Family Medicine to Preventive Medicine: Is it a career change?

[Leukocyte]

To all those of you who have given me great advice on my previous thread...Thank You very much.

So as you might know, I am a Family Medicine physician who is looking at "non-clinical" medical specialties for a career change. Pathology is what I like most of all the "non-clinical" specialties, but after applying to 67 Pathology residency programs this past November in the match, I only got 1 interview and did not match anywere. I desperately want to get out of Family Medicine. As I stand now, I have the opportunity to do a Preventive Medicine residency at a good school starting this July! That is next month! Thank God. I see this as a "once in a life-time opportunity" for me, as a "way out" of Family Medicine. The Preventive Medicine residency director agreed to give me a one year credit for my past Family Medicine residency, so the Preventive Medicine residency will take me 2 years to complete (MPH included).

So what do you guys think? Should I take this Preventive Medicine residency offer that will start next month?

The problem I have is that I am afraid Preventive Medicine is just "another name" for Family Medicine. So is it really an opportunity for a career change? I do not really know what Preventive Medicine doctors do or were they work. I am afraid that if I agreed to take this residency offer, that it might be a waste of time since I am afraid that I will not be able to find a "pure" Preventive Medicine job after finishing this residency, thus forcing me to work in Family Medicine back again. So I am worried that it might not be a career change opportunity after all! If I agree to take this Preventive Medicine offer, I want to be semi-sure that I will work in a "pure" Preventive Medicine job, and not in Family Medicine. Is this possibe?

So what do you guys think? Take this Preventive Medicine residency offer (beacuse it will be a career change from family medicine)? or Do not take this Preventive Medicine residency offer (because it might not really be a career change from family medicine)?

Thanks

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[mlw03]

An internet forum is not the place to get information to make a decision of this magnitude. You're considering entering a residency and don't even know what those physicians do - that's not a wise move. And why is the PD from that program willing to take someone so unfamiliar with what the specialty even is, let alone their specific program. Desperation can lead to some poor choices when they're uninformed ones.

 

[Leukocyte]

Desperation can lead to some poor choices when they're uninformed ones.

Very true. But I am hoping that by doing a Preventive Medicine residency, I would be able to get a public health job in the government or get an academic job teaching public health. If that is the case, then great. But the problem is that Preventive Medicine as a specialty is very vague and very broad in nature, and despite my searches on this field, I am not able to reach a clear conclusion as to what Preventive Medicine docs REALLY do. Most of those who do a Preventive Medicine residency do it as a combined residency with another field (ex. IM/PM), and end up working in their other specialty's field. Most of the graduating residents that I met at that PM residency program will be working in primary care, or do fellowships in their "other" combined specialty. Very few residents who graduated acctually work as medical officers in public health...and that worries me.

 

[mlw03]

As it should. If people taking a path you're considering aren't getting where you want to go, you probably shouldn't follow them down that road.

 

[michaelrack]

The Preventive Medicine residency director agreed to give me a one year credit for my past Family Medicine residency, so the Preventive Medicine residency will take me 2 years to complete (MPH included).



Thanks

Isn't that pretty standard for Prv Med- to get credit for primary care/prelim/transitional internships?

 

[NotAProgDirector]

I'd highly recommend talking to some PM trained folks to get a sense of what their job is like before starting something like this.

My experience with academic jobs is that they are very "pedigree" driven. If the program you are looking at is not well known, do not expect much love. In addition, do not expect to get paid well for "teaching".

I know nothing about gov't jobs. But, from my limited viewpoint, I see most gov'ts running out of money, and likely downsizing as time goes on.

Looking at www.physemp.com is a helpful exercise. I find it's the best first stop looking for job options. If I search for permanent FP jobs, I get 3038 positions currently open. Obviously this doesn't capture all open positions, and some positions may be listed twice or more by employers and recruiters. But it gives us a denominator.

Now search for permanent, full time PM jobs. How many do you find?

I found one.

Moral of the story: getting a full time, permanent PM job directly out of residency is unlikely from my viewpoint -- but really you should be talking to PM grads. I'd ask the PD for contact information for the residents currently graduating this month, and see what type of jobs they were able to get.

