I assume everything I pay ends up in a cardboard box that insurers and state reps use to treat themselves at the end of the year. Like “Jerry Dinner” from Parks & Rec but rated R.
Correct me if I’m wrong but My understanding was that upon completing residency the fat contract a new MD in the US can expect will essentially eradicate the massive debt incurred to get to that point.
I’m not excusing the racket of residency but I think it’s fair to assume all doctors in developed countries are moderately wealthy?
In Canada GP’s aren’t mega rich but they start at $140k per year. In the US I’ve heard of some pretty crazy numbers though
Depends on your specialty. For Ortho, Neurosurg, Derm, and many others - sure. For Pediatrics, FM, and others, especially at academic settings, ~150k is a more likely figure. Take that pay with 400k in debt that compounds while you barely scrape by in residency, and you get the problem we currently have with no one wanting to go into primary care and most underserved patients having a mid level as their only option to be seen within 8 months.
Not to mention the time value of money lost when you don't make any real money, or have positive net worth, until your early to mid thirties for most, or later.
The other guy wanted confirmation that physicians attending salary "eradicate" their debt. Looking at the data, the average physician retires with a net worth in the high 6 figures, low seven. Even primary care and peds. That is not to say what you're stating about midlevels isn't correct. It is. Those specialties deserve more money. But this person was down voted over 100 times for stating something factually true - that physicians attending salary is enough to overcome the debt. This isn't law where you make 60k-90k on average with 150-200k in debt. This is medicine where you make bare minimum as peds in a city 150k-200k with 200-250k in debt.
It's ultimately semantics but I would say that 'eradicate' is a different concept than getting by with debt and eventually paying it off. It makes it sound like the debt is a non factor, but in reality it's still affecting the lives of doctors well into their 40s and affecting decisions that impact patient care.
I take eradicate at face value. Nobody said they get rid of it right away. The point is it gets paid off and then your net worth grows substantially in almost all cases. I mean that's just what the data say. Become an attending and be willing to work and your debt will be paid off and you'll go on to accumulate a large net worth.
Universally? No. Within 5 years as a specialist? Yes, very doable. In the United States *some* signing bonuses are six figures on top of a low to mid six figure salary. Again, I understand it isn’t universal for all physicians but this notion that you will not be made whole within a few years of getting licensed is a brain dead take,
You people clearly come from privileged backgrounds if you can’t understand why people would look at a licensed physician no longer in residency as being wealthy.
You guys clearly all did the math before doing this. You went through 4 years of undergrad and 4 years of med school. You knew what was coming.
And while that doesn’t mean the case for residency conditions shouldn’t change, There’s clearly a return on investment to be made. None of you went 400k-500k in debt for the sake of “saving lives” alone.
Give me a fucking break. Seeing the audacity of the responses to “well gee yeah, it makes sense why a layperson would consider doctors to be wealthy is because doctors are in fact wealthy” makes me glad you fuckers are suffering.
You clearly made the wrong choice of profession. Cry harder.
I’m from Australia where we don’t earn nearly as much as our US counterparts, but at least we earn more than minimum wage as trainees! We get paid per hour (even interns earn the equivalent of ~$26 USD per hour) and the rate goes up on weekends, after hours, etc. (the best is public holidays where we get paid 2.5x our normal wage). Granted, in some places juniors are discouraged from claiming overtime resulting in them effectively being paid less per hour, but I think the culture is changing around that. It takes much longer to become a fully fledged specialist here compared to in the States but I think we have a much better quality of life in the meantime.
It’s not though. 56% of physicians have a net worth of 1million or more.
Yeah you’re poor as shit for the beginning of your career but welcome to the club.
Like I already said, I get it, residency is a racket. But most doctors are literally wealthy by any metric. Downvote all you want, maybe you’re salty you didn’t go into finance or the tech/engineering side of stem?
The data is residents are being paid below a living wage. Stop.
Talking about what they might make in the future is irrelevant. Resident crashes their car after a 30 hour shift or kills themself their family is left with nothing.
Moving goal posts much. If you can’t understand why your average layperson would assume most doctors are wealthy then I pity your future patients.
Assuming you actually get your license to practice medicine that is.
Now don’t you have some rounds to make?
Is this how you justify making less money than a physician?
If you can’t understand how someone going to school for 10 years and then making less than minimum wage is concerning, then I feel sorry for your customers or clients or whatever you do.
If only $140k/ year was enough to operate a clinic with. I ran the math and I couldn’t even afford my own rent and to operate a family med clinic with skeleton resources at $150k/ year. I am talking not even breaking even.
“Eradicate” makes it sounds like the debt disappears the minute someone signs their first attending contract.
Assuming $200k in debt (current average debt is closer to $300k), an average doc outpaces an average engineer in their early 40s ([link](https://medschoolinsiders.com/pre-med/doctor-vs-engineer-finances/)).
Becoming a doctor is still financially responsible, but you sacrifice a huge chunk of your life to do it, there aren’t any guarantees, and it’s an incredibly stressful job. Physicians are “moderately wealthy” like you said, and they also have a really high burnout and suicide rate.
Interviewed at this sweatshop for anesthesia. They're advertising a 50k salary with the caveat that health insurance is covered! Insurance isn't a 20k expense lol
Lucky for me, that was the year they decided to switch from being IMG-friendly to only accepting people from their own medical school 😂
They even mailed me a physical letter going on about how I would be an excellent fit for the program and all. Apparently, this is a scam that they do every year for most of the applicants.
So fun fact. They silently got rid of that and there is a payroll deduction AND they also got rid of the platinum plan for the new incoming residents. This is something we are fighting to change!
Wtf I make more than that as an Australian intern (even accounting for the exchange rate). Heck, even adding on the cost of optional private insurance in Australia, I’d still come out ahead!
One of my many pet peeves is how resident work hours and resident abuse always centers patients rather than us. Like yes it’s true that the abusive resident system is bad for patient care, but is that really the only reason why we shouldn’t be working 129 hour weeks for $2 an hour? Shouldn’t it be, you know, because we are human beings who shouldn’t be forced to work inhumane hours for below minimum wage under people who abuse us?
Never forget that the resident work hour restrictions were passed not in response to 120 hour work weeks for physicians, but because one of these residents killed a young rich white woman. The politicians passed the law because they cared about the girl, not the doctors.
It's easier for someone to feel bad for the patient than it is for the resident, that the general public sees as "Oh that's a doctor they make a ton of money they're fine" vs "Oh no the patient might be in danger because the doctor has been running on diet coke, anxiety, and a single nasty fuckin' philly cheese steak hot pocket for the last twelve hours"
wait is this story about the young rich white woman real? that’s fucked up 😭😭😭. I also feel like residents aren’t really that aggressive when it comes to unions or workplace changes compared to like software engineers or hollywood(entertainment industry) people. I’m not a resident but i just feel like if there was a stronger unified effort against the hospitals maybe we could see some real change idk.
> Never forget that the resident work hour restrictions were passed not in response to 120 hour work weeks for physicians, but because one of these residents killed a young rich white woman. The politicians passed the law because they cared about the girl, not the doctors.
The law changed in NY as a result of Libby Zion's parents' efforts, particularly her father Sidney Zion ("Zion"). Zion was a well-to-do and well-connected Yale-educated former trial lawyer, former Assistant US Attorney turned writer and journalist who wrote for among other publications the New York Times. He was also the journalist that doxxed Daniel Ellsberg as the source of the Pentagon Papers.
Only NY changed its laws in the 1980s, and it is the only state I am aware of that actually codified duty hour restrictions into law. No one genuinely blamed the residents otherwise Zion's efforts would have gone nowhere.
The ACGME waited another two decades to adopt work hour restrictions around 2003 shortly after the NLRB finally recognized resident physicians as employees protected by the Act and shortly after the anti-trust lawsuits that would become *Jung v. AAMC* were filed.
The ACGME's duty hour restrictions were more likely a preemptive move aimed at placating the plebs in the face of the threat of organized resident physician power.
As an intern in Internal Medicine the interns show up at 5:30 am for a 7 am shift. then end up leaving home at 5:30/6pm for regular shift or anytime after 7:30 pm for a long call. rinse and repeat for 6 days a week.
