Career change: From physican to full-time college professor, is it possible?

[Leukocyte]

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Dear Members,

OK. I have now came to peace with myself and agree that I might have chosen the wrong career path by being in clinical medicine. I have tried to get out of clinical medicine, but I just do not seem to be able to do so. Unlike many of those who were successful in changing their careers out of clinical medicine, I am different : I do not have any special talents, I am not creative, and I am not as smart as those who have succeeded out of clinical medicine. I am just a simple, boring, shy person with nothing special about me. The only thing I think I might be able to be good at is teaching. I know I like Biology, so I can teach Biology. The problem is that I am a 35 year old Family Medicine physician, and I do not think it is logicaly possible or economically feasable to go back to college and get a PhD in Biology to start my new career as a college professor. I do not even have a MS degree. All I have are my BS and MD degrees.

So what would be your advice?

- Take the GRE, and go for a PhD program in Biology?

or

- Take the GRE, and go for a MS program in Biology (but I am not sure if I can teach with just a MS)?

or

- Go into a MPH program (but I am not sure if I can teach with just a MPH)?

or

-Go into a MBA program, and go into a full-time health care administation career?

or

- Stay in FM for now, and apply AGAIN to a Pathology residency program in the next match season. I applied in this past match season to 67 pathology programs, but got only 1 interview!!!!

or

-Just give-up on my career change plans out of clinical medicine, and just live with the bitter truth/reality that I will be a FM physician for the rest of my remaining years in this life.

Thank you, and I am open to any suggestions.

 

[mlw03]

Do you want to teach high school or beyond? If high school, you need to do alternative certification. If college level, the MD probably isn't enough.

What about trying to alter your FM practice to suit your wishes a bit better? There seem to be lots of business models out there nowadays.

 

[physicsnerd42]

At what level do you want to teach? You're not going to get a tenure track job at a big research school because you don't have the academic background. Lecturing at a community college or smaller liberal arts school (or adjunct at a bigger school) in biology might work out. The problem with these jobs are that they don't pay much. How much of a pay cut are you willing to take?

Definitely don't do the PhD. It's a very painful experience if you don't love research, the pay is pretty bad in grad school, and there is currently a glut of people with PhDs in biology who can't get academic jobs. I'm also not sure the MS helps much.

For the MBA, the school you go to matters (unlike med school). If want to be successful, you need to go to a pretty high-tier place.

What is it about FM you hate? Why would path be better? Would a different practice environment help you feel better about FM?

 

[Medstudentquest]

Dear Members,

OK. I have now came to peace with myself and agree that I might have chosen the wrong career path by being in clinical medicine. I have tried to get out of clinical medicine, but I just do not seem to be able to do so. Unlike many of those who were successful in changing their careers out of clinical medicine, I am different : I do not have any special talents, I am not creative, and I am not as smart as those who have succeeded out of clinical medicine. I am just a simple, boring, shy person with nothing special about me. The only thing I think I might be able to be good at is teaching. I know I like Biology, so I can teach Biology. The problem is that I am a 35 year old Family Medicine physician, and I do not think it is logicaly possible or economically feasable to go back to college and get a PhD in Biology to start my new career as a college professor. I do not even have a MS degree. All I have are my BS and MD degrees.

So what would be your advice?

- Take the GRE, and go for a PhD program in Biology?

or

- Take the GRE, and go for a MS program in Biology (but I am not sure if I can teach with just a MS)?

or

- Go into a MPH program (but I am not sure if I can teach with just a MPH)?

or

-Go into a MBA program, and go into a full-time health care administation career?

or

- Stay in FM for now, and apply AGAIN to a Pathology residency program in the next match season. I applied in this past match season to 67 pathology programs, but got only 1 interview!!!!

or

-Just give-up on my career change plans out of clinical medicine, and just live with the bitter truth/reality that I will be a FM physician for the rest of my remaining years in this life.

Thank you, and I am open to any suggestions.

What is it that you hate about FM? There must have been something you liked about it as a med student. Can you change your practice at all to make it more appealing?

