Cardiology Job market

[Silent Cool]

Had chat with another colleague of mine. Basically, MGMA salaries are overinflated. These salaries are not verified and are by self report only. Physicians obviously have an axe to grind here because if the salaries are high in the survey, they can negotiate a higher number.

redlined, what is the scoop? I will be interested in hearing why do you think the situation is the way it is.

I am also interested in hearing about if people are able to negotiate future salary increases. Future increase is not mentioned in my contract at least.

I have heard this before, too. Medscape apparently is more accurate. Basically, I think the MGMA surveys include TOTAL compensation--so that's not the take-home; it's the total value of malpractice (if paid), healthcare, retirement contributions, any paid time off, etc... Actual take-home (or net) is actually much less, I believe, on average.

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[IMDoc607]

Anyone know if there's a role for a interventional cardiologists to do just procedures, nukes, and echos with little outpatient time? I love the procedures and would rather be a procedural guy than seeing patients in the office.

Thanks

 

[punk]

Anyone know if there's a role for a interventional cardiologists to do just procedures, nukes, and echos with little outpatient time? I love the procedures and would rather be a procedural guy than seeing patients in the office.

Thanks

Some of the interventional/EP folks do procedures most of the time and have only little outpatient time. However, remember that the procedures are what drives your RVU earnings. Otherwise, you will be seeing a lot of patients to make up for the RVUs. Where everyone is trying to generate RVUs, your dream job may not be possible. Where you get fixed salary without any RVU consideration (rare job), this might be a possibility.

 

[IMDoc607]

Some of the interventional/EP folks do procedures most of the time and have only little outpatient time. However, remember that the procedures are what drives your RVU earnings. Otherwise, you will be seeing a lot of patients to make up for the RVUs. Where everyone is trying to generate RVUs, your dream job may not be possible. Where you get fixed salary without any RVU consideration (rare job), this might be a possibility.

Which is what I would prefer. I would rather do straight up procedures.

 

[nope80]

Two job offers:

1. Semi-rural college town:
Non-invasive
300K guaranteed first year then you eat what you kill for 4 years before being able to leave.
Call is 1:4
No mention of partnership

2. 40 minutes from major US city (subarb of the city):
Non-invasive
350K starting with bonus, partnership in 2 years
Call is 1:6

Yeah I signed up with number 2

How many hours per week would one be working in a job like this on average? I'm trying to calculate the hourly pay rate to compare to hospitalist, just out of my curiosity

 

[CassieBagley]

nothing

 

[dragonfly99]

Now having taken a job, and now in month 3 post fellowship...I will add this:

The vast majority of jobs have become employment based with a hospital or a hospital group where after your guarantee is done(2-3 yrs) you will be primarily compensated based on your work RVUs.

When you go out and look for a job, it is critical that along with a up front guarantee there be some explanation of where these work RVUs will come from after your guarantee is over. I interviewed at a place that was offering me $400K for non invasive but did not have the echo or nuclear volume to support such a salary. I'd have to see 30-40 patients a day in order to produce the wRVUs equal to my guarantee salary.

Whats the point of earning $400K for 2-3 years only to either have to leave because the compensation drops after the initial period or having to deal with a unsustainable work schedule to meet that guarantee?

Also these "guarantees" are not really guaranteed. The "standard" contracts I was sent often had language in them saying that they could scale back the promised dollar amounts if your production was way lower than they anticipated.

A 250K job that will definitively grow and has the potential for large amounts wRVU production may be superior to the 350K job that comes with a pipe dream of potential production.

