Pedi GI Salary

[NightSwim]

MS4 here trying to decide whether or not to do peds then a GI fellowship. I've gotten conflicted reports from 2 people about pediatric gastroenterologist's salary. An attending said 150k starting for GI in academia and that can go up to ~200 with experience. The GI nurse, however, told me she heard from attendings that it can be in the range of 250-300k in academia.

I'm looking for more input. 250k would be AWESOME. I could make do with 200k. But, 150k after a 6-year residency would be disappointing. That being said, the lifestyle of pedi GI's seems legit! And it seems like working harder could earn you more?? though maybe not the case if you are salaried at an academic hospital. Thanks in advance. Would really appreciate it.

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[justdoit31]

I don't have a specific answer- I know Peds GI is one of the higher paying fields. I know Hem/Onc usually makes less than Gen Peds.

But the main answer to this is- if you don't love a field don't go into it- seriously you can make by with 100k- you would still be making double what the average American household makes and by staying in a non-profit academic system you can have your loans forgiven in 10 years with IBR and PSLF. Money isn't everything- go into something you are PASSIONATE about you will be doing it for a long time!

 

[Silent Cool]

MS4 here trying to decide whether or not to do peds then a GI fellowship. I've gotten conflicted reports from 2 people about pediatric gastroenterologist's salary. An attending said 150k starting for GI in academia and that can go up to ~200 with experience. The GI nurse, however, told me she heard from attendings that it can be in the range of 250-300k in academia.

I'm looking for more input. 250k would be AWESOME. I could make do with 200k. But, 150k after a 6-year residency would be disappointing. That being said, the lifestyle of pedi GI's seems legit! And it seems like working harder could earn you more?? though maybe not the case if you are salaried at an academic hospital. Thanks in advance. Would really appreciate it.

Would you tell me briefly why you want to be a PEDS GI doc? In general, I don't see the appeal of GI, but specifically regarding children. The idea of performing GI procedures on children just doesn't give me warm fuzzies.

TIA.

 

[DeadCactus]

Would you tell me briefly why you want to be a PEDS GI doc? In general, I don't see the appeal of GI, but specifically regarding children. The idea of performing GI procedures on children just doesn't give me warm fuzzies.

TIA.

Same reason adult GI is popular. Procedures, high pay, good lifestyle...

 

[Siverhideo1985]

There was a paper published in pediatrics, I believe, that compared overall income potential among general and subspecialty pediatricians and found that only three specialities earned you more money in the long run (considering lost wages due to longer training, etc) - those were peds cardio, NICU and PICU. I'm sure with some more digging you could find the paper and take a closer look.

Then there is papers like this that basically state that even though gen peds gets paid less they are the happiest.

http://www.ncbi.nlm.nih.gov/pubmed/11533358

The AAMC's career in medicine website has average salaries for pediatric subspecialities as well - its really a useful website overall, you could check it out.

From their website: Pediatric Gastroenterology (25th - median - 75th percentile, left to right)

Academic:
Assistant Professor $158,000 $169,000 $189,000
Associate/Full Professor $195,000 $224,000 $266,000

Source: Association of American Medical Colleges. Report on Medical School Faculty Salaries 2011-2012. Washington, DC: Association of American Medical Colleges; 2013.
Understanding Physician Compensation

Clinical Practice

Starting Salaries N/A N/A N/A
1 - 2 Years in Specialty N/A N/A N/A
All Physicians $219,195 $265,289 $321,769

IM very humble O, salary needs to be one of the things to consider (especially if you have loans and plans for a house or family, etc), but personally it is much more important to me to be happy in what I am doing. Maybe think big picture and take salary into account with that.

Hope this helps!

 

[NightSwim]

Would you tell me briefly why you want to be a PEDS GI doc? In general, I don't see the appeal of GI, but specifically regarding children. The idea of performing GI procedures on children just doesn't give me warm fuzzies.

TIA.

My take:
Pros: variety, the pathology (i find GI diseases very interesting), procedures, going all over the hospital (nicu, picu, ED, clinic, OR), age range - involves lots of babies and lots of teenagers, good opportunities for research (like any field though), I want to be a "specialist", I loved the collegiality between the docs,

Cons: poop, scopes are kinda boring, EGDs are usually normal appearing, pathology is not as interesting as adult GI, functional abdominal pain, definitely less 'action' than other fields I'm considering

 

[NightSwim]

There was a paper published in pediatrics, I believe, that compared overall income potential among general and subspecialty pediatricians and found that only three specialities earned you more money in the long run (considering lost wages due to longer training, etc) - those were peds cardio, NICU and PICU. I'm sure with some more digging you could find the paper and take a closer look.

