'UW says its doctors in training want too much money'

[Stagg737]

Yeah, the thing is realistically med school tuition can still rise quite a bit to the point where attending income minus eventual debt payments still makes a damn good lifestyle compared to your typical job for an educated individual (especially considering the sellers market mess that professorships have become for PhDs.) I just wonder what's the threshold at which those without financial support (and I fully disclose that I had some when I describe my own situation...though a decent chunk of it was due to unforeseen circumstances) decide to look at other options due to the barriers to entry.

Absolutely, I'd be lying if the job/financial security wasn't a factor for me entering medicine, and I think any intelligent individual would probably say the same. I'd probably be willing to take on 300-400k in debt if I know I'd be employed and making 200k+ doing something I enjoyed for the rest of my life.

The bolded is where I think the real question and problem lie. As long as the gov is willing to dish out loans that will cover the cost tuition + living, there will be people out there financially naive enough to pursue any career. There are people that are willing to take out 50k+/year in loans to go to undergrad schools and then pursue careers in arts or other fields that probably won't pay more than 40k/year or where they end up working in retail or some other low-paying, miserable industry. So as long as the loans are there and the interest rates don't skyrocket, I think tuition could skyrocket and med schools wouldn't be hurting for applicants.

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[chipwhitley]

ummm, I'm not sure who you're quoting there, but it wasn't me.

I was quoting SouthernSurgeon, actually. Not sure why it came up under your name...

Edit: Fixed it.

 

[ThoracicGuy]

I think this is the biggest issue. If monumental loans weren't a factor, I doubt people would be as fired up about salary during residency. Honestly, 50K/year isn't a bad deal if you consider that it's for an extension of training and that medical insurance is generally covered. Heck, it's a good deal more money than my family grew up on. The issue as I see it is that people have to start paying back 300K loans during residency because the financial powers that be don't view it as an extension of training and won't allow deferments or lower monthly payments. When so much money goes to loans, it's easy to be frustrated by how many hours residents work for so much financial headache.

Aren't you able to significantly reduce your monthly payments according to your income level via IBR? Or refinance with some of the private lenders that allow a $100/month payment during residency with an overall lower rate than your federal loans?

When did they stop with deferments/forebearance? I used that extensively during training. No problems there...

 

[Krupke]

Did you all see how the British residents are going on strikes right now to get their demands met?

The salary of a resident is fine if debt didn't exist, but I do wish there was pressure being put on the gov't to subsidize the interest accruing on the loans or an increase in resident salary so we can pay more towards loans. I haven't even started med school and the interest during residency is a big concern to me. I will have over $350K in debt and if I do a 5 yr residency, it will add ~$130K to my loans and bring me to about $500K in debt. Many students have enough debt that they are actually taking on $20K/yr in interest for each year of residency even if they dedicate all their spare money toward paying loans.

I know people will disagree, but it doesn't seem crazy to me for there to be some option to not have your debt grow by over $100K during residency.

 

[ohioguy]

About time residents stood up to being cheap hospital labor.

 

[Psai]

Did you all see how the British residents are going on strikes right now to get their demands met?

The salary of a resident is fine if debt didn't exist, but I do wish there was pressure being put on the gov't to subsidize the interest accruing on the loans or an increase in resident salary so we can pay more towards loans. I haven't even started med school and the interest during residency is a big concern to me. I will have over $350K in debt and if I do a 5 yr residency, it will add ~$130K to my loans and bring me to about $500K in debt. Many students have enough debt that they are actually taking on $20K/yr in interest for each year of residency even if they dedicate all their spare money toward paying loans.

I know people will disagree, but it doesn't seem crazy to me for there to be some option to not have your debt grow by over $100K during residency.

It didn't grow during medical school until recently.

 

[Stagg737]

Aren't you able to significantly reduce your monthly payments according to your income level via IBR? Or refinance with some of the private lenders that allow a $100/month payment during residency with an overall lower rate than your federal loans?

When did they stop with deferments/forebearance? I used that extensively during training. No problems there...

