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[famguy225]

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[InternistDO]

Once you're an attending, no one cares what your degree is unless you're applying to some super fancy academic location.

Philly is also one of the most DO friendly cities in the country.

 

[AnatomyGrey12]

No becoming a hospitalist is not difficult.

 

[AMEHigh]

Where are you seeing that it's hard to get a hospitalist job in Philly?

You will have no problem finding a job in Philly.

 

[InternistDO]

I was curious as to the ability for DOs to work at institutions like Temple or Jefferson; but I guess that falls under the umbrella of academic medicine, which is more difficult for DOs?

You can try looking at their faculty for the medicine department. My understanding is that academic medicine is more dependent on where you did your residency.

 

[Mad Jack]

Why would you want to work at places with such garbage salaries? I don't understand academic medicine, so much work for so little pay. May as well take half of your paychecks and light them on fire just for the privilege of teaching and research

 

[Mass Effect]

Why would you want to work at places with such garbage salaries? I don't understand academic medicine, so much work for so little pay. May as well take half of your paychecks and light them on fire just for the privilege of teaching and research

Some are in it for a lot more than money. Some people like research. Others enjoy teaching residents and med students. Others like having experts in every field in the building working alongside them.

It is not hard for most DOs to get jobs at academic institutions. This is a myth perpetuated by pre-meds and med students on SDN.

 

[NurWollen]

Why would you want to work at places with such garbage salaries? I don't understand academic medicine, so much work for so little pay. May as well take half of your paychecks and light them on fire just for the privilege of teaching and research

You have residents to write all your notes for you and to buffer you from getting paged about random stuff all night long.

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[NurWollen]

Dumb follow up question; then what are “non” academic hospitals in downtown philly? Seems like everything’s associated with one of the big local MD programs now. Or is “academic” medicine just at their flagship sites?

Frankly I have zero interest in research. Teaching could be cool but not worth less money IMO.

I'm not familiar with Philly specifically but there's a range of what constitutes "academic." Obviously you have your big name institutions like Penn that are going to be super academic. But there are also going to be community hospitals with a random community IM or FM program that could still give you the opportunity to teach and supervise residents but with better pay and less research burden than to big academic places.

Additionally, every metro area is going to have community hospitals without any GME at all and staffed by private practice hospitalists and specialists. Some of these are increasingly getting bought out by the big academic healthcare institutions, but they're still community hospitals, just with a fancy name.


This is part of a larger trend of health system mergers. The big academic quaternary care centers are buying up community hospitals in order to expand their referall base.

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[InternistDO]

The only place in Center City that isn't a large academic hospital is Pennsylvania Hospital, which is still a community/academic hybrid affiliated with U Penn.

Further out there's Penn Presby (still academic ish), Aria Health (Northeast), Mercy Philly (West Philly), Methodist (South Philly), Episcopal (Kensington), Roxborough, and Chestnut Hill. All of them have some level of academic affiliation but much of it is minor.

In medicine, the ****tier the area, the less prestigious the hospital, and the more rural you go, the more money you make. If you want to work in CC you will sacrifice income to do that. If you want to work in CC at a big name hospital you will sacrifice more. Some people would gladly make less money to work and live in a big city, others would rather live out in the sticks and make more money. There's no right or wrong answer, you gotta find out what works for you.

You also have many many years before worrying about being in a specific specialty in a specific area of a specific city. Just know that if you end up as an IM hospitalist you can find work anywhere in the country, including major NE cities like Philly and NYC.

 

[NurWollen]

The only place in Center City that isn't a large academic hospital is Pennsylvania Hospital, which is still a community/academic hybrid affiliated with U Penn.

Further out there's Penn Presby (still academic ish), Aria Health (Northeast), Mercy Philly (West Philly), Methodist (South Philly), Episcopal (Kensington), Roxborough, and Chestnut Hill. All of them have some level of academic affiliation but much of it is minor.

