Why DOCTORS are UNDERPAID 

Thanks so much for your kind and considered response Dr Cellini - a huge privilege to be featured and hear your thoughts. Just trying to clear up a few things 1) My bio was very out of date(!) - I'm now a Foundation Year 1 doctor (sort of equivalent to a PGY1 resident/intern) 2) Our training works as follows - you finish medical school (usually 5 years), then must complete 2 years of generalist rotations in medicine and surgery (the Foundation Programme), after which you then complete 2-3 years of generalist training in medicine OR surgery (called Core Training),and only then after all that you become a resident (registrar) in a given specialty for 3-4 years, and then you ultimately become a consultant (attending). 3) The hours of work question is always difficult. Officially I'm employed for 48 hours, but when I was working in surgery was doing anywhere between 50-60 hours per week with all those additional hours unpaid. That's still of course nothing compared to what US residents do, but there's still very much a culture of staying until the work is done despite the salary and prospects not keeping pace with expectations.

Resident income is truly the biggest slap in the face in healthcare imo- making the big decisions as a physician with lives on your hand for 80hr work weeks for 60k/yr. For example… some targets employees are making 24/hr to be a cashier now. 80hrs a week as a target cashier makes 2400/week (1.5x OT) or 124k/yr as a target employee. And they’re not 270k in debt…

Everyone is underpaid. No one can survive with all the prices going up.

I am a junior doctor in Germany and I’ve been working in hospital in internal medicine for about a year now. Out of the last 35 days I have worked on 32. I am already thinking about quitting my job because I have absolutely no quality of life. Every evening I am too tired to meet friends or enjoy myself. All I can do is think about work because I am afraid of making mistakes because I am overworked and less concentrated. I don’t know how to keep up with this for the next 7 years until I finish my training.

We should cut out the parasitic administrators, insurance companies, and middlemen that exist in the medical system; then improve working conditions for doctors.

Same for pharmacists. I graduated high school in 2005 in the midst of a major pharmacist shortage. Around that time, pharmacists were able to name their price within reason, and new grads were starting at $50-60/hr, getting student loan reimbursement, company paid BMWs, sign on bonuses. The projection was, by 2011-2012 when I’d be expected to graduate, salaries would continue to increase into the $200k level. Also, if you chose to go into business and own your own independent pharmacy, it was very profitable. Then many things happened. 2007 recession, boomers lost their retirements so they continued to work instead of retiring. More schools opened up. Hospitals began switching to EMR systems that drastically reduced necessary staffing levels/workload, since with a CPOE EMR system, the prescriber electronically enters the order instead of handwriting it on an order sheet. It completely eliminated the transcription step of our job, which was good because it helps reduce errors made in the transcription process and not having to interpret bad handwriting anymore. All of that turned the situation into a pharmacist surplus and killed the job growth. People started getting offered less money, no sign on bonuses, no reimbursement for student loans. There are some places offering $40-45/hr nowadays, which adjusted for inflation is less than half of what was being offered back in 2005.

Honestly American and Canadian doctors IMO are really paid well compared to the rest of the world. In the UK and other European countries you get paid shit and residency training is longer because of the extra amount of years you have to work as a junior doctor before you can advance to residency. It gets worse when you’re from an African country, you work in such harsh conditions and get paid rubbish 🤦🏽‍♂️.

Im a 1st year med student in the U.S. and I do truly believe that I am a part of the last generation where going to medical school is still somewhat justifiable, but give it another 10-20 years and it will be a lose lose life decision. I have a friend who works in infection prevention at a hospital, only needed a 4 year degree, is 25 years old and making >100k/year and gets an automatic 2% raise every year that can be higher depending on certain bench marks. Meanwhile doctors' pay is going down every year and they are working harder.

In Turkiye, doctors are underpaid + working 80+ hours a week depending on the specialty. And we have to do mandatory 500 days service in rural areas after the graduation and finishing the residency. The only better thing is med schools are free in Turkiye except private schools. That's why currently there is a huge brain drain especially towards Germany.

Really Like the video! Would love a collab between the two of you discussing all the differences between the US and UK healthcare systems.

