DO attending AMA

[SLC]

Hello all, I’m bored and have some time this weekend. Figured I’d start an AMA thread that anyone here can ask questions in. I am ~3yrs graduated from residency and life is finally slowing down and feeling chill. Time to pay it forward:

About me:
- Former member of the OG underdogs thread. Only went on one med-school interview and was accepted. This was 2011.
- SDN member for the past 11or so years.
- Went to ATSU-SOMA, 100% LOVED the school.
- Changed my specialty plans several times. Thought I’d be an Oncologist until literally 1 week before ERAS opened, then got real with myself and applied FM. I have zero regrets and am legit in-love with my specialty and career.
- Residency apps didn’t go smooth. See itching specialties until the last possible moment probably didn’t help that. SOAP’d into a great program though. Top 20 out of over 400 FM programs.
- Signed an employment contract in Intern year. Got paid $$$ on the side just to not go looking for another job. I’m 3 years out at that job and still very happy with it.
- I am a rural FM doc now. I do a LOT of stuff. Inpatient, Outpatient, procedures, etc.

Happy to answer any burning questions. Pre-med, OMS1-OMS4, even any upcoming interns or current residents.

How can I help?

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[Goro]

How has COVID affected your practice?

 

[Jack Donaghy]

What do you mean by "top 20" FM program? There is no such rating for FM programs so I'm curious how you got that notion.

Do you feel like you'll get burned out from the full spectrum nature of your current gig? I'd love to do something similar but I feel like it'd be daunting after a while. What are your hours like?

Did you get approached with that PGY1 contract offer or did you seek it out? What things should residents look for to determine whether these kinds of offers are good or bad?

Thanks for your time!

 

[SLC]

How has COVID affected your practice?

if anything, it’s helped. I’m the sole full time physician in town. There are 7000+ here. I’ve taken on almost 900 new patients since the pandemic began.

I’ve maintained a policy of being willing to see anyone who wants to be seen. I haven’t pushed people away or asked them to do telemedicine visits. Our office is careful, and strategic about when we schedule people with respiratory symptoms so as to minimize spread. I won’t allow anyone in unless they mask up. People have appreciated that, and I’ve continued to take on new patients at a rapid pace. I’m about 2000 in my panel now, started 2.5 years ago with 0.

 

[SLC]

What do you mean by "top 20" FM program? There is no such rating for FM programs so I'm curious how you got that notion.

Do you feel like you'll get burned out from the full spectrum nature of your current gig? I'd love to do something similar but I feel like it'd be daunting after a while. What are your hours like?

Did you get approached with that PGY1 contract offer or did you seek it out? What things should residents look for to determine whether these kinds of offers are good or bad?

Thanks for your time!

The program is top 20 in doximity’s residency navigator. It’s a pretty decent ranking for the top 50 to 100 or so programs based on my experience and opinion. After that, doesn’t much matter.

I don’t think that I’ll get burned out here. I enjoy the variety that rural practice brings. On any given day I can have digit amputations fractures other acute injuries, well visits, typical chronic condition care, and a host of routine office procedures. I actually think I would get bored in a more suburban or urban clinic where I mainly did chronic condition care all day. I also really enjoy the hospital work, there are enough doctors in our hospital staff that it’s not too burdensome. I do 48 hours of inpatient medicine call once every six weeks. The census is generally low, we have a very small hospital, so most of that 48 hours is spent at home relaxing. And being paid.

I found my job in the classifieds section of the print version of the New England Journal during residency. I had a goal of returning to my home state for practice. This job is approximately 1.25 hours from where I grew up and where my family currently resides. Close enough for me to go visit whenever I like, far enough away that I’m not getting dropped in on when I would not want it. The company I work for is a large hospital system known for being forward thinking financially conservative and fiscally solvent. It’s not the highest pay I could’ve found but it’s not low either, and I do not worry about the stability of my job. I have every resource I could ever need to offer to my patients. And I’m generally happy with the company. My patient panel skews towards the younger end of the Spectrum. Probably averages in the upper 30s to mid 40s age wise. Benefits of living in a college town!

I honestly don’t think I could be happier. They say the average doctor lasts six months or less in his/her first job. I honestly at this point think I would be happy to retire here. Things could change, but I’m not looking at the emails that come in multiple times a day for different jobs right now.

