Thanks so much for your kind and considered response Dr Cellini - a huge privilege to be featured and hear your thoughts. Just trying to clear up a few things 1) My bio was very out of date(!) - I'm now a Foundation Year 1 doctor (sort of equivalent to a PGY1 resident/intern) 2) Our training works as follows - you finish medical school (usually 5 years), then must complete 2 years of generalist rotations in medicine and surgery (the Foundation Programme), after which you then complete 2-3 years of generalist training in medicine OR surgery (called Core Training),and only then after all that you become a resident (registrar) in a given specialty for 3-4 years, and then you ultimately become a consultant (attending). 3) The hours of work question is always difficult. Officially I'm employed for 48 hours, but when I was working in surgery was doing anywhere between 50-60 hours per week with all those additional hours unpaid. That's still of course nothing compared to what US residents do, but there's still very much a culture of staying until the work is done despite the salary and prospects not keeping pace with expectations.
Most people also do not do 4 years of undergrad in the UK that is required here in the US, correct? Also wondering how competitive the application process is for medical school is? In the U.S. it is slightly less than 40%. What do you do if you do not get in after your first try? I personally did not and it took me a couple of cycles of work plus post-bach to get in.
@@MrAbubakrz That's right sir. If you apply as an undergrad straight from high school, it can be anywhere from around 4-10 applicants per place depending on which schools you apply for (with the caveat that you can only ever apply to 4 universities per year for medicine). If you apply WITH an undergraduate degree already (like I did) it tends to fall more in the range of 8-25 applicants per place. Still very competitive and can take a few cycles to get in.
Resident income is truly the biggest slap in the face in healthcare imo- making the big decisions as a physician with lives on your hand for 80hr work weeks for 60k/yr. For example… some targets employees are making 24/hr to be a cashier now. 80hrs a week as a target cashier makes 2400/week (1.5x OT) or 124k/yr as a target employee. And they’re not 270k in debt…
That come-on from Target was not what it seemed. They pay that for their top people like store manager or district manager or higher. Same as a lie to me. Tells me your can't trust Target for anything. Bad PR move if you ask me.
Ya well NO one wants to be a target cashier and literally 5000 people apply for 100 spots in med school because they know eventually they make 400-500k a year often and can pay off that debt in 4 years. Meanwhile they get all the social status, gold digging whores, and attention and pats of the back a person could possibly take. Maybe your just ugly and you thought women would like you because you started making mad cash? They will gold dig off your but never actually like YOU. Residents should be paid more but not much. Nurses make 84k to do equal hours as a resident. I'm a nurse on a teaching medicine unit so I know exactly how much work residents actually do. We get a new set every 8 weeks. We work just as hard, have to actually be on our feet for most of our shifts not sit at a desk or computer, have just as much responsibility as a resident becauses it's up to us to judge whether we trust the resident and to call the attending instead (who is never there). So resident should be paid more but an attending should be paid WAY less. Everyone knows there is a pot of gold at the end and that's why EVERYONE does it.
@@ryaniam22 It's always good to hear all sides of issues. I hear financial talk of F.I.R.E. (financial independence, retire early) which interests more and more doctors for many of the same reasons noted in this video. I suspect Dr. Cellini is not unaware of this. The strategy is to keep on living frugally for a few more years, paying off debt and investing wisely. Then when the time is right and the money has been amassed, live off your investments and do whatever you want, however you want. Doctors have the ability to do that as few others do. Specialists are paid too much and primary care far too little. Mostly, the whole system in the US is a royal mess which makes health care here twice as expensive as it should be. Why can't we change that?!!!!!!!!!!
If they are paid, there are still lots of places in the world where juniors, interns and residents are not paid, Im from Colombia, we just got residency salary couple of years ago so the legistalation' still in the works so here YOU PAY to work 80-110 hour weeks for 4-5 years
I am a junior doctor in Germany and I’ve been working in hospital in internal medicine for about a year now. Out of the last 35 days I have worked on 32. I am already thinking about quitting my job because I have absolutely no quality of life. Every evening I am too tired to meet friends or enjoy myself. All I can do is think about work because I am afraid of making mistakes because I am overworked and less concentrated. I don’t know how to keep up with this for the next 7 years until I finish my training.
What the f*** How the hell are you now? Isn't Germany supposed to be a first world country caring for a everyone. Who planned your work schedule. I feel sorry about this for you.
We should cut out the parasitic administrators, insurance companies, and middlemen that exist in the medical system; then improve working conditions for doctors.
My husband is a middle man. But does more work than the higher administrators, however, he gets paid crap. It isn’t all the middle man’s fault. They get dumped on for little pay. My husband opened 3 new clinics for a hospital system, brought on 6 practitioners (2 Orthopedic surgeons, 2 family practice doctors, a new DNP, and a pediatrician), and saved the behavior health clinic. That was within the last 3 years. He hasn’t had a raise since he started with that system (which was 6 years ago). However, he has gotten raises for all the practitioners, is trying to save the DNP from getting fired (money reasons. Nothing else. Just to help the costs in the short term not long term). He has gotten the “Princess” ortho needs accepted, and the Princess doesn’t work as much. He picks and chooses what he does and refuses to work on knees. While he gets pennies. Literal pennies. It’s the up top, CEO, Presidents, COOs, CNOs, Hospital Lawyers Getting MILLIONS while passing down work to everyone else.
@@deo3367 Agreed, not all administrators are parasitic; we have to go after the ones who make bazillions of dollars by preying upon patients with surprise charges and overcharging. So parasitic vs. needed and non-parasitic middle men.
@@deo3367 The ultimate problem is capitalism in the US. It's all about the investors, squeezing as much profit out of the whole system to pay the investors and the top people obscene amounts of money. Government needs to rein in corporations, but politicians won't do that because the corporations give them money to not do that so it's a stalemate for the citizens who no longer can afford health care. This is not working!
Im a 1st year med student in the U.S. and I do truly believe that I am a part of the last generation where going to medical school is still somewhat justifiable, but give it another 10-20 years and it will be a lose lose life decision. I have a friend who works in infection prevention at a hospital, only needed a 4 year degree, is 25 years old and making >100k/year and gets an automatic 2% raise every year that can be higher depending on certain bench marks. Meanwhile doctors' pay is going down every year and they are working harder.
Working harder or doing more work. Not the same. Someone at Walmart does a lot of work but it's very simple and repetitive. Let's not lie to ourselves and think the majority of doctors are doing complicated problem solving
Honestly American and Canadian doctors IMO are really paid well compared to the rest of the world. In the UK and other European countries you get paid shit and residency training is longer because of the extra amount of years you have to work as a junior doctor before you can advance to residency. It gets worse when you’re from an African country, you work in such harsh conditions and get paid rubbish 🤦🏽♂️.
In Turkiye, doctors are underpaid + working 80+ hours a week depending on the specialty. And we have to do mandatory 500 days service in rural areas after the graduation and finishing the residency. The only better thing is med schools are free in Turkiye except private schools. That's why currently there is a huge brain drain especially towards Germany.
Maybe more controversial opinion is the opposite. I truly believe the vast majority of the work performed by most medical professionals is very simple and in many cases can be automated
I think the issues this doctor described in his video explain why I see a lot of young doctors from the UK coming to Australia to train. We have our own issues but the pay is much better for the conditions. Even in Aus though, considering the time spent trying to get into medical school in the first place, and the sheer amount of study and youth taken to get into training programs, the pay is still not enough, and there's still exploitation of junior doctors
@@DrCellini They don't just make make 33k btw. Most jobs that do nights and 'unsociable hours' (not FM, but most specialities) getting 40-50% banding. So 33k+ 50% = roughly 50k However, your salary slowly goes up and from 50k every stage of training and after 8years(2 as an intern, 3 as junior resident, 4-6 as senior) of training you become a consultant and make 85k gross per year. A consultant(attending) starting is 85k gross FOR ALL SPECIALITIES. I don't know a single IR doc who make more than an FM doc in the UK.
@@TharsisVolcano I’m assuming your numbers are in pounds and not dollars, which when converted (based on your numbers), amounts to roughly $110k-$130k a year, which is laughably low when compared to other countries. Imagine telling a neurosurgeon in the US, whom average $680k a year, that he/she is going to make $130k max, all while working the same hours and ridiculous call schedule, they ain’t gonna be happy.
