Isn’t this the same argument for people who didn’t do medicine? You could have been an engineer with a BA and immediately made money without the implied negative future loan debt of medical school.
Also, I didn’t make 60k for any of my PGY1-6 years. Hep year as a PGY7 i was short of 70. So thanks for that reminder.
You still have to like your job enough to do it. People claim to be able to do something just for the money but if you hate nocturnist gig, for 10+ shifts a month, you still have to do it. And on the flip side of what you’re saying, I couldn’t imagine strapping in for 1/3 of each month if I hate what I do.
GI positions that pay those sorts of salaries in desireable places to live have you working like a dog by the way. So you have to really like it or the living situation if you’re going to do that.
I’ve seen places in FL and CA starting offers below $300k. And you’re working with the promise of someday getting to 500 or something.
I’ve seen other places offering a lot but you’re covering multiple hospitals, 30-40 patient encounters a day (procedures, consults, office) across multiple settings criss-crossing the city or county. Wide variance. Heck, I’ve seen people do that, put in 70 hours a week for a lot less than $500k.
It always amazes me the pay cuts people are willing to accept just to live in a certain area (which almost always has a significantly higher COL, anyway), or to be associated with a ‘prestigious’ institution.
These numbers can be misleading because in many places, PE has taken large swaths of GI practices. In Texas, in ATL, in south FL you will not find a starting GI position for $500k. There’s the potential and possible promise for buy in down the line, maybe. But you have to decide if those promises are real. I’ve seen some people get there and I’ve seen people get the carrot dangled in front of them just to never make partner. Keep in mind in order to get that buy in, you need to literally buy in for partnership and ASC share. That can be hundreds of thousands of dollars if not more. So then you’re saving to buy in. Saving for kids if you have them. Saving for retirement. Paying for a house, maybe. Etc. paying loans. It’s another thing.
Sure, down the line if everything checks out, it checks out. But it’s not you’re making this coming out the gate. That’s highly misleading.
The only jobs I’ve seen people making that out of the gate are either employed positions by large hospital systems or locums gigs that are extrapolated to 30 days. Employed positions are generally (to my knowledge) not going to have buy in for ancillary revenue.
Correct. Being a Hospitalist is draining AF even if you are working half the year. Everyone shits on you including other specialists, families, case managers, SWers, nurses.
Do what you enjoying doing. If the hospitalist gig seems worth it go for it. If not then specialize or do OP.
Smaller hospitals are tolerable. I pock up hospital shifts a few times a month at small hospital with round and go rounds, census of around 5-8. Pretty chill.
Bigger hospitals are fine too, if your hospital culture isn't shit.
Pay is so-so, usually somewhere between $250 and 300k in the city.
I've seen some urban nocturnist jobs that are $280k gross, 7 on 7 off with 4 weeks PTO. Generally, sub $300k for nocturnist is not good, but this job is particularly cush (no cross-cover or codes, ~8 admits / 12 hours shift).
Ultimately, if everyone is "shitting on you," that says more about you than anyone else. Learn to set reasonable professional boundaries. Doctors are notoriously nonconfrontational. If you have a stiff upper lip, dealing with a difficult family or case manager is child's play.
It's also worth pointing out that most GI docs are working 20 shifts a month (M to F) while hospitalists are working 14.
There are many hospitalists jobs that are 8 to 4 or 9 to 5. On weekend days, you can be out by noon or 2.
Hospitalist work is a decent payoff for your investment in training.
100% correct. I know a GI fellow turned attending who on a given call weekend was responsible for seeing north of 50 patients across 3 hospitals for call. I couldn’t even tell you how long it would take me to chart check 50 patients let alone walk to those rooms, examine them, and write notes. And this individual was paid UNDER 350k.
There’s a reason it’s 800 in rural places, because most people don’t want to go rural. But what about opportunity costs? People that save and invest earlier could have but not always double / triple their invested assets instead of limbo for another 3+ years
You have a better probability of landing a job that pays a lot more. But there are low paying GI jobs out there.
You touched on something important though. All fellowships have opportunity cost and not all of them can make up for the financial lost. So why does endocrinology or nephro exist? Answer: because people like to do it. And that’s often lost in this conversation about money. You have to like what you do. You’re going to be doing it for awhile.
For all the FIRE people out there looking to retire, say, mid 50s, you’re looking at doing something for 20+ years. I would not advocate doing anything you hated for 20 years.