-----------
Agree with this 100%
If they will not discuss how the RVU's are calculated and how the billing is done, etc., then you are really taking the job with blind faith that people are not going to lie to you...or maybe stretch the truth is more accurate. Also, sometimes they will lie about the call schedule...in my case, my amount of weekend call is not that much but there are 2-3 different call schedules for who covers the ER, patient calls, etc. on the week nights and calls from the ER or other docs during the day. It's hard to understand and cumbersome. I have been in my current job for 1 year, feel like I'm working my tail off and just go a "projected salary" letter for what my salary WOULD be if I didn't have an income guarantee for the first 2 years. It basically says my salary would be cut by 40%. For that amount of money, I could do as well doing primary care and taking NO hospital or night call at all (like our internists and fp's do). However, I would almost sooner slit my wrists than do outpatient primary care all day....and I don't think they will actually cut my salary by 40%, but do think they would take away some portion of my salary that is supposed to be based on "production bonus" which is about 20-30K a year. Sometimes my clinic has not been full so that is part of the problem, but another part of the problem is that doing diagnostic caths and the occasional TEE doesn't generate many RVU's, from what I understand. I/we don't read our own nuclear studies, which probably reimbursed pretty well. So I'm left with clinic patients, reading TTE's and some hospital work to general RVU's...as well as a ton of patient phone calls and med refills to clinic that generate NO RVU's but can take up an hour a day, since I'm often covering for colleagues who are not in the office.

I think if the main reason you are doing cardiology is for the money, it may not be worth it, particularly unless you are planning to do EP or interventional and willing to work crap hours to make your 300-400k.

As an aside, I feel really sorry for any of the med students who took out 300-400k of debt to get an MD or DO...they can dig themselves out of that hole but it sure is going to take a while. I would urge them to go into some specialty that does have better income potential than primary care, if they can. But I think things like radiology, or even pulmonary/critical care potentially takes less time and can make similar money to cardiology. Cardiology, if you like it and don't mind the 3-5 or 6 years extra training beyond IM residency, can be cool....but I don't think it is worth it for the money alone. And by signing up for cardiology you are in most cases signing up for a lifetime of call until you are 60 or 65 years old, so don't forget that. Especially if you do interventional you will be getting calls in the middle of the night for STEMI call for the next 20-30 years or your life, which is a long time.

 

[dragonfly99]

quoted

"FWIW, I don't know a fellow in the last 3 years from my program in the West that started for less than 350k. Not SF/LA area but otherwise big western cities. Most General have been 350-450k (higher end was more rural). Interventional/EP 400-500k (one rural for 600+). Personally I couldn't even fathom taking a non-academic gig for <300k and I sure wouldn't be all that fired up for a 300k/year spot"

I don't agree with this. I work close to and within a major metro area in the West that is not SF or LA and I don't make, nor do I know anyone in my graduating group who made/was offered 400-450k for general cards. I'm not sure what offers the interventional guys got.
One person I think got 300 but 250-280 is more the norm in our area, if you are not EP or interventional. That is still a nice salary...I don't have a problem with the salary, for me with my 130k or loans...it is fine. I do have a problem with the relentless pressure to see more and more patients and do more and more to try to maintain that salary, after my salary guarantee expires in a year or so...and that the hospital/med system did nothing to "market" me...and that I am on call for the local hospital several days a week, limiting my ability to have "a life" outside medicine yet receiving no pay for being on call except if I get to do a consult or procedure while on call. All the other stuff - telephone calls rom patients/families, med refills, "curbsides" from ER doc or hospitalist over the phone, nurse calls at 2 a.m. for a Tylenol if I admit a patient, etc., does not general any revenue for me/my practice, despite the time and life energy it sucks up.

 

[infarct]

quoted

"FWIW, I don't know a fellow in the last 3 years from my program in the West that started for less than 350k. Not SF/LA area but otherwise big western cities. Most General have been 350-450k (higher end was more rural). Interventional/EP 400-500k (one rural for 600+). Personally I couldn't even fathom taking a non-academic gig for <300k and I sure wouldn't be all that fired up for a 300k/year spot"

I don't agree with this. I work close to and within a major metro area in the West that is not SF or LA and I don't make, nor do I know anyone in my graduating group who made/was offered 400-450k for general cards. I'm not sure what offers the interventional guys got.
One person I think got 300 but 250-280 is more the norm in our area, if you are not EP or interventional. That is still a nice salary...I don't have a problem with the salary, for me with my 130k or loans...it is fine. I do have a problem with the relentless pressure to see more and more patients and do more and more to try to maintain that salary, after my salary guarantee expires in a year or so...and that the hospital/med system did nothing to "market" me...and that I am on call for the local hospital several days a week, limiting my ability to have "a life" outside medicine yet receiving no pay for being on call except if I get to do a consult or procedure while on call. All the other stuff - telephone calls rom patients/families, med refills, "curbsides" from ER doc or hospitalist over the phone, nurse calls at 2 a.m. for a Tylenol if I admit a patient, etc., does not general any revenue for me/my practice, despite the time and life energy it sucks up.

could you just refuse to curbside and come in a put an official consult in?

