Career in Critical care Medicine in Tier 1 academic places!

[deleted1164820]

Hi everyone!
I matched into a Tier 3-4 critical care fellowship program and I am wondering what are the pros and cons of working in Tier 1 academic centers anywhere in the USA. I am have been told that s/p fellowship, working in a place like Columbia/NYU/Yale/UPenn will likely offered significantly lower salary(I am told lower and I 'm not sure how lower it is either). My question is what are the other tangible downsides of working in a places like that? or more clearly is there any upsides of working in places like that other than brand value it offers. I am considering the north east for personal reasons.

edit:
I plan to be in academic places for my research interest in my other subspeciality which is Nephrology. I am going to be trained in both Nephrology and critical care.

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[Student3322]

If comparing tier 1 to lower tier academic programs, the only upsides other than prestige that I can think of are perhaps being more likely to get research grants when applying from a more prestigious place and maybe marginally better residents/fellows. Pay is quite low (I know one of those places was offering non-negotiable <200k for full time CCM or PCCM as of a year ago) and generally there are more egos/hierarchy/politics the more ivory tower you go.

 

[deleted1164820]

Pay is quite low (I know one of those places was offering non-negotiable <200k for full time CCM or PCCM as of a year ago) and generally there are more egos/hierarchy/politics the more ivory tower you go.

How can I avoid this? I am not seeking for administrative position, I just want to be a place where I can just do my research job with most resources and without the politics. When I type this, I feel like I am looking for an utopian university that doesn't exist. Realistically, I may have to either find solace with what I get or try to find the needle in the haystack which I may I never find it as it does not even exist outside my brain in the real world.

 

[CallMeDoctorLov]

you are looking for a place that
1) allows you to work clinically part time in both critical care and nephrology
2) dedicated research time/resources in nephrology
3) reasonable pay
4) in the northeast


correct?


you MIGHT be able to pull off 2 out of those 4

 

[deleted1164820]

you are looking for a place that
1) allows you to work clinically part time in both critical care and nephrology
2) dedicated research time/resources in nephrology
3) reasonable pay
4) in the northeast


correct?


you MIGHT be able to pull off 2 out of those 4

1. I want to work full time critical care which is essentially 7 week on/off schedule. Nephrology Clinical practice is not that I am looking forward to.
2. I want to to do research in Nephrology when I am off from critical care.

With the way things are looking I am malleable to the idea of looking at places other than northeast as well.

 

[grt398]

CallMeDoctorLov above is correct...basically NE academics in places you're talking about = low pay, higher than average workload. You'll be expected to have a full clinical schedule plus put in full time research effort as well. I was a research assistant a long time ago at one of the Harvard hospitals, worked in the cardiac cath lab, and the starting pay for an MD/PhD interventional cardiologist who was finishing their fellowship with a good research background was ~40% of what they were offered to start in PP.

Your best bet for what you're looking for would be to look outside the NE and towards geographically "unpopular" areas. I've become more and more firmly of the opinion that the best chance for a new doc to have a good quality of life/work environment/pay is to become more open to moving outside the major metro areas. If that's not an option for you under any circumstances, you may just have to put up with what employers offer you. Healthcare consolidation by major corporations has done nothing but increase.

 

[ProReduction]

I would also remember that a tiny minority of MDs at those "Tier 1" centers have any external research funding. The "academic" components to most of their jobs is teaching, endless committee meetings, quality improvement meetings, medical/program directing, etc. So in the end it is way more work for less pay and no legit research save case reports. If you have a PhD or a strong publication record with current research momentum then that changes things.

 

[deleted1164820]

I would also remember that a tiny minority of MDs at those "Tier 1" centers have any external research funding. The "academic" components to most of their jobs is teaching, endless committee meetings, quality improvement meetings, medical/program directing, etc. So in the end it is way more work for less pay and no legit research save case reports. If you have a PhD or a strong publication record with current research momentum then that changes things.

I am not PhD, but I do have some 30 odd publications to my name. I can create my own retrospective projects and mentor few people down the road. I don't know how the hiring team would value that. It depends on lot of variables I guess.