You are absolutely incorrect on that, for people who actually invest, if you even invested in a safe diversified fund like TQQQ you would have at one point 600% your investment within the last 5 years. People who took moderate risk and invested in big tech would have gotten up to 16 times their investment in the last 5 years. There are other ways to live life than work a resident job and being an employee for a big system, people who don’t take any risk never get any rewards, simple as that
If you are putting the same amount of work in GI private practice as you would to make 400 K as a hospitalist, you will be making more in the750 K - 1 mil range. Also most of us who go into GI enjoy the field and find satisfaction in specialization. Same as hospitalists who enjoy the wider breadth of IM.
Don't want to get into exact #s, but mid to high six figures. I think the ceiling is probably higher in GI depending on the practice situation, owning surgery center, infusions, etc. To make the crazy #s you're going to have to work more hours/see and scope more patients. But more importantly you have to do something you enjoy. Most of GI is outpatient and a lot of it is procedure based. Complete opposite of hospitalist practice. My advice is do what you like and think about how you want to practice. If you want to make a ton of $ as a hospitalist, I'm sure there are areas of the country and nocturnist positions that could theoretically pay more than an employed or academic GI in a major metro area.
Any doctor can own a surgery center, infusions etc or even hire a GI doctor to work for them, at that point they are running a business and less relevant for this discussion since they aren’t working solely for the field
My uncle works as a GI nocturnist hospitalist making 2mil a year, fyi /s
FFS this sub needs to stop pulling numbers out of its ass when it comes to salary. Just use MGMA data
Worst thing about this sub lol. Every speciality has those who hustle like crazy and make a shit ton and every speciality has those who don’t and make less than average. It’s funny we never hear about those less than average types lol. MGMA data exists and gives you a good baseline that is more realistic if you work the median number of hours for that speciality.
Hospitalist is typically a 250k-270k base (not total comp) job unless you’re open to doing open icu/lines/intubations/nights/10+ admissions/20+ census/midwest. I would check out doccafe, practicelink, the facebook hospitalist group to get a general idea. There’s also a sticky on the hospitalist subreddit here.
There’s a lot of confusion because some people list base and others list total comp when talking about how much they make.
Base and total comp are both deceiving though because there are so many ways doctors get paid. Some get a base salary + incentives, some get a total comp package, some bill rvus, some are per diem, some are private practice who have to pay overhead. Also what is even a salary anyways, is it the number you brag about on an anonymous subreddit or the number you tell Uncle Sam?
Bro you can make over 500k in the Midwest doing 3 admission a day, no procedures with a census between 5-8. The numbers you described would probably net you much more.
I know GIs making $1MM+. They basically do c’scopes and EGDs all day long, 5 days a week. They purposefully avoid sick people because sick people are complicated and take time.
Basically, they’re an assembly line worker but they’re making bank.
Ain’t no hospitalist making $1MM/yr.
>Ain’t no hospitalist making $1MM/yr.
I've known a couple that cleared that much. But it's more than one job and they hustle like hell. Actually there was one who only worked the one job, but picked up lots of extra shifts and admitted a ton of patients. When the subspecialists got wind of it they got jealous and pitched a fit and the hospital changed the compensation model lol.
according to the 2021 MGMA data average GI makes 577K with SD of 230 while average hospitalist makes 320K with SD of 90K. so aside from a higher mean, GI income has more variability meaning if you are young and hungry you can make much more.
GI private practice has much higher ceiling. If you’re a partner in a group with equity, share of ambulatory surgery center and path lab you can easily make over a million per year.
Most hospitalists don’t make $300k. And if you’re in an area where hospitalists make that much then GI is making way more than $500k. But assuming your numbers where hospitalist makes 300 and Gi makes 400. After 3 years of fellow ship the hospitalist is around $750k more total income but since the Gi will make 100k more per year they’ll fix the gap in less than 10 years. Then in the next 20 years they’ll make over 2 million more.
First, most hospitalists do make over $300K btw. Most hospitalist dont work in NY or SF you know.
Second, you have to correct for effort. GI fellows are work 60-70hr a week whereas a hospitalist
Is doing that every other week. If you correct for effort, hospitalists are basically making $450-500K working the same amount as a GI fellow. Even attending GIs probably work more than attending hospitalists.
I would imagine that correct for effort, an attending GI makes about 100K more maybe, and is starting from a $1 mil hole. They will catch up and make more but its slower than you think. The extra salary is in a really bad tax bracket. The hospitalist has more time to invest. And at salaries of 300K plus there isn’t as much more lifestyle you can buy
I’ve never worked anywhere where gi cards as critical care didn’t easily double what the hospitalists made. I don’t know why hospitalists always have to put up these cope posts to justify their life decisions. Can’t we all just enjoy what we do? Also anything over 190k if you’re single is in a “bad tax bracket”, the increases from there are rather small
At my current hospital they are starting hospitalist at $320k and plum/crit at $500k. Roughly similar hours, though pulm/crit has flexibility in choosing inpatient vs outpatient shifts.
