Can EM/CC get a job in your state?

[DadBod]

I'm interested in CC, and the institution I'm at has a CC fellowship for EM grads. I was talking to an EM attending, and he said I should ask around the CC community about the job opportunities for EM/CC. He mentioned that there are some regions where EM/CC-trained docs aren't able to get jobs because hospitals and groups prefer IM/CC/Pulm and anesthesiologists. I understand why this would be true in academic institutions, but what about in the community?
Are EM/CC-trained intensivists getting jobs in your market? I want to end up in Phoenix-- anyone have any experience in the market there?

---

Members don't see this ad.

 

[deleted171991]

There are community hospitals whose recruiters are so f-ing stupid that they won't even forward your resume if you're not IM-boarded, because "you won't be able to get privileges". Of course, they won't tell you that, until you inquire a few weeks later why you haven't heard anything back. And, of course, they will refuse to budge, because the IQ of a (corporate) recruiter is one point above a cockroach's; neither should exist in healthcare. This is on the East coast, by the way.

So, if you're not ABIM-certified, anytime you see a job announcement for IM- or Pulm-CCM, get the contact details of the ICU director and talk to her directly. In my case, he was able to confirm that the base specialty didn't matter, but he had already hired somebody in the meanwhile.

 

[Hamhock]

FFP makes a great point, but I will take it a bit further for EM grads.

Although there is still some skepticism among community old-school Pulm-CCM grads out there, they and recruiters are much more likely to take a deeper look at your application if their first glance shows you are ABIM-CCM board certified (Yes, I know it goes through ABEM technically).

This should be a strong consideration for EM grads who want to go into the community after fellowship.

When deciding between and IM or anesthesiology based CCM fellowship, consider the base specialty of the directors of the unit you want to work in after fellowship.

Hopefully, someday all this nonsense will disappear and we will all be intensivists after finishing fairly similar CCM fellowships...but for now we do love tribalism.

HH

Edit to add: there are community shops in WA, OR, CA, and PA that I know take EM-CCM grads who completed an IM-based CCM fellowship.

 

[chocomorsel]

Yes. But you will always be discriminated against as a non IM CCM. It’s ignorance really like FFP said.

 

[CCM-MD]

In my opinion, you probably won’t have trouble finding a job as long as you want to do full time CCM. If you want to practice a combination - 50% EM and 50% CCM - I have heard that it can be near impossible to find a gig like that.

 

[deleted547339]

In my opinion, you probably won’t have trouble finding a job as long as you want to do full time CCM. If you want to practice a combination - 50% EM and 50% CCM - I have heard that it can be near impossible to find a gig like that.

It’s not easy....I was able to land one, but it took some work and several people either said no or there were large barriers I didn’t want to deal with.

If doing full time CCM, probably not hard.

 

[tartesos]

You can always do locums for both, pays really well and you can do as much or as little of either as you like each month ( could also be a good way through the door, to make them build a position for you if it fits you both).



Sent from my iPhone using SDN mobile

 

[Dr.CCM]

Full time CCM, typically it doesn’t matter as long as you can get board certified.

If You want to do a full time combo in the community it will be harder unless your group staffs the ER and ICU which is becoming more common. So most people pick one or the other and moonlight as a side gig.

If you are having trouble contact the medical director of the job you want.

 

[VA Hopeful Dr]

There are community hospitals whose recruiters are so f-ing stupid that they won't even forward your resume if you're not IM-boarded, because "you won't be able to get privileges". Of course, they won't tell you that, until you inquire a few weeks later why you haven't heard anything back. And, of course, they will refuse to budge, because the IQ of a (corporate) recruiter is one point above a cockroach's; neither should exist in healthcare. This is on the East coast, by the way.

So, if you're not ABIM-certified, anytime you see a job announcement for IM- or Pulm-CCM, get the contact details of the ICU director and talk to her directly. In my case, he was able to confirm that the base specialty didn't matter, but he had already hired somebody in the meanwhile.

