Doctor, doctor, give me the news

trust me, I'm a Doctor t-shirt

There are a number of popular comparisons going around right now. On a recent episode of The Daily Show, John Stewart compares “fat cat teachers” to bankers and Wall Street investors and points out the gross disparity between million-dollar executive bonuses resulting from billion-dollar federal bailouts and the $50,000+ salaries of teachers in a climate of billion-dollar budget cuts in education. On a recent Wonk Room post, I’ve read comparisons between the millions of dollars in proposed cuts to federal subsidies for PBS, NPR, and (appropriate to this conversation) the NEA, and the billions of dollars in federal subsidies being extended to the oil industry. Both are worthy comparisons, but both are problematic in so many ways I don’t even want to go into them here (and I’m sure you can point them out yourselves).

Vodpod videos no longer available.

Crisis in the Dairyland – For Richer and Poorer…, posted with vodpod

The comparison I’ve always made is between doctors and doctors, by which I mean medical doctors and academic doctors. It’s not exactly comparing oranges to oranges, but it’s definitely not oranges and apples. It’s more like oranges and tangerines. It’s certainly a comparison the general public is familiar with, even if they aren’t comfortable with it: when I completed my PhD, my brother bought me a t-shirt that reads “Trust me, I’m a doctor”; whenever I wear it, people on the street smile and ask, “Oh really? What kind of doctor are you?” I explain I’m a PhD, and their smiles collapse.

“Oh,” they say.

They don’t even bother to add out loud what they’re saying in their head: “Never mind, then.” They simply change the subject or end the conversation.

This is a disparity of respect, but it’s based, I think, in a disparity of salary, as though how much we make determines our worth. I won’t go into the philosophical or quasi-religious arguments for this (research social or socio-economic evolution, or prosperity theology, if you’re interested), but it does seem to be a dominant ideology in America. If you want a syllogism to express it, it would go something like this: “If people are paid according to what they’re worth (or the value of what they provide), then people who receive high salaries must be worth more (or provide greater value) than people who receive lower salaries.” According to this perspective, then, a medical doctor is worth more, or provides a greater service, than a teacher.

(I should point out that I’m primarily talking about college and university professors, because that’s my field of direct experience and because that’s where you’re most likely to find teaching academic PhDs. But plenty of PhDs work in education in other ways, via research or writing or other cultural venues; and plenty of teachers in our K-12 schools, both public and private, have higher ed degrees, including PhDs. So while most of the examples that will follow are from colleges and universities, I’ll use the term “teacher” to apply to anyone who provides educational services to society as a whole.)

On the surface, this disparity of “merit” might seem pretty valid. After all, medical doctors save lives, or at least (in the case of most doctors) prevent the early demise of lives. They help people achieve healthier lives and, therefore, presumably happier lives, and they also help prolong those lives. That’s a heck of a service to society.

Of course, teachers help people achieve more enlightened, more aware lives and, therefore, presumably happier lives. They also help improve people’s ability to continue improving themselves, which, in our sadly money-minded society, often translates to greater earning potential, higher salaries, and so on. I don’t like thinking of education in terms of its financial payoff, but in fact the higher level of education a person has attained, the greater that person’s salary is likely to be. According to the US Census Bureau, the mean income for a person with a high school diploma or equivalency is $31,280; some college, even without graduating, bumps that number up to $32,500. Finish a bachelors, and you leap to $58,600. (Keep these next numbers in mind for later.) A masters brings you to $70,800 and a PhD to nearly $100,000.  So, clearly, educating people does improve their lives, at least financially, and in this way, academic doctors benefit and, from a certain perspective, prolong the life of society as a whole. And in many, many cases, the education we help people attain does, both directly and indirectly, wind up saving lives.

So surely, teaching doctors provide a service comparable to medical doctors. Why then this disparity?