 

[iforget2]

When interviewing for FM jobs, is it possible to be very clear that I won't see more than x number of patients per day? My FM preceptor essentially had no cap on the number of patients she saw per day since her practice took walk-ins and every zocdoc appointment even if multiple patients book the same time slot. I was with her when she had 40 patients in a day. I'm still just a medical student, but I can't see myself taking more than 20 patients per day without burning out longterm.

 

[SLC]

When interviewing for FM jobs, is it possible to be very clear that I won't see more than x number of patients per day? My FM preceptor essentially had no cap on the number of patients she saw per day since her practice took walk-ins and every zocdoc appointment even if multiple patients book the same time slot. I was with her when she had 40 patients in a day. I'm still just a medical student, but I can't see myself taking more than 20 patients per day without burning out longterm.

you can, and if they won’t commit, you run.

I have 100% control over my schedule. I can carve it up any way I like. I can see as few or as many as I can find a way to build a schedule with.

I do 20min routine visits, and 40 min extended visits. Most I’ve ever seen in a day was 25. And frankly if I’m seeing that many, it’s mostly walk-in complaints that I can leave the room with a signed note. It’s not too bad honestly. 40? Forget about it. The documentation burden alone would be too much.

BTW I can hit mid 500’s to 600-650 wRVU’s that way pretty reliably.

 

[PapaGuava]

Are you satisfied with your career choice?

-Also, I'll add your thread to the AMA sticky.

 

[SLC]

Are you satisfied with your career choice?

-Also, I'll add your thread to the AMA sticky.

On the whole, yes. I love what I do 100%. I don’t ever wish I had someone else’s job, except maybe a pro downhill MTB racer’s. 😉. I don’t envy other specialties, only their paychecks. I couldn’t be happy doing another job in medicine. I’m a Family Doc through and through.

What I’m less satisfied with is what it took to get here. Which was: a lot of money, time, and missed opportunities to build closer relationships with my kids. That was a byproduct of being a non-trad though.

 

[Jack Donaghy]

Do you mind sharing specifics of the $$ situation? As in, salary, benefits, vacation time, etc. You can PM me if that's too sensitive for an AMA

 

[SLC]

Do you mind sharing specifics of the $$ situation? As in, salary, benefits, vacation time, etc. You can PM me if that's too sensitive for an AMA

I make ~$300k/year. I have full medical and dental benefits, 401k with matching, pension plan, $3,500/yr CME, all licensing and professional memberships paid, malpractice paid. I get 4wks vacation which were paid when I was on salary, and not counted against production averages now that I’m on a production (wRVU) model.

 

[Kardio]

Thought I’d be an Oncologist until literally 1 week before ERAS opened, then got real with myself and applied FM

Thank you for doing this! M1 here.

Could you explain what ‘got real with yourself’ means? Was it a matter of competitiveness, or your desire for work/life balance, or something else?

Do you use OMM in the office?

In what way is your life ‘better’ for having chosen FM over Onc? In what way is it ‘worse’?

 

[SLC]

Thank you for doing this! M1 here.

Could you explain what ‘got real with yourself’ means? Was it a matter of competitiveness, or your desire for work/life balance, or something else?

Do you use OMM in the office?

In what way is your life ‘better’ for having chosen FM over Onc? In what way is it ‘worse’?

getting real with myself meant that I finally quit telling myself that primary care was not good enough for me. That I needed to be a specialist. My personality is much better suited to being a jack of all trades. It’s why at one point along the way I thought about most other medicine specialties. The only thing I’d definitively ruled out was any type of surgery.

I have used OMM, maybe a handful of times in the past 2.5 years as an Attending. Mainly when I’ve had DO students rotating with me.

My life is better for having chosen FM because I’m content. I realize now that I’m drawn to the work-up of malignancy much more than the actual treatment. And I identify more with the palliative care aspect of cancer care more than the treatment as well. All very much in the realm of a quality Family Physician. I really value having the broad scope of practice I maintain. Also, I got out of training 3yrs sooner by going FM, and in the end that was HUGE too. I’m not sure I even had 3 more years left in my tank to give to a training program.

Personally I don’t think my life is any worse-off. I’m making about what I anticipated I’d earn in Oncology. I’m never bored at work. I look forward to going in to my office. Someone in my situation, but with regrets, might feel differently.