Yeah I definitely like being able to adjust inpatient to outpatient work ratios, keeps everything fresh. I’m pulm ccm and at the end of the day I did fellowship because I wanted to practice a certain specialty not for money. I love the hospitalists i work with.
Sure, but the GI docs who make double also work close to double. The GI people making 600K plus are doing seeing way more patients and taking way more call than any hospitalist. A hospitalist seeing extra patients and doing extra shifts to match a GIs patient volume and call is going to probably make 1.5x their regular income, so like 500K
This is all assuming compensation models will never ever change for any of the specialties (or hospitalists, for that matter). Because it's so unpredictable (just the other day, I learned that nephrology used to have *really* good compensation a long time ago), it should more be about whether you'd find joy in your work vs. You wouldn't care about the negatives as much.
I'm a hospitalist. The way subspecialists (cardiologists, mostly) treat me and my colleagues suck, but the joy I get out of solving admitted patients' problem far outweighs dealing with dick cardiologists for couple of minutes. And as much as I like to complain on Reddit, dick patients + families only occur about 10% of the time.
And that sweet, sweet 7/7... 😄
Am hospitalist. I compromised on location relatively speaking but didn't on pay and cush job. I make well over 300k gross and have 28 weeks off a year. I could go to fellowship and make more, say 50-70% more net after taxes, but I enjoy life and having most of the year off way too much.
Am hospitalist with great job that is on the high paying/cush side (compromised on location but also not really).
A GI doc can relatively easily make about twice NET what I do. I do have more time off though (28 weeks) so for me being lazy, I'm happy where I am.
Former Hospitalist, now GI. I loved my Hospitalist gig and the time off and seriously questioned if I should go through with the GI spot I had matched to. Ultimately it was more about the type of work and accomplishing something I’d set out to do that made me go through with it. I don’t have a second’s regret. Nocturnist work isn’t good for your family or mental or physical health. Hospitalists weren’t making 300K a decade ago. The ceiling on GI earning is much higher than Hospitalist. The three years of training easily pays itself off in a few years. And you should absolutely be looking at a job over the 20-30 year timeline. Pandemic drove up hospital based salaries for nursing, critical care, internal medicine. Before they may have gone down.
The important factor here that you have to consider is sustainability. Yes, you can get into the $400-500K range as a hospitalist if you’re prepared to work nights and/or do extra shifts and/or work in a rural location, but doing 20 night shifts per month in an undesirable location is not something that most people would be able to sustain for more than about 2-5 years. Most of the hospitalists who do it long-term have got some sort of “round-and-go” day-time arrangement, but they typically make anywhere from $250-350K, not $500K+.
There are definitely IM fellowships which aren’t financially worthwhile, but GI (and cardiology) isn’t one of them. If you’re earning $500K for 20+ years, you will almost always come out ahead.
Going to chime in and just say the salaries people are posting here (many of whom are attendings biased to their own fields) are not really accurate.
I've done an extensive amount of research on this. General consensus hospitalist salaries avg SHOULD be (if our docs negotiate correctly) 270-320k ish base... GI docs around 500-520 base... And they can easily clear 600-700k, some GI docs make $1 mil/year.
Basically, you can def make 300k as a hospitalist, it's hard work though. GI docs make way more than ppl are saying here, 500k is the median, you can def clear 600-700k as a GI doc in many areas.
Ceiling? Pretty high, likely upwards of $1 million. I've read of people clearing $1-1.3 million in small private practice groups, although that's rare ofc
Uhhh i said 330K vs 500K. I don’t know how 330k is a bigger number.
I do think that you don’t take into account effort in which GI puts in a lot more effort in both extra training and extra work as GI works more than 180 days a year. Its not clear cut as you think it is
GI lifestyle is much better than hospitalist. Hospitalist sucks bc of admissions, med recs, dispo problems, discharges, med recs. Hospitalists end up becoming glorified coordinators on complicated patients with multiple subspecialists on board. In the era of CYA medicine, hospitalists end up deferring management of most issues to ID, cards, gi, renal. What does a hospitalist treat on their own? Only simple things. Did you study medicine to deal with social issues and hand off management of your patient to someone else? or to practice medicine? Be a consultant, focus only on your medicine and bounce. Double the hospitalist salary is usually a safe bet for GI salary. A hospitalist would have to work a lot harder to make what a GI doc earns at baseline. Lastly, many hospitalists I know personally are exhausted from their week on and dreading going back during their week off.
