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Pay Levels for Clinical Fellows Effective July 2010

Mar 29 2010

Posted In:

OPA Blog

sent to supdssworkgroup and director_finance_administration_meeting lists on 3/29/2010

TO: School of Medicine Directors of Finance and Administration; Postdoctoral Administrators; Fellowship Program Directors

RE: Pay Levels for Clinical Fellows Effective July 2010

Effective July 1, 2010, all clinical postdoctoral trainees appointed through the Office of Postdoctoral Affairs (OPA) will be subject to their appropriate PGY levels set by the Graduate Medical Education (GME) office at the SHC. This applies to any trainee who will be seeing patients at the hospital, in accredited programs, in non-accredited programs, or in advanced training. This decision follows School policy of 2008 which stated that trainees should be paid based on the established SHC PGY levels and benefits, and which further suggested that departments develop an implementation plan to meet this mandate by 2009. In the last two years, most departments and divisions successfully developed such plans and the majority of trainees today are funded at or near their appropriate PGY level. This memo establishes the PGY scale as the required pay scale for all trainees at the School with clinical responsibilities.

While this policy addresses the concerns raised by trainees with respect to compensation, other issues regarding benefits remain. Differences in the benefits offered to clinical trainees who are on SHC payroll and those offered through the Stanford University Postdoctoral Benefits Plan are a point of malcontent for fellows. The problem arises when fellows drop from SHC payroll to less than 50% FTE, which results in their loss of SHC benefits. The impact is also in loss of eligibility to receive social security or the state-funded Paid Family Leave (PFL) benefits when the switch to OPA changes the trainee’s funding from salary to stipend (this has been a problem for women trainees in particular who become pregnant towards the end of their training only to realize that their PFL eligibility is affected as a result of receiving stipend rather than wages).

While a systemic solution is currently under consideration, departments should address the benefits inequity in the coming year through one or more of the following approaches:

1. Make every effort to maintain at least a 50% FTE on SHC payroll for every clinical trainee, including the utilization of inter-entity transfer mechanisms when using unrestricted SoM funding sources.

Structure the funding sources such that it remains possible for future trainees to maintain at least 50% effort on SHC payroll.

Pay for 100% of the trainee health insurance plans, rather than 70%, for dependent plans. This solution in particular must be a uniform policy within the department (i.e., where all trainees with dependents are treated the same). This can be up to approximately $400/month for a trainee with family in after-tax out-of-pocket expense that did not exist when the fellow was covered on the SHC plan.

OPA and GME are currently considering various solutions to the benefits issues. Cost considerations are taken into account, as well as a variety of logistical and legal concerns within Stanford and also with the insurance carriers.

Additional Information Regarding the Appointment Process of Clinical Fellows:

  • Clinical Instructor Appointments: departments may hire clinical fellows in a 90/10 or 80/20 split between a postdoctoral fellow and clinical instructor provided that it is allowable within the program guidelines, that the PGY level is met, and that compensation corresponds to job responsibilities.
  • OPA and GME will communicate their respective deadlines to submit appointment paperwork for the trainees. For OPA appointees, there will be revisions to the forms used. Stay tuned!
  • The calculation to determine the PGY level continues to be based on accredited years of experience as is currently done for fellows appointed though the GME office. For example GME and OPA do not count a Chief Resident year for a trainee who is completing an ACGME year of required clinical or research training.
  • In the rare case of fellows who short track their residency program and owe two additional years of research (which include ½ day/week of continuity clinic and possible on-call): These additional years are not reportable to ACGME, therefore, will the new policy apply to these fellows? OPA and GME would consider this to be an exception, (not frequently occurring), and we would ask for a justification.
  • The PGY levels are available from GME Office:


Rania Sanford, Ed.D.

Assistant Dean for Postdoctoral Affairs

1215 Welch Rd., Modular A, Room 86

Stanford University

Stanford, CA 94305-5402

Tel: 650-725-5075