Same for pharmacists. I graduated high school in 2005 in the midst of a major pharmacist shortage. Around that time, pharmacists were able to name their price within reason, and new grads were starting at $50-60/hr, getting student loan reimbursement, company paid BMWs, sign on bonuses. The projection was, by 2011-2012 when I’d be expected to graduate, salaries would continue to increase into the $200k level. Also, if you chose to go into business and own your own independent pharmacy, it was very profitable. Then many things happened. 2007 recession, boomers lost their retirements so they continued to work instead of retiring. More schools opened up. Hospitals began switching to EMR systems that drastically reduced necessary staffing levels/workload, since with a CPOE EMR system, the prescriber electronically enters the order instead of handwriting it on an order sheet. It completely eliminated the transcription step of our job, which was good because it helps reduce errors made in the transcription process and not having to interpret bad handwriting anymore. All of that turned the situation into a pharmacist surplus and killed the job growth. People started getting offered less money, no sign on bonuses, no reimbursement for student loans. There are some places offering $40-45/hr nowadays, which adjusted for inflation is less than half of what was being offered back in 2005.
@@torstenheling3830 American physicians have to fund the full cost of their education and training and do not rely on the nanny state. American physicians do not receive full pay for six months if they go off sick. American physicians do not retire early on taxpayer subsidised, gold plated, index linked pensions. American physicians have to take out expensive professional liability insurance and do not rely on the taxpayer to foot the bill for compensation claims for clinical negligence and associated legal costs. American physicians have to work longer hours than most European ones. What America pays its physicians is their business.
@@taffyterrier Then Americans are idiots. The taxpayers should fund free tuition for medical education, pay for early retirement (no older than 65 if the physician wants), require physicians work fewer hours, and then pay American physicians half what they earn now. They don’t deserve any more than a European physician. That’s rank stupidity. Typical dumb Americans not knowing how to run a society. A wake up call: the nanny State is good for everyone.
I guess the „nanny State“ is to blame for that free public education from K-12th grade your kids got, or for the cost of calling the police when you think something fishy was going on in your neighborhood, or the cost of the fire department putting out someone‘s house fire for free, instead of sending them a bill for $50000 for „services rendered“. Yeah, the nasty nanny State is to blame for building that big freeway you drive on for free or for all those roads in your town you drive on for free. Where do you draw the line on the big bad „nanny State“? Healthcare? Higher education? Why there and not on a bloated and overfunded US military?
Meanwhile in my country Indonesia, all residents must work 60-100+ hours every week, they don't get paid a single peanut AND have to PAY huge amount of money every semester to University. Sorry for my English.
I am in medical school and no one wants to do primary care because the salary is underpaid. Some of the salaries are barely above a nurse practioner or a physician assistant with way more responsibility. Then just a simple house now will cost $750k with the new market.
@Butter Milk exactly haha, it's the shortest training pathway, with the most autonomy over your work/life balance, and the easiest to make good money. Most GPs I know in my family locum and make £800-1000 per day working 9-5 and only work 3 days of the week.
52 yo surgeon here. Still have 43k in loan debt. No doubt the time loss of making money, dwindling reimbursement makes medicine a terrible career choice for young talented people in college. There is ever lessening incentive to go into medical career. I would not do it again if I could go back.
Not only doctors but pretty much all healthcare workers. Our pay hasn’t kept up with inflation but you look at places like Target, Chick-fil-A, etc, they are keeping up better than most hospitals!
@@DocwithaJ Yes. But radiologist won’t have anything to read without the employees that obtain those images. It’s a team effort and it’s a growing problem that is affecting more than just doctors.
@@DocwithaJ yet I would love to see doctors taking their times to clean up patients, and do EVERYTHING a tech would have to do, or housekeeping, or he’ll even a nurse. It takes a village for a hospital to run. Not just doctors. I would love to see all y’all doctors going to work and then being told “hey. So we cut a lot of costs… so you’re going to have to clean your rooms, do all of you own orders, and keep your patient’s clean. Remember… turn the patient’s every two hours! Hourly rounding on all of your patients! And we created this AMAZING system where you have to take your computer into the room, scan a bar code over a patient’s head, wake them up, ask them if they have to pee, or if they are in pain, need to change position, if they have the call light. Oh and you have to wear this tracker! Because we will be keeping track of how long you will be in the room! We will be posting it”. I would like to see that happen.
Doctors are no underpaid in the USA (in my perception). The doctors in my country (Colombia) They really are underpaid, they paid around 1,000 USD a month to a family doctor (12,000 USD a year) and around 5,000 USD to the surgeons. So you could be an engineer and make easily the same amount of money of a surgeon.
My high school friend is an anesthesiologist in Washington State and he went to medical school in England it’s called Saint Christopher supposedly a good medical school and his was very cheap. He had been a respiratory therapist in the United States for 14 years prior to going to medical school he did not even need to take out loans and then did his residency Emory University.
Be thankful for being a physician in the US. The situation in Europe is ridiculous. Not only are you getting paid less, but the taxes are much higher here and in certain countries if you’re an employee you can’t work more than 40 hours a week. It’s like « hey you wanna be rich? Sorry not here. » All in the name of « socialism ». God bless America. I’m working my ass off every day to get the hell out of here.
@@s.9417 France. I’m mostly interested in moving to Texas or some other state with zero state income tax (Nevada and TN are ones I consider highly). But really it doesn’t matter in the beginning, I just wanna get the hell out of here. too much regulations and government interventions
@@DrCellini yeah man.. now granted, you’re not in debt if you go to med school in France, BUT you’ll be paying exorbitant amounts of taxes for the rest of your life and the more money you make the more you taxes you pay. Nothing is free. Anyone who thinks we have « free » education or «free » healthcare has no idea what they’re talking about.
@@kad.k1 Bro Texas is cool but many people left NYC for Texas so might be expensive start. My advice is to start somehwere managable and see the regulations for your field to practice. you might need to to do some research first. TN is definitely a good choice, Nevada not sure how is it now. I feel you eventually will come here but make sure to ask a lot to utitilize your start in a good way. best wishes
In general in Europe, the residency is performed in the public health care system, not in private owned hospitals. The number of residents each year is decided by the Ministry of Health in conjunction with Universities of Medicine based on the capabilities of the hospitals to train residents. And the residents are paid by the Ministry of Health through the hospitals to which they are assigned as contract physician between 3 (family Medicine) and 7 years (neurosurgery). At least this how it is in my country, Romania. That's why there is a monopoly.
I love this video and you nailed it. Just imagine now being a State Veterinarian in Hawaii, one of the most $$$ states and being paid as "technical labor". Starting salaries for a State Veterinarian in Hawaii is $68,000. With an average graduating debt of over $100K and median cost of a home in HI at just over 1 million for a termite infested tiny box it is a wonder we can even find anyone to work for us. I love what I do mainly because of the work life balance but still...... The biggest stress is financial. We have a great group but are grossly underpaid and most only think we do Rabies quarantine stuff. Far from it.
1:06 - In the UK, 18yo goes to 5 years of university, this is Med school (not 4 years undergrad and 4 years med school like the US), then at 23yo they graduate, apply for the UK national match and become an FY1 upon section. 6:25 - Docs in the UK (NHS specifically) are held upon a pedestal in the eyes of the public and in the eyes of other doctors. It seems to be prideful and patriotic, in a similar fashion to the way US Military personnel are viewed, and, honestly, many UK docs seem to accept this recognition and reverence as part of their compensation. Also, UK private practices are growing faster than ever along with private health insurance. In these practices, exams are often covered (although, most every specialty can only train within the NHS but, there are a few caveats here) 7:44 - 18yo University/Med school, 23yo is FY1 called a junior doc (4th year/intern,) 24yo is FY2 called a junior doc (intern,) 25 to 32-35 is specialty training called a Registrar (Resident,) and then finally they are Consultants (Attendings) where it takes 19 years from this point (in your 50s...) to hit the max pay grade (~115k) as an NHS Doc. (Several caveats for the pay grade aspect and a few differences in training based on specialty like becoming a GP) It's late, I'm tired. Tons more nuance here but, this is good enough for now.