 

[Kardio]

getting real with myself meant that I finally quit telling myself that primary care was not good enough for me. That I needed to be a specialist. My personality is much better suited to being a jack of all trades. It’s why at one point along the way I thought about most other medicine specialties. The only thing I’d definitively ruled out was any type of surgery.

I have used OMM, maybe a handful of times in the past 2.5 years as an Attending. Mainly when I’ve had DO students rotating with me.

My life is better for having chosen FM because I’m content. I realize now that I’m drawn to the work-up of malignancy much more than the actual treatment. And I identify more with the palliative care aspect of cancer care more than the treatment as well. All very much in the realm of a quality Family Physician. I really value having the broad scope of practice I maintain. Also, I got out of training 3yrs sooner by going FM, and in the end that was HUGE too. I’m not sure I even had 3 more years left in my tank to give to a training program.

Personally I don’t think my life is any worse-off. I’m making about what I anticipated I’d earn in Oncology. I’m never bored at work. I look forward to going in to my office. Someone in my situation, but with regrets, might feel differently.

Thank you for answering questions about your experience. It’s interesting to hear how you came to see FM as right for you - your points sound very reasonable. I’m glad you shared them with us.

 

[Tinyhandz]

It's always nice to know primary care is a solid choice in certain places.

I am curious, how did you choose the place your living in? How did you decide you wanted rural and what are the upsides of that lifestyle? Is it boring? Do you feel like you have enough to do? Or is it a different place. I currently live in NYC as a OMS1 but plan on moving out eventually that is less cuthroat or at least such a grind.

 

[Cranjis McBasketball]

getting real with myself meant that I finally quit telling myself that primary care was not good enough for me. That I needed to be a specialist. My personality is much better suited to being a jack of all trades. It’s why at one point along the way I thought about most other medicine specialties. The only thing I’d definitively ruled out was any type of surgery.

I have used OMM, maybe a handful of times in the past 2.5 years as an Attending. Mainly when I’ve had DO students rotating with me.

My life is better for having chosen FM because I’m content. I realize now that I’m drawn to the work-up of malignancy much more than the actual treatment. And I identify more with the palliative care aspect of cancer care more than the treatment as well. All very much in the realm of a quality Family Physician. I really value having the broad scope of practice I maintain. Also, I got out of training 3yrs sooner by going FM, and in the end that was HUGE too. I’m not sure I even had 3 more years left in my tank to give to a training program.

Personally I don’t think my life is any worse-off. I’m making about what I anticipated I’d earn in Oncology. I’m never bored at work. I look forward to going in to my office. Someone in my situation, but with regrets, might feel differently.

What are some of the negatives of your job and the negatives of living in a small/rural town?

Every time you post I'm reminded how awesome your job is

 

[SLC]

It's always nice to know primary care is a solid choice in certain places.

I am curious, how did you choose the place your living in? How did you decide you wanted rural and what are the upsides of that lifestyle? Is it boring? Do you feel like you have enough to do? Or is it a different place. I currently live in NYC as a OMS1 but plan on moving out eventually that is less cuthroat or at least such a grind.

I chose it because it was close to where I grew up. The lifestyle is nice, it’s quiet here, slow pace. But it’s only a 45 minute drive to be into the city and around shopping and restaurants etc when I need/want that. I’m into outdoors activities, fly fishing and mountain biking primarily. There’s plenty to keep me busy here in that regard. I also have a world class rock climbing canyon just a couple of miles from here. People literally travel from all over the world to climb there.

I thought I’d struggle in a rural location. I knew I’d like the work, but I thought I’d struggle living here. I honestly don’t at all. Every time I head into the city, I detest the congestion and how hard it is to get around. And when I drive back home I usually get a sense of relief as I crest the hill and can see the town I live in. I like it a lot here.

 

[futuredocz95]

what did you like about ATSU-SOMA?

i'm a current OMS-II at ATSU-SOMA and I want to see how much things have changed. I love it here and so far, it's been a blast.

 

[SLC]

What are some of the negatives of your job and the negatives of living in a small/rural town?