In medicine, the ****tier the area, the less prestigious the hospital, and the more rural you go, the more money you make. If you want to work in CC you will sacrifice income to do that. If you want to work in CC at a big name hospital you will sacrifice more. Some people would gladly make less money to work and live in a big city, others would rather live out in the sticks and make more money. There's no right or wrong answer, you gotta find out what works for you.

You also have many many years before worrying about being in a specific specialty in a specific area of a specific city. Just know that if you end up as an IM hospitalist you can find work anywhere in the country, including major NE cities like Philly and NYC.

When I said there will be non-academic places in any metro area, I define that as the metro area. If you're willing to sacrifice 50k just to avoid a 20 minute commute for drinks after work, then I don't really know what to tell you.

If you want the big academic center because of the research, intellectual challenge, cutting edge medicine, name recognition, prestige, etc, that's a lot more understandable.

Edit: totally agree with the last part.
I'd ad that outside to SDN, 90% of physicians don't work-and don't want to work- in big academic settings.
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[InternistDO]

When I said there will be non-academic places in any metro area, I define that as the metro area. If you're willing to sacrifice 50k just to avoid a 20 minute commute for drinks after work, then I don't really know what to tell you.

If you want the big academic center because of the research, intellectual challenge, cutting edge medicine, name recognition, prestige, etc, that's a lot more understandable.

Edit: totally agree with the last part.
I'd ad that outside to SDN, 90% of physicians don't work-and don't want to work- in big academic settings.
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Yeah I figured you were, I was replying to the question famguy asked about Center City Philly specifically. I probably should have quoted him.

I totally get why someone would want to both live and work in a major downtown area (just like I also get why some people would rather live in a small town), but you have to go into it understanding the upsides and downsides. The nice part about medicine is that you have the option to do either, and you can change your mind whenever you want.

 

[AnatomyGrey12]

Academic medicine is such a broad term you really have to specify exactly what you mean. It’s a catch all for literally dozens of practice models

 

[Mad Jack]

Some are in it for a lot more than money. Some people like research. Others enjoy teaching residents and med students. Others like having experts in every field in the building working alongside them.

It is not hard for most DOs to get jobs at academic institutions. This is a myth perpetuated by pre-meds and med students on SDN.

It is hard for them to get jobs at certain academic institutions. I worked at one that explicitly questioned the only DO surgeon they ever hired about his "questionable educational credentials" during their interview. To this day out of well over a thousand physicians, only three are DOs on the academic services in all specialties combined. They will hire DOs on the non-academic outpatient and hospitalist services but refuse to bring them on board for teaching unless they have a research reputation that precedes them.

 

[Mad Jack]

Thanks for the info. I was concerned if there was some barrier to this for DOs since there didnt seem to be a lot on staff at some of these places but sounds like as you say it is more just a personal preferences thing.

DOs also tend to have much more debt so they're more likely to go for jobs that pay early on in their careers versus academic ones.

 

[AMEHigh]

I was curious as to the ability for DOs to work at institutions like Temple or Jefferson; but I guess that falls under the umbrella of academic medicine, which is more difficult for DOs?

Where are you getting this info from?
And why do you want to work specifically in center city? Just curious. There are so many job options here that I wouldn't limit yourself to specifically center city. I love living in the city, but won't limit myself to job opportunities to such a small radius. There are some great hospitals throughout the region. Even at the community hospitals, Lankenau, Abington, etc you will still be able to teach residents and med students.

There are definitely going to be more MDs at those institutions due to the shear numbers of MDs vs DOs, but I don't think that means that they forbid DOs from working there.

 

[Mass Effect]

It is hard for them to get jobs at certain academic institutions. I worked at one that explicitly questioned the only DO surgeon they ever hired about his "questionable educational credentials" during their interview. To this day out of well over a thousand physicians, only three are DOs on the academic services in all specialties combined. They will hire DOs on the non-academic outpatient and hospitalist services but refuse to bring them on board for teaching unless they have a research reputation that precedes them.

I can't speak for all academic institutions, but there are plenty of DOs in academic medicine all over the country, including the west coast and the northeast.