Hey that is a great video and I’d like to answer a couple questions that you had in the video. I graduated from medical school in United States in 1985 but one of the things I did during my training in medical school was I did my OB/GYN rotation at the Royal Free Hospital in London. So this is where my experience has come from. I also had to borrow my way through medical school back when the interest rates were 12% and there was no deferment of compounding of interest. Therefore on the day I graduated I owed twice as much as I had borrowed. I have worked as a pediatric emergency physician once I completed my 14 years of residency and subspecialty training for 32 years. So here goes: Being a consultant in the UK means that you’re a sub specialist pretty much everybody or the vast majority of the physicians become GPs general practitioners and work for the NHS. Life for doctors at the time I rotated at the Royal free was a bit more relaxed. For instance during my US internship in surgery I clocked 120 hours a week in hospital time. That was back in the day when we did not have night coverage so we worked 36 on 12 off 12 on and another 36 on in a typical every third night call. Salary for interns was 25K at the time. In contrast the Royal free had not one but two pubs in the hospital one for attendings and one for medical students. They also had a rugby team and I was privileged to be able to see the royal free rugby team win the hospital‘s cup for the first time in history while I was there. I also noticed that they did not worry at all about malpractice and in general didn’t really respect their patients as much as American doctors did. That said, I have traveled in Europe and have needed medical attention from time to time and never had to pay a fraction of what we pay in this country. As for burn out and other comments that you made about our country I totally agree. I have seen over the past 32 years medicine be raped by greed from not only corporations but from regulators on both sides of the fence we get it. It has caused me to retire much earlier than I planned to because it was killing my health and I couldn’t stand the corporate greed going on all around me. A lot of doctors are trying to do direct to patient care but this is difficult and there are many barriers put up by our greedy insurance companies and hospital systems. ZDoggMD talks alot about this in some of his videos. For profit medicine is NOT the answer it is the cancer that must be weeded out of healthcare.
Great to hear about your experience all those years ago. I'm a student at the university that the Royal Free is a part of, and I can confirm that the medical students' pub has now been converted to a common room 😪. It's still quite nice though.
You think that's bad, look at how teachers are paid for the work they do, and without them, there'd be no doctors, lawyers, CEO or politicians. Those college costs don't go toward professors pay. Teachers work long hours for poverty pay.
Not mentioned I think is the superb NHS pension plan (retirement plan). The employer puts in a large contribution each year and it's a final salary scheme that is gold plated as pensions go these days and an enormous benefit.
For a consultant in the UK which is the equivalent of an attending, the starting salary is £84,559 which is ~$110,000 and an experienced consultant makes £114,003 which is ~$152,000. This is their base pay and does not reflect any overtime or extra responsibilities which earn them extra e.g. management roles, teaching, departmental leads etc. I know of many consultants who earn between $180-300k with overtime or supplementary private practice, some others who make $300-500k and one who makes $750k but that’s in London where salaries can be wild at the top level with private practice.
@@taffyterrier What a strange comment. I was not comparing cleverness (although FYI the average iQ of a doctor has been estimated as 125 - 130 ). Are you from the UK? I was treated under the NHS. It was so bad I ended up in hospital after being misdiagnosed by a nurse who I was forced to see - even though I told her what the actual diagnosis was and how antibiotics would mask the results of testing she would not believe me.
for the monopsony thing i hope you read this basically in the US you ahve university programmes that essentially train you be it intern year or residency and they are all in their own right decentralised in a way in the UK training is only for NHS so until youre an attending you cant really work in a private set up like theres no rpivate hospital taht take charge in training residents those are all done in NHS hospital and only after they become consultants can they work in private healthcare( which is 3 yrs of IM training + 4 to 5 yrs of your speciality it varies according to specialities and depends on if your specialty is an uncoupled training programme or a run thru like neurosurgery paeds radiology where you apply once and go thru year 7 together in one go) so intern year which you guys have 1 they have 2 and its called Foundation year after which they do core medical or surgical training like in the US for IM then they do their residency for after which they become an attending( consultant) doctors in the UK work 40 hrs a week per month so its possible that they work excessively one week then have off days in between on calls are only 12 hrs strictly not 24 hrs so if youre on the night float youll be on the night float and off the entire next day and then do a normal day after that i dont know how the 12 hr on call works for surgeons in the OT
Swiss doctor here, the situation in Switzerland is very similar to the one in the UK and US. Another important factor that justifies the need for a higher salary: responsibility. Everyday we risk to KILL someone if we are not careful enough! We need to get together and FIGHT! Also, as a resident here a normal day is 12 hours of work! 5 fucking days a week! WTF?!
Why is ned school so $$$$? I'm an engineer, have taught, so I know the expense of outfitting a school's engineering lab. Big bucks, So, why the $$$$$ for med school?
This was a good reaction. However Drs in the US dont work harder than Doctors elsewhere. In fact Doctors elsewhere work MORE. They treat the contract as a mere suggestion....so that politically it can be said that these are the hours you work but everyone knows you dont leave until everything is done, you dont complain about being asked to work extra shifts and you dont get overtime. The rub lies in the wording of the contract. Doctors in most places are exhausted.
I did 4 years of nursing, now doing 4 more years to get MD (curently on my last year). Then I have to do 1 year of obligatory general residency (akin to foundation in the UK), finishing with 5-6 years to become a specialist. So all in all 14/15 years to end up working shifts and weekends for average pay... The only good thing is that I didn't have to get into debt for it
Canadian IM resident here, excellent video guys! This is spot-on for most healthcare systems around the world. Wages have not kept up with inflation and school debt has skyrocketed. Granted, this is true of most fields, but what is often hidden is the time it takes to become a full-fledged physician in your 20s (into your 30s). The "you'll be fine" as a doctor comment is tough to swallow as you watch your peers start their full-fledged careers nearly a decade before you with less debt and set up investments/buy property to get ahead. All the while there is a large amount of responsibility placed on residents who are working long hours without any real compensation (I think my averaged-out salary is about $11 CAD/hr lol). We are typically the first ones in to make urgent/emergency decisions for crashing patients in hospital, and do a large amount of overnight call (I do a 26-hour shift 1 in every 4 days). I love what I do, but I can't blame people for trying to find better work environments and pay. The traits required to be a great physician (work ethic, organization, performance under pressure, and people skills) are well-rewarded elsewhere. In addition, it's tough to argue for better pay as a trainee as it's an engrained "process" to become a doctor, and even as a staff physician/consultant it's not negotiable as you're already perceived as well-off.
Similar situation in Australia. It's a legacy of years of politicians and economists stigmatising doctors as rich volvo driving golf playing physicians.
I see a lot of uk doctors here in Canada. Also a lot from South Africa. It seems we have way more doctors from out of the country then we do natural born citizens. I’m not sure where our doctors go, we graduate quite a few every year.
I am a doctor and we are underpaid. The hours we put in, the incredibly stressful situations we deal with and have minutes to act is not worth the money we are paid. I would rather make less money doing less stressful stuff and fewer hours but have a good life. As soon as I pay off my loans I'm doing something else - this job really sucks
There is a reason I went into mental health counseling and got my PhD. instead of going into medical school. Will be graduating next month with only 5k in student loans
I'm an engineer, have taught, I've gotta wonder why med school is so $$$. The cost of outfitting an school's engineering lab is very expensive, so why is med school $$$$$.
Apparently, the training situation is a bit similar to Portugal, which also has a free National Healthcare System. After we finish medical school (6 years), we do a final exam, so that we can be ranked into a specialty. We then proceed to a full year rotating specialties and then apply to a medical specialty. You can only enroll in a (4-6) year of training to become a specialist in hospitals that belong to the national healthcare system and that provide those programs. These programs have to meet quality and training criteria (for example, a certain number of internships / rotations /procedures etc), By doing so, since you'll be working, you have to get a contract. Private practice isn't interested in hemorrhaging money making Specialists. Instead, they just snatch young doctors after they become physician specialists without contributing a cent to their education. Since our Healthcare is built upon a free system, usually the best hospitals, with the best doctors and professors, are public, particularly the "central" teaching hospitals. Private practice, in my opinion, is a money-making machine, that when things go bad or the patients run out of money, kicks them back to non-private hospitals to deal with the fallout.
Can you address the glaring problem of hospitalists. I don’t know when this happened but I remember your own primary care physician was often responsible for your care or would be involved or would minor the treatment plan. A week ago my elderly mother had a fall and needed partial hip surgery, the surgery went successful. However the hospitalists who works for the hospital and has an interest reducing the costs for the hospital and not for the patient discharged my mother 2 days after surgery even though we felt her incision would still take a few more days to heal, her arms were swollen and she was not eating. Two days later our beloved mother died at the rehab. I blame the hospitalist for rushing her out of an environment where she could have been better monitor and her symptoms could have been better managed than at a rehab facility with no physical on site.
That's really terrible, sorry to hear about your loss.. I wonder if it was a combination of the hospitalists and administration (I know everyone likes to make administration the bogeyman but still). In my experience with talking to hospitalists, a lot of them tell me that they always have administrators harping on them to discharge patients super quickly and efficiently. Not sure where the disconnect is though. Definitely could be both.
