illegallysmooth

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Hey there.

I'm in my last year of residency and still debating if I want an academic or community job. I do have approximately 328 buttloads of loans to pay back, and I'm thinking about all the other factors as well. Can any recent grads who were on the job hunt in the last couple years give me an idea of what kind of gap they saw between the two? I'm going to be looking in Texas mostly, maybe the Carolinas. I understand there is more to compensation than salary, and more to job satisfaction than dollars in your pocket, but even a rough idea would help.

Thanks in advance if you can offer some insight.

EDIT
AAaaand even though I did a search, of course right after submitting the thread I see this one:
http://forums.studentdoctor.net/threads/compensation-the-real-story.1212158/

Very helpful, thank you. If anyone else has personal experience from the Lone Star State, that would be appreciated.
 

GeneralVeers

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You will always make a lot less in academics. For Texas a good academic job will get you around $300K. Private practice/locums can easily be $400K + depending on how much you work and location.
 

OccupyTheED

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What I found helpful was shopping health insurance policies and the other things that come as a part of your benefits package in academics that you may not have provided in the community. Of course this is gonna vary by state and your medical history etc but for me the cost of obtaining my own benefits/saving for my own retirement were a whole lot less than the difference in salaries between academic and community jobs. So financially it wasn't even close for me, I'm making out a lot better in the community all things considered. I work in the Atlanta area so for me that pretty much just means Emory vs the surrounding community shops/groups.
 

emergentmd

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Hey there.

I'm in my last year of residency and still debating if I want an academic or community job. I do have approximately 328 buttloads of loans to pay back, and I'm thinking about all the other factors as well. Can any recent grads who were on the job hunt in the last couple years give me an idea of what kind of gap they saw between the two? I'm going to be looking in Texas mostly, maybe the Carolinas. I understand there is more to compensation than salary, and more to job satisfaction than dollars in your pocket, but even a rough idea would help.

Thanks in advance if you can offer some insight.

EDIT
AAaaand even though I did a search, of course right after submitting the thread I see this one:
http://forums.studentdoctor.net/threads/compensation-the-real-story.1212158/

Very helpful, thank you. If anyone else has personal experience from the Lone Star State, that would be appreciated.
If you have 328K loans, go community. Pay it off...... then do what you want.
 
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Community medicine is more move the meat, less thinking, more dispo oriented.

If that makes you upset, dont do it.

Cant put a price on happiness my g
 

irJanus

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Or make income based repayments as a resident for 3-4 years and have your loans forgiven after 6-7 years in academics.
2017 (and this election) will be telling. Millions of dollars of discharged debt for the top earners. We won't get sympathy. I'm hopeful it work out... I'm semi banking on it
 
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GeneralVeers

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2017 (and this election) will be telling. Millions of dollars of discharged debt for the top earners. We won't get sympathy. I'm hopeful it work out... I'm semi banking on it
Don't bank on anything. We aren't going to do better no matter who is elected. One party will likely (barely) be able to maintain the status quo. The other has stated they want to make things a lot worse for us. Choose your poison.
 

The White Coat Investor

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Many academic job salaries are public knowledge. For example, at my local university hospital, there is an EM professor who makes $360K. It used to be easier to look up as they listed them by specialty, now just by what level of professor they are, so you actually have to know their names. But that's not tough. For example, an assistant professor is making $280K but another is making $377K. I have no idea how much each are working, of course. But clearly there are decent incomes to be had by academics. At my residency program I looked up starting academic salaries a year or two ago and found them under $200K.

I'd plan to either work more or be paid less if going into academics. If going for PSLF, divide the amount you expect to be forgiven by 6-7 years and add it to the salary (don't forget to adjust for tax as PSLF is like tax-free income.) Then compare. But truly, I wouldn't make this particular decision based on money. Figure out what you like to do and do that, realizing that it is easier to go academic --> community than community ---> academic.
 
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gamerEMdoc

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Cant put a price on how academics improves your life. In the community, its just you vs the chart rack. Its very isolating and easy to burn out. I love bouncing cases off people, chatting about interesting cases, constantly learning, etc. That stuff, to me, is worth any salary offset.

That being said, I made over 400K last year with overtime. Our base is 350K for 12 9 hr shifts as faculty. So there are some decent paying jobs in academics. They do tend to be in community academic hospitals. Most universities pay way less. We had a faculty member interview for a program director job at a University based program, only to find the offer to be the PD was 100K less than what he made as general faculty.

