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k0mm13 t1_j8xtsd3 wrote

Residents and many fellows participate in a process called the “match”. You interview for positions, put in your preferences and on a certain day the computer spits out where you will work. This means there are no opportunities to meaningfully compare or negotiate salary or benefits. And once you’re matched your choice is to either take the job or significantly derail your career after you’ve already spent 8 years studying (undergrads + med school).

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aguafiestas t1_j8zpze1 wrote

Eh, I don't think the match is the issue. I think it would be worse for residents on a more open market system.

The issue is they've got you over the barrel. You've got hundreds of thousands of debt on one end and need residency to get to the actual income on the other. And there are more people who want those spots than positions to fill.

You can't counter that imbalance with a one-on-one negotiation. You need a union - and even then.

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k0mm13 t1_j91g3g6 wrote

Agreed - that was my point but you summarized it well!

I wanted to let others know that residents can’t just “pick up” and find another job like any other employee. There is a huge power imbalance between hospitals and the trainee doctors who work there. There are also essentially no market forces to dictate better conditions since medical students do not directly choose their residency program.

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[deleted] t1_j8xxeq6 wrote

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Celdurant t1_j8y166f wrote

Absolutely laughable how divorced from reality this is.

Also, future earning potential is not an excuse for working conditions that are unsafe for residents (and their patients).

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i_330 t1_j8xzrj9 wrote

That is patently untrue lmao. There are some surgical specialists (cardiac, neurosurgery, plastics) who make 700+, but not many. 300-450k is more in range for general surgery, and these are people who have been through 5 years of grueling residency and usually have $250-500k in student loan debt to pay off. Surgery is not as sweet a deal as it seems to the general public, in fact it's widely regarded in medicine as a specialty for insane people.

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just_start_doing_it t1_j8y979g wrote

There is certainly hard-work and debt that is put into it but most doctors in the US are part of the top 1% in terms of wealth. They are compensated very well. Medicine pays much more in the US than comparable European countries.

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c_pike1 t1_j8yogwa wrote

What's the average US vs. European med school grad's debt?

That's why US doctors get paid more. They're starting from a huge negative

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just_start_doing_it t1_j8ywtm7 wrote

It’s more than 2x in the US compared to the UL and Germany. Debt from school accounts for some but not all the difference. This has been explored extensively and it is widely accepted that in the US physician salaries, on average, are profligate.

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hippopowertamus t1_j8zv5e2 wrote

Wealth and income are not synonyms.

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just_start_doing_it t1_j91r5l7 wrote

Yes, in this case it is both. It is a hard grueling job (especially the training)— i’m in a family of doctors— but for most they end up very well paid.

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hippopowertamus t1_j92neef wrote

I see your "being in a family of doctors" and raise you "being a doctor in a family of poor people". My income is way higher than my family aggregate growing up. My wealth is negative: I'm still hundreds of thousands in debt, despite living like I'm still in section 8.

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just_start_doing_it t1_j9329nr wrote

I’m sorry to hear that. Not sure how long you have been a doc. Have you read white cost investor?

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hippopowertamus t1_j937llt wrote

Just in my 4th year now. Definitely have looked at whitecoatinvestor and have been aggressively (most would say too aggressively) implementing financial best practices for awhile now. Still, despite having had a full ride to undergrad, worked since I was 16, and having had a side gig in med school, the debt is enormous. PSLF and REPAYE should get me through, but quite a few of my colleagues are in worse shape, and other career paths would have had much higher ROI. Workers everywhere are getting a raw deal, docs included. Capital defeats labor by a landslide.

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just_start_doing_it t1_j8yx8pr wrote

I’m unclear about the down votes. These wages are publicly available in US labor reports and you can see that they are in the top 1% (even among some of the lower paid specialist). This is just a fact. Now, if you think they are too high, too low, or just right— that can be debated.

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_Abobo t1_j8zamel wrote

You're being downvoted because Reddit can't reconcile a concept of the the victimized proletariat also being part of the oppressive 1%.

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Cute-Interest3362 t1_j8xyrf3 wrote

Incorrect. The national average annual salary of US doctors is $183,500

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i_330 t1_j8y17ve wrote

It's probably a tiny bit more than that (I would estimate low 200s), which is good money, but people often forget the INSANE amounts of debt we take on for med school. I'm finishing up my third year and 200k in the hole, and I'm one of the lucky ones because I don't have undergrad debt. Some of my classmates are on track to hit $500k in debt by graduation :(

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orpheus2708 t1_j8y1vjd wrote

And at penn it’s even lower. Hospitalists at penn start at the mid $140s. After 10+ years post residency they can expect to be in the $200s.

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phillyapple t1_j8y1qb8 wrote

Lol this is coming from Mr. Rittenhouse. I graduate this year with 300k+ in debt (only from med school). Will get paid ~60k working 80+ hours and most of that will go to my loans. I'm just hoping the match algorithm allows me to stay in my $750 a month apartment that floods with a hole in the ceiling that I felt lucky to have for med school given my financial situation. Yes, as an attending I'll finally get paid a good wage nowhere near 700k (200k if I'm lucky) and most of that money will be going to those loans for a while.

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[deleted] t1_j8yared wrote

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phillyapple t1_j8ycj12 wrote

Making $1M is pretty much unheard of unless you’re a neurosurgeon working insane hours. Your friend is definitely an anomaly. Paradoxically you get paid less in more desirable urban areas with higher COLs as a physician. So it’s true that if you’re fine with living in an area that has a physician shortage you can make really good money in a low COL area. I find a lot of meaning in my work and overall don’t regret my decision but these days if you’re going into medicine for the money, you’re gonna have a bad time.

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matane t1_j8yd2ks wrote

lol just throwing your one anectode out as a hard fact. Reddit's fucking hilarious. Ortho is literally one of like 3 highest paid specialties maybe your brother should have mentioned that

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c_pike1 t1_j8yools wrote

Fellowship comes after residency. You're comparing someone fresh out of residency training to an attending that just finished optional fellowship training

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Oreo_ t1_j8zr321 wrote

This is a really embarrassing way to realize that doctor lied to you Lmao

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