This is a follow up to my post about beginning a career in the remote/austere medicine world.
Before I get in to the numbers I want to explain a bit of my perspective and why I am sharing this info.
I believe that when employers keep employees in the dark about pay rates the only ones who benefit are the employers. In my opinion, making pay rates transparent and how they are calculated can limit some of the biases that come in to play and reduces the ability of the employer to take advantage of someone’s ignorance even if they only do so without intending to.
Industries have very different standards and applying the standard of one industry to another may result in someone asking for far too much or far too little. In the former case it shows that an individual is naive about that industry, in the latter it allows the employer to accept that low ball offer and underpay someone. Underpaying one person can drive down rates for others as well. I recognize that businesses have an imperative to make a profit but that should occur within the context of paying employees appropriate, ethical wages.
Hourly, daily, and weekly rates vary across different industries and for different roles but a few things that should remain constant are as follows:
Travel: You shouldn’t eat the cost of travel to an out of area gig. Ideally the employer will book the travel for you. This will almost certainly be economy/cheapest available. It’s possible that an employer may ask you to book your own travel and they will reimburse you. That may not be an unreasonable ask depending on how much that will cost.
Last minute tickets around the world are pricey and that could be a cost you have to sit on for a month or more while they work on reimbursing you. If I don’t know the employer already I’m pretty reluctant to hold on to that sort of expense. If I have an established relationship then I might consider it. If you have to pick up a rental car at your destination that will likely go on your credit card, at least for a while. In the TV/film world you might be driven around by a production assistant, especially if there is a language/cultural barrier. In other industries picking up a rental and driving yourself around is reasonable.
If you don’t already know how to drive a standard transmission vehicle that’s a useful skill to pick up.
Lodging: These might not be nice but they should be provided. This is another expense that the employer should cover. What the actual conditions are varies quite a bit based on the job. You might be in a mediocre hotel every night or on cot in a gymnasium or a hot trailer. You will need to get a sense of what is reasonable for the area. 1 week post disaster means you might be in pretty rough conditions, remote location for a well resourced, well established natural resources contract you should have a bed and power.
Per diem/food: This is another expense that you shouldn’t eat as the employer should cover it immediately or later on. If you are being paid a per diem that may be reimbursed to you which could take a few weeks. When working at a location that serves food (fishing vessel, residential educational facility) you should be included in that, assuming the other staff are. My US based employers use the federal per diem rate of $51/day.
Here are some industry specific info from my experience:
Commercial fishing industry: Vessel Medical Officer for a 300’ Factory Trawler practicing at the paramedic level with an expanded scope, working on the Bering sea, $325-400/day.
Television and Film: Safety Guide/Set Medic for a major TV network practicing at the BLS level with additional survival and risk identification/mitigation responsibilities, $325-550/day, paid weekly. Additionally a kit fee should be paid, discussed later.
Offshore Oil & Gas: Vessel medic for seismic vessels on the Gulf of Mexico. US and Norwegian flagged vessels. $450 per day, paid monthly.
Non-Governmental Organizations: Paramedic, project manager, trainer, or risk manager. $100-250 per day. Paid when the organization feels like it.
Kit Fees: This exists in the TV/Film world. The production company doesn’t actually own any medical or safety gear so they rent the gear from the person they hire. The kit fee is the rental fee for that gear. The more sophisticated the services you are offering and the more gear you are bringing the higher the kit fee should be. $50-200 per week is reasonable for a BLS through ALS kit. If they are renting technical rescue or other sorts of speciality equipment that would be a separate kit fee. I can’t speak to the specific numbers for those. If you have consumables in your kit that should be considered when quoting a kit fee. You won’t be paid to restock what you use, restocking comes from the kit fee.
If working a TV gig with ALS scope or rescue responsibly (technical, swift water, avalanche) then your day rate and kit fee should increase. $400-$450 per day is reasonable for a paramedic operating at that scope plus a $100-200 kit fee per week. I’m willing to take a little less if I’m really excited about the project or location. I can’t speak to specific rates for the rescue/rigging roles.
“High threat” medical support: Perhaps my assessment is a bit warped but the reason I put “high threat” in quotes is that a lot of the work described as high threat is more like medium threat in a sometimes risky region. Working as a paramedic on an established military base in Afghanistan is considered high threat. Big difference between that and being at the front lines supporting direct action missions. I would consider the work done by Special Forces Medics (SOCMs & 18Ds) to be high threat. The work I’m describing as medium threat may have more risk than being a paramedic on an ambulance in the US so it warrants a higher level of pay.
Additionally you may have responsibilities like training, supply management, sick call, Water Sanitation Hygiene (WASH), etc beyond that of a typical paramedic which also warrants a higher pay rate. For this medium threat work $500/day is average. As the risk and or responsibilities increase ones pay should as well.
A colleague worked as an armed medic in Libya shortly after the regime fell when ISIS was operating aggressively there. He was already a combat veteran and had served UN peacekeeping missions involving response to genocide. That Libya gig was the worst of his career and one incident involving superior numbers of ISIS fighters actively targeting his position made him have serious doubts about if he’d be coming home alive. I consider that be to high threat and should be compensated accordingly. For some there may not be an appropriate amount of money for that level of risk but I would say based on other positions a rate of at least $1000 per day is appropriate. I don’t even consider the work I did in Mosul to be high threat.
Teaching wilderness/tactical medicine: Assuming this is happening in a reasonably safe place (eg not Syria or Niger) a rate of $25-35 per hour or $200-300 per day is appropriate. Whoever you are teaching for should cover the standard things I mentioned above plus provide the gear set to make the class possible. If you bring a few extra, odd, or specialized items to contribute to the class that’s perfectly reasonable and one of the great things about having instructors with a variety of experiences. If you are expected to own most of the gear used in the class and you aren’t getting most of the proceeds of the class there’s a problem.
In summary, working for a company shouldn’t be viewed as a privilege you have to pay for. Being an employee of a for-profit shouldn’t cost you money. Gaining experience is great and there’s really value in that but also recognize experience doesn’t pay the rent. If someone else is profiting off of you “gaining experience” seriously question the business model. There’s also a difference between a medical or nursing student paying to take part in a program specifically designed to give them educational experience and someone being asked to perform specialized work where the organization reaps the bulk of the benefit.