The reason this is even a conversation right now, of course, is because of the recent spotlight on teachers as a whole and some of the misguided (I’m tempted to use the words “delusional,” “idiotic,” or even “lunatic”) assumptions about how “overpaid” teachers are. And I’m writing this today because most of what I’ve seen are anecdotal arguments: “I know a teacher who milked the system and ripped off taxpayers for a small fortune!” Or, “I am a teacher, and I drive a shit car and am in danger of losing my house because I’m paid so little!” And I started wondering, what are the real numbers? When people complain teachers are “overpaid” or “underpaid,” on what standard are they basing this?

Those seeking to cut teacher salaries and benefits talk about how teachers make $50,000, $70,000, even $90,000, while the “average” American worker is doing good to pull in $30,000. Meanwhile, the teachers and their supporters argue that people with far fewer qualifications — less education, for example — make far more money. Scott Walker, the governor of Wisconsin who is seeking to kill the collective bargaining rights of all state employees, including teachers, and to cut their salaries, make them pay more for their benefits, and so on, is a college drop-out, yet he makes $137,092, plus benefits. (That’s just his government salary; I don’t know what he made in the private sector.)

But we really ought to be comparing people with similar credentials — similar levels of expertise, similar levels of education — and since the level of education required for the PhD has so few corollaries in the private-sector world, the easiest comparison seems to be between PhDs and MDs.

So I did some digging, and here’s what I found:

After the initial bachelors degree (often a specialized, science-heavy pre-med degree) medical doctors typically spend about four years in medical school, followed by a one-year internship and two to three years as a medical resident. That’s a total of seven to eight years of postgraduate education.

Medical school typically costs between $180,000 and $200,000. During this time, most medical students offset the costs of school with teaching or medical assistant positions, the average pay for which is around $28,000. Understandably, most medical students wind up taking out huge student loans. Still, the internship and residency that follow med school are paid positions and, as far as I can find, are essentially “on the job training,” meaning they are still a vital part of a doctor’s education but they are also (poorly) paid positions and require no tuition (though I suspect there remain some at least nominal education costs, like books, supplies, and conferences, comparable to the cost of continuing education for any post-grad employee). Most internships pay an average of $35,000, and most residencies pay between $36,000 and $41,000 a year. Enough to live on, but only just, and they do nothing to help pay off those hefty student loans. So, depending on how frugally student doctors live, they can complete their degree and become board-certified with as much as $20,000 in debt, or as much as $20,000 in the bank. That’s a dicey financial position to be in, so to help these new doctors get back on their feet, they command high salaries.

Finding a medical field equivalent to a PhD is difficult. Some fields, like the astronomically well-paid specialized surgeons, are so minutely area-specific that it’s almost impossible to find an academic equivalent, or, when I can, those fields are so far out on the fringes that comparing them isn’t really relvant. Other fields, like the general “Family Practioner,” seem to require slightly less medical school (three years rather than four); in the academic world, it might be the equivalent of someone teaching with a masters degree or, perhaps more accurately, ABD. I could go with “General Surgeon” because that seems to require a high degree of specialization but is still “general,” making it more relatively comparable to some PhDs. But “Psychiatrist” or “Internal Medicine” seems closer to what we academics do (though the latter, like “Family Practitioner,” requires one year less of schooling), so those might be a fairer comparison. In the end, I’m going to use an average of those latter three.

I also found an array of sources for salaries, but all are in the ballpark of each other, and since I’ll use the Bureau of Labor Statistics for PhDs later, I’ll give you the BLS numbers here as well: The average pay for doctors (internists, psychiatrists, and general surgeons) is $189,140.

And I say they deserve it.

But now let’s look at PhDs.

