Pm & R REAL salary

[PMRing]

Hi, 

I'm currently a med1. 

Even before coming to med school, I got interested in pmr due to personal experience. I've shadowed one and I did love it as well. 

And of course the main reason why I would want to go into pmr is not because of its salary, but I would just like to have the right expectation. 

CMA number is showing around 280k. Some say, due to overhead (don't really what that is), they are much more paid, but others say they are paid a lot less than other specialists, not even 280k. 

I'm wondering if anyone actually knows how much they are really paid. 

Thanks! 

[ZBL]

It ranges on province, and practice setup. In general, inpatient pays less while private practice MSK or pain can pay more. On average across Canada, somewhere in the $250-370 range is probably what you’re looking at in terms of gross billing. Overhead is your operating costs, so whatever your billing is, subtract overhead, which for pmr is probably in the 20-30% range again depending on whether you do inpatient or private practice. 

 

Personally, if private practice MSK is your jam, I think FM + sports med probably makes more sense. 

[PMRing]

2 minutes ago, ZBL said:

It ranges on province, and practice setup. In general, inpatient pays less while private practice MSK or pain can pay more. On average across Canada, somewhere in the $270-370 range is probably what you’re looking at in terms of gross billing. Overhead is your operating costs, so whatever your billing is, subtract overhead, which for pmr is probably in the 20-30% range again depending on whether you do inpatient or private practice. 

 

Personally, if private practice MSK is your jam, I think FM + sports med probably makes more sense. 

Thanks sooo much for your answer! 

I like MSK but also neuro, one of the reasons why I am interested in pmr.  

But do you know how competitive it would to get the +1 in sports med? I heard you also have to compete for it.. 

[ZBL]

Sports med fellowships through FM are competitive, but really not that bad. You also technically don’t need to do the +1 to be sports med certified - you just need to show evidence of team coverage and pass the test, and you can do it after any specialty - FM, rheum, IM, rads, heck even derm. It’s just that the +1 guarantees you team exposure and also rotations in relevant specialties. 

 

But if you are also really interested in neuro, then pmr is a good combo of both. Most of the pmr residency is more neuro focused (and inpatient) than MSK focused from what I understand. 

[PMRing]

2 minutes ago, ZBL said:

Sports med fellowships through FM are competitive, but really not that bad. You also technically don’t need to do the +1 to be sports med certified - you just need to show evidence of team coverage and pass the test, and you can do it after any specialty - FM, rheum, IM, rads, heck even derm. It’s just that the +1 guarantees you team exposure and also rotations in relevant specialties. 

 

But if you are also really interested in neuro, then pmr is a good combo of both. Most of the pmr residency is more neuro focused (and inpatient) than MSK focused from what I understand. 

Wow so it is competitive! Was kind of hoping that it wouldn't be haha yeah there are so many possibilities with FM! And yeah, sport medicine would definitely be one of my top interests. 

Talking about salary again, between 270-370 is really not bad, I think.. Or is it, compared to other specialities? Everytime I tell my classmates that I am interested in PMR, first, they don't even know what it is, and then they just assume that it's a lot less paid than others. And everytime I google PMR on google, people always say "cons: A LOT LESS remunerated than others". Is that actually true?

Thanks again for your very kind answer! 

[ZBL]

Well, relatively speaking sports med is not that competitive - it’s one of the more competitive ones within FM but the vast majority of FM grads have no interest in a +1, so most people do match if they want it. 

 

Regarding salary, PMR doesn’t have the highest salary, but they also don’t work that many hours. Yes, an orthopaedic surgeon (~450K) or interventional cardiologist (~700K) will make more money, but they will also be working evenings and weekends while you’re at home having a beer - there are very few specialties that make a lot of money while also having the flexibility of not working very much. So I think on an hourly basis, PMR does ok overall and is probably roughly on par with most other specialties (same for family med, or family + sports med), and it’s up to you to scale up or down the hours as you wish. PMR is definitely a lifestyle specialty, and is moderately competitive to match in CaRMS. 

[Let'sGo1990]

If you can tolerate it, you can do medicolegals and make a killing. 

[PMRing]

1 minute ago, Let'sGo1990 said:

If you can tolerate it, you can do medicolegals and make a killing. 

what exactly is medicolegals?? And what makes it untoleratable for others??

Are every pmr docs qualified for it?

Thanks so much!

[Snowmen]

9 hours ago, PMRing said:

what exactly is medicolegals?? And what makes it untoleratable for others??

Are every pmr docs qualified for it?

Thanks so much!

I was going to mention it. It's basically filling out expert reports for court proceedings such as someone suing an employer after a work-related injury or for insurance companies looking for a way not to give a big pay-out after an injury. It's a lot of paperwork but is very lucrative (some who do it almost full time can reach a million/year).

Average remuneration figures do not include that as it is private work. For instance, the average in Quebec is about 400k (Quebec has much less variation between specialties) which includes billings from the RAMQ (public insurance) and CNESST (workers protection) but not from the SAAQ (drivers protection) or medicolegal work.

Therefore, your actual income will vary depending on your practice. Someone doing sports medicine is unlikely to have billings other than from health insurance but someone focusing on medicolegal, medullary injuries or chronic pain management could have extensive medicolegal or SAAQ billings on top which are not reflected by that previous data.

[1D7]

11 hours ago, PMRing said:

Wow so it is competitive! Was kind of hoping that it wouldn't be haha yeah there are so many possibilities with FM! And yeah, sport medicine would definitely be one of my top interests. 