Deferment/Forbearance does still exist, but interest continues to collect during that time. Depending on the company the interest rates might even get jacked up (My SO's rates went from 7.8% to 10.5% when she entered forebearance with Sallie Mae). You can consolidate or refinance with private lenders, but all of them that I've seen will only offer lower rates while you're actually in school, and rates once you have an income (aka residency) jump to 8%+.

It sucks for people that are currently M2-PGY1s because we fall right in the time when undergrad interest rates were the highest (since the 90's) and also have to deal with getting bent over by the current federal administration by losing subsidized graduate loans.

 

[IslandStyle808]

Absolutely, I'd be lying if the job/financial security wasn't a factor for me entering medicine, and I think any intelligent individual would probably say the same. I'd probably be willing to take on 300-400k in debt if I know I'd be employed and making 200k+ doing something I enjoyed for the rest of my life.

The bolded is where I think the real question and problem lie. As long as the gov is willing to dish out loans that will cover the cost tuition + living, there will be people out there financially naive enough to pursue any career. There are people that are willing to take out 50k+/year in loans to go to undergrad schools and then pursue careers in arts or other fields that probably won't pay more than 40k/year or where they end up working in retail or some other low-paying, miserable industry. So as long as the loans are there and the interest rates don't skyrocket, I think tuition could skyrocket and med schools wouldn't be hurting for applicants.

They definitely would be hurting for applicants if tuition skyrocketed too much and salaries don't rise along with it. It is just that medical school tuition hasn't reached that point yet, med school still has an inelastic demand.

 

[PL198]

They definitely would be hurting for applicants if tuition skyrocketed too much and salaries don't rise along with it. It is just that medical school tuition hasn't reached that point yet, med school still has an inelastic demand.

Med school would still fill if tuition was 100k/yr. I understand your point but it would only happen if tuition was multiples of what it is now. By and large, medicine is still a rich man's game.

 

[NotAProgDirector]

I know people will disagree, but it doesn't seem crazy to me for there to be some option to not have your debt grow by over $100K during residency.

I certainly agree with the sentiment of this. But what is the solution? Medical school tuition has skyrocketed in the last decade or so, mainly because they can get away with it and you can get infinite loans from the government. And now that Med Schools are fat on tuition, it's my problem to pay you more so you can service that debt? And once I do that, what stops medical schools from just cranking up tuition more, because, you know, now you can afford it because you will have a higher salary?

I have no problem having a discussion about resident salaries, and whether they are "right" or not. And if my residents were to make a concerted push to increase their salary, I'd try to support them. Their salary is defined by GME, so I don't have any direct control over salaries. But "our loans are really big" is one of the worst arguments, in my opinion. The gov't needs to cap loan funding at a reasonable level, and you'll see schools match that amount in tuition.

 

[Krupke]

I certainly agree with the sentiment of this. But what is the solution? Medical school tuition has skyrocketed in the last decade or so, mainly because they can get away with it and you can get infinite loans from the government. And now that Med Schools are fat on tuition, it's my problem to pay you more so you can service that debt? And once I do that, what stops medical schools from just cranking up tuition more, because, you know, now you can afford it because you will have a higher salary?

I have no problem having a discussion about resident salaries, and whether they are "right" or not. And if my residents were to make a concerted push to increase their salary, I'd try to support them. Their salary is defined by GME, so I don't have any direct control over salaries. But "our loans are really big" is one of the worst arguments, in my opinion. The gov't needs to cap loan funding at a reasonable level, and you'll see schools match that amount in tuition.

Oh, I definitely agree that it is 100% the gov't's fault that tuition is the way it is and that things will only get worse until the gov't caps loans. But I think residents will still try to increase their salary because they don't see another solution. Even though residents don't have that much power in getting their demands met in the hospital, they are more likely to make gains there than they are telling the gov't to stop screwing everyone over.

What do you think students can do to get the gov't to cap loans?