In the end, having done both, I don't think I'd ever go back to community medicine. Maybe some occasional locums work on the side for extra cash, MAYBE, but for a full time job, never.
 
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goodoldalky

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Our base is 350K for 12 9 hr shifts as faculty. So there are some decent paying jobs in academics.
$270 an hour? What else are you not telling us? Otherwise this is the highest paying academic job in the country, and higher than the vast majority of community jobs.
 
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gamerEMdoc

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$270 an hour? What else are you not telling us? Otherwise this is the highest paying academic job in the country, and higher than the vast majority of community jobs.
I misquoted, I got out a calculator, its 320k base salary, not 350K.

12 shifts plus four paid "academic days" a month (paid the same as a shift). You get paid for 16 shifts, work 12. All the academic work (conference, research, etc) you do for the residency is covered under those four paid academic days.

Rate is 185/hr; 225 overtime rate for any shift over your minimum number.
 

gman33

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I misquoted, I got out a calculator, its 320k base salary, not 350K.

12 shifts plus four paid "academic days" a month (paid the same as a shift). You get paid for 16 shifts, work 12. All the academic work (conference, research, etc) you do for the residency is covered under those four paid academic days.

Rate is 185/hr; 225 overtime rate for any shift over your minimum number.
That's more than virtually all the private jobs in my part of the country.
Nice.
 

gamerEMdoc

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Location, location, location. If you want to live in San Diego, you're gonna get paid far less than working in a smaller town in Pennsylvania. Its all a trade off.
 

Hercules

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Cant put a price on how academics improves your life. In the community, its just you vs the chart rack. Its very isolating and easy to burn out. I love bouncing cases off people, chatting about interesting cases, constantly learning, etc. That stuff, to me, is worth any salary offset.

That being said, I made over 400K last year with overtime. Our base is 350K for 12 9 hr shifts as faculty. So there are some decent paying jobs in academics. They do tend to be in community academic hospitals. Most universities pay way less. We had a faculty member interview for a program director job at a University based program, only to find the offer to be the PD was 100K less than what he made as general faculty.

In the end, having done both, I don't think I'd ever go back to community medicine. Maybe some occasional locums work on the side for extra cash, MAYBE, but for a full time job, never.
I think academic EM and community EM are virtually apples and oranges and you have o know which is right for you. Most are willing to take a pay cut to do academics. I simply didn't like the academic environment and you would have to pay me significantly more than my community job to get me to do it (which likely isn't going to happen).


Sent from my iPhone using SDN mobile
 

GeneralVeers

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Academic jobs may put in fewer clinical hours, but many will have to put in hours doing uncompensated academic work. Research, teaching, administrative stuff, not to mention after-work parties, get-to-gethers and conferences. Yes at 12x9 shifts per month you may only be working 108 clinical hours, but there could be another 50 hours per week of non-clinical work.
 

Angry Birds

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Academic jobs may put in fewer clinical hours, but many will have to put in hours doing uncompensated academic work. Research, teaching, administrative stuff, not to mention after-work parties, get-to-gethers and conferences. Yes at 12x9 shifts per month you may only be working 108 clinical hours, but there could be another 50 hours per week of non-clinical work.
Man, I'd so much rather do that. I enjoy teaching, research, and (less so) admin stuff. Anything to reduce clinical time haha. But aside from that I really enjoy teaching and research, and wonder how much one could lessen clinical load by taking on teaching and research. I wouldn't mind a pay cut either, as long as I'm making north of 200.
 
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illegallysmooth

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I think academic EM and community EM are virtually apples and oranges and you have o know which is right for you. Most are willing to take a pay cut to do academics. I simply didn't like the academic environment and you would have to pay me significantly more than my community job to get me to do it (which likely isn't going to happen).
Very true. I really adore teaching, and I like discussing things, learning, etc. However, I'm really not trying to do anymore research, I don't want to write book chapters, and I don't want to feel like my bosses want me to do either. And like I said, my loans are... real scary. So for right now I'm looking for a community job. Maybe down the road I'll be able to share all my wisdom with the youngins.
 