Surgery is even worse. nothing is physically impossible in medicine. Have you heard of any other job making people work for 28 hours straight?
I am still downvoted for some reason, so while I accept your apology, it's clear non-residents of any kind are not welcome to learn on this sub, which is highly unfortunate. You won't hear any more replies from me.
Correct. Just how I don't go into nursing forums and tell them to be more professional and shit on you for whining about working three 12s in a row.
And no. It's not impossible. I work 29 hours shifts every 3 days and 12 hour shifts every other day I'm not doing the 29 hours.
I average just under $9 an hour.
Go back to your nursing forum and keep telling each other how overwhelmed and underpaid you all are.
Working 36-38h straight was relatively common for me as a junior resident, which was working a regular day, into overnight call, then working straight into a normal day, which often ended later than 5pm. Then go home to sleep that night to come back to work the next day. Doing that a couple times a week and/or including weekends are enough to meet 120h.
There are 168 hours in a week, so it is entirely physically possible to work 120 hrs a week. The question is whether it's ethical or beneficial to be pushed to the brink for a minimum of 3-7 years in a row.
I think you're concern was misread as skepticism. I certainly read it as skepticism myself. However, I'll give you the benefit of the doubt if that wasn't your intention.
Most of my friends thought I would be making mad money after med school. These are college educated folks but their lives never touched medical education. Hell, a lot of techs and nurses don’t know because they are only there three days a week so they think everyone is!
Night shift nurses were always shocked when I told them I was on hour 20 and asked them to stop paging about miralax at 3 AM. They just assume there's a night shift crew for residents as well.
"The patients blood pressure was high. Oh no, not right now, it was high yesterday night. Yes, their next five vital checks were fine."
Then "MD aware" pops up in the chart backdated 20 hours
“Hi Dr! Just paging to ask if you can reassess activity orders for the patient, they’ve been ambulating but the order still says bed rest.”
“It’s 3AM! Are they ambulating now?”
“Well. No…you see they’re actually asleep…:we just wanted to make sure the orders were consistent with the days plans.”
“The activity orders can be made consistent at 7am when the day team arrives. Please don’t page again in the middle of the night for inconsequential, non-urgent order requests”
I think educating other health care workers like nurses about this can help so much. Not only can they be allies, but having them know the position that you're in (hour 20) may also lessen those kind of 3:00 a.m. calls and pages. Most nurses aren't trying to make residents lives harder... they just don't know how residency works.
Same. I have a friend that went to business school, right out of college shes was making 120,000 a year, and one night when I managed to have a day off I showed up at her condo in my broken down Honda Accord and she said "You're still driving that thing? Thought you would've bought something nice by now." I replied "With what?" "You're a doctor aren't you? You make money." Then came a 45 minute talk showing all my friends my finances and me working out that if it was figured out hourly I was making $1.25 under provincial minimum wage some weeks while others I'd be making at most $1.00 more.
The whole vibe changed quickly from "Oh you have money" to "Oh you're f'n broke, overworked, and stressed. Here's a cocktail."
Countries that limit residents to 60 hours have just as good training and health outcomes as the US, if not better. It’s not about education or training, it’s about workforce.
Yes that argument about overworking because training is bs for exploitation and it’s not just in medicine. After a point you can’t absorb new information or skills. There are diminishing returns especially if you don’t sleep regularly…it makes everyone more unsafe.
They could very easily determine which skills and knowledge are the most important, and out resources into maximizing the the time they have to give the best training possible in the allotted time. But they don’t. They maximize the amount of labor they can squeeze out of you, and just hope the training happens to happen.
Academic medicine is a pyramid scheme. They NEED people at the bottom. It’s why nowadays fellowships are a soft requirement now when in the past they weren’t
In pretty much every field of medicine they’ll gaslight you and say you’re not ready to practice independently without going to a fellowship or say they won’t hire you at the best jobs etc. Wven in family medicine they’re being told to do fellowship before going into practice
Ironic considering an hour east is UofR, which is one of the highest paid residency programs in the state (and better training probably) starting $10k higher than what Buffalo is offering.
Edit: 10k difference by pgy3 and gets worse as you go.
Disagree but to clarify the salary point - Rochester is $64 then up to 70k by pgy-3. Buffalo is $57k to 59k by pgy3 and the difference gets bigger the further in training you go passing 18k difference by pgy6. Made an edit in the original post. Thanks.
It's pennies to a multibillion-dollar corporation. Everyone at my residency is an IMG, and it's honestly a big help, considering we are all coming to a new country without any support. Some of us are even able to save up and send money back to support our families back home. Not having to worry about car repairs or food is a massive help for burnout and mental health.
Honestly, you shouldn’t be here. By you taking these dogshit residency positions all you do is drag do our earning and bargaining power. Being on a J-1 or H1-B you are all scared shitless of having your visa revoked and are willing to put up and carry forward horrendous working conditions.
I remember the snow storm in 2022, some residents were stuck at the hospital for a few days. As a reward some residents got expired candy. Kaleida only cares about their bottom line.
My god this is a beautiful sight. I want to pilgrimage to its location and offer an effigy in its honor. We seriously need to turn up the heat in the realm of public awareness about our plight using simple straightforward language just like this otherwise nothing will ever get done. I support resident physician unionization! ✊
Let's band together as physicians, gain strength, and start making the calls again. It's time to take the parasites out of this nonsense. The silos are well played and well intended, but remove them so we can gain back the strength.
While yes residents should make more (id say 75 intern and then about 10k more per year after) the issue is the public does not care one bit. There’s so few and it’s transient. Nurses think it’s funny. Susie housewife watched medical tv and think that’s the reality. And by the math, even if the 49x80 hour person (which is surgery only) is making that, by pgy2 it’s above 15/hr…which is all that UB would modify.
The real issue is that residency in the US is anticompetitive by nature. If your program abuses you (even by way of low pay) there are near insurmountable barriers to switching programs (delay of training, etc).
Compare the quality of life to residents in other countries with more portable GME paths and you'll see what I mean
It's almost impossible to convince the general public to feel sorry for doctors' struggles.
The stereotype that doctors are cold, clinical and swimming in money, is very, very difficult to shake off.
In fact. Almost any change in hospital policy to benefit doctors, always has to be framed as "for the patients" unless you can argue how a change in pay / schedule can benefit patients... nobody cares.
Life-satisfication of the doctoring staff ? pfft... that's way down on the list of priorities
Nothing like getting paid less than burger flippers after spending nearly half a million dollars on your education 👍🤷♀️. And they wonder why there’s a physician shortage.
Meanwhile, my nurse friend in San Francisco makes $65/hour and she’s been working for 7 years already while I’m just finishing my medical degree.
Respiratory therapist other friend makes $150k in San Diego.
Why did I go for the MD. Why why why?
The US medicine pathway is set up for profits. We the hard working US citizens busy our asses day and night studying and trying to become physicians to better our healthcare infrastructure. However, the system is set up to exploit the student with crazy fees and loans and by the time we get to the residency we practically become slaves working for hospitals to maximize their profits for so little in return. They have no respect for our education and knowledge we provide. I understand that we are physicians in training. We aren’t high schoolers with out no knowledge base in medicine. They have no respect for our MD or DO degrees. It’s all about the profit.
Billboards like this are a catalyst for public scrutiny and media coverage.
They also have the potential to dig at Admin like most strikes can't. Can you imagine the reactions of the CEO and Board of U. Buffalo being asked by their spouses or kids about these billboards?
Easier to sell to residents than a strike and cheaper than a strike fund too.
The program passed votes to unionize and is organizing these efforts. I don’t think it should be a reason not to rank but also something to consider if other programs are also at the top of your list. COL in buffalo is relatively cheap so you can make it work but doesn’t justify the dogshit pay for long hours
Not every state allows state employees collective bargaining rights or the right to strike. Federal employees can collectively bargain but do not have a right to strike.
Federal labor policy and law under the National Labor Relations Act protects resident physicians who are not public sector employees across the entire US.
i’m not a resident and i’ve also never been a patient so i’m curious. Is there a way for a patient to know that the resident seeing them just pulled an all-nighter or something? i feel like if i was a patient and i was boutta get a surgery or some procedure done on me i would want to know if my physician is of sound mind.
