Am I a nobody?

[glorifiedresident]

I recently went to a 20 yr medical school reunion. Some classmates are assitant deans and department heads, high powered specialized specialists, and big wigs in their fields, and then there's me (lowly hospitalist- glorified resident - worker bee). I've never been the envious or jealous type, but it is interesting to see. Anyone else can relate and does it bother you? Don't get me wrong, I'm happy, I've had a good career so far and I've done well due to good financial habits etc.

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[DarkBluMage]

I recently went to a 20 yr medical school reunion. Some classmates are assitant deans and department heads, high powered specialized specialists, and big wigs in their fields, and then there's me (lowly hospitalist- glorified resident - worker bee). I've never been the envious or jealous type, but it is interesting to see. Anyone else can relate and does it bother you? Don't get me wrong, I'm happy, I've had a good career so far and I've done well due to good financial habits etc.

If you’ve had a good career that’s all that matters. You don’t know their lives or what they’ve sacrificed to get their positions. Run your own race. “Prestige” is only important if you think it is.

 

[DarkBluMage]

I’m personally not interested in being in any high level positions. I’ll be fully content to work and then go home to a happy and healthy family and spend my free time with them vs grinding away at research or putting academic responsibilities on my plate as well. That’s honestly my dream.

 

[Calizboosted76]

I recently went to a 20 yr medical school reunion. Some classmates are assitant deans and department heads, high powered specialized specialists, and big wigs in their fields, and then there's me (lowly hospitalist- glorified resident - worker bee). I've never been the envious or jealous type, but it is interesting to see. Anyone else can relate and does it bother you? Don't get me wrong, I'm happy, I've had a good career so far and I've done well due to good financial habits etc.

This is something that really worries me about choosing to be a hospitalist. I wanted surgery for the longest time and I am worried that I may end up feeling unfulfilled in the long run if I choose to be a hospitalist. Even though I really have enjoyed my IM rotations on inpatient. However, I dont think youre a nobody. You are a somebody.

 

[DrMetal]

I recently went to a 20 yr medical school reunion.

A medical school reunion, is that such thing?! It was all a blur, I'd hardly remember anyone.

Ahh . . but you know how to dispo a meth head without insurance to a SNF. You are the real man of genius.

 

[timpview]

No one’s important in medicine these days..

All the guys you listed could be replaced by their bosses in a heartbeat and not one person would care.

 

[DrMetal]

No one’s important in medicine these days..

Not true. MBAs/HCAs and Nurse administrators are still pretty important.

 

[NewYorkDoctors]

I have no academic title. I teach fellows pro bono (and do bronchoscopies with them) but I run a busy private practice and employ other physicians, PAs, RTs, (no nurses dont need em lol), medical assistants, secretaries and make more money than any of them academics.

but it's not all about the money


I did 206 CPET tests in my office and 2,100 PFTs in my office in 2023. I'd like to see how my office volume compares to the "academic" PFT labs. take that zing

 

[DrMetal]

I did 206 CPET tests in my office and 2,100 PFTs in my office in 2023. I'd like to see how my office volume compares to the "academic" PFT labs. take that zing

What's your golf handicap? That's what I really wanna know.

 

[NewYorkDoctors]

What's your golf handicap? That's what I really wanna know.

i played minigolf with my kids. i dont know what golf terms mean. bogey! eagle! hole in one! par! green! rough! something something from Wii Sports golf

im about 5'10" and I can stick touch the backboard with a running start at age 40. good for me.

 

[bronx43]

I recently went to a 20 yr medical school reunion. Some classmates are assitant deans and department heads, high powered specialized specialists, and big wigs in their fields, and then there's me (lowly hospitalist- glorified resident - worker bee). I've never been the envious or jealous type, but it is interesting to see. Anyone else can relate and does it bother you? Don't get me wrong, I'm happy, I've had a good career so far and I've done well due to good financial habits etc.

That kind of stuff used to impress me. But then I got a job at my own academic institution and quickly realized that it was all just an embarrassing sham - bunch of insignificant clowns who thought they were the s***. No one was doing anything of real value and most were just playing the game to get ahead.

