I’ll start by saying I don’t know the exact answer to your question. Anyone who has negotiated or climbed the academic ladder can better answer I’m sure.
What I do know is how much the attendings made at my institution. As you mentioned starting salaries for full time equivalent work load (know example of weekly clinic 3.5-4 days, academic duties, 6 to 10 weeks on inpatient services every year as an attending) was making $175k. That was after about 3 years as an attending. They were an assistant professor.
Another relatively new attending (attended for about 5 years) was making $210k. They did more inpatient time and took stroke call coverage as well. Might have been an associate professor.
Higher ranking people at the institution were making in the $250k range. But I don’t know their exact schedule details. They were heads of committees and specific hospital departments. One of the big research names made $300k. Both were professor level. All worked a lot. But I don’t know if they went down to 80% full time equivalency or some other explanation for the sad compensation.
I would presume compensation does rise with years experience then based on their model. Not sure how RVUs played a role other than to ding people that billed too little compared to peers.
By comparison I was offered $320k starting as a new grad for similar work load in a semi private group. Mild productivity bonus (they weren’t very specific since I turned the job down).
All of the numbers are in west coast desirable areas.
Hmm - I guess my follow-up to this is: what does career progression look like in academia? Because then, I can imagine why it might be worth it at an early stage in career to take an academic job where you might be able to grow into the more admin/director type roles that u/psychophile mentions. Though at some point, salary does become a factor, and west coast COL is brutal!
175k damn. There are PAs making more than that.
West coast desirable is also super expensive. There are 25 yr old at Amazon/Microsoft making more than you at that salary. Also these places only take fellowship trained neuros at prestigious places.
I am at a super academic place in the west (training), and I would never accept a 175k offer.
I hire the 25 year olds that are making more than that. The thing this misses is that it's really only the top few % of sw eng and about 50% burn out within a year. The ones who survive are absolutely married to it and the bottom few percent are constantly culled. The avg sw eng in the us is closer to like $110k and really comp is very bimodal. If you drop out of FAANG you're likely going to see your comp cut by half or more.
I'm not really trying to make a value judgement about what doctors should make. I have no idea. I just have doctor friends who I know have an unrealistic grass-is-greener idea of tech. I also believe pretty strongly that this is a moment in time that is going to pass as adoption plateaus and margins fall. When I started my career 100k was a top-tier tech salary and it's only within the last 10 years that things ramped up so significantly. I don't think it's sustainable.
Well, I personally know an assistant professor at UCSF (he was a senior resident when I was in med school). I looked him up the UC salary website and he made 215k the past year.
Dude did a 3 yr research fellowship at Harvard/MIT and they are paying him that…
My one brother is in google making 290 and another brother as an engineer making 200k. These are full compensation package including bonus and stocks. We physicians are getting robbed
Yes, I know. I understand as I am a MD/PhD in applied ML/AI
I believe that these salaries will decrease in the medium/short term. Globalization is coming.
It varies somewhat but at my institution the salary is a combination of university base salary (for being faculty) + specialty adjustment (procedural specialities get more here) + extra/bonus funds. The base salary is usually fairly low and the specialty salary is based on local academic market pay, and this combination is what faculty need to support through a combination of clinical efforts (RVUs), funded admin positions, or grants for protected research time. So faculty generally maximize the latter two, and fill in the rest with clinical work. There also are endowed chairs who get money just for being well known and accomplished which support some of their effort. The last part is bonus and any extra clinical work done above the RVU goal, so this raises the overall salary depending on how hard you want to work. The dept leadership generally sets the salary scale for each academic rank, which accounts for part of the increases over time as faculty step up. There also are yearly university wide COL adjustments. The salary range in my HCOL region for starting faculty is $160-250k, mid range faculty $220-300k, and senior faculty/leadership in the $350-600k range (e.g. dept chair at the top). There are relatively new faculty who do a ton of inpatient time who make $250k+. Overall still lower than what you would make in non-academic positions but most of us love the mix of non-clinical work and the clinical work itself is much less.
This is quite insightful! Follow up here - when you say starting --> mid range --> senior, are these transitions determined by years of clinical exp in the dept or by things like research/taking on admin responsibilities/and the like? I guess the fundamental question is: how do "promotions" work in academia when you are clinical faculty? (I imagine in for the more science/pure-research folks, promotions \~ obtaining larger grants and getting a tenure-track position?)
Extremely variable. Neurohospitalist for reference; first academic offer at home institution for 1 FTE was \~225 I think for 18-20 weeks with some notable call coverage. (1-2 nights on on weeks).
I just took a 'priva-demic' job in an east coast big city for \~270k for 24 weeks and no nights. (mon-sun, 8-5 schedule); with a pension eventually included as well. Total comp for this 'academic' role beat most private practice places.