 

[punk]

-----------
Agree with this 100%
If they will not discuss how the RVU's are calculated and how the billing is done, etc., then you are really taking the job with blind faith that people are not going to lie to you...or maybe stretch the truth is more accurate. Also, sometimes they will lie about the call schedule...in my case, my amount of weekend call is not that much but there are 2-3 different call schedules for who covers the ER, patient calls, etc. on the week nights and calls from the ER or other docs during the day. It's hard to understand and cumbersome. I have been in my current job for 1 year, feel like I'm working my tail off and just go a "projected salary" letter for what my salary WOULD be if I didn't have an income guarantee for the first 2 years. It basically says my salary would be cut by 40%. For that amount of money, I could do as well doing primary care and taking NO hospital or night call at all (like our internists and fp's do). However, I would almost sooner slit my wrists than do outpatient primary care all day....and I don't think they will actually cut my salary by 40%, but do think they would take away some portion of my salary that is supposed to be based on "production bonus" which is about 20-30K a year. Sometimes my clinic has not been full so that is part of the problem, but another part of the problem is that doing diagnostic caths and the occasional TEE doesn't generate many RVU's, from what I understand. I/we don't read our own nuclear studies, which probably reimbursed pretty well. So I'm left with clinic patients, reading TTE's and some hospital work to general RVU's...as well as a ton of patient phone calls and med refills to clinic that generate NO RVU's but can take up an hour a day, since I'm often covering for colleagues who are not in the office.

I think if the main reason you are doing cardiology is for the money, it may not be worth it, particularly unless you are planning to do EP or interventional and willing to work crap hours to make your 300-400k.

As an aside, I feel really sorry for any of the med students who took out 300-400k of debt to get an MD or DO...they can dig themselves out of that hole but it sure is going to take a while. I would urge them to go into some specialty that does have better income potential than primary care, if they can. But I think things like radiology, or even pulmonary/critical care potentially takes less time and can make similar money to cardiology. Cardiology, if you like it and don't mind the 3-5 or 6 years extra training beyond IM residency, can be cool....but I don't think it is worth it for the money alone. And by signing up for cardiology you are in most cases signing up for a lifetime of call until you are 60 or 65 years old, so don't forget that. Especially if you do interventional you will be getting calls in the middle of the night for STEMI call for the next 20-30 years or your life, which is a long time.

, dragonfly, you must be a really cool girl. Those are exactly my thoughts about primary care.

I am yet to start my job post-fellowship but I hope its not as bad as yours. I did not get too much details on how RVUs are calculated or billing is done but I thought that probably applied more to group practice rather than hospital employed position that mine is. Fortunately, my skills will be marketed well by the hospital. I am sure that I will not be making much money for the hospital in the first year.

 

[Silent Cool]

-----------
Agree with this 100%
If they will not discuss how the RVU's are calculated and how the billing is done, etc., then you are really taking the job with blind faith that people are not going to lie to you...or maybe stretch the truth is more accurate. Also, sometimes they will lie about the call schedule...in my case, my amount of weekend call is not that much but there are 2-3 different call schedules for who covers the ER, patient calls, etc. on the week nights and calls from the ER or other docs during the day. It's hard to understand and cumbersome. I have been in my current job for 1 year, feel like I'm working my tail off and just go a "projected salary" letter for what my salary WOULD be if I didn't have an income guarantee for the first 2 years. It basically says my salary would be cut by 40%. For that amount of money, I could do as well doing primary care and taking NO hospital or night call at all (like our internists and fp's do). However, I would almost sooner slit my wrists than do outpatient primary care all day....and I don't think they will actually cut my salary by 40%, but do think they would take away some portion of my salary that is supposed to be based on "production bonus" which is about 20-30K a year. Sometimes my clinic has not been full so that is part of the problem, but another part of the problem is that doing diagnostic caths and the occasional TEE doesn't generate many RVU's, from what I understand. I/we don't read our own nuclear studies, which probably reimbursed pretty well. So I'm left with clinic patients, reading TTE's and some hospital work to general RVU's...as well as a ton of patient phone calls and med refills to clinic that generate NO RVU's but can take up an hour a day, since I'm often covering for colleagues who are not in the office.