Now? I’m most impressed (and jealous?) of the dude that FAT FIRED at 45 and now spends his Tuesday mornings doing 2 laps around the park trail.

 

[NewYorkDoctors]

That kind of stuff used to impress me. But then I got a job at my own academic institution and quickly realized that it was all just an embarrassing sham - bunch of insignificant clowns who thought they were the s***. No one was doing anything of real value and most were just playing the game to get ahead.

Now? I’m most impressed (and jealous?) of the dude that FAT FIRED at 45 and now spends his Tuesday mornings doing 2 laps around the park trail.

i dont understand what this means?

i googled this term

What Is Fat FIRE? The Best Early Retirement Lifestyle

Fat FIRE (Financial Independence Retire Early) is being able to live it up in retirement without having to sacrifice your spending. If you are Fat FIRE, you can easily survive without a job because your investment income more than covers your best life's living expenses. You don't need to work...

www.financialsamurai.com

sounds intruiging. but also seems unsustainable?

 

[anonperson]

I recently went to a 20 yr medical school reunion. Some classmates are assitant deans and department heads, high powered specialized specialists, and big wigs in their fields, and then there's me (lowly hospitalist- glorified resident - worker bee). I've never been the envious or jealous type, but it is interesting to see. Anyone else can relate and does it bother you? Don't get me wrong, I'm happy, I've had a good career so far and I've done well due to good financial habits etc.

Most academics is a scam.

If you're at the top of the pyramid, life is great but that's a tough place to get to. Lots of luck and politics (lots of race/gender games) that can impact the trajectory of your career.

I'm fellowship trained in a surgical specialty. A lot of my peers are either in an academic institution or apart of large health system like Kaiser etc.

I work at an Fqhc. Not glamourous by any means but reasonable pay for a Monday through Friday gig and still do my sub specialty work.

I take pride in my work and being a good physician. But other things make me happy and fulfilled: religion, family, my lawn (not a joke), growing fruits and vegetables, barbecue, etc.

 

[HemeOncHopeful19]

I think I might have one of the best hospitalist gigs out there--
Average of 10 patients rounding a day, no admissions on rounding shifts. I usually leave by 1:30 (cover cross cover issues until 4PM)
no mandatory nights
It is not unusual for us to have a single digit census when rounding due to good staffing.
I have been doing hospitalist for almost 20 years, it was a great decision and I'm glad I chose it.
The only thing is that there are a wide variety of hospitalist jobs, and many of them just sound awful.
I make mid 300's with very generous benefits.
I think if you find a good hospitalist job it's hard to beat.
The best part of being a hospitalist is the freedom to structure my day the way I see fit. If I had to go to the clinic, I would retire.

Gonna quote your post from another thread if ya don’t mind.

I would imagine if you walked around your reunion saying that you’d get quite a few people envious of you, whether they said it aloud or not lol

 

[glorifiedresident]

Gonna quote your post from another thread if ya don’t mind.

I would imagine if you walked around your reunion saying that you’d get quite a few people envious of you, whether they said it aloud or not lol

Yes I have a good job, I am grateful for it.

 

[gutonc]

We can be nobodies together!

I'm an MD/PhD who did the PSTP and an extra super-fellow/post-doc year. I realized that I was never going to be happy being a physician-scientist (better that than never) and went into a fully clinical academ-ish position. I then worked my way into hospital/clinic leadership and burned myself out on that.

I'm now "just" a medical oncologist in a rural setting (NB, it's rural in the same way that Jackson Hole, WY or Sedona, AZ are rural) and the medical director of the "cancer institute" there (I direct me...no seriously, that's it). I could not be happier with where I am and couldn't possibly care less what other people think about it.

 

[aafisahar]

We're all nobodies. The only people who care if you died tomorrow are your friends/families and maybe the administration until they cover your call schedule.