 

[Leukocyte]

I'd highly recommend talking to some PM trained folks to get a sense of what their job is like before starting something like this.

Thanks a ProgDirector. It is very difficult to see my salay's pay-check cut by 78% by returning back to residency. Wow. I will be back to a PGY-2 pay-scale. I never actually felt how low I was being paid when I was a resident until now. I cannot believe that I will only be getting 22% of my attending salary. This is brutal, but if it means that I might end up being happier in the end, then so be it.

My program is strong academically, and as part of the deal of being a PM resident, I have to work for a goverment health care research institution to conduct research there through-out the 2 years. Some people before me who went through this are now working there full-time. So I hope that I can find a way to do the same.

But man, losing 78% of my pay-check is a very tough sacrifice to make. Residents are really way underpaid.

 

[toomuch]

I am currently doing an occupational medicine residency which is part of the prev med board and I am finishing at the end of the month. Unlike, general prevmed, occ med does a bit more clinic in addition to public health. My friends in general prevmed have done various things after residencies, but 2/3 previous year's prevmed graduates in my friend's program are doing occ med residencies and the other is doing research. In this year, one got an urgent care job, one started in an occ med job and the other is still unsure what to do. I know general prevmed graduates will take public health jobs, but an mph in epi is likely the most desirable for employers. The public health service is an option and working in various government jobs(VA, local departments) is possible, but again occ med may provide a little more job opportunities here. I am not biased toward occ med. This is just what I've observed so far. In occ med, many do clinical work initially, but the opportunity to doalmost a completely administrative job is available after enough experience is gained. I also know that more companies are starting to hire gen prevmed physicians to manage thier wellness programs so these ar nice job options for gen prevmed graduates as well. THe prev med board and path are sponsoring a new clinical informatics fellowship which may be of interest as well after you finish.

 

[dragonfly99]

It seems like you really dislike clinical fm, so I would say take the residency (if it's really at a good place) and then "work it" and work on networking from the month you start. I agree with some of the other helpful comments posted here also. You need to figure out what kind of job you can get when you are done...NIH, CDC, etc. Or maybe running a wellness program for a big hospital, GME office, etc. One hospital I worked at had this incredible employee health program...it was out of control (in a good way). Not sure it would need a doctor to run it but I think they probably had one. I know the NIH and FDA hire physicians. I agree with one of the above posters that knowledge of epidemiology and/or statistics would be helpful. Can you get some sort of master's degree while you are in residency? particularly since you already did one residency?

 

[Leukocyte]

Can you get some sort of master's degree while you are in residency? particularly since you already did one residency?

Absolutely. Getting a MPH is a must and is automaticaly part of every PM residency. Also my program is sponcored by the ACS so the focus is on cancer prevention and control practice and research. So I hope that after finishing this residency that I will either:

-Continue working at the goverment cancer research agency that I will be training at as a Medical Officer

or

-Work as a Medical Officer at a local city or county health dept.

or

-Work as a Medical Officer at a federal agency (CDC, FDA, NIH, ....)

or

-Work as a physician at a city or county public health clinic (STD, AIDS, Family Planning...)


I am not sure if my public health background would be of any "real" value (market wise) to a private health-care facility, so I am not sure if working as a public health medical officer in a private company is even possibe. Having said that, if I do this PM residency, I will gave to say good-bye to my relatively hight FM salary. Relatively, PM docs hardly make any "real" money.

Thanks.

 

[toomuch]

If you are interested in Federal Jobs, I would reccomend that you do a public health service comissioned corps junior or senoir costep program in your first year. They fund it, but applying early is always better.

An MPH is required to get board certified in the traditional residency track and most programs who have enough funding will pay for it and fill fast, but others like hopkins and a few others make you fund your own mph.

 

[Leukocyte]

If you are interested in Federal Jobs, I would reccomend that you do a public health service comissioned corps junior or senoir costep program in your first year. They fund it, but applying early is always better.

An MPH is required to get board certified in the traditional residency track and most programs who have enough funding will pay for it and fill fast, but others like hopkins and a few others make you fund your own mph.

Thank you for this GREAT advice...the co-step program is a good first step.