As I see it:

-PhD= no way! Getting in is hard, getting through is hard, and getting a tenure track professorship is tough. Lots of PhD's out there, not enough position. You are looking at 4+ years to get the PhD, + another 5+ if lucky to get a tenure track position, in addition to a post doc post PhD. Bad idea! Teaching positions also pay crap. Teaching at a community college, etc. also pays crap. I would not recommend it.

-MS= pointless. Can't really do much with it.

-MPH= you CAN teach with an MPH and an MD, but again, you don't get MD pay. Have you taught before? It's not what a lot of people think it is, and quitting clinical medicine for some idea of what teaching is can be difficult.

-MBA= you need to go to a top 5-10 school. Admission can be competitive, also very $$$. Can you afford that? And with an MBA you can go into the business world sure, but it's tough and completely different from medicine. If you are shy, do you think it's the best place to be? Health care administration I'm sure is not easy to get into. Lots of people want to do that, and I think those positions usually are given to people in the loop/connected in a hospital setting.

-Clinical path=what's so great about pathology that sucks about FM? Are you willing/ready to go for another 4+ year residency? Realize that according to the path forum, the job market sucks in path currently, and people are doing a # of fellowships to get in.

I ask again-what makes you feel that FM is so terrible?

 

[Leukocyte]

Thank you all for your input and advice. You asked why I do not like FM. It has to do with career-personality compatability. I am a person who is shy, quite, non-confrontational, cautious, afraid to take risks, nerdy, "office space cubicle worker" kind of person. Clinical medicine in-general requires a person to have a strong personality. It requires someone who is a leader, and who is not afraid to take risks and not afraid of confrontations. I am more of a nerdy science geek type, as opposed to a leader or risk taker. I hate arguing and confrontations. I am a simple person, who just wants to get through life peacefully and quitely. Basically, "a fly on the wall" type of person. That is why I thought that Pathology would be a better fit for me, since it is more like a "hybrid" between medicine and basic science. Also teaching would be a good fit for me (I enjoyed teaching medical students medical science theories in residency, but I did not like the clinical practice part).

So I tried appying to Pathology programs late this past November, but I failed. I am not sure if appying again next year would help any. Maybe if I appied in early September that might help? Should I even apply again this year (2013 match) to Pathology programs? Would it help if I apply again very early (September) this coming season, as opposed to November?

I also applied to MPH / Preventive Medicine programs hoping that I could teach full-time with a MPH degree. But again, I am not sure if I can guanatee a full-time teaching career with the MPH. As for a teaching career, I would like to teach full-time at the communty college level or higher. Would a MPH be enough to teach full-time at the community college level or higher? Is a MPH better than a MS in biology for community college teaching jobs? Can I even qualify to teach full-time at a college with MPH?

If I would have it my way, I would turn back the clock and go into a PhD biology degree program instead of medical school, but it is too late for this now. At 35 years old with lots of medical school debt, any career change is almost impossible.

Thank You again, and any advice is helpful.

 

[Medstudentquest]

Thank you all for your input and advice. You asked why I do not like FM. It has to do with career-personality compatability. I am a person who is shy, quite, non-confrontational, cautious, afraid to take risks, nerdy, "office space cubicle worker" kind of person. Clinical medicine in-general requires a person to have a strong personality. It requires someone who is a leader, and who is not afraid to take risks and not afraid of confrontations. I am more of a nerdy science geek type, as opposed to a leader or risk taker. I hate arguing and confrontations. I am a simple person, who just wants to get through life peacefully and quitely. Basically, "a fly on the wall" type of person. That is why I thought that Pathology would be a better fit for me, since it is more like a "hybrid" between medicine and basic science. Also teaching would be a good fit for me (I enjoyed teaching medical students medical science theories in residency, but I did not like the clinical practice part).

So I tried appying to Pathology programs late this past November, but I failed. I am not sure if appying again next year would help any. Maybe if I appied in early September that might help? Should I even apply again this year (2013 match) to Pathology programs? Would it help if I apply again very early (September) this coming season, as opposed to November?

I also applied to MPH / Preventive Medicine programs hoping that I could teach full-time with a MPH degree. But again, I am not sure if I can guanatee a full-time teaching career with the MPH. As for a teaching career, I would like to teach full-time at the communty college level or higher. Would a MPH be enough to teach full-time at the community college level or higher? Is a MPH better than a MS in biology for community college teaching jobs? Can I even qualify to teach full-time at a college with MPH?