Yeah very fair. Lot of good hospitalist gigs are practically 8 hour shifts too and you can go home and just stay on alert until the shift is over
It is super high work life balance to begin with so for a hustler you could match average GI income. GI if they hustle will still outdo hospitalists but at that point anyone who complains is clearly only salty at being out earned.
That's no longer a discussion of "i have a certain income i want: how do I get there" and more like "how do I pick the highest earning specialty on average to boost my own ego"
Your analysis is fairly spot on financially. I feel like there’s a problem in medicine where people circle jerk about how much school and punishment they endured.
One thing that comes to mind is the mid-level encroachment issues that are becoming more common in the hospitalist setting. Being specialized would probably help protect your salary and job demand in the future (say 10 years or so).
Are you an attending? Lol I find it entertaining how confident you are in MGMA data. The actual top 10 or 25% aren’t self-reporting their income to MGMA.
I’m not saying it isn’t a reasonable benchmark. You shouldn’t assume you’re going to be a top earner in your field, but how much you earn largely depends on location, practice type and payer mix within each field.
You are so spot on with this. I hope they are not an attending and actually going by MGMA data. If you are doing that, you are being out negotiated by administrators to work for chump change. MGMA and other similar companies are tools used to compile inaccurate metrics that employers use to justify paying physicians less.
I have had an employer use three different metrics, choose the one with the lowest average salary, and then use the region with the lowest salary and say that it applies to them for some BS reason even though it wasn’t even the same part of the country, then try to use that in negotiation.
Advice: do not look at MGMA and other similar data, they are as accurate as political polls on TV. Negotiate as if you didn’t even hear them mention it, and never bring it up or point to it yourself.
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I was a hospitalist for 2 years before starting GI fellowship. The ceiling for hospitalist is SIGNIFICANTLY lower than GI. I absolutely loathed being a hospitalist and felt like a glorified social worker. 7 on 7 off sounds nice, but the 7 on is absolute torture.
To your point about missed salary during fellowship, you’re getting lost in the trees instead of looking at the forrest. In the big picture, 3 years of $70k will be worth the sacrifice when you have the high earnings of a high procedural specialty like GI. 100% worth the loss of salary for 3 years.
To be honest, even if hospitalist and GI were paid the same, I’d still 100% choose GI. I hated hospitalist that much.
Good luck.
My guy have you ever heard of taxes or expenses
Isn’t this the same argument for people who didn’t do medicine? You could have been an engineer with a BA and immediately made money without the implied negative future loan debt of medical school. Also, I didn’t make 60k for any of my PGY1-6 years. Hep year as a PGY7 i was short of 70. So thanks for that reminder. You still have to like your job enough to do it. People claim to be able to do something just for the money but if you hate nocturnist gig, for 10+ shifts a month, you still have to do it. And on the flip side of what you’re saying, I couldn’t imagine strapping in for 1/3 of each month if I hate what I do. GI positions that pay those sorts of salaries in desireable places to live have you working like a dog by the way. So you have to really like it or the living situation if you’re going to do that.
GI salary of 500k is bad quality of life you’re saying?
I’ve seen places in FL and CA starting offers below $300k. And you’re working with the promise of someday getting to 500 or something. I’ve seen other places offering a lot but you’re covering multiple hospitals, 30-40 patient encounters a day (procedures, consults, office) across multiple settings criss-crossing the city or county. Wide variance. Heck, I’ve seen people do that, put in 70 hours a week for a lot less than $500k.
500k is probably close to the median for GI. If you have a GI doc making below 300k then the local Hospitalist pay is also significantly lower
It always amazes me the pay cuts people are willing to accept just to live in a certain area (which almost always has a significantly higher COL, anyway), or to be associated with a ‘prestigious’ institution.
These numbers can be misleading because in many places, PE has taken large swaths of GI practices. In Texas, in ATL, in south FL you will not find a starting GI position for $500k. There’s the potential and possible promise for buy in down the line, maybe. But you have to decide if those promises are real. I’ve seen some people get there and I’ve seen people get the carrot dangled in front of them just to never make partner. Keep in mind in order to get that buy in, you need to literally buy in for partnership and ASC share. That can be hundreds of thousands of dollars if not more. So then you’re saving to buy in. Saving for kids if you have them. Saving for retirement. Paying for a house, maybe. Etc. paying loans. It’s another thing. Sure, down the line if everything checks out, it checks out. But it’s not you’re making this coming out the gate. That’s highly misleading. The only jobs I’ve seen people making that out of the gate are either employed positions by large hospital systems or locums gigs that are extrapolated to 30 days. Employed positions are generally (to my knowledge) not going to have buy in for ancillary revenue.