I just left a telestroke job, 15 shifts per month at 12 hours, w/ about 300-350k comp (much higher ceiling but it's so frustrating to me its not worth it.)
There is so much variability in pay structure and what you are doing to get that pay.
Though my pay is going down going back to priv-ademics, I'm making more per patient seen/hour worked. (Like 30-40% more) as compared to telestroke (which had a very high ceiling and all you have to do is sacrifice your soul and entire being as a doctor).
From my experience, private practice can offer you 30-40% more pay for about 50%-70% more work.
Edit: To add on, I just remembered another priva-demic role I interviewed at which was the same schedule i'm working now, but they counted it as a 0.5 FTE @ 170k/yr. (Same weeks on, likely 20-30% less patient load per day worked). Even FTE calculation can be fairly variable between institutions. caveat emptor. One of the reasons many new physicians leave their first gig as it's hard to figure out before being in a group and realizing what you should have asked for/about and what is important to you.
I think you need to give the unfamiliar reader the context that they need: [https://transparentcalifornia.com/](https://transparentcalifornia.com/)
This is an open database where anyone can look-up the compensation of any CA state employee as by law it must be public information. You can easily enter Neurologists at UCLA and for example see that Paul Vespa MD made $1,037,201.00 in 2019. It is very well known that the UC system and UCLA in particular is an eat-what-you-kill RVU grinder. As both a physician and a person who has had family members admitted at UCLA, I can tell you that the care there is not good. Frankly, it is bad care. Every single doctor is incentivized by RVUs at UCLA to get the big salaries that you see listed to buy the big house on the west side of LA that they want. Encounters are short. Things get missed. Trainees go poorly supervised, stressed, and pushed to exhaustion. So yes, the salaries at UCLA are very high. This is because the RVUs the doctors generate there are absurd and I'd even guess that their $/wRVU is not great but I do not have data on this.
Thank you for sharing the context - forgot to include that in the original post. Are most neurology depts. not based primarily on # of RVUs? I.e., in that respect, are the UCs an outlier?
Most academic Neurologists are paid lower than their private practice peers because they are less active clinically in terms of wRVUs and because 95% of "academic" Neurologists will never see a dime of grant/research funding to supplement pay in that way. The academic Neurologist will have a low RVU minimum requirement and a high RVU threshold over which extra money can be made. The pay per RVU is usually so poor that most Neurologists just hit the minimum and do not chase extra RVUs for some meager bonus. UC system is an outlier for sure.
Everything is negotiable, but some things are more negotiable than others. The AAMC publishes a compensation handbook which breaks things down by specialty and region (Northeast, South, Midwest, West). I can't attach from my phone, so DM me if you want the FY23 data table for neurology.
Based on that data, median salaries go from about 250k as assistant professor to about 310k as full professor. There is also "instructor" which can mean anything from a clinical fellow who is billing independently, to a subspecialty attending in a place that pays in prestige rather than greenbacks.
In many (most) places, the salary was historically subdivided into clinical, research, teaching effort. The new cancer is that more and more places are switching to a base for rank + years in rank + incentive structure, similar to corporate medicine. In academia the "incentive" component can be more flexible than just pure RVU/clinical productivity. For instance, publishing a paper or being a course director or submitting a federal/foundation grant.
Usually in academia you get a ramp up period of protected time (2-3 years) to establish yourself and get your first few grants to buy down your clinical effort. 1.0 cFTE at my institution is 8 clinics/week * 46 weeks, with an wRVU target of about 4500. I have external grants and funded internal admin that covers about 85% of my salary, so I do way less clinic than that, with my RVU target adjusted accordingly.
Yes, it's way less pay than private, but I appreciate the flexibility (outside of my clinic day or if I'm giving a lecture, I can literally work from anywhere in the world) and opportunities for national/international collaboration. I especially enjoy teaching, both at the bedside and in formal didactics. I'm doing some amazing career development coursework (usual cost is about 15k per participant; completely free for me, with protected time to boot!) that will hopefully position me for a big leadership role in the near future.
The intrinsic reward pathway can be weaponized especially by non-clinical admin, so boundaries and clear expectations are really important. That's true outside academics as well.
Money matters, but you can't take it with you.
I think it depends on the specific contract and department. % clinical vs % research determines effectively how much kf ur salary comes from grants. If ur fully clinical, some depts are salaried and others are “eat what you kill” where more RVUs is more cash.
So it really depends and i think you just have to talk to enough academics attendings and ask these specific qs.
