Academic vs Private Pulm-CCM practice

[stillers]

Would love to hear thoughts from the senior folks here on why they chose academic vs. private practice (or some other model), and how their decision and job has worked out for them.
Are you happy in your current job?
Do you have any regrets about leaving, or staying in academia? How are your hours? Do you feel your compensation is low, or fair? If you are in academia, do you enjoy teaching? Do you feel undue pressure to put out research? If you're in private practice, do you feel pressured to see patients/make RVUs?

Background: I'm a 3rd year Pulm-CCM fellow currently on a research training grant, starting my job search.

Thanks.

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[Colorado outliers]

Are you happy in your current job?
Do you have any regrets about leaving, or staying in academia? How are your hours? Do you feel your compensation is low, or fair? If you are in academia, do you enjoy teaching? Do you feel undue pressure to put out research? If you're in private practice, do you feel pressured to see patients/make RVUs?

Currently work in academia (clinical track) for the last 3 years and can try to answer some of the questions.

Academia: Hours terrible while on-service (30 weeks a year), especially ICU. Much better without inpatient service. Compensation low
(~$180,000) for the amount of work I do while on service, but when off-service only do 2 clinics a week. There is some opportunity
to make extra money working overnight in ICU or E-ICU another 30-50 grand per year).

I don't really enjoy teaching because the housestaff are often lazy, don't take responsibility for patients and instead this falls on the fellow and attending (Me).
I don't so far feel 'pressure' to put out research but probably to get promoted I'll have to put out some dumb review article that
nobody reads or the old 'risk factors for ICU readmission, UTI' BS that everyone spits out these days.

What I enjoy about academia at a tertiary referral center is being the 'end of the line' for patients and having a subspecialty within pulmonary
medicine - basically an ego boost.
However don't know if I'd be happier in private practice because I've never tried it! Not sure if my ego could handle it but I guess at some point
staying at a job out of sheer hubris will get old

 

[SRT 1983]

I am in a partnership track pvt practice yr 2, will make a little over 300 k this yr after bonuses. Will become partner in 3 months.
Work 4 days/week, 1/6 weekends. On call nights from home 1/6 , hospitalists are the primary and I never had to go in. Usually get 1-2 calls per night on call.
I do bread and butter PCCM with a smallish 12 bed ICU but a very heavy outpt office.

Pros: Good lifestyle, decent money which should increase significantly soon once I become a partner.
Nobody really bothers me and do not have to answer to anybody
Cons: I feel like a jack of all trades .
Sometimes feels like a retirement job.

 

[Pkboi24]

I am in a partnership track pvt practice yr 2, will make a little over 300 k this yr after bonuses. Will become partner in 3 months.
Work 4 days/week, 1/6 weekends. On call nights from home 1/6 , hospitalists are the primary and I never had to go in. Usually get 1-2 calls per night on call.
I do bread and butter PCCM with a smallish 12 bed ICU but a very heavy outpt office.

Pros: Good lifestyle, decent money which should increase significantly soon once I become a partner.
Nobody really bothers me and do not have to answer to anybody
Cons: I feel like a jack of all trades .
Sometimes feels like a retirement job.

I’m just about to finish fellowship and would love to know where you work. Urban center? Suburbs? How did you land this job? It sounds amazing.

 

[chocomorsel]

Currently work in academia (clinical track) for the last 3 years and can try to answer some of the questions.

Academia: Hours terrible while on-service (30 weeks a year), especially ICU. Much better without inpatient service. Compensation low
(~$180,000) for the amount of work I do while on service, but when off-service only do 2 clinics a week. There is some opportunity
to make extra money working overnight in ICU or E-ICU another 30-50 grand per year).

I don't really enjoy teaching because the housestaff are often lazy, don't take responsibility for patients and instead this falls on the fellow and attending (Me).
I don't so far feel 'pressure' to put out research but probably to get promoted I'll have to put out some dumb review article that
nobody reads or the old 'risk factors for ICU readmission, UTI' BS that everyone spits out these days.

What I enjoy about academia at a tertiary referral center is being the 'end of the line' for patients and having a subspecialty within pulmonary
medicine - basically an ego boost.
However don't know if I'd be happier in private practice because I've never tried it! Not sure if my ego could handle it but I guess at some point
staying at a job out of sheer hubris will get old

This is sad.

 

[aafisahar]

Currently work in academia (clinical track) for the last 3 years and can try to answer some of the questions.