 

[Mad Jack]

I can't speak for all academic institutions, but there are plenty of DOs in academic medicine all over the country, including the west coast and the northeast.

I'm not saying it's not possible, but I'm saying it limits options for sure and the difficulty of landing a good university residency further limits options.

 

[NurWollen]

It is hard for them to get jobs at certain academic institutions. I worked at one that explicitly questioned the only DO surgeon they ever hired about his "questionable educational credentials" during their interview. To this day out of well over a thousand physicians, only three are DOs on the academic services in all specialties combined. They will hire DOs on the non-academic outpatient and hospitalist services but refuse to bring them on board for teaching unless they have a research reputation that precedes them.

This kind if elitism just nauseates me. If a program is unwilling to take me because of of "questionable" educational pedigree (while probably being willing to take an MD grad from my residency program with similar performance as me), then I don't want to go there.

I like the idea of teaching, so I might end up looking for a faculty position at a community program or smaller University program. I'm in peds, so if I subspecialize, I'll probably end up at that kind if place by default.

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[Mad Jack]

This kind if elitism just nauseates me. If a program is unwilling to take me because of of "questionable" educational pedigree (while probably being willing to take an MD grad from my residency program with similar performance as me), then I don't want to go there.

I like the idea of teaching, so I might end up looking for a faculty position at a community program or smaller University program. I'm in peds, so if I subspecialize, I'll probably end up at that kind if place by default.

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He basically told them that if they didn't like his credentials, he had plenty of other places that would be more than happy to take him. They laid off a bit after his results started speaking for themselves, but he eventually left for various reasons (not all institution related, he had a good reason to relocate).

 

[AnatomyGrey12]

People have to remember that getting the types of faculty positions that are at university hospitals that are residency faculty usually have a pretty substantial research expectation. I don’t know many DOs that even have that sort of interest.

Yeah it’s going to be a lot harder to land these types of jobs as a DO simply because:

1. It’s harder to get an academic residency
2. Because of 1 you are competing for that job against MDs who went to an academic residency and will have good research CVS already and already have plans for further research.
3. Because of 1 you will likely have less connections than the MDs who trained with people who know people at that hospital. Networking is a big part of any job that has ever existed.

 

[Candidate2017]

Why would you want to work at places with such garbage salaries? I don't understand academic medicine, so much work for so little pay. May as well take half of your paychecks and light them on fire just for the privilege of teaching and research

But where else in the real world will gunner 3rd year med students and beholden residents hang on your every word, witness your greatness and fuel your narcissism with daily ego stroking? Just about every non-researcher in academic medicine fits this bill.

 

[Goro]

Why would you want to work at places with such garbage salaries? I don't understand academic medicine, so much work for so little pay. May as well take half of your paychecks and light them on fire just for the privilege of teaching and research

Some of us love teaching and will take the pay cut for it.

 

[Mad Jack]

Some of us love teaching and will take the pay cut for it.

Easy to do what you love when you don't have almost a half million dollars in student loan debt lol. I truly enjoy teaching, but literally can't afford to do it given the pay cut involved.

 

[Goro]

Easy to do what you love when you don't have almost a half million dollars in student loan debt lol. I truly enjoy teaching, but literally can't afford to do it given the pay cut involved.

True that!

 

[Mass Effect]

People have to remember that getting the types of faculty positions that are at university hospitals that are residency faculty usually have a pretty substantial research expectation. I don’t know many DOs that even have that sort of interest.

Yeah it’s going to be a lot harder to land these types of jobs as a DO simply because:

1. It’s harder to get an academic residency
2. Because of 1 you are competing for that job against MDs who went to an academic residency and will have good research CVS already and already have plans for further research.
3. Because of 1 you will likely have less connections than the MDs who trained with people who know people at that hospital. Networking is a big part of any job that has ever existed.

I think there's a lot of doom-and-gloom being spread here by people who have yet to begin residency. As a DO, if you want a job at an academic institution, the trick is to do some aways at academic hospitals, impress the hell out of them, land a residency there, make those connections, don't piss people off, and do the best job you can. I didn't do a lick of research, but I did the above.