For the sake of making comparisons I’m familiar with, I’m going to go with degrees in the Humanities, particularly English, because that’s what I do. I should point out a few discrepancies, though. On the one hand, PhDs in the Humanities make some of the lowest salaries of any academic teacher at the college or university level, so comparing them to doctors is going to look a bit skewed. For a better representation, I have added in (much) higher paying fields like engineering. On the other hand, degrees in humanities typically take up to two years longer to complete than degrees in engineering (don’t ask me why — I have no explanation for this), which, in terms of time spent on education and therefore, presumably, overall qualifications, makes Humanities PhDs more comparable to MDs.

For the sake of comparison, though, the faculty salary numbers from the BLS do include all areas of study, not just Humanities. (English professors, if you’re curious, make between $15,000 and $40,000 a year LESS than engineering professors. So bear that in mind when you see the AVERAGE PhD salaries below.)

But I’m getting ahead of myself. To fairly compare these fields, we should look at how PhDs get started, so let’s look at their education.

Like MDs, PhDs require a lot of expensive postgraduate study. Don’t think med school gets the monopoly on “grueling effort.” On average, most PhDs will take between six and eight years, though it can get done more quickly if you run through a single degree (effectively wrapping the masters degree into the PhD). Still, a masters degree typically takes between two and three years to finish, followed by another three to five years (minimum) for the PhD. (Some in the Humanities spend as long as seven years just on the PhD, because the nature of their research is tedious and their resources far-flung. I spent four and a half years on mine, for a total of six and a half years of postgraduate education, which is the average.)

After this, in order to best compete on the market, many PhDs will engage in a year (or sometimes several years) of postdoctoral study, which is probably the best equivalent of, say, the medical residency. But it’s not a requirement, and most do just fine without it, so let’s skip that scenario.

During this average six and a half years of study, PhD students will spend, on average, between $160,000 and $200,000 on their education. To compensate, they take on positions as teaching assistants, program assistants, or research assistants, earning between $32,000 and $40,000 a year. (These numbers, like those for the tuition here and in the medical field, are based on the University of Wisconsin-Madison, more on which in the footnote below. I bring it up here, though, because I made nowhere near these figures while working as a teaching assistant and later a teaching fellow in Texas — and I won awards for my work there. Texas notwithstanding, though, Wisconsin’s pay for their grad students is more or less average compared with the rest of the country.)

So, PhD students make roughly the same as medical students, and their tuition is comparable though slightly cheaper (a frugal grad student in Wisconsin might be able to clear school with no debt, but a med student might not be so lucky).

But now that they’ve finished their degree (roughly equal to an MD), it’s time to start earning, and here’s where the disparity kicks in.

According to the BLS’s 2008-2009 numbers, the average salary for full-time faculty was $79,439. But this included the lower tiers of full-time teachers, “instructor” and “lecturer.” These rankings are difficult to line up with medical practitioners. For some, the ranks of “instructor” or “lecturer” are the equivalent of a medical students’ residency years, essentially on-the-job training. (This isn’t at all fair to the many hard-working teachers with a masters degree, but it’s an easy comparison for argument’s sake.) On the other hand, those committed to teaching at the instructor or lecturer level, with a masters or a PhD, are something like the medical equivalent of a family doctor or internal medicine expert (for lack of better comparisons), and so we should probably more accurately compare their salaries to these levels of doctors. But since we’re talking about doctors — whether an MD or a PhD — I’ll confine this to those positions most likely (though not always) requiring a doctorate to teach: the top three levels of professorship.

By rank, then, the average salary for these top three tiers are $108,749 for professors, $76,147 for associate professors, and $63,827 for assistant professors. (Anyone interested in crunching extra numbers might like to know that instructors make $45,977, and lecturers make $52,436. You might also like to know that in Wisconsin, I never made anything close to those numbers.)

I should also pause to point out that the BLS comments on how high-paying non-academic fields impact the payscale in the academic market: “In fields with high-paying nonacademic alternatives — medicine, law, engineering, and business, among others — earnings exceed these averages. In others fields, such as the humanities and education, earnings are lower.”

I can tell you as a guy who teaches in the Humanities, the earnings are MUCH lower.