If I would have it my way, I would turn back the clock and go into a PhD biology degree program instead of medical school, but it is too late for this now. At 35 years old with lots of medical school debt, any career change is almost impossible.

Thank You again, and any advice is helpful.

As I mentioned in my prior post, PhD should be out of the question. With an MS, you *may* be able to teach at a community college, but usually community college teaching is done per course, and you get x amount per course, which is minimal, roughly 1k/month if that! My husband has a PhD from a pretty good place and he wanted to teach, taught for a semester at a community college and kinda hated it! In order to teach at a university, you need a PhD and in order to teach full time a tenure position. So the work will likely be sporadic at a community college depending on need, not stable and certainly low paying. MPH is the same-you can teach with it and the MD but it will be sporadic, not a full time gig that can likely provide a decent income.

Preventive medicine programs are not competitive and since you did a FM residency it would be easier for you to find a job, but it's similar to it and will have patient interaction. I don't understand why you feel FM is confrontational or that it requires a great deal of risk?! Pathology does not have much patient interaction, same with rads but rads is more training and competitive. Teaching in general requires a ton of interaction with students, potential grade disputes, issues with other faculty, etc. Not the most confrontrational-less field.

Can you find a niche in your specialty at all? Can you work at a smaller/community type hospital? Also are you a girl or a guy and do you have a partner who is working as well?

 

[NotAProgDirector]

Applying in November is way too late. Apply right when ERAS opens. Be clear in your PS why you are doing what you are doing -- don't say that you're an office cubicle kind of person (that's not going to win you any interviews). Just stress that you're more interested in the "science" of medicine and hence are drawn to pathology. It will be better for your application if you can show that you're actually working as a physician

 

[Leukocyte]

Thank you Medstudentquest for your input. I did not know that teaching at community colleges was sporadic, temporary and unsustainable. $1000 / month!!! Wow. Are there any full-time / long-term community college teaching jobs that are more sustainable, or are all of them pretty much sporadic and temporary?

To answer your questions: I am a guy. No partner. Can I find a niche in FM that would be more appealing? I do not think so (the only thing that comes to mind is boutique medicine and cosmetic "spa" medicine, and I am not interested in that). Can I work at a smaller/community type hospital? Again, FM is FM, anywhere and everywhere, so I am not sure if that will help much (if not add to the stress of an FM doctor since there will be little to no consult specialist support in rural areas). Why is FM confrontational? Well it is not as "confrontational" or as a high-risk as say surgery, but the stress/risk of FM comes in the fact that the FM doctor is the PRIMARY care provider who is responsible for the ENTIRE health of patient. That is a huge responsibility to carry, and carries with it a considerable risk. A FM might not get sued in a malpractice law suit against a specialist that provided care for that FM patient, but that FM might get sued depending on how he/she handleded that referal or to what extent the FM played in the follow-up care. At the very least the FM might get questioned in a deposition of a law suit. Basically, the FM doctor has to be very careful in addressing ALL and EVERY health problem the patient has. That comes with a risk and might require, at times, confrontations (as in being a proactive voice) for the benefit of the patients.

Thanks again.

 

[Tiki]

So I tried appying to Pathology programs late this past November, but I failed. I am not sure if appying again next year would help any. Maybe if I appied in early September that might help? Should I even apply again this year (2013 match) to Pathology programs? Would it help if I apply again very early (September) this coming season, as opposed to November?

I'm not sure what your stats/experiences are, but applying in November definitely hurt you for Path. When I applied (back in 2008), I started receiving interview offers in mid-September and received the last one in the middle of October. Pathology is notorious for starting the invite process early, most places don't wait for dean's letters.

The other thing that could hurt you for Path is if you don't have experience (path electives or observerships).

 

[Leukocyte]

Applying in November is way too late. Apply right when ERAS opens. Be clear in your PS why you are doing what you are doing -- don't say that you're an office cubicle kind of person (that's not going to win you any interviews). Just stress that you're more interested in the "science" of medicine and hence are drawn to pathology. It will be better for your application if you can show that you're actually working as a physician

Thanks aProgDirector. So you think that having applied in November (as opposed to September) made a difference in my failure of getting any interviews? I will try to apply agian this September. I just hope it will work this time. Thanks.