 

[Mad Jack]

I think there's a lot of doom-and-gloom being spread here by people who have yet to begin residency. As a DO, if you want a job at an academic institution, the trick is to do some aways at academic hospitals, impress the hell out of them, land a residency there, make those connections, don't piss people off, and do the best job you can. I didn't do a lick of research, but I did the above.

That's doom and gloom from those of us that have survived the match and seen our friends' hopes and dreams of academic medicine dashed despite doing what you recommended. If you look at the majority of DO matches, they are not at academic medical centers in most specialties. Doesn't mean it's impossible, just far more difficult

 

[Mass Effect]

That's doom and gloom from those of us that have survived the match and seen our friends' hopes and dreams of academic medicine dashed despite doing what you recommended. If you look at the majority of DO matches, they are not at academic medical centers in most specialties. Doesn't mean it's impossible, just far more difficult

Which is why I think a lot of perspectives are skewed. I haven't crunched the numbers to figure out the majority, but I saw many, many, many academic medical center matches this year. And for the ones who didn't match at an academic center, hope at a career in academic medicine is not lost. These types of threads stop being helpful when people commenting are coming from a point of view of disappointment and/or have little to no experience actually doing the job. When the two are combined, the bias does more harm than good.

 

[mwsapphire]

That's doom and gloom from those of us that have survived the match and seen our friends' hopes and dreams of academic medicine dashed despite doing what you recommended. If you look at the majority of DO matches, they are not at academic medical centers in most specialties. Doesn't mean it's impossible, just far more difficult

When it comes to doing an IM subspecialty, do you need to do an academic residency? Like if you wanna do immunology/endocronology or something more competitive like heme/onc. I never fully understood this. I know an academic residency makes it easier but for the less competative stuff is it needed?

Also, looking at match lists, it does seem that when DO do makes it to academic centers, it tends to be IM/peds, so does that mean making to an Academic Residency for IM is feasible for DO's? ( but harder for other specialties , like gen surg)?

 

[Mad Jack]

Which is why I think a lot of perspectives are skewed. I haven't crunched the numbers to figure out the majority, but I saw many, many, many academic medical center matches this year. And for the ones who didn't match at an academic center, hope at a career in academic medicine is not lost. These types of threads stop being helpful when people commenting are coming from a point of view of disappointment and/or have little to no experience actually doing the job. When the two are combined, the bias does more harm than good.

The match list thread is pretty self-explanatory. Depending on the school roughly 20-40% of students match university IM.

 

[Mad Jack]

When it comes to doing an IM subspecialty, do you need to do an academic residency? Like if you wanna do immunology/endocronology or something more competitive like heme/onc. I never fully understood this. I know an academic residency makes it easier but for the less competative stuff is it needed?

Also, looking at match lists, it does seem that when DO do makes it to academic centers, it tends to be IM/peds, so does that mean making to an Academic Residency for IM is feasible for DO's? ( but harder for other specialties , like gen surg)?

Academic IM is feasible, absolutely. But don't take it as a given is my point. Basically any US MD with no step failures can generally get into a university program somewhere, but as a DO you've really got to prove yourself and apply smart. As to subspecialties, community doesn't make it impossible, but you should look for strong university-affiliated community programs.

 

[Mass Effect]

The match list thread is pretty self-explanatory. Depending on the school roughly 20-40% of students match university IM.

And that doesn't mean the others are destined to community hospital work for the rest of their careers.

 

[Mad Jack]

And that doesn't mean the others are destined to community hospital work for the rest of their careers.

True. But statistically, you're most likely to end up doing outpatient or community hospital work.

 

[Mass Effect]

True. But statistically, you're most likely to end up doing outpatient or community hospital work.

And most do that by choice.

 

[Mad Jack]

And most do that by choice.

We can't say for sure, all we have are the outcomes not the reasons behind them

 

[Mass Effect]

We can't say for sure, all we have are the outcomes not the reasons behind them

Again, that's why it becomes dangerous when people who are disappointed about the match and have little to no experience actually