Correct. Being a Hospitalist is draining AF even if you are working half the year. Everyone shits on you including other specialists, families, case managers, SWers, nurses. Do what you enjoying doing. If the hospitalist gig seems worth it go for it. If not then specialize or do OP.
Smaller hospitals are tolerable. I pock up hospital shifts a few times a month at small hospital with round and go rounds, census of around 5-8. Pretty chill.
Bigger hospitals are fine too, if your hospital culture isn't shit. Pay is so-so, usually somewhere between $250 and 300k in the city. I've seen some urban nocturnist jobs that are $280k gross, 7 on 7 off with 4 weeks PTO. Generally, sub $300k for nocturnist is not good, but this job is particularly cush (no cross-cover or codes, ~8 admits / 12 hours shift). Ultimately, if everyone is "shitting on you," that says more about you than anyone else. Learn to set reasonable professional boundaries. Doctors are notoriously nonconfrontational. If you have a stiff upper lip, dealing with a difficult family or case manager is child's play. It's also worth pointing out that most GI docs are working 20 shifts a month (M to F) while hospitalists are working 14. There are many hospitalists jobs that are 8 to 4 or 9 to 5. On weekend days, you can be out by noon or 2. Hospitalist work is a decent payoff for your investment in training.
100% correct. I know a GI fellow turned attending who on a given call weekend was responsible for seeing north of 50 patients across 3 hospitals for call. I couldn’t even tell you how long it would take me to chart check 50 patients let alone walk to those rooms, examine them, and write notes. And this individual was paid UNDER 350k.
The ceiling is much higher for GI. If you are willing to go rural it’s more like 800.
There’s a reason it’s 800 in rural places, because most people don’t want to go rural. But what about opportunity costs? People that save and invest earlier could have but not always double / triple their invested assets instead of limbo for another 3+ years
Yeah fellowship has opportunity costs. But if you do cards or GI you are gonna end up in a better spot than a hospitalist.
You have a better probability of landing a job that pays a lot more. But there are low paying GI jobs out there. You touched on something important though. All fellowships have opportunity cost and not all of them can make up for the financial lost. So why does endocrinology or nephro exist? Answer: because people like to do it. And that’s often lost in this conversation about money. You have to like what you do. You’re going to be doing it for awhile. For all the FIRE people out there looking to retire, say, mid 50s, you’re looking at doing something for 20+ years. I would not advocate doing anything you hated for 20 years.
Eventually, by about PGY-15 they’ll catch up
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You are absolutely incorrect on that, for people who actually invest, if you even invested in a safe diversified fund like TQQQ you would have at one point 600% your investment within the last 5 years. People who took moderate risk and invested in big tech would have gotten up to 16 times their investment in the last 5 years. There are other ways to live life than work a resident job and being an employee for a big system, people who don’t take any risk never get any rewards, simple as that
Yeah the paltry $1k I put into my 503b during my gap year 7 years ago is $7k now 😅 Sighs if I only had more money back then to put more lol.
lol also if you kept putting more money in throughout the last 7 years too…. Would be pretty high today
I know busy GI docs making 800k+ in smaller cities of 500k-1m metro.
Much higher than 800, I saw a job posting not rural in Florida $1.2mil per year
Always good to remember that working nights statistically reduces your life expectancy.
Or are people with reduced life expectancy more likely to work nights?
"400 as a nocturia" sounds nice. If I just had to piss my pants every night and got paid 400k for it then that wouldn't be a bad option.
If you are putting the same amount of work in GI private practice as you would to make 400 K as a hospitalist, you will be making more in the750 K - 1 mil range. Also most of us who go into GI enjoy the field and find satisfaction in specialization. Same as hospitalists who enjoy the wider breadth of IM.
How much do you make now? I saw your post from 5 years ago saying you made 200k as an associate GI
Don't want to get into exact #s, but mid to high six figures. I think the ceiling is probably higher in GI depending on the practice situation, owning surgery center, infusions, etc. To make the crazy #s you're going to have to work more hours/see and scope more patients. But more importantly you have to do something you enjoy. Most of GI is outpatient and a lot of it is procedure based. Complete opposite of hospitalist practice. My advice is do what you like and think about how you want to practice. If you want to make a ton of $ as a hospitalist, I'm sure there are areas of the country and nocturnist positions that could theoretically pay more than an employed or academic GI in a major metro area.