 

[Leukocyte]

I'm not sure what your stats/experiences are, but applying in November definitely hurt you for Path. When I applied (back in 2008), I started receiving interview offers in mid-September and received the last one in the middle of October. Pathology is notorious for starting the invite process early, most places don't wait for dean's letters.

The other thing that could hurt you for Path is if you don't have experience (path electives or observerships).

Thank TiKi! Encouraging post. Wow, I did not know that just a 2 months difference would mean the difference between sucess and failure.

 

[Medstudentquest]

Thank TiKi! Encouraging post. Wow, I did not know that just a 2 months difference would mean the difference between sucess and failure.

Is there a path department in the place where you work at? Maybe talking to someone there might help! Have you considered any other more introverted type/less generalist type fields other than path? I don't think path is generally that competitive but unless you have some sort of previous experience programs may wonder why you are trying to switch.

I think you options may be feasible:
1-Have you considered doing a fellowship in FM, perhaps sports fellowship?
2-Preventive/occupational medicine type gigs-you do not concern yourself with the whole care of the patient, and since you've done a primary care residency already, it may be easier to get in. I don't know where you are geographically, but there are a few positions open for July 2012, not sure if you've considered that. I think they take 1-2 years, and usually they pay for your MPH. I think that would be a good option for you if path does not work out! 🙂

 

[gutonc]

Thank you Medstudentquest for your input. I did not know that teaching at community colleges was sporadic, temporary and unsustainable. $1000 / month!!! Wow. Are there any full-time / long-term comminty college teaching jobs that are more sustainable. or are all of them pretty much sporadic and temporary?

This is pretty close to on-target salary-wise. Teaching as an adjunct (what you would be doing) in the CC or even large state undergrad setting is a good way to maintain your skills and CV while you pay your rent and student loans with your barista or Whole Foods cashier job.

A good friend of mine has a PhD in Marine Ecology and an instructor/adjunct position at the largest university in our state. She makes ~$45K/year, $25K of that is from grants for her research, the other $20K comes from teaching 3-5 undergrad classes/quarter, 3 quarters/year. Another friend has a PhD in Molecular and Cell Biology and is currently a law student. She teaches 1 section of intro bio at a fancy ($40K/yr tuition) liberal arts college in town and clears almost enough to pay for her books.

If you don't have a research career to go along with it, you should assume something in the $20K/year range for FT teaching entry level science classes to undergrads.

 

[Medstudentquest]

This is pretty close to on-target salary-wise. Teaching as an adjunct (what you would be doing) in the CC or even large state undergrad setting is a good way to maintain your skills and CV while you pay your rent and student loans with your barista or Whole Foods cashier job.

A good friend of mine has a PhD in Marine Ecology and an instructor/adjunct position at the largest university in our state. She makes ~$45K/year, $25K of that is from grants for her research, the other $20K comes from teaching 3-5 undergrad classes/quarter, 3 quarters/year. Another friend has a PhD in Molecular and Cell Biology and is currently a law student. She teaches 1 section of intro bio at a fancy ($40K/yr tuition) liberal arts college in town and clears almost enough to pay for her books.

If you don't have a research career to go along with it, you should assume something in the $20K/year range for FT teaching entry level science classes to undergrads.

Yep, exactly! I found out from personal experience with my husband teaching with a pretty rigorous PhD from a great place. It was kinda sad! And these courses are so time consuming it's crazy, not to mention that whehter one will get a job or not for the semester depends in part on the # of students, whether the course will be needed or not, etc.

 

[peppy]

If you still think you'd like path better, I definitely think you should try again for Pathology. Get your application in the first day that ERAS opens and I bet you'll get more interviews than you did last time.

If you think you would enjoy teaching, do you think there is any chance you would hate FM less if you were an attending in an academic setting?

