Academic Hospitalist - Salary, lifestyle, etc.

[docscience]

I am a PGY2 at a university hospital - IM program.

I am looking into either being a hospitalist or doing a fellowship after residency. I like all the subspecialties and can't really pick one, not sure if I can do more years of training. Also, if I wanted to apply to something competitive, I might have to apply during my 3rd year/after a year or two of hospitalist medicine to get more experience/research.

After reading SDN and my own research it seems like subspecialists in general have more job satisfaction/call the shots, command more salary, and have a better lifestyle.

Was wondering if this type of structure is doable?:
- Academic hospitalist meaning I would be working with a resident/intern/medical student team. They would write notes and I would round with them on patients after they see everyone.
- I really enjoy teaching and would love to head up morning report/noon conference/teaching conference for residents/medical students
- I think I would also enjoy being on committees, interviewing residency candidates, dabble a bit in the business side
- I am willing to do some clinic/outpatient - though it is not my favorite
- When I am fresh out of training/young, I would be willing to see some patients on my own - perhaps 5-10 pts to round on after rounding with my resident team.

Are there jobs like this available? How easy are they to get? Geography decent? Salary? Lifestyle? Should I be signing up on a headhunters list?

Thanks for all the help yall!

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[OveractiveBrain]

I am a PGY2 at a university hospital - IM program.

I am looking into either being a hospitalist or doing a fellowship after residency. I like all the subspecialties and can't really pick one, not sure if I can do more years of training. Also, if I wanted to apply to something competitive, I might have to apply during my 3rd year/after a year or two of hospitalist medicine to get more experience/research.

After reading SDN and my own research it seems like subspecialists in general have more job satisfaction/call the shots, command more salary, and have a better lifestyle.

Was wondering if this type of structure is doable?:
- Academic hospitalist meaning I would be working with a resident/intern/medical student team. They would write notes and I would round with them on patients after they see everyone.
- I really enjoy teaching and would love to head up morning report/noon conference/teaching conference for residents/medical students
- I think I would also enjoy being on committees, interviewing residency candidates, dabble a bit in the business side
- I am willing to do some clinic/outpatient - though it is not my favorite
- When I am fresh out of training/young, I would be willing to see some patients on my own - perhaps 5-10 pts to round on after rounding with my resident team.

Are there jobs like this available? How easy are they to get? Geography decent? Salary? Lifestyle? Should I be signing up on a headhunters list?

Thanks for all the help yall!

MOST of the time, teaching services are the coveted spots. You may be an "academic hospitalist" but what that means is "hospitalist that does research, works for nonteaching services, and eventually, maybe, gets to attend on teaching services." Non-teaching services are not 5-10 on your own. They are 15-20 on your own.

If you are looking for your intended path, you need to scour far and wide for a spot at a plcae that will let you do what you are asking to do, and accept a reduced pay (like 125 versus 250, 90 versus 180) for doing what you want, rather than making the hospital money. Of course, that is, unless you bring in grants.

Very few places have actual teaching-only services.

 

[niuyiar]

I agree with the previous post, finding that Ideal spot which you are talking about will be very hard, why? Well for the reasons you outlined on your own post. Your best bet would be to look for a spot in an institution were teaching is available, and your desired location, build raport with the teaching staff and plan for the long haul. The most desirable positions happen through word of mouth, references, or you've been in the hospital for god knows how long and they know you. Be careful of headhunters. Work your old contacts and keep your eye open for spots in the institution your doing residency.

Once you get an offer MAKE sure you go through every minute detail of what you're supposed to be doing or covering, how is the call schedule, how many pt u will be covering, any ICU coverage if yes how big the ICU etc. It is a very tricky world out there, I got offered enticing positions but when you really get down to the nitty gritty, I pretty much was going to get destroyed every other weekend cross covering an absurd amount of patients, not to name admissions and ICU. Make sure you know exactly what you're getting into, sorry can't stress this enough.
Best of Luck.

 

[staup]

The above posts are correct. At academic hospitals, teaching services are usually coveted and only come for a portion of the time, with seniority, or just luck.

In my experience, hospitalists rarely do research. If they do, they are not planning a career in hospitalist medicine and are usually planning on doing a subspecialty, thus being a hospitalist is a temporary thing. They often work in QI and administrative projects, but not exactly research that someone would get a grant for.


If someone does have grant support, they are on another level in the department of medicine and can usually just do whatever service they want because they usually do a limited amount of clinical time and have salary support from their grants.

It is rare for someone to get a grant without some type of research fellowship first, either in a subspecialty or general medicine research.

