tvelocity514

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Can someone help me understand how the academic (as a physician) field works please. Are there two types of "academics"?
1. Where a physician performs research on the side (e.g. 60:40) and
2. Where you are very specialized and can only work at a big hospital?

I'm curious also because some say that if you want to work in academics and pursue research you make significantly less, but from reading different conversations it seems that positions such as pediatric urology or peds nsgy means you also work in academics but I don't think you are required to pursue a ton of research (after your fellowship) so I'm confused as to why they are considered that. I know they are such a small field and very specific that they have to work at a big hospital. Are they in the umbrella of academics based on the fact that they probably will have to be teaching med students/ residents / fellows?

Thanks for the help
 

WingedOx

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Totally depends on where you are. If you're like me (I work in an affiliate hospital to a med school) you can train students and residents and still be otherwise 100% clinical.
 
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tvelocity514

tvelocity514

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Totally depends on where you are. If you're like me (I work in an affiliate hospital to a med school) you can train students and residents and still be otherwise 100% clinical.
So you still say you work in academics even with 100% clinical right? That's the type I was confused about (and would fit in my second option with no research time each week)?

Thanks!
 

mimelim

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So you still say you work in academics even with 100% clinical right? That's the type I was confused about (and would fit in my second option with no research time each week)?

Thanks!
Academic position means that you are employed by an academic institution. It is a broad category that covers any number of types of practices. It is rare for someone to be truly 100% clinical as most institutions will have some sort of administrative or research expectation. But, the reality is that those expectations may be very small, or could be as simple as being on some sort of sub-committee for the hospital/school. The range is therefor between 99% clinical and 0% clinical.

Each year there are a limited number of academic spots available, depending on how attractive you are as an applicant. Even if you are a superstar, for a first job out of residency or fellowship, you typically have little wiggle room as an academic center is looking for someone to fit a particular role. If you are inflexible or want 100% clinical, your options will be more limited.
 

WingedOx

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Another thing to remember is that if a spot at a particular place in competitive, they don't have an incentive to pay you well. Starting salary at the place I trained (and the other big program in my specialty in my city) is notoriously low.
 
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IlDestriero

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Can someone help me understand how the academic (as a physician) field works please. Are there two types of "academics"?
1. Where a physician performs research on the side (e.g. 60:40) and
2. Where you are very specialized and can only work at a big hospital?

I'm curious also because some say that if you want to work in academics and pursue research you make significantly less, but from reading different conversations it seems that positions such as pediatric urology or peds nsgy means you also work in academics but I don't think you are required to pursue a ton of research (after your fellowship) so I'm confused as to why they are considered that. I know they are such a small field and very specific that they have to work at a big hospital. Are they in the umbrella of academics based on the fact that they probably will have to be teaching med students/ residents / fellows?

Thanks for the help
Here's something I wrote for another thread about academic tracks.

Most medical schools, including all that I looked at for a job, and the two where I have been on the faculty, offered three distinct academic pathways. They are separate and have different promotion requirements. What they are called may differ from university to university.
1. Tenure- Essentially a serious researcher who does limited clinical work as well. Usually 75% or more protected non clinical time. These guys earn their clinical time off by paying their salaries with grants, etc. Grant support and significant academic productivity is required for retention and promotion. An MD PhD would be useful for this track. Research has shown that academic career success in this track is significantly higher at >80% protected time, which makes sense.
2. The academic-clinicians, primarily clinical people who have 20-50% protected nonclinical time to engage in research. ~50% of our faculty are on this path. The department/hospital supports their time off, some have small grants, a couple are significant, and some are quite successful convincing manufacturers to donate their equipment, etc. for their projects. Some get money (time) from the university or hospital to devote significant time to important committees or projects, patient safety, quality improvement, etc. Research is required for promotion and Up or Out applies, though much less than for the tenure track.
3. The clinical-educator path. This represents a growing percentage of the appointments at the medical school. They teach residents and fellows and others rotating through the department, not usually lecturing to the medical students though. Promotion requires zero research commitment/productivity. Though many, myself included, have lectured at meetings, written chapters in textbooks, participated in clinical research, mentored fellows chart reviews, case reports, etc. The purpose of this track is to generate outstanding clinicians and superior educators for the residents and fellows. The other benefit is to have more people on the ground every day getting the clinical work done in the trenches. It also unloads some administrative burden off the research faculty. By report the university is very happy with it's success and the number of appointments into this track is increasing. The medical school has 3 goals. Excellence in research, education, and clinical work. The non research path recognizes that one can excel in the area of resident education and be clinically outstanding, without being a research leader. Clearly an asset to a demanding academic department. I do know that some other departments at the university do not have many/any non research track faculty. The individual department chairs have to decide what they want from their faculty, and mine places a very high value on trainee education and the reputation of it's graduates as well as clinical excellence and hires a significant amount of non research faculty. Promotion requires evidence of clinical excellence as well as higher teaching scores than the other tracks. Up or out does not apply. (here)
The reason I am in academic medicine is that I have a desire to participate in resident and fellow education, and I'm good at it. Also, I thrive on the constant supply of interesting and challenging cases available at a world class academic referral center. As an anesthesiologist, it's also fascinating to participate in cutting edge techniques that few facilities/surgeons in the world offer.
Anesthesia is a bit unique as it requires a lot of boots on the ground every day. You don't just have one call and back up person covering an entire service for a week at a time while all the other faculty have 1-2 clinic days and 3-4 research days, you need >20 faculty every day, working the whole time. If everyone had a tenure track or 50% protected non clinical time we would have a lot of problems with the clinical load and we would make a lot less money because we would have to hire so many more faculty.
There are also adjunct faculty that are affiliated with the university, but not really part of the university faculty. They may be guest lecturers, host clinical rotations at their hospitals or offices, etc. I'm not sure if they get any money for that service, I'd guess not. They don't vote in the faculty senate, can't hold university admin positions, etc.
As to income, many (most?) academic programs will pay less than similar private practice jobs where you own the group and contracts, but it's very variable. Some actually pay quite well, particularly comparing income to hours/days worked, offering incentive compensation, productivity based bonuses, etc. There are also groups that are really structured like a private practice model, but at major academic centers with real faculty appointments. That's a good gig if you can get it. Obviously that's a harder job to get as you have the benefits of higher income from a PP model as well as the benefits of being a member of the faculty at an academic program.
 
