[ArmyOrtho]

PGY-1 Salary in Houston, Texas in the Texas Medical Center (Largest in the World) for a categorical intern in Orthopaedic Surgery is $35,750. PGY-2. $37,750. PGY-3 $39,750. PGY-4 $41,750. PGY-5 (Chief) $42,000.

There is no housing allowance. You cannot moonlight until you pass USMLE Step 3, have passed all licensing requirements in the State of Texas (there are two other exams to take) and have achieved a ranking of at least 80% in your year group on the Orthopaedic In Training Examination.

I just got off the phone with a 2nd year anesthesia resident at UT Houston who is currently making the exact same amount I posted here. She cannot recall off the top of her head what she'll be making next year, but she thinks $39,750 "sounds right". I have no reason to believe that an anesthesia resident in Houston is making any more than an orthopod. The fact that you seem to be raking it in shows that perhaps it is not standardized across the country, but the point remains that she is making substantially more as a resident in the military than you are as a civilian.

US Military Pay Scale:

http://www.dfas.mil/militarypay/militarypaytables/2008MilitaryPayChart.pdf

I chose my words carefully and exaggerate very little, if at all. BTW, what are you a PGY-1 in?

 

[Toshi]

i think texas just underpays.

transitional year mean salary $43.7k
surgery PGY-1 mean salary $44.4k
IM PGY-1 mean salary $44.4k

i'm prelim surg before radiology btw.

 

[ArmyOrtho]

i think texas just underpays.

Honestly, that doesn't surprise me. Thanks for the links. My buddies in Houston are going to just love the info.

A surgical internship can be torturous for anyone, but your only alternative would have been medicine, or a transitional, and I would have killed myself after about two weeks in either of those. You ought to be about halfway there before your sequestration to the darkened abyss of the Reading Rooms.

Best of luck to you. Thanks again for the links.

 

[ArmyOrtho]

Bull sh*t. Doctors are no better, or smarter than any other intelligent person. They have more perseverance, and study more, but it's really no different than any other specialty. You can tell me I'm wrong, but I will continue to respectfully disagree.

I agree 100%.

Hardest part is getting accepted. I ace'd med school and residency and I'm not any smarter than the guy that sat next to me in the turret of a Bradley Fighting Vehicle for 4 years.

I was lucky enough to convince someone into accepting me into a school in which I probably didn't belong, and the rest is history.

Life throws all kinds of pitches at you. Make sure you're standing at the plate when they get there.

 

[dante]

Re: student loans. I consolidated mine at 2.1%. It's not about that. I am fully aware they are deferred. What you have absolutely no clue about, yet seem fit to lecture, it the salary of a military resident versus civilian.

She got med school paid for. So, no money out of pocket, but you have a valid point that if she had taken the loans, she would still have no money out of pocket in that they are deferred until after graduation (interest still accrues, however, and before I consolidated, the rates were over 6%...of $186,000...) In accepting a residency in the military for Anesthesia, she was commissioned as a captain in the United States Army and paid as such. After her internship, she began to draw professional pay as a medical officer. Her total benefits, including a huge housing allowance for residency is in excess of $70,000 a year. Of YOUR tax dollars. If she hadn't taken the military scholarship and thereby been offered a military residency, she would be making the civilian salary for an anesthesia resident. $35,000 - $42,000 per year, with NO housing allowance (refuted below). And, she'd have to start paying back her loans upon graduation.

If your main point of contention is the difference between the captain's salary that she received, and the residency salary that she would have received had she been in the private sector, you might have bothered to mention that in your original post. I could care less about the $200,000 in education that the US Gov't paid for, since she offered to pay it back with interest. So at the very worst she got out slightly ahead by making a captain's salary instead of $35-42,000 during her residency (as opposed to taking out student loans and going the private route). Not exactly something that I'd be freaking out over.