GeneralVeers

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Very true. I really adore teaching, and I like discussing things, learning, etc. However, I'm really not trying to do anymore research, I don't want to write book chapters, and I don't want to feel like my bosses want me to do either. And like I said, my loans are... real scary. So for right now I'm looking for a community job. Maybe down the road I'll be able to share all my wisdom with the youngins.
I agree with you. I like teaching residents/students. I don't want to do research, write book chapters, or go to meetings/conferences. There are plenty of community jobs where you can get some teaching and still make the $$$. One of my locums jobs in TX has medical students, and EM/IM residents as well.
 

gamerEMdoc

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Man, I'd so much rather do that. I enjoy teaching, research, and (less so) admin stuff. Anything to reduce clinical time haha. But aside from that I really enjoy teaching and research, and wonder how much one could lessen clinical load by taking on teaching and research. I wouldn't mind a pay cut either, as long as I'm making north of 200.
I totally agree. The difference between working 12 shifts and 16 shifts is staggering. I'm don't love research/writing either, but if it means getting paid to work 16 days, while only working 12, that's a very sustainable career and to me, I'd much rather do that.
 
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TooMuchResearch

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I totally agree. The difference between working 12 shifts and 16 shifts is staggering. I'm don't love research/writing either, but if it means getting paid to work 16 days, while only working 12, that's a very sustainable career and to me, I'd much rather do that.
This is something I've been contemplating a lot as the employment search continues.

I'm not sure how I feel about supervising residents doing procedures I would only have done as a resident if I go straight academic from residency.
 

Dakota

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I'm not sure how I feel about supervising residents doing procedures I would only have done as a resident if I go straight academic from residency.
Depends on your set up. I went straight from residency to being clinical faculty at an academic program. Despite my occasional whining here I actually think it is a pretty good mix.

I work 3/4 time at a major tertiary care center. We have everything except transplant. At least 1/3 of patients are seen by attending only, so plenty of opportunity to intubate, place lines, chest tubes, drain priapism, whatever. The way coverage is split shifts either have a bunch of resident coverage and you see a good handful by yourself, or you are in a part of the ED without residents and do everything by yourself.

I also work 1/4 at a rural hospital that has basically nothing and surprising acuity. I have to transfer at least 4 patients a shift, admit another 4 or so, and usually average 2.5 per hour.

With this set up everyone still has to be able to pull their own weight.
 

gamerEMdoc

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Agree with Dakota. If you still want to work in academics but don't want to lose 100% of your procedures, you have several options to still get some independent procedure experience:

1. Work some conference days. Every residency program has a protected conference day where the ED is staffed by the faculty.
2. Work some of the contracted shifts at other hospitals in the system (as Dakota suggested)
3. Moonlight in a place without a residency 1-2 shifts a month
4. Pick up primary charts as an attending

Or you can just be confident in your training that you know what you are doing. Honestly, I get just as much from watching residents carefully during difficult procedures and giving them tips/pearls as much as I do doing the procedure itself. For instance, the C-Mac has really changed what I get out of supervising an intubation, compared to just standing there having no clue what the resident is seeing.
 
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emergentmd

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Depends on your set up. I went straight from residency to being clinical faculty at an academic program. Despite my occasional whining here I actually think it is a pretty good mix.

I work 3/4 time at a major tertiary care center. We have everything except transplant. At least 1/3 of patients are seen by attending only, so plenty of opportunity to intubate, place lines, chest tubes, drain priapism, whatever. The way coverage is split shifts either have a bunch of resident coverage and you see a good handful by yourself, or you are in a part of the ED without residents and do everything by yourself.

I also work 1/4 at a rural hospital that has basically nothing and surprising acuity. I have to transfer at least 4 patients a shift, admit another 4 or so, and usually average 2.5 per hour.

With this set up everyone still has to be able to pull their own weight.
I find ED procedures like riding a bike. Once you have mastered them, you rarely really need to do any to be confident. Central lines, chest tubes, LP, lac repair, fracture/dislocation reduction which are most of our procedures..... most could go over a year and would still not skip a beat doing them.
 
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TimesNewRoman

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This is something I've been contemplating a lot as the employment search continues.

I'm not sure how I feel about supervising residents doing procedures I would only have done as a resident if I go straight academic from residency.
A) You should be procedurally competent after residency.

B) If you work with interns, you'll still be doing procedures.
 

EMedGrrl

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Man, I'd so much rather do that. I enjoy teaching, research, and (less so) admin stuff. Anything to reduce clinical time haha. But aside from that I really enjoy teaching and research, and wonder how much one could lessen clinical load by taking on teaching and research. I wouldn't mind a pay cut either, as long as I'm making north of 200.
Research isn't going to buy you much time unless it's funded, and it takes a LOT of work and a LONG time to get there (generally).
Teaching if you have a clerkship director, APD or other significant role. Showing up at conference a couple times a month isn't going to cut it.
The real money (time) is in admin. Sorry.
 
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