Then there is papers like this that basically state that even though gen peds gets paid less they are the happiest.

http://www.ncbi.nlm.nih.gov/pubmed/11533358

The AAMC's career in medicine website has average salaries for pediatric subspecialities as well - its really a useful website overall, you could check it out.

From their website: Pediatric Gastroenterology (25th - median - 75th percentile, left to right)

Academic:
Assistant Professor $158,000 $169,000 $189,000
Associate/Full Professor $195,000 $224,000 $266,000

Source: Association of American Medical Colleges. Report on Medical School Faculty Salaries 2011-2012. Washington, DC: Association of American Medical Colleges; 2013.
Understanding Physician Compensation

Clinical Practice

Starting Salaries N/A N/A N/A
1 - 2 Years in Specialty N/A N/A N/A
All Physicians $219,195 $265,289 $321,769

IM very humble O, salary needs to be one of the things to consider (especially if you have loans and plans for a house or family, etc), but personally it is much more important to me to be happy in what I am doing. Maybe think big picture and take salary into account with that.

Hope this helps!

thanks, I hadn't seen those AAMC #s. Agreed on your last statement, well said. Obviously the issue of salary will vary person to person. I don't think it will influence my decision. But I would like to make as informed a decision as I can considering which specialty to choose isn't clear for me.

 

[fpd1987]

I believe this is the paper on returns of subspecialties when compared to gen peds mentioned above
http://pediatrics.aappublications.org/content/127/2/254

 

[umass rower]

I'm looking for more input.

The answer is yes. Any of those salaries are possible, as is often the case with specialties there is a wide range of possible salaries. In general, unless you're pulling in humongoid grants as a researcher, academia will pay less than private practice. Places doing cutting-edge stuff will pay less than places that have to recruit harder. Most academic locations won't have much in the way of productivity bonuses. I would estimate that most salaries in the academic world range in the 150-200k neighborhood. I can't really speak to private practice, since there isn't much of that around here.

 

[Giic]

MS4 here trying to decide whether or not to do peds then a GI fellowship. I've gotten conflicted reports from 2 people about pediatric gastroenterologist's salary. An attending said 150k starting for GI in academia and that can go up to ~200 with experience. The GI nurse, however, told me she heard from attendings that it can be in the range of 250-300k in academia.

I'm looking for more input. 250k would be AWESOME. I could make do with 200k. But, 150k after a 6-year residency would be disappointing. That being said, the lifestyle of pedi GI's seems legit! And it seems like working harder could earn you more?? though maybe not the case if you are salaried at an academic hospital. Thanks in advance. Would really appreciate it.

Soooooo...... you're chosing your fellowship based on salary and compensation? And you could "make do" with 200K? Do you know how many people make 120K after 6 years of training?

 

[Perrotfish]

Soooooo...... you're chosing your fellowship based on salary and compensation? And you could "make do" with 200K? Do you know how many people make 120K after 6 years of training?

I don't think many of them are making do with 120K if they have the kind of loan burden that private school students these days are carrying after residency. Or if they are they are doing so praying that IBR/PSLF comes through while their student loans climb into the stratosphere.

 

[Lokhtar]

I don't think many of them are making do with 120K if they have the kind of loan burden that private school students these days are carrying after residency. Or if they are they are doing so praying that IBR/PSLF comes through while their student loans climb into the stratosphere.

If the average household makes ~50k/year. Your salary of $120k would more than cover the loan difference.

I'm not saying physicians should make $120k...I'm just saying you would still be above the average household income, by yourself, even with taking loans into account.

 

[DeadCactus]

If the average household makes ~50k/year. Your salary of $120k would more than cover the loan difference.

I'm not saying physicians should make $120k...I'm just saying you would still be above the average household income, by yourself, even with taking loans into account.

And once they get those pesky loans out of the way, they can start making up the $1million income deficit they earned while in medical school and graduate medical education.

Never mind appropriate compensation for sacrificing much of one's twenties, compensation for assuming the large financial risk of pursuing a medical career, and the portion of a physician's income going toward the overhead inherent in a professional career...

 

[Perrotfish]

If the average household makes ~50k/year. Your salary of $120k would more than cover the loan difference.

I'm not saying physicians should make $120k...I'm just saying you would still be above the average household income, by yourself, even with taking loans into account.

Average principal loan at a private school is 280K, the interest is about 7.5%

Loans are unsubsidized, they accrue through medial school, so at the end of medical school you owe 330K.

It KEEPs accumulating through residency and fellowship when you're on IBR, the IBR payments are almost negligible, and at the end of 6 years you owe 500K.

With 500K, if you start a 10 year payment plan you'll owe almost exactly 1.5x the current principal broken up into annual equal payments, approximately 75K/year for 10 years.

That's all from after tax income and non-deductible. So you have 120K, you pay nearly 30% between state and local taxes, pay 75K in loans, and that gives you about 15K to live on, not even close to the average household income.