Academia: Hours terrible while on-service (30 weeks a year), especially ICU. Much better without inpatient service. Compensation low
(~$180,000) for the amount of work I do while on service, but when off-service only do 2 clinics a week. There is some opportunity
to make extra money working overnight in ICU or E-ICU another 30-50 grand per year).

I don't really enjoy teaching because the housestaff are often lazy, don't take responsibility for patients and instead this falls on the fellow and attending (Me).
I don't so far feel 'pressure' to put out research but probably to get promoted I'll have to put out some dumb review article that
nobody reads or the old 'risk factors for ICU readmission, UTI' BS that everyone spits out these days.

What I enjoy about academia at a tertiary referral center is being the 'end of the line' for patients and having a subspecialty within pulmonary
medicine - basically an ego boost.
However don't know if I'd be happier in private practice because I've never tried it! Not sure if my ego could handle it but I guess at some point
staying at a job out of sheer hubris will get old

Sounds like a suckers job. Why are you working more for less pay. Even academic hospitalists make about the same.

 

[chocomorsel]

Sounds like a suckers job. Why are you working more for less pay. Even academic hospitalists make about the same.

He or she, (most likely a he), already told us that he wants daily ego stroking from taking care of "end of the line" patients.

 

[Colorado outliers]

Sounds like a suckers job. Why are you working more for less pay. Even academic hospitalists make about the same.

That's a good question (although you didn't actually use a question mark).
Minor point, but there is no such thing as an 'academic' hospitalist. Hospitalists are essentially triage nurses at an tertiary academic center, deferring everything to specialists or to the patient's PCP.
Hospitalists in a rural setting, however, potentially are real doctors.
The hospitalists here actually get paid 200-250K per year, more than us! We're
not alone - GI, general Cards, etc all get paid less than hospitalists. However the hospitalists basically get treated like residents.
Endo/Rheum/ID are paid even lower.

My salary is comparable to most 'top' academic medical centers where a Dean's tax takes 10-15% of your profit and uses it to fund research. 2nd and 3rd tier academic centers will pay significantly more, typically don't use the 'Dean's tax' model
The only reason(s) somebody would do this job are:
1. enjoy teaching
2. want to do clinical research
3. like complex cases
4. don't want to work a lot - I looked at some academic jobs w/ only 16 weeks of service a year
5. Ego

Usually it's some combination of the above (heavy emphasis on #5)

 

[Colorado outliers]

This is sad.

I'm quite happy with my job and life. You coming here to post that is really what's sad. If you have something
productive to add in response to original post, please share with us.

 

[chocomorsel]

I'm quite happy with my job and life. You coming here to post that is really what's sad. If you have something
productive to add in response to original post, please share with us.

Really? Cuz your post speaks for itself.
But sure, keep lying to yourself. I don’t really give a crap really as I have no horse in this game. And I certainly don’t need my ego stroked like you.

 

[Colorado outliers]

Really? Cuz your post speaks for itself.
But sure, keep lying to yourself. I don’t really give a crap really as I have no horse in this game. And I certainly don’t need my ego stroked like you.

If you really have 'no horse in this game', why would you post crap?. You've contributed nothing to this thread and probably are bitter because you work at some 4th-tier community hospital. All I did was try to answer the original question. Although there are some aspects of my job I don't like (as is the case with any job) I'm generally happy and putting together a research program, which is something I couldn't do in the private sector.

 

[chocomorsel]

If you really have 'no horse in this game', why would you post crap?. You've contributed nothing to this thread and probably are bitter because you work at some 4th-tier community hospital. All I did was try to answer the original question. Although there are some aspects of my job I don't like (as is the case with any job) I'm generally happy and putting together a research program, which is something I couldn't do in the private sector.

Because I am bored and it’s a free country. And so what if I work at some 4th tier community hospital? Most patients don’t need a level 1 to survive and do well.

Do you know how sad, defensive and pathetic you sound?

I posted this response months ago. Are you just now getting out of your hole of a lab to respond to me? Maybe if you hadn’t offered commentary on the sad job that you stay in to get your balls stroked you wouldn’t have anyone commenting on it.

Move on.

 

[SRT 1983]

Thank you for your input Colorado

 

[Colorado outliers]

Thank you for your input Colorado

No problem, I couldn’t find much info about academic jobs on SDN before starting my search, so I’m trying to provide some specific data. Academia is not for everyone and I’ll be the first to admit that.