Edit: The fact that anyone can take out an unlimited amount of loans is an obvious problem (and is even worse for non-medical fields where art students are taking out $100K for a mfa, etc.), but the gov't still refuses to do anything. You have the gov't scratching their heads about what we can do about the student debt problem--> But they don't want to give up the money they can make from student loan interest and will do everything they can to allow schools to increase tuition. Then you have med schools scratching their heads about how we can get students to commit to primary care--> But they won't reduce tuition so that students can actually afford to not specialize because they want to profit.
Something has to give somewhere, and I think resident's salary is the one thing that students feel they can have the slightest influence on

 

[ridethecliche]

I'm actually not as concerned with PA/NP/RN salaries as I am about the compensation of non-medical management at institutions. Seems to me that this is a bigger bubble than just about everything else.

 

[meister]

It's amazing to me that fellow physicians would argue against higher resident salaries or cast doubt on their ability to command higher salaries. Sure, they're in training and legally require an attending's signature to bill and certainly no one is saying they should make attending money, but tell the CCM fellow personally caring for 30 ICU patients overnight without an attending in sight that he is really only worth half a per diem RN. Tell the surgical chief seeing fifteen consults and supervising several interns while her attending gets a nice night's sleep that she is worth $15 an hour. Give me a break.

In the past with relatively low debt burdens and favorable government loan financing these issues weren't as big of a deal. But medicine is changing. Those in med school and in residency face uncertain futures. With cost of living far outpacing salaries and student loans swallowing ever increasing amounts of income, why is it so bad that residents start to question the premises rather than just accept the status quo and move on?

Historically medicine had a nice s*** sandwich waiting for you on July 1 PGY1 with the expectation that you would make it big and cash out some day. I don't think many would argue residency is harder now than it used to be, in fact most would acknowledge the opposite. Howver no such guarantee of a golden ticket exists anymore, and it's about time we all started accepting that.

 

[Pacna]

I'm late to this thread, so my apologies if I am backtracking.
Be careful what you wish for. As I mentioned above, the value of a resident doing an elective, or their own independent research project (to help with their fellowship applications), is likely zero. And this could easily set various residents against each other. Peds is, in general, a huge money loser.

I didn't mean just residents. The other side of the table could well benefit from the information. Either way, it should be sorted out.

 

[WingedOx]

or cast doubt on their ability to command higher salaries

again, please provide a mechanism for them to do so... We've had 5 pages of this and no one has provided an avenue for which they would be able to.

 

[exsanguination]

It's amazing to me that fellow physicians would argue against higher resident salaries or cast doubt on their ability to command higher salaries. Sure, they're in training and legally require an attending's signature to bill and certainly no one is saying they should make attending money, but tell the CCM fellow personally caring for 30 ICU patients overnight without an attending in sight that he is really only worth half a per diem RN. Tell the surgical chief seeing fifteen consults and supervising several interns while her attending gets a nice night's sleep that she is worth $15 an hour. Give me a break.

In the past with relatively low debt burdens and favorable government loan financing these issues weren't as big of a deal. But medicine is changing. Those in med school and in residency face uncertain futures. With cost of living far outpacing salaries and student loans swallowing ever increasing amounts of income, why is it so bad that residents start to question the premises rather than just accept the status quo and move on?

Historically medicine had a nice s*** sandwich waiting for you on July 1 PGY1 with the expectation that you would make it big and cash out some day. I don't think many would argue residency is harder now than it used to be, in fact most would acknowledge the opposite. Howver no such guarantee of a golden ticket exists anymore, and it's about time we all started accepting that.

EXACTLY.

Everybody here who plans on being an MD/DO needs to READ THIS POST

United we stand - DIVIDED WE FALL.

Until we start putting up for each other, and I mean REALLY putting up for each other, there will be nothing but darkness for the future of our career. Until the attending starts supporting the resident's wellness needs, the suicides will continue. Until orthopaedics and neurosurgery start respecting the family practitioner as a highly trained knowledgeable professional, the legislation and hospital administration will continue to divide and conquer us.

Why have nurses and MLPs been able to gain so much ground? It's because the PHYSICIAN has lost any modicum of grip we had on healthcare. We do not sit at the captains chair any more, we do not steer the healthcare ship, and as a result we've found ourselves in choppy waters.. are any of you surprised?

