July 19, 2021

How providers are compensated for teaching students in clinic​

Bruce Peyser, MD, FACP
Director of Education and Teaching, Duke Primary and Urgent Care
Physician, Duke Primary Care Pickett Road

Professor of Medicine, Duke University School of Medicine

Since I became director of education and teaching for Duke Primary and Urgent Care, a number of providers have on occasion asked, “How much will I get paid to teach a student, and how does the compensation work?” The discussion is always more mild-mannered than how the gifted football star played by Cuba Gooding Jr. called his agent, Jerry Maguire (played by Tom Cruise), and chanted “show me the money” as a contract was being negotiated. Here I provide some details about the stipend that is allocated to providers when they are teaching individual learners in our clinics.

Well, if Cuba worked at Duke Primary Care, he would be quite pleased because our network has been both generous and straightforward with sharing the money. For each half day that a provider instructs a learner from a Duke program, he/she will be paid $75. When a learner’s rotation is completed at a clinic, typically the practice medical director or health center administrator collects the total number of half-day sessions worked and sends that information to Kelly Trousdale in DPC Human Resources. We review the numbers and confirm the work effort, and then forward that information to our folks in Finance. The total money that should be paid to the provider is calculated. A percentage of the extra compensation is deducted to cover applicable taxes. The remaining money is allocated to the provider, and he/she will see that extra money in the next month’s paycheck. Additional compensation appears under a notation called Flat Sup.

It does not matter if you teach a nurse practitioner student, a physician assistant student, or a medical student, the teaching stipend is the same. But there are some instances when someone might not get paid. Sometimes medical students are rotating during the first year of their training. When that happens, the number of sessions is small, the extra effort to involve them is diminished, and providers are not paid for that effort. Additionally, there are times that third- or fourth-year medical students train with us. When that happens, again, providers will not receive a stipend. Their “payment” is received in a different manner that is detailed below. In the past, there have been some students who try to work in our clinics even though they come from schools not affiliated with Duke. We have decided to strongly endorse our NP, PA, and medical school programs, and we do not provide a stipend for teaching outside students. We strongly urge you to decline their requests that are often sent in mass emails to many Duke providers.

While it’s great to be paid for the extra work and effort to teach a learner, there are other intangible benefits as well. It is certainly nice to have a younger colleague working beside you, and oftentimes their questions help us to be sure we are delivering high-quality care to our patients. Over time, learners can help write notes on patients they are seeing, but this should be limited to no more than three notes per half day. I have found that with proper amounts of coaching and guidance, these notes become quite invaluable and help me to get through my workday in a more efficient fashion. Lastly, many of us have found these working relationships are quite gratifying, and friendships develop that continue over time.

There are lots of great reasons to volunteer to teach learners in your clinic. For many, this is a shared effort, where a learner might come to a clinic for a month and rotate with different providers. Other clinicians opt to have a learner work with them all the time, in a longitudinal fashion. We will have more than 200 learners come to our DPC clinics for the academic year 2021–2022. If you are new to teaching, please consider signing up for one of our many faculty development teaching sessions which are interactive and fun. One specifically for pediatrics will occur Friday, April 23 and a second one for primary and urgent care providers will take place Wednesday, May 5.