Every time you post I'm reminded how awesome your job is

negatives of my job would be that I am employed, so while I have a lot of independence and ability to control my practice, I don’t have 100% independence or control. Sometimes things are put upon me that I don’t agree with.

I also can’t stand the hospital administration here at our little hospital. We’re a critical access hospital. Sorta expected to run in the red, but our administrator refuses to pay fairly and as a result we turn in a profit regularly. I’m sure he gets a nice bonus for that; but it has made me back way back from the hospital. I do my minimum now, and focus on my clinic. I’m happier that way. I still like taking care of inpatients, so I still do. But I’m not trying to get involved in the day to day politics of the hospital medical staff anymore.

negatives of the rural location? I get a lot of weird political views expressed. I’ve had people ask me mine and weren’t shy about saying the planned to use them to decide if they could trust me as their doctor. It’s a pretty hard-right place. And while I’m probably more right of center than left of center, it’s really off putting how hard core some folks are.

it’s also not a place with too many great food options. We have a couple of really good restaurants; but only a couple, and their menu’s haven’t been changing. We really struggle to find/get high quality produce and other ingredients here too. So that aspect of my life has suffered. But I do have a habit of take liking coolers with me when I go into the city, and coming back with a load of nice stuff. That helps.

Other than that, I love it here.

I will say, I got a very nice and spacious home, brand new, for under $400k when I moved here. I have ~4K square feet. I’ve furnished it such that I don’t mind staying here, and am not constantly off looking for something to do. The home theater system replaces the new high-tech movie theaters pretty well. And with COVID, we’ve been watching films that are released direct to video in more comfort than we would in the theaters. There is a movie theater just down the hill from me, and they’ve stayed open selling popcorn and other snacks. I’ll go down there and pick up some stuff and we’ll chill in front of our 84” 4k screen, I put in a Sonos surround sound system and some comfy reclining leather sectional seats. It’s perfect.

I even installed an outdoor theater in my back-yard and got an outdoor sound system. In the summer and fall, it’s tough to beat being out there under the stars. There’s nothing behind my house but a couple hundred yards of open grassland and then a mountain, so it’s the perfect backdrop and I don’t worry about it bothering anyone when we are using the theater system in the backyard.

 

[SLC]

what did you like about ATSU-SOMA?

i'm a current OMS-II at ATSU-SOMA and I want to see how much things have changed. I love it here and so far, it's been a blast.

I really loved the curriculum. It’s definitely legit.

the 1+3 model was meh...but not a problem either. But man, the curriculum really helped put everything you learn in immediate context. I learned so well and so easily in that school.

 

[futuredocz95]

I really loved the curriculum. It’s definitely legit.

the 1+3 model was meh...but not a problem either. But man, the curriculum really helped put everything you learn in immediate context. I learned so well and so easily in that school.

thanks for answering! I love the 1+3 model but at times, I do want to just study for boards/exams instead of going into the clinic for 8 hours.

what didn't you like about your clinic experience during your second year?

 

[SLC]

thanks for answering! I love the 1+3 model but at times, I do want to just study for boards/exams instead of going into the clinic for 8 hours.

what didn't you like about your clinic experience during your second year?

just didn’t find it necessary, or that helpful. Maybe mine just wasn’t a good one, but I shadowed a lot.

 

[TwistedTea]

How many hours per week do you work about

 

[futuredocz95]

just didn’t find it necessary, or that helpful. Maybe mine just wasn’t a good one, but I shadowed a lot.

oh wow. yea i guess things have changed since we do more than shadowing.

At least at my CHC, all of us are able to see patients on our own, write/document the HPI, ROS, PE, and tell the preceptor what our assessment and plan are. After that, the preceptor goes in to check our work and complete the A&P/other relevant parts of the SOAP note.

i feel like it might be a lot more work on our preceptors but im so thankful for what they do to help us learn.

 

[bigindian4891]

Just want to say thank you, everything youre saying really resonates with my outlook and personality, and definitely makes me reassured I'm going into the right field.

Do you have much time/opportunity to teach?

 

[SLC]

Just want to say thank you, everything youre saying really resonates with my outlook and personality, and definitely makes me reassured I'm going into the right field.

Do you have much time/opportunity to teach?

I do. So far I’ve had 3 medical students, 1 NP student (a nurse from my hospital and personal friend).