 

[Leukocyte]

1-Have you considered doing a fellowship in FM, perhaps sports fellowship?
2-Preventive/occupational medicine type gigs-you do not concern yourself with the whole care of the patient, and since you've done a primary care residency already, it may be easier to get in. I don't know where you are geographically, but there are a few positions open for July 2012, not sure if you've considered that. I think they take 1-2 years, and usually they pay for your MPH. I think that would be a good option for you if path does not work out! 🙂

Thanks again. As far as option #1 (FM fellowships), well as you know there are not many options there, and none which are interesting. In addition, a fellowship trained FM in anything (lets say sports medicine) is still a FM and almost all fellowship trained FM docs work as PCPs with regular "bread and butter" FM work in-addition to their special interest focus. As for option #2 (PM), it is what I am indeed thinking about if Pathology does not work out. The challenge though is finding pure PM practice jobs in government public health clinics (not very common). That is why I was thinking about using the MPH to teach, if I end up going that route. Thanks again.

 

[Leukocyte]

This is pretty close to on-target salary-wise. Teaching as an adjunct (what you would be doing) in the CC or even large state undergrad setting is a good way to maintain your skills and CV while you pay your rent and student loans with your barista or Whole Foods cashier job.

A good friend of mine has a PhD in Marine Ecology and an instructor/adjunct position at the largest university in our state. She makes ~$45K/year, $25K of that is from grants for her research, the other $20K comes from teaching 3-5 undergrad classes/quarter, 3 quarters/year. Another friend has a PhD in Molecular and Cell Biology and is currently a law student. She teaches 1 section of intro bio at a fancy ($40K/yr tuition) liberal arts college in town and clears almost enough to pay for her books.

If you don't have a research career to go along with it, you should assume something in the $20K/year range for FT teaching entry level science classes to undergrads.

Wow, 45K for a PhD! Thanks Gutonc. I never knew that teaching was such an under-valued career. I am glad I knew this now. Thanks

 

[Leukocyte]

If you still think you'd like path better, I definitely think you should try again for Pathology. Get your application in the first day that ERAS opens and I bet you'll get more interviews than you did last time.

If you think you would enjoy teaching, do you think there is any chance you would hate FM less if you were an attending in an academic setting?

I would ABSOLUTELY, positively, surely, definately.......like path better. No question there. My worry is getting in, and if I got in, I will be 40 years old when I finish residency! That kinda scars me, but I am willing to do it.

As for teaching FM at the residency level. That is really out of the question, since almost all acedemic FM doctors are "hardcore" FM lovers. I mean you really need to love FM to teach it. Not only that, but to teach FM, you need to literaly "do everything"...that means Peds, Adults, Geriatrics, Gyn, OB, Minor surgical procedures...the whole deal.. And that, my friend, will be a nightmare to me.

I will try to go again for Pathology in the next match season. If that does not work out, then I am only left with PM/MPH & teaching (but now I am having second thoughts after reading Gutonc's and Medstudentquest's posts).

 

[Cali2]

Glad your thinking broadly about career options, especially if you are unhappy with where you are now in your professional life. That said, you appear to be contemplating some pretty significant expenses, lifestyle changes, and long term commitments to a broad range of advanced degrees, without a lot of knowledge of the career prospects associated with those degrees. Getting yourself better informed about the career paths you are considering, hopefully not just through an online forum(!), may help you narrow down your options.

In case pathology does not work out, or takes some time to work out, if you truly find a traditional family practice role excessively stressful, I'd agree with the posts about about occupational health/insurance jobs. Also, perhaps student health (college etc) would be of interest to you, given that the patient population tends to be younger and healthier. It would also reduce the longitudinal care component to only 3-5 years or so, so may also reduce your stress related to total responsibility for your patient's long term health. If you choose a position near a medical school, you might also be able to work in a teaching role with medical students.

 

[belle54321]

I would ABSOLUTELY, positively, surely, definately.......like path better. No question there. My worry is getting in, and if I got in, I will be 40 years old when I finish residency! That kinda scars me, but I am willing to do it.

As for teaching FM at the residency level. That is really out of the question, since almost all acedemic FM doctors are "hardcore" FM lovers. I mean you really need to love FM to teach it. Not only that, but to teach FM, you need to literaly "do everything"...that means Peds, Adults, Geriatrics, Gyn, OB, Minor surgical procedures...the whole deal.. And that, my friend, will be a nightmare to me.

I will try to go again for Pathology in the next match season. If that does not work out, then I am only left with PM/MPH & teaching (but now I am having second thoughts after reading Gutonc's and Medstudentquest's posts).