 

[NewYorkDoctors]

I am the "President" of my own Professional Corporation. My "constituents?" Myself as this is a sole proprietorship

 

[dozitgetchahi]

I recently went to a 20 yr medical school reunion. Some classmates are assitant deans and department heads, high powered specialized specialists, and big wigs in their fields, and then there's me (lowly hospitalist- glorified resident - worker bee). I've never been the envious or jealous type, but it is interesting to see. Anyone else can relate and does it bother you? Don't get me wrong, I'm happy, I've had a good career so far and I've done well due to good financial habits etc.

Personally, I’d never see myself going to anything like this.

Throughout medical school/residency/fellowship, I pursued the “prestige” until I ended up at a “top ranked” rheumatology fellowship…and burned out dealing with the immense pressure to fill every spare minute with research, “projects”, and all the other assorted nonsense associated with high octane academia. That fellowship experience basically cured me of any further urges to pursue “prestige academia” (or academia altogether, for that matter).

Now? I make at least double the salary of my co fellows who went into academia, and I work less. I get to enjoy the rest of my life, and finally - after 13 years of grinding through training - I’ve been able to arrange my life the way I want it, doing the things I like doing in my spare time. I couldn’t care less about chasing the things my academic colleagues are burning themselves out to pursue.

 

[dozitgetchahi]

We're all nobodies. The only people who care if you died tomorrow are your friends/families and maybe the administration until they cover your call schedule.

Yep. I have a funny story:

When I moved to take my current job, I found a relatively famous person in rheumatology suddenly working in a private practice that was in a town not too far away. He had been a relatively big academician, with a relatively big reputation. So why was he working at a PP? I was told that he didn’t have the money to retire - all those years of subpar academic pay hadn’t added up to enough to retire on. So he was scrambling to try to save up enough to actually retire with.

The tragic part of this story is that the guy died suddenly about a year after starting his PP job. He never got to enjoy his retirement.

Lesson: your “academic reputation” amounts to diddly squat when push comes to shove. All those years of conferences, papers and effort didn’t add up into a retirement for this guy. Money matters too. Also, the most valuable thing we all have is time. Live your life now. Set up your job so you can actually enjoy your time and life, because you never know when you’re gonna be dead.

 

[NewYorkDoctors]

academicians love to compare the size of their....





























pubmed citation list

 

[Crayola227]

Most academics is a scam.

Yes.

If you're at the top of the pyramid, life is great

Lol but is it really 🤣

 

[bronx43]

academicians love to compare the size of their....


pubmed citation list

lol the most pathetic is when people try to flex with their pubmed papers… then you realize all of them are 4th author.

 

[HemeOncHopeful19]

I am the "President" of my own Professional Corporation. My "constituents?" Myself as this is a sole proprietorship

I’m the King of my castle, although my spouse tells me I fulfill more of a court jester position

 

[dozitgetchahi]

lol the most pathetic is when people try to flex with their pubmed papers… then you realize all of them are 4th author.

I think I finally realized how stupid all of this was when I interviewed for community rheumatology jobs and put my pubs on my CV…and nobody cared. I literally had zero questions asked about any of them, ever, even at practices where they claimed to be doing research. I’ve also given exactly zero presentations after leaving fellowship, despite being forced to do several presentations weekly as a fellow (and having the faculty obsess over trivial details of these presentations, and give you **** if they didn’t think your presentations were good enough, etc). Those presentations essentially had no relevance whatsoever to my day to day functioning as a PP physician.

Academics truly reside in a different world altogether. I just chose to stop caring about what they seem to care about, and I’ve never been happier.

 

[IM_to_ortho_hopeful]

i dont understand what this means?

i googled this term

What Is Fat FIRE? The Best Early Retirement Lifestyle

Fat FIRE (Financial Independence Retire Early) is being able to live it up in retirement without having to sacrifice your spending. If you are Fat FIRE, you can easily survive without a job because your investment income more than covers your best life's living expenses. You don't need to work...

www.financialsamurai.com

sounds intruiging. but also seems unsustainable?