Talking about salary again, between 270-370 is really not bad, I think.. Or is it, compared to other specialities? Everytime I tell my classmates that I am interested in PMR, first, they don't even know what it is, and then they just assume that it's a lot less paid than others. And everytime I google PMR on google, people always say "cons: A LOT LESS remunerated than others". Is that actually true?

Thanks again for your very kind answer! 

90% of what you read online comes from American numbers, which cannot be relied upon unless you intend to practice there.

There is actually not much reliable information out on the Internet that you can use to understand what pay is like in Canada aside from CMA's average figures. IMO your best bet is to talk to multiple fellows and staff about this subject if you really care about it.

At the end of the day you'll be comfortable with what you make. It's easy to get caught up comparing yourself to your peers, but for most people lifestyle generally becomes much more of a consideration after M3/M4.

[PMRing]

5 hours ago, Snowmen said:

I was going to mention it. It's basically filling out expert reports for court proceedings such as someone suing an employer after a work-related injury or for insurance companies looking for a way not to give a big pay-out after an injury. It's a lot of paperwork but is very lucrative (some who do it almost full time can reach a million/year).

Average remuneration figures do not include that as it is private work. For instance, the average in Quebec is about 400k (Quebec has much less variation between specialties) which includes billings from the RAMQ (public insurance) and CNESST (workers protection) but not from the SAAQ (drivers protection) or medicolegal work.

Therefore, your actual income will vary depending on your practice. Someone doing sports medicine is unlikely to have billings other than from health insurance but someone focusing on medicolegal, medullary injuries or chronic pain management could have extensive medicolegal or SAAQ billings on top which are not reflected by that previous data.

Thanks for your answer! 

Do you know if a lot of PMRs actually do a lot of medicolegal works?? 

And if one wants to do that work, does he need any extra education?

[Mithril]

On 4/13/2018 at 8:24 PM, Let'sGo1990 said:

If you can tolerate it, you can do medicolegals and make a killing. 

Yes...you definitely could. But do you want to feel like a dementor is eating away at your soul? Because that's what filling one of these out feels like.

[PMRing]

6 hours ago, Mithril said:

Yes...you definitely could. But do you want to feel like a dementor is eating away at your soul? Because that's what filling one of these out feels like.

Would you mind telling what aspects of it makes it feel like "a dementor is eating away at your sou"? lol 

What can be so painful about it? Many paperworks and that's pretty much it right?

[ellorie]

I’ve worked with supervisors who do IMEs and it can also feel crummy because especially if you do them for insurance companies, you aren’t really on the patient’s side, a lot of them are really angry with the system which you then become the face of, and it can feel kind of adversarial or at least not collaborative. 

[rmorelan]

1 hour ago, ellorie said:

I’ve worked with supervisors who do IMEs and it can also feel crummy because especially if you do them for insurance companies, you aren’t really on the patient’s side, a lot of them are really angry with the system which you then become the face of, and it can feel kind of adversarial or at least not collaborative. 

and you have to do them for the insurance company - if you pick a side in the cases you review you have an automatic bias that can be used against you. 

Messy business

[FeelingTheBern]

1 hour ago, rmorelan said:

and you have to do them for the insurance company - if you pick a side in the cases you review you have an automatic bias that can be used against you. 

Messy business

to add on to this, the insurance companies also stop giving you work if you don't take their side on cases. 

[NeuroD]

56 minutes ago, FeelingTheBern said:

to add on to this, the insurance companies also stop giving you work if you don't take their side on cases. 

Is this true or speculation? I worked with a supervisor who said that he didn't experience that.

[Mithril]

17 hours ago, PMRing said:

Would you mind telling what aspects of it makes it feel like "a dementor is eating away at your sou"? lol 

What can be so painful about it? Many paperworks and that's pretty much it right?

In addition to the stated above it's paperwork. It's paperwork that just doesn't feel like medicine. And it's paperwork that residency doesn't prepare you for. If you're just starting your practice you don't really know what you need to include, how much detail, etc. When I had to do one I had no idea how to start. Luckily I work with my old preceptor from residency and he showed me how he does his.

[PMRing]

17 hours ago, Mithril said:

In addition to the stated above it's paperwork. It's paperwork that just doesn't feel like medicine. And it's paperwork that residency doesn't prepare you for. If you're just starting your practice you don't really know what you need to include, how much detail, etc. When I had to do one I had no idea how to start. Luckily I work with my old preceptor from residency and he showed me how he does his.

Would you mind if I ask you if you are a practicing pmr right now? 

Are PMRs or sport med doctors better put than other specialists for these kind of work? 

How's the job market like for the mediolegals work? 

Thanks!

[Mithril]

2 hours ago, PMRing said:

Would you mind if I ask you if you are a practicing pmr right now? 

Are PMRs or sport med doctors better put than other specialists for these kind of work? 

How's the job market like for the mediolegals work? 

Thanks!

I'm not a PMR doc. I'm a family physician. Medicolegals are not too common in my practice but I still need to do them for ICBC and sometimes work-related injuries.

[PMRing]

11 hours ago, Mithril said:

I'm not a PMR doc. I'm a family physician. Medicolegals are not too common in my practice but I still need to do them for ICBC and sometimes work-related injuries.

Oh cool! But do a lot other family doctors do medicolegals work? Or is that something that PMRs or sports med do mostly? 

[Mithril]

13 hours ago, PMRing said:

Oh cool! But do a lot other family doctors do medicolegals work? Or is that something that PMRs or sports med do mostly? 

All the family doctors at my clinic do medicolegals for their patient roster. I can't speak for other family physicians. I imagine that it's fairly common if you're full service.