There should be nothing but UNBRIDLED SUPPORT from all physician levels to increase resident salaries. Anybody bickering about "millennial entitlement" or other red herrings is missing the point. The overarching message here is that we need to unite and speak as one.

Of course this will never happen.. things will have to get a lot worse before they get better. Until the average debt is closer to half a mil with salaries nearing 150k/year for our non-surgical colleagues, nothing will change.

 

[Krupke]

again, please provide a mechanism for them to do so... We've had 5 pages of this and no one has provided an avenue for which they would be able to.

Why wouldn't something like what is being done in the UK work?

Residents are working only on emergency cases and the other residents are striking. Attendings are stepping up to cover the residents' service while they strike.

And the British attendings interviewed in the articles I read said that the are gladly filling in for the residents and stand with them.

 

[meister]

My favorite is that those of us with some basic understanding of market forces and incentives are somehow "against" residents...

It's a little silly to consider medicine, let alone medical training, a "market" of any kind. It is extremely structured, controlled and legalized to hell. Residents have little recourse against bad conditions simply because they will get labeled and have their entire careers destroyed. Unless you consider the rigid confines within which we practice to be a "market," then yeah I guess you're right.

The answer of course has been said several times in this thread. Namely collective action, with a touch of staff solidarity and a non-hostile government.

 

[The Duck Knows]

.

 

[235009]

One thing not yet mentioned is that, when people do "the math" about what a resident should be paid, they use 80 hours. 80 hours is the maximum that residents can work in a week. Although perhaps in some residencies residents work 80 hours each week, in most that's not true. In my IM program, residents have inpatient rotations where they routinely work ~70-75 hours per week (designed that way so that they do not break 80), but they also have elective and outpatient rotations where they work much less, usually 40-50 hours per week. In fact, for my PGY-3's fully half of their rotations are like this. And, when they are on electives, they add no business value to the institution -- if they were not there, the same work would get done. PA's don't get that -- they get the same job, every day.

I've made this point before even citing specific numbers and it almost always gets ignored just like this comment was. This is where the arguments made by the pre-meds and med students in this thread fall apart. I'm not surprised it was ignored yet again because it doesn't follow the sensationalism and slave labor narrative.

As an example I have only 21 weeks this year where I potentially work 60-80 hours per week. Add to that another 10 weeks of clinic where I'm only adding value during my 16 hours of continuity clinic or at most 40 hours depending on what I'm doing in the afternoon. Overall doesn't add up to the 80 hours a week for 52 weeks that produce those minimum wage numbers.

 

[maxxor]

That's the estimated revenue a resident would bring in if they were allowed to bill. It's a neat thought exercise about alternative mechanisms for Medicare funding of residency, not an argument to pay residents more.

Why should midlevels be able to bill, but residents (many of whom have full licenses) cannot? That has never made sense to me.

 

[ThoracicGuy]

It's amazing to me that fellow physicians would argue against higher resident salaries or cast doubt on their ability to command higher salaries. Sure, they're in training and legally require an attending's signature to bill and certainly no one is saying they should make attending money, but tell the CCM fellow personally caring for 30 ICU patients overnight without an attending in sight that he is really only worth half a per diem RN. Tell the surgical chief seeing fifteen consults and supervising several interns while her attending gets a nice night's sleep that she is worth $15 an hour. Give me a break.

In the past with relatively low debt burdens and favorable government loan financing these issues weren't as big of a deal. But medicine is changing. Those in med school and in residency face uncertain futures. With cost of living far outpacing salaries and student loans swallowing ever increasing amounts of income, why is it so bad that residents start to question the premises rather than just accept the status quo and move on?

Historically medicine had a nice s*** sandwich waiting for you on July 1 PGY1 with the expectation that you would make it big and cash out some day. I don't think many would argue residency is harder now than it used to be, in fact most would acknowledge the opposite. Howver no such guarantee of a golden ticket exists anymore, and it's about time we all started accepting that.

Where is this money that you believe residents deserve going to come from?

