Finding a job with a good work-life balance

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hemonc12345

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Hey guys,

So I am really enjoying my fellowship. I'm at a great program that really treats us well. I am starting to think about options after fellowship, and am really trying to hone in on the right practice setting. I don't really like doing research that much, and I worry that staying in academics with a mostly clinical focus is probably a recipe for being extremely financially undervalued. That said, I am not looking to make 50th percentile MGMA (which as per that excel file floating around SDN is ~440K; I realize that this is total compensation and the take-home number is probably a bit less). I think a good balance would be a job with four days in clinic per week, using the fifth day to get paperwork, etc., done (realizing that I might have to see my hospitalized patients that day), and hopefully allow me to clock in right around 50-55 hours/week. I would be willing to compromise on location -- I am ok with living an hour or two from a big city where I could head into town on weekends. I did speak with at least one recruiter, who told me that such jobs were available and actually pay reasonably well by virtue of being in a less saturated area.

Does the above sound reasonable? Is the above situation (4 days of clinic/week with the fifth day off) common or negotiable? I know GutOnc sees patients three days/week, so I suppose that is at least one example.

Thanks in advance.

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Yeah just do a search. I think the numbers a bit high but give a ballpark. Anyway... Any thoughts on the four day a week gig guys? Are most places open to this?
 
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Every single group in my city has a 4 clinic day full time schedule.

That is really interesting. We don't learn much about the private practice world in fellowship. Does this sort of schedule allow for a ~50-55 hours work week assuming ~15-18 patients/day? I guess if the average hem onc works close to 60 hours/week, I suppose I am looking for a .8 FTE job and am wondering what that would look like in terms of a clinical commitment.
 
Thanks gutonc. I really appreciate you coming on here all the time. I think my plan, when looking in a few months, is to really try to keep an eye on what the expectations of the job are. I guess I would be open to working at the VA, for a hospital, or for a multispecialty group, and will try to go for an employed position to give a bit more stability. I have heard that one good way to get places to be open to somewhat less than full time is to be willing to pitch in equally on call, which I would definitely be willing to do. Or maybe folks at some places (like the VA) already work a lighter schedule and choose to make less, so less than full time wouldn't be needed? Thankfully I am hearing from the seniors this year that the job market is pretty good. If I'm somewhat flexible on location and salary, I have to hope that I'll find some flexibility on the lifestyle side. Only time will tell! Any other advice you would give? When in the job hunt did you sort of bring up that you wanted to work part time?
 
Thanks gutonc. I really appreciate you coming on here all the time. I think my plan, when looking in a few months, is to really try to keep an eye on what the expectations of the job are. I guess I would be open to working at the VA, for a hospital, or for a multispecialty group, and will try to go for an employed position to give a bit more stability. I have heard that one good way to get places to be open to somewhat less than full time is to be willing to pitch in equally on call, which I would definitely be willing to do. Or maybe folks at some places (like the VA) already work a lighter schedule and choose to make less, so less than full time wouldn't be needed? Thankfully I am hearing from the seniors this year that the job market is pretty good. If I'm somewhat flexible on location and salary, I have to hope that I'll find some flexibility on the lifestyle side. Only time will tell! Any other advice you would give? When in the job hunt did you sort of bring up that you wanted to work part time?
My job hunt was "unique" so I won't give you advice about that specifically. We did just interview a guy (and made an offer) who asked about being 3/4 time when he interviewed with me. My group is relatively open to it (almost 1/3 of the docs are less than FT clinically).

Employed positions will likely be more open to it than the few remaining "Eat what you kill" groups out there, since for them, any time you're not spending on writing chemo orders is time wasted as far as they're concerned.

And FWIW, every one of the graduating fellows at my program has multiple offers this year, all in "tight" markets. You'll be fine.
 
My job hunt was "unique" so I won't give you advice about that specifically. We did just interview a guy (and made an offer) who asked about being 3/4 time when he interviewed with me. My group is relatively open to it (almost 1/3 of the docs are less than FT clinically).

Employed positions will likely be more open to it than the few remaining "Eat what you kill" groups out there, since for them, any time you're not spending on writing chemo orders is time wasted as far as they're concerned.

And FWIW, every one of the graduating fellows at my program has multiple offers this year, all in "tight" markets. You'll be fine.

Is 50% percentile for heme/onc really 440k? That seems really high to me.
 
this is a bit off topic but does fit the work-life balance theme... I love heme/onc subject matter but I'm not sure if it fits me as a career. I value having some schedule flexibility and my wife and I love to travel. If you're working in an "average" sized private practice group, is it difficult to go on vacations? Do you just not schedule any appointments (a few months in advance, of course) for a given week or two, and ask your colleagues to cover any emergencies? My experience with heme/onc is limited to a day of clinic shadowing and reading consult notes so I appreciate any guidance. thanks
 
My understanding (admittedly, as a fellow) is that of course people do go on vacation and, yes, you just don't schedule your patients that day. Your partners will have to cover for any emergencies, and you may have to double book a few patients the week before or after. Remember that the average sized practice is getting larger and larger! By the time you practice we may all be hospital-employed, working for huge multispecialty groups, or in academics.

Having a patient population that relies on you does make it harder to just "get away" than, say, a radiologist or anesthesiologist. In another respect, I would imagine that having so many patients rely on and trust you personally would make your position more secure even in a hospital-employed position.

Also, remember that half of hem-onc fellows are now women, and this demographic is highly likely to demand more of an emphasis on work-life balance in the coming years.

I presume that you are an internal medicine resident. If you like hematology-oncology, you may also want to take a look at other non-procedural fields including allergy, endocrinology, and rheumatology.
 
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I presume that you are an internal medicine resident. If you like hematology-oncology, you may also want to take a look at other non-procedural fields including allergy, endocrinology, and rheumatology.

Not quite yet! T minus 3.5 months. Thanks for your thoughts. Until recently i was all about Pulm CC but im tapping the brakes a bit to see what else is out there.
 
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