lol brave man, consult the case Yung vs AAMC. Nurses and midlevels are paid because they can negotiate the terms of their labor. Residents are subject to violations of competitive and anti trust regulations nowhere else seen in the workforce.
This all has to due with the fact that a residents' salary and GME funding comes from Medicare/Medicaid (can't recall which one specifically). Technically, each residency program is allocated ~$160,000-200,000 per resident. The hospital/GME program takes a cut of that to train you/provide you with education/training in your specific field and pays you a living wage. So technically, residents actually get paid $150k+, BUT you're essentially paying the hospital for your training therefore your net is ~$55k. I know, sounds arbitrary when you compare to NP/PA salary straight out of graduation, but as a resident you're receiving further training in your respective field.
This is a great perspective as to why the pay is the way it is. I guess there will be another argument made on the level of training and expertise. Even though residents are “paying” to continue training, one could argue they already have more experience and knowledge than a freshly minted PA/NP and why do they not need to “pay” for further on the job training?
@@jacobpereramd8094 Shorter version: Yes, have more experience and knowledge BUT not to the level of an independently practicing attending physician, quite literally in the middle. More than NP/PA, but not enough practice/expertise to be independent physician yet. Residents need to pay for further on the job training because they require more Hospital resource allocation/monitoring/attending physicians time and resources to be oversighted. Hospitals spend a lot of money to allocate resources to train residents; we are also a liability. But yes, I agree with you. As a resident, eventually, we are practicing independently with some attending oversight come PGY-1.5-PHY2, therefore I do think residents need to be paid more. But then again, it's short term, ~3-5 years then you're making ~5x as much =D Longer Version: For sure, and that would be for ACGME, GME and the Government. This also goes into the whole physician shortage debate. We've been hearing this for years; predicted physician shortage for each year steadily treading upwards as population increases. This all has to do with funding for GME via the Government. Historically, for the past 30+ years, the number of residency programs has been consistent, ~30K positions per year, though now increasing through increased funding we've seen over the past few years. So the same argument that applies to residency positions, why aren't there more, applies to residency salary, why aren't we paid more? But as you pointed out, level of training and expertise, but yet not ready for independent practice/unsupervised practice. NPs and PAs are ready for independent practice right out of graduation, there for do not require supervision or monitoring. Residents require supervision and oversight by attendings which take away from Hospital resources which are allocated for GME which the hospital receives in return via funding and allocation by various programs, hence many hospitals fight every year to become university affiliated or become a GME program so they can further expand their funding and receive more resources.
pipeline3609 Excellent points! Of course this will always lead back to the debate of whether NP’s/PA’s should be allowed to practice independently right out of school. And even if they aren’t independent and need physician oversight, they make significantly more than residents still.
@@jacobpereramd8094 Not sure where you stand, but I personally don't think they should be allowed to practice independently. The data and evidence is there that they can be a detriment to long term health outcomes and overall increased cost to a hospital/practice system in regards to malpractice/liability settlements. However, they are a great addition to the overall healthcare team; case managers, social workers, etc. Not every patient needs to be seen by an MD/DO every single time, once a patient is established, they can 100% provide continuity of care. COME AT ME SJWs and PC culture but it is what it is. If there aren't enough physicians to see more patients to increase more money for hospitals/practices, the capitalist system will find ways to be able to churn more numbers. That's just the way it is. A hospital would rather hire 2 PAs/NPs for the price of 1 MD/DO.
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lol brave man, consult the case Yung vs AAMC. Nurses and midlevels are paid because they can negotiate the terms of their labor. Residents are subject to violations of competitive and anti trust regulations nowhere else seen in the workforce.
Do you think residents deserve to be paid more? Why or why not? Drop a comment and lets talk!
This all has to due with the fact that a residents' salary and GME funding comes from Medicare/Medicaid (can't recall which one specifically). Technically, each residency program is allocated ~$160,000-200,000 per resident. The hospital/GME program takes a cut of that to train you/provide you with education/training in your specific field and pays you a living wage.
So technically, residents actually get paid $150k+, BUT you're essentially paying the hospital for your training therefore your net is ~$55k.
I know, sounds arbitrary when you compare to NP/PA salary straight out of graduation, but as a resident you're receiving further training in your respective field.
This is a great perspective as to why the pay is the way it is. I guess there will be another argument made on the level of training and expertise. Even though residents are “paying” to continue training, one could argue they already have more experience and knowledge than a freshly minted PA/NP and why do they not need to “pay” for further on the job training?
@@jacobpereramd8094
Shorter version:
Yes, have more experience and knowledge BUT not to the level of an independently practicing attending physician, quite literally in the middle. More than NP/PA, but not enough practice/expertise to be independent physician yet. Residents need to pay for further on the job training because they require more Hospital resource allocation/monitoring/attending physicians time and resources to be oversighted. Hospitals spend a lot of money to allocate resources to train residents; we are also a liability.
But yes, I agree with you. As a resident, eventually, we are practicing independently with some attending oversight come PGY-1.5-PHY2, therefore I do think residents need to be paid more. But then again, it's short term, ~3-5 years then you're making ~5x as much =D
Longer Version:
For sure, and that would be for ACGME, GME and the Government. This also goes into the whole physician shortage debate. We've been hearing this for years; predicted physician shortage for each year steadily treading upwards as population increases. This all has to do with funding for GME via the Government. Historically, for the past 30+ years, the number of residency programs has been consistent, ~30K positions per year, though now increasing through increased funding we've seen over the past few years.
So the same argument that applies to residency positions, why aren't there more, applies to residency salary, why aren't we paid more?
But as you pointed out, level of training and expertise, but yet not ready for independent practice/unsupervised practice. NPs and PAs are ready for independent practice right out of graduation, there for do not require supervision or monitoring. Residents require supervision and oversight by attendings which take away from Hospital resources which are allocated for GME which the hospital receives in return via funding and allocation by various programs, hence many hospitals fight every year to become university affiliated or become a GME program so they can further expand their funding and receive more resources.
pipeline3609 Excellent points! Of course this will always lead back to the debate of whether NP’s/PA’s should be allowed to practice independently right out of school. And even if they aren’t independent and need physician oversight, they make significantly more than residents still.
@@jacobpereramd8094 Not sure where you stand, but I personally don't think they should be allowed to practice independently. The data and evidence is there that they can be a detriment to long term health outcomes and overall increased cost to a hospital/practice system in regards to malpractice/liability settlements. However, they are a great addition to the overall healthcare team; case managers, social workers, etc. Not every patient needs to be seen by an MD/DO every single time, once a patient is established, they can 100% provide continuity of care.
COME AT ME SJWs and PC culture but it is what it is. If there aren't enough physicians to see more patients to increase more money for hospitals/practices, the capitalist system will find ways to be able to churn more numbers. That's just the way it is.
A hospital would rather hire 2 PAs/NPs for the price of 1 MD/DO.
pipeline3609 couldn’t agree more!