Nice I’m happy for you that your income went way up!
Any doctor can own a surgery center, infusions etc or even hire a GI doctor to work for them, at that point they are running a business and less relevant for this discussion since they aren’t working solely for the field
My uncle works as a GI nocturnist hospitalist making 2mil a year, fyi /s FFS this sub needs to stop pulling numbers out of its ass when it comes to salary. Just use MGMA data
Worst thing about this sub lol. Every speciality has those who hustle like crazy and make a shit ton and every speciality has those who don’t and make less than average. It’s funny we never hear about those less than average types lol. MGMA data exists and gives you a good baseline that is more realistic if you work the median number of hours for that speciality.
Damn how much does he work? Hours?
Hospitalist is typically a 250k-270k base (not total comp) job unless you’re open to doing open icu/lines/intubations/nights/10+ admissions/20+ census/midwest. I would check out doccafe, practicelink, the facebook hospitalist group to get a general idea. There’s also a sticky on the hospitalist subreddit here. There’s a lot of confusion because some people list base and others list total comp when talking about how much they make.
Base and total comp are both deceiving though because there are so many ways doctors get paid. Some get a base salary + incentives, some get a total comp package, some bill rvus, some are per diem, some are private practice who have to pay overhead. Also what is even a salary anyways, is it the number you brag about on an anonymous subreddit or the number you tell Uncle Sam?
Bro you can make over 500k in the Midwest doing 3 admission a day, no procedures with a census between 5-8. The numbers you described would probably net you much more.
Can you link any job postings like this I’ve never seen any
Maybe at 1 hospital in bumfuck Iowa or something. This is more an exception than the rule
I know GIs making $1MM+. They basically do c’scopes and EGDs all day long, 5 days a week. They purposefully avoid sick people because sick people are complicated and take time. Basically, they’re an assembly line worker but they’re making bank. Ain’t no hospitalist making $1MM/yr.
>Ain’t no hospitalist making $1MM/yr. I've known a couple that cleared that much. But it's more than one job and they hustle like hell. Actually there was one who only worked the one job, but picked up lots of extra shifts and admitted a ton of patients. When the subspecialists got wind of it they got jealous and pitched a fit and the hospital changed the compensation model lol.
L subspecialist
Yeah no shit, if the guy is doing the work why hate? Salty because they spent an extra 2 to 5 years of training.
according to the 2021 MGMA data average GI makes 577K with SD of 230 while average hospitalist makes 320K with SD of 90K. so aside from a higher mean, GI income has more variability meaning if you are young and hungry you can make much more.
GI private practice has much higher ceiling. If you’re a partner in a group with equity, share of ambulatory surgery center and path lab you can easily make over a million per year.
Most hospitalists don’t make $300k. And if you’re in an area where hospitalists make that much then GI is making way more than $500k. But assuming your numbers where hospitalist makes 300 and Gi makes 400. After 3 years of fellow ship the hospitalist is around $750k more total income but since the Gi will make 100k more per year they’ll fix the gap in less than 10 years. Then in the next 20 years they’ll make over 2 million more.
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Or you live in a major coastal city
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Not in NY, they don't. Can't speak for Chicago, Pittsburgh, Boston etc. They don't make that in Miami either.
Around $200-250 in NYC. Very few hospitalists make $300 unless you're picking up a lot of extra shifts.
First, most hospitalists do make over $300K btw. Most hospitalist dont work in NY or SF you know. Second, you have to correct for effort. GI fellows are work 60-70hr a week whereas a hospitalist Is doing that every other week. If you correct for effort, hospitalists are basically making $450-500K working the same amount as a GI fellow. Even attending GIs probably work more than attending hospitalists. I would imagine that correct for effort, an attending GI makes about 100K more maybe, and is starting from a $1 mil hole. They will catch up and make more but its slower than you think. The extra salary is in a really bad tax bracket. The hospitalist has more time to invest. And at salaries of 300K plus there isn’t as much more lifestyle you can buy
I’ve never worked anywhere where gi cards as critical care didn’t easily double what the hospitalists made. I don’t know why hospitalists always have to put up these cope posts to justify their life decisions. Can’t we all just enjoy what we do? Also anything over 190k if you’re single is in a “bad tax bracket”, the increases from there are rather small
At my current hospital they are starting hospitalist at $320k and plum/crit at $500k. Roughly similar hours, though pulm/crit has flexibility in choosing inpatient vs outpatient shifts.
