Resident physicians are doctors that completed medical school and are in the process of becoming specialists. The number of years required to graduate depend on their specialty and interest. Some residencies are three years in length, while some are seven years. Unfortunately, this population is the most vulnerable as they have one of the lowest wages among medical providers yet one of the highest number of work hours. According to the AAMC, the governing body of the medical schools in the US, the average salary of a resident physician is 57,000 dollars in the academic year of 2020. They also work an average of 60-80 hours per week, depending on the specialty. Despite being an above-average salary in the US, the length of education, debts, inflation, and the high-stress environment have made it one of the highest drug abuse and suicide professions. This article will discuss why resident physicians deserve better pay and how our healthcare system is setting our trainees for failure.
1. They work very long hours.
Despite the new ACGME rules on resident work hours implemented in 2019, it is common to see resident physicians work between 60 to 80 hours per week, not including scholarly activities at home. Most resident doctors can work up to 100 hours per week if we include these scholarly activities, volunteer work, commute, and preparation outside the clinical setting. In my ICU training, it is common to max out at least 80 hours per week, with another 20 hours working from home, which are not supposed to be counted according to the program and the ACGME governing body. In addition, we are often scheduled with countless didactic hours and expected to do research and be published in medical journals. These obligations lead to stress, microaggression, and ultimately, mental health disorders such as depression, anxiety, and suicide. It is no wonder approximately 5-10 residents physicians commit suicide every year, and these statistics have been climbing in the past 15 years.
2. They are underpaid, and many programs barely have meal funds.
Resident physicians are underpaid for the amount of work they perform. Despite being above the national average salary, resident physicians also work almost double the number of hours compared to an average American. Compared to other lines of workers, such as hospitality workers, their compensations and benefits are much greater than resident doctors, despite having significantly fewer training years and debt. Unfortunately, the COVID19 pandemic also placed a significant financial strain on our training system, and many programs in this country cannot even offer meal funds to their residents. Training programs in many parts of the country can barely offer more than 50 dollars a month. That is less than 2 dollars a day! Many are not allowed into the physician lounge and are told that the new generations don’t work as hard as they used to. With the rise of inflation, many resident physicians continue to take on debts and are not able to afford their daily living.
3. They essentially run the hospital and do all the scut work.
In many parts of the country, resident physicians essentially run the hospital. The attending physicians in an academic center rarely write notes, put orders, and explain medical conditions to the patients. In community hospitals, it can be common to have resident physicians run the medical floor, the medical ICU, the burn care, and the surgical unit with minimum supervision. Resident physicians are responsible for the ins and outs of the entire hospitalization, including medical documentation, billing, orders, procedures, and end-of-life discussions. And all of these are done in the name of “training” the next generation of physicians. It is no wonder why resident physicians are struggling in this country. Attending physicians have salaries of several hundred thousand dollars, but they don’t have any obligations to care for patients in some of these hospitals.
Unfortunately, not many resident physicians will voice these concerns as they are afraid of repercussions, as well as affecting the accreditation of their training program. In conclusion, resident physicians deserve better compensation in respect, work-life balance, and pay. I believe the current training system in the US can be improved, but we will need to work together to make this happen.
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