Academic positions in internal medicine?

[nope80]

I'm leaning towards doing an IM residency but I wanted to know about the ins/outs of academic medicine. How hard is it to land a job at a teaching hospital after residency? How about if you are interested particularly in med school education - is that difficult to get involved with? How do they typically divide ones time between inpatient work and say, medical education? Also, how much of a pay cut does one take on compared with private practice? I'm definitely not interested in private practice but i'm wondering how starting salaries compare as well as salary growth after a few years.

Anyone with any experience or ideas about this, I really appreciate any help!!

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[adam6]

1. Job hunt: Finding a position in academic medicine should not be overly difficult. You will probably have the best shot at your training institution. However, finding a position with immediate/significant medical education involvement may be more difficult - especially at a large institution.

2. Pay: I'm sure there is a wide range...but generally you can expect to make 50-100% more in private practice.

3. Medical education: meaningful positions in medical schools can be hard to come by as a recent grad. Sometimes there is quite the queue to obtain one of these. And to clarify, I mean it is difficult to obtain a position that provides monetary support. After all, med schools would love for you to DONATE your time. But the key for you is to get a percentage of your FTE (full-time-equivalent) salary covered. Eg: if you are hired to be a 100% academic outpatient clinician (as an example), you would probably be expected to have ~8 half-day clinics/week (with one administrative day). Consequently, each half-day constitutes ~10% of your FTE. You would need the medical school to commit to covering at least 10% FTE or else you would not be able to reduce your clinical load - and you'd have no time for medical education.

I'm sure you have more questions - but hope this helps, as a start.

 

[nope80]

Thanks for the great advice! Anyone else w any ideas feel free to chime in!

 

[Moonglow]

Usually you will need to prove that you can teach, this goes for other academic situations as well as medicine. Near completion of your final year of residency you can put out applications to academic programs looking for "Instructors". If hired, you will sign a one-year contract with the School of Medicine and work as an attending at the university hospital - you will have your own service. After nine months of work, you will be offered a contract, usually for three years, as an Assistant Professor.

If you can not get a contract as an Instructor initially, you can always sign on as a hospitalist - you will not have your own service, but as an attending you will still work with residents and students.

 

[ResidentMD]

Usually you will need to prove that you can teach, this goes for other academic situations as well as medicine. Near completion of your final year of residency you can put out applications to academic programs looking for "Instructors". If hired, you will sign a one-year contract with the School of Medicine and work as an attending at the university hospital - you will have your own service. After nine months of work, you will be offered a contract, usually for three years, as an Assistant Professor.

If you can not get a contract as an Instructor initially, you can always sign on as a hospitalist - you will not have your own service, but as an attending you will still work with residents and students.

How do you then progress to becoming an associate professor and a full professor (how much time does it take on an average)? I know its different for different institutions, and especially in the Harvard system, you can be an instructor all your life.

Also how do those who do not do significant research get tenure? What goes into giving an associate professor/full professor tenure, and how much time does it take?

Lastly, what is the average pay for an assistant, associate and full professor at a reasonably decent university program (lets put it this way - on SDN's rank 8-25 list . This is excluding research funding, and from any consulting affiliations that you may have with pharma companies, etc.

 

[staup]

How do you then progress to becoming an associate professor and a full professor (how much time does it take on an average)? I know its different for different institutions, and especially in the Harvard system, you can be an instructor all your life.

Also how do those who do not do significant research get tenure? What goes into giving an associate professor/full professor tenure, and how much time does it take?

Lastly, what is the average pay for an assistant, associate and full professor at a reasonably decent university program (lets put it this way - on SDN's rank 8-25 list . This is excluding research funding, and from any consulting affiliations that you may have with pharma companies, etc.

This is highly dependent on the school, with less academic schools basically functioning as private practices and people getting promoted/tenure just by seniority or years of service.

With the academic powerhouses though, you usually have to create meaningful research to get promoted. You are promoted through a committee process which reviews your work in the similar way someone's dissertation gets approved. People can live at the asst prof level forever if they never do anything meaningful.

Most places now though have a "non research" track where people are promoted on their clinical and medical educational activities alone. Sometimes they are thought of as second class citizens though, and may not be eligible for tenure.

The easiest way to get into academics right now is in departments of medicine as a hospitalist. Many places, even academic powerhouses, hire hospitalists at the instructor/asst prof level because it is such in demand right now. It may not be that way in 5-10 years.

Finally, one thing to know that the more high powered academic place, the less they pay in general for a new attending. Sometimes internal medicine specialists will start at salaries between 100 and 130k at the elite places. The less elite the place, the more the salaries approach private practice levels.

 

[MidwestMD]

If you're serious about going into medical education and want to open as many doors as possible, I'd consider getting a Masters in Medical Education (2yr program) or doing a General Medicine Fellowship.

Personally, I'd rather drive 18 gauges underneath my toenails than waste 1-2 yrs doing a Gen Med fellowship...but it seems that more and more academic centers are looking for this now. The institution I'm at currently treats junior faculty who don't have a fellowship under their belt as second class citizens.

Again not my bag, but I thought I'd throw it out there

 

[ResidentMD]

If you're serious about going into medical education and want to open as many doors as possible, I'd consider getting a Masters in Medical Education (2yr program) or doing a General Medicine Fellowship.

Personally, I'd rather drive 18 gauges underneath my toenails than waste 1-2 yrs doing a Gen Med fellowship...but it seems that more and more academic centers are looking for this now. The institution I'm at currently treats junior faculty who don't have a fellowship under their belt as second class citizens.

Again not my bag, but I thought I'd throw it out there

Not to divert the thread entirely, but the University of Iowa has a Masters in Medical Education built INTO their residency curriculum...you can get it for free (I think) during your residency and not put in ANY extra time.

 

[Moonglow]

I will be finishing my General Internal Medicine Fellowship this June. I do consider the fellowship important to continue at the top academic medicine programs; though, the fellowship is really not necessary for those who did an internal medicine chief residency year.

The General Internal Medicine Fellowship is akin to getting an MBA for those in business. Examples:

http://www.hopkinsmedicine.org/gim/fellowship/Track_MedEd.html

http://www.hms.harvard.edu/hfdfp/

Also, there is quite a varitey of Internal Medicine academic fellowships available. Examples:

http://www.acponline.org/residents_fellows/fellowships/