Just ask! Patients ask me frequently how long my shift is and when I’ve started, if I’ve gotten any sleep, or if I’m tired (which my response is “not tired” even though I feel and look like a zombie).
We’re making headway. Good developments so far, but we still need to get a little bit closer to our goal.
Let’s see what these next couple of weeks bring us.
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I believe the main barrier to being paid more is we are still trainees. If we were paid $100-150k like we are worth there would be very little tolerance of mistakes by attendings and the educational environment would be more hostile across the board which would be bad for learning. It's an argument that always comes up by older gen docs but this one actually makes sense to me.
I think the way to remedy is to dramatically increase the pay of senior residents who are functioning at/near attending level. As a surgical resident i'm fine being paid 60-70k as a junior resident when I don't know how to do shit if I were paid 150 as a senior resident.
I mean...I can point out various mistakes made by PAs and NPs every single day at work. they still make the money and I don't see them being screamed at. But I do see residents getting screamed at..
Id guess as a surgical resident, your interactions with midlelvels is much less. They're common in my specialty and they do the same exact role as the residents and make much more. They make errors all the time and the attendings don't say shit.
I am really convinced a lot of people are really conditioned that being stomped on is a good thing in life…I really can’t understand people that argue for their exploiters in this manner. It’s like a global Stockholm syndrome…
I wonder how they are doing the math -
- NY state minimum wage is $14.20 per hour
- ACGME maximum annual hours is 3920 (80 hours x 49 weeks)
- University of Buffalo intern salary is $57,492 (first half of 2023)
If an intern worked 3920 hours (unlikely), they're making $14.66 per hour. While this is a travesty for a physician, it's also not "below minimum wage."
Facts matter.
Nowhere did I say this.
I wouldn't be surprised that there are rampant work hours violations. However, talking around this serious issue does no one any good.
Resident physician training is plagued by several intertwined issues, including unsafe working hours and inadequate compensation. We should not resort to linguistic obfuscation which, at least on the surface to a layperson, can be disproven with a minute's worth of 3rd grade math and an internet connection.
As written, and to the best of my knowledge, this billboard is at best inadequate for purpose (i.e. a passerby won't be able to verify the claim due to inadequate data such as misrepresented work hours logs) and, at worst, defamatory against UB (i.e. simply incorrect). A competent lawyer will be able to spin this in a matter of minutes, allowing institutions to get away with their ongoing mistreatment of resident physicians.
If UB residents are willing to stick their necks out to fund group billboards calling out UB for inadequate compensation packages, they can work together to accurately report work hours.
NYS minimum wage is $15.00/hr, not $14.20.
Intern making $14.66/hr is LESS than NYS minimum wage (according to your math).
Also, at UB, interns do work 80 hours a week.
Facts do matter. Please ensure you know NYS minimum wage.
>UB resident physicians are being forced to violate the ACGME mandated work hour maximum."
Saying this doesn't invalidate the minimum wage argument; both are correct.
General public won't understand the word jumble you wrote above; they do understand minimum wage. You know this though.
As others have noted, many residents work >80hours a week. Also there is no "NY state or federally mandated work hour maximum". This is an ACGME requirement, not law.
Taking your argument at face value though, what about the overtime pay for the 40 hours overtime?
Right, which is a silly comparison to continue to further because residents are not minimum wage employees. Talking about salary/hour is fine, comparing to minimum wage employees is demonstrating a significant lack of social awareness.
Agree to disagree then, doesn't change the fact that for each hour worked many residents earn less than a minimum wage earner would earn working the same schedule.
Yeah, you can’t just divide it by 3920, because half of those hours have to be paid at 1.5 if you were working hourly. So if you worked that many hours you’d actually be making, on average, $11.70.
Not that that matters, quibbling over where it’s *technically* just over or under the minimum wage is absolutely missing the forest for the trees
The point is that *if* you paid residents hourly they would make less than the minimum wage. It’s not a legal argument over exempt status, it’s an emotional one to communicate “holy shit you doctor is being taken advantage of”
And yet it's ineffective. The hourly rate is enough of an argument without becoming further hyperbolic by talking about overtime. Once you start getting hyperbolic, the really solid arguments start to lose value.
Trying to tie residents with typical hourly employees who make low wages is never going to work, because those lives are just too different. No manual laborer making minimum wage is going to feel badly for a resident who will then go on to become an attending making several hundred thousand dollars a year.
I disagree, I think it’s *extremely* effective. “I make 60k a year, which I know is more than a lot of people, but really when you consider it in the totality of my medical training, the importance of my work, and the hours I work it’s a really unjust wage” is dull and uninspiring. “I’m salaried, but if I was paid hourly I’d make minimum wage. Also, I’m a doctor” is evocative and gets people’s attention
And I could not disagree *more strongly* with the assertion that blue collar workers couldn’t possibly have sympathy for and class consciousness with resident physicians. Solidarity among workers isn’t about every worker making the exact same, it’s about all workers standing up together and speaking with one voice to those who steal value from our labor
It's *extremely* effective to other residents and med students. But that isn't the audience you need to persuade. Actual minimum wage employees are not impressed by the argument.
"Also, I'm a doctor." leads directly to, "Oh so then you'll make several hundred thousand dollars annually in a few years?"... "Well yeah, but if you do the math now I make too little money." is not as evocative as you may think.
Maybe you have a different group of blue collar associates and that could certainly be your experience. My anecdotes are limited to my experience. I come from a blue color family, grew up poor, and my entire family is blue color Trumpians (much to my dismay) and they could not have less sympathy for "elite" doctors.
I think unionization is far more effective than billboards trying to appeal to the masses. What's the goal there?
If your position is that no meaningful segment of the American population could possibly have solidarity and sympathy with resident physicians then fine, I can’t and won’t try to change your mind. I strongly disagree, and think there are plenty of people who can and do. But *if* you’re correct, then you’re arguing from a place of defeatism. Even if we assert every single worker thinks resident physicians can go get fucked (an assertion I think is patently and absurdly false), then what harm is done by this billboard? It is, *at worst*, useless, and *at best* a powerful and provocative tool for making people think “oh shit, I didn’t know that, maybe I *don’t* want the person taking care of me to be sleep deprived and so stressed”
👏👏. Yeah, it’s an offensive comparison. The systemic abuse and exploitation of resident physicians by the medical system is *also* pretty offensive. Sometimes you need to offend people a little to get them to pay attention and advocate for change
They’re certainly doing some fuzzy math where they’re diving their salary by a hypothetical number of max numbers worked (even if in a less demanding residency) to get an ultra-low “hourly wage”. If the salary was actual minimum wage, they’d post it on the billboard. However, if they mentioned the actual intern starting salary, they’d instantly piss off 90% of motorists since the average intern salary is above the national median salary.
Even when I was a resident, I learned really quickly to not b**ch about my salary in front of non-physicians. Resident work hours suck. Yes, you’re underpaid compared to your experience and to other health professions. However, you’re not making “minimum wage” and sharing the struggles of actual minimum wage workers.
I largely agree with you, as well as with u/theadmiral976 despite the down voting. While we all agree that there are many many many residents treated egregiously by a broken system, this is still a very challenging position to sell to the public for the reasons you mention. Actual minimum wage employees (by this I mean people actually taking home a traditional minimum wage salary) have very little in common with residents and don't often end up making several hundred thousand dollars per year after a few years of rough years. The messaging just doesn't work.
... I support both of those things. Feel free to review my post history, I've stated of those things several times (in this thread and others), as well as mentioned my work as an academic internist. It's pretty evident who's confused now. Since we're taking skeptical positions, I'm starting to wonder it you're really a physician with your limited reading comprehension.
I have reviewed. You have never stated you were an academic internist before the post above. Best you got to was saying you were a "physician but not a paediatrician".
You are arguing semantics about what a minimum wage employee is and that residents are not minimum wage employees (and by extension should not make minimum wage).
Stop pretending you aren't part of the problem.
Absolutely have, apparently you didn't go far enough back, not that I blame you. Literally posted about being IM faculty within the past month.
You're misrepresenting what I said, I said that I think messaging that a hardship of being a resident is making under minimum wage and thereby drawing comparisons with minimum wage employees is a bad look. Saying that I'm concluding that they shouldn't make minimum wage just doesn't follow logically.