All in all, teachers with PhDs make something in the neighborhood of $83,000 (though this is the national average across all fields — my friends teaching English in Wisconsin make a little more than half that), which means that doctors, with almost identical levels of education, expertise, and professional credentials to teachers, make on average more than twice what a PhD makes.

Enter the “we work harder” arguments.

This is similar to the “dollar for worth” argument I mentioned at the beginning. Its syllogism (which is more easily quantifiable and therefore, on the surface if it, easier to argue), reads: “If people are paid according to how often (or how hard) they work, then people who receive high salaries must be working more often (or harder) than people who receive lower salaries.”

A lot of people, when backed into this corner, start complaining that teachers are spoiled not because they make so much money (which, clearly, they don’t), but because they don’t have to work as hard. They get Thanksgiving and Christmas and Spring Break off. They get summers off. They quit work early. One guest on Fox News recently said his own mother was a teacher and she was finished by 2:30 in the afternoon, was home by 3.

I don’t know his mother or what kind of teacher she was, but this statement strikes me as ridiculous. My mother, too, was a teacher, and I was a latchkey kid starting in fourth grade because even though my school finished at 3 in the afternoon, my mother couldn’t get home till after 5, on a good day. Most weekends, she was up at the school preparing the classroom or grading papers — even though they often turned off air on weekends to save money, and we lived in Texas. When we kids had off for holidays, as often as not my mother was in teacher in-service, attending meetings or working on professional development. As much as half her summer break went to wrapping up the end of one academic year or gearing up for the next. And this is K-12. PhDs work at least as hard.

In a speech from 1992, one University of Virginia professor described the time he spent meeting with students, preparing lessons, grading assignments, attending committee meetings, advising organizations, conducting community outreach, engaging in research, writing scholarly papers to advance the field of research and thereby better teach the students, to say nothing of the time he actually spent in the classroom.  He tallied his working week at 50 to 55 hours. And I got the sense from his speech that he was tenured.  More recently, in an open letter to Governor Walker in Wisconsin, a Wisconsin university professor calculated his work week at 60 hours. When I taught in Wisconsin (I was an LTE teaching five English classes each semester), I figured out I was putting in an average of 60 to 70 hours a week.

Which makes me wonder, how many hours a week do doctors work?

A lot, you would imagine. They’re doctors, after all. They’re responsible for the health of their patients and are, in theory, “on call” all the time even if they aren’t specialists or ER surgeons.

According to a 2003 survey in the Journal of the American Medical Association, doctors work an average of 54 hours a week. The lowest number (dermatologists) was 45.5 hours; the highest (anesthesiologists and OBGYNs) was 61. That’s well within the range of what PhDs work. Even when I looked only at those three fields I was using for the salary averages (internists, psychiatrists, and general surgeons), the average work week was 55 hours. The average work week for PhDs comes out to around 60 hours, which means we do work harder, but not by much.

Plus, we have all that vacation to look forward to.

So I ran the numbers a different way. Assuming doctors work 50 weeks a year — taking only two weeks for vacation (and if I were a medical doctor, I’d feel crazy for taking that little in down time!) — doctors work, on average, about 2,750 hours in a year. If we were paying doctors an hourly wage, they’d make about $68 an hour.

PhDs, by comparison, work roughly 40 weeks a year (16 weeks each semester, a couple of weeks on each end for prep and wrap-up, a couple of weeks in the middle for between-semester committee work, occasional summer teaching, etc). That gives them around 2,400 working hours in a year, give or take a couple of weeks, which is a good 350 hours less than doctors.

But if we were paying teachers by the hour, they’d only make $34. Exactly half what medical doctors make.

A comparable amount of time spent in school and training, a comparable financial investment in their education and their careers, and equivalent levels of work (longer weeks for teachers, but fewer of them).

But teachers are only worth half as much?