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tvelocity514

tvelocity514

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Mar 14, 2011
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Here's something I wrote for another thread about academic tracks.

Most medical schools, including all that I looked at for a job, and the two where I have been on the faculty, offered three distinct academic pathways. They are separate and have different promotion requirements. What they are called may differ from university to university.
1. Tenure- Essentially a serious researcher who does limited clinical work as well. Usually 75% or more protected non clinical time. These guys earn their clinical time off by paying their salaries with grants, etc. Grant support and significant academic productivity is required for retention and promotion. An MD PhD would be useful for this track. Research has shown that academic career success in this track is significantly higher at >80% protected time, which makes sense.
2. The academic-clinicians, primarily clinical people who have 20-50% protected nonclinical time to engage in research. ~50% of our faculty are on this path. The department/hospital supports their time off, some have small grants, a couple are significant, and some are quite successful convincing manufacturers to donate their equipment, etc. for their projects. Some get money (time) from the university or hospital to devote significant time to important committees or projects, patient safety, quality improvement, etc. Research is required for promotion and Up or Out applies, though much less than for the tenure track.
3. The clinical-educator path. This represents a growing percentage of the appointments at the medical school. They teach residents and fellows and others rotating through the department, not usually lecturing to the medical students though. Promotion requires zero research commitment/productivity. Though many, myself included, have lectured at meetings, written chapters in textbooks, participated in clinical research, mentored fellows chart reviews, case reports, etc. The purpose of this track is to generate outstanding clinicians and superior educators for the residents and fellows. The other benefit is to have more people on the ground every day getting the clinical work done in the trenches. It also unloads some administrative burden off the research faculty. By report the university is very happy with it's success and the number of appointments into this track is increasing. The medical school has 3 goals. Excellence in research, education, and clinical work. The non research path recognizes that one can excel in the area of resident education and be clinically outstanding, without being a research leader. Clearly an asset to a demanding academic department. I do know that some other departments at the university do not have many/any non research track faculty. The individual department chairs have to decide what they want from their faculty, and mine places a very high value on trainee education and the reputation of it's graduates as well as clinical excellence and hires a significant amount of non research faculty. Promotion requires evidence of clinical excellence as well as higher teaching scores than the other tracks. Up or out does not apply. (here)
The reason I am in academic medicine is that I have a desire to participate in resident and fellow education, and I'm good at it. Also, I thrive on the constant supply of interesting and challenging cases available at a world class academic referral center. As an anesthesiologist, it's also fascinating to participate in cutting edge techniques that few facilities/surgeons in the world offer.
Anesthesia is a bit unique as it requires a lot of boots on the ground every day. You don't just have one call and back up person covering an entire service for a week at a time while all the other faculty have 1-2 clinic days and 3-4 research days, you need >20 faculty every day, working the whole time. If everyone had a tenure track or 50% protected non clinical time we would have a lot of problems with the clinical load and we would make a lot less money because we would have to hire so many more faculty.
There are also adjunct faculty that are affiliated with the university, but not really part of the university faculty. They may be guest lecturers, host clinical rotations at their hospitals or offices, etc. I'm not sure if they get any money for that service, I'd guess not. They don't vote in the faculty senate, can't hold university admin positions, etc.
As to income, many (most?) academic programs will pay less than similar private practice jobs where you own the group and contracts, but it's very variable. Some actually pay quite well, particularly comparing income to hours/days worked, offering incentive compensation, productivity based bonuses, etc. There are also groups that are really structured like a private practice model, but at major academic centers with real faculty appointments. That's a good gig if you can get it. Obviously that's a harder job to get as you have the benefits of higher income from a PP model as well as the benefits of being a member of the faculty at an academic program.
Wow, thank you for the in-depth explanation. That was a huge help to me (and I know to many others). It's great to know that there are so many options in regards to what practice models are available as a physician. Thanks again for all of your help!!
 
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