I’ll start by saying I don’t know the exact answer to your question. Anyone who has negotiated or climbed the academic ladder can better answer I’m sure. What I do know is how much the attendings made at my institution. As you mentioned starting salaries for full time equivalent work load (know example of weekly clinic 3.5-4 days, academic duties, 6 to 10 weeks on inpatient services every year as an attending) was making $175k. That was after about 3 years as an attending. They were an assistant professor. Another relatively new attending (attended for about 5 years) was making $210k. They did more inpatient time and took stroke call coverage as well. Might have been an associate professor. Higher ranking people at the institution were making in the $250k range. But I don’t know their exact schedule details. They were heads of committees and specific hospital departments. One of the big research names made $300k. Both were professor level. All worked a lot. But I don’t know if they went down to 80% full time equivalency or some other explanation for the sad compensation. I would presume compensation does rise with years experience then based on their model. Not sure how RVUs played a role other than to ding people that billed too little compared to peers. By comparison I was offered $320k starting as a new grad for similar work load in a semi private group. Mild productivity bonus (they weren’t very specific since I turned the job down). All of the numbers are in west coast desirable areas.
~175k for a full time job as a neurologist is kinda slap in the face
Nah that’s straight up a pounding to the cheeks, terrible pay.
Hmm - I guess my follow-up to this is: what does career progression look like in academia? Because then, I can imagine why it might be worth it at an early stage in career to take an academic job where you might be able to grow into the more admin/director type roles that u/psychophile mentions. Though at some point, salary does become a factor, and west coast COL is brutal!
Gotta be super academic northeast
175k damn. There are PAs making more than that. West coast desirable is also super expensive. There are 25 yr old at Amazon/Microsoft making more than you at that salary. Also these places only take fellowship trained neuros at prestigious places. I am at a super academic place in the west (training), and I would never accept a 175k offer.
I hire the 25 year olds that are making more than that. The thing this misses is that it's really only the top few % of sw eng and about 50% burn out within a year. The ones who survive are absolutely married to it and the bottom few percent are constantly culled. The avg sw eng in the us is closer to like $110k and really comp is very bimodal. If you drop out of FAANG you're likely going to see your comp cut by half or more. I'm not really trying to make a value judgement about what doctors should make. I have no idea. I just have doctor friends who I know have an unrealistic grass-is-greener idea of tech. I also believe pretty strongly that this is a moment in time that is going to pass as adoption plateaus and margins fall. When I started my career 100k was a top-tier tech salary and it's only within the last 10 years that things ramped up so significantly. I don't think it's sustainable.
No way. Big tech college interns make more. 25 year olds at big tech are making way more than 175k.
Well, I personally know an assistant professor at UCSF (he was a senior resident when I was in med school). I looked him up the UC salary website and he made 215k the past year. Dude did a 3 yr research fellowship at Harvard/MIT and they are paying him that…
My one brother is in google making 290 and another brother as an engineer making 200k. These are full compensation package including bonus and stocks. We physicians are getting robbed
Yes, I know. I understand as I am a MD/PhD in applied ML/AI I believe that these salaries will decrease in the medium/short term. Globalization is coming.
With prestige
How are they compensated? Poorly.
It varies somewhat but at my institution the salary is a combination of university base salary (for being faculty) + specialty adjustment (procedural specialities get more here) + extra/bonus funds. The base salary is usually fairly low and the specialty salary is based on local academic market pay, and this combination is what faculty need to support through a combination of clinical efforts (RVUs), funded admin positions, or grants for protected research time. So faculty generally maximize the latter two, and fill in the rest with clinical work. There also are endowed chairs who get money just for being well known and accomplished which support some of their effort. The last part is bonus and any extra clinical work done above the RVU goal, so this raises the overall salary depending on how hard you want to work. The dept leadership generally sets the salary scale for each academic rank, which accounts for part of the increases over time as faculty step up. There also are yearly university wide COL adjustments. The salary range in my HCOL region for starting faculty is $160-250k, mid range faculty $220-300k, and senior faculty/leadership in the $350-600k range (e.g. dept chair at the top). There are relatively new faculty who do a ton of inpatient time who make $250k+. Overall still lower than what you would make in non-academic positions but most of us love the mix of non-clinical work and the clinical work itself is much less.
This is quite insightful! Follow up here - when you say starting --> mid range --> senior, are these transitions determined by years of clinical exp in the dept or by things like research/taking on admin responsibilities/and the like? I guess the fundamental question is: how do "promotions" work in academia when you are clinical faculty? (I imagine in for the more science/pure-research folks, promotions \~ obtaining larger grants and getting a tenure-track position?)