 

[WingedOx]

My current site could probably

Theoretically because residents are supervised and being taught, so it would result in double billing for the work the attending is already doing. For procedures at least, it's Medicare fraud if you bill for it and weren't physically present. Similarly, in a teaching hospital if you have a second attending scrub a case and bill for first assist fees, you have to attest in your op note that there was no qualified resident available and a modifier gets added by the billing people.

In actuality, it's kind of dumb and antiquated and would be one of the better ways to reform Medicare GME funding.

Given that I trained at a place that was majority medicaid AND a good chunk of what I ended up seeing in residency was non-billable for various reasons, my thoughts on linking resident compensation to what residents bring in financially is a hot steaming cup of NOPE.

 

[WingedOx]

EXACTLY.

Everybody here who plans on being an MD/DO needs to READ THIS POST

United we stand - DIVIDED WE FALL.

Until we start putting up for each other, and I mean REALLY putting up for each other, there will be nothing but darkness for the future of our career. Until the attending starts supporting the resident's wellness needs, the suicides will continue. Until orthopaedics and neurosurgery start respecting the family practitioner as a highly trained knowledgeable professional, the legislation and hospital administration will continue to divide and conquer us.

Why have nurses and MLPs been able to gain so much ground? It's because the PHYSICIAN has lost any modicum of grip we had on healthcare. We do not sit at the captains chair any more, we do not steer the healthcare ship, and as a result we've found ourselves in choppy waters.. are any of you surprised?

There should be nothing but UNBRIDLED SUPPORT from all physician levels to increase resident salaries. Anybody bickering about "millennial entitlement" or other red herrings is missing the point. The overarching message here is that we need to unite and speak as one.

Of course this will never happen.. things will have to get a lot worse before they get better. Until the average debt is closer to half a mil with salaries nearing 150k/year for our non-surgical colleagues, nothing will change.

 

[Stagg737]

I have no problem having a discussion about resident salaries, and whether they are "right" or not. And if my residents were to make a concerted push to increase their salary, I'd try to support them. Their salary is defined by GME, so I don't have any direct control over salaries. But "our loans are really big" is one of the worst arguments, in my opinion. The gov't needs to cap loan funding at a reasonable level, and you'll see schools match that amount in tuition.

The bolded would help, but I doubt you'd see many schools drop their tuition to match unless the gov. capped loans at 10k/year. There are plenty of credit cart companies and private companies that are more than happy to give out large loans at an 6-8% interest rate. Sure, the applicant pool would decrease if schools didn't also drop their tuition, but not so much that med schools would be hurting for people to fill their seats.

I've made this point before even citing specific numbers and it almost always gets ignored just like this comment was. This is where the arguments made by the pre-meds and med students in this thread fall apart. I'm not surprised it was ignored yet again because it doesn't follow the sensationalism and slave labor narrative.

As an example I have only 21 weeks this year where I potentially work 60-80 hours per week. Add to that another 10 weeks of clinic where I'm only adding value during my 16 hours of continuity clinic or at most 40 hours depending on what I'm doing in the afternoon. Overall doesn't add up to the 80 hours a week for 52 weeks that produce those minimum wage numbers.

I've always done the calculations using 60 hour weeks, so assuming 60 hour weeks for 50 weeks of the year at 55k/year comes out to around $18/hr. Not terrible, but considering I was able to make that as a delivery driver and twice that as a tutor in a state with pretty average minimum wage, I'd say 18/hr is pretty mediocre for someone doing an essential service to society.

 

[Mjolner]

I've always done the calculations using 60 hour weeks, so assuming 60 hour weeks for 50 weeks of the year at 55k/year comes out to around $18/hr. Not terrible, but considering I was able to make that as a delivery driver and twice that as a tutor in a state with pretty average minimum wage, I'd say 18/hr is pretty mediocre for someone doing an essential service to society.

But did either of those jobs have a salary increase guarantee after a few years like you're going to get when you become an attending?

Be patient. This isn't a field for people who can't handle delayed gratification.

 

[TwinsFan]

Remember to use time and a half (150%) for all hours above 40 worked per week as standard compensation. So 18/hr is about 65k/yr at 60hr/wk in 52 wk/yr.

 

[Stagg737]

But did either of those jobs have a salary increase guarantee after a few years like you're going to get when you become an attending?

