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Keith L. Martin | August 7, 2020
| Contributor Information
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Medscape Residents Salary & Debt Report 2020
Keith L. Martin | August 7, 2020 | Contributor Information
COVID-19 has created challenges for nearly all medical professionals in the United States.
Residents are trying to quell a pandemic while still honing their skills. In this year's report, we explore not only their compensation and hours worked in hospitals, but also how their training has prepared them for these tasks. More than 1600 residents in 30-plus specialties also told us about their relationships with attendings, nurses, and physician assistants.
(Note: Label values in charts are rounded, but rankings and calculations are based on raw data to avoid rounding errors.)
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Medscape Residents Salary & Debt Report 2020
Keith L. Martin | August 7, 2020 | Contributor Information
The average resident salary continues to trend upward, according to our report. For the third year in a row, the average salary has risen 3% annually, to $63,400 this year.
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Medscape Residents Salary & Debt Report 2020
Keith L. Martin | August 7, 2020 | Contributor Information
The highest-paying specialties for residents include allergy & immunology, hematology, and rheumatology, while family medicine residents are at the low end of the pay scale.
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Medscape Residents Salary & Debt Report 2020
Keith L. Martin | August 7, 2020 | Contributor Information
Average salary in the sixth through eighth year of residency ($68,500) shows a notable increase from that received in the first year ($57,100).
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Medscape Residents Salary & Debt Report 2020
Keith L. Martin | August 7, 2020 | Contributor Information
Keith L. Martin | August 7, 2020 | Contributor Information
Last year, about half of residents in their sixth through eighth year of residency felt fairly compensated. That number is down significantly this year. In fact, each year of residency reported a slight decrease in satisfaction from last year's report.
Amelia Breyre, a fourth-year emergency medicine resident at Highland Hospital in Oakland, California, says that in some circumstances, when averaged over an 80-hour work week, intern salaries are often below $15 per hour. While that's above minimum wage, it "can still create a financial burden when considering compounded student debt," she says.
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Medscape Residents Salary & Debt Report 2020
Keith L. Martin | August 7, 2020 | Contributor Information
For the sixth straight year, more female than male residents are happy with their compensation. This year, however, salary satisfaction levels are slightly lower than in last year's report.
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Medscape Residents Salary & Debt Report 2020
Keith L. Martin | August 7, 2020 | Contributor Information
Residents' chief reasons for dissatisfaction with salary are that it doesn't reflect the number of hours worked and is not comparable with what other medical staff are paid. Overall, nearly 6 in 10 residents say they do not feel fairly compensated, an increase from last year (53%).
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Medscape Residents Salary & Debt Report 2020
Keith L. Martin | August 7, 2020 | Contributor Information
About one third of residents said they feel they should receive 26%-50% more in compensation, similar to last year's response (35%). Forty percent of male residents seek a 51% higher paycheck, compared with 25% of their female counterparts.
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Medscape Residents Salary & Debt Report 2020
Keith L. Martin | August 7, 2020 | Contributor Information
Benefits have remained largely unchanged over the past 2 years, with health insurance and paid time off garnering the largest responses. Among the rarer benefits for residents were expenses for childcare and a housing allowance.
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Medscape Residents Salary & Debt Report 2020
Keith L. Martin | August 7, 2020 | Contributor Information
More than 90% of all residents say future earnings have an influence on their specialty choice. More men than women felt this way (93% and 86% respectively), similar to last year's responses.
Breyre notes that the burden of debt from undergraduate through medical school weighs on many medical professionals in training as they select a specialty. "There is an egregious discrepancy in income between specialties that reflects a healthcare system profit model that rewards procedural intervention more than it does prevention."
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Medscape Residents Salary & Debt Report 2020
Keith L. Martin | August 7, 2020 | Contributor Information
More than half of primary care residents said they plan to subspecialize, with a slightly lower percentage indicating that they plan on working in primary care. Male residents (52%) are more likely to plan on subspecializing than their female counterparts (35%).
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Medscape Residents Salary & Debt Report 2020
Keith L. Martin | August 7, 2020 | Contributor Information
Nearly half of medical students owe more than $200,000 in medical school loans, with 24% in debt of $300,000 or more. Meanwhile, 23% of residents say they have no debt at all.
Breyre, 34, said she is fortunate to not be burdened by as much debt as her co-residents. "Student debt detracts from the ability to contribute to retirement accounts or accumulate savings for down payment on a house and other financial life milestones."
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Medscape Residents Salary & Debt Report 2020
Keith L. Martin | August 7, 2020 | Contributor Information
Residents are no strangers to long hours. Nearly identical percentages of residents said they work more than 61 hours per week or more than 70 hours per week. Another fifth say they spend 51-60 hours on patient care. In comparison, physicians out of residency spend an average of 37.8 hours per week seeing patients, according to the Medscape Physician Compensation Report 2020.
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Medscape Residents Salary & Debt Report 2020
Keith L. Martin | August 7, 2020 | Contributor Information
Residents continue to spend most of their time at hospitals. Nearly one fifth spend over 70 hours per week, with 16% spending 61-70 hours and 20% spending 51-60 hours. Among residents, 62% of first-years spend more than 60 hours, while at the other end of the spectrum, 32% of residents in years six through eight spend over 60 hours at the hospital.