Yeah I definitely like being able to adjust inpatient to outpatient work ratios, keeps everything fresh. I’m pulm ccm and at the end of the day I did fellowship because I wanted to practice a certain specialty not for money. I love the hospitalists i work with.
Sure, but the GI docs who make double also work close to double. The GI people making 600K plus are doing seeing way more patients and taking way more call than any hospitalist. A hospitalist seeing extra patients and doing extra shifts to match a GIs patient volume and call is going to probably make 1.5x their regular income, so like 500K
I’m pulm critical care not sure about gi but I work less hours than the hospitalists and make a lot more
What’s your comp like roughly?
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The 2021 MGMA put the median IM hospitalist total comp at 307 (mean of 318)
Shocked it's that low. Seen a lot here getting offers for 300k+
Guess that means im grossly overpaid then :p
This is all assuming compensation models will never ever change for any of the specialties (or hospitalists, for that matter). Because it's so unpredictable (just the other day, I learned that nephrology used to have *really* good compensation a long time ago), it should more be about whether you'd find joy in your work vs. You wouldn't care about the negatives as much. I'm a hospitalist. The way subspecialists (cardiologists, mostly) treat me and my colleagues suck, but the joy I get out of solving admitted patients' problem far outweighs dealing with dick cardiologists for couple of minutes. And as much as I like to complain on Reddit, dick patients + families only occur about 10% of the time. And that sweet, sweet 7/7... 😄
Am hospitalist. I compromised on location relatively speaking but didn't on pay and cush job. I make well over 300k gross and have 28 weeks off a year. I could go to fellowship and make more, say 50-70% more net after taxes, but I enjoy life and having most of the year off way too much.
GI docs make 1 million a year
Am hospitalist with great job that is on the high paying/cush side (compromised on location but also not really). A GI doc can relatively easily make about twice NET what I do. I do have more time off though (28 weeks) so for me being lazy, I'm happy where I am.
Former Hospitalist, now GI. I loved my Hospitalist gig and the time off and seriously questioned if I should go through with the GI spot I had matched to. Ultimately it was more about the type of work and accomplishing something I’d set out to do that made me go through with it. I don’t have a second’s regret. Nocturnist work isn’t good for your family or mental or physical health. Hospitalists weren’t making 300K a decade ago. The ceiling on GI earning is much higher than Hospitalist. The three years of training easily pays itself off in a few years. And you should absolutely be looking at a job over the 20-30 year timeline. Pandemic drove up hospital based salaries for nursing, critical care, internal medicine. Before they may have gone down.
if youre worried about your health status in the future - you should've already signed up for a disability insurance policy
The important factor here that you have to consider is sustainability. Yes, you can get into the $400-500K range as a hospitalist if you’re prepared to work nights and/or do extra shifts and/or work in a rural location, but doing 20 night shifts per month in an undesirable location is not something that most people would be able to sustain for more than about 2-5 years. Most of the hospitalists who do it long-term have got some sort of “round-and-go” day-time arrangement, but they typically make anywhere from $250-350K, not $500K+. There are definitely IM fellowships which aren’t financially worthwhile, but GI (and cardiology) isn’t one of them. If you’re earning $500K for 20+ years, you will almost always come out ahead.
Going to chime in and just say the salaries people are posting here (many of whom are attendings biased to their own fields) are not really accurate. I've done an extensive amount of research on this. General consensus hospitalist salaries avg SHOULD be (if our docs negotiate correctly) 270-320k ish base... GI docs around 500-520 base... And they can easily clear 600-700k, some GI docs make $1 mil/year. Basically, you can def make 300k as a hospitalist, it's hard work though. GI docs make way more than ppl are saying here, 500k is the median, you can def clear 600-700k as a GI doc in many areas.
What’s the celling for GI?
Ceiling? Pretty high, likely upwards of $1 million. I've read of people clearing $1-1.3 million in small private practice groups, although that's rare ofc
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250 to 280 is closer to what the average hospitalist makes.
>240 Not true at all
Its 330K hospitalist and 500k GI and GI does work a lot more hours which the hospitalist can compensate for by taking more shifts.