I enjoy teaching. I’m affiliated/adjunct faculty at both current medical schools in my state. I provide a nice full-spectrum FM experience that, hopefully, shows students how awesome the field can actually be. And how different it is from the experiences they’ve probably had in the city.

 

[Goro]

I do. So far I’ve had 3 medical students, 1 NP student (a nurse from my hospital and personal friend).

I enjoy teaching. I’m affiliated/adjunct faculty at both current medical schools in my state. I provide a nice full-spectrum FM experience that, hopefully, shows students how awesome the field can actually be. And how different it is from the experiences they’ve probably had in the city.

I think I already know the answer, but it's a teaching moment...Have any patients fussed about you being a DO?

 

[SLC]

I think I already know the answer, but it's a teaching moment...Have any patients fussed about you being a DO?

Zero.

I have had some ask what DO meant. And some have assumed that I’m automatically going to be more down with their alternative medicine proclivities and that I must personally know their ND that chelates them, and be buddies with their chiropractor etc.

But I’ve had zero complaints or refusals to accept my help due to my status as a DO. I’ve heard no underhanded comments about it. Quite the opposite. I get rave reviews, people like coming in.

Now I suppose it’s possible that people who have a problem with the DO credentials might just stay away from my clinic entirely; no way to know I suppose. But I have as many patients now as the MD’s who’ve been here for 20+ years, and have had quite a few of those providers patients switch over to me after I squeezed them in for a walk in appt or something. It’s easy to see when patients change their designated PCP.

I don’t lose many patients, usually when I do it’s a difficult patient who wasn’t happy with my refusal to engage in nonsense or prescribe controlled’s for inappropriate reasons etc, so I’m usually happy to see them go.

 

[DarkHorizon]

I think I already know the answer, but it's a teaching moment...Have any patients fussed about you being a DO?

Not my thread, but I have found no difference. I’m in an exceptionally competitive area. I find that the large DO PCP base in the area is advantageous being a DO specialist. It’s like a special club. I haven’t been asked what a DO is. 6 years of training and coming up on 2 years in practice.

 

[acapnial]

negatives of my job would be that I am employed, so while I have a lot of independence and ability to control my practice, I don’t have 100% independence or control. Sometimes things are put upon me that I don’t agree with.

I also can’t stand the hospital administration here at our little hospital. We’re a critical access hospital. Sorta expected to run in the red, but our administrator refuses to pay fairly and as a result we turn in a profit regularly. I’m sure he gets a nice bonus for that; but it has made me back way back from the hospital. I do my minimum now, and focus on my clinic. I’m happier that way. I still like taking care of inpatients, so I still do. But I’m not trying to get involved in the day to day politics of the hospital medical staff anymore.

negatives of the rural location? I get a lot of weird political views expressed. I’ve had people ask me mine and weren’t shy about saying the planned to use them to decide if they could trust me as their doctor. It’s a pretty hard-right place. And while I’m probably more right of center than left of center, it’s really off putting how hard core some folks are.

it’s also not a place with too many great food options. We have a couple of really good restaurants; but only a couple, and their menu’s haven’t been changing. We really struggle to find/get high quality produce and other ingredients here too. So that aspect of my life has suffered. But I do have a habit of take liking coolers with me when I go into the city, and coming back with a load of nice stuff. That helps.

Other than that, I love it here.

I will say, I got a very nice and spacious home, brand new, for under $400k when I moved here. I have ~4K square feet. I’ve furnished it such that I don’t mind staying here, and am not constantly off looking for something to do. The home theater system replaces the new high-tech movie theaters pretty well. And with COVID, we’ve been watching films that are released direct to video in more comfort than we would in the theaters. There is a movie theater just down the hill from me, and they’ve stayed open selling popcorn and other snacks. I’ll go down there and pick up some stuff and we’ll chill in front of our 84” 4k screen, I put in a Sonos surround sound system and some comfy reclining leather sectional seats. It’s perfect.

I even installed an outdoor theater in my back-yard and got an outdoor sound system. In the summer and fall, it’s tough to beat being out there under the stars. There’s nothing behind my house but a couple hundred yards of open grassland and then a mountain, so it’s the perfect backdrop and I don’t worry about it bothering anyone when we are using the theater system in the backyard.