 

[docscience]

Wow! Thank you for all the info!

I guess I see a lot of "IMG docs" at my institution who are on the teaching service. So it is coveted?? Everyone wants to have a resident team? So that their jobs are much easier? Also it seems like it is pretty easy to get a job at a local VA with a teaching service.I have seen attendings come in at the VA around 7/8 in the morning, round with their team by 11/12. Teach a little bit - and go home by 2 or so.
The big downside?? Pay they say is only about $150K or so.

I am currently at a private hospital rotating on the general medicine wards. The private hospitalist group splits their service with the teaching service. So I usually round with my team/attending in the morning and they attending is also seeing his own patients - usually rounds with us on about 10 pts and has about 10 of his own. It seems really busy - but a good balance of private practice, having a resident team, and also doing a bit of teaching.

The above seems perfect for me! Anyone know the job market enough to know if private hospitalist jobs with resident services might be easier to get vs. academic with teaching + QI/committee

Also, how the heck do I get on mailing lists/call lists for hospitalist positions??? Did I miss that signup session? Some of my buddies get calls/mailing list.

 

[trppo]

Wow! Thank you for all the info!

I guess I see a lot of "IMG docs" at my institution who are on the teaching service. So it is coveted?? Everyone wants to have a resident team? So that their jobs are much easier? Also it seems like it is pretty easy to get a job at a local VA with a teaching service.I have seen attendings come in at the VA around 7/8 in the morning, round with their team by 11/12. Teach a little bit - and go home by 2 or so.
The big downside?? Pay they say is only about $150K or so.

I am currently at a private hospital rotating on the general medicine wards. The private hospitalist group splits their service with the teaching service. So I usually round with my team/attending in the morning and they attending is also seeing his own patients - usually rounds with us on about 10 pts and has about 10 of his own. It seems really busy - but a good balance of private practice, having a resident team, and also doing a bit of teaching.

The above seems perfect for me! Anyone know the job market enough to know if private hospitalist jobs with resident services might be easier to get vs. academic with teaching + QI/committee

Also, how the heck do I get on mailing lists/call lists for hospitalist positions??? Did I miss that signup session? Some of my buddies get calls/mailing list.

Ok i can relate to much of your posting here and possibly some apprehensions... I have been an IM Hospitalist for the last 6 years and likes it to bits and pieces... I am at that stage in my program, that i make my own schedule a couple of months ahead and get paid accordingly..

I chose being a hospitalist for the flexibility of working schedule, reasonable pay rates and above all, i always wanted to manage my patients as a single human body, not just the heart, kidneys, lungs etc etc...

Believe me, writing notes etc is not the most difficult part of being a hospitalist...and if you are looking at an academic program, where you do not have to write the notes daily, then that should not be your biggest worry either.... Besides when you manage a patient you want to know about it all, starting from the presenting medical problem, to the social issues to managing that problem etc etc... If i am starting as a hospitalist, what i would look at is: The Scheduling....The programs expectations from me and what should i expect from them... Also what are my prospects if i stay with the program for long, and what i am being compensated with...

Good Luck for your future endeavors..

 

[docscience]

Thank you to the above posts!

- How do I get on these call lists for headhunters? Just so I can see what is out there.

- Anyone thinking about taking a year off and doing hospitalist medicine? I was going to apply for fellowships at the end of my 3rd year and go work for a year to pay loans, live a healthy life, etc. and then go into fellowship

- Where are job openings mostly posted? NEJM? Google "hospitalist positions"?

- Any other tips?

 

[scpod]

Thank you to the above posts!

- How do I get on these call lists for headhunters? Just so I can see what is out there.

- Anyone thinking about taking a year off and doing hospitalist medicine? I was going to apply for fellowships at the end of my 3rd year and go work for a year to pay loans, live a healthy life, etc. and then go into fellowship

- Where are job openings mostly posted? NEJM? Google "hospitalist positions"?

- Any other tips?

Headhunters won't talk to you until you are nearly out of residency. It is a cut-throat business. The first time you place your CV on a board you will not be able to handle the responses that show up the next day, unless you try to geographically place yourself.

When I wanted to look for my first attending job I sent CV's directly to a few of the hospitals in the area. Most hospitals have their own recruiter, but you will find that the hospitals owned by large companies may use on recruiter for more than one hospital if they have a few nearby. I posted my CV on one website (there are many of them) and posted a very, very limited area and type of peractice I wanted. I wanted a specific part ofmy state as a hospitalist with a 7 on- 7 off schedule. I had 24 calls and emails the next day. Within a week I was inundated with repsponses. A lot of them were trying to get me to send a CV to the same jobs. They all use the same database for finding jobs apparently.