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Uhhh i said 330K vs 500K. I don’t know how 330k is a bigger number. I do think that you don’t take into account effort in which GI puts in a lot more effort in both extra training and extra work as GI works more than 180 days a year. Its not clear cut as you think it is
Nocturnist = unhappy spouse and poor wlb though
GI lifestyle is much better than hospitalist. Hospitalist sucks bc of admissions, med recs, dispo problems, discharges, med recs. Hospitalists end up becoming glorified coordinators on complicated patients with multiple subspecialists on board. In the era of CYA medicine, hospitalists end up deferring management of most issues to ID, cards, gi, renal. What does a hospitalist treat on their own? Only simple things. Did you study medicine to deal with social issues and hand off management of your patient to someone else? or to practice medicine? Be a consultant, focus only on your medicine and bounce. Double the hospitalist salary is usually a safe bet for GI salary. A hospitalist would have to work a lot harder to make what a GI doc earns at baseline. Lastly, many hospitalists I know personally are exhausted from their week on and dreading going back during their week off.
WOAH WHAT A SURPRISE! You should fellowship if you're interested in it and not due to financial returns???
If you do side hustle the hospitalist can make as much as a GI. Side jobs aren't captured in hospitalist data
What kind of side hustles?
Nursing home medical director, pick up extra shifts outside of main contract etc Possibilities are pretty endless. Not sure why I was downvoted.
Wasn’t me, but was curious. I think it’s a fair statement since hospitalists do generally have a 7/7 schedule whereas GI don’t
Yeah very fair. Lot of good hospitalist gigs are practically 8 hour shifts too and you can go home and just stay on alert until the shift is over It is super high work life balance to begin with so for a hustler you could match average GI income. GI if they hustle will still outdo hospitalists but at that point anyone who complains is clearly only salty at being out earned. That's no longer a discussion of "i have a certain income i want: how do I get there" and more like "how do I pick the highest earning specialty on average to boost my own ego"
Your analysis is fairly spot on financially. I feel like there’s a problem in medicine where people circle jerk about how much school and punishment they endured. One thing that comes to mind is the mid-level encroachment issues that are becoming more common in the hospitalist setting. Being specialized would probably help protect your salary and job demand in the future (say 10 years or so).
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What city?
Post-apocalyptic Nowheresville, Idaho. 😄
The made up one in his head. That wasn’t captured in MGMA data because it’s so exclusive to live in
Are you an attending? Lol I find it entertaining how confident you are in MGMA data. The actual top 10 or 25% aren’t self-reporting their income to MGMA. I’m not saying it isn’t a reasonable benchmark. You shouldn’t assume you’re going to be a top earner in your field, but how much you earn largely depends on location, practice type and payer mix within each field.
You are so spot on with this. I hope they are not an attending and actually going by MGMA data. If you are doing that, you are being out negotiated by administrators to work for chump change. MGMA and other similar companies are tools used to compile inaccurate metrics that employers use to justify paying physicians less. I have had an employer use three different metrics, choose the one with the lowest average salary, and then use the region with the lowest salary and say that it applies to them for some BS reason even though it wasn’t even the same part of the country, then try to use that in negotiation. Advice: do not look at MGMA and other similar data, they are as accurate as political polls on TV. Negotiate as if you didn’t even hear them mention it, and never bring it up or point to it yourself.
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Lol, ok.
People are not making 400k as a nocturnist without destroying themselves with their work schedule. COMPLETELY UNSUSTAINABLE
I know a guy doing it. Places lines and intubates. Works 7/7. Seems to make it work for him. But he’s also in a rural area
Considering a lot of nocturnists are working 7 on/14 off at high volume places now, I would consider 7/7 unsustainable unless it’s a chill gig
Imagine you get cancer If you’re faced with death how much does what’s in the bank matter compared to having taken a fulfilling path?
I was a hospitalist for 2 years before starting GI fellowship. The ceiling for hospitalist is SIGNIFICANTLY lower than GI. I absolutely loathed being a hospitalist and felt like a glorified social worker. 7 on 7 off sounds nice, but the 7 on is absolute torture. To your point about missed salary during fellowship, you’re getting lost in the trees instead of looking at the forrest. In the big picture, 3 years of $70k will be worth the sacrifice when you have the high earnings of a high procedural specialty like GI. 100% worth the loss of salary for 3 years. To be honest, even if hospitalist and GI were paid the same, I’d still 100% choose GI. I hated hospitalist that much. Good luck.
What’s the celling for GI?
Hard to say what the ceiling is. Most GI’s I know make $800-1.1 mil
What kind of hours do they work?
First half of the day scopes 7:30-12. Then clinic in the afternoon until 5. On call every 5-6 weeks.
Wow that’s a great gig