I also think you're overstating the average anesthesiologist's salary as well. This site shows that the median salary is $300,000, with the lower 25th percentile (starting salary?) making $250k. I highly doubt that Dr Hanna is going to get a job immediately making $460,000 in her first year...

And point out where I was "lecturing" about salaries in my previous post? I didn't say a word about salaries...

 

[ArmyOrtho]

*sigh*

In El Paso, Texas, there are 4 non-military hospitals. They majority of the anesthesia care is delivered by CRNAs. Certified Registered Nurse Anesthestists. These are nurses that have undergone specialized training to provide anesthesia care under the supervision of an anesthesiologist. At Thomason Hospital, the level 1 trauma center here in town, the CRNAs start at $275,000 annually.

Two of the Army anesthesiologists in town that just completed their military obligation and have decided to stay in town for the duration of their careers. One of them was hired at Thomason with a beginning salary of $350,000 despite whatever she happens to collect from billings. That's her salary. Guaranteed, and it will go no higher if she decides to work longer or harder.

The other (her husband), began working for a group that covers the remainder of the hospitals in town and has decided to forgo a guaranteed salary in order to keep 100% (minus a small percentage for office fees) of what he billed in his first year. The three other members of his practice each took home near $600,000 last year.

There are also sites far across the wonderful internet that list the average orthopaedic surgeon salary at $375,000. What this is listing is a SALARIED position, such as one in academics, or the Level 1 Trauma Centers here in Texas. This is not, however, how the vast majority of surgeons receive their compensation and can lead you to think that surgeons and anesthesiologists (among others) are taking home far less than they actually are. When given the opportunity to guarantee yourself a salary of $375,000 (which isn't bad at all, don't get me wrong), or to Eat-What-You-Kill at $500,000+, you can see why there aren't many that would want the salaried position.

And regarding the points made in my original post. The gist of the discussion was that if any physician in the military was given the opportunity to simply pay back (with interest, as you say) the money the gov't spent to put them through training rather than pay back that money with a term of service, you would be hard pressed to find anyone specialist stay in the military. The Army pays you less than you can make in a civilian world (if you chose to believe a website over what I'm telling you, that's your prerogative, but you can see that even your website shows her salary will double when she leaves military service). The fact remains that she had an obligation to serve, not to pay monetarily, and she chose the easy way out. The only ones that lost anything in this arrangement is the American Service Member and they deserve better.

Anything else you want to quibble about? It's the weekend, I can do this all day.

 

[splat]

Anything else you want to quibble about? It's the weekend, I can do this all day.

BTW ortho do you ride a bike ??

 

[dante]

So you're quibbling about the starting salary of an anesthesiologist, but not about the fact that if the good Dr had just gone to medical school on her own dime and left with $250,000 worth of student loans she'd be in practically the same position that she's in now? Fine, I can agree with that.

OMFG, she had an easier time in residency thanks to the US taxpayer!!! She raised and then dashed the military's hopes for a star anesthesiologist, and is *only* paying them back in full for her education plus interest! The end of the world is here!!!11!!1



Happy?

 

[ArmyOrtho]

BTW ortho do you ride a bike ??

Yes

I ride a Giant OCR-3 for road races and just got a Canondale from my brother to tool around in the desert.

And, Dante, if you can't see the point in that she obligated herself and left without fulfilling that obligation, and how this is a travesty, then there is no way I, or anyone, will be able to convince you otherwise across a message board on the internet.

Your certainly have the right to your opinions, and I'm glad that you have a dissenting view and are willing to express it, but I think you are having difficulty grasping the overall concept of what this is all about. What kind of world do we live in now where you can't even expect someone to follow though on a promise (to say nothing of a signed contract) without hiring a team of lawyers (all pro-bono) to get you out of it?

 

[splat]

And lets not forget about the poor Sap who didn't get in, who would have been willing to server his obligation, and got left out because she took his spot.

the other thing that gets me is how she waited until the very end of her training to change her mind. I'm sure she knew long before that that she was going to try to do any thing to get out and/or hoping the hostilities would end, while she milked the tax payers.