 

[Colorado outliers]

Because I am bored and it’s a free country. And so what if I work at some 4th tier community hospital? Most patients don’t need a level 1 to survive and do well.

Do you know how sad, defensive and pathetic you sound?

I posted this response months ago. Are you just now getting out of your hole of a lab to respond to me? Maybe if you hadn’t offered commentary on the sad job that you stay in to get your balls stroked you wouldn’t have anyone commenting on it.

Move on.

Lol. You still have not posted any useful info.

 

[Winged Scapula]

Users are asked to remain civil and refrain from personal attacks/call outs.

 

[beeFs]

I appreciate the discussion, its generally been helpful. I know I'm not the only one torn between staying in academics and heading into the PP after finishing fellowship. I enjoy the teaching aspect of academics, though I'm not sure I'm passionate enough about it to forego the benefits of PP. Certainly the money of PP looks great when finishing training with a hefty amount of debt. My question for those in PP is how are you all keeping your practice current and up to date (journals, conferences, podcasts, etc.)? It seems like clinical education in an academic setting forces you to be current so out in the private world it might be more difficult.

 

[SRT 1983]

I appreciate the discussion, its generally been helpful. I know I'm not the only one torn between staying in academics and heading into the PP after finishing fellowship. I enjoy the teaching aspect of academics, though I'm not sure I'm passionate enough about it to forego the benefits of PP. Certainly the money of PP looks great when finishing training with a hefty amount of debt. My question for those in PP is how are you all keeping your practice current and up to date (journals, conferences, podcasts, etc.)? It seems like clinical education in an academic setting forces you to be current so out in the private world it might be more difficult.

It is upto you , you have access to all the resources/conferences.
I have seen some pretty smart private practice doctors and some pretty dumb academic ones.
The big difference is you most likely won't be able to sub specialize in PP, so obviously someone who is only seeing PH/ILD in academics will be better management of that one disease .You will be seeing everything and will likely be managing MOST of the patients according to current guidelines.

 

[AZpath]

If someone is interest in for a well paid rural position.

Our hospital is looking for 2 PCCMs. It is a nice area not as remote as most, about 70 mile from a major city.
The administration will bend over back wards to get someone , new fellow or experienced.
You can private message me and I can tell you more.

 

[chocomorsel]

If someone is interest in for a well paid rural position.

Our hospital is looking for 2 PCCMs. It is a nice area not as remote as most, about 70 mile from a major city.
The administration will bend over back wards to get someone , new fellow or experienced.
You can private message me and I can tell you more.

Are they specifically looking for pulmonary CCM or just CCM? Just curious. As in what does the job entail?

 

[AZpath]

You would have to ask administration. Might be room for both.
The oncologists and I would like to some lung biopsies again

You can private message me. I can tell you more or give you the phone number for our COO .

Thanks

 

[Gastrapathy]

@Colorado outliers

It is very unlikely that GI and Cards are paid less than hospital medicine. I suspect you’ve been told that by your chair but it isn’t true. If you are willing to take a major pay cut to be there, so be it. For future folks, I’d recommend putting the difference in a spreadsheet and see how many years of your life this choice costs before FI.

 

[Colorado outliers]

@Colorado outliers

It is very unlikely that GI and Cards are paid less than hospital medicine. I suspect you’ve been told that by your chair but it isn’t true. If you are willing to take a major pay cut to be there, so be it. For future folks, I’d recommend putting the difference in a spreadsheet and see how many years of your life this choice costs before FI.

I know it is true at my institution (I have friends in both GI and Cards) that GI and Cards make more than Pulm/CCM but slightly less than hospitalists. Hospitalists are making 225-250 here and GI/Cards start around 200-225. Potentially with bonuses, they are making more. Although my base salary is 170, w/ ICU coverage 2-3 nights a months I am making about 240, so pay is not terrible. I have minimal loans (60K) because of a federal service obligation which helps also.

As I stated previously the issue is the 'Dean's tax' exercised by many medical schools - this takes 10% of clinic revenue, essentially negating
profit from clinic. Procedural specialties, however will generate more money by inpatient care and procedures which are not 'taxed'. Hospitalists are employed by the hospital while specialists are employed by the medical school.

These salaries are typical for 'top-tier' institutions (ie US News top 15 hospitals). I don't claim that this is the case
for most academic medical centers. People are here because they want to be (research, prestige, don't want to move, etc). They could
certainly move to a lower-tier academic center for higher pay, and many have.