I think if the main reason you are doing cardiology is for the money, it may not be worth it, particularly unless you are planning to do EP or interventional and willing to work crap hours to make your 300-400k.

As an aside, I feel really sorry for any of the med students who took out 300-400k of debt to get an MD or DO...they can dig themselves out of that hole but it sure is going to take a while. I would urge them to go into some specialty that does have better income potential than primary care, if they can. But I think things like radiology, or even pulmonary/critical care potentially takes less time and can make similar money to cardiology. Cardiology, if you like it and don't mind the 3-5 or 6 years extra training beyond IM residency, can be cool....but I don't think it is worth it for the money alone. And by signing up for cardiology you are in most cases signing up for a lifetime of call until you are 60 or 65 years old, so don't forget that. Especially if you do interventional you will be getting calls in the middle of the night for STEMI call for the next 20-30 years or your life, which is a long time.

Dragon,

I tried sending you a PM but your mailbox is full.

just an FYI
-sc

 

[nope80]

Guys, how about a few yrs into practice - how do the salaries change? anyone w numbers?

 

[sacrament]

Anyone know if there's a role for a interventional cardiologists to do just procedures, nukes, and echos with little outpatient time? I love the procedures and would rather be a procedural guy than seeing patients in the office.

Thanks

I average out to 1.5 days of clinic a week, and it's hard to imagine doing fewer than that. I need that many slots just to do follow-ups on the work I've already done, and to see new consults who are sent for procedures. Some practices farm out the "consult for procedure" visits to PAs or their general cardiologists, but the patients (and referring doctors) much prefer to meet the physician who will actually be doing their procedure.

 

[fasteddie911]

I had a slightly off-topic question regarding cardio jobs, but have any of you experienced or heard of anything in regards to fellowship program reputation vs job offers? Does the fellowship program's reputation and such have a significant affect on the offers people are getting? I am interested in general cardiology and going into private practice. I am a resident looking into cardio programs and I'm wondering if sacrificing location for a more "reputable" program is worth it in the long run in terms of future job prospects.

 

[JACO22]

My opinion is that it would be helpful to graduate from a program that people have at least heard of. Going to "top" program is important for those seeking academic careers. But personally I think location might be more important if you want to eventually practice in a location that is highly desirable, in that it helps to make connections.

 

[dragonfly99]

My opinion is that it would be helpful to graduate from a program that people have at least heard of. Going to "top" program is important for those seeking academic careers. But personally I think location might be more important if you want to eventually practice in a location that is highly desirable, in that it helps to make connections.

quoted for truth. If you want to look for a job in the LA area, it won't help if you are over in Pennsylvania or Boston while doing it...if you can go to a Harvard program or some place really famous, and you want to join a prestigious private practice it might help, but it depends on your other options.

 

[fasteddie911]

quoted for truth. If you want to look for a job in the LA area, it won't help if you are over in Pennsylvania or Boston while doing it...if you can go to a Harvard program or some place really famous, and you want to join a prestigious private practice it might help, but it depends on your other options.

My opinion is that it would be helpful to graduate from a program that people have at least heard of. Going to "top" program is important for those seeking academic careers. But personally I think location might be more important if you want to eventually practice in a location that is highly desirable, in that it helps to make connections.

Thanks for your input and advice. I have heard it both ways from various Physicians, some saying to get into the best program possible, and other saying to go somewhere to build a network. It's great to hear other experienced opinions on this.

 

[nope80]

I'm wondering what percentage of cardiologists are still in private practice? It seems as though the trend is to move towards hospital employment. If this trend continues, it seems as though cardiologists will be monopolized by hospital employment and at that point, what is there to protect ones salary?

 

[punk]

Thanks for your input and advice. I have heard it both ways from various Physicians, some saying to get into the best program possible, and other saying to go somewhere to build a network. It's great to hear other experienced opinions on this.