If teaching is your thing, then consider teaching high school/AP biology, etc. If you get tenured in a public school, then you are probably going to make more than an adjunct professor who probably doesn't get benefits or any security. (Though, public school teachers have less security these days as their performances are linked with test scores.) Have you ever taught before? You might consider calling up some CC in your areas or even high school evening schools and see if you can teach one class as a trial. I think the idea of teaching and the actual practice of teaching are very different.

I am switching from obgyn to psychiatry, so I know switching specialty is definitely possible. The first thing that I did was that I went back to my med school and talked to my psych professor (I had done a summer research project with her). She was very helpful with setting me up with the PC at the program and other professors. I think you should definitely call up a few people from your past. Also path is very different from FM, so I think like others who have mentioned it, you should definitely try to spend some time in a pathology lab.

 

[cnpyr8]

Heres just my $.02.

If you wanna teach, it may be possible to teach at an osteopathic or (possibly) allopathic medical school. However I do know that many of the MD/professors have plenty of extracurriculars, research, or both. I believe their compensation is much better than college professors.

Another possibility would be to go to a year EM fellowship. I knew an FP who went that route after his residency and LOVED it. He works now at a Level II ER and couldnt be happier. In addition, he is making $350K+, not a bad pay raise 🙂



Sent from my VM670 using SDN Mobile

 

[NotAProgDirector]

Thank you Medstudentquest for your input. I did not know that teaching at community colleges was sporadic, temporary and unsustainable. $1000 / month!!! Wow. Are there any full-time / long-term community college teaching jobs that are more sustainable, or are all of them pretty much sporadic and temporary?

To answer your questions: I am a guy. No partner. Can I find a niche in FM that would be more appealing? I do not think so (the only thing that comes to mind is boutique medicine and cosmetic "spa" medicine, and I am not interested in that). Can I work at a smaller/community type hospital? Again, FM is FM, anywhere and everywhere, so I am not sure if that will help much (if not add to the stress of an FM doctor since there will be little to no consult specialist support in rural areas). Why is FM confrontational? Well it is not as "confrontational" or as a high-risk as say surgery, but the stress/risk of FM comes in the fact that the FM doctor is the PRIMARY care provider who is responsible for the ENTIRE health of patient. That is a huge responsibility to carry, and carries with it a considerable risk. A FM might not get sued in a malpractice law suit against a specialist that provided care for that FM patient, but that FM might get sued depending on how he/she handleded that referal or to what extent the FM played in the follow-up care. At the very least the FM might get questioned in a deposition of a law suit. Basically, the FM doctor has to be very careful in addressing ALL and EVERY health problem the patient has. That comes with a risk and might require, at times, confrontations (as in being a proactive voice) for the benefit of the patients.

Thanks again.

Based on this post, I'm not certain that path is the panacea that you think it is. Although path does not involve direct contact with patients (usually), and you are not responsible for the entire care of the patient, in path you are called on to examine specimens and make a diagnosis. You'd like to think that doing so is straightforward, but it isn't. Lots of cases are borderline, and your decision (as a pathologist) has a huge impact on the case. If you say the lesion is malignant, then the surgeon might operate more. If you say it's benign, then not. Your risk of being sued as a pathologist is very high -- you will read 1000's of biopsies each year, and when something goes wrong, people will look back at the biopsy readings with a magnifying glass, looking for something you missed.

As others have mentioned, I would recommend spending a few days with a pathologist to get a sense of what the job is like. In addition, if you do so now you'll be able to get an LOR. Since you have a medical license, you should be able to do so without much difficulty.

Clinical pathology (i.e. running a lab) is another choice, but it will be "confrontational" at least with the people whom work in the lab.

There are many different things you can do with your FM training which might be a better fit for you, rather than running an FM practice.

1. urgent care -- you might be able to get a job in an urgent care center. These are a level far below what an ED can provide, so anyone whom is really "sick" just gets sent to the ED.

2. Warfarin management -- although perhaps on its way out due to new anticoagulants, running a warfarin clinic that checks INR's and adjusts warfarin doses can be an option.

