The first year of residency salary of 300,000+ how does Mayo Clinic regulate?

This article is written by Zhou Lujing

Since the Ministry of Health issued the Notice on the Implementation of the Trial Measures for the Standardized Training of Clinical Resident Physicians in 1993, various parts of the mainland have gradually carried out the preliminary exploration of standardized training for residents of different scales and at different levels.

Since 2010, Shanghai has officially opened the training of resident doctors, and the quota and training base have been designated by the government, and since then, the standardized training path for resident doctors has become closer and closer to the American resident training system. We're here to discuss how mayo Clinic's residency training approaches are for your reference.

Resident is a word that translates particularly well, and as the name suggests, it is often necessary to stay in the hospital when you first become a doctor, and over time, it is like "living in the hospital".

The rank of Chinese doctor currently has a resident doctor - attending doctor - deputy chief doctor - chief doctor, in fact, when the attending doctor needs to choose their own profession, become a doctor with a special direction.

In the United States, doctors have only residency - specialist training - to become the attending physician certified in the relevant profession, and the so-called chief deputy director is an administrative appointment given in administrative matters.

The world's medical students are miserable. After entering medical school, American medical students need to complete the following "monster upgrading" process:

Complete the USMLE STEP1 and STPE2 exams at school;

Apply for and match residency programs;

Graduated from medical school;

Start a residency training program and obtain a license;

Get your own specialist certification.

In the United States, both residency and specialist screening is to enter the National Resident Matching System (NRMP). The system's algorithm provided the most appropriate match between the hospital and the applicant, and the inventor even won the 2012 Nobel Prize in Economics. Every year in March, the results of the list can be described as more nervous than the college entrance examination, and the medical students who successfully matched the list should be celebrated by the whole family.

The number of annual residents in the United States is determined by government funding, most of which comes from the government's Medicare program, which is about $9.5 billion per year. Since 1980, the number of applicants has been significantly larger than the number of residents recruited in the United States every year. In the past 2021, despite the COVID-19 pandemic, the number of people participating in the application for residency matching in the United States has risen to an all-time high of 48,700.

After understanding the basic growth path of residents in the United States, let's take a look: How does the famous Mayo Clinic do residency training?

Taking surgery as an example, Mayo's residency training subjects are: oral and maxillofacial surgery, plastic surgery, general surgery, basic surgery, thoracic surgery, vascular surgery, neurosurgery, orthopedic surgery, and otolaryngology.

The following specialist training subjects in surgery are: Abdominal Organ Transplant Surgery, Cardiovascular Surgery, Colorectal Surgery, Endocrine Surgery, General Thoracic Surgery, Minimally Invasive Surgical Surgery, Minimally Invasive Gynecological Surgery Surgery, Hepatobiliary and Pancreatic Surgery, Extracorporeal Circulation and Heart Transplantation, Breast Surgery, Peripheral Neurosurgery, Vascular Surgery, Surgical Intensive Care, Urological Reparation Surgery and Pelvic Reconstruction, Neuroradology of Vascular Surgery, Adult Reconstructive Surgery, Adult Reconstructive Surgery (Lower Extremities), Adult Reconstructive Surgery (Upper Extremities), Hand Surgery, Skeletal and musculoskeletal system oncology surgery, sports surgery, spine surgery, advanced head and neck microvascular and reconstructive surgery.

For example, a general surgery residency, for example, requires the following amount of work to be completed during a 5-year training cycle:

Completed more than 750 major surgeries, of which the total stage of hospitalization in the last year must not be less than 150;

Master various endoscopic techniques;

Grasp the latest treatment progress of various diseases in general surgery.

In addition to the total surgical volume requirement, the minimum surgical volume of each specialty also has the following minimum requirements:

In addition to the above workload evaluation, resident doctors also need to evaluate from the following dimensions:

360° Assessment;

Six major competencies: clinical ability, medical knowledge, professionalism, ability to work in different medical systems and doctor-patient environments, learning and improvement ability in clinical learning, interpersonal communication skills;

Unified electronic assessment.

Taking "Interpersonal Communication Skills" as an example, the ability assessment is divided into 5 specific levels, which is convenient for the doctor to evaluate:

Non-conforming

Level I: Ability to use a variety of methods to ensure clear and effective communication with patients and their families about the underlying condition;

Level II: Ability to communicate according to the patient's characteristics (e.g., religious culture) and to provide the patient with the latest medical conditions at any time;

Level III: Ability to effectively inform patients and families of sensitive and bad news;

Level IV: Ability to process difficult information with patients according to the situation (such as informing terminal information), can help resolve conflicts between patients and families, etc.

Let's take a look at the salaries of Mayo residencies, using the 2015 salary scale as an example:

The first year of residency, 52483 knives / year (about RMB 333991 yuan)

Third year of residency, 56842 knives / year (about RMB 361731 yuan)

Residency for the fifth year, 61775 knives / year (about RMB 393123 yuan)

Of course, don't just look at the superficial salary, after all, most American medical students rely on loans to pay tuition, so almost half of the salary has to be repaid, and on average, all loans can be repaid in the 2nd to 3rd year of residency.

Eventually, after obtaining a medical license, 20% of doctors will become academic doctors: that is, stay in the university hospital, carry out medical + scientific research and teaching management. 80% become private practitioners: private hospitals, doctor groups, private clinics.