Statistically, most of the fellows settle in the areas surrounding their fellowship programs. As final year fellows, we were also aware of several local opportunities that were not advertised anywhere. One lesson that I have learnt from other fellows' experience is to be on good terms with everyone in the program: you never know who is going to call whom for reference. At least at the local level, people tend to know each other very well.

 

[punk]

I'm wondering what percentage of cardiologists are still in private practice? It seems as though the trend is to move towards hospital employment. If this trend continues, it seems as though cardiologists will be monopolized by hospital employment and at that point, what is there to protect ones salary?

It is true that there has been a movement towards hospital employment by the cardiologists. Both group practice and hospital employment have their advantages or disadvantages. One of the disadvantages you already mentioned. An advantage will be that you will be highly mobile. There are no practice assets to buy into if you are hospital employed.

 

[dragonfly99]

I think it depends on the area of the country as well.
private practice is quickly dying in many areas, though.
The capital required to buy and maintain heavy equipment like echocardiogram machine, treadmill stress testing machine, etc., is more than most people could scare up, I imagine. And all the health care regulations are an nightmare.

 

[Cardiac imaging]

Punk, which of the advanced imaging skills did you find to be more attractive/marketable for hospitals? Are level ii multimodality skills good enough for private practice? Thanks!

 

[IMDoc607]

I took a look at some other forums one of them being the pathology one. Something doesn't add up. The salaries they are quoting are highly variable from $125K to 375K. This doesn't any sense. So you're saying that a cardiologist makes $100K less than a pathologist starting off? It either is a terrible offer or there is a regional bias. It could also be that the offers we see here are base salaries and do not take into account incentives, bonuses etc. Looking at all surveys cardiologists make 100 to 150k more than a pathologist. Furthermore, merrit hawkins said in a report the average offer to cardiologists was ~460K. All these numbers being thrown around do not make sense.

Anyone care to comment?

 

[Silent Cool]

I took a look at some other forums one of them being the pathology one. Something doesn't add up. The salaries they are quoting are highly variable from $125K to 375K. This doesn't any sense. So you're saying that a cardiologist makes $100K less than a pathologist starting off? It either is a terrible offer or there is a regional bias. It could also be that the offers we see here are base salaries and do not take into account incentives, bonuses etc. Looking at all surveys cardiologists make 100 to 150k more than a pathologist. Furthermore, merrit hawkins said in a report the average offer to cardiologists was ~460K. All these numbers being thrown around do not make sense.

Anyone care to comment?

IMDoc,

I follow the Path forums regularly so I have some idea what you are talking about.

The path doc at the high end (375K) is someone who is retiring. That income seems highly unusual for a starting Pathologist. Their market is very saturated. The low end of those salaries reflects the starting income of a Path doc.

Re: Merritt/Hawkins, from everything I have read, I think that Meritt's surveys are "total compensation"--in other words, those numbers are not take-home income. The numbers include things like retirement, malpractice, other benefits, and take-home.

Just IMO.

 

[bronx43]

IMDoc,

I follow the Path forums regularly so I have some idea what you are talking about.

The path doc at the high end (375K) is someone who is retiring. That income seems highly unusual for a starting Pathologist. Their market is very saturated. The low end of those salaries reflects the starting income of a Path doc.

Re: Merritt/Hawkins, from everything I have read, I think that Meritt's surveys are "total compensation"--in other words, those numbers are not take-home income. The numbers include things like retirement, malpractice, other benefits, and take-home.

Just IMO.

This is exactly the case. People shouldn't take Merritt Hawkins numbers to be their take home. Furthermore, MH is a recruiting company, so they have incentive to inflate their numbers.

 

[IMDoc607]

This is exactly the case. People shouldn't take Merritt Hawkins numbers to be their take home. Furthermore, MH is a recruiting company, so they have incentive to inflate their numbers.

Ok that's fine. So all included the overall compensation is $461K. I fail to see why that's a problem. I say that because of the sense I get that people feel cardiology is getting paid poorly. I realize your not taking home $461K but isn't your purchasing power around that given that you're not paying for what you would have to anyway?

 

[NDESTRUKT]

I recently signed up with a group in the Bay Area of Northern CA (30 minutes outside of SF) for a general cardiology position which includes imaging but no procedures involved. Starting was 320K plus bonus. It was definitely through networking. Otherwise the job market in CA seems slightly dimmer.