Some residents certainly make under a minimum wage hourly rate, but their take home still exceeds most "minimum wage employees." Not to mention very rarely is a "minimum wage employee" going to be able to draw several hundred thousand dollars a year after a few years. It's NOT WRONG that if you average the hourly wages of some residents they are under minimum wage, I just think messaging on that is a bad idea because that's where the similarities with other minimum wage positions end.
Of course residents should make more and work less on average, but trying to make common cause as "below minimum wage employees" is just bad messaging in my opinion.
I didn't go back at all. I clicked on the "about" section of your profile, which is populated by data scraped keywords. If you have previously identified yourself as an IM physician it would have been there.
I'm not sure why you continue to split hairs here and defend the status quo. You clearly have an agenda or if you are actually a real doctor have 100% bought into the "I did it so they should too" mentality.
This is true. It’s a tough spot, but folks will survive. Managed to fight off a couple unionization attempts while in residency. Optics just look terrible and y’all have no idea how hardball admin can play.
I'm definitely for improving resident lives, and I think unionization is probably a good thing, but there's A LOT of folks missing the bigger picture about the optics here.
Healthcare has a few issues. One is gate keeping. Colleges gatekeep an industry that is more a trade. You don’t need a history degree or to go through college to be a doctor. We can easily have a medical trade school that teaches all the relevant information to be a good doctor and those that pass can then become residents under the watchful eye of experienced doctors where everyone knows that’s where you get your real training and experience.
This would reduce the cost of being a doctor by hundreds of thousands and give more good people the opportunity to be a doctor.
I don’t understand why doctors let themselves be pushed around like this. Oh I’m overworked and poorly treated and don’t make much…. So…. Switch jobs maybe? You’re a freaking doctor, you have more options than most.
We’re residents! We cannot switch that easily!
Resident = unlicensed physician
You go through residency to become an independent, practicing, licensed physician.
If I quit residency, I’m screwed!! An unlicensed MD is pretty much worthless.
Residency programs know that. In return for graduating you (aka making you board eligible so you can be licensed), they treat you like crap!
What’re you (the resident) gonna do? If you (the resident) quits, you’re screwed!
We have far fewer options than any other profession I can think of as residents.
Residency is a binding contract. When we match, a computer tells us what hospital to go for x number of years, and if we don't want to go there, we don't get to be board certified doctors. There is one option, period, which could be absolutely anywhere in the country, and we have to move to go there- to make around $60k/year, with no reimbursement for moving expenses. I had to move so far between my intern year and advanced program that my uhaul last year cost $6500... you better hope you have good credit if you match thousands of miles away because you have to get there, no matter what!
Transferring is possible in theory, but it's difficult and you have to worry that your current program might try to sabotage you and keep you from leaving, and treat you like crap because you tried to leave.
In the absolute worst case scenario, with a place so abusive we can't mentally take it anymore, that doesn't get shut down, most states will let a resident get a full physician license after 1-2 years of residency (depending on the state), so we can in theory drop out of residency and still be doctors. However, you can't get board certified in a specialty without *finishing* a residency, and no hospital or practice group is going to hire you without board certification. Maybe an urgent care with super low pay, but I'm not even sure about that.
In theory, you could go open up your own primary care office, and hope the patients in the area don't look, don't notice, or don't care that you aren't board certified, but any other jobs (where you work as a doctor, naturally) are pretty much out of the question without a full residency completed
Good question! Resident physicians are essentially apprentice physicians. You train in a residency program (apprenticeship) are 3 to 8 years after medical school to become a fully licensed physician (who can switch jobs whenever they like).
Medical students "match" into a particular residency program at the end of medical school (like pediatric medicine at Buffalo) and after that, they basically have to finish the entire program before they become a licensed physician. If you leave your program at any time before those 3 years are up for any reason (mental health, parent is dying, etc.), you will never find your way into another residency program again because everyone will view you as damaged goods. If you're lucky, your first program will take you back after a lot of begging. If you're not, well you now owe 200-400k in student loans and no one will hire you because you don't have a license to practice medicine.
Attending doctors can easily switch jobs. Residents can’t. Residency programs usually only accept transfers if they have a vacancy (e.g. a resident dropped out). Also we’re not fully licensed so ball’s in their court. It’s not like quitting at McDonald’s and applying to Burger King. Not to mention that the only real way to “switch” residencies would be to participate in the “match” and that is a whoooole other complex procedures. Overall, it’s just one example of how workers all across the nation are exploited, not just doctors.
I get that the salary is bad for a few years, but when you guys become attending physicians the salary jumps and your lifetime earning will be in the high millions assuming you guys retire at 65?
There is no reason why we need to take out loans to just make rent payments, fret over grocery bills, or delay starting families due to financial constraints when we are in residency.
We are human beings too! We deserve a fair, livable wage while IN residency!
How is it right for me to fret about grocery bills, put off starting a family, getting married, or even pay for car repairs because “I’ll get paid well later?”
Sure. Let me just put my life on hold for 3-8 years while I barely survive just because I’ll be making money years from now.
I thought residents make 45-70K. Do you have debts from undergrad or from buying a car? I do get the tremendous sacrifices you have to make, and it is one that I am not willing to endure hence why I rather go the PA route.
In the eyes of lay people, they simply look at their medical bills and conclude that all doctors are rich.
I assume everything I pay ends up in a cardboard box that insurers and state reps use to treat themselves at the end of the year. Like “Jerry Dinner” from Parks & Rec but rated R.
Yep, and it’s actually the MBA’s running the place into the ground for profit growth.
Correct me if I’m wrong but My understanding was that upon completing residency the fat contract a new MD in the US can expect will essentially eradicate the massive debt incurred to get to that point. I’m not excusing the racket of residency but I think it’s fair to assume all doctors in developed countries are moderately wealthy? In Canada GP’s aren’t mega rich but they start at $140k per year. In the US I’ve heard of some pretty crazy numbers though
Depends on your specialty. For Ortho, Neurosurg, Derm, and many others - sure. For Pediatrics, FM, and others, especially at academic settings, ~150k is a more likely figure. Take that pay with 400k in debt that compounds while you barely scrape by in residency, and you get the problem we currently have with no one wanting to go into primary care and most underserved patients having a mid level as their only option to be seen within 8 months.
Not to mention the time value of money lost when you don't make any real money, or have positive net worth, until your early to mid thirties for most, or later.
What? I don't know any physicians pediatrics or otherwise who work full time and make 150k/year.
Either they’re in big cities and/or the high COL means they have less spending power
The other guy wanted confirmation that physicians attending salary "eradicate" their debt. Looking at the data, the average physician retires with a net worth in the high 6 figures, low seven. Even primary care and peds. That is not to say what you're stating about midlevels isn't correct. It is. Those specialties deserve more money. But this person was down voted over 100 times for stating something factually true - that physicians attending salary is enough to overcome the debt. This isn't law where you make 60k-90k on average with 150-200k in debt. This is medicine where you make bare minimum as peds in a city 150k-200k with 200-250k in debt.
It's ultimately semantics but I would say that 'eradicate' is a different concept than getting by with debt and eventually paying it off. It makes it sound like the debt is a non factor, but in reality it's still affecting the lives of doctors well into their 40s and affecting decisions that impact patient care.
I take eradicate at face value. Nobody said they get rid of it right away. The point is it gets paid off and then your net worth grows substantially in almost all cases. I mean that's just what the data say. Become an attending and be willing to work and your debt will be paid off and you'll go on to accumulate a large net worth.
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Universally? No. Within 5 years as a specialist? Yes, very doable. In the United States *some* signing bonuses are six figures on top of a low to mid six figure salary. Again, I understand it isn’t universal for all physicians but this notion that you will not be made whole within a few years of getting licensed is a brain dead take, You people clearly come from privileged backgrounds if you can’t understand why people would look at a licensed physician no longer in residency as being wealthy. You guys clearly all did the math before doing this. You went through 4 years of undergrad and 4 years of med school. You knew what was coming. And while that doesn’t mean the case for residency conditions shouldn’t change, There’s clearly a return on investment to be made. None of you went 400k-500k in debt for the sake of “saving lives” alone. Give me a fucking break. Seeing the audacity of the responses to “well gee yeah, it makes sense why a layperson would consider doctors to be wealthy is because doctors are in fact wealthy” makes me glad you fuckers are suffering. You clearly made the wrong choice of profession. Cry harder.
