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Med School Debt & Resident Salary

Med School Debt & Resident Salary

Medscape’s Residents Salary & Debt Report 2014 was just released this week, surveying over 1,200 medical residents across more than 25 specialty residency programs. The survey focused on medical residents’ salary, debt, and overall experiences in residency. Survey results found that the average resident salary was $55,300. Other highlights from the report are as follows: * Average salaries were highest in the Northwest (71k); lowest in the Southeast (50k) * Residents in critical care received the highest salary at 65k * Family Medicine residents received the lowest salary at 52k * Average salaries increased from 51k the first year to 60k after the fifth year * Men and women made an average of 56k and 54k, respectively * Only 48% of men feel fairly compensated, compared to 57% of women * 58% of residents owe over $100,000 of medical school debt after 5 years in * 36% of residents owe more than $200,000 * The majority of residents (77%) felt that the hours worked are sufficient for training Results of the Medscape survey follow closely with the Association of American Medical Colleges’ recent statistics of the indebted graduates, class of 2013, in their Medical Student Education: Debt, Costs, and Loan Repayment Fact Card. According to the AAMC, the mean debt for residents attending a public institution was 162k, and the mean debt was 181k for a private institution. The AAMC reports that 79% of graduates owe over 100k, while 40% owe over 200k. In May, the New England Journal of Medicine reported that in inflation-adjusted terms, compensation has been essentially unchanged for 40 years. And according to a recent...
Career Plans Among Internal Medicine Residents

Career Plans Among Internal Medicine Residents

General internists are expected to play a pivotal role in providing healthcare as the population ages, the burden of chronic disease grows, and healthcare reform tries to improve coverage for millions of currently uninsured patients. Studies suggest that only 20% to 25% of internal medicine (IM) residency grad­uates pursue general medical careers. Complicating the problem is that fewer medical students appear to be interested in general medicine and primary care. Career Plans Among Internal Medicine Residents It’s unclear to what degree primary care training program graduates favor general IM careers, and few studies have explored how career plans may differ across sociodemographic factors. In JAMA, Denise M. Dupras, MD, PhD, and I had a study published that looked at the career plans of IM residents by training program, sex, and medical school location. We also looked at how career plans evolved during training. According to our results, graduates of primary care IM training programs, women, and medical school graduates were more likely than their counterparts to report generalist career plans. These residents were also more likely to remain interested in generalist careers over the course of their training. However, general medicine career plans were less common than subspecialty career plans in each of these groups. The small number of IM residents reporting plans for generalist careers means that only a limited number of generalists can be expected to enter practice each year. Serious Implications on General Internal Medicine Overall, only one in five IM graduates planned a career in general internal medicine. Even in primary care IM residency programs that are dedicated to generalist and primary care training, most graduates still...

Law School Applications Down; Are Med Schools Next?

The number of people applying to law schools is in steep decline. So says a recent post on a website called “The National Jurist.” The post cited some remarkable data from the American Bar Association. In 2012, law school applicant numbers were down 14% from 2011 and 23% from 2010. For the fall of 2012, there were 44,481 first-year law students enrolled, down about 4,000 from 2010. Many schools have decreased enrollments, with more than 90 trimming class sizes by more than 10%. On January 2, the Wall Street Journal reported: “The Bureau of Labor Statistics estimates that the economy will provide 21,880 new jobs for lawyers annually between 2010 and 2020; law schools since 2010, however, have produced more than 44,000 graduates each year.” For the non-math majors, that’s a ratio of more than two graduates for every job. There are way too many lawyers around anyway. Could something like this happen in medicine? It might not be exactly the same, but an interesting dilemma is looming. A 2011 paper in the New England Journal of Medicine expressed concern that in a couple of years, the number of US medical school graduates will exceed the number of first-year residency training positions available. In response to projected physician shortages, many medical schools have expanded their class sizes, and several new medical schools have opened or are soon to open. But the problem is that many years ago, the federal government established a cap on the number of residency training positions in this country. And there are persistent rumors that spending on graduate medical education (GME) will be among the many future...

Medical School Grading: Everyone Gets a Trophy

“Variation and Imprecision of Clerkship Grading in US Medical Schools” is the understated title of the paper in the August 2012 issue of the journal Academic Medicine. The authors, from the department of medicine at Brigham and Women’s Hospital, analyzed 2009-2010 third-year clerkship grades from 119 (97%) of the 123 US medical schools. They found many different grading systems ranging from two levels (pass/fail) to 11 levels of grades. The terminology used by the schools to describe the different grades is positively comical. To borrow an analogy I’ve used in a previous blog about dean’s letters, the citizens of Lake Wobegon would be proud because no student is “average.” Here are some examples: High honors, honors, pass, fail (In some schools “honors” is not the highest possible grade). Honors, satisfactory plus, satisfactory, fail. Honors, satisfactory, low satisfactory, fail. Honors, high satisfactory, satisfactory, low satisfactory, unsatisfactory. (Does “unsatisfactory” mean, dare I say it, “fail”?) Honors, near honors, pass, fail. Excellent, good, fail. Honors, advanced, proficient, fail. Honors, letter of commendation, fail. The highest grade attainable was awarded to 23% of those students in schools with three-tiered systems (range 5-51%), to 34% (range 2-84%) in four-tiered systems and to 33% (7-93%) in schools with five grade levels. It gets worse. The authors noted that 97% of all medical students were given one of the top three grades regardless of whether the schools used 4, 5, or 6 levels of grading. From the paper, “Less than 1% of all US medical students fail required clerkships, regardless of the grading system used.” This raises the question of whether the grade “fail” is even...
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