 150-200K right away and have great hours. You'll already be 200-300K better off than your GS counterpart... (Difference in your provate practice salary and his resident salary for 2 years). EM does not have the same earning potential as surgical fields though. It's possible for a GS to have a nice lifestyle in private practice, and make 400K/yr. In EM, you will probably never make 400K/yr.... but most people don't choose EM for the money anyway (or so they tell me), they choose it for the light work schedule and a good lifestyle. Anyway, it's a big decision. Don't base it all on ca$h. But think about it.

If more physicians were more invested in their financial health, we probably wouldn't sit around scratching our asses while our paychecks decline, and our workloads increase.

 

[scrubs69]

If you did surgery and loved it, then go into surgery. Choosing something you don't like or don't like nearly as much for a few tens of thousands a year (one way or the other) is stupid. How much is your happiness worth to you?

This isn't my forum, but since you're trying to decide between my specialty and surgery, I thought I'd offer an opinion.

Don't do it for the $$.

 

[matthewtam2002]

wow
you are mostly all so money orientated i cant believe it
i love the way you use 'reimbursement' rather than 'salary' or 'pay'

if you work 80 hours a week and take 2 weeks vacation
how are you going to have time to enjoy or spend it?
sure, maybe your wife will buy nice lingerie and have a great time
spending it with someone else while you were rounding or doing a Hartmann's at 2am

and sure, office based practice at 400k
thats there now but it will get taken away and controlled.
the natural history, economically speaking, means that there will
always be someone who can do something cheaper or better so
the competition right now is huge.

 

[Bo Hurley]

wow
you are mostly all so money orientated i cant believe it

Nothing wrong with wanting to make a lot of money for all the work you've put in.

 

[meister]

Wanting to make good money isn't a bad thing.

 

[Bo Hurley]

How about making so much money that you no longer bother operating because you're too busy counting your money and snorting lines off a stripper's belly?

One day, one day...

 

[zidanereal2003]

How about making so much money that you no longer bother operating because you're too busy counting your money and snorting lines off a stripper's belly?

One day, one day...

Why don't you flip a coin and choose ? I am just joking.
I am sure it is not an easy decision to make.. but if you have a family and kids I would say ER should be your choice.. Your family has rights as well. I don't think it would be fair to let go through GS residency with you..
This is my opinion. You like both ER and GS .. So choosing ER won't be so bad.
Sorry If I was harsh or something
Take care.

 

[Winged Scapula]

wow
you are mostly all so money orientated i cant believe it
i love the way you use 'reimbursement' rather than 'salary' or 'pay'

The term "reimbursement" is perfectly correct as those going into any type of surgical practice in the US, especially those with a large Medi-Care population, are dependent on insurance reimbursement rather than salary, especially those in private practice.

While no one will argue that going into a specialty "just for the money" is a bad decision, please remember that your colleagues here in the US often have much more debt and are interested in ways of paying that off and still having a nice lifestyle.

 

[dry dre]

. . . please remember that your colleagues here in the US often have much more debt and are interested in ways of paying that off and still having a nice lifestyle.

Are you referring to student loan debt? Call me unsympathetic, but I hate hearing about the "loan debt" that folks in medicine often complain about. I've got over $150k of it, and I'm not complaining.

Just for perspective, I ran the following numbers:

Physician: Assumption 200K student loan debt (above average), 3% interest rate over 30 years equals $844 a month, or $10,120 per year.

For a physician at $291,000, this debt burden requires 3.5% of annual gross, leaving ~280k/year ~pre-tax to have a nice lifestyle.

For a physician at $216,000, this debt burden requires 4.7% of annual gross, leaving ~205k/year ~pre-tax to have a nice lifestyle.

Teacher: Assumption 40K student loan debt (~average), 3% interest rate over 30 years equals $169 a month, or $2020 per year.

For a teacher at $40,000 annual income, this debt burden requires 4.8% of annual gross, leaving ~38K/year to have a nice lifestyle.

This may be apples to oranges in most peoples' minds, but this is why I don't complain about my debt.

 

[Winged Scapula]

Are you referring to student loan debt? Call me unsympathetic, but I hate hearing about the "loan debt" that folks in medicine often complain about. I've got over $150k of it, and I'm not complaining.

Just for perspective, I ran the following numbers:

Physician: Assumption 200K student loan debt (above average), 3% interest rate over 30 years equals $844 a month, or $10,120 per year.

For a physician at $291,000, this debt burden requires 3.5% of annual gross, leaving ~280k/year ~pre-tax to have a nice lifestyle.

For a physician at $216,000, this debt burden requires 4.7% of annual gross, leaving ~205k/year ~pre-tax to have a nice lifestyle.

Teacher: Assumption 40K student loan debt (~average), 3% interest rate over 30 years equals $169 a month, or $2020 per year.

For a teacher at $40,000 annual income, this debt burden requires 4.8% of annual gross, leaving ~38K/year to have a nice lifestyle.

This may be apples to oranges in most peoples' minds, but this is why I don't complain about my debt.

I am well aware that many other professions have large loan debts without the comparative salary (I racked up a fair bit in my former life, but paid them off before medical school, so I could "start fresh"). I don't complain about my debt load either (much) because I know I can pay it off and still live a nice life, better than most of the general population.