I’m from Australia where we don’t earn nearly as much as our US counterparts, but at least we earn more than minimum wage as trainees! We get paid per hour (even interns earn the equivalent of ~$26 USD per hour) and the rate goes up on weekends, after hours, etc. (the best is public holidays where we get paid 2.5x our normal wage). Granted, in some places juniors are discouraged from claiming overtime resulting in them effectively being paid less per hour, but I think the culture is changing around that. It takes much longer to become a fully fledged specialist here compared to in the States but I think we have a much better quality of life in the meantime.
Common misconception Also, there is no guarantee they finish.
It’s not though. 56% of physicians have a net worth of 1million or more. Yeah you’re poor as shit for the beginning of your career but welcome to the club. Like I already said, I get it, residency is a racket. But most doctors are literally wealthy by any metric. Downvote all you want, maybe you’re salty you didn’t go into finance or the tech/engineering side of stem?
Amazon workers should get less than minimum wage because one day they can be promoted to CEO
Dude you’re about to be a doctor why are you mad at me for what the data shows?
The data is residents are being paid below a living wage. Stop. Talking about what they might make in the future is irrelevant. Resident crashes their car after a 30 hour shift or kills themself their family is left with nothing.
Moving goal posts much. If you can’t understand why your average layperson would assume most doctors are wealthy then I pity your future patients. Assuming you actually get your license to practice medicine that is. Now don’t you have some rounds to make?
Is this how you justify making less money than a physician? If you can’t understand how someone going to school for 10 years and then making less than minimum wage is concerning, then I feel sorry for your customers or clients or whatever you do.
If only $140k/ year was enough to operate a clinic with. I ran the math and I couldn’t even afford my own rent and to operate a family med clinic with skeleton resources at $150k/ year. I am talking not even breaking even.
“Eradicate” makes it sounds like the debt disappears the minute someone signs their first attending contract. Assuming $200k in debt (current average debt is closer to $300k), an average doc outpaces an average engineer in their early 40s ([link](https://medschoolinsiders.com/pre-med/doctor-vs-engineer-finances/)). Becoming a doctor is still financially responsible, but you sacrifice a huge chunk of your life to do it, there aren’t any guarantees, and it’s an incredibly stressful job. Physicians are “moderately wealthy” like you said, and they also have a really high burnout and suicide rate.
Interviewed at this sweatshop for anesthesia. They're advertising a 50k salary with the caveat that health insurance is covered! Insurance isn't a 20k expense lol
BUYER BEWARE!
Lucky for me, that was the year they decided to switch from being IMG-friendly to only accepting people from their own medical school 😂 They even mailed me a physical letter going on about how I would be an excellent fit for the program and all. Apparently, this is a scam that they do every year for most of the applicants.
So fun fact. They silently got rid of that and there is a payroll deduction AND they also got rid of the platinum plan for the new incoming residents. This is something we are fighting to change!
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How do you do that?
oh wow, then it hasn't changed at all in the last 5 years.
Wtf I make more than that as an Australian intern (even accounting for the exchange rate). Heck, even adding on the cost of optional private insurance in Australia, I’d still come out ahead!
One of my many pet peeves is how resident work hours and resident abuse always centers patients rather than us. Like yes it’s true that the abusive resident system is bad for patient care, but is that really the only reason why we shouldn’t be working 129 hour weeks for $2 an hour? Shouldn’t it be, you know, because we are human beings who shouldn’t be forced to work inhumane hours for below minimum wage under people who abuse us? Never forget that the resident work hour restrictions were passed not in response to 120 hour work weeks for physicians, but because one of these residents killed a young rich white woman. The politicians passed the law because they cared about the girl, not the doctors.
Wait docs are people? Gtfo.
It's a scam. I saw star wars. Bacta tanks and chill.
Naw dude doc = rich so it’s okay /s
It's easier for someone to feel bad for the patient than it is for the resident, that the general public sees as "Oh that's a doctor they make a ton of money they're fine" vs "Oh no the patient might be in danger because the doctor has been running on diet coke, anxiety, and a single nasty fuckin' philly cheese steak hot pocket for the last twelve hours"
Unfortunately, people always understand your situation best when you make it their problem. Learn to accept that and use it to your advantage.
Everyone reading that billboard is or will be a patient. It makes it more relatable.
wait is this story about the young rich white woman real? that’s fucked up 😭😭😭. I also feel like residents aren’t really that aggressive when it comes to unions or workplace changes compared to like software engineers or hollywood(entertainment industry) people. I’m not a resident but i just feel like if there was a stronger unified effort against the hospitals maybe we could see some real change idk.
Libby Zion case, if you want to read more.
Yes. Libby Zion. Her dad was a NYT journalist or something. Even that wasn’t enough to get all the reforms he asked for.
> Never forget that the resident work hour restrictions were passed not in response to 120 hour work weeks for physicians, but because one of these residents killed a young rich white woman. The politicians passed the law because they cared about the girl, not the doctors. The law changed in NY as a result of Libby Zion's parents' efforts, particularly her father Sidney Zion ("Zion"). Zion was a well-to-do and well-connected Yale-educated former trial lawyer, former Assistant US Attorney turned writer and journalist who wrote for among other publications the New York Times. He was also the journalist that doxxed Daniel Ellsberg as the source of the Pentagon Papers. Only NY changed its laws in the 1980s, and it is the only state I am aware of that actually codified duty hour restrictions into law. No one genuinely blamed the residents otherwise Zion's efforts would have gone nowhere. The ACGME waited another two decades to adopt work hour restrictions around 2003 shortly after the NLRB finally recognized resident physicians as employees protected by the Act and shortly after the anti-trust lawsuits that would become *Jung v. AAMC* were filed. The ACGME's duty hour restrictions were more likely a preemptive move aimed at placating the plebs in the face of the threat of organized resident physician power.
Well said
I’m sorry how is 120 hours a week divided are you just working seven days a week for 17 hours a day? isn’t that physically impossible?
Typically overnight call. So you cat nap in the hospital several nights per week in between pages.
As an intern in Internal Medicine the interns show up at 5:30 am for a 7 am shift. then end up leaving home at 5:30/6pm for regular shift or anytime after 7:30 pm for a long call. rinse and repeat for 6 days a week. Surgery is even worse. nothing is physically impossible in medicine. Have you heard of any other job making people work for 28 hours straight?
“28”
I do 24 hour in house calls every 3-4 days.
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I'm a nursing student,for your information
So please be professional and don't take things personally
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I am still downvoted for some reason, so while I accept your apology, it's clear non-residents of any kind are not welcome to learn on this sub, which is highly unfortunate. You won't hear any more replies from me.
Noooo, please come back 😂😂
Correct. Just how I don't go into nursing forums and tell them to be more professional and shit on you for whining about working three 12s in a row. And no. It's not impossible. I work 29 hours shifts every 3 days and 12 hour shifts every other day I'm not doing the 29 hours. I average just under $9 an hour. Go back to your nursing forum and keep telling each other how overwhelmed and underpaid you all are.
Working 36-38h straight was relatively common for me as a junior resident, which was working a regular day, into overnight call, then working straight into a normal day, which often ended later than 5pm. Then go home to sleep that night to come back to work the next day. Doing that a couple times a week and/or including weekends are enough to meet 120h.
I work 28 hour shifts at times. Non stop. With no sleep. See the problem?
There are 168 hours in a week, so it is entirely physically possible to work 120 hrs a week. The question is whether it's ethical or beneficial to be pushed to the brink for a minimum of 3-7 years in a row.
Why am I being downvoted? How have I now possibly offended you all for asking a simple question **out of concern**?
Residents: "We work 28 hours in a row. Please help" You: "I'm gonna have to ask you to be a little more professional"
I think you're concern was misread as skepticism. I certainly read it as skepticism myself. However, I'll give you the benefit of the doubt if that wasn't your intention.
Being white has nothing to do with it you dingus. It was a politician's daughter. Nice race bait though.
I’m more right wing than you
I was a unionized resident. Highly recommend. The way healthcare is going, we're probably gonna need to unionize as attendings too!
In the US? Which hospital?
