Your experience with being employed by a hospital the first year out.

[LovelyRita]

Title is self explanatory.

I know there aren't a lot of attendings on here (hi, WS, NJBMD... )

There is a lot of yammer amongst residents and attendings out there, specifically at these annual meetings, congresses, etc. I appreciate all the input I've received so far.

I see explosive numbers like people making "300K" and puny numbers like "they're gonna start you at 150K".

Do I believe I'm going to get a straight answer on here? Not really. But I'm getting to the 18-month-prior-to-being-done mark, and the time has come for me to start thinking about this.

I have an inherent sense of what I should do (do a fellowship vs "just" gensurg).

The numbers thing is interesting to me though. I know we're in a new age of medicine and no one can expect to make money like what was once the norm. But seriously. Seriously. I know internists who started around 150K (do I have proof of this? no. again, heresay), and right now, I believe that to do this residency and make the same is.....insulting. (at least that was my first reaction.) OR should I adapt and be thankful I'll at least be getting that much?

I look to SDN for hopefully the last time in my life. (Started posting here the spring before med school )

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[Pilot Doc]

It's late, and perhaps it's me, but I'm not entirely sure what your question is. I think you're asking how much does a general surgeon make.

To which I would answer, what sort of job do you want. Are you limited geographically? Are you willing to work in a place that is small or uncultured or remote or all 3? Are you interested in working as hard or harder than you did as a resident or do you want to work less?

Depending on your answer, you could make $150K or well over $300K.

For a point of reference, the VA pays general surgeons low 200s.

 

[Winged Scapula]

There is a book published by the ACS which lists average salaries for academic surgeons by region of the country. It is expensive (around $175) so see if somone on faculty has a copy.

It is indeed true that general surgeons, even fellowship trained ones can start at $150. I saw this in the book mentioned above, and friends of mine who came back to our residency program were started at $153K as assistant prof of surgery.

How much you make will depend on geography, whether you are fellowship trained, whether you take gen surg call and the contract you negotiate. You can be paid extra for taking GS call, or it can be bundled into your salary. $300 as a general surgeon in an academic hospital would be most unlikely in my experience. In private practice, once you are steadily working and busy, more attainable.

 

[LovelyRita]

Thank you both for your concise answers. (it wasn't just you, Pilot Doc, but I'm well aware of how much a GS makes -- I think-- and WS put it nicely). I'm interested mostly in the "being employed by the hospital" thing.

I've heard malpractice and health ins are covered.

The other thing I wonder is, who do you answer to when you are employed by the hospital? The CFO? Chief of Staff? It seems like hospital might have the upper hand overall on a new surgeon and that I might be sitting in the nurses lounge having a cup of coffee with them complaining about how the man is out to get me. In other words, autonomy--is it out the door?

 

[Winged Scapula]

Thank you both for your concise answers. (it wasn't just you, Pilot Doc, but I'm well aware of how much a GS makes -- I think-- and WS put it nicely). I'm interested mostly in the "being employed by the hospital" thing.

I've heard malpractice and health ins are covered.

Yes, that $150K would include malpractice (which for a general surgeon is substantial in many states), health insurance, sometimes free tuition for children (if associated with a university), administrative staff, CME funds, vacation, etc. In private practice, you are responsible for these things of course.

The other thing I wonder is, who do you answer to when you are employed by the hospital? The CFO? Chief of Staff? It seems like hospital might have the upper hand overall on a new surgeon and that I might be sitting in the nurses lounge having a cup of coffee with them complaining about how the man is out to get me. In other words, autonomy--is it out the door?

You "answer" to the Department Chair mostly, but in the grander scheme the Chief of Staff is also involved, but not on a day to day basis.

When employed by anyone, some autonomy is lost. You will be expected to work certain hours, bring in X amount of dollars, take a certain amount of vacation, do things a certain way, etc. Even in private practice, unless a solo practitioner, you will have rules you have to follow.

As an employee of a hospital, there are politics you have to deal with. I would not recommend sitting in the nurse's lounge and discussing hospital politics with them. Is that something you do now?

 

[JackADeli]

...I might be sitting in the nurses lounge having a cup of coffee with them complaining about how the man is out to get me....

Have you been hiding in a cave? The Man is out to get you!!!

 

[LovelyRita]

I would not recommend sitting in the nurse's lounge and discussing hospital politics with them. Is that something you do now?

eh, no.

Have you been hiding in a cave? The Man is out to get you!!!

Yes. I have been hiding in a cave. It's called residency.

 

[Winged Scapula]

Yes. I have been hiding in a cave. It's called residency.

 

[LovelyRita]

It's late, and perhaps it's me, but I'm not entirely sure what your question is. I think you're asking how much does a general surgeon make.

To which I would answer, what sort of job do you want. Are you limited geographically? Are you willing to work in a place that is small or uncultured or remote or all 3? Are you interested in working as hard or harder than you did as a resident or do you want to work less?

Depending on your answer, you could make $150K or well over $300K.

For a point of reference, the VA pays general surgeons low 200s.

Oh, and then the other thing I wanted to mention was, I've heard these numbers and variables thrown around for years, but as a resident, it is what it is, you know?

I mean, when I was a pgy2, I'd hear numbers tossed around, but honestly at that point I'd think "what does it matter? I still have 3 years of residency and then maybe fellowship and God knows what the earning situation will be by the time I'm out." So, I just wanted to make sure we weren't trivializing my query here.

I've been aware of these numbers for some time, but didn't feel the need to address it until I was close to being done, which is now coming upon me.