How to answer “Are doctors overpaid?” in a medical school interview

A strong answer to "are doctors overpaid" takes the argument seriously, sets out what physician pay costs and what it buys, and reaches a measured view without defensiveness. The interviewer knows you hope to earn that income one day, and they're watching how honestly you can reason about it.

What the interviewer is assessing

• Health systems and advocacy
• Critical thinking

Physician pay is a public question in both Canada and the US, and future physicians will have to answer it in front of patients, politicians and their own colleagues. The interviewer listens for whether you can state the critics' case fairly, whether you know how physicians are paid in the system where you're interviewing, and whether you can hold a view that isn't self-interest. Critical thinking shows when you notice that pay differs widely between specialties and between countries, so one answer doesn't cover all physicians.

In a panel interview, the question often arrives after you've talked about why you want to be a doctor, and the contrast is deliberate. In a multiple mini interview (MMI), it appears as a policy station, sometimes with a newspaper quote to react to.

How to structure your answer

1. Define the question precisely, since "too much" can mean relative to other health care workers, relative to the public budget, or relative to the training and responsibility involved.
2. Name the stakeholders: patients, taxpayers or premium payers, nurses and other staff, physicians in lower-paid specialties, and the governments or insurers who set fees.
3. Give the critics' strongest case, including that physician pay is a visible part of what health care costs and that the gap with nurses and other staff is wide.
4. Give the other side, including years of training, debt, hours, responsibility for decisions that can end a life, and the need to attract physicians to hard specialties and underserved places.
5. Take a position that allows for differences between specialties and systems, and say what evidence would change it.
6. Close with how the way physicians are paid affects patients, such as whether being paid per visit rewards short visits or whether a salary changes who gets seen.

Know the basics of how physicians are paid where you're interviewing. In Canada, much of physician pay comes from fee-for-service billing to a provincial plan, which pays the physician for each visit or procedure. Salaried and other arrangements exist alongside it. In the US, pay comes from a mix of salary, fee-for-service billing and contracts with insurers.

Don't quote salary figures unless you're certain of them and their source, because a panel of physicians knows the real numbers. Mention student debt as a factor that differs by country and by school, without making it the whole argument. Three minutes allows about a minute per side and a minute for your position.

Common mistakes

• Defending physician pay from the first sentence tells the panel you heard a threat rather than a question.
• Agreeing that physicians are overpaid in order to seem humble is as unconsidered as the reverse, and the panel will ask you to defend it.
• Quoting a salary figure you half remember invites a correction from someone who knows.
• Treating all physicians as one group ignores the gap between a family physician and a surgeon, which is where most of the real argument is.
• Leaving patients out of the answer turns a question about health care into a question about income.

Follow-up questions to prepare for

• Should a family physician and a surgeon be paid the same for an hour of work?
• Would you accept a lower income in exchange for forgiven student debt?
• How does the way physicians are paid change the care patients receive?
• If physician pay were cut by a quarter, what would happen?
• Are nurses underpaid, and is that the same question?