There's much scope for specialist doctors in the u.a.e where they compensate them fairly. I'm not even into a residency but I'm already looking to explore other options after I graduate !
Had a mechanical engineer friend from Ireland. Said it wasn't possible (told by his firm) to be a Sr. Engineer there before you were 40 -- licenses, exams and all. No (compensated) responsibility till then. To design sewage treatment plants... Moved to the US and worked as a service engineer in the Semi business for the money. Trying to think of an EE or ME engineer I've known who was senior before ~35 other than by starting a company and getting there via an IP or equity swap when acquired by a bigger firm.
Excellent video. Issues were discussed clearly. I went to study uk healthcare in 2005 for MHA program. The hospital reminder me of stepping back to the 1980s. Sharing equipment etc. of course waiting lists for non emergent procedures. However, at least all citizens have access to care. It is disgusting that all US citizens do not have access. I did see a private insurance company in England. People who can afford private get private insurance. I think that is very cool 😊
Comparing pay is a lot more nuanced. In the US, even with high student loans and a late start, unless you insist on living in an extremely high cost of living area, then moderate financial discipline will get you debt free and financially independent restively early in life compared to most. You will have to resist pressures to live a stereotypical (in some fields, antiquated) “rich doctor” lifestyle, but you will be comfortable. Is that fair compensation for your sacrifices? Maybe maybe not. When comparing to other countries, it gets much more complicated. I’m slightly familiar with at least one other universal healthcare country. Physicians pay on the surface seems much much lower. However, it’s unionized and you get substantial union and government benefits plus a potentially generous pension plan which is pretty much non existent in the US. Again, purely from a financial and professional perspective, it’s hard to compare and both can be seen as very good viable life choices/careers. It’s important to look at the bigger picture. More importantly: Workload and burnout need to be addressed, more power on the hands of doctors not insurance and admin. Physician jobs have the potential to be extremely rewarding even if they were paid more modestly, but that aspect is being strangled out of the profession.
If you guys are interested in the U.S. healthcare system. You should really check out The Price We Pay by Dr. Marty Mackay. Great book really talks about the cost of our system. I highly recommend it.
In India also doctors getting low pay ..that is really too low.. bcz such money is not enough for ur daily base... Other people's are getting higher then medicinal feild
Fantastic video! One of the best courses I took as an undergrad was comparative health economics. A blend between the German and American system (eliminating for-profit health insurance) would be awesome, but America loves its admin salaries :’)
I don't understand why if u have to pay already just tto go to med school/ residents ect then on top of that u have to pay for exams and certifications! We have such a shortage of doctors u would think 🤔 school should be free. The government should pay it all. I fully agree this guy! Like why go into medicine? That's just wrong. Thanks for video
So why are people still pursuing medicine in the UK? These are very smart kids competing at this level. They will not make foolish decisions if the payoff is not there.
Someone told me, “as a doctor you won’t have a problem putting food on the table.” Even though physician salaries aren’t looking great, it’s still enough to pay off debts and live a comfortable life. And I think it always will be. There is unfairness in many career fields, but as long as you love what you do I think the unfairness is easier to look past.
Poor doctor. I make more as an RN here in the USA than that doctor. I have only been an RN for 8 years and have a BSN. I make easily over 6 figures and get days off at a time! Less debt too!
The NHS requirement is 35 hours per week and physicians can supplement income in the private sector with Kaiser like HMOs like BUPA but even this is not enough to stop a major brain drain of docs to AUS, NZ and US or into administrative jobs at the NHS
Wrong - every doctor is rotated for 48hrs a week Perhaps only consultants in certain specialties can negotiate this. But the contracts are always on 48hrs a week.
A lot of people don’t understand that doctors and other healthcare professionals or staff working with patients should be paid high wages; the stress and responsibility that comes with taking care of and dealing with patients lives is invaluable and expensive. You kill someone by accident your career could be over, make a mistake career could be over. It’s not like other jobs where the death of someone doesn’t directly impact you because it’s not your responsibility. For anyone working in the NHS it is and not only would you be causing yourself to feel low but people in the public would additionally. It really is a matter of responsibility is equal to pay if you feel pay should be low responsibility should be low as well, none of us would accept the death of a family member to a irresponsible doctor so the same should be true for pay.
Folks are always going to want to be physicians. French and UK doctors are willing to accept a lot less to be doctors, and if American doctors think it won’t happen to us, then we have blinders on. It’s not a good trend for US MDs (I’m one), but it is what will happen.
I hope not! We lost yrs of life and time with family/friends sacrificing for this career. There has to be a financial reward at the end to help us build our own lives.
I feel doctors , nurses, police, paramedics, fire fighter, teachers and all the people that are responsible for keeping society safe and advancing are undervalued. Athletes and entertainment is ridiculously paid. ( I read base ball player min wage went from 600,000 to 700,000 😮) But don’t think we can blame government and corporations. If our society values entertainment over a functional and safe community then thats a societal flaw and we need to take responsibility for this trend.
Doctors are underpaid because a lot of responsabilities are exclusively safe guarded for them via legislation, in most countries. If one does believe dumping more money in a already expensive pro is the only viable solution then a lot more MDs will continue to be underpaid.
So the 2 year foundation… year one is internship where you rotate and work as a doctor in all 4 major medical specialities (OBGYN, Peds, Internal Medicine and Surgery) the send year is called senior house officer…. In which you can choose any speciality you wish to get more experience in…. Then after those two years you then apply for a speciality you want to pursue and yes consultancy is the UK version of the American attending
Correct me if I'm wrong. It is my understanding that education loans can be forgiven if the graduate does some community service. I do know that the US military will pay all med school expenses.
Every medical student/physician that supports the idea of nationalized healthcare in the US needs to watch this video to see exactly how bad things can go. In America, the best and brightest go into medicine in large part of the financial incentives that are guaranteed at the end of years of sacrifice. Take those incentives away and you will undoubtedly see a drop in quality of those applying to medical school
Thanks so much for your kind and considered response Dr Cellini - a huge privilege to be featured and hear your thoughts.
Just trying to clear up a few things
1) My bio was very out of date(!) - I'm now a Foundation Year 1 doctor (sort of equivalent to a PGY1 resident/intern)
2) Our training works as follows - you finish medical school (usually 5 years), then must complete 2 years of generalist rotations in medicine and surgery (the Foundation Programme), after which you then complete 2-3 years of generalist training in medicine OR surgery (called Core Training),and only then after all that you become a resident (registrar) in a given specialty for 3-4 years, and then you ultimately become a consultant (attending).
3) The hours of work question is always difficult. Officially I'm employed for 48 hours, but when I was working in surgery was doing anywhere between 50-60 hours per week with all those additional hours unpaid. That's still of course nothing compared to what US residents do, but there's still very much a culture of staying until the work is done despite the salary and prospects not keeping pace with expectations.
Most people also do not do 4 years of undergrad in the UK that is required here in the US, correct? Also wondering how competitive the application process is for medical school is? In the U.S. it is slightly less than 40%. What do you do if you do not get in after your first try? I personally did not and it took me a couple of cycles of work plus post-bach to get in.
Although overall I will say, I am very happy to be in medicine in the U.S. I do not know if I would feel the same if I were in other countries.
@@MrAbubakrz That's right sir. If you apply as an undergrad straight from high school, it can be anywhere from around 4-10 applicants per place depending on which schools you apply for (with the caveat that you can only ever apply to 4 universities per year for medicine). If you apply WITH an undergraduate degree already (like I did) it tends to fall more in the range of 8-25 applicants per place. Still very competitive and can take a few cycles to get in.
thanks for sharing! i watched your video and was very informative. keep sharing your thoughts!
So, 17 years out of high school to become a full doctor at 35 years old.
Resident income is truly the biggest slap in the face in healthcare imo- making the big decisions as a physician with lives on your hand for 80hr work weeks for 60k/yr. For example… some targets employees are making 24/hr to be a cashier now. 80hrs a week as a target cashier makes 2400/week (1.5x OT) or 124k/yr as a target employee. And they’re not 270k in debt…
You’re delusional if you think target pays cashiers 24/hr
That come-on from Target was not what it seemed. They pay that for their top people like store manager or district manager or higher. Same as a lie to me. Tells me your can't trust Target for anything. Bad PR move if you ask me.