"Many argue that working long hours is an important part of medical training, especially skills-based trainings like surgical specialties. However, it does seem that medical training in other countries, such as many Scandinavian countries, achieves similar levels of medical proficiency although through a less grueling process," says Breyre.
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Medscape Residents Salary & Debt Report 2020
Keith L. Martin | August 7, 2020 | Contributor Information
Nearly half of residents spend 1-5 nights on call per month, while 28% spend 6-10 nights. Sixteen percent of men and 21% of women said they don't spend any nights waiting to report to duty.
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Medscape Residents Salary & Debt Report 2020
Keith L. Martin | August 7, 2020 | Contributor Information
Most residents appear satisfied with the training they receive. One fifth felt that they get more training than needed, and only 2% indicated that they have too few hours of training.
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Medscape Residents Salary & Debt Report 2020
Keith L. Martin | August 7, 2020 | Contributor Information
Three of every 10 residents said they felt unprepared to handle the global pandemic based on their training, with a similar amount unsure as cases continue to arise across the United States.
Breyre says she has cared for dozens of COVID-19 patients over the past few months and that, in her opinion, the whole healthcare system was unprepared for the pandemic. Fortunately, she notes, she has reasonable access to PPE, "largely in part due to union organizing efforts."
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Medscape Residents Salary & Debt Report 2020
Keith L. Martin | August 7, 2020 | Contributor Information
More than half of residents are performing 1-10 hours of scut work (defined as unskilled tasks) per week. About another 20% are spending 11-20 hours on these duties. No matter the number of hours, the majority of residents feel that the time spent on scut work is appropriate.
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Medscape Residents Salary & Debt Report 2020
Keith L. Martin | August 7, 2020 | Contributor Information
Similar to last year's results, most residents feel that they receive the appropriate degree of supervision. Only 7% of residents think there is too much supervision.
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Medscape Residents Salary & Debt Report 2020
Keith L. Martin | August 7, 2020 | Contributor Information
The majority of residents feel that they are getting a quality education. More than three quarters said they are very or somewhat satisfied, with equal amounts feeling dissatisfied or neutral in their opinion.
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Medscape Residents Salary & Debt Report 2020
Keith L. Martin | August 7, 2020 | Contributor Information
Most residents are also satisfied with the way attending physicians treat them. Eighty-one percent say they are very or somewhat satisfied with their attendings' treatment. Only 9% said they were somewhat or very dissatisfied.
Among that latter group, one resident said, "[Attendings] aren't particularly interested in resident education. We do mostly self-learning." Said another about working amid COVID-19, "A lot of attendings stayed home while residents were beyond and above responsibilities. There is no mentorship and almost no education."
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Medscape Residents Salary & Debt Report 2020
Keith L. Martin | August 7, 2020 | Contributor Information
Nearly all residents noted a positive relationship with their attending physicians. Only 2% of residents said the relationship was poor or very poor.
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Medscape Residents Salary & Debt Report 2020
Keith L. Martin | August 7, 2020 | Contributor Information
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Medscape Residents Salary & Debt Report 2020
Keith L. Martin | August 7, 2020 | Contributor Information
Residents work closely with nurses and physician assistants. The majority (82%) of residents graded these relationships as very good or good. Fifteen percent said the relationships were fair, and only 3% indicated a poor or very poor working relationship.
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Medscape Residents Salary & Debt Report 2020
Keith L. Martin | August 7, 2020 | Contributor Information
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Medscape Residents Salary & Debt Report 2020
Keith L. Martin | August 7, 2020 | Contributor Information
Overall, 28% of residents anticipate employment, while 21% plan on becoming a partner or owning their own practice. When broken down by gender, more men anticipate becoming an owner, while more women anticipate becoming employed.
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Medscape Residents Salary & Debt Report 2020
Keith L. Martin | August 7, 2020 | Contributor Information
Gaining clinical knowledge and experience was most often cited as the top reward of residency, no matter the year. Being proud of being a doctor decreases with year post-MD, from 60% at years 1-2 to 44% at years 7-8.
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Medscape Residents Salary & Debt Report 2020
Keith L. Martin | August 7, 2020 | Contributor Information
No matter the year of residency, balancing work and personal life remains the top challenge. Residents in years 1 through 4 more often cited fear of failure or making a serious mistake than their peers in years 5 through 8.
"The process of becoming a doctor is full of humbling, frustrating, and rewarding moments," says Breyre. "Residency has taught me how to become a better advocate for myself, for patients, and for a better healthcare system. The best part is that residency is just the beginning."
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Medscape Residents Salary & Debt Report 2020
Keith L. Martin | August 7, 2020 | Contributor Information
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Medscape Residents Salary & Debt Report 2020
Keith L. Martin | August 7, 2020 | Contributor Information
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Medscape Residents Salary & Debt Report 2020
Keith L. Martin | August 7, 2020 | Contributor Information
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Medscape Residents Salary & Debt Report 2020
Keith L. Martin | August 7, 2020 | Contributor Information
Best & Worst Places to Practice 2020: In the Time of COVID-19
Physicians still look for salary and a great lifestyle, but some doctors now consider social distancing and access to healthcare to be increasingly important factors.Medscape Features Slideshows, June 2020
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Keith L. Martin
Editorial Director, Medscape Business of Medicine
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