Then I started getting recruiters calling that were from locums companies, that had out-of-state opportunities they wanted me to look at, that had outppatient jobs they wanted to talk to me about... they swarm on you like flies. I didn't even want any of those types of jobs, but they don't give up very easily.

In the end, I signed with one of the local hospitals that I sent my own CV to. I was offered a spot with the teaching service at my residency, but turned it down for a number of reasons. One was a considerable difference in compensation. The other is that I don't really want to hang around all day and deal with the residents. I can go home when I'm not admitting now and take calls over the phone when they occur. So, if I finish before noon and I'm not admitting, that's more time to spend with my family.

I do like working with residents and the service, but I have had my fill with being chief resident already. I have done more lectures and morning reports and resident rounds than I ever want to do again. I want a better lifestyle than that because my family has already lived through years of "torture" without me. The kids are growing up not knowing me and my wife doesn't know who I am these days either. You may very well change your mind about what you want to do over the next few years, but there are opportunities for everyone.

As for tips. When you do post your CV finally use a totaly new email that you only use for job searching. Give them a phone number that they can reach you at personally or leave a good message. Be specific in what you are looking for. The more specific the better. Good luck.

 

[gutonc]

- Anyone thinking about taking a year off and doing hospitalist medicine? I was going to apply for fellowships at the end of my 3rd year and go work for a year to pay loans, live a healthy life, etc. and then go into fellowship

Two things you need to be aware of that might change your plan (or not...but you should still be aware of them).

1. The fellowship application timeline has changed beginning this year (I'm surprised you're not aware of this already) such that you apply early in your 3rd year (interviews are happening right now) and start the following year. There's no longer a 1y lag. So if you wait until "late in 3rd year), you'll actually be applying after you graduate...which is fine, you just need to be aware of that.

2. Nobody (okay...almost nobody) will hire you to be an academic teaching hospitalist for 1 year while you kill time before fellowship. In fact, many academic centers won't hire you for their non-teaching service either if they know you're going to be bailing out in a year. You will have more luck in a small community hospital desperate for hospitalists, or perhaps as a nocturnist (the only 1-2y positions that my hospitals offer anymore). Locums is also a good bet for this kind of a time period.

 

[docscience]

scpod and gutonc!!! You guys are active posters and are a huge help in these forums. Thanks much! Few more questions:

Fellowship:
I do understand that the application cycle is "extended" this year and one can apply the beginning of third year BUT I am not sure I am ready to make a decision - I have it narrowed to a few specialties icu vs. nephro vs. (hospitalist medicine as above). I suppose I would start applying around July/August of 2013 if I was going straight to fellowship. Is that enough time starting now to perhaps do some research and make connections????

I also have a strong geographic preference as can be seen by my prior posts. I really would like to live in a coastal city - San Diego, SF, Portland, Seattle, Boston, NYC, maybe Mami, Philly, DC, or pretty much a young, vibrant city. Is this doable for nephrology? ICU/Pulm?

Hospitalist:
I wanted to work at an academic center for the reason that there is an open door to fellowships - the connections exist, right? Hard to go work for a private hospital and get back into fellowship and such?
Also wanted to work with residents/students as I enjoy teaching (the little bit that I know) and enjoy the academic setting overall. I guess I need to think about the compensation also.

spcod, could you share these websites? or PM me with them?

Locums!! This is very interesting to me! I did a search, but didn't find much info. How do these jobs work? Usually a 1-2 month contract? How geographically picky can you be with a locums job? Easy to find say in Boston/SF or much more likely in a small town near these big cities?
Any thoughts about locums jobs? Perhaps no consistency lends itself to burnout? Hard to keep moving every few months?

Thanks again for answering questions on these forums.

 

[docscience]

Badam bump!

 

[gutonc]

Badam bump!

Not sure why you felt you had to bump this but here it goes. Remember...you asked.

scpod and gutonc!!! You guys are active posters and are a huge help in these forums. Thanks much! Few more questions:

Fellowship:
I do understand that the application cycle is "extended" this year and one can apply the beginning of third year BUT I am not sure I am ready to make a decision - I have it narrowed to a few specialties icu vs. nephro vs. (hospitalist medicine as above). I suppose I would start applying around July/August of 2013 if I was going straight to fellowship. Is that enough time starting now to perhaps do some research and make connections???

The app cycle isn't extended, it got moved. And yes, if you want to go straight from residency to fellowship, you'll apply next July. But first you need to put on your big boy/girl pants and decide what you want to be when you grow up. Then you need to get some connections/research/extra electives. You still have time to do it this year, but you need to do it now...actually, 3 months ago would have been a good idea.