What I would recommend to those weighing their options (private vs academic) is:
-consider why you really want to be in academics and whether this will sustain you through your career
-loan burden - if you have 200k+ in loans, unless you're doing NIH loan repayment, financially it doesn't make sense to stay
in academia, especially if you have a family
-visit a financial planner to make projections based on your expected earnings and determine whether you can save enough
money to do what you want with your life
-consider whether the academic job offers a tuition benefit for your children - if it does, at least you won't have to worry as much about saving for college

 

[Colorado outliers]

@Colorado outliers

It is very unlikely that GI and Cards are paid less than hospital medicine. I suspect you’ve been told that by your chair but it isn’t true. If you are willing to take a major pay cut to be there, so be it. For future folks, I’d recommend putting the difference in a spreadsheet and see how many years of your life this choice costs before FI.

Also, you seem to claim to know more about my institution than I do.

If you don't believe me, find a top-15 medical center affiliated with a public university and search their salary database online. You will
see that hospitalists are paid the same or more than assistant clinical professors in Cards/GI. However, I can't account for bonuses etc
that are not publicly reported. I assume you're an attending, so if you have further information about this, I would love to hear about it.

As long as academic medical centers can sign up 'suckers' to work for low pay, they will continue to do so. It's still plenty of money, unless you
have a ton of loans or live on the coasts, but it's not for everybody.

 

[Gastrapathy]

I don’t know your institution which is why I said it was unlikely only. At the places I actually know salary info, I’m confident I’m correct. The University of California system salaries are public and the names are on their websites. I not going to write the specific names to search because I’m sure those physicians would rather not have this thread show up when they are googled by patients.

 

[95beretta]

I’m not particularly senior (2 years out of fellowship) but will offer my situation for example and feedback. I finished fellowship in 2016 and took a private practice position. I had thought I would enjoy academics but had $320k+ of student loans and took a private practice job thinking that I may enjoy private practice just as much as academics. The first two years of private practice were successful financially - this year I will probably have made between $450-500k. But most weeks are 70-hour weeks, and I feel that I am missing a ton of family time (two kids with a third on the way). I have also missed academics. Over the last perhaps 6 months, I have looked at going back to an academic position that would likely be about $250-280k salary with about 26 weeks of on service (icu, pulmonary consults) per year. I would appreciate any opinions on both the salary and schedule from the forum and hope this may serve as an additional example of private practice/academics comparison.

 

[SRT 1983]

I’m not particularly senior (2 years out of fellowship) but will offer my situation for example and feedback. I finished fellowship in 2016 and took a private practice position. I had thought I would enjoy academics but had $320k+ of student loans and took a private practice job thinking that I may enjoy private practice just as much as academics. The first two years of private practice were successful financially - this year I will probably have made between $450-500k. But most weeks are 70-hour weeks, and I feel that I am missing a ton of family time (two kids with a third on the way). I have also missed academics. Over the last perhaps 6 months, I have looked at going back to an academic position that would likely be about $250-280k salary with about 26 weeks of on service (icu, pulmonary consults) per year. I would appreciate any opinions on both the salary and schedule from the forum and hope this may serve as an additional example of private practice/academics comparison.

I have a pretty similar story, I also graduated in 2016..... I was setup for academics, had more research productivity than ALL of my attendings during fellowship in a major teaching hospital on the east coast and was offered 190k for a pretty similar schedule( 26 weeks) including 1/4 weekends and occasional night call(home). I am on track to make 550k this yr(first yr as a partner) in a small community hospital also on the east coast . I work 4 days( all busy) and 1/6 weekends(also very busy).
I was never interested in teaching . In my experience, it is impossible to be a good clinician AND do good research, you have to pick one. I love clinical practice . Also in my opinion, MOST ppl in academics do not publish anything of any impact. Building an academic career and getting your name out requires a lot of hussle and was not worth it for me.
I miss the camaraderie of academics and also the ability to focus on one disease. I am a jack of all trades in private practice but overall am happy with my decision.
Unless you think you can not be happy in private practice seeing bread and butter stuff, I do not recommend academia. I have utmost respect for people in academia who are there for the right reasons( not ego).
I have also started enjoying the management side of running a private practice a little bit and have 30 MAs that work for us. There is no BS red tape to run through to make any decisions , things get done faster
You can cut back on clinical work in private practice and still make significantly more than academics. Overall , a personal decision. Hope this helps.

 

[235009]

Currently work in academia (clinical track) for the last 3 years and can try to answer some of the questions.