3. SNF or NH care -- you could be the provider for patients in an SNF or NH. You need to see your patients once a month, but they are a "captive audience" and are monitored by the nurses.

4. Cruise ship doc

5. Hospice care. You might need to do a fellowship in Hospice and Palliative Care. This will greatly limit the scope of your practice.

6. Sleep medicine -- another way to greatly limit the scope of your practice. This also would require a fellowship, but I believe it may only be 1 year. Reading sleep studies and prescribing CPAP is low stress.

 

[Perrotfish]

Thanks again. As far as option #1 (FM fellowships), well as you know there are not many options there, and none which are interesting. In addition, a fellowship trained FM in anything (lets say sports medicine) is still a FM and almost all fellowship trained FM docs work as PCPs with regular "bread and butter" FM work in-addition to their special interest focus.

I was always told that there were two family medicine specialties that you could make a career out of: sports medicine and sleep medicine. Have you considered asking your old medical school/residences FM department about career prospects in those two fields?

 

[docB]

There are jobs doing deputy medical direction for HMOs/insurers where you review cases and make recommendations on whether the expense should be covered or not. There is pressure from the insurer to deny but it is the cubicle environment you are looking for. If you cobble that together with some comm coll teaching or some of the other options people have mentioned it might work for you.

 

[TexasPhysician]

I think your personality could fit great with hospice. Have you considered that?

 

[michaelrack]

6. Sleep medicine -- another way to greatly limit the scope of your practice. This also would require a fellowship, but I believe it may only be 1 year. Reading sleep studies and prescribing CPAP is low stress.

Reading sleep studies is usually low stress. Seeing sleep pts can be stressful at times, though not as bad as primary care. Dealing with truck drivers needing clearance for their commercial driver's licenses can be quite stressful. It is getting harder these days to practice 100% sleep medicine, though it is possible- especially if you are willing to take large financial risks to start up a sleep lab.

More info on the field of sleep med is available in the sleep medicine forum.

 

[DocDanny]

It seems like you kinda have low self esteem. Maybe you'd fall in love with FM if you became a more confident individual. Then maybe you'd like being in the lead.

Have you ever considered CBT?

 

[link2swim06]

Every think of teaching at a med school?

ICM courses (into to clinical medicine) typically span 1st and 2nd year. They are perfect for FM to internal medicine people. Or do you hate medicine that much?

I would think if you want to "teach", you would be most qualified to teach somehow in a med school.

 

[45408]

Preventive medicine programs are not competitive and since you did a FM residency it would be easier for you to find a job, but it's similar to it and will have patient interaction.

What about working in occupational health or a pre-operative clinic? We've got a department that sees patients for a pre-op H&P if they don't already have a PCP. Seems fairly low-stress.

Every think of teaching at a med school?

ICM courses (into to clinical medicine) typically span 1st and 2nd year. They are perfect for FM to internal medicine people. Or do you hate medicine that much?

I thought of this too. We had several FPs doing this sort of thing.

I think your personality could fit great with hospice. Have you considered that?

Although some of the life-and-death discussions might not be suited to a "fly on the wall" personality.

 

[pparikh]

Ever considered moving to Canada? Lot's of researchers at University of Toronto, UBC and McGill with MDs - and I can tell you that teaching/research at Canadian universities definitely pays better - not doctor better but 80-100 K/year once you're established. You might even be able to do a microbiology residency there - as fly on the wall as you can get. As an American grad you're considered on par with Canadian grads to apply to CaRMS (their equivalent of ERAS), but it's tough to get in because of the limited spots - but path and micro might be open.

 

[soccer98]

Pathology resident here.

When I was on the interview trail, I met a couple older people who were previously practicing a clinical speciality for years before entering path residency. They generally were happy, but had trouble playing the resident role again after years of being accustomed to attending/private practice life. It was almost like a Billy Madison experience for some of them.

Starting a residency again would be a challenge. You might have more maturity than the younger people, but you might not have the physical or mental stamina to do it again.

How about teaching community college as a short term option?

 

[michaelrack]

It was almost like a Billy Madison experience for some of them.
?

do you mean like this:

http://youtu.be/iED81CnIJk4

or this:

http://youtu.be/fGjOsfV3ar8 ???

 

[Leukocyte]

Thank you all very much.