Leaving aside the question of whether average household income is reasonable compensation for a physician and a subspecialist, I just don't see how you can carry those kinds of loans with that kind of interest on a 120K salary without turning to IBR/PSLF for help.

 

[Silent Cool]

Average principal loan at a private school is 280K, the interest is about 7.5%

Loans are unsubsidized, they accrue through medial school, so at the end of medical school you owe 330K.

It KEEPs accumulating through residency and fellowship when you're on IBR, the IBR payments are almost negligible, and at the end of 6 years you owe 500K.

With 500K, if you start a 10 year payment plan you'll owe almost exactly 1.5x the current principal broken up into annual equal payments, approximately 75K/year for 10 years.

That's all from after tax income and non-deductible. So you have 120K, you pay nearly 30% between state and local taxes, pay 75K in loans, and that gives you about 15K to live on, not even close to the average household income.

Leaving aside the question of whether average household income is reasonable compensation for a physician and a subspecialist, I just don't see how you can carry those kinds of loans with that kind of interest on a 120K salary without turning to IBR/PSLF for help.

Yup.

https://www.youtube.com/watch?v=1b8nN5nPAyE

 

[Lokhtar]

Average principal loan at a private school is 280K, the interest is about 7.5%

Loans are unsubsidized, they accrue through medial school, so at the end of medical school you owe 330K.

It KEEPs accumulating through residency and fellowship when you're on IBR, the IBR payments are almost negligible, and at the end of 6 years you owe 500K.

With 500K, if you start a 10 year payment plan you'll owe almost exactly 1.5x the current principal broken up into annual equal payments, approximately 75K/year for 10 years.

That's all from after tax income and non-deductible. So you have 120K, you pay nearly 30% between state and local taxes, pay 75K in loans, and that gives you about 15K to live on, not even close to the average household income.

Leaving aside the question of whether average household income is reasonable compensation for a physician and a subspecialist, I just don't see how you can carry those kinds of loans with that kind of interest on a 120K salary without turning to IBR/PSLF for help.

I said it wasn't. I was making a point purely on the finances. Don't start a 10 year plan - that's a ridiculously fast repayment option for a $500k loan.

 

[Perrotfish]

I said it wasn't. I was making a point purely on the finances. Don't start a 10 year plan - that's a ridiculously fast repayment option for a $500k loan.

You said that that the extra income would more than make up for the loan difference, it won't. If a 10 year plan is too much, you can do a 30 year plan: for a 500,000K loan you pay a little over 2.5 times the principle over the lifetime of the payment plan (1.3 million), which works out to 43K of after tax income a year. That's about 40K/year after tax after debt income that you get to actually spend. That does almost (but not quite) gets you to the level of average household after tax income if you ignore the 10 years of income that got sucked into a black hole when you were in school. However if you DO factor those years in you're still clearly losing, your lifetime after tax after debt earnings aren't close to the average household. You still have a modest lead on an average (high school educated) individual, I guess. Very modest.

Anyway, the point is that if you have high levels of high interest student loans you should run screaming from any subspecialty training that doesn't double your pay. If enough of us do it maybe the ABP will finally get rid of the 'three years for everyone' fellowship system.

 

[shaggy alfresco]

So I really love peds, but I will have about $320k in loans when I graduate. I don't think I would want to do general peds, so my question is: for an average to slightly below average (below average board scores but decent clinical grades) applicant, how hard is it to get into a residency which would allow me to get a fellowship like EM, Cards or Critical Care? I am not looking to get rich, but these loans are scaring me and I see the AAMC Careers in Medicine Starting salary for general peds and with the loan burden...I don't see how it's possible. I can probably do things like Anesthesia that would pay a lot more, but I wouldn't like it so those are out. However, there are 1-2 fields that pay $200-$250k (similar to fellowship trained peds) starting which are a 'close second' in terms of how much I like them (especially things like child psych - which would also allow me to work with children) which I could do. Can existing residents/attending with similar loan burdens/concerns chime in? Also, how are the job prospects for pediatricians - with the aging population and all?

 

[mvenus929]

Also, how are the job prospects for pediatricians - with the aging population and all?

The population is aging because there are simply more people living longer, not because people aren't having kids anymore.

 

[umass rower]

how hard is it to get into a residency which would allow me to get a fellowship like EM, Cards or Critical Care?

To reiterate from the other thread: not hard. My residency was definitely not a powerhouse of sub-specialty care, only had 13 people per class, and in my 3 years there we had people match into: GI, PICU, NICU, Heme-Onc, EM, ID, Endocrine, Pulm, and Developmental, off the top of my head. Several of those had multiple people matching, even from the same year. We also had people matching into some of the non-ACGME fellowships like Hospitalist and Academic General Peds.