I'm Curious if any one knows , has she been hired by any one ? or is this being held against her ?

 

[dante]

I'm Curious if any one knows , has she been hired by any one ? or is this being held against her ?

Working as a doc in Maryland

And ArmyOrtho, if it's only about her not fulfilling her contractual obligations, then I missed your indignation at the dozens of other conscientious objectors each year, or the hundreds of others who "out" themselves to avoid their contract for military service. The only reason this made the news was because the military paid for her education. She's paying that back, with interest. Was it the right thing to do? No. Was it the "oh my god she's scamming the taxpayer and getting away with murder" scenario that your first post implied? No.

 

[ArmyOrtho]

My apologies for not listing in detail everything about the world that bothers me. I had no idea you were so interested. The medical community is small and since this made national news, she'll have to deal with it for the rest of her career. Nothing substantial, just people saying that she's "that doctor" they heard about.

If she stays in northeast, she'll probably be ok.

 

[DirtMcGirk]

1. The world, especially the medical community, is not the Army/Navy/Air Force. I've been on both sides of that coin, and the reality is that those coming out of the Armed Forces are not always viewed with the highest regard among their civilian peers. Sometimes, by other doctors, military trained doctors are seen and regarded as abrasive, too rigid, and unable to cope with a less structured world once they leave the service.

I know people who are close to this issue, again on both sides of the fence, and a lot of civilian doctors view this woman with a measure of respect and regard. She went with her conscience, which firmly did not believe in a war. She understood that if she were to go through with her obligation that she would be voiding the very oath she gave first, her hippocratic oath.

In case you've forgotten what it is, let me refresh your memory:

I swear to fulfill, to the best of my ability and judgment, this covenant:

I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.

I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism.

I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.

I will not be ashamed to say "I know not," nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery.

I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.

I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.

I will prevent disease whenever I can, for prevention is preferable to cure.

I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.

If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.

From the original version might I suggest you remember the line "First do no harm..."

2. She'd do fine just about anywhere she wants to go, including Texas.

You over assume that your values, or the values of the armed services, carry over one iota into the outside world. In a world where we are dreadfully short of doctors, especially well trained and proficient anesthesiologists, needed skills will carry past political and religious picadillos.

3. You seem to forget the costs...

Maybe Hanna thought through the real costs of what the military life are. Maybe she realized that all of the sacrifice her family had to give willingly to get her through medical school (because trust me Bubba, it takes a village to train an idiot) were enough, and that she was going to do the right thing and the smart thing and put her family and her faith first. You mock that as disingenuous or cowardly, while others might see that as all things good and right.

I am part of the "military family" establishment, and in a lot of ways that whole establishment is why my marriage is drawing to a close. The constant moving, the outright lies told by the military, the litany of day in, day out bull**** that your conscription into the military forces those you "love" to endure is amazing and soul crushing.

Maybe you don't have a family, maybe you don't have a woman who loves you in your life, maybe you don't give a **** about these people as they, in your mind, cannot come before your commitment to OD Green.

But maybe that wasn't the case for Mary.



What I am saying is I find it to be pretty ****ed for you to judge this woman. Would you really want someone "fighting by your side" who was not committed to the cause and the colors? Do you know or understand her personal situation? For some reason I don't think you do.

One other thing you might want to consider. Want to see an end to war? Well according to Plato there are two ways. Either don't fight, or join the dead. Only the dead know the end of war, but Mary found a way she does not have to further a cause she finds no merit in.

Good for her.

 

[ArmyOrtho]

Very valid points.

Sometimes, by other doctors, military trained doctors are seen and regarded as abrasive, too rigid, and unable to cope with a less structured world once they leave the service.

Agree 100%.

She went with her conscience, which firmly did not believe in a war.