Ya well NO one wants to be a target cashier and literally 5000 people apply for 100 spots in med school because they know eventually they make 400-500k a year often and can pay off that debt in 4 years. Meanwhile they get all the social status, gold digging whores, and attention and pats of the back a person could possibly take. Maybe your just ugly and you thought women would like you because you started making mad cash? They will gold dig off your but never actually like YOU. Residents should be paid more but not much. Nurses make 84k to do equal hours as a resident. I'm a nurse on a teaching medicine unit so I know exactly how much work residents actually do. We get a new set every 8 weeks. We work just as hard, have to actually be on our feet for most of our shifts not sit at a desk or computer, have just as much responsibility as a resident becauses it's up to us to judge whether we trust the resident and to call the attending instead (who is never there). So resident should be paid more but an attending should be paid WAY less. Everyone knows there is a pot of gold at the end and that's why EVERYONE does it.
@@ryaniam22 It's always good to hear all sides of issues. I hear financial talk of F.I.R.E. (financial independence, retire early) which interests more and more doctors for many of the same reasons noted in this video. I suspect Dr. Cellini is not unaware of this. The strategy is to keep on living frugally for a few more years, paying off debt and investing wisely. Then when the time is right and the money has been amassed, live off your investments and do whatever you want, however you want. Doctors have the ability to do that as few others do. Specialists are paid too much and primary care far too little. Mostly, the whole system in the US is a royal mess which makes health care here twice as expensive as it should be. Why can't we change that?!!!!!!!!!!
If they are paid, there are still lots of places in the world where juniors, interns and residents are not paid, Im from Colombia, we just got residency salary couple of years ago so the legistalation' still in the works so here YOU PAY to work 80-110 hour weeks for 4-5 years
I am a junior doctor in Germany and I’ve been working in hospital in internal medicine for about a year now. Out of the last 35 days I have worked on 32. I am already thinking about quitting my job because I have absolutely no quality of life. Every evening I am too tired to meet friends or enjoy myself. All I can do is think about work because I am afraid of making mistakes because I am overworked and less concentrated. I don’t know how to keep up with this for the next 7 years until I finish my training.
What the f***
How the hell are you now?
Isn't Germany supposed to be a first world country caring for a everyone. Who planned your work schedule. I feel sorry about this for you.
Everyone is underpaid. No one can survive with all the prices going up.
We should cut out the parasitic administrators, insurance companies, and middlemen that exist in the medical system; then improve working conditions for doctors.
My husband is a middle man. But does more work than the higher administrators, however, he gets paid crap. It isn’t all the middle man’s fault. They get dumped on for little pay. My husband opened 3 new clinics for a hospital system, brought on 6 practitioners (2 Orthopedic surgeons, 2 family practice doctors, a new DNP, and a pediatrician), and saved the behavior health clinic. That was within the last 3 years. He hasn’t had a raise since he started with that system (which was 6 years ago).
However, he has gotten raises for all the practitioners, is trying to save the DNP from getting fired (money reasons. Nothing else. Just to help the costs in the short term not long term). He has gotten the “Princess” ortho needs accepted, and the Princess doesn’t work as much. He picks and chooses what he does and refuses to work on knees. While he gets pennies. Literal pennies.
It’s the up top, CEO, Presidents, COOs, CNOs, Hospital Lawyers Getting MILLIONS while passing down work to everyone else.
I think this is where blockchain technology could be incorporated
@@deo3367 Agreed, not all administrators are parasitic; we have to go after the ones who make bazillions of dollars by preying upon patients with surprise charges and overcharging. So parasitic vs. needed and non-parasitic middle men.
Haha. You described government health. Get ready of government pay.
@@deo3367 The ultimate problem is capitalism in the US. It's all about the investors, squeezing as much profit out of the whole system to pay the investors and the top people obscene amounts of money. Government needs to rein in corporations, but politicians won't do that because the corporations give them money to not do that so it's a stalemate for the citizens who no longer can afford health care. This is not working!
Im a 1st year med student in the U.S. and I do truly believe that I am a part of the last generation where going to medical school is still somewhat justifiable, but give it another 10-20 years and it will be a lose lose life decision. I have a friend who works in infection prevention at a hospital, only needed a 4 year degree, is 25 years old and making >100k/year and gets an automatic 2% raise every year that can be higher depending on certain bench marks. Meanwhile doctors' pay is going down every year and they are working harder.
What degree do you need for infection prevention?
Working harder or doing more work. Not the same. Someone at Walmart does a lot of work but it's very simple and repetitive. Let's not lie to ourselves and think the majority of doctors are doing complicated problem solving
Honestly American and Canadian doctors IMO are really paid well compared to the rest of the world. In the UK and other European countries you get paid shit and residency training is longer because of the extra amount of years you have to work as a junior doctor before you can advance to residency. It gets worse when you’re from an African country, you work in such harsh conditions and get paid rubbish 🤦🏽♂️.
In Turkiye, doctors are underpaid + working 80+ hours a week depending on the specialty. And we have to do mandatory 500 days service in rural areas after the graduation and finishing the residency. The only better thing is med schools are free in Turkiye except private schools. That's why currently there is a huge brain drain especially towards Germany.
Same in india as well
Maybe more controversial opinion is the opposite. I truly believe the vast majority of the work performed by most medical professionals is very simple and in many cases can be automated
Really Like the video! Would love a collab between the two of you discussing all the differences between the US and UK healthcare systems.
That's a good idea. Maybe Dr. C will read your comment and consider this.
I think the issues this doctor described in his video explain why I see a lot of young doctors from the UK coming to Australia to train. We have our own issues but the pay is much better for the conditions. Even in Aus though, considering the time spent trying to get into medical school in the first place, and the sheer amount of study and youth taken to get into training programs, the pay is still not enough, and there's still exploitation of junior doctors
It seems to me that every country has issues with medical education
@@DrCellini They don't just make make 33k btw. Most jobs that do nights and 'unsociable hours' (not FM, but most specialities) getting 40-50% banding.
So 33k+ 50% = roughly 50k
However, your salary slowly goes up and from 50k every stage of training and after 8years(2 as an intern, 3 as junior resident, 4-6 as senior) of training you become a consultant and make 85k gross per year.
A consultant(attending) starting is 85k gross FOR ALL SPECIALITIES.
I don't know a single IR doc who make more than an FM doc in the UK.
@@TharsisVolcano
I’m assuming your numbers are in pounds and not dollars, which when converted (based on your numbers), amounts to roughly $110k-$130k a year, which is laughably low when compared to other countries. Imagine telling a neurosurgeon in the US, whom average $680k a year, that he/she is going to make $130k max, all while working the same hours and ridiculous call schedule, they ain’t gonna be happy.
@@TharsisVolcano check the newest junior doctor contact. Most docs in the UK don't get this banding system.
It's not much better in Australia. $37 for a basic GP consultation but my dentist just charged $300 for exam and teeth cleaning.
Same for pharmacists.
I graduated high school in 2005 in the midst of a major pharmacist shortage. Around that time, pharmacists were able to name their price within reason, and new grads were starting at $50-60/hr, getting student loan reimbursement, company paid BMWs, sign on bonuses.
The projection was, by 2011-2012 when I’d be expected to graduate, salaries would continue to increase into the $200k level. Also, if you chose to go into business and own your own independent pharmacy, it was very profitable.
Then many things happened. 2007 recession, boomers lost their retirements so they continued to work instead of retiring. More schools opened up. Hospitals began switching to EMR systems that drastically reduced necessary staffing levels/workload, since with a CPOE EMR system, the prescriber electronically enters the order instead of handwriting it on an order sheet. It completely eliminated the transcription step of our job, which was good because it helps reduce errors made in the transcription process and not having to interpret bad handwriting anymore.
All of that turned the situation into a pharmacist surplus and killed the job growth. People started getting offered less money, no sign on bonuses, no reimbursement for student loans.
There are some places offering $40-45/hr nowadays, which adjusted for inflation is less than half of what was being offered back in 2005.
US physicians make $350,000 per year. That’s a rip off for healthcare insurers. The average salary for a UK physician 76,300£ ($99,100).
US physicians are clever.
@@taffyterrier American physicians are no better and work no more hours than European ones. So why three times the salary? Makes no sense.
@@torstenheling3830 American physicians have to fund the full cost of their education and training and do not rely on the nanny state. American physicians do not receive full pay for six months if they go off sick. American physicians do not retire early on taxpayer subsidised, gold plated, index linked pensions. American physicians have to take out expensive professional liability insurance and do not rely on the taxpayer to foot the bill for compensation claims for clinical negligence and associated legal costs. American physicians have to work longer hours than most European ones. What America pays its physicians is their business.
@@taffyterrier Then Americans are idiots. The taxpayers should fund free tuition for medical education, pay for early retirement (no older than 65 if the physician wants), require physicians work fewer hours, and then pay American physicians half what they earn now. They don’t deserve any more than a European physician. That’s rank stupidity. Typical dumb Americans not knowing how to run a society. A wake up call: the nanny State is good for everyone.