This is the opposite of unsustainable. If your money grows faster than you spend it you can unplug from the matrix

 

[dozitgetchahi]

This is the opposite of unsustainable. If your money grows faster than you spend it you can unplug from the matrix

Financial independence is a great and worthy goal…my problem with the Fat Fire types is that they’re often willing to do extreme things, like eat food out of garbage cans and live in trailers, to accomplish said goal. I’m not exactly an “extravagant” spender by any means (for a while we had one car and lived in a $1000/month rental, and that was well after residency was over), but some of what they do is unsustainable in that it’s not the kind of life I want to be living.

Also, I encountered at least one insane Far Fire type who was an attending when I was a resident…he worked something like 2 doctor jobs with a ridiculous amount of moonlighting, all to try to bail out of medicine within 10 years…he was a horrible doc and was just going through the motions to try to get out asap. There’s nothing honorable about doing a complete **** job as a doc just to try to bail out faster.

Then, there are news articles where these people have run out of money and went back to work…or where they realized they didn’t want to live like a pauper for the rest of their lives, and went back to work…

Again, I think financial independence is a worthy goal…just don’t go crazy with it…

 

[NewYorkDoctors]

to be fair the point b

This is the opposite of unsustainable. If your money grows faster than you spend it you can unplug from the matrix

i should look into it

currently i just work more and earn more at the moment. nice thing about PP in a high volume area is that there is a near linear relationship between work and revenue. though profits are not so linear given more staff is needed to see that higher volume

 

[dozitgetchahi]

I remembered this Emily Dickinson poem today and immediately thought of this thread:

I’m Nobody! Who are you?
Are you – Nobody – too?
Then there’s a pair of us!
Don't tell! they'd advertise – you know!

How dreary – to be – Somebody!
How public – like a Frog –
To tell one’s name – the livelong June –
To an admiring Bog!

 

[onconc]

We're all nobodies. The only people who care if you died tomorrow are your friends/families and maybe the administration until they cover your call schedule.

+1
The only people who will remember that you worked hard will be your kids.
And spouse.
And other family members.
And perhaps friends if they are that close

 

[Calizboosted76]

+1
The only people who will remember that you worked hard will be your kids.
And spouse.
And other family members.
And perhaps friends if they are that close

These sentiments are really pushing me towards IM. My daughter already is missing me alot. I cannot imagine putting her through a surgical residency but its what I have been gunning for.

 

[HemeOncHopeful19]

These sentiments are really pushing me towards IM. My daughter already is missing me alot. I cannot imagine putting her through a surgical residency but its what I have been gunning for.

You can have a decent life as a surgeon.

You cannot have a decent life as a surgery resident.

 

[Calizboosted76]

You can have a decent life as a surgeon.

You cannot have a decent life as a surgery resident.

Yea this is my fear. My daughter is 5 and these are years that I will want to be present for.

 

[gutonc]

Yea this is my fear. My daughter is 5 and these are years that I will want to be present for.

At best your kid will be 11 or 12 when you finish a gen surg residency. If you do a sub-specialty or a fellowship, she'll be in high school when you finish.

My daughter was born at the end of my intern year. I didn't sleep much/at all until I was I was in my 3rd year of fellowship. I started my first attending job when she was 5. I chose a job that allowed me to spend more time with her as she was growing up and it was only in the last year (after she turned 16) that I chose a job for me, not for her. I mean, I'm still working for her, but my time is more for me now.

Do what will make you happy for the rest of your life. But don't underestimate the impact that will have on your kids now, and in the future. Building "generational wealth" for a kid who barely knows you doesn't seem like a great investment of your time/energy.

 

[Calizboosted76]

At best your kid will be 11 or 12 when you finish a gen surg residency. If you do a sub-specialty or a fellowship, she'll be in high school when you finish.

My daughter was born at the end of my intern year. I didn't sleep much/at all until I was I was in my 3rd year of fellowship. I started my first attending job when she was 5. I chose a job that allowed me to spend more time with her as she was growing up and it was only in the last year (after she turned 16) that I chose a job for me, not for her. I mean, I'm still working for her, but my time is more for me now.