I also have a strong geographic preference as can be seen by my prior posts. I really would like to live in a coastal city - San Diego, SF, Portland, Seattle, Boston, NYC, maybe Mami, Philly, DC, or pretty much a young, vibrant city. Is this doable for nephrology? ICU/Pulm?

So apply there. It didn't work out for you for residency, but it might for fellowship. PCCM and renal aren't particularly competitive. And fellowship is only 2-3 years. So if you wind up in another craphole like AZ for fellowship, you'll be out soon enough and can go wherever you want and can find someone to hire you when it's time for a real job.

Hospitalist:
I wanted to work at an academic center for the reason that there is an open door to fellowships - the connections exist, right? Hard to go work for a private hospital and get back into fellowship and such?
Also wanted to work with residents/students as I enjoy teaching (the little bit that I know) and enjoy the academic setting overall. I guess I need to think about the compensation also.

OK...this is where I think you're either incredibly naive or intentionally obtuse, in either case, time to get your learn on.

1. Lots of people want to work as hospitalists in academic settings for reasons you have laid out here and elsewhere. The residents do most of your work for you. You get to "teach." Your pager almost never goes off. Etc. In fact, I would venture to bet that there are at least 3 or 4 other people in your residency class that want to do this. Are you head and shoulders above them in performance during residency? Is your institution hiring teaching hospitalists right now? Because that's the best/only place for you to find such a job, especially if you're thinking about doing it for a year or so while you apply for fellowship. As a concrete example, I am at a University hospital in one of the cities you want to go to. In the last 4 years, they have hired exactly 0 recent grads onto their teaching service (the affiliated VA has hired 3, all of whom split time between the teaching and non-teaching services). There are several people (I can think of 6 off the top of my head) who are non-teaching hospitalists/nocturnists that either did Chief years or GIM fellowships (both in 1 case) and are still on the waiting list for teaching hospitalist positions.

Bottom line...if you want to be a teaching hospitalist, do that. If you want to be a nephrologist or an ICU doc, do that. You can't do both. It's time to give up that fantasy.

2. Compensation: Yes, there is a significant difference in compensation between PP and academics. But that shouldn't be your reason for choosing one over the other. Also, even a crappy hospitalist job will pay at least 3X what you make as an R3. If you're just doing it to kill time, you don't need to worry about the salary that much. A locums job will pay even more (but you'll need your own health and probably malpractice insurance).

3. I'm not sure how things are at your program, but as an Onc fellow, I can count on one hand the number of times I had any meaningful interaction with a non-teaching hospitalist in my 3 years. And I can count on no hands the number of times my attendings did. By this I mean to say that, if you don't already have a meaningful relationship with important people in the subspecialty you're interested in, at the hospital you work in, you're not going to get it as a hospitalist there...teaching or non-teaching. The best option you have is to do your 7-on as a hospitalist and spend your 7-off working in somebody's lab or doing somebody's chart reviews. This will (somewhat ironically) be easier to do as a non-teaching hospitalist or even a nocturnist and will probably be more beneficial.

So there you go. You asked...I answered.

 

[robin082006]

Headhunters won't talk to you until you are nearly out of residency. It is a cut-throat business. The first time you place your CV on a board you will not be able to handle the responses that show up the next day, unless you try to geographically place yourself.

When I wanted to look for my first attending job I sent CV's directly to a few of the hospitals in the area. Most hospitals have their own recruiter, but you will find that the hospitals owned by large companies may use on recruiter for more than one hospital if they have a few nearby. I posted my CV on one website (there are many of them) and posted a very, very limited area and type of peractice I wanted. I wanted a specific part ofmy state as a hospitalist with a 7 on- 7 off schedule. I had 24 calls and emails the next day. Within a week I was inundated with repsponses. A lot of them were trying to get me to send a CV to the same jobs. They all use the same database for finding jobs apparently.

Then I started getting recruiters calling that were from locums companies, that had out-of-state opportunities they wanted me to look at, that had outppatient jobs they wanted to talk to me about... they swarm on you like flies. I didn't even want any of those types of jobs, but they don't give up very easily.

In the end, I signed with one of the local hospitals that I sent my own CV to. I was offered a spot with the teaching service at my residency, but turned it down for a number of reasons. One was a considerable difference in compensation. The other is that I don't really want to hang around all day and deal with the residents. I can go home when I'm not admitting now and take calls over the phone when they occur. So, if I finish before noon and I'm not admitting, that's more time to spend with my family.