Do you think that every soldier in the history of warfare believed in the war in which they were participating? She has an obligation to serve in the military. The military went so far as to guarantee her a non-deployable spot in San Antonio during which time she would be providing care of wounded soldiers that have come back from the front lines. She has decided not to participate in their care because she is a CO to the politics behind the conflict. What are the implications for her Hippocratic Oath with her refusal to provide care for a wounded 19 year old infantryman because she didn't believe in the reason he went overseas and got shot up in the first place?

You are correct to point out that the military oath of service and the hippocratic oath of medicine are not always easy to integrate, and things cannot always be seen clearly. The situation becomes even less clear when a provider is faced with treating a more severely injured enemy combatant in lieu of a less injured american service member. The Hippocratic oath mandates you treat the most wounded person first, despite the fact that saving this "enemy" will possibly drain you of the resources needed to provide care to the american service members that it is in your charter to provide for.

I concede this point. I don't have an answer to these quandaries and know of no one who has a "book answer", but I can tell you that in my experience and in those of surgeons that have recently deployed overseas, these conundrums are handled on a "case by case" basis.

Would you really want someone "fighting by your side" who was not committed to the cause and the colors?

This is a very good point, and one that is used by service members who are looking to get out of a pending deployment all the time. I've been in combat and can tell you from experience that when the rounds start flying, you don't fight because you were sent there looking for mythical Weapons of Mass Destruction, you fight because of the person to your left and your right, as cliche as it sounds. But, she was told she didn't have to fight. She was told she'd never have to go dodge mortar rounds (unless the gang violence in San Antonio has escalated to a level I was not aware of). The only difference between the care she's now providing in Maryland and the care she'd be providing in San Antonio is that she'd be treating wounded warriors. But, she's decided that these people don't deserve her care because she objects to the reason they got blown up in the first place.

I'll be the first to admit that there are a significant number of people who take the HPSP Scholarship to medical school simply as a means to an end and realize, only too late, that the cost savings of the scholarship are not at all worth the loss in pay and potential deployments the military offers you. These people are exactly as you state - less than interested in fighting by my side, but they all remain because they made the promise to stay, and they stood by their word. They had the integrity to look beyond themselves and provide care for those who need it regardless of what actions on their part or the part of some politician in Washington put them on the operating table in the first place.

Maybe you don't have a family, maybe you don't have a woman who loves you in your life, maybe you don't give a **** about these people as they, in your mind, cannot come before your commitment to OD Green.

Ease up. I'm sure you didn't mean this as a personal attack, so I won't take it as such. I am a happily married father of two with 10 years of commissioned service in the military. My obligation is up August 20, 2014 and I will be resigning my commission on that very day. My thoughts on the legality or ethics of this war have absolutely nothing to do with my continued service. On May 24, 1997, I raised my right hand and was sworn in a second-lieutenant in the US Army Infantry and when my time was near complete, I applied for and was accepted to medical school. On August 6, 2001, I raised my right hand again took the same oath. Upon graduation from medical school in May 2005, I swore a new oath, that of Hippocrates, which you so eloquently quoted, and I am fulfilling all three, despite how inconvenient they may be to me at any given time.

My military deployments have kept me from loved ones for more time than I care to recall and I've been in more firefights than I care to remember. I didn't enjoy this, but I did it anyway, because I said I would. I am by no means married to the military, and I disagree with quite alot of the bull**** that's seemingly ever-present. Please do not begin to tell me what I am thinking in 'my mind'.

One other thing you might want to consider. Want to see an end to war? Well according to Plato there are two ways. Either don't fight, or join the dead. Only the dead know the end of war, but Mary found a way she does not have to further a cause she finds no merit in.

So, you along with Plato would state that all armed conflict would simply stop should there be no participants? I agree. However, I will ensure that the ones I love and care about will not be taken advantage of by those who decide to hold out from pacifism until they get all they want. If it involves my continued service in the profession of arms, then so be it.