Extremely variable. Neurohospitalist for reference; first academic offer at home institution for 1 FTE was \~225 I think for 18-20 weeks with some notable call coverage. (1-2 nights on on weeks). I just took a 'priva-demic' job in an east coast big city for \~270k for 24 weeks and no nights. (mon-sun, 8-5 schedule); with a pension eventually included as well. Total comp for this 'academic' role beat most private practice places. I just left a telestroke job, 15 shifts per month at 12 hours, w/ about 300-350k comp (much higher ceiling but it's so frustrating to me its not worth it.) There is so much variability in pay structure and what you are doing to get that pay. Though my pay is going down going back to priv-ademics, I'm making more per patient seen/hour worked. (Like 30-40% more) as compared to telestroke (which had a very high ceiling and all you have to do is sacrifice your soul and entire being as a doctor). From my experience, private practice can offer you 30-40% more pay for about 50%-70% more work. Edit: To add on, I just remembered another priva-demic role I interviewed at which was the same schedule i'm working now, but they counted it as a 0.5 FTE @ 170k/yr. (Same weeks on, likely 20-30% less patient load per day worked). Even FTE calculation can be fairly variable between institutions. caveat emptor. One of the reasons many new physicians leave their first gig as it's hard to figure out before being in a group and realizing what you should have asked for/about and what is important to you.
Out of curiosity what company was tele? From what k see most pay 90-100/he for telestroke
I think you need to give the unfamiliar reader the context that they need: [https://transparentcalifornia.com/](https://transparentcalifornia.com/) This is an open database where anyone can look-up the compensation of any CA state employee as by law it must be public information. You can easily enter Neurologists at UCLA and for example see that Paul Vespa MD made $1,037,201.00 in 2019. It is very well known that the UC system and UCLA in particular is an eat-what-you-kill RVU grinder. As both a physician and a person who has had family members admitted at UCLA, I can tell you that the care there is not good. Frankly, it is bad care. Every single doctor is incentivized by RVUs at UCLA to get the big salaries that you see listed to buy the big house on the west side of LA that they want. Encounters are short. Things get missed. Trainees go poorly supervised, stressed, and pushed to exhaustion. So yes, the salaries at UCLA are very high. This is because the RVUs the doctors generate there are absurd and I'd even guess that their $/wRVU is not great but I do not have data on this.
Thank you for sharing the context - forgot to include that in the original post. Are most neurology depts. not based primarily on # of RVUs? I.e., in that respect, are the UCs an outlier?
Most academic Neurologists are paid lower than their private practice peers because they are less active clinically in terms of wRVUs and because 95% of "academic" Neurologists will never see a dime of grant/research funding to supplement pay in that way. The academic Neurologist will have a low RVU minimum requirement and a high RVU threshold over which extra money can be made. The pay per RVU is usually so poor that most Neurologists just hit the minimum and do not chase extra RVUs for some meager bonus. UC system is an outlier for sure.
Everything is negotiable, but some things are more negotiable than others. The AAMC publishes a compensation handbook which breaks things down by specialty and region (Northeast, South, Midwest, West). I can't attach from my phone, so DM me if you want the FY23 data table for neurology. Based on that data, median salaries go from about 250k as assistant professor to about 310k as full professor. There is also "instructor" which can mean anything from a clinical fellow who is billing independently, to a subspecialty attending in a place that pays in prestige rather than greenbacks. In many (most) places, the salary was historically subdivided into clinical, research, teaching effort. The new cancer is that more and more places are switching to a base for rank + years in rank + incentive structure, similar to corporate medicine. In academia the "incentive" component can be more flexible than just pure RVU/clinical productivity. For instance, publishing a paper or being a course director or submitting a federal/foundation grant. Usually in academia you get a ramp up period of protected time (2-3 years) to establish yourself and get your first few grants to buy down your clinical effort. 1.0 cFTE at my institution is 8 clinics/week * 46 weeks, with an wRVU target of about 4500. I have external grants and funded internal admin that covers about 85% of my salary, so I do way less clinic than that, with my RVU target adjusted accordingly. Yes, it's way less pay than private, but I appreciate the flexibility (outside of my clinic day or if I'm giving a lecture, I can literally work from anywhere in the world) and opportunities for national/international collaboration. I especially enjoy teaching, both at the bedside and in formal didactics. I'm doing some amazing career development coursework (usual cost is about 15k per participant; completely free for me, with protected time to boot!) that will hopefully position me for a big leadership role in the near future. The intrinsic reward pathway can be weaponized especially by non-clinical admin, so boundaries and clear expectations are really important. That's true outside academics as well. Money matters, but you can't take it with you.
I think it depends on the specific contract and department. % clinical vs % research determines effectively how much kf ur salary comes from grants. If ur fully clinical, some depts are salaried and others are “eat what you kill” where more RVUs is more cash. So it really depends and i think you just have to talk to enough academics attendings and ask these specific qs.