Do what will make you happy for the rest of your life. But don't underestimate the impact that will have on your kids now, and in the future. Building "generational wealth" for a kid who barely knows you doesn't seem like a great investment of your time/energy.

This is amazing and probably what I will do. I enjoy rounding and Hospitalist work but I also enjoy surgery and being part of breast cancer treatment.

I know that they say pick a specialty for what you love and not the money but after seeing some hospitalist salaries I am worried that I’m the future they may fall even lower due to midlevels. So I am iffy on choosing IM.

My daughter comes first no matter what though. Im a parent first and med student second.

 

[dgdg]

A lot of good supporting comments.
I started med school about 5 years later than the typical path. I would have loved to specialize, prob GI and would have gotten in, but I looked ahead and realized general IM would be just fine. I needed to stop my training and move on.
Then I loved the IM hospital work, but now I do primary care and outpt hospice. Given the age of many of my patients, I deal with some complex stuff.
Every once in a while, I see something less common that is important for me to quickly recognize and help manage. In a way, general outpt IM can be routine 98% of the time but you have to be ever watchful for the remainder and you never know when it comes in your door waiting for discovery. For that patient, it is extremely important that you are ever the curious physician.
I enjoy the endless learning opportunities in general IM. It all depends what will get you out of bed in the morning feeling like you have a motivating purpose. Comparative money won't get you out of bed eager to go to work.

No one else can ever determine your value as a person even if they try, only you can. Never forget that.
We are all 'nobodies' in the sense that we all have equal value as a human being. Granted, we have extra importance to familiy and ourselves.
I cringe everytime I see some web news article about someone's "worth" and they discuss how much money they have saved up. Far from it. Our "worth" is who we are as a person.

Caliz,
Plotting out a vision of how your training options will affect your personal life is a substantial question. Once you commit to a training path, your mostly in quicksand. Even if hospitalist salaries decline, you'll still make more than the vast majority of the people in the world and the usa. You're skills will be amazing and your worth to patients will be important. If you are wise with your lifestyle, you can be very comfortable. Aim for what makes you overall the happiest, it's not an extra $50K.

 

[NewYorkDoctors]

a good PCP is tremendously valuable. a good PCP is not someone who "knows it all and is a one-person show." Rather someone who can manage the routine issues well, do basic workup on the complex issues and quarterbacks the referrals, sets proper expectations with the patients, and for the love of whatever deity one does or does not believe in do NOT gaslight the patient.
recall I do some PCP myself so I speak from actually doing and not just talking out loud.

many patients I see are told by their PCPS that the 4mm nodule MIGHT BE CANCER.

sigh.

 

[dozitgetchahi]

a good PCP is tremendously valuable. a good PCP is not someone who "knows it all and is a one-person show." Rather someone who can manage the routine issues well, do basic workup on the complex issues and quarterbacks the referrals, sets proper expectations with the patients, and for the love of whatever deity one does or does not believe in do NOT gaslight the patient.
recall I do some PCP myself so I speak from actually doing and not just talking out loud.

many patients I see are told by their PCPS that the 4mm nodule MIGHT BE CANCER.

sigh.

And that every positive ANA “probably is SLE”..,

 

[Calizboosted76]

A lot of good supporting comments.
I started med school about 5 years later than the typical path. I would have loved to specialize, prob GI and would have gotten in, but I looked ahead and realized general IM would be just fine. I needed to stop my training and move on.
Then I loved the IM hospital work, but now I do primary care and outpt hospice. Given the age of many of my patients, I deal with some complex stuff.
Every once in a while, I see something less common that is important for me to quickly recognize and help manage. In a way, general outpt IM can be routine 98% of the time but you have to be ever watchful for the remainder and you never know when it comes in your door waiting for discovery. For that patient, it is extremely important that you are ever the curious physician.
I enjoy the endless learning opportunities in general IM. It all depends what will get you out of bed in the morning feeling like you have a motivating purpose. Comparative money won't get you out of bed eager to go to work.

No one else can ever determine your value as a person even if they try, only you can. Never forget that.
We are all 'nobodies' in the sense that we all have equal value as a human being. Granted, we have extra importance to familiy and ourselves.
I cringe everytime I see some web news article about someone's "worth" and they discuss how much money they have saved up. Far from it. Our "worth" is who we are as a person.