 

[IMDoc607]

I recently signed up with a group in the Bay Area of Northern CA (30 minutes outside of SF) for a general cardiology position which includes imaging but no procedures involved. Starting was 320K plus bonus. It was definitely through networking. Otherwise the job market in CA seems slightly dimmer.

Thats amazing….I would be thrilled with that especially since its only 30 minutes out of SF.

Congrats! I am very jealous

 

[joejabjab]

I recently signed up with a group in the Bay Area of Northern CA (30 minutes outside of SF) for a general cardiology position which includes imaging but no procedures involved. Starting was 320K plus bonus. It was definitely through networking. Otherwise the job market in CA seems slightly dimmer.

Congratulations! That's awesome. If you're comfortable sharing, what's the bonus structure like? Timeline to partnering? Thanks for sharing.

 

[sanj238]

I recently signed up with a group in the Bay Area of Northern CA (30 minutes outside of SF) for a general cardiology position which includes imaging but no procedures involved. Starting was 320K plus bonus. It was definitely through networking. Otherwise the job market in CA seems slightly dimmer.

what does this mean. does this include malpractice/health insurance/overhead etc?

 

[josephf1]

got an offer in a major metro area oversaturated with too many card docs
just the thought of hearing a new fellow around town makes them run in panic away
offer is to join a solo guy as the 2nd potential partner
will have to build my own practice out of the multiple hospitals he rounds at, will get no patients from him
offering 250K for 3 yrs and small bonus (maybe 20K, bonus only over 500K collections)
after 3 years a 200K buy in to full partner,
BUT then there is not equal sharing of profits, each partner eats what he kills and only shares expenses
would anyone sign this?

 

[DoctwoB]

got an offer in a major metro area oversaturated with too many card docs
just the thought of hearing a new fellow around town makes them run in panic away
offer is to join a solo guy as the 2nd potential partner
will have to build my own practice out of the multiple hospitals he rounds at, will get no patients from him
offering 250K for 3 yrs and small bonus (maybe 20K, bonus only over 500K collections)
after 3 years a 200K buy in to full partner,
BUT then there is not equal sharing of profits, each partner eats what he kills and only shares expenses
would anyone sign this?

Just a med student here, but if you still have to build your own practice and then only eat what you kill, what exactly are you buying into?? Does the practice own much in the way of capital?

 

[bronx43]

I recently signed up with a group in the Bay Area of Northern CA (30 minutes outside of SF) for a general cardiology position which includes imaging but no procedures involved. Starting was 320K plus bonus. It was definitely through networking. Otherwise the job market in CA seems slightly dimmer.

How many year contract is this? Is the 320k the first year guarantee? If so, what does the rest of the contract look like? As far as job offers go, the devil is all in the details. Networking or not, the question remains why would they offer this contract when they can find 5 other grads who can do the same job for less in a saturated market?

 

[NDESTRUKT]

How many year contract is this? Is the 320k the first year guarantee? If so, what does the rest of the contract look like? As far as job offers go, the devil is all in the details. Networking or not, the question remains why would they offer this contract when they can find 5 other grads who can do the same job for less in a saturated market?

Malpractice, health insurance, and overhead included.

Bonus is twice a year based on how well the group as a whole does.

It is not a "guaranteed" salary type situation. I won't go into details but partnership is 3 years.

The salary is based off of their standard. They're not looking to shortchange anyone.

 

[Instatewaiter]

got an offer in a major metro area oversaturated with too many card docs
just the thought of hearing a new fellow around town makes them run in panic away
offer is to join a solo guy as the 2nd potential partner
will have to build my own practice out of the multiple hospitals he rounds at, will get no patients from him
offering 250K for 3 yrs and small bonus (maybe 20K, bonus only over 500K collections)
after 3 years a 200K buy in to full partner,
BUT then there is not equal sharing of profits, each partner eats what he kills and only shares expenses
would anyone sign this?

I agree with the med-stud. What exactly are you buying with 200K? Seems like a ripoff if you are setting up your own practice and getting essentially no help from the other guy. Realistically you are probably helping him since you're going to be splitting call.

So your salary is really $180K because at the end it sounds like you are giving him 200K back...