Ollie is very intelligent and hard working. I've been wathcing his videos for some time. Thanks for doing this one!

In general in Europe, the residency is performed in the public health care system, not in private owned hospitals. The number of residents each year is decided by the Ministry of Health in conjunction with Universities of Medicine based on the capabilities of the hospitals to train residents. And the residents are paid by the Ministry of Health through the hospitals to which they are assigned as contract physician between 3 (family Medicine) and 7 years (neurosurgery). At least this how it is in my country, Romania. That's why there is a monopoly.

Meanwhile in my country Indonesia, all residents must work 60-100+ hours every week, they don't get paid a single peanut AND have to PAY huge amount of money every semester to University. Sorry for my English.

I think the issues this doctor described in his video explain why I see a lot of young doctors from the UK coming to Australia to train. We have our own issues but the pay is much better for the conditions. Even in Aus though, considering the time spent trying to get into medical school in the first place, and the sheer amount of study and youth taken to get into training programs, the pay is still not enough, and there's still exploitation of junior doctors

Canadian IM resident here, excellent video guys! This is spot-on for most healthcare systems around the world. Wages have not kept up with inflation and school debt has skyrocketed. Granted, this is true of most fields, but what is often hidden is the time it takes to become a full-fledged physician in your 20s (into your 30s). The "you'll be fine" as a doctor comment is tough to swallow as you watch your peers start their full-fledged careers nearly a decade before you with less debt and set up investments/buy property to get ahead. All the while there is a large amount of responsibility placed on residents who are working long hours without any real compensation (I think my averaged-out salary is about $11 CAD/hr lol). We are typically the first ones in to make urgent/emergency decisions for crashing patients in hospital, and do a large amount of overnight call (I do a 26-hour shift 1 in every 4 days). I love what I do, but I can't blame people for trying to find better work environments and pay. The traits required to be a great physician (work ethic, organization, performance under pressure, and people skills) are well-rewarded elsewhere. In addition, it's tough to argue for better pay as a trainee as it's an engrained "process" to become a doctor, and even as a staff physician/consultant it's not negotiable as you're already perceived as well-off.

My high school friend is an anesthesiologist in Washington State and he went to medical school in England it’s called Saint Christopher supposedly a good medical school and his was very cheap. He had been a respiratory therapist in the United States for 14 years prior to going to medical school he did not even need to take out loans and then did his residency Emory University.

I am in medical school and no one wants to do primary care because the salary is underpaid. Some of the salaries are barely above a nurse practioner or a physician assistant with way more responsibility. Then just a simple house now will cost $750k with the new market.

Excellent video. Issues were discussed clearly. I went to study uk healthcare in 2005 for MHA program. The hospital reminder me of stepping back to the 1980s. Sharing equipment etc. of course waiting lists for non emergent procedures. However, at least all citizens have access to care. It is disgusting that all US citizens do not have access. I did see a private insurance company in England. People who can afford private get private insurance. I think that is very cool 😊

Fantastic video! One of the best courses I took as an undergrad was comparative health economics. A blend between the German and American system (eliminating for-profit health insurance) would be awesome, but America loves its admin salaries :’)

Love your latest videos. More insights on d issues besetting the healthcare systems from all sides, pls? Stay safe...🥰