However, I was referring to the posts by matthewtam2002 (here and in other trheads) who is a house officer in the UK and can't understand why US students and residents were so obsessed with money. Since he makes nearly twice what most Chief residents and fellows in the US do (and by working significantly less hours), didn't spend nearly as much to educate himself, I simply wanted to point out (which he probably already knows) that many worry about how much they'll make because of the massive loan debt. Of course, many worry simply because they like making lots of money and the fun stuff it can buy.

 

[Tristero]

hey matthewtam2002,

why don't you stay out of conversations in which you have no relevant input?

cheers,

tristero.

 

[matthewtam2002]

tristero
subject - how much money does a surgeon make?
i have no right to talk about this?
why so aggressive?

 

[WatchingWaiting]

Are you referring to student loan debt? Call me unsympathetic, but I hate hearing about the "loan debt" that folks in medicine often complain about. I've got over $150k of it, and I'm not complaining.

Just for perspective, I ran the following numbers:

Physician: Assumption 200K student loan debt (above average), 3% interest rate over 30 years equals $844 a month, or $10,120 per year.

For a physician at $291,000, this debt burden requires 3.5% of annual gross, leaving ~280k/year ~pre-tax to have a nice lifestyle.

For a physician at $216,000, this debt burden requires 4.7% of annual gross, leaving ~205k/year ~pre-tax to have a nice lifestyle.

Teacher: Assumption 40K student loan debt (~average), 3% interest rate over 30 years equals $169 a month, or $2020 per year.

For a teacher at $40,000 annual income, this debt burden requires 4.8% of annual gross, leaving ~38K/year to have a nice lifestyle.

This may be apples to oranges in most peoples' minds, but this is why I don't complain about my debt.

This is a remarkably dumb analysis. First off, where did you come up with 3% interest rate over 30 years? Interest rates are at the lowest levels they have been in 40 years right now-- banking on these rates lasting for the long-term is just wrong. In addition, for people with large debt loads, the bulk of it is in the form of unsubsidized loans, which will not be subject to any kind of interest-free deferrment and will be paid out at more like 7% a year interest, after growing 30-40% during residency deferment. Second, you may not have much familiarity with the tax system, but a gross income of $216,000 per year corresponds to an actual income of more like $130,000 per year when you put in all the state, federal, social security, FICA, and other taxes. In addition, I don't know if your average doc really wants to be repaying his student loans when he is 65, so I don't think your assumption of a 30-year repayment period is particularly accurate.

Given more realistic assumptions, you'll be looking at more like 15-20% of your take-home pay going towards paying off your student loans. Second, why don't you make a comparison to a lawyer or a business executive? Why on Earth should the best and brightest doing some of the most intellectually and interpersonally challenging, as well as valuable, work in this country not be compensated comparably to some scumbag corporate lawyer or a vice president of a mid-to-large sized company?

 

[navysurgeon]

in the navy, as a general surgeon, i was making $130k a year

i'm looking for a private practice job right now, in the seattle area. salaries range from $150k to $225k with my 3 years of experience as an attending.

this is in metro market. salaries are higher, sometimes considerably, in less metro markets...i've hard about jobs in west texas approaching $500k a year...

hope that helps.

the date published in the salary surveys are good benchmarks.

 

[Bo Hurley]

...i've hard about jobs in west texas approaching $500k a year...

West Texas, eh...

Is it a decent place to live?

 

[dry dre]

This is a remarkably dumb analysis...

Given more realistic assumptions, you'll be looking at more like 15-20% of your take-home pay going towards paying off your student loans. Second, why don't you make a comparison to a lawyer or a business executive? Why on Earth should the best and brightest doing some of the most intellectually and interpersonally challenging, as well as valuable, work in this country not be compensated comparably to some scumbag corporate lawyer or a vice president of a mid-to-large sized company?

For Christ's sake, I wasn't submitting this "analysis" to congress. Regarding 3%, I suppose you're not familiar with the repayment process/consolidation. Taking inflation into account, the rate is below 2%, maybe below 1%. Bottom line, less than $900 a month. This will be peanuts in 20 years.

Regarding best & brightest vs salaries...this is a tired debate. The rest of the developed world finds people equally bright to serve as physicians for a smaller relative salary....I'm not saying that paying less is ideal, but it is what is for the rest of the world, and this status quo undermines the typical argument that you have to pay relatively high in a society to get good doctors/healtcare. Stomp your feet, beat your fists, yell, use words with many syllables, tell me to move, but you can't undo this fact. Believe it or not, some of us would still go into medicine if the money was less.

 

[binary502]

Has anything changed in the past 7 years from what was said here more or less?

 

[45408]

Yeah, he apparently went into vascular surgery....

 

[Green Grass]

Yeah, he apparently went into vascular surgery....

And so ended the great salary debate of 2004...

 

[Paddington]

From hearing a few docs' salaries, i'm really starting to wonder how accurate those surveys are. The Gsurg attendings I've talked to make between 150-200 a few years after residency, the obgyns 140-190 in private practice or hmo, and fps 100-120. this is in the Bay Area (northern california). These figures are all way below the 'average' quoted on those surveys, and this is an area with an incredibly high cost of living!

Old numbers, but those salaries sound horribly low.