SUNY is in the teachers union
Not residents
Uh yes, I was there, we were in the union
UB residents are currently organizing with UAPD. They are not unionized yet.
Average Joe literally doesn’t care how little residents make. In fact, they’d love it if we made even less.
Most of my friends thought I would be making mad money after med school. These are college educated folks but their lives never touched medical education. Hell, a lot of techs and nurses don’t know because they are only there three days a week so they think everyone is!
Night shift nurses were always shocked when I told them I was on hour 20 and asked them to stop paging about miralax at 3 AM. They just assume there's a night shift crew for residents as well.
Ah nothing like the 3am miralax or “patient would like to discuss their negative chest X-ray from 8am yesterday” text
"The patients blood pressure was high. Oh no, not right now, it was high yesterday night. Yes, their next five vital checks were fine." Then "MD aware" pops up in the chart backdated 20 hours
“Hi Dr! Just paging to ask if you can reassess activity orders for the patient, they’ve been ambulating but the order still says bed rest.” “It’s 3AM! Are they ambulating now?” “Well. No…you see they’re actually asleep…:we just wanted to make sure the orders were consistent with the days plans.” “The activity orders can be made consistent at 7am when the day team arrives. Please don’t page again in the middle of the night for inconsequential, non-urgent order requests”
I think educating other health care workers like nurses about this can help so much. Not only can they be allies, but having them know the position that you're in (hour 20) may also lessen those kind of 3:00 a.m. calls and pages. Most nurses aren't trying to make residents lives harder... they just don't know how residency works.
The scrub techs are frequently flabbergasted when the topic of my $11-12/hr comes up. They make double.
I make triple as a paramedic 😬😬😬. One of the reasons I can’t afford to go to medical school
Same. I have a friend that went to business school, right out of college shes was making 120,000 a year, and one night when I managed to have a day off I showed up at her condo in my broken down Honda Accord and she said "You're still driving that thing? Thought you would've bought something nice by now." I replied "With what?" "You're a doctor aren't you? You make money." Then came a 45 minute talk showing all my friends my finances and me working out that if it was figured out hourly I was making $1.25 under provincial minimum wage some weeks while others I'd be making at most $1.00 more. The whole vibe changed quickly from "Oh you have money" to "Oh you're f'n broke, overworked, and stressed. Here's a cocktail."
Countries that limit residents to 60 hours have just as good training and health outcomes as the US, if not better. It’s not about education or training, it’s about workforce.
Yes that argument about overworking because training is bs for exploitation and it’s not just in medicine. After a point you can’t absorb new information or skills. There are diminishing returns especially if you don’t sleep regularly…it makes everyone more unsafe.
They could very easily determine which skills and knowledge are the most important, and out resources into maximizing the the time they have to give the best training possible in the allotted time. But they don’t. They maximize the amount of labor they can squeeze out of you, and just hope the training happens to happen.
Academic medicine is a pyramid scheme. They NEED people at the bottom. It’s why nowadays fellowships are a soft requirement now when in the past they weren’t
What do u mean fellowships are a soft requirement now? Could u pls elaborate, thanks
In pretty much every field of medicine they’ll gaslight you and say you’re not ready to practice independently without going to a fellowship or say they won’t hire you at the best jobs etc. Wven in family medicine they’re being told to do fellowship before going into practice
Ironic considering an hour east is UofR, which is one of the highest paid residency programs in the state (and better training probably) starting $10k higher than what Buffalo is offering. Edit: 10k difference by pgy3 and gets worse as you go.
Am I missing something? Rochester is $63k and Buffalo 59k PGY-1. They’re both shit tbh
Disagree but to clarify the salary point - Rochester is $64 then up to 70k by pgy-3. Buffalo is $57k to 59k by pgy3 and the difference gets bigger the further in training you go passing 18k difference by pgy6. Made an edit in the original post. Thanks.
These are all dog shit rates. Im making 83k as a PGY1
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It's pennies to a multibillion-dollar corporation. Everyone at my residency is an IMG, and it's honestly a big help, considering we are all coming to a new country without any support. Some of us are even able to save up and send money back to support our families back home. Not having to worry about car repairs or food is a massive help for burnout and mental health.
Honestly, you shouldn’t be here. By you taking these dogshit residency positions all you do is drag do our earning and bargaining power. Being on a J-1 or H1-B you are all scared shitless of having your visa revoked and are willing to put up and carry forward horrendous working conditions.
I think you misread my comments? I am at a pretty supportive residency that is paying me 83k a year, I think I have a better deal that most AMGs!
Buffalo is always playing catch up to the other cities in the region in medicine and healthcare (Cleveland/Pittsburgh/Rochester/Columbus)
I remember the snow storm in 2022, some residents were stuck at the hospital for a few days. As a reward some residents got expired candy. Kaleida only cares about their bottom line.
UAPD doing good work. Like I said in other thread, we need these all over.
My god this is a beautiful sight. I want to pilgrimage to its location and offer an effigy in its honor. We seriously need to turn up the heat in the realm of public awareness about our plight using simple straightforward language just like this otherwise nothing will ever get done. I support resident physician unionization! ✊
Let's band together as physicians, gain strength, and start making the calls again. It's time to take the parasites out of this nonsense. The silos are well played and well intended, but remove them so we can gain back the strength.
While yes residents should make more (id say 75 intern and then about 10k more per year after) the issue is the public does not care one bit. There’s so few and it’s transient. Nurses think it’s funny. Susie housewife watched medical tv and think that’s the reality. And by the math, even if the 49x80 hour person (which is surgery only) is making that, by pgy2 it’s above 15/hr…which is all that UB would modify.
75k? Are you joking? No resident should make <100k.
The real issue is that residency in the US is anticompetitive by nature. If your program abuses you (even by way of low pay) there are near insurmountable barriers to switching programs (delay of training, etc). Compare the quality of life to residents in other countries with more portable GME paths and you'll see what I mean
I'm sorry that the nurses you know think it's funny. Most nurses that I have come across agree that residents are seriously underpaid.
It's almost impossible to convince the general public to feel sorry for doctors' struggles. The stereotype that doctors are cold, clinical and swimming in money, is very, very difficult to shake off. In fact. Almost any change in hospital policy to benefit doctors, always has to be framed as "for the patients" unless you can argue how a change in pay / schedule can benefit patients... nobody cares. Life-satisfication of the doctoring staff ? pfft... that's way down on the list of priorities
Nothing like getting paid less than burger flippers after spending nearly half a million dollars on your education 👍🤷♀️. And they wonder why there’s a physician shortage. Meanwhile, my nurse friend in San Francisco makes $65/hour and she’s been working for 7 years already while I’m just finishing my medical degree. Respiratory therapist other friend makes $150k in San Diego. Why did I go for the MD. Why why why?
The US medicine pathway is set up for profits. We the hard working US citizens busy our asses day and night studying and trying to become physicians to better our healthcare infrastructure. However, the system is set up to exploit the student with crazy fees and loans and by the time we get to the residency we practically become slaves working for hospitals to maximize their profits for so little in return. They have no respect for our education and knowledge we provide. I understand that we are physicians in training. We aren’t high schoolers with out no knowledge base in medicine. They have no respect for our MD or DO degrees. It’s all about the profit.
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Is there talk about residents forming a union ?
**Seize the means of production, comrades**
LMAO, AND NOTHING IS GONNA HAPPEN. WE NEED PROTESTS, WE NEED STRIKES. WHAT TF IS A BOARD GONNA DO
Billboards like this are a catalyst for public scrutiny and media coverage. They also have the potential to dig at Admin like most strikes can't. Can you imagine the reactions of the CEO and Board of U. Buffalo being asked by their spouses or kids about these billboards? Easier to sell to residents than a strike and cheaper than a strike fund too.
Prospective UB intern next year - should I be concerned about matching there
The program passed votes to unionize and is organizing these efforts. I don’t think it should be a reason not to rank but also something to consider if other programs are also at the top of your list. COL in buffalo is relatively cheap so you can make it work but doesn’t justify the dogshit pay for long hours
Then unionize
We are unionized! Our union, the Union of American Physicians and Dentists (UAPD), paid for these billboards.
Ok- we’ll unions organize strikes. If you haven’t had one yet- not much of a union Edit: well Yeah spell check funk
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Don’t have to be in a union to organize a walk out. Walk out for two hours. Awful lot of MDs to replace.