I guess the „nanny State“ is to blame for that free public education from K-12th grade your kids got, or for the cost of calling the police when you think something fishy was going on in your neighborhood, or the cost of the fire department putting out someone‘s house fire for free, instead of sending them a bill for $50000 for „services rendered“. Yeah, the nasty nanny State is to blame for building that big freeway you drive on for free or for all those roads in your town you drive on for free. Where do you draw the line on the big bad „nanny State“? Healthcare? Higher education? Why there and not on a bloated and overfunded US military?
Meanwhile in my country Indonesia, all residents must work 60-100+ hours every week, they don't get paid a single peanut AND have to PAY huge amount of money every semester to University.
Sorry for my English.
I am in medical school and no one wants to do primary care because the salary is underpaid. Some of the salaries are barely above a nurse practioner or a physician assistant with way more responsibility. Then just a simple house now will cost $750k with the new market.
The housing market will go down. Won't be overnight but it will
@@mustang8206 I really hope so
@@mustang8206 No it won't. Private equity firms are buying up literal blocks of housing as rentals.
@Butter Milk exactly haha, it's the shortest training pathway, with the most autonomy over your work/life balance, and the easiest to make good money. Most GPs I know in my family locum and make £800-1000 per day working 9-5 and only work 3 days of the week.
52 yo surgeon here. Still have 43k in loan debt. No doubt the time loss of making money, dwindling reimbursement makes medicine a terrible career choice for young talented people in college. There is ever lessening incentive to go into medical career. I would not do it again if I could go back.
Ollie is very intelligent and hard working. I've been wathcing his videos for some time. Thanks for doing this one!
Not only doctors but pretty much all healthcare workers. Our pay hasn’t kept up with inflation but you look at places like Target, Chick-fil-A, etc, they are keeping up better than most hospitals!
This is an all lives matter argument. Save it for another post. It's time we focus on doctors pay for once.
@@cstuartdc doctors are what makes hospitals money. Not other providers.
@@DocwithaJ Yes. But radiologist won’t have anything to read without the employees that obtain those images. It’s a team effort and it’s a growing problem that is affecting more than just doctors.
@@DocwithaJ yet I would love to see doctors taking their times to clean up patients, and do EVERYTHING a tech would have to do, or housekeeping, or he’ll even a nurse. It takes a village for a hospital to run. Not just doctors.
I would love to see all y’all doctors going to work and then being told “hey. So we cut a lot of costs… so you’re going to have to clean your rooms, do all of you own orders, and keep your patient’s clean. Remember… turn the patient’s every two hours! Hourly rounding on all of your patients! And we created this AMAZING system where you have to take your computer into the room, scan a bar code over a patient’s head, wake them up, ask them if they have to pee, or if they are in pain, need to change position, if they have the call light. Oh and you have to wear this tracker! Because we will be keeping track of how long you will be in the room! We will be posting it”. I would like to see that happen.
@@deo3367 people that say all lives matter at a black lives matter protest are wrong. You're doing the same.
Doctors are no underpaid in the USA (in my perception). The doctors in my country (Colombia) They really are underpaid, they paid around 1,000 USD a month to a family doctor (12,000 USD a year) and around 5,000 USD to the surgeons. So you could be an engineer and make easily the same amount of money of a surgeon.
My high school friend is an anesthesiologist in Washington State and he went to medical school in England it’s called Saint Christopher supposedly a good medical school and his was very cheap. He had been a respiratory therapist in the United States for 14 years prior to going to medical school he did not even need to take out loans and then did his residency Emory University.
No med school in the uk called st. chris
@@jaybee1196 don’t be a ass. en.wikipedia.org/wiki/St_Christopher_Iba_Mar_Diop_College_of_Medicine. He is doing fine btw
Be thankful for being a physician in the US. The situation in Europe is ridiculous. Not only are you getting paid less, but the taxes are much higher here and in certain countries if you’re an employee you can’t work more than 40 hours a week. It’s like « hey you wanna be rich? Sorry not here. » All in the name of « socialism ». God bless America. I’m working my ass off every day to get the hell out of here.
Which country are you in? Try to aim for Midwest if you’re coming soon, east coast would be expensive start.. good luck
I didn't even consider taxes...
@@s.9417 France. I’m mostly interested in moving to Texas or some other state with zero state income tax (Nevada and TN are ones I consider highly). But really it doesn’t matter in the beginning, I just wanna get the hell out of here. too much regulations and government interventions
@@DrCellini yeah man.. now granted, you’re not in debt if you go to med school in France, BUT you’ll be paying exorbitant amounts of taxes for the rest of your life and the more money you make the more you taxes you pay. Nothing is free. Anyone who thinks we have « free » education or «free » healthcare has no idea what they’re talking about.
@@kad.k1 Bro Texas is cool but many people left NYC for Texas so might be expensive start. My advice is to start somehwere managable and see the regulations for your field to practice. you might need to to do some research first. TN is definitely a good choice, Nevada not sure how is it now. I feel you eventually will come here but make sure to ask a lot to utitilize your start in a good way. best wishes
In general in Europe, the residency is performed in the public health care system, not in private owned hospitals. The number of residents each year is decided by the Ministry of Health in conjunction with Universities of Medicine based on the capabilities of the hospitals to train residents. And the residents are paid by the Ministry of Health through the hospitals to which they are assigned as contract physician between 3 (family Medicine) and 7 years (neurosurgery). At least this how it is in my country, Romania. That's why there is a monopoly.
I love this video and you nailed it. Just imagine now being a State Veterinarian in Hawaii, one of the most $$$ states and being paid as "technical labor". Starting salaries for a State Veterinarian in Hawaii is $68,000. With an average graduating debt of over $100K and median cost of a home in HI at just over 1 million for a termite infested tiny box it is a wonder we can even find anyone to work for us. I love what I do mainly because of the work life balance but still...... The biggest stress is financial. We have a great group but are grossly underpaid and most only think we do Rabies quarantine stuff. Far from it.
1:06 - In the UK, 18yo goes to 5 years of university, this is Med school (not 4 years undergrad and 4 years med school like the US), then at 23yo they graduate, apply for the UK national match and become an FY1 upon section.
6:25 - Docs in the UK (NHS specifically) are held upon a pedestal in the eyes of the public and in the eyes of other doctors. It seems to be prideful and patriotic, in a similar fashion to the way US Military personnel are viewed, and, honestly, many UK docs seem to accept this recognition and reverence as part of their compensation. Also, UK private practices are growing faster than ever along with private health insurance. In these practices, exams are often covered (although, most every specialty can only train within the NHS but, there are a few caveats here)
7:44 - 18yo University/Med school, 23yo is FY1 called a junior doc (4th year/intern,) 24yo is FY2 called a junior doc (intern,) 25 to 32-35 is specialty training called a Registrar (Resident,) and then finally they are Consultants (Attendings) where it takes 19 years from this point (in your 50s...) to hit the max pay grade (~115k) as an NHS Doc. (Several caveats for the pay grade aspect and a few differences in training based on specialty like becoming a GP)
It's late, I'm tired. Tons more nuance here but, this is good enough for now.
The British public’s belief that indigenous NHS doctors are lifesaving altruists is naive in the extreme.
LIke Dr. Cellini mentioned before. Making medical school cheaper would be much helpful too!!
I'm an italian resident and we get paid around 19k euros a year here...
I'm a resident doctor in Lithuania. ~12k € annual salary here!
Hey that is a great video and I’d like to answer a couple questions that you had in the video. I graduated from medical school in United States in 1985 but one of the things I did during my training in medical school was I did my OB/GYN rotation at the Royal Free Hospital in London. So this is where my experience has come from. I also had to borrow my way through medical school back when the interest rates were 12% and there was no deferment of compounding of interest. Therefore on the day I graduated I owed twice as much as I had borrowed. I have worked as a pediatric emergency physician once I completed my 14 years of residency and subspecialty training for 32 years. So here goes:
Being a consultant in the UK means that you’re a sub specialist pretty much everybody or the vast majority of the physicians become GPs general practitioners and work for the NHS. Life for doctors at the time I rotated at the Royal free was a bit more relaxed. For instance during my US internship in surgery I clocked 120 hours a week in hospital time. That was back in the day when we did not have night coverage so we worked 36 on 12 off 12 on and another 36 on in a typical every third night call. Salary for interns was 25K at the time. In contrast the Royal free had not one but two pubs in the hospital one for attendings and one for medical students. They also had a rugby team and I was privileged to be able to see the royal free rugby team win the hospital‘s cup for the first time in history while I was there. I also noticed that they did not worry at all about malpractice and in general didn’t really respect their patients as much as American doctors did. That said, I have traveled in Europe and have needed medical attention from time to time and never had to pay a fraction of what we pay in this country. As for burn out and other comments that you made about our country I totally agree. I have seen over the past 32 years medicine be raped by greed from not only corporations but from regulators on both sides of the fence we get it. It has caused me to retire much earlier than I planned to because it was killing my health and I couldn’t stand the corporate greed going on all around me. A lot of doctors are trying to do direct to patient care but this is difficult and there are many barriers put up by our greedy insurance companies and hospital systems. ZDoggMD talks alot about this in some of his videos. For profit medicine is NOT the answer it is the cancer that must be weeded out of healthcare.