What are their political litmus test questions? Or do they just dive right in and ask if you're conservative?

 

[SLC]

What are their political litmus test questions? Or do they just dive right in and ask if you're conservative?

usually “who did you vote for”. And when I don’t answer it’s followed by “how can I know if I can trust you or not”.

I won’t engage in that. I just say, “you’ll have to see what you think about my diagnosis and treatment plan...”

 

[TwistedTea]

usually “who did you vote for”. And when I don’t answer it’s followed by “how can I know if I can trust you or not”.

I won’t engage in that. I just say, “you’ll have to see what you think about my diagnosis and treatment plan...”

I’ve heard some non sense from both sides like that. Sadly people care more about their businesses beliefs than the product now a days.

How big of a town do you live in and which part of country (NE SE SW NW Midwest)?

 

[group_theory]

I think I already know the answer, but it's a teaching moment...Have any patients fussed about you being a DO?

I haven't. In the office, usually patient come to see me as a specialist, not as a DO. Only a few times (less than a handful) have patients noticed DO on my badge, but would often say "Oh, my old family doctor was a DO, I miss him" or variation of such. I haven't heard anything negative or have heard of patients refusing to see me because I'm a DO.

As a counterpoint to SLC, while he/she was able to sign a nice employment contract while in residency, please be mindful that there's risk involved as well. Studies have shown that 40-70% of doctors end up leaving their first employment after residency within 5 years (I don't recall the numbers for leaving within 1 year but was surprised it was quite high). Signing a contract, especially with payment up front, means there's usually a payback clause if things don't work out (depending on contract, there may be an early termination penalty as well).

It turned out well for SLC. I'm still with my first job post training. But that might not always be the case - and the financial consequences of a bad employer-employee marriage (especially if you've been paid up front) could be devastating.

Higher Job Turnover In Medicine Than Expected

Most new doctors don't last more than several years at their first job. Job turnover can be as high as 70% within 5 years for certain specialties.

investingdoc.com

Study Shows First Job after Medical Residency Often Doesn't Last

/PRNewswire/ -- It is ironic that medical residents and fellows, while being experienced in the practice of medicine, are often inexperienced in navigating...

www.prnewswire.com

 

[Jack Donaghy]

I haven't. In the office, usually patient come to see me as a specialist, not as a DO. Only a few times (less than a handful) have patients noticed DO on my badge, but would often say "Oh, my old family doctor was a DO, I miss him" or variation of such. I haven't heard anything negative or have heard of patients refusing to see me because I'm a DO.

As a counterpoint to SLC, while he/she was able to sign a nice employment contract while in residency, please be mindful that there's risk involved as well. Studies have shown that 40-70% of doctors end up leaving their first employment after residency within 5 years (I don't recall the numbers for leaving within 1 year but was surprised it was quite high). Signing a contract, especially with payment up front, means there's usually a payback clause if things don't work out (depending on contract, there may be an early termination penalty as well).

It turned out well for SLC. I'm still with my first job post training. But that might not always be the case - and the financial consequences of a bad employer-employee marriage (especially if you've been paid up front) could be devastating.

Higher Job Turnover In Medicine Than Expected

Most new doctors don't last more than several years at their first job. Job turnover can be as high as 70% within 5 years for certain specialties.

investingdoc.com

Study Shows First Job after Medical Residency Often Doesn't Last

/PRNewswire/ -- It is ironic that medical residents and fellows, while being experienced in the practice of medicine, are often inexperienced in navigating...

www.prnewswire.com

To piggyback off this, how would one know whether the deal is sour or not? Let's say, for instance, the hospital system that currently employs you as a resident offers you a contract to stay on as an attending. Assuming you've had a good experience with your program, what sorts of things would be red flags to look out for?

 

[SLC]

I haven't. In the office, usually patient come to see me as a specialist, not as a DO. Only a few times (less than a handful) have patients noticed DO on my badge, but would often say "Oh, my old family doctor was a DO, I miss him" or variation of such. I haven't heard anything negative or have heard of patients refusing to see me because I'm a DO.

As a counterpoint to SLC, while he/she was able to sign a nice employment contract while in residency, please be mindful that there's risk involved as well. Studies have shown that 40-70% of doctors end up leaving their first employment after residency within 5 years (I don't recall the numbers for leaving within 1 year but was surprised it was quite high). Signing a contract, especially with payment up front, means there's usually a payback clause if things don't work out (depending on contract, there may be an early termination penalty as well).