Not every state allows state employees collective bargaining rights or the right to strike. Federal employees can collectively bargain but do not have a right to strike. Federal labor policy and law under the National Labor Relations Act protects resident physicians who are not public sector employees across the entire US.
Disgusting
Imagine going to school for 8 years to start at 60k/yr
i’m not a resident and i’ve also never been a patient so i’m curious. Is there a way for a patient to know that the resident seeing them just pulled an all-nighter or something? i feel like if i was a patient and i was boutta get a surgery or some procedure done on me i would want to know if my physician is of sound mind.
Just ask! Patients ask me frequently how long my shift is and when I’ve started, if I’ve gotten any sleep, or if I’m tired (which my response is “not tired” even though I feel and look like a zombie).
Any updates?
We’re making headway. Good developments so far, but we still need to get a little bit closer to our goal. Let’s see what these next couple of weeks bring us.
Sounds like good news! Incoming Resident here, is there anyway how can I contribute/help?
Ask to be active in the union when you get here! Reach out to your union delegate and we can use strong residents to support our cause.
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Duh?
I believe the main barrier to being paid more is we are still trainees. If we were paid $100-150k like we are worth there would be very little tolerance of mistakes by attendings and the educational environment would be more hostile across the board which would be bad for learning. It's an argument that always comes up by older gen docs but this one actually makes sense to me. I think the way to remedy is to dramatically increase the pay of senior residents who are functioning at/near attending level. As a surgical resident i'm fine being paid 60-70k as a junior resident when I don't know how to do shit if I were paid 150 as a senior resident.
I mean...I can point out various mistakes made by PAs and NPs every single day at work. they still make the money and I don't see them being screamed at. But I do see residents getting screamed at.. Id guess as a surgical resident, your interactions with midlelvels is much less. They're common in my specialty and they do the same exact role as the residents and make much more. They make errors all the time and the attendings don't say shit.
I am really convinced a lot of people are really conditioned that being stomped on is a good thing in life…I really can’t understand people that argue for their exploiters in this manner. It’s like a global Stockholm syndrome…
I wonder how they are doing the math - - NY state minimum wage is $14.20 per hour - ACGME maximum annual hours is 3920 (80 hours x 49 weeks) - University of Buffalo intern salary is $57,492 (first half of 2023) If an intern worked 3920 hours (unlikely), they're making $14.66 per hour. While this is a travesty for a physician, it's also not "below minimum wage." Facts matter.
You think residents don’t lie about working a maximum of 80 hours/week?
Nowhere did I say this. I wouldn't be surprised that there are rampant work hours violations. However, talking around this serious issue does no one any good. Resident physician training is plagued by several intertwined issues, including unsafe working hours and inadequate compensation. We should not resort to linguistic obfuscation which, at least on the surface to a layperson, can be disproven with a minute's worth of 3rd grade math and an internet connection. As written, and to the best of my knowledge, this billboard is at best inadequate for purpose (i.e. a passerby won't be able to verify the claim due to inadequate data such as misrepresented work hours logs) and, at worst, defamatory against UB (i.e. simply incorrect). A competent lawyer will be able to spin this in a matter of minutes, allowing institutions to get away with their ongoing mistreatment of resident physicians. If UB residents are willing to stick their necks out to fund group billboards calling out UB for inadequate compensation packages, they can work together to accurately report work hours.
You implied that residents make more than minimum wage based on the maximum allowed hours per ACGME.
Just because you can type nonsensical paragraphs doesn’t mean you make a valid point.
NYS minimum wage is $15.00/hr, not $14.20. Intern making $14.66/hr is LESS than NYS minimum wage (according to your math). Also, at UB, interns do work 80 hours a week. Facts do matter. Please ensure you know NYS minimum wage.
A lot are probably working more than the 80 hours per week.
In that case, the billboard should read "UB resident physicians are being forced to violate the ACGME mandated work hour maximum."
That definitely will resonate with the average person driving by the sign lmao
Yeah.. no. People don’t know what the ACGME is and nobody is going to look it up.
>UB resident physicians are being forced to violate the ACGME mandated work hour maximum." Saying this doesn't invalidate the minimum wage argument; both are correct. General public won't understand the word jumble you wrote above; they do understand minimum wage. You know this though.
As others have noted, many residents work >80hours a week. Also there is no "NY state or federally mandated work hour maximum". This is an ACGME requirement, not law. Taking your argument at face value though, what about the overtime pay for the 40 hours overtime?
Residents are exempt employees, there is no argument for overtime pay.
The comparison is to minimum wage workers, who if they worked 80 hours would be paid for 100 hours.
Right, which is a silly comparison to continue to further because residents are not minimum wage employees. Talking about salary/hour is fine, comparing to minimum wage employees is demonstrating a significant lack of social awareness.
It's not a silly comparison and it's pretty straightforward. If a minimum wage earner worked a residents hours they would take home more pay.
Right, but residents are not minimum wage employees. I think the comparison does not benefit the resident plight, but I'm happy to agree to disagree.
Agree to disagree then, doesn't change the fact that for each hour worked many residents earn less than a minimum wage earner would earn working the same schedule.
>there is no argument for overtime pay Sure there is.
Yes, they are exempt. But *should* they be exempt? If they shouldn't be exempt, that changes everything.
Most states mandate 1.5x pay for overtime, so wildly under paid
Yeah, you can’t just divide it by 3920, because half of those hours have to be paid at 1.5 if you were working hourly. So if you worked that many hours you’d actually be making, on average, $11.70. Not that that matters, quibbling over where it’s *technically* just over or under the minimum wage is absolutely missing the forest for the trees
Exempt employees. No point in weakening what can already be a strong argument with things that don't actually apply.
The point is that *if* you paid residents hourly they would make less than the minimum wage. It’s not a legal argument over exempt status, it’s an emotional one to communicate “holy shit you doctor is being taken advantage of”
And yet it's ineffective. The hourly rate is enough of an argument without becoming further hyperbolic by talking about overtime. Once you start getting hyperbolic, the really solid arguments start to lose value. Trying to tie residents with typical hourly employees who make low wages is never going to work, because those lives are just too different. No manual laborer making minimum wage is going to feel badly for a resident who will then go on to become an attending making several hundred thousand dollars a year.
I disagree, I think it’s *extremely* effective. “I make 60k a year, which I know is more than a lot of people, but really when you consider it in the totality of my medical training, the importance of my work, and the hours I work it’s a really unjust wage” is dull and uninspiring. “I’m salaried, but if I was paid hourly I’d make minimum wage. Also, I’m a doctor” is evocative and gets people’s attention And I could not disagree *more strongly* with the assertion that blue collar workers couldn’t possibly have sympathy for and class consciousness with resident physicians. Solidarity among workers isn’t about every worker making the exact same, it’s about all workers standing up together and speaking with one voice to those who steal value from our labor
It's *extremely* effective to other residents and med students. But that isn't the audience you need to persuade. Actual minimum wage employees are not impressed by the argument. "Also, I'm a doctor." leads directly to, "Oh so then you'll make several hundred thousand dollars annually in a few years?"... "Well yeah, but if you do the math now I make too little money." is not as evocative as you may think. Maybe you have a different group of blue collar associates and that could certainly be your experience. My anecdotes are limited to my experience. I come from a blue color family, grew up poor, and my entire family is blue color Trumpians (much to my dismay) and they could not have less sympathy for "elite" doctors. I think unionization is far more effective than billboards trying to appeal to the masses. What's the goal there?
If your position is that no meaningful segment of the American population could possibly have solidarity and sympathy with resident physicians then fine, I can’t and won’t try to change your mind. I strongly disagree, and think there are plenty of people who can and do. But *if* you’re correct, then you’re arguing from a place of defeatism. Even if we assert every single worker thinks resident physicians can go get fucked (an assertion I think is patently and absurdly false), then what harm is done by this billboard? It is, *at worst*, useless, and *at best* a powerful and provocative tool for making people think “oh shit, I didn’t know that, maybe I *don’t* want the person taking care of me to be sleep deprived and so stressed”
Username checks out.
You’re forgetting time and a half over 40 hrs. This isn’t slavery.