I do like working with residents and the service, but I have had my fill with being chief resident already. I have done more lectures and morning reports and resident rounds than I ever want to do again. I want a better lifestyle than that because my family has already lived through years of "torture" without me. The kids are growing up not knowing me and my wife doesn't know who I am these days either. You may very well change your mind about what you want to do over the next few years, but there are opportunities for everyone.

As for tips. When you do post your CV finally use a totaly new email that you only use for job searching. Give them a phone number that they can reach you at personally or leave a good message. Be specific in what you are looking for. The more specific the better. Good luck.

Good Points!

I want to add som info about THIRD-PARTY RECRUITERS, most of recruiters are crap, they don't care about what you are looking for, they just try to get you CV first to fill their database.

e.g: You post your ads on a website, saying that you are looking for a full time hopsitalist in Southern California. If you post during the daytime, within some minutes you will get emails or phone calls (if you put your phone number). I told that they are crap because 90% of them don't have the openings you are seeking but they still call, email, and bombard you. They may call you for jobs in Alaska, Alabama, Arizona and everywhere in the states. And they always ask you to send your CV. Some of them may call you for locumtenens (although you are looking for full time), primary care (although you are looking for hospitalist job)..

At the begining, I was very excited to answer their calls and emails, but finally I found that they are very annoying and denied their calls, also deleted my online application. None of my friends and I have got any potisions from them. All of us got contract by submitting CV directly to employers. Apparently, employers tried to avoid hiring doctors from them because they have to pay them 30-40k for a successful contract (unless employers cannot find doctors by themselves).

One more thing, you should submit your CV directly to employers first if possible. Don't ASK THEM to send your CV, if you do that, your chance to get contract become lower. As a general rule, employers cannot hire you without paying them during the next 2 years.

 

[tartesos]

Good Points!

I want to add som info about THIRD-PARTY RECRUITERS, most of recruiters are crap, they don't care about what you are looking for, they just try to get you CV first to fill their database.

e.g: You post your ads on a website, saying that you are looking for a full time hopsitalist in Southern California. If you post during the daytime, within some minutes you will get emails or phone calls (if you put your phone number). I told that they are crap because 90% of them don't have the openings you are seeking but they still call, email, and bombard you. They may call you for jobs in Alaska, Alabama, Arizona and everywhere in the states. And they always ask you to send your CV. Some of them may call you for locumtenens (although you are looking for full time), primary care (although you are looking for hospitalist job)..

At the begining, I was very excited to answer their calls and emails, but finally I found that they are very annoying and denied their calls, also deleted my online application. None of my friends and I have got any potisions from them. All of us got contract by submitting CV directly to employers. Apparently, employers tried to avoid hiring doctors from them because they have to pay them 30-40k for a successful contract (unless employers cannot find doctors by themselves).

One more thing, you should submit your CV directly to employers first if possible. Don't ASK THEM to send your CV, if you do that, your chance to get contract become lower. As a general rule, employers cannot hire you without paying them during the next 2 years.

I've had same experience with recruiters, they really don't care about you and only look at the money they will make by placing you( unless you click with someone and become friends, and at least they will be open and tell you, but still $$$).
About the 2 y clause, that is written on a physician agreement that you must sign for some of them to present you to a hospital( or to tell you the name/location of the hospital) and those things can be very funny and binding( even forcing you to pay them if you get hired within 2 years of braking the agreement with them).
Read carefully,and careful what you sign, but If u don't sign anything with them, they can post your cv in the newspaper for all you care, and there is no bind between you should you sign with any hospital.
Don't sign anything without reading it twice and if you don't understand it, pass it on to someone who does.

Or.... You can make up your mind and decide what you want for next year!! Time flies an the clock is ticking... No pressure 🙂

 

[nope80]

How hard is it to get hospitalist position in large cities on the west vs east coast? Is the market saturated? How about working part time, how does the schedule work? Also does the pay scale change much as your experience level increases??

 

[gutonc]

How hard is it to get hospitalist position in large cities on the west vs east coast? Is the market saturated? How about working part time, how does the schedule work? Also does the pay scale change much as your experience level increases??

Finding a job won't be that hard. Finding a good job that pays well in a city you want to live in might. None of my friend had problems finding jobs on the West Coast (mostly NW), but some either wound up in less desirable (to them) areas or taking lower paying jobs to live where they wanted/needed to.

Pay scale changes somewhat but more along the lines of a COLA rather than the kind of pay bump you look at when you become a partner in a different kind of practice.

 

[C5toC9]

what are the hospitalist salaries like in the NW?

 

[docscience]

bump