Hey that is a great video and I’d like to answer a couple questions that you had in the video. I graduated from medical school in United States in 1985 but one of the things I did during my training in medical school was I did my OB/GYN rotation at the Royal Free Hospital in London. So this is where my experience has come from. I also had to borrow my way through medical school back when the interest rates were 12% and there was no deferment of compounding of interest. Therefore on the day I graduated I owed twice as much as I had borrowed. I have worked as a pediatric emergency physician once I completed my 14 years of residency and subspecialty training for 32 years. So here goes: Being a consultant in the UK means that you’re a sub specialist pretty much everybody or the vast majority of the physicians become GPs general practitioners and work for the NHS. Life for doctors at the time I rotated at the Royal free was a bit more relaxed. For instance during my US internship in surgery I clocked 120 hours a week in hospital time. That was back in the day when we did not have night coverage so we worked 36 on 12 off 12 on and another 36 on in a typical every third night call. Salary for interns was 25K at the time. In contrast the Royal free had not one but two pubs in the hospital one for attendings and one for medical students. They also had a rugby team and I was privileged to be able to see the royal free rugby team win the hospital‘s cup for the first time in history while I was there. I also noticed that they did not worry at all about malpractice and in general didn’t really respect their patients as much as American doctors did. That said, I have traveled in Europe and have needed medical attention from time to time and never had to pay a fraction of what we pay in this country. As for burn out and other comments that you made about our country I totally agree. I have seen over the past 32 years medicine be raped by greed from not only corporations but from regulators on both sides of the fence we get it. It has caused me to retire much earlier than I planned to because it was killing my health and I couldn’t stand the corporate greed going on all around me. A lot of doctors are trying to do direct to patient care but this is difficult and there are many barriers put up by our greedy insurance companies and hospital systems. ZDoggMD talks alot about this in some of his videos. For profit medicine is NOT the answer it is the cancer that must be weeded out of healthcare.

There's much scope for specialist doctors in the u.a.e where they compensate them fairly. I'm not even into a residency but I'm already looking to explore other options after I graduate !

52 yo surgeon here. Still have 43k in loan debt. No doubt the time loss of making money, dwindling reimbursement makes medicine a terrible career choice for young talented people in college. There is ever lessening incentive to go into medical career. I would not do it again if I could go back.

Great video with insights most people do not consider

Apparently, the training situation is a bit similar to Portugal, which also has a free National Healthcare System. After we finish medical school (6 years), we do a final exam, so that we can be ranked into a specialty. We then proceed to a full year rotating specialties and then apply to a medical specialty. You can only enroll in a (4-6) year of training to become a specialist in hospitals that belong to the national healthcare system and that provide those programs. These programs have to meet quality and training criteria (for example, a certain number of internships / rotations /procedures etc), By doing so, since you'll be working, you have to get a contract. Private practice isn't interested in hemorrhaging money making Specialists. Instead, they just snatch young doctors after they become physician specialists without contributing a cent to their education. Since our Healthcare is built upon a free system, usually the best hospitals, with the best doctors and professors, are public, particularly the "central" teaching hospitals. Private practice, in my opinion, is a money-making machine, that when things go bad or the patients run out of money, kicks them back to non-private hospitals to deal with the fallout.

Not only doctors but pretty much all healthcare workers. Our pay hasn’t kept up with inflation but you look at places like Target, Chick-fil-A, etc, they are keeping up better than most hospitals!

Had a mechanical engineer friend from Ireland. Said it wasn't possible (told by his firm) to be a Sr. Engineer there before you were 40 -- licenses, exams and all. No (compensated) responsibility till then. To design sewage treatment plants... Moved to the US and worked as a service engineer in the Semi business for the money. Trying to think of an EE or ME engineer I've known who was senior before ~35 other than by starting a company and getting there via an IP or equity swap when acquired by a bigger firm.

I love this video and you nailed it. Just imagine now being a State Veterinarian in Hawaii, one of the most $$$ states and being paid as "technical labor". Starting salaries for a State Veterinarian in Hawaii is $68,000. With an average graduating debt of over $100K and median cost of a home in HI at just over 1 million for a termite infested tiny box it is a wonder we can even find anyone to work for us. I love what I do mainly because of the work life balance but still...... The biggest stress is financial. We have a great group but are grossly underpaid and most only think we do Rabies quarantine stuff. Far from it.

I completely agree with this!

LIke Dr. Cellini mentioned before. Making medical school cheaper would be much helpful too!!

Becoming a doctor is truly not worth it in todays day and age.