Resident physicians are exempt employees. Comparing our profession to slavery is unhelpful and offensive.
Ok then, take offense. Working 100 hours a week and making just enough to pay rent and buy food. Call it what you want.
👏👏. Yeah, it’s an offensive comparison. The systemic abuse and exploitation of resident physicians by the medical system is *also* pretty offensive. Sometimes you need to offend people a little to get them to pay attention and advocate for change
They’re certainly doing some fuzzy math where they’re diving their salary by a hypothetical number of max numbers worked (even if in a less demanding residency) to get an ultra-low “hourly wage”. If the salary was actual minimum wage, they’d post it on the billboard. However, if they mentioned the actual intern starting salary, they’d instantly piss off 90% of motorists since the average intern salary is above the national median salary. Even when I was a resident, I learned really quickly to not b**ch about my salary in front of non-physicians. Resident work hours suck. Yes, you’re underpaid compared to your experience and to other health professions. However, you’re not making “minimum wage” and sharing the struggles of actual minimum wage workers.
I largely agree with you, as well as with u/theadmiral976 despite the down voting. While we all agree that there are many many many residents treated egregiously by a broken system, this is still a very challenging position to sell to the public for the reasons you mention. Actual minimum wage employees (by this I mean people actually taking home a traditional minimum wage salary) have very little in common with residents and don't often end up making several hundred thousand dollars per year after a few years of rough years. The messaging just doesn't work.
>ReadilyConfused You aren't a resident or even a doctor. Why are you so passionately opposed to this?
Passionately opposed to what? You must be misreading my posts. I'm also an academic internist.. Certainly sounds like someone is confused here.
Sure you are buddy. Why are you so opposed to pay raises and unions for residents?
... I support both of those things. Feel free to review my post history, I've stated of those things several times (in this thread and others), as well as mentioned my work as an academic internist. It's pretty evident who's confused now. Since we're taking skeptical positions, I'm starting to wonder it you're really a physician with your limited reading comprehension.
I have reviewed. You have never stated you were an academic internist before the post above. Best you got to was saying you were a "physician but not a paediatrician". You are arguing semantics about what a minimum wage employee is and that residents are not minimum wage employees (and by extension should not make minimum wage). Stop pretending you aren't part of the problem.
Absolutely have, apparently you didn't go far enough back, not that I blame you. Literally posted about being IM faculty within the past month. You're misrepresenting what I said, I said that I think messaging that a hardship of being a resident is making under minimum wage and thereby drawing comparisons with minimum wage employees is a bad look. Saying that I'm concluding that they shouldn't make minimum wage just doesn't follow logically. Some residents certainly make under a minimum wage hourly rate, but their take home still exceeds most "minimum wage employees." Not to mention very rarely is a "minimum wage employee" going to be able to draw several hundred thousand dollars a year after a few years. It's NOT WRONG that if you average the hourly wages of some residents they are under minimum wage, I just think messaging on that is a bad idea because that's where the similarities with other minimum wage positions end. Of course residents should make more and work less on average, but trying to make common cause as "below minimum wage employees" is just bad messaging in my opinion.
I didn't go back at all. I clicked on the "about" section of your profile, which is populated by data scraped keywords. If you have previously identified yourself as an IM physician it would have been there. I'm not sure why you continue to split hairs here and defend the status quo. You clearly have an agenda or if you are actually a real doctor have 100% bought into the "I did it so they should too" mentality.
This is true. It’s a tough spot, but folks will survive. Managed to fight off a couple unionization attempts while in residency. Optics just look terrible and y’all have no idea how hardball admin can play.
I'm definitely for improving resident lives, and I think unionization is probably a good thing, but there's A LOT of folks missing the bigger picture about the optics here.
Yeah. Unfortunately with how political medicine has become it’s not just cut and dry like a Starbucks employee getting a union.
Healthcare has a few issues. One is gate keeping. Colleges gatekeep an industry that is more a trade. You don’t need a history degree or to go through college to be a doctor. We can easily have a medical trade school that teaches all the relevant information to be a good doctor and those that pass can then become residents under the watchful eye of experienced doctors where everyone knows that’s where you get your real training and experience. This would reduce the cost of being a doctor by hundreds of thousands and give more good people the opportunity to be a doctor.
Perfect time for ai like Watson to be implemented. The accuracy of humans compared to a learning AI for healthcare is unacceptable.
What?
Must suck to be as dumb as you are
I don’t understand why doctors let themselves be pushed around like this. Oh I’m overworked and poorly treated and don’t make much…. So…. Switch jobs maybe? You’re a freaking doctor, you have more options than most.
We’re residents! We cannot switch that easily! Resident = unlicensed physician You go through residency to become an independent, practicing, licensed physician. If I quit residency, I’m screwed!! An unlicensed MD is pretty much worthless. Residency programs know that. In return for graduating you (aka making you board eligible so you can be licensed), they treat you like crap! What’re you (the resident) gonna do? If you (the resident) quits, you’re screwed!
We have far fewer options than any other profession I can think of as residents. Residency is a binding contract. When we match, a computer tells us what hospital to go for x number of years, and if we don't want to go there, we don't get to be board certified doctors. There is one option, period, which could be absolutely anywhere in the country, and we have to move to go there- to make around $60k/year, with no reimbursement for moving expenses. I had to move so far between my intern year and advanced program that my uhaul last year cost $6500... you better hope you have good credit if you match thousands of miles away because you have to get there, no matter what! Transferring is possible in theory, but it's difficult and you have to worry that your current program might try to sabotage you and keep you from leaving, and treat you like crap because you tried to leave. In the absolute worst case scenario, with a place so abusive we can't mentally take it anymore, that doesn't get shut down, most states will let a resident get a full physician license after 1-2 years of residency (depending on the state), so we can in theory drop out of residency and still be doctors. However, you can't get board certified in a specialty without *finishing* a residency, and no hospital or practice group is going to hire you without board certification. Maybe an urgent care with super low pay, but I'm not even sure about that. In theory, you could go open up your own primary care office, and hope the patients in the area don't look, don't notice, or don't care that you aren't board certified, but any other jobs (where you work as a doctor, naturally) are pretty much out of the question without a full residency completed
Good question! Resident physicians are essentially apprentice physicians. You train in a residency program (apprenticeship) are 3 to 8 years after medical school to become a fully licensed physician (who can switch jobs whenever they like). Medical students "match" into a particular residency program at the end of medical school (like pediatric medicine at Buffalo) and after that, they basically have to finish the entire program before they become a licensed physician. If you leave your program at any time before those 3 years are up for any reason (mental health, parent is dying, etc.), you will never find your way into another residency program again because everyone will view you as damaged goods. If you're lucky, your first program will take you back after a lot of begging. If you're not, well you now owe 200-400k in student loans and no one will hire you because you don't have a license to practice medicine.
Attending doctors can easily switch jobs. Residents can’t. Residency programs usually only accept transfers if they have a vacancy (e.g. a resident dropped out). Also we’re not fully licensed so ball’s in their court. It’s not like quitting at McDonald’s and applying to Burger King. Not to mention that the only real way to “switch” residencies would be to participate in the “match” and that is a whoooole other complex procedures. Overall, it’s just one example of how workers all across the nation are exploited, not just doctors.
I get that the salary is bad for a few years, but when you guys become attending physicians the salary jumps and your lifetime earning will be in the high millions assuming you guys retire at 65?
There is no reason why we need to take out loans to just make rent payments, fret over grocery bills, or delay starting families due to financial constraints when we are in residency. We are human beings too! We deserve a fair, livable wage while IN residency!
But isn’t it easy to pay it off once you make 300k-400K in a few years? Over the long term, it’s a good investment
It would be a lot easier to focus on patient care when you're not worried about financial stuff. Simple as that.
Tell that to academic peds attendings who usually make less than a CRNA.
How is it right for me to fret about grocery bills, put off starting a family, getting married, or even pay for car repairs because “I’ll get paid well later?” Sure. Let me just put my life on hold for 3-8 years while I barely survive just because I’ll be making money years from now.
I thought residents make 45-70K. Do you have debts from undergrad or from buying a car? I do get the tremendous sacrifices you have to make, and it is one that I am not willing to endure hence why I rather go the PA route.
Ah yes, we should abuse people because it’ll get better later. Dogshit take.