I hear from a lot of classmates that they "love clinic" but hate working inpatient.
And when I tell people that I am interested in inpatient rehab, specifically SCI, I tend to get a lot of funny looks.
am i the only one?
Related question: is it difficult to find a job as an inpatient physiatrist (my case SCI rehab)? (naive and broad question) But I am assuming that most rehab hospitals already have attendings that are responsible for inpt wards.
thank you.
I'm an attending faculty at a large residency program doing inpatient mostly, some EMG and outpatient. Like many I went into the field kind of thinking outpatient.
I like what I do. Its difficult as a resident to see the value of inpatient... some of the more bold residents tell me 'well the therapist does the work you just watch.' That may be true for inpatient physicians who don't care or are not very good. Its a lot different when you are with a very good inpatient physiatrist who can really appreciate, understand, diagnose, and treat the things that make a difference in restoring function that all the other doctors miss.
Its also different when you get to see your patients in outpatient and follow their conditions up. I actually gave up outpatient for a short time and became a 'hospitalist physiatrist' and I noticed it made me very unhappy... Probably because I didn't get a chance to appreciate and see how much better the patients get after they leave, and I still ahve the chance to make a big difference in restoring them from home to the community.
I think the best model of practice if you choose to like inpatient is to have a variety of some outpatient and procedure (EMG, etc.). Inpatient can be somewhat boring at times. Then again, all fields in medicine can get boring.. I was once told by someone go into the field where its the 5% of unusual stuff that really excites you, and the 5% of stuff you really hate doesn't bother you that much... 90% of medicine to some degree becomes routine after a while.
The hardest part is that unlike say being a medicine hospitalist the multi-disciplinary thing also means that I lose some control of the process. All things have a trade off.
In the end go with what you like to do. I thought seriously about going into a pain fellowship after 3 years as an attending. As hard as I tried, I just didn't see myself wanting to deal with a lot of the major components of what it takes to be a *good* pain physician.
To answer your last question is it hard to find a job as an i npatient attending. I believe the answer is no. I believe its actually fairly wide open although remember as a new grad your choices are limited. Again, having good skills in outpatient and EMG etc. make you much more appealing.
Also remember a final benefit to inpatient is that directorship opportuntiies are available quite often. These do not pay as well as I understand they did in say, the 80's, but they are nice titles, pay some money, and more importantly allow you to get on the ladder to administrative and business type activities in the hospital if that is what you like to do. Its definitely not for everyone though.
