We are not expecting to get salaries that are equivalent to an attending. N.Y. Residents generally accept that they have to live like students rather than like practicing physicians while they are in training, she said. The COTH report found that stipends continue to differ from region to region. As in previous years, the highest stipends last year were paid in the Northeast, followed by the Midwest, then the West, and then the South, where Dr. Berger works. Residency leaders say those differences largely reflect the cost of living in respective regions.
Residents point out that regional differences in pay can be exacerbated by local living costs.
In Miami, for example, Dr. Berger has found that housing costs are high largely because the city is still recovering from the devastation left by Hurricane Andrew in 1992. He explained that any spending money residents might have had in previous years now goes to pay for housing. As a result, Dr. Berger said, some residents at his hospital are arguing for a pay raise, something they have not seen in several years. Interestingly, however, when comparing only first-year stipends, the South came out ahead of the West. Thus, first-year residents in the South might start at a higher pay level than someone in the West yet end up earning less in their third year of residency than that same Western resident.