Caliz,
Plotting out a vision of how your training options will affect your personal life is a substantial question. Once you commit to a training path, your mostly in quicksand. Even if hospitalist salaries decline, you'll still make more than the vast majority of the people in the world and the usa. You're skills will be amazing and your worth to patients will be important. If you are wise with your lifestyle, you can be very comfortable. Aim for what makes you overall the happiest, it's not an extra $50K.

I really appreciate the advice! This has been weighing on me heavily all of third year so far and I just feel so lost. On one hand I want to be a specialist or be "That person" that everything gets sent to and I actively do interventions that save lifes. On the other hand I don't know that I am okay sacrificing years of my daughters life during general surgery residency when I may be just as happy being a hospitalist.

We will see how the rest of rotations go I guess. I know that I enjoy rounding and hate outpatient so if I went IM it would have to be hospital medicine. Another fear though is that I will not have a niche to fall back on if I burn out of hospital medicine. It was a lot easier when I was a surgery gunner, the added stress of not know what to do sucks.

 

[quickpsych]

I am a psychologist, not an MD or DO. This thread caught my eye even though outside my normal forum on here and even though different disciplines, struck me that there are many commonalities of this experience.

Know plenty of colleagues that are on the "grind" so to speak with goals or actively being a clinician, a professor, maybe a department head of a university or a clinic, working on research and publications, etc. Some run entire departments or programs, some go on book and speaking tours. Some work in the executive suites. Essentially having multiple hats and roles, working 50-60 hours a week doing these. Living and breathing the profession I suppose.

I'm pretty content just being a "grunt" so to speak doing mostly clinical direct patient work working maybe 20 -25 hours a week and spending my time outside the work on my own endeavors and interests for now.

 

[NewYorkDoctors]

And that every positive ANA “probably is SLE”..,

yeah they should get rid of that "arthritis panel" from the commercial labs...

i mean if PCP (provider in this case. midlevels are primary care providers now and they do this all the time) wrote down "I tried to talk the patient out of it and send to rheumatology first for blank state evaluation but patient insisted on the arthritis panel." then that would seem fine.

but it's "too much effort" to have that few minute sof talk....


joints hurt

arthritis panel

done . pat oneself on back



not to mention when primary care does a basic spirometry with their.... nurse at best ... secretary at worst... and its poor effort on the flow volume loop and they refer due to "severe restriction."
i don't deny the PCP from doing the spiro to get some 94010 action in.

but why prescribe all those inhalers and never show your patient how to use it?
you could have shown them how to use it properly and used 94664

maybe some older providers dont know how to use it themselves....

 

[dgdg]

I really appreciate the advice! This has been weighing on me heavily all of third year so far and I just feel so lost. On one hand I want to be a specialist or be "That person" that everything gets sent to and I actively do interventions that save lifes. On the other hand I don't know that I am okay sacrificing years of my daughters life during general surgery residency when I may be just as happy being a hospitalist.

We will see how the rest of rotations go I guess. I know that I enjoy rounding and hate outpatient so if I went IM it would have to be hospital medicine. Another fear though is that I will not have a niche to fall back on if I burn out of hospital medicine. It was a lot easier when I was a surgery gunner, the added stress of not know what to do sucks.

You call go from hospital to outpt medicine. It's a transition, but you can do it.

 

[Calizboosted76]

You call go from hospital to outpt medicine. It's a transition, but you can do it.

Right, but I despise outpatient primary care medicine.

 

[gutonc]

Right, but I despise outpatient primary care medicine.

With all due respect, you have no idea what you think about outpatient primary care as an M3. You know what you've seen as a student. In residency you will see what that looks like. Neither of those have much, if anything, to do with what PC is like in the real world. There are so many different options out there, so many different practice patterns/settings/opportunities in PC that it's honestly impossible to know whether or not it would be a good fit for you.