I did 4 years of nursing, now doing 4 more years to get MD (curently on my last year). Then I have to do 1 year of obligatory general residency (akin to foundation in the UK), finishing with 5-6 years to become a specialist. So all in all 14/15 years to end up working shifts and weekends for average pay... The only good thing is that I didn't have to get into debt for it

for the monopsony thing i hope you read this basically in the US you ahve university programmes that essentially train you be it intern year or residency and they are all in their own right decentralised in a way in the UK training is only for NHS so until youre an attending you cant really work in a private set up like theres no rpivate hospital taht take charge in training residents those are all done in NHS hospital and only after they become consultants can they work in private healthcare( which is 3 yrs of IM training + 4 to 5 yrs of your speciality it varies according to specialities and depends on if your specialty is an uncoupled training programme or a run thru like neurosurgery paeds radiology where you apply once and go thru year 7 together in one go) so intern year which you guys have 1 they have 2 and its called Foundation year after which they do core medical or surgical training like in the US for IM then they do their residency for after which they become an attending( consultant) doctors in the UK work 40 hrs a week per month so its possible that they work excessively one week then have off days in between on calls are only 12 hrs strictly not 24 hrs so if youre on the night float youll be on the night float and off the entire next day and then do a normal day after that i dont know how the 12 hr on call works for surgeons in the OT

Can you do a video on scope creep with NPs and PAs taking over?

I'm an italian resident and we get paid around 19k euros a year here...

I'm a resident doctor in Lithuania. ~12k € annual salary here!

There is a reason I went into mental health counseling and got my PhD. instead of going into medical school. Will be graduating next month with only 5k in student loans

Not mentioned I think is the superb NHS pension plan (retirement plan). The employer puts in a large contribution each year and it's a final salary scheme that is gold plated as pensions go these days and an enormous benefit.

The ONLY profession that I know that takes 10 years to become & continues to get paid less each year… literally makes no sense

Be thankful for being a physician in the US. The situation in Europe is ridiculous. Not only are you getting paid less, but the taxes are much higher here and in certain countries if you’re an employee you can’t work more than 40 hours a week. It’s like « hey you wanna be rich? Sorry not here. » All in the name of « socialism ». God bless America. I’m working my ass off every day to get the hell out of here.

For a consultant in the UK which is the equivalent of an attending, the starting salary is £84,559 which is ~$110,000 and an experienced consultant makes £114,003 which is ~$152,000. This is their base pay and does not reflect any overtime or extra responsibilities which earn them extra e.g. management roles, teaching, departmental leads etc. I know of many consultants who earn between $180-300k with overtime or supplementary private practice, some others who make $300-500k and one who makes $750k but that’s in London where salaries can be wild at the top level with private practice.

Swiss doctor here, the situation in Switzerland is very similar to the one in the UK and US. Another important factor that justifies the need for a higher salary: responsibility. Everyday we risk to KILL someone if we are not careful enough! We need to get together and FIGHT! Also, as a resident here a normal day is 12 hours of work! 5 fucking days a week! WTF?!

Just a quick correction. Although Ollie's profile states he's a medical student hes now a junior Dr rather than a student.

If you guys are interested in the U.S. healthcare system. You should really check out The Price We Pay by Dr. Marty Mackay. Great book really talks about the cost of our system. I highly recommend it.

Huge difference from UK to US in salaries, after residency ofc.

Similar situation in Australia. It's a legacy of years of politicians and economists stigmatising doctors as rich volvo driving golf playing physicians.

I think the cost of college is way to expensive. I mean, where is all that money for it even going ? 🤔

*Doctors Underpaid* Me: *Cries in Lab*

A pound is usually quite a bit more than a dollar, too.

Can you address the glaring problem of hospitalists. I don’t know when this happened but I remember your own primary care physician was often responsible for your care or would be involved or would minor the treatment plan. A week ago my elderly mother had a fall and needed partial hip surgery, the surgery went successful. However the hospitalists who works for the hospital and has an interest reducing the costs for the hospital and not for the patient discharged my mother 2 days after surgery even though we felt her incision would still take a few more days to heal, her arms were swollen and she was not eating. Two days later our beloved mother died at the rehab. I blame the hospitalist for rushing her out of an environment where she could have been better monitor and her symptoms could have been better managed than at a rehab facility with no physical on site.

