Do Doctors Get Paid During Fellowship? Compensation Overview

After finishing your medical residency, you might consider pursuing a fellowship in your area of interest. Embarking on a medical fellowship is a significant step in your career, as it helps bridge the gap from residency to specialization. Fellowships also allow you to deepen your expertise and gain additional skills necessary in your chosen specialty.

As the total debt during medical school can amount to $250,995, a crucial question to consider is “Do doctors get paid during fellowship training?” Exploring this question allows you to make financial plans and well-informed career decisions. In this overview, we’ll delve into the details of how fellows are compensated, shedding light on what to expect financially during this pivotal stage in your medical career. 

What Is a Medical Fellowship?

A medical fellowship is more than just an advanced training program. It’s a pathway for medical school graduates who have finished their residency and wish to pursue advanced training in a specific medical specialty. The primary purpose of a fellowship is to produce highly skilled physicians who are experts in their chosen specialty. These physicians earn the title “fellowship trained,” demonstrating the highest dedication to their field.

Typically, a fellowship program lasts one to three years, depending on the specialty and the program’s requirements. Common fellowship durations in various specialties are:

• Nephrology: Two years;
• Gastroenterology: Three years;
• Cardiology: Three years;
• Sports medicine: One year;
• Rheumatology: Two years.

Fellowships generally involve multiple components, such as:

• Departmental rotations and shadowing;
• Community and civic activities;
• Exposure to executive leadership and decision-making processes.

Fellows also work under the supervision of experienced specialists, participate in patient care, and engage in research projects. During fellowship training, fellows usually have rigorous responsibilities and intense schedules. Although their responsibilities vary depending on the subspecialty in general, they:

• See patients in clinics or the hospital;
• Order and interpret tests;
• Develop treatment plans and track patient progress;
• Coordinate work schedules with other fellows, nurses and physicians;
• Prescribe medications;
• Diagnose various medical conditions, some of which may be complex and challenging.

During fellowships, they acquire in-depth knowledge and develop advanced clinical skills in their chosen subspecialty. This means mastering complex procedures and keeping up-to-date with the latest research and treatment modalities. Moreover, upon completion, fellows are eligible to take board-certification exams in their specialty, which validate their expertise and can enhance their career opportunities. They can also work in academic settings and educate residents and medical students, conduct research, and publish medical research papers. 

How Much Do Fellowship Doctors Make?

While fellows do get paid, it’s usually not financially equivalent to being a staff physician. However, given the advantage of undertaking such programs, most fellows see it as a valuable investment. After completing fellowship training, specialists earn much higher salaries than general practitioners. In general, fellows can expect a salary between $46,000 and $93,000, which on average is $66,364. 

Fellowship vs. residency salaries

Fellows are typically better compensated than residents, who, on average, earn about $60,000. Several reasons account for this salary difference, some of which are:

• Level of training: Residents are in the initial stages of their post-medical school training, whereas fellows have completed their residency and are pursuing further specialized training.
• Responsibilities: Residents typically have more supervised roles with a strong emphasis on learning. Fellows, on the other hand, have more specialized roles, often with increased responsibilities in their specific field. They can also perform complex procedures and may have teaching and researching duties.
• Professional status: As they’re at the beginning of their medical training, residents aren’t fully credentialed physicians. On the other hand, fellows are fully credentialed physicians who are able to practice medicine independently.

Besides the difference in pay, fellows often receive more comprehensive benefits and compensation packages, such as:

• Paid time off;
• Commuter assistance;
• Health insurance;
• License reimbursement;
• Tuition reimbursement.

Fellowship salaries across medical specialties

The average salary of a fellow physician can vary widely depending on their specialty. Some of the highest-paid fellowship specialties include:

• Cardiology: $143,378;
• Plastic Surgery: $125,373;
• Neurosurgery: $187,926;
• Gastroenterology: $143,335.

These specialties command higher salaries for many reasons, including:

• Advanced expertise: They require a deeper understanding of complex systems within the human body and often involve high-stakes decision-making and precision;
• Skill level: These specialties require an advanced level of skill and expertise and the ability to perform complex procedures;
• Workload: They also have more intense workloads and more patient care responsibilities;
• Demand: Certain conditions, such as digestive system disorders or heart-related conditions, are highly prevalent, so there’s a high demand for specialists in these areas.