Academia: Hours terrible while on-service (30 weeks a year), especially ICU. Much better without inpatient service. Compensation low
(~$180,000) for the amount of work I do while on service, but when off-service only do 2 clinics a week. There is some opportunity
to make extra money working overnight in ICU or E-ICU another 30-50 grand per year).

I don't really enjoy teaching because the housestaff are often lazy, don't take responsibility for patients and instead this falls on the fellow and attending (Me).
I don't so far feel 'pressure' to put out research but probably to get promoted I'll have to put out some dumb review article that
nobody reads or the old 'risk factors for ICU readmission, UTI' BS that everyone spits out these days.

What I enjoy about academia at a tertiary referral center is being the 'end of the line' for patients and having a subspecialty within pulmonary
medicine - basically an ego boost.
However don't know if I'd be happier in private practice because I've never tried it! Not sure if my ego could handle it but I guess at some point
staying at a job out of sheer hubris will get old

The compensation you quote is definitely on par with top tier academic programs, so that's definitely not surprising. What is surprising though is how much clinical time you're doing. Are you seriously doing THIRTY weeks on service?! How does this leave any time for research? I'm guessing you aren't NIH funded since this would definitely not fly. How much protected time is in your contract? This basically sounds like a 100% clinical job.

I’m not particularly senior (2 years out of fellowship) but will offer my situation for example and feedback. I finished fellowship in 2016 and took a private practice position. I had thought I would enjoy academics but had $320k+ of student loans and took a private practice job thinking that I may enjoy private practice just as much as academics. The first two years of private practice were successful financially - this year I will probably have made between $450-500k. But most weeks are 70-hour weeks, and I feel that I am missing a ton of family time (two kids with a third on the way). I have also missed academics. Over the last perhaps 6 months, I have looked at going back to an academic position that would likely be about $250-280k salary with about 26 weeks of on service (icu, pulmonary consults) per year. I would appreciate any opinions on both the salary and schedule from the forum and hope this may serve as an additional example of private practice/academics comparison.

This is the main reason to go into academics. Work-life balance is way better with much more flexibility. What's half a million dollars if you don't have any time to enjoy it?

 

[Hamhock]

Are you seriously doing THIRTY weeks on service?! How does this leave any time for research? I'm guessing you aren't NIH funded since this would definitely not fly. How much protected time is in your contract? This basically sounds like a 100% clinical job

.

 

[deleted547339]

The compensation you quote is definitely on par with top tier academic programs, so that's definitely not surprising. What is surprising though is how much clinical time you're doing. Are you seriously doing THIRTY weeks on service?! How does this leave any time for research? I'm guessing you aren't NIH funded since this would definitely not fly. How much protected time is in your contract? This basically sounds like a 100% clinical job.



This is the main reason to go into academics. Work-life balance is way better with much more flexibility. What's half a million dollars if you don't have any time to enjoy it?

As I found in my job search 1 week at one shop is not equal to one week at another. Some places do a week of twelve hour shifts plus sign out alternating days and nights - that’s brutal. Some places do 7-3/5 Monday through Friday, consolidate weekends, heavily compensate nights and only require you do a couple weeks of nights a year. My job is much closer to the latter. I’m out early, rarely work nights and weekends. I work more weeks than most, but I have no desire to do weeks of twelves anymore.

 

[AZpath]

I work at nice rural hospital in AZ. They have been looking for PCCM for a while and they really need two.
The administration is quite motivated. You could work out a great contract on your terms.
Email me at titansmoons AT yahoo DOT com
I would be happy to put you in touch.

PS I am a pathologist not a paid recruiter. I just love our community and work at a really nice hospital.

 

[Colorado outliers]

The compensation you quote is definitely on par with top tier academic programs, so that's definitely not surprising. What is surprising though is how much clinical time you're doing. Are you seriously doing THIRTY weeks on service?! How does this leave any time for research? I'm guessing you aren't NIH funded since this would definitely not fly. How much protected time is in your contract? This basically sounds like a 100% clinical job.



This is the main reason to go into academics. Work-life balance is way better with much more flexibility. What's half a million dollars if you don't have any time to enjoy it?

Yes, I am doing 28 weeks, but still a lot for academic places. It is a full clinical track position. I am not NIH-funded - this requires essentially a 90/10 research/clinical split at my institution, which I was not interested in. I am doing some research - funded through alternate means and unfunded but don't have a ton of time to do this. My contract stipulates 28 weeks without service a year (although I still have clinic twice a week).
I interviewed for clinical-track jobs at other institutions - generally there service requirements were less, ranging from 14-20 weeks per year.