The next time you visit your doctor and he asks to stick a needle in your arm, or she wants to cut you open for surgery, ask yourself, What would happen to my doctor — and what would happen to me — if I paid this person only half as much?

And the next time you send your kid to school, or you enroll in a college course, or you hear on the news how American education is falling behind other parts of the world, ask yourself, What would our future look like if I paid teachers twice as much as they make now?

UPDATE: This post is getting a lot of traffic, so I thought I’d add here that I’ve since written a coda with some more information, which you can find here.

It’s worth noting that I’m using a lot of statistics from UW-Madison (including their med school stats), because it makes for a convenient benchmark: as Wisconsin and now the nation debates state employee pay, teacher salaries, and collective bargaining rights, keep in mind that Wisconsin is NOT typical. On the one hand, UW-Madison’s compensation for graduate students, in teaching or research assistantships, is somewhat higher than the national average (and SIGNIFICANTLY higher than any compensation I ever got in Texas). This is mostly due to the collective bargaining rights of the state’s Teaching Assistants Association — the same group, I should point out, that began the march to the Wisconsin state capitol building and has maintained the momentum on the protest movement throughout its duration. On the other hand, teachers in Wisconsin have already sacrificed significant salary and benefits concessions, to the extent that while Wisconsin has a strong reputation as one of the best educational systems in the country, it also does not turn up on any of the Bureau of Labor Statistics tables for highest-paid professors at any level. In fact, most national data charts place Wisconsin at 28th in the nation in overall teacher pay; it ranks lower, as I understand it, for college and university faculty. My point is this: Don’t assume Wisconsin’s numbers are average, and don’t assume they’re either higher or lower than the average. They are both higher and lower, depending on the level of education you’re considering (higher up front, lower in the long run); but they are representative, I think.

Also worth noting: According to the Bureau of Labor Statistics, the industry employing the most English profs is “Colleges, Universities, and Professional schools” (with an employment rate of 37,530), with an average pay of $65,570.

BUT: The highest paying employer is “Educational Support Services,” with an employment rate of only 110 but paying $67,650. Of the five industries listed, “Colleges, Universities, and Professional schools” ranked 4th. Even junior colleges — which require less education and credentials of their faculty — pay an average of $1,100 more than Colleges and Universities.

Published by Samuel Snoek-Brown

I write fiction and teach college writing and literature. I'm the author of the story collection There Is No Other Way to Worship Them, the novel Hagridden, and the flash fiction chapbooks Box Cutters and Where There Is Ruin.

2 thoughts on “Doctor, doctor, give me the news

  1. Excellent breakdown–though it’s making me feel even more underpaid. Do those salary numbers for the TA speak of take-home pay only or do they include tuition reimbursement? It seems that’s an important distinction to make between TA and residency and whether or not someone is able to finish college debt free.

    1. Thanks, Wendy, for the comment and just for stopping by to read!

      You know, I’m not sure about the reimbursement thing. I know many graduate programs do not offer tuition waivers anymore, and some never did (down in Texas, I never had a waiver or reimbursement), but in Wisconsin, it seems like most TAs, RAs, and now PAs — certainly in the TAA union but sometimes even without joining the union — get the waivers. So that would further reduce their education costs.

      On the other hand, I don’t know how tuition reimbursement works in the medical field. Because I was trying to compare like to like, a lot of these figures — including the cost of education — come from UW-Madison, which has both a med school program and many academic grad school programs, so I’m assuming the tuition waivers would work the same regardless which program you’re enrolled in.

      For the purposes of these calculations, then, the difference remains pretty much as I stated it, but it’s definitely worth looking into more closely, because, colleges being the bottom-line corporations they are fast becoming and doctors expecting such a significantly higher salary in the end, I would imagine most medical programs would be reluctant to offer their soon-to-be doctors a break, which means few would ever get a tuition waiver. But I haven’t looked into that yet. I’ll get on that tomorrow. Thanks for the idea!

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