It turned out well for SLC. I'm still with my first job post training. But that might not always be the case - and the financial consequences of a bad employer-employee marriage (especially if you've been paid up front) could be devastating.

Higher Job Turnover In Medicine Than Expected

Most new doctors don't last more than several years at their first job. Job turnover can be as high as 70% within 5 years for certain specialties.

investingdoc.com

Study Shows First Job after Medical Residency Often Doesn't Last

/PRNewswire/ -- It is ironic that medical residents and fellows, while being experienced in the practice of medicine, are often inexperienced in navigating...

www.prnewswire.com

the advice about early sign contracts here is good. I was fortunate to find a good one. My commitment was 3years, and it was for the signing bonus and other perks, and was pro-rated. All told it was about 60k that I would have had to pay back if I’d quit right away. But that number went down progressively as I stayed here and now it’s approaching zero. Being from the area, I also knew the company well, knew it’s reputation, and knew I wasn’t getting taken advantage of.

 

[AMEHigh]

I would just like to add that working in an urban area doesn’t mean you’ll just be managing chronic conditions like was said above.

One can still have a pretty full spectrum practice in urban areas as well if that’s what you’re looking to do.

 

[SLC]

How many hours per week do you work about

36 patient facing hours. I’m supposed to have a day of admin time, but I use it as a day off.

and I do a 48hr hospital on call from Fri night to Sun night every 6 or so weeks.

 

[SLC]

I’ve heard some non sense from both sides like that. Sadly people care more about their businesses beliefs than the product now a days.

How big of a town do you live in and which part of country (NE SE SW NW Midwest)?

I live in a small town, less than 10k people, in the Intermountain west

 

[deleted859689]

Did you have any research under your belt prior to applying to residency programs?

 

[SLC]

Did you have any research under your belt prior to applying to residency programs?

some basic science research as an undergraduate student, but nothing else.

 

[SLC]

I’ve heard some non sense from both sides like that. Sadly people care more about their businesses beliefs than the product now a days.

How big of a town do you live in and which part of country (NE SE SW NW Midwest)?

Yeah, I’ve had it from both sides here. But being rural, I get more conservative tests. The left leaning folks have been more vocal/staunch about it though (more likely to insist I declare my politics, less likely to come back unless they think I align with their political feelings.).

 

[Tinyhandz]

Yeah, I’ve had it from both sides here. But being rural, I get more conservative tests. The left leaning folks have been more vocal/staunch about it though (more likely to insist I declare my politics, less likely to come back unless they think I align with their political feelings.).

Why do these people care what a doctors political belief? I find that strange but at the same time I suppose politics is being infused every where.

 

[turtle2019]

Thank you for this. Have you ever considered a fellowship?

 

[SLC]

Why do these people care what a doctors political belief? I find that strange but at the same time I suppose politics is being infused every where.

I can’t figure it out either. But, political division is the flavor of the month I suppose.

 

[SLC]

Thank you for this. Have you ever considered a fellowship?

I considered Palliative Care

 

[ThatSameGuy]

What are your thoughts on DPC in a small rural setting like you're in? Would it be feasible in a town <10k? Is there the pathology to stay knowledgeable in that size of a setting?

 

[SLC]

What are your thoughts on DPC in a small rural setting like you're in? Would it be feasible in a town <10k? Is there the pathology to stay knowledgeable in that size of a setting?

id be more worried about people being able to find a way to pay for DPC here.

 

[TwistedTea]

What kind of things yall for for fun out there? I love rural

 

[Prehealth1011]

Sorry if you've already mentioned this. Did you consider going IM and doing primary care that way? Pros and Cons of IM-PCP vs FM-PCP in your experience?

 

[SLC]

What kind of things yall for for fun out there? I love rural

Mountain Biking. I’m close enough to Moab to make it a day trip. I’ve also got some seriously good trail systems here where I live.

I also like hiking and camping and off-roading. Moab is good for all of that. I’m also smack in the middle of 6 national parks and several national monuments.

I do a lot of fly fishing too. Have to drive an hour or two for that, but there are good streams that are accessible from where I live.