Specialties with salaries on the lower end of the spectrum include:

• Nephrology: $90,989;
• Research Fellowship: $71,785;
• Rheumatology: $56,000;
• Pulmonary/Critical Care: $94,351;
• Infectious Diseases: $66,400.

While primary care, general medicine, and research-related fellowships tend to have lower salaries, they provide a high level of job satisfaction stemming from direct patient care and community impact. Furthermore, these fields offer stability and the potential for significant contributions to medical research.

States that pay the most for fellowships

Fellow salaries vary significantly depending on the state. The states that pay some of the highest salaries include:

1. Tennessee: $94,634;
2. Connecticut: $81,389;
3. California: $79,879;
4. Rhode Island: $78,492;
5. Maine: $77,590;
6. New Jersey: $77,138;
7. Arizona: $74,523;
8. Idaho: $74,239;
9. Hawaii: $74,084;
10. Indiana: $73,104.

On the other hand, the states that pay some of the lowest salaries for fellows include:

1. North Dakota: $44,690;
2. Louisiana: $45,551;
3. Utah: $49,175;
4. South Carolina: $51,229;
5. Mississippi: $51, 954;
6. Georgia: $52,141;
7. Texas: $54,543;
8. Kansas: $54,926;
9. New Mexico: $55,058;
10. Alabama: $55,669.

Understanding the factors that significantly contribute to higher pay in certain states is crucial. These factors include:

• Cost of living: States with a higher cost of living, like California, offer higher salaries to offset living expenses and attract talent to expensive urban areas.
• Demand for specialists: Regions with high demand for medical specialists tend to offer higher salaries to attract and retain qualified professionals.
• Concentration of medical facilities: In highly competitive healthcare markets, hospitals offer attractive salaries to lure top talent. For example, urban centers or regions with a higher concentration of specialized medical facilities typically offer better compensation. 

Factors Influencing Fellow Salaries

The salary of a fellow doctor is influenced by several factors, such as specialty demand, geographic location, experience, and market conditions. Understanding the factors that affect fellowship salary helps aspiring fellows make informed decisions about their careers and financial future. Let’s explore these factors in more detail.

• Type of institution: Generally, fellowships at academic institutions tend to offer lower salaries than private hospitals. This is because private hospitals have better funding to attract and retain skilled fellows.
• Geographic location: Salaries vary based on the geographic location, which in turn depends on the cost of living and demand for specific specialties in the area.
• Specialty and subspecialty: Certain specialties offer higher salaries due to their complexity and demand. Specialties like cardiology, anesthesiology, and neurosurgery tend to be more lucrative.
• Years of experience and additional qualifications: Additional experience and qualifications in the medical field can impact compensation. These include research experience, specialized training, and publications. Furthermore, engaging in additional training and obtaining certification in a subspecialty broadens their expertise and marketability.
• Negotiating skills: Negotiating a salary is essential, as it can make the difference between a good and a great compensation package. This includes a better base salary, bonuses, and benefits.   
• Job market conditions: Some specialties may be in higher demand due to advancements in treatment, demographic shifts, or emerging health challenges. The highest-paying specialties include interventional cardiology, orthopedic surgery, and neurosurgery. 

Conclusion

Medical fellowships are a crucial step if you’re seeking to specialize and advance in your career. Moreover, they’re enriching experiences and represent outstanding professional achievements. While fellows do receive compensation, the amount can vary significantly depending on specialty, institution, and location. 

As you evaluate fellowship opportunities, take into account not just the salary but also the benefits, work-life balance, and long-term career prospects each program offers. Ensuring you have a comprehensive understanding of the multifaceted factors that affect fellowships will help you make the best decision for your career. However, if you’re genuinely passionate about your specialty, pursuing a medical fellowship might be the right course of action for you. 

Frequently Asked Questions

Who can join a fellowship program?

Only medical doctors who have already earned a medical degree and completed a residency program can seek advanced training in a subspecialty in their field. In general, medical fellowships are highly competitive, with only a handful of applicants being selected. 

How long does a fellowship program last?

A fellowship program in medical training typically lasts one to three years. For example, a dermatopathology fellowship takes one year, whereas a neonatal-perinatal medicine fellowship takes three. 

What is the highest fellowship salary in the United States?

The highest fellowship salary in the United States is $93,000. 

What is the lowest fellowship salary in the United States?

The lowest salary for a medical fellow in the United States is $46,000.