I'm not trying to talk you in or out of it. I'm just suggesting that you're not necessarily in the best place right now (professionally or personally given your general uncertainty about IM vs Surgery at this point) to be as definitive as you claim to be right now.

 

[Calizboosted76]

With all due respect, you have no idea what you think about outpatient primary care as an M3. You know what you've seen as a student. In residency you will see what that looks like. Neither of those have much, if anything, to do with what PC is like in the real world. There are so many different options out there, so many different practice patterns/settings/opportunities in PC that it's honestly impossible to know whether or not it would be a good fit for you.

I'm not trying to talk you in or out of it. I'm just suggesting that you're not necessarily in the best place right now (professionally or personally given your general uncertainty about IM vs Surgery at this point) to be as definitive as you claim to be right now.

I always appreciate your input. My dislike for outpatient primary care comes from working several years in an outpatient clinic setting and it was something that I feel I would not like as a physician. My rotations on FM out patient as well as IM outpatient clinic (both in residency programs) solidified that I do not like outpatient primary care. Maybe providing primary care (as a cardio or heme/onc) is different and may suit me better but the FM/IM outpatient stuff did not suit me at all. I also love being in the hospital. I have a sense of calmness while there. Who knows. We will see after my next surgery rotation whether I choose to take the IM or surgery route.

 

[VA Hopeful Dr]

I always appreciate your input. My dislike for outpatient primary care comes from working several years in an outpatient clinic setting and it was something that I feel I would not like as a physician. My rotations on FM out patient as well as IM outpatient clinic (both in residency programs) solidified that I do not like outpatient primary care. Maybe providing primary care (as a cardio or heme/onc) is different and may suit me better but the FM/IM outpatient stuff did not suit me at all. I also love being in the hospital. I have a sense of calmness while there. Who knows. We will see after my next surgery rotation whether I choose to take the IM or surgery route.

Residency clinic is nothing like real world primary care.

 

[Calizboosted76]

I do want to add that I absolutely admire what solid PCPs do. I just feel that outpatient PC is not for me. I do not enjoy being in clinic. This comes from my background prior to medical school as well. So I am not just basing it off of residency clinics.

 

[NewYorkDoctors]

residency clinic is fractured and has lack of continuity. even the progrms that do 4+ 1 or 6 + 2 or whatever, the patients themselves always want ot walk in and will not always adhere to the resident's schedule. hence if one resident writes an unclear note, then the next resident is struggling and anger from aptient ensures.
not to mention all of those scripts for controlled substances, the pain management agreements, the prior authorizations for ozempic off lable for weight loss, etc...

in a private practice that is well run, these things tend to be a bit more smooth as the provider can dictate how the workflow actually goes rathe rthan be "at the whim of the system." after "getting to know the patients" and having a chance to make a rock solid organized chart, things become easier going forward

 

[Calizboosted76]

residency clinic is fractured and has lack of continuity. even the progrms that do 4+ 1 or 6 + 2 or whatever, the patients themselves always want ot walk in and will not always adhere to the resident's schedule. hence if one resident writes an unclear note, then the next resident is struggling and anger from aptient ensures.
not to mention all of those scripts for controlled substances, the pain management agreements, the prior authorizations for ozempic off lable for weight loss, etc...

in a private practice that is well run, these things tend to be a bit more smooth as the provider can dictate how the workflow actually goes rathe rthan be "at the whim of the system." after "getting to know the patients" and having a chance to make a rock solid organized chart, things become easier going forward

Oh no, I totally get that and my decision of not like outpatient PC doesn't factor any of the scut that residents go through. I find that I enjoy much more acute settings.

 

[gutonc]

Oh no, I totally get that and my decision of not like outpatient PC doesn't factor any of the scut that residents go through. I find that I enjoy much more acute settings.

Every med student does. That's the sexy s***. It's what TV taught us to think medicine was. Med school and residency training in most specialties prioritize the emergent and acute care clinical experiences over the far more common (and probably more impactful) non-emergent and chronic care that makes up the bulk of healthcare.

A dozen years in and I'll take a clinic full of simple 99213s all day every day.