Be patient. This isn't a field for people who can't handle delayed gratification.

They did not. As I've stated, I've got no problem making 50k as a resident, even if it is 70 hour weeks because of that eventual pay jump and job security. I was just pointing out the fact that there are plenty of other, more menial, positions where you can easily make that or more.

Remember to use time and a half (150%) for all hours above 40 worked per week as standard compensation. So 18/hr is about 65k/yr at 60hr/wk in 52 wk/yr.

Valid point, but after malpractice insurance and other benefits it probably comes out to an 18/hr equivalent.

 

[WingedOx]

I don't think that it should tie to resident compensation. I think resident billing could be an alternative to the current methods of Medicare GME funding. However this is obviously more feasible for procedure heavy specialties.

Still I'm not sure my hospital would come out ahead in that scenario. At least not when a huge chunk of what we're billing for is outpatient psych for the indigent.

 

[235009]

I've always done the calculations using 60 hour weeks, so assuming 60 hour weeks for 50 weeks of the year at 55k/year comes out to around $18/hr. Not terrible, but considering I was able to make that as a delivery driver and twice that as a tutor in a state with pretty average minimum wage, I'd say 18/hr is pretty mediocre for someone doing an essential service to society.

How did you come up with 50 weeks at 60 hours? I'm telling you that I only have 21 weeks where I could potentially work 60-80 hours plus clinic. The rest is elective or backup call. That comes out to roughly $32/hr plus free health insurance, meals, etc.

 

[WingedOx]

How did you come up with 50 weeks at 60 hours? I'm telling you that I only have 21 weeks where I could potentially work 60-80 hours plus clinic. The rest is elective or backup call. That comes out to roughly $32/hr plus free health insurance, meals, etc.

I wonder if our surgical friends are much different. I know I could push close to 70 during inpatient IM months of intern year but again that was the exception rather than the rule.

/and 50 weeks? how much vacation time do the residents here get?

 

[ThoracicGuy]

I wonder if our surgical friends are much different. I know I could push close to 70 during inpatient IM months of intern year but again that was the exception rather than the rule.

/and 50 weeks? how much vacation time do the residents here get?

I averaged 70-80 hours/week for 48-49 weeks a year during residency... at least once we had to start tracking hours.

 

[NotWayneBrady]

I don't think I've met many people that were legitimately changed by the BS courses they were required to take as the humanities requirements of the BS degree.

Sorry for replying to a pretty old post of yours, but (n=1) I was pretty dramatically changed by what appeared to be a BS humanities GE in undergrad.

 

[ortnakas]

Where is this money that you believe residents deserve going to come from?

This x100. There doesn't seem to be federal money to expand GME. By extension, I seriously doubt there's money to almost double the salary of residents currently in GME (not that they don't "deserve" it or that it wouldn't be nice).

 

[Mad Jack]

Sorry for replying to a pretty old post of yours, but (n=1) I was pretty dramatically changed by what appeared to be a BS humanities GE in undergrad.

You're a unicorn. And one whose attitude might change drastically with time (I remember those courses feeling meaningful, but the farther away you get form them, the more you realize they didn't mean a damn thing).

 

[Mad Jack]

This x100. There doesn't seem to be federal money to expand GME. By extension, I seriously doubt there's money to almost double the salary of residents currently in GME (not that they don't "deserve" it or that it wouldn't be nice).

I think most people here are of the opinion that you get at least as much productivity out of a resident, even after losses to training, than you get out of a PA or NP. So they should be paid at least those wages, which could come out of the excess money many (but definitely not all- a great number of smaller residency programs run in the red) programs make off of the back of their residents. I disagree with this general assessment, as I'm aware that these people are both being provided an education tuition-free, and that many programs actually cost more money than they make to operate.

 

[Mjolner]

How did you come up with 50 weeks at 60 hours? I'm telling you that I only have 21 weeks where I could potentially work 60-80 hours plus clinic. The rest is elective or backup call. That comes out to roughly $32/hr plus free health insurance, meals, etc.

What do you know. You're only actually experiencing this.