I wonder if it has something to do with lots of community hospitals not having just pure CC positions.

What I mean is that in every hospital I've ever worked for, the ICU was covered by the pulmonologists on their call days. Those same doctors when not on call were in the pulm clinic. Could be a regional thing as I haven't left the state since I got home from undergrad, but just throwing that out there.

 

[CCM-MD]

I wonder if it has something to do with lots of community hospitals not having just pure CC positions.

What I mean is that in every hospital I've ever worked for, the ICU was covered by the pulmonologists on their call days. Those same doctors when not on call were in the pulm clinic. Could be a regional thing as I haven't left the state since I got home from undergrad, but just throwing that out there.

There is a lot of regional variation in regards to this. My area (large Midwest city), majority of the hospitals have hospital employed intensivists - many of these physicians are dual trained in Pulm and CCM but choose to do intensivist work, and others are pure CCM.

From my experience, the general trend is towards hospital employed intensivists. At least for moderate to large hospitals. More and more hospitals have been using intensivist presence as a “selling point” when it comes to hiring hospitalists - many hospitalists (especially newer guys) are not comfortable/don’t want to deal with ICU patients. There has also been a recent proliferation of large “staffing” companies like Sound, Team Health, “intensivist group” that staff the ICU with intensivists which has also led to reduced number of traditional Pulm/CCM practices of round in the ICU and go see patients in your office.

My experience has been that the smaller the hospital and the further away it is from a city, the more likely they don’t have in-house intensivists, and may have the traditional practice model. There may be some regional variation to this. There are also a lot of Pulm/CCM practices that have transitioned to “blocks” of CCM - when their physicians are in the ICU, they don’t do Pulm. These practices often hire CCM (non-Pulm) physicians also.

 

[VA Hopeful Dr]

There is a lot of regional variation in regards to this. My area (large Midwest city), majority of the hospitals have hospital employed intensivists - many of these physicians are dual trained in Pulm and CCM but choose to do intensivist work, and others are pure CCM.

From my experience, the general trend is towards hospital employed intensivists. At least for moderate to large hospitals. More and more hospitals have been using intensivist presence as a “selling point” when it comes to hiring hospitalists - many hospitalists (especially newer guys) are not comfortable/don’t want to deal with ICU patients. There has also been a recent proliferation of large “staffing” companies like Sound, Team Health, “intensivist group” that staff the ICU with intensivists which has also led to reduced number of traditional Pulm/CCM practices of round in the ICU and go see patients in your office.

My experience has been that the smaller the hospital and the further away it is from a city, the more likely they don’t have in-house intensivists, and may have the traditional practice model. There may be some regional variation to this. There are also a lot of Pulm/CCM practices that have transitioned to “blocks” of CCM - when their physicians are in the ICU, they don’t do Pulm. These practices often hire CCM (non-Pulm) physicians also.

And I certainly think it makes more sense to have a dedicated CC person (or people depending how big a hospital) as opposed to just rotating a different pulm-CC person every 24 hours. Must be a regional thing, because the way I described is how it was done at my wife's 900 bed (90 ICU bed) residency training hospital. Of course despite being a tertiary shop their ICU was still open so might not be a selling point for that hospital...

I can definitely see things shifting away from that, especially with what looks to be increasing numbers of non-pulm CC folks coming out of fellowship these days.

 

[CCM-MD]

I can definitely see things shifting away from that, especially with what looks to be increasing numbers of non-pulm CC folks coming out of fellowship these days.

That might be part of it but I think there may be more of dual trained physicians choosing to work as intensivists. Near half of the physicians in my hospital based intensivist group are Pulm/CCM trained but don't practice pulm. A couple of these guys have been doing this for >10 years. Most do this because they like the ICU more. Some would like to do Pulm simultaneously but due to the nature of the opportunities in our area are not able to - for some reason there is a scarcity of good opportunities in this area that allow people to do both.