 

[Trifling Jester]

got an offer in a major metro area oversaturated with too many card docs
just the thought of hearing a new fellow around town makes them run in panic away
offer is to join a solo guy as the 2nd potential partner
will have to build my own practice out of the multiple hospitals he rounds at, will get no patients from him
offering 250K for 3 yrs and small bonus (maybe 20K, bonus only over 500K collections)
after 3 years a 200K buy in to full partner,
BUT then there is not equal sharing of profits, each partner eats what he kills and only shares expenses
would anyone sign this?

No, but then I'm not looking for a major metro area oversaturated with cards.

You need to find out what partner really means. Will you own the machines? The office? The land? How are you sharing call?

 

[keindo]

If I go to a Cardiology fellowship at e.g. Kaiser San Francisco, does that hurt my chances of getting a job after? Versus e.g. OHSU. Would greatly prefer a job in California.

 

[trickster123]

If I go to a Cardiology fellowship at e.g. Kaiser San Francisco, does that hurt my chances of getting a job after? Versus e.g. OHSU. Would greatly prefer a job in California.

I too am curious about this...I want to do private practice...is it better to gun for the most prestigious/well-known cards fellowship or go to a "local" fellowship program in the desired location that you'd eventually want to establish/join a practice??

 

[Trifling Jester]

I too am curious about this...I want to do private practice...is it better to gun for the most prestigious/well-known cards fellowship or go to a "local" fellowship program in the desired location that you'd eventually want to establish/join a practice??

From what I have seen private practice cares more about what you can do than where you're from. If you're not interventional that means you can read echos, nucs, do tee's etc. If you're interventional that means the above plus peripherals plus maybe structural. So if you already know you want PP then just make sure you can get cocats 2 in everything wherever you go. I don't think doing the local fellowship program in and of itself will necessarily help, but having contacts there would.

 

[trickster123]

From what I have seen private practice cares more about what you can do than where you're from. If you're not interventional that means you can read echos, nucs, do tee's etc. If you're interventional that means the above plus peripherals plus maybe structural. So if you already know you want PP then just make sure you can get cocats 2 in everything wherever you go. I don't think doing the local fellowship program in and of itself will necessarily help, but having contacts there would.

I am assuming that these fellowships that historically provide cocats 2 in everything are fairly competitive? What are some programs that historically have been able to provide cocats 2 to all fellows, just so I could get an idea of what programs I should be gunning for....

 

[hotshotdoc]

Whats the scope for a non-invasive COCATS level 3 MRI/ECHO/Nuc/CTA trained cardiologist in a private setting (hospital based)? Does level 3 in imaging help one in private practice (hospital based) where paychecks depend upon RVUs one generates? Most cardiologists employed by hospitals read their own echos, nucs and CTAs, so the imaging guy doesnt really get any extra volume. I am not sure what MRI volume is like in private practices?.
Any comments?

 

[phillydoc]

Wanted to put in my two cents here.
Graduated cards fellowship in 2013 from a major Univ program in northwest. Then interventional fellowship from major Midwest program. Have been looking for a perm job since Feb last year.
The only job offer I got so far was from a small city in Iowa, 2hrs from any major town ( salary-500k first yr). Did not take that job as it was early in my search. Since then I have interviews at a least 10 places but no offers. Got a offer from a NJ town, 1.5 hrs from NYC from a solo guys. Salary 250k. Call q3-4 from general and intervention call q7-8 shared with other groups in the hospital. There is a carrot of 25k increase in salary for year 2 and buy in partnership after that.
As of now doing locums 200-250/hr. I didn't think that I will have to struggle as much for a job.
Bottom line job market sucks.

 

[PlutoBoy]

Wanted to put in my two cents here.
Graduated cards fellowship in 2013 from a major Univ program in northwest. Then interventional fellowship from major Midwest program. Have been looking for a perm job since Feb last year.
The only job offer I got so far was from a small city in Iowa, 2hrs from any major town ( salary-500k first yr). Did not take that job as it was early in my search. Since then I have interviews at a least 10 places but no offers. Got a offer from a NJ town, 1.5 hrs from NYC from a solo guys. Salary 250k. Call q3-4 from general and intervention call q7-8 shared with other groups in the hospital. There is a carrot of 25k increase in salary for year 2 and buy in partnership after that.
As of now doing locums 200-250/hr. I didn't think that I will have to struggle as much for a job.
Bottom line job market sucks.