Agree that work-life balance is a reason to go into academia...however you can work yourself to death in academic and potentially have better work-life balance in private practice with an intensivist-only gig working 12 shifts a months and getting paid 350k (common in my area).

One other thing I enjoy about my academic job is that the institution is supporting outreach to a remote rural underserved area where I previously worked, this wouldn't work in private practice.

At the end of the day, it's my first post-fellowship job and I have family here. I can easily transition from this institution to other places, or even to private practice in the future if I get tired of it (however I am enjoying it at the moment)

 

[235009]

Yes, I am doing 28 weeks, but still a lot for academic places. It is a full clinical track position. I am not NIH-funded - this requires essentially a 90/10 research/clinical split at my institution, which I was not interested in. I am doing some research - funded through alternate means and unfunded but don't have a ton of time to do this. My contract stipulates 28 weeks without service a year (although I still have clinic twice a week).
I interviewed for clinical-track jobs at other institutions - generally there service requirements were less, ranging from 14-20 weeks per year.

Agree that work-life balance is a reason to go into academia...however you can work yourself to death in academic and potentially have better work-life balance in private practice with an intensivist-only gig working 12 shifts a months and getting paid 350k (common in my area).

One other thing I enjoy about my academic job is that the institution is supporting outreach to a remote rural underserved area where I previously worked, this wouldn't work in private practice.

At the end of the day, it's my first post-fellowship job and I have family here. I can easily transition from this institution to other places, or even to private practice in the future if I get tired of it (however I am enjoying it at the moment)

Thanks for your thorough reply. Is it safe to assume based on your username that you work at the largest PCCM academic program in the country?

 

[Colorado outliers]

Thanks for your thorough reply. Is it safe to assume based on your username that you work at the largest PCCM academic program in the country?

No problem. I do not work for UPMC, haha (just saying that because they would claim they're larger). Although I used to live in Colorado, I also do NOT work at U of C or NJH.

 

[pathslides]

I know it is true at my institution (I have friends in both GI and Cards) that GI and Cards make more than Pulm/CCM but slightly less than hospitalists. Hospitalists are making 225-250 here and GI/Cards start around 200-225. Potentially with bonuses, they are making more. Although my base salary is 170, w/ ICU coverage 2-3 nights a months I am making about 240, so pay is not terrible. I have minimal loans (60K) because of a federal service obligation which helps also.

Man, your hospital/admin sucks hard. Those would be garbage salaries for the respective specialties you mentioned at the hospital I work at. Leave that joint and get yourself a fair wage for your hard work.

 

[AZpath]

Pathslides is correct that is a joke. My rural hospital recruiting hard for PulmCCM right now.
The administration is quite motivated. You could work out a great contract.
You just have to fit into a mid sized rural community in the high desert.
I live here and like it a lot.

Email me at titansmoons AT yahoo DOT com
If your interested in a job.

 

[Colorado outliers]

Pathslides is correct that is a joke. My rural hospital recruiting hard for PulmCCM right now.
The administration is quite motivated. You could work out a great contract.
You just have to fit into a mid sized rural community in the high desert.
I live here and like it a lot.

Email me at titansmoons AT yahoo DOT com
If your interested in a job.

You guys are making me laugh.

Saw my W2 today - total income for the last year was about 250K (including night coverage), so not as low as you might think. Top 15 academic centers all pay similarly, or less - see the other thread for specifics. The only exception I have heard of is UCLA, but with the cost of living in Westwood they might as well be paying the same.

I enjoy my job and have minimal loans. It's worth it to me because I have an academic clinical/research interest I couldn't pursue in the private sector or a lower-tier academic center. IT'S NOT for everyone and we all know that rural/private places will pay better.

AZpath, as an aside do you work in Flagstaff, or somewhere else? Southwest high desert is beautiful country. However not interested in working there for at least 20 years =)

 

[AZpath]

Not Flagstaff. It is high dessert and cooler that Phoenix and Tucson.
Flag get real snow.
I am done with that

 

[stillers]

Would love to hear thoughts from the senior folks here on why they chose academic vs. private practice (or some other model), and how their decision and job has worked out for them.
Are you happy in your current job?
Do you have any regrets about leaving, or staying in academia? How are your hours? Do you feel your compensation is low, or fair? If you are in academia, do you enjoy teaching? Do you feel undue pressure to put out research? If you're in private practice, do you feel pressured to see patients/make RVUs?

