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[quote=Anonymous]MDs at NIH are considerably underpaid compared with their colleagues at medical schools (and elsewhere) but also have far less clinical responsibility and no requirement to support themselves with grants/RVU goals etc.  NIH loses the better ones mid-career when the pay disparity becomes greatest (2-3x more at medical schools for example) - just lost the heads of multiple myeloma, the oncology fellowship, a cancer cell immunotherapy expert and a cancer neurosurgeon that way in past 6 months....

The physicians they get at NIH are those right out of fellowship building their research credentials, those totally committed to research that they feel they can only do there -  or the 65-80 year olds who either do little clinically (often with administrative or leadership titles) or are now so specialized in just one thing that they are unemployable elsewhere.

PhDs in staff scientist roles are however paid well compared with other options  - in many ways this is the best job at NiH.

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