CCM vs pulm ccm

[eimaise]

PGY-3 here in a 4 year combined med/peds program planning on applying to IM-CCM programs next year, but I keep hearing comments from residents here saying the job market for pulm-ccm is "much better," than straight CCM; it's also "more desirable" from a hospital's perspective to hire combined pulm-ccm physicians and the jobs are "easier to find." In other words, I could do the IM-CCM fellowship, but I may be geographically limited in where I can work. I find this hard to believe, but wanted some feedback from folks here.

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[deleted547339]

PGY-3 here in a 4 year combined med/peds program planning on applying to IM-CCM programs next year, but I keep hearing comments from residents here saying the job market for pulm-ccm is "much better," than straight CCM; it's also "more desirable" from a hospital's perspective to hire combined pulm-ccm physicians and the jobs are "easier to find." In other words, I could do the IM-CCM fellowship, but I may be geographically limited in where I can work. I find this hard to believe, but wanted some feedback from folks here.

I'm EM/CCM. CCM only jobs are a plenty. It probably was harder 10 years ago, but now it's pretty common. I've been able to find potential jobs with minimal effort in every city I've seriously considered, obviously some are better than others.

I can't comment on pccm jobs.

 

[CCM-MD]

PGY-3 here in a 4 year combined med/peds program planning on applying to IM-CCM programs next year, but I keep hearing comments from residents here saying the job market for pulm-ccm is "much better," than straight CCM; it's also "more desirable" from a hospital's perspective to hire combined pulm-ccm physicians and the jobs are "easier to find." In other words, I could do the IM-CCM fellowship, but I may be geographically limited in where I can work. I find this hard to believe, but wanted some feedback from folks here.

Job market for CCM is strong, you should be able to get a job easily in most locations. CCM currently pays better than pulmonary - I say this based on recent AMGA and MGMA medians. Which is why you will see a lot of younger physicians who are dual trained working as pure intensivists. From a hospitals perspective, most are moving towards closed ICUs even in smaller community hospitals - the old model of a pulmonary doc rounding in the unit, then going to the office is becoming uncommon. What it comes down to is how interested you are in practicing pulmonary. If you have no interest in it you will be fine without it with regards to jobs and compensation. People will always have their biases, those who are trained in Pulm and CCM will recommend doing both, and those who are only CCM trained will tell you otherwise. You will be fine regardless of which path you choose to take.

 

[spacegun]

Job market for CCM is strong, you should be able to get a job easily in most locations. CCM currently pays better than pulmonary - I say this based on recent AMGA and MGMA medians. Which is why you will see a lot of younger physicians who are dual trained working as pure intensivists. From a hospitals perspective, most are moving towards closed ICUs even in smaller community hospitals - the old model of a pulmonary doc rounding in the unit, then going to the office is becoming uncommon. What it comes down to is how interested you are in practicing pulmonary. If you have no interest in it you will be fine without it with regards to jobs and compensation. People will always have their biases, those who are trained in Pulm and CCM will recommend doing both, and those who are only CCM trained will tell you otherwise. You will be fine regardless of which path you choose to take.

Maybe a dumb med student question but do you ever worry about burnout doing pure CCM? I heard CCM has a high burnout, but it seems so fun. Maybe you just work less shifts if you burnout (though make less money), or you work at lower level trauma centers? I don't know what other options there are to escape burnout if it happens.

 

[CCM-MD]

Maybe a dumb med student question but do you ever worry about burnout doing pure CCM? I heard CCM has a high burnout, but it seems so fun. Maybe you just work less shifts if you burnout (though make less money), or you work at lower level trauma centers? I don't know what other options there are to escape burnout if it happens.

Burnout is a concern for sure but it is not unique to CCM. Other specialties like invasive cardiology, EM, general surgery, and other surgical specialties come to mind. I think burn out could arguably be less in CCM than some others mentioned. There's always eICU, hire more midlevels to help with the grunt work, move to a lower acuity hospital, LTAC work. I see lots of ICU docs involved in hospital administration which is also an option. If you are pulmonary trained, transitioning to outpatient pulmonary is an option if that is something you enjoy. I personally don't enjoy it, so it is not something I would do even if I was dual trained.

 

[eimaise]

Thanks for the helpful information. Exactly what I needed.

 

[maverickdoc]

There is more to pulmonary than outpt .
All my partners ( I am not a partner yet ) make 375-500 k working 4 days/ week, 1/6 weekends in a mid level city in New England .
Do what you like , but I have not met anyone who regrets doing the extra yr of pulmonary.
And in those MGMA surveys , ppl put pulmonary as their primary speciality but pretty much everybody does icu as well .

Goto any big program that has both the fellowships and look at the fellows' profiles and decide for yourself

 

[spacegun]

There is more to pulmonary than outpt .
All my partners ( I am not a partner yet ) make 375-500 k working 4 days/ week, 1/6 weekends in a mid level city in New England .
Do what you like , but I have not met anyone who regrets doing the extra yr of pulmonary.
And in those MGMA surveys , ppl put pulmonary as their primary speciality but pretty much everybody does icu as well .

Goto any big program that has both the fellowships and look at the fellows' profiles and decide for yourself

Can I please ask if the 4 days/week are all pulm, no ICU? I'm wondering because $375-500 seems like a big difference in salary for partners, but maybe some of your partners pick up extra shifts in the ICU to make more?

 

[maverickdoc]

It's both ICU and pulm . Ppl that make more , see more pts , come a little early, leave later , do more procedures, take less vacation,squeeze more pts in the clinic etc etc