1:06 - In the UK, 18yo goes to 5 years of university, this is Med school (not 4 years undergrad and 4 years med school like the US), then at 23yo they graduate, apply for the UK national match and become an FY1 upon section. 6:25 - Docs in the UK (NHS specifically) are held upon a pedestal in the eyes of the public and in the eyes of other doctors. It seems to be prideful and patriotic, in a similar fashion to the way US Military personnel are viewed, and, honestly, many UK docs seem to accept this recognition and reverence as part of their compensation. Also, UK private practices are growing faster than ever along with private health insurance. In these practices, exams are often covered (although, most every specialty can only train within the NHS but, there are a few caveats here) 7:44 - 18yo University/Med school, 23yo is FY1 called a junior doc (4th year/intern,) 24yo is FY2 called a junior doc (intern,) 25 to 32-35 is specialty training called a Registrar (Resident,) and then finally they are Consultants (Attendings) where it takes 19 years from this point (in your 50s...) to hit the max pay grade (~115k) as an NHS Doc. (Several caveats for the pay grade aspect and a few differences in training based on specialty like becoming a GP) It's late, I'm tired. Tons more nuance here but, this is good enough for now.

I've always thought junior doctors in the US and UK - interns, residents/registrars, and fellows are paid way too low. Almost criminal.

I see a lot of uk doctors here in Canada. Also a lot from South Africa. It seems we have way more doctors from out of the country then we do natural born citizens. I’m not sure where our doctors go, we graduate quite a few every year.

In Puerto Rico "U.S.A" a General practitioner starts $60-$70K a year with the same debt as main land. Do the math. It's NOT worth it.

I have not gotten a pay raise in almost ten years... phuchk this shxtt...

Low pay, in part, due to perceived, rock star status. A beginer flight attendant starts out at $45k a year.

its 1,31 dollars for 1 pound sterling

Yeah the starting wage for target is $15 per hour regardless of job.

Keep in mind the British pound is normally worth about twice the US dollar.

Doctors are no underpaid in the USA (in my perception). The doctors in my country (Colombia) They really are underpaid, they paid around 1,000 USD a month to a family doctor (12,000 USD a year) and around 5,000 USD to the surgeons. So you could be an engineer and make easily the same amount of money of a surgeon.

Comparing pay is a lot more nuanced. In the US, even with high student loans and a late start, unless you insist on living in an extremely high cost of living area, then moderate financial discipline will get you debt free and financially independent restively early in life compared to most. You will have to resist pressures to live a stereotypical (in some fields, antiquated) “rich doctor” lifestyle, but you will be comfortable. Is that fair compensation for your sacrifices? Maybe maybe not. When comparing to other countries, it gets much more complicated. I’m slightly familiar with at least one other universal healthcare country. Physicians pay on the surface seems much much lower. However, it’s unionized and you get substantial union and government benefits plus a potentially generous pension plan which is pretty much non existent in the US. Again, purely from a financial and professional perspective, it’s hard to compare and both can be seen as very good viable life choices/careers. It’s important to look at the bigger picture. More importantly: Workload and burnout need to be addressed, more power on the hands of doctors not insurance and admin. Physician jobs have the potential to be extremely rewarding even if they were paid more modestly, but that aspect is being strangled out of the profession.

This was a good reaction. However Drs in the US dont work harder than Doctors elsewhere. In fact Doctors elsewhere work MORE. They treat the contract as a mere suggestion....so that politically it can be said that these are the hours you work but everyone knows you dont leave until everything is done, you dont complain about being asked to work extra shifts and you dont get overtime. The rub lies in the wording of the contract. Doctors in most places are exhausted.

I am a doctor and we are underpaid. The hours we put in, the incredibly stressful situations we deal with and have minutes to act is not worth the money we are paid. I would rather make less money doing less stressful stuff and fewer hours but have a good life. As soon as I pay off my loans I'm doing something else - this job really sucks

80k pounds is about 110k usd

If I did it again I'll be an auto mechanic, HAC technician or electrician

Maybe more controversial opinion is the opposite. I truly believe the vast majority of the work performed by most medical professionals is very simple and in many cases can be automated

84k pounds is about $109k

You think that's bad, look at how teachers are paid for the work they do, and without them, there'd be no doctors, lawyers, CEO or politicians. Those college costs don't go toward professors pay. Teachers work long hours for poverty pay.

