Salary, Debt, Depression Issues Facing US Medical Residents

Megan Brooks

July 20, 2016

Despite a shrinking gender gap in compensation, medical residents in the United States are battling debt and depression and a fair number aren't satisfied with their salary, according to results of the 2016 Medscape Residents Salary & Debt Report.

The report, released today, is based on an online survey of 1888 medical residents across 25 specialty residency programs. The margin of error for the survey was +/- 2.31% at a 95% confidence level.

In 2016, the average resident salary is $56,500, which is up slightly over that reported in Medscape's 2015 Residents Salary & Debt Report ($55,400). Male residents earn an average $56,700 and female residents earn $56,100 — averages comparable to those in 2015 ($56,000 for men, $55,000 for women).

Most male and female residents believe they are fairly compensated (52% and 55%, respectively), but these rates are lower than in the 2015 report (60% and 65%, respectively).

Reasons for their discontent include higher pay earned by nonphysician healthcare professionals (nurse practitioners and physician assistants [PAs]) and nonmedical professionals with comparable education and experience.

Saddled with a significant amount of medical school debt, 56% of residents say future compensation will influence what specialty they pick (and 36% said it is the leading factor in specialty choice). More than two thirds (68%) owe $50,000 or more and 40% report debt of $200,000 or greater, according to the report.

Nearly one quarter of residents (22%) said they envision a future in private practice, either solo or with partners — a slight drop from 2015 (26%). Employment is preferred by 29%, up from 24% last year, and 28% have yet to decide. Forty-three percent of residents said they plan to remain in primary care, with 45% indicating they plan to subspecialize.

Work Relationships Good, but Depression Still an Issue

Residents' relationships with attending physicians were slightly less positive this year than last. In Medscape's 2015 survey, 96% of respondents rated their relationships with attending physicians as good, very good, or excellent. In this year's survey, 88% of participating residents felt the same.

Nearly one quarter of respondents said they have suffered bullying from physicians often or occasionally.

Most residents said that their relationships with nurses and PAs were positive, but a minority perceived a clash of cultures. These doctors said that nurses and PAs were disrespectful, had passive-aggressive tendencies, cozied up to attending physicians while treating residents as though they were second-class citizens, and were not as helpful as they could be.

Eighty-seven percent of residents were satisfied with the degree of supervision by attending physicians, and 76% felt satisfied with the quality of their learning experiences. Still, more than half of residents (55%) said that they only occasionally have sufficient time with patients, and nearly one in five (19%) said they have doubts about their ability to be a good physician.

Depression is a problem for some residents, with 10% saying they feel depressed always or most of the time — a figure higher than the 6.7% seen in the general population (National Institute of Mental Health, 2014). And 9% of respondents said they have considered suicide, compared with 3.9% of the general population aged 26 to 49 years (Substance Abuse and Mental Health Services Administration, 2013).

"Our report yielded some surprising insights about the next generation of physicians," said Leslie Kane, senior director, Medscape's Business of Medicine. "While medical school debt remains a concern and depression is a serious issue for too many residents, they remain largely positive about the future, which we believe has a lot to do with what they value most about the profession. For example, when asked to rank the most rewarding aspects of their job, relationships with patients, gaining clinical knowledge, and pride in being a doctor are at the top of the list while potential for making money ranks low."

The second part of the survey, to be released in early August, will focus on lifestyle-related issues facing US medical residents.

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