A doctors' salary in Canada can vary, and although it might have been your passion that got you interested in medicine, your earning potential is still an important part of your decision making process, especially if you have a fair amount of student loans.
This is an edited version of a story previously published on Dr. Bill.
As of April 2022, the average physician salary in Canada can range from $83,379 per year to $414,389 per year. With such a large range, what drives such a difference? These 6 factors will help shed some light:
1. Number of patients
The average physician salary in Canada comes from many sources. The main one is a fee for service model that allows physicians to bill the government for each patient they see. Canadian doctor salary is comprised of a rate per service, which is claimed and submitted to the government for compensation. Under this model, the average doctor salary will depend on how many patients they are able to see in a day, what services they're providing and the province where they operate. Family medicine doctors billed an average of $51 per service in 2019, while medical and surgical specialists billed $87 and $91 respectively.
According to the Canadian Institute for Health Information, 72% of physicians work under a fee-for-service model. The other payment models are alternative payment plans (which usually include some fee-for-service tasks), or salaries. Under the fee for services model, a doctor's salary in Canada per hour will differ based on the province where they work, the number of patients they see per hour, and the amount they can bill for each patient. Family physicians see more patients per day, but specialists can bill a higher rate per patient, so a doctor's yearly salary will depend on both how many patients they can see, how many hours they work, and how much they can charge for each service.
Your specialization will determine the rate you charge per visit, which in turn determine your annual salary. According to the CIHI, the average gross payment per physician in 2020 was $354,000. Family medicine doctors earned $287,000, medical specialists earned $370,000, and surgical specialists earned an average of $487,000. Keep in mind that these numbers are reported as the gross amount doctors bill to the provincial government — it doesn't include the amount they pay in practice overhead, taxes, or other expenses, which can be around 20-30%.
More highly specialized medical fields will demand higher salaries, but also might come with longer hours. Make sure to balance the decision about how much you hope to earn with the other factors that would influence your choice of specialization. Keep in mind that there are other factors that influence a doctor's yearly salary within specialization – higher paying specializations often require more years of schooling, more hours, or a more stressful working environment. Some specializations may earn more in terms of doctor career salary, while earning less per hour than others.
A main driver for salary fluctuation is the province & location a doctor chooses to practice in. While all provinces and territories use the fee for service model, there is some variability in what you are allowed to charge in each province. Even location premiums depend on your level of specialization – more highly specialized physicians will earn a higher salary and have less variation across the different provinces. For example:
- Family physicians earn an average salary of $308,000 per year in BC and $303,000 in Ontario
- Cardiologists in BC earn $599,000 per year versus $508,000 in Ontario
- Psychiatrists earn $316,000 in BC versus $281,000 in Ontario
In addition, there are certain remote areas and underserved communities where the government will incentivize doctors to work. These programs provide student loan relief and bursaries to doctors who are interested in working in approved underserved or rural areas across Canada. Doctors who are fresh from medical school should consider working in these programs to increase their annual salary and get out of debt after medical school.
4. Whether you receive alternative payment methods
Depending on your specialization, you may be able to earn more for your services outside the fee for service model. These alternative methods include salaries, sessional and hourly rates, capitation models and contract work. According to Glassdoor, the average physician salary was $142,000, although this figure doesn't account for fee for service billings or the number of hours worked. Salary contracts allow physicians to earn more money through other means than just seeing patients. These other models of payment apply mainly to family doctors – 34% of family doctors earned more than half of their total clinical payments through alternative payment methods, versus 16% of medical specialists and just 8% of surgical specialists.
Where you live matters as well — the same CIHI data suggests alternative doctor salary in Canada varies by province, with over half of doctors in Ontario receiving some form of alternative payment, while only 17% of doctors in Alberta say the same. Alternative payment methods could look different for every doctor, but are often used to give doctors who live in areas with fewer patients a more consistent income. They also provide a more reasonable Canadian doctor salary for time consuming patient protocols or procedures.
5. Whether you have your own practice
Doctor salary in Canada can also be impacted by their choice of work environment. Working in a hospital or for a larger medical institution can mean a lower average annual salary for a doctor, since doctors with their own medical practice are free to pay themselves a salary or another form of compensation as income from the practice. Doctors with their own medical practice also report being happier and having a better work life balance than working in a hospital environment. If you're considering opening your own private practice, keep in mind that you will be financially responsible for the overhead and monthly fixed costs in addition to your student loan payments – so if you're considering this as an option, it's a good idea to make sure you're financially stable. At least for the first few years, you will likely be taking on loans to finance your practice, and you don't want to leave yourself overextended.
6. Whether you do research or teach
Your research interests can also impact the amount of salary you could earn. Through working with a university or a research institute, some doctors can earn a higher salary for themselves by teaching, researching, and planning and organizing conferences. Physicians can add to their doctor salary through an academic salary as a researcher, or teacher which could earn you an additional salary per year. This can come through full time university research or teaching positions held on a sessional or contract basis.
Other ways physicians can earn money through their research are through grants, such as the ones through the Medical Council of Canada, fellowships, or research stipends. How much you can earn through academic means really depends on how much you want a clinical career versus an academic one. The ivory tower might not be for everyone, but if you enjoyed research in school or are heavily invested in your area of study, it's not a bad idea to look into adding this to your doctor career salary.
Medical doctors in Canada are fortunate to have one of the most flexible careers for making money. In addition to the fee for service model that makes up most doctors' income, there are plenty of creative ways to make more per year. The salary of a medical doctor in Canada can differ based on where you live, how many patients you see, and what you studied in school – so medical students choosing a specialization should do their research well in advance of picking their major.
- 20 Most in-Demand Specializations in Canada
- Canada's Top 5 Most (and Least) Competitive Residencies
- The Different Types of Medical Practices
This article originally appeared on the RBC Healthcare - Advice & Learning
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