I sincerely hope you are kidding.

 

[desdinova]

Whats the scope for a non-invasive COCATS level 3 MRI/ECHO/Nuc/CTA trained cardiologist in a private setting (hospital based)? Does level 3 in imaging help one in private practice (hospital based) where paychecks depend upon RVUs one generates? Most cardiologists employed by hospitals read their own echos, nucs and CTAs, so the imaging guy doesnt really get any extra volume. I am not sure what MRI volume is like in private practices?.
Any comments?

Volume of CMRI is general is very low and studies themselves are poorly reimbursed so realistically advanced imaging guy will not use those skills unless in a big academic center.

 

[bronx43]

Wanted to put in my two cents here.
Graduated cards fellowship in 2013 from a major Univ program in northwest. Then interventional fellowship from major Midwest program. Have been looking for a perm job since Feb last year.
The only job offer I got so far was from a small city in Iowa, 2hrs from any major town ( salary-500k first yr). Did not take that job as it was early in my search. Since then I have interviews at a least 10 places but no offers. Got a offer from a NJ town, 1.5 hrs from NYC from a solo guys. Salary 250k. Call q3-4 from general and intervention call q7-8 shared with other groups in the hospital. There is a carrot of 25k increase in salary for year 2 and buy in partnership after that.
As of now doing locums 200-250/hr. I didn't think that I will have to struggle as much for a job.
Bottom line job market sucks.

This is the trend. New docs struggle to find good gigs while established guys are still raking in the cash. True for most specialties nowadays.

 

[phillydoc]

I sincerely hope you are kidding.

This my reality. I wonder did I make a mistake by not taking that Iowa job.
I am seriously considering this NJ job options I have at hand. I am also going for couple more interview in next 2-3 weeks. One in western PA and another in Seattle area.
As I mentioned earlier, I have interviewed mutiple places including south, Midwest and northeast. Interviews go well but the offer never comes in.
I may add that my fellowship trained us primarily in Coronary intervention and some structural disease . No significant peripheral exposure. This may be my significant shortcoming for private practice job. As my fellowship was at a major university program, I also got a diploma in clinical research and have couple of publications during fellowship. I had thought that this should be good to get an academic job..but no luck there too..

 

[bronx43]

This my reality. I wonder did I make a mistake by not taking that Iowa job.
I am seriously considering this NJ job options I have at hand. I am also going for couple more interview in next 2-3 weeks. One in western PA and another in Seattle area.
As I mentioned earlier, I have interviewed mutiple places including south, Midwest and northeast. Interviews go well but the offer never comes in.
I may add that my fellowship trained us primarily in Coronary intervention and some structural disease . No significant peripheral exposure. This may be my significant shortcoming for private practice job. As my fellowship was at a major university program, I also got a diploma in clinical research and have couple of publications during fellowship. I had thought that this should be good to get an academic job..but no luck there too..

Do you still keep in contact with your co-fellows? How are they doing in job searching?

 

[phillydoc]

Do you still keep in contact with your co-fellows? How are they doing in job searching?

My co fellow went for a structural year. He is looking for a job now..

 

[phillydoc]

Is salary of 250 standard for a private practice job in NJ area. I have no idea of current salaries for interventional in NJ. What are the beginning salaries for noninvasive jobs in north east closer to major cities?? Does it matter if the job is in the city or in suburbs about a hour or so from major city???

 

[MrTee]

Is salary of 250 standard for a private practice job in NJ area. I have no idea of current salaries for interventional in NJ. What are the beginning salaries for noninvasive jobs in north east closer to major cities?? Does it matter if the job is in the city or in suburbs about a hour or so from major city???

Seeing your story makes me glad I didn't do interventional, although I would have done a 2 year gig with structural and peripherals included. 250 is extremely low for interventional (especially with that frequency of general call) unless you're in an academic center where you have fellows doing the grunt work. Perhaps its because the PCI volume is low? I can't speak for northeast salaries, but in the west, non interventional jobs seem to start 250-300 depending on the setup.