Great to hear about your experience all those years ago. I'm a student at the university that the Royal Free is a part of, and I can confirm that the medical students' pub has now been converted to a common room 😪. It's still quite nice though.
That must have been a long time ago
You think that's bad, look at how teachers are paid for the work they do, and without them, there'd be no doctors, lawyers, CEO or politicians. Those college costs don't go toward professors pay. Teachers work long hours for poverty pay.
Not mentioned I think is the superb NHS pension plan (retirement plan). The employer puts in a large contribution each year and it's a final salary scheme that is gold plated as pensions go these days and an enormous benefit.
For a consultant in the UK which is the equivalent of an attending, the starting salary is £84,559 which is ~$110,000 and an experienced consultant makes £114,003 which is ~$152,000. This is their base pay and does not reflect any overtime or extra responsibilities which earn them extra e.g. management roles, teaching, departmental leads etc. I know of many consultants who earn between $180-300k with overtime or supplementary private practice, some others who make $300-500k and one who makes $750k but that’s in London where salaries can be wild at the top level with private practice.
Only a fraction of consultants make that money through private and it's largely down to who you know
That's not much compared to a senior finance manager or barrister of comparable seniority.
@@Prtyh You have to be clever to be a senior finance manager or a barrister.
@@taffyterrier What a strange comment. I was not comparing cleverness (although FYI the average iQ of a doctor has been estimated as 125 - 130 ). Are you from the UK? I was treated under the NHS. It was so bad I ended up in hospital after being misdiagnosed by a nurse who I was forced to see - even though I told her what the actual diagnosis was and how antibiotics would mask the results of testing she would not believe me.
for the monopsony thing i hope you read this
basically in the US you ahve university programmes that essentially train you be it intern year or residency and they are all in their own right decentralised in a way
in the UK training is only for NHS so until youre an attending you cant really work in a private set up
like theres no rpivate hospital taht take charge in training residents those are all done in NHS hospital and only after they become consultants can they work in private healthcare( which is 3 yrs of IM training + 4 to 5 yrs of your speciality it varies according to specialities and depends on if your specialty is an uncoupled training programme or a run thru like neurosurgery paeds radiology where you apply once and go thru year 7 together in one go)
so intern year which you guys have 1 they have 2 and its called Foundation year after which they do core medical or surgical training like in the US for IM then they do their residency for after which they become an attending( consultant)
doctors in the UK work 40 hrs a week per month so its possible that they work excessively one week then have off days in between
on calls are only 12 hrs strictly not 24 hrs so if youre on the night float youll be on the night float and off the entire next day and then do a normal day after that
i dont know how the 12 hr on call works for surgeons in the OT
Swiss doctor here, the situation in Switzerland is very similar to the one in the UK and US.
Another important factor that justifies the need for a higher salary: responsibility. Everyday we risk to KILL someone if we are not careful enough!
We need to get together and FIGHT!
Also, as a resident here a normal day is 12 hours of work! 5 fucking days a week! WTF?!
Yes it’s more hours in Us with less pay and interestingly no one has complained until now.
Becoming a doctor is truly not worth it in todays day and age.
In Puerto Rico "U.S.A" a General practitioner starts $60-$70K a year with the same debt as main land. Do the math. It's NOT worth it.
Why is ned school so $$$$? I'm an engineer, have taught, so I know the expense of outfitting a school's engineering lab. Big bucks, So, why the $$$$$ for med school?
This was a good reaction. However Drs in the US dont work harder than Doctors elsewhere. In fact Doctors elsewhere work MORE. They treat the contract as a mere suggestion....so that politically it can be said that these are the hours you work but everyone knows you dont leave until everything is done, you dont complain about being asked to work extra shifts and you dont get overtime. The rub lies in the wording of the contract. Doctors in most places are exhausted.
I did 4 years of nursing, now doing 4 more years to get MD (curently on my last year). Then I have to do 1 year of obligatory general residency (akin to foundation in the UK), finishing with 5-6 years to become a specialist. So all in all 14/15 years to end up working shifts and weekends for average pay... The only good thing is that I didn't have to get into debt for it
I completely agree with this!
Canadian IM resident here, excellent video guys! This is spot-on for most healthcare systems around the world. Wages have not kept up with inflation and school debt has skyrocketed. Granted, this is true of most fields, but what is often hidden is the time it takes to become a full-fledged physician in your 20s (into your 30s). The "you'll be fine" as a doctor comment is tough to swallow as you watch your peers start their full-fledged careers nearly a decade before you with less debt and set up investments/buy property to get ahead. All the while there is a large amount of responsibility placed on residents who are working long hours without any real compensation (I think my averaged-out salary is about $11 CAD/hr lol). We are typically the first ones in to make urgent/emergency decisions for crashing patients in hospital, and do a large amount of overnight call (I do a 26-hour shift 1 in every 4 days).
I love what I do, but I can't blame people for trying to find better work environments and pay. The traits required to be a great physician (work ethic, organization, performance under pressure, and people skills) are well-rewarded elsewhere. In addition, it's tough to argue for better pay as a trainee as it's an engrained "process" to become a doctor, and even as a staff physician/consultant it's not negotiable as you're already perceived as well-off.
Similar situation in Australia. It's a legacy of years of politicians and economists stigmatising doctors as rich volvo driving golf playing physicians.
I see a lot of uk doctors here in Canada. Also a lot from South Africa. It seems we have way more doctors from out of the country then we do natural born citizens. I’m not sure where our doctors go, we graduate quite a few every year.
I am a doctor and we are underpaid. The hours we put in, the incredibly stressful situations we deal with and have minutes to act is not worth the money we are paid. I would rather make less money doing less stressful stuff and fewer hours but have a good life. As soon as I pay off my loans I'm doing something else - this job really sucks
*Doctors Underpaid*
Me: *Cries in Lab*
There is a reason I went into mental health counseling and got my PhD. instead of going into medical school. Will be graduating next month with only 5k in student loans
I'm an engineer, have taught, I've gotta wonder why med school is so $$$. The cost of outfitting an school's engineering lab is very expensive, so why is med school $$$$$.
Apparently, the training situation is a bit similar to Portugal, which also has a free National Healthcare System. After we finish medical school (6 years), we do a final exam, so that we can be ranked into a specialty. We then proceed to a full year rotating specialties and then apply to a medical specialty. You can only enroll in a (4-6) year of training to become a specialist in hospitals that belong to the national healthcare system and that provide those programs. These programs have to meet quality and training criteria (for example, a certain number of internships / rotations /procedures etc), By doing so, since you'll be working, you have to get a contract. Private practice isn't interested in hemorrhaging money making Specialists. Instead, they just snatch young doctors after they become physician specialists without contributing a cent to their education.
Since our Healthcare is built upon a free system, usually the best hospitals, with the best doctors and professors, are public, particularly the "central" teaching hospitals. Private practice, in my opinion, is a money-making machine, that when things go bad or the patients run out of money, kicks them back to non-private hospitals to deal with the fallout.
Can you address the glaring problem of hospitalists. I don’t know when this happened but I remember your own primary care physician was often responsible for your care or would be involved or would minor the treatment plan. A week ago my elderly mother had a fall and needed partial hip surgery, the surgery went successful. However the hospitalists who works for the hospital and has an interest reducing the costs for the hospital and not for the patient discharged my mother 2 days after surgery even though we felt her incision would still take a few more days to heal, her arms were swollen and she was not eating. Two days later our beloved mother died at the rehab. I blame the hospitalist for rushing her out of an environment where she could have been better monitor and her symptoms could have been better managed than at a rehab facility with no physical on site.