Background: I'm a 3rd year Pulm-CCM fellow currently on a research training grant, starting my job search.

Thanks.

Thanks to all who contributed to this thread. For anyone who is interested, I ended up taking a clinical track position at a large academic medical center. Schedule is 20 wks of inpatient service a year, and 2-3 clinics per week. Salary is 240. Seems like a good fit so far Good luck to all who will be looking for jobs in the upcoming academic year.

 

[aafisahar]

Thanks to all who contributed to this thread. For anyone who is interested, I ended up taking a clinical track position at a large academic medical center. Schedule is 20 wks of inpatient service a year, and 2-3 clinics per week. Salary is 240. Seems like a good fit so far Good luck to all who will be looking for jobs in the upcoming academic year.

Not to be a dick, but I'd turn a job like this as a hospitalist. You are accepting academic pay for private practice type workload. A classmate signed up with a hospitalist group in the suburbs of Chicago for 22 weeks, 260k plus bonus.

 

[stillers]

Not to be a dick, but I'd turn a job like this as a hospitalist. You are accepting academic pay for private practice type workload. A classmate signed up with a hospitalist group in the suburbs of Chicago for 22 weeks, 260k plus bonus.

Cool story, bro.
I am aware that I could easily make 50k more as a private hospitalist. Don’t care though. You couldn’t pay me enough to do that job, which here basically is equivalent to resident status. That may not be the case at every hospital. Personally i’d rather be a PCP, which I was previously.

Yes, private practice Pulm-CCM pays better too, but I enjoy research and teaching. To each their own. I like my gig.

 

[stillers]

Sorry for the late reply. Not sure if it's still useful to you, but to answer your questions:
-Many of the academic jobs I looked at had weekday coverage of ICUs, w/ weekends being a separate person covering. Most jobs on average required 1 in 5 weekends.
-Outside academia, the gigs with the best hours were outpatient-only pulmonary gigs (probably 50 hrs per week) and ICU-only jobs (11-12 shifts per month). There were also jobs with 1 week ICU, 2 weeks clinic, 1 week off, but not sure if you'd just be catching up on your 'week off'.

If you take a clinical academic job at a medical center with a fairly large Pulm-CCM department, it's unlikely you'll be working too many weekends or average more than 60 hrs per week when service time is divided among all the attendings. However if you're planning to go all-out on the research stuff, you could easily work 70-80 hrs per week. I don't know any clinical track attendings here working 80 hrs a week, unless they're heavily entrenched in research.

 

[ILikeMilk]

I am in a partnership track pvt practice yr 2, will make a little over 300 k this yr after bonuses. Will become partner in 3 months.
Work 4 days/week, 1/6 weekends. On call nights from home 1/6 , hospitalists are the primary and I never had to go in. Usually get 1-2 calls per night on call.
I do bread and butter PCCM with a smallish 12 bed ICU but a very heavy outpt office.

Pros: Good lifestyle, decent money which should increase significantly soon once I become a partner.
Nobody really bothers me and do not have to answer to anybody
Cons: I feel like a jack of all trades .
Sometimes feels like a retirement job.

"Should increase significantly soon once I become a partner"
I see people say this all the time and I see job offers mention this frequently. How significant are we talking exactly? Its hard to really comprehend the pros and cons without knowing specific numbers. Thanks in advance.

 

[Doc Doc Doc Goose]

That's a good question (although you didn't actually use a question mark).
Minor point, but there is no such thing as an 'academic' hospitalist. Hospitalists are essentially triage nurses at an tertiary academic center, deferring everything to specialists or to the patient's PCP.
Hospitalists in a rural setting, however, potentially are real doctors.
The hospitalists here actually get paid 200-250K per year, more than us! We're
not alone - GI, general Cards, etc all get paid less than hospitalists. However the hospitalists basically get treated like residents.
Endo/Rheum/ID are paid even lower.

My salary is comparable to most 'top' academic medical centers where a Dean's tax takes 10-15% of your profit and uses it to fund research. 2nd and 3rd tier academic centers will pay significantly more, typically don't use the 'Dean's tax' model
The only reason(s) somebody would do this job are:
1. enjoy teaching
2. want to do clinical research
3. like complex cases
4. don't want to work a lot - I looked at some academic jobs w/ only 16 weeks of service a year
5. Ego

Usually it's some combination of the above (heavy emphasis on #5)

Clarification: Does “service” refer to time staffing the ICU?