Simple reason: Medicare Act of 1965. The government sets the fees. Thus, the government sets the value of your work.

Administrators lie around and do nothing useful. This stuff could be automated in a few years

So human med is on track to be as financially screwed as we are over in vet med 😢

Someone told me, “as a doctor you won’t have a problem putting food on the table.” Even though physician salaries aren’t looking great, it’s still enough to pay off debts and live a comfortable life. And I think it always will be. There is unfairness in many career fields, but as long as you love what you do I think the unfairness is easier to look past.

What happened to "🆓 college" over there though it actually not really "🆓"

In India also doctors getting low pay ..that is really too low.. bcz such money is not enough for ur daily base... Other people's are getting higher then medicinal feild

I don't understand why if u have to pay already just tto go to med school/ residents ect then on top of that u have to pay for exams and certifications! We have such a shortage of doctors u would think 🤔 school should be free. The government should pay it all. I fully agree this guy! Like why go into medicine? That's just wrong. Thanks for video

Hi Michael!

Show me a doctor who makes less than a quarter million dollars per year -

Watched both of my ads to help you out ;)

Cost of living in daily life in the UK is way more expensive.

So the 2 year foundation… year one is internship where you rotate and work as a doctor in all 4 major medical specialities (OBGYN, Peds, Internal Medicine and Surgery) the send year is called senior house officer…. In which you can choose any speciality you wish to get more experience in…. Then after those two years you then apply for a speciality you want to pursue and yes consultancy is the UK version of the American attending

Pounds not DOLLARS

Try going to england

The NHS requirement is 35 hours per week and physicians can supplement income in the private sector with Kaiser like HMOs like BUPA but even this is not enough to stop a major brain drain of docs to AUS, NZ and US or into administrative jobs at the NHS

If school was free, they wouldn't need to be paid so much.

A lot of people don’t understand that doctors and other healthcare professionals or staff working with patients should be paid high wages; the stress and responsibility that comes with taking care of and dealing with patients lives is invaluable and expensive. You kill someone by accident your career could be over, make a mistake career could be over. It’s not like other jobs where the death of someone doesn’t directly impact you because it’s not your responsibility. For anyone working in the NHS it is and not only would you be causing yourself to feel low but people in the public would additionally. It really is a matter of responsibility is equal to pay if you feel pay should be low responsibility should be low as well, none of us would accept the death of a family member to a irresponsible doctor so the same should be true for pay.

He means about 9000 UK pounds per year in debt....

One day, all these people will just realized we've been looted. I dunno if people will ever go after the looters and really do what it takes.

NHS + National Health Service

Ollie is the best!

UK per week working contract “48hours” Working 2 days in US😄

Doctors are underpaid because a lot of responsabilities are exclusively safe guarded for them via legislation, in most countries. If one does believe dumping more money in a already expensive pro is the only viable solution then a lot more MDs will continue to be underpaid.

medical school starts in high school

same teachers are also underpaid

Looking forward to your video on the US system!

So why are people still pursuing medicine in the UK? These are very smart kids competing at this level. They will not make foolish decisions if the payoff is not there.

I feel doctors , nurses, police, paramedics, fire fighter, teachers and all the people that are responsible for keeping society safe and advancing are undervalued. Athletes and entertainment is ridiculously paid. ( I read base ball player min wage went from 600,000 to 700,000 😮) But don’t think we can blame government and corporations. If our society values entertainment over a functional and safe community then thats a societal flaw and we need to take responsibility for this trend.

Folks are always going to want to be physicians. French and UK doctors are willing to accept a lot less to be doctors, and if American doctors think it won’t happen to us, then we have blinders on. It’s not a good trend for US MDs (I’m one), but it is what will happen.

8:15 so thisis the drawback for free healthcare for all? 11:42 I would say this kinda already came

Correct me if I'm wrong. It is my understanding that education loans can be forgiven if the graduate does some community service. I do know that the US military will pay all med school expenses.

Poor doctor. I make more as an RN here in the USA than that doctor. I have only been an RN for 8 years and have a BSN. I make easily over 6 figures and get days off at a time! Less debt too!