 

[WingedOx]

We get four weeks. I know some programs only give 2.

Yeah, the community program I did my med school rotation at only gave theirs 2. That seems more criminal than the compensation problems.

 

[NotWayneBrady]

You're a unicorn. And one whose attitude might change drastically with time (I remember those courses feeling meaningful, but the farther away you get form them, the more you realize they didn't mean a damn thing).

Fair. Who knows what can happen really.

 

[Psai]

My med school gave 2 to the interns and 4 to the seniors lol.

Or you can go the MGH route and decide assigning individual vacations is too much of a pain and just assign each resident a 4 week block off

You don't become man's greatest hospital by giving out reasonable vacation schedules

 

[WingedOx]

Since this thread has cooled down to a pile of smoldering embers, I figured I'd throw some new kindling on...

http://www.cbc.ca/news/world/uk-doctors-strike-1.3399740

 

[PL198]

Since this thread has cooled down to a pile of smoldering embers, I figured I'd throw some new kindling on...

http://www.cbc.ca/news/world/uk-doctors-strike-1.3399740

lol the residents there probably work like 50 hours a week and get 8 weeks of vacation and they're still striking, meanwhile here it's like " shut up, in my day we worked for 168 hours straight and I took 2 days of vacation during my entire residency"

 

[mimelim]

I think most people here are of the opinion that you get at least as much productivity out of a resident, even after losses to training, than you get out of a PA or NP. So they should be paid at least those wages, which could come out of the excess money many (but definitely not all- a great number of smaller residency programs run in the red) programs make off of the back of their residents. I disagree with this general assessment, as I'm aware that these people are both being provided an education tuition-free, and that many programs actually cost more money than they make to operate.

Depends on the resident. Our NPs and PAs are far more productive than our PGY1/2s primarily because they don't need oversight. They also bill directly for doing things, unlike residents.

 

[Mjolner]

lol the residents there probably work like 50 hours a week and get 8 weeks of vacation and they're still striking, meanwhile here it's like " shut up, in my day we worked for 168 hours straight and I took 2 days of vacation during my entire residency"

"Two days of vacation? You had it easy. In my day daydreaming counted as vacation."

 

[meister]

What's happening in the UK is heartening, until you realize Cameron and the Tories wanted this fight and are going to crush them unfortunately.

 

[Stagg737]

How did you come up with 50 weeks at 60 hours? I'm telling you that I only have 21 weeks where I could potentially work 60-80 hours plus clinic. The rest is elective or backup call. That comes out to roughly $32/hr plus free health insurance, meals, etc.

I was accounting for the average in all fields. See previous posts...

 

[maxxor]

They also bill directly for doing things, unlike residents.

This isn't a universal law of the universe. Why shouldn't resident physicians with a full license bill as a midlevel? It doesn't make any sense that they can't, other than "that's the way it's done".

 

[psychMDhopefully]

"That's the way its always been done, so that's the way it should be", is an attitude that is going to bury American medicine. The mid levels have already said FU to that way of thinking and started lobby hard for independent practice and in a lot of states they are winning. I wonder if its a generational thing, younger physicians are probably more likely to challenge the status quo than submit to good ol boy club idealism. There is no reason residents couldn't be paid more, they should be paid more, and the fact that people with less education can bill for their efforts, while a docotor who have finished PGY 1 and has a license to practice medicine can't is insulting.

 

[W19]

How about when residents moonlight--are they able to bill?

 

[PL198]

"That's the way its always been done, so that's the way it should be", is an attitude that is going to bury American medicine. The mid levels have already said FU to that way of thinking and started lobby hard for independent practice and in a lot of states they are winning. I wonder if its a generational thing, younger physicians are probably more likely to challenge the status quo than submit to good ol boy club idealism. There is no reason residents couldn't be paid more, they should be paid more, and the fact that people with less education can bill for their efforts, while a docotor who have finished PGY 1 and has a license to practice medicine can't is insulting.

yeah medical students aren't idealistic at all, what with them comprising like 95 % of AMA membership, all the silly stuff AMSA puts out and their typical political preferences.....