That's really terrible, sorry to hear about your loss.. I wonder if it was a combination of the hospitalists and administration (I know everyone likes to make administration the bogeyman but still). In my experience with talking to hospitalists, a lot of them tell me that they always have administrators harping on them to discharge patients super quickly and efficiently. Not sure where the disconnect is though. Definitely could be both.
Yeah the starting wage for target is $15 per hour regardless of job.
There's much scope for specialist doctors in the u.a.e where they compensate them fairly. I'm not even into a residency but I'm already looking to explore other options after I graduate !
Had a mechanical engineer friend from Ireland. Said it wasn't possible (told by his firm) to be a Sr. Engineer there before you were 40 -- licenses, exams and all. No (compensated) responsibility till then. To design sewage treatment plants... Moved to the US and worked as a service engineer in the Semi business for the money. Trying to think of an EE or ME engineer I've known who was senior before ~35 other than by starting a company and getting there via an IP or equity swap when acquired by a bigger firm.
Just a quick correction.
Although Ollie's profile states he's a medical student hes now a junior Dr rather than a student.
Excellent video. Issues were discussed clearly. I went to study uk healthcare in 2005 for MHA program. The hospital reminder me of stepping back to the 1980s. Sharing equipment etc. of course waiting lists for non emergent procedures. However, at least all citizens have access to care. It is disgusting that all US citizens do not have access. I did see a private insurance company in England. People who can afford private get private insurance. I think that is very cool 😊
Comparing pay is a lot more nuanced.
In the US, even with high student loans and a late start, unless you insist on living in an extremely high cost of living area, then moderate financial discipline will get you debt free and financially independent restively early in life compared to most. You will have to resist pressures to live a stereotypical (in some fields, antiquated) “rich doctor” lifestyle, but you will be comfortable. Is that fair compensation for your sacrifices? Maybe maybe not.
When comparing to other countries, it gets much more complicated. I’m slightly familiar with at least one other universal healthcare country. Physicians pay on the surface seems much much lower. However, it’s unionized and you get substantial union and government benefits plus a potentially generous pension plan which is pretty much non existent in the US. Again, purely from a financial and professional perspective, it’s hard to compare and both can be seen as very good viable life choices/careers. It’s important to look at the bigger picture.
More importantly:
Workload and burnout need to be addressed, more power on the hands of doctors not insurance and admin. Physician jobs have the potential to be extremely rewarding even if they were paid more modestly, but that aspect is being strangled out of the profession.
If you guys are interested in the U.S. healthcare system. You should really check out The Price We Pay by Dr. Marty Mackay. Great book really talks about the cost of our system. I highly recommend it.
I think the cost of college is way to expensive. I mean, where is all that money for it even going ? 🤔
In India also doctors getting low pay ..that is really too low.. bcz such money is not enough for ur daily base... Other people's are getting higher then medicinal feild
A pound is usually quite a bit more than a dollar, too.
Can you do a video on scope creep with NPs and PAs taking over?
The ONLY profession that I know that takes 10 years to become & continues to get paid less each year… literally makes no sense
Huge difference from UK to US in salaries, after residency ofc.
Fantastic video! One of the best courses I took as an undergrad was comparative health economics. A blend between the German and American system (eliminating for-profit health insurance) would be awesome, but America loves its admin salaries :’)
Low pay, in part, due to perceived, rock star status. A beginer flight attendant starts out at $45k a year.
If I did it again I'll be an auto mechanic, HAC technician or electrician
why is that?
its 1,31 dollars for 1 pound sterling
I have not gotten a pay raise in almost ten years... phuchk this shxtt...
The public is on your side - there would be no public outcry if you were to campaign for a significant salary increase.
Great video with insights most people do not consider
I've always thought junior doctors in the US and UK - interns, residents/registrars, and fellows are paid way too low. Almost criminal.
What happened to "🆓 college" over there though it actually not really "🆓"
Keep in mind the British pound is normally worth about twice the US dollar.
Simple reason: Medicare Act of 1965. The government sets the fees. Thus, the government sets the value of your work.
I don't understand why if u have to pay already just tto go to med school/ residents ect then on top of that u have to pay for exams and certifications! We have such a shortage of doctors u would think 🤔 school should be free. The government should pay it all. I fully agree this guy! Like why go into medicine? That's just wrong. Thanks for video
84k pounds is about $109k
Administrators lie around and do nothing useful. This stuff could be automated in a few years
80k pounds is about 110k usd
Try going to england
So why are people still pursuing medicine in the UK? These are very smart kids competing at this level. They will not make foolish decisions if the payoff is not there.
Anyone of average intelligence can become a doctor in dumbed down Britain.
Show me a doctor who makes less than a quarter million dollars per year -
Someone told me, “as a doctor you won’t have a problem putting food on the table.” Even though physician salaries aren’t looking great, it’s still enough to pay off debts and live a comfortable life. And I think it always will be. There is unfairness in many career fields, but as long as you love what you do I think the unfairness is easier to look past.
He means about 9000 UK pounds per year in debt....
Pounds not DOLLARS
Cost of living in daily life in the UK is way more expensive.
If school was free, they wouldn't need to be paid so much.
Poor doctor. I make more as an RN here in the USA than that doctor. I have only been an RN for 8 years and have a BSN. I make easily over 6 figures and get days off at a time! Less debt too!
Doctors are overpaid.
The NHS requirement is 35 hours per week and physicians can supplement income in the private sector with Kaiser like HMOs like BUPA but even this is not enough to stop a major brain drain of docs to AUS, NZ and US or into administrative jobs at the NHS
Correction 37.5 hours
Wrong - every doctor is rotated for 48hrs a week
Perhaps only consultants in certain specialties can negotiate this. But the contracts are always on 48hrs a week.
Love your latest videos. More insights on d issues besetting the healthcare systems from all sides, pls? Stay safe...🥰
A lot of people don’t understand that doctors and other healthcare professionals or staff working with patients should be paid high wages; the stress and responsibility that comes with taking care of and dealing with patients lives is invaluable and expensive. You kill someone by accident your career could be over, make a mistake career could be over. It’s not like other jobs where the death of someone doesn’t directly impact you because it’s not your responsibility. For anyone working in the NHS it is and not only would you be causing yourself to feel low but people in the public would additionally. It really is a matter of responsibility is equal to pay if you feel pay should be low responsibility should be low as well, none of us would accept the death of a family member to a irresponsible doctor so the same should be true for pay.
So human med is on track to be as financially screwed as we are over in vet med 😢
Hi Michael!
Folks are always going to want to be physicians. French and UK doctors are willing to accept a lot less to be doctors, and if American doctors think it won’t happen to us, then we have blinders on. It’s not a good trend for US MDs (I’m one), but it is what will happen.
I hope not! We lost yrs of life and time with family/friends sacrificing for this career. There has to be a financial reward at the end to help us build our own lives.
8:15 so thisis the drawback for free healthcare for all?
11:42 I would say this kinda already came
I feel doctors , nurses, police, paramedics, fire fighter, teachers and all the people that are responsible for keeping society safe and advancing are undervalued.
Athletes and entertainment is ridiculously paid. ( I read base ball player min wage went from 600,000 to 700,000 😮)
But don’t think we can blame government and corporations. If our society values entertainment over a functional and safe community then thats a societal flaw and we need to take responsibility for this trend.
Doctors are underpaid because a lot of responsabilities are exclusively safe guarded for them via legislation, in most countries. If one does believe dumping more money in a already expensive pro is the only viable solution then a lot more MDs will continue to be underpaid.
Ollie is the best!
So the 2 year foundation… year one is internship where you rotate and work as a doctor in all 4 major medical specialities (OBGYN, Peds, Internal Medicine and Surgery) the send year is called senior house officer…. In which you can choose any speciality you wish to get more experience in…. Then after those two years you then apply for a speciality you want to pursue and yes consultancy is the UK version of the American attending
ahhhh thanks for clearing this up!
Correct me if I'm wrong. It is my understanding that education loans can be forgiven if the graduate does some community service. I do know that the US military will pay all med school expenses.
NHS + National Health Service
One day, all these people will just realized we've been looted. I dunno if people will ever go after the looters and really do what it takes.
84k?! Jesus Christ man.. We have nurses making almost double of what these guy's doctors are making
@Butter Milk why not compare it though? That’s atleast a start to awareness of the issue
Every medical student/physician that supports the idea of nationalized healthcare in the US needs to watch this video to see exactly how bad things can go. In America, the best and brightest go into medicine in large part of the financial incentives that are guaranteed at the end of years of sacrifice. Take those incentives away and you will undoubtedly see a drop in quality of those applying to medical school
Are you interested in disussing a medical draft?