Physician training involves many years of education and work, including a minimum of four years of medical school, three to seven years of residency, one to three years of fellowship and continuing of education through Maintenance of Certification (MOC) requirements.1 Given the high cost of medical school and often inevitable debt,2 aspiring physicians may take compensation into account when choosing a specialty.3 Anesthesiology, though a more lucrative specialty than over half of all medical specialties,4 can show variation in compensation across career phases, regions and genders.5
Residency programs, which follow medical school and allow physicians to learn about different aspects of their chosen specialties,1 are periods in which anesthesiologists’ work schedules and compensation differ widely from senior anesthesia practitioners.5 While anesthesiologists earn an average of $386,000 per year according to the Medscape Physician Compensation Report,4 anesthesiologists are offered lower compensation based on their experience and postgraduate year (PGY). In the 2011–2012 academic year, PGY-1 anesthesiology residents at Northwestern University’s Feinberg School of medicine were paid $48,754.5 Meanwhile, PGY-2 residents received $50,519, PGY-3 residents received $53,122 and PGY-4 residents received $56,143.5 Given inflation, today’s anesthesiology residents generally receive more than this wage;5 however, they still receive lower pay than more practicing anesthesiologists.5 Resident anesthesiologists’ compensation also differs by region.5 For example, for the 2011–2012 academic year, anesthesiology residents at Northwestern’s Feinberg School of Medicine earned more than residents at the Wexner Medical Center at Ohio State University, who earned more than those at the University of Tennessee Graduate School of Medicine.5 Clearly, salaries in anesthesiology differ widely based on years of experience and area of the United States.
Aside from salary, other factors affect resident anesthesiologists’ quality of life. Residency programs may offer benefits such as health care, book allowances and “per diem” compensation for professional conferences.5 The Wexner Medical Center program offers 15 days of paid vacation and five days of professional leave, while the Feinberg School of Medicine provides comprehensive individual and family health, vision and dental care packages.5 Meanwhile, the University of Tennessee provides anesthesiology residents with monogrammed lab coats, free meals while on call, notary services and free parking.5 Recently, organizations such as the American Society of Anesthesiologists (ASA) have made efforts to reduce overworking and burnout in anesthesiology residents by shortening on-call shifts.6,7 One study showed that on-call duties for anesthesiology residents should not be scheduled more than one in every five nights, and that residents should sleep more than two hours while on call.6 The ASA also published guidelines based on the Accreditation Council for Graduate Medical Education (AGCME), stating that duty hours for resident anesthesiologists must be limited to an average of 80 hours per week over one four-week period.7 Additionally, they state that programs must provide residents with one day per week free of all educational and clinical activities, and that there must be a 10-hour rest period between all duty periods.7
While anesthesiology residents often follow rigorous work schedules and have lower salaries than attending physicians, some may face more challenges than others. For example, a recent study on workplace experiences of anesthesiology residents found that women were significantly more likely to feel that their gender put them at a disadvantage; to note sexist behavior at work; and to have experienced discrimination from patients, attending physicians and other residents.8 However, the study’s sample size was small, and more research is needed on gender discrimination among residents specifically.
Overall, anesthesiology residency involves lower pay9 and longer hours10 than work as an attending anesthesiologist. However, programs may offer perks such as family health care and paid vacation days, and regulations are in place to keep resident anesthesiologists from working day-long shifts.7 Future studies should explore race, region, ethnicity, gender and other factors that influence anesthesiology residents’ experiences. Researchers should also investigate the effects of different shift lengths and salaries on residents’ satisfaction and quality of life.
1. Thompson AE. A Physician’s Education. JAMA. 2014;312(22):2456.
2. Jolly P. Medical School Tuition And Young Physicians’ Indebtedness. Health Affairs. 2005;24(2):527–535.
3. Baker LC, Barker DC. Factors associated with the perception that debt influences physicians’ specialty choices. Academic Medicine. 1997;72(12):1088–1096.
4. Kane L. Medscape Physician Compensation Report 2019. Web: Medscape; April 10, 2019.
5. Parker M. The Salary of an Anesthesiology Resident. Houston Chronicle 2019.
6. Hanlon JG, Hayter MA, Bould MD, Joo HS, Naik VN. Perceived sleepiness in Canadian anesthesia residents: A national survey. Canadian Journal of Anesthesia/Journal canadien d’anesthésie. 2009;56(1):27–34.
7. Jeffries M. Residency Duty Hours. 2019; https://www.asahq.org/education-and-career/asa-resident-component/residency-duty-hours.
8. Miller J, Katz D. Gender Differences in Perception of Workplace Experience Among Anesthesiology Residents. The Journal of Education in Perioperative Medicine. 2018;20(1):E618–E618.
9. Metheny WP, Ling FW, Mitchum M. What to Expect From a Residency Program: Answers From a Directory of Residency Programs in Obstetrics and Gynecology. Obstetrics & Gynecology. 1998;91(2):311–314.
10. Park R. Why So Many Young Doctors Work Such Awful Hours. The Atlantic: The Atlantic Monthly Group; February 21, 2017.