 

[Doc Doc Doc Goose]

I am in a partnership track pvt practice yr 2, will make a little over 300 k this yr after bonuses. Will become partner in 3 months.
Work 4 days/week, 1/6 weekends. On call nights from home 1/6 , hospitalists are the primary and I never had to go in. Usually get 1-2 calls per night on call.
I do bread and butter PCCM with a smallish 12 bed ICU but a very heavy outpt office.

Pros: Good lifestyle, decent money which should increase significantly soon once I become a partner.
Nobody really bothers me and do not have to answer to anybody
Cons: I feel like a jack of all trades .
Sometimes feels like a retirement job.

Sorry can you clarify: so do you work a full week (7 days) every 6th week, this being your week in the ICU? 12 hour days I presume?
And then the other 5/6 weeks you are working in the outpatient clinic, 4 days a week? How many hours/day? And consults are worked in to that time m?

 

[Doc Doc Doc Goose]

As I found in my job search 1 week at one shop is not equal to one week at another. Some places do a week of twelve hour shifts plus sign out alternating days and nights - that’s brutal. Some places do 7-3/5 Monday through Friday, consolidate weekends, heavily compensate nights and only require you do a couple weeks of nights a year. My job is much closer to the latter. I’m out early, rarely work nights and weekends. I work more weeks than most, but I have no desire to do weeks of twelves anymore.

So can you describe your schedule for me please. What’s your ICU spread like: days? Hours? q4 wks or q6? What is your clinic schedule like? Consults are just built into icu time? How many hours a week? A month?

 

[Doc Doc Doc Goose]

Yes, I am doing 28 weeks, but still a lot for academic places. It is a full clinical track position. I am not NIH-funded - this requires essentially a 90/10 research/clinical split at my institution, which I was not interested in. I am doing some research - funded through alternate means and unfunded but don't have a ton of time to do this. My contract stipulates 28 weeks without service a year (although I still have clinic twice a week).
I interviewed for clinical-track jobs at other institutions - generally there service requirements were less, ranging from 14-20 weeks per year.

Agree that work-life balance is a reason to go into academia...however you can work yourself to death in academic and potentially have better work-life balance in private practice with an intensivist-only gig working 12 shifts a months and getting paid 350k (common in my area).

One other thing I enjoy about my academic job is that the institution is supporting outreach to a remote rural underserved area where I previously worked, this wouldn't work in private practice.

At the end of the day, it's my first post-fellowship job and I have family here. I can easily transition from this institution to other places, or even to private practice in the future if I get tired of it (however I am enjoying it at the moment)

Those CCM-only positions You described what sort of schedule are they working?

 

[Doc Doc Doc Goose]

Sorry for the late reply. Not sure if it's still useful to you, but to answer your questions:
-Many of the academic jobs I looked at had weekday coverage of ICUs, w/ weekends being a separate person covering. Most jobs on average required 1 in 5 weekends.
-Outside academia, the gigs with the best hours were outpatient-only pulmonary gigs (probably 50 hrs per week) and ICU-only jobs (11-12 shifts per month). There were also jobs with 1 week ICU, 2 weeks clinic, 1 week off, but not sure if you'd just be catching up on your 'week off'.

If you take a clinical academic job at a medical center with a fairly large Pulm-CCM department, it's unlikely you'll be working too many weekends or average more than 60 hrs per week when service time is divided among all the attendings. However if you're planning to go all-out on the research stuff, you could easily work 70-80 hrs per week. I don't know any clinical track attendings here working 80 hrs a week, unless they're heavily entrenched in research.

These CCM-only jobs? 11-12 shifts of 12hrs/day for what kind of salary?
And then the 1 weeks Icu, two weeks clinics, 1 week off: so 7 days icu, 12 hour days and then ~50 hour clinic weeks?

 

[Doc Doc Doc Goose]

Thanks to all who contributed to this thread. For anyone who is interested, I ended up taking a clinical track position at a large academic medical center. Schedule is 20 wks of inpatient service a year, and 2-3 clinics per week. Salary is 240. Seems like a good fit so far Good luck to all who will be looking for jobs in the upcoming academic year.

Sorry what does “2-3 clinics/week” mean exactly? 2-3 days of clinics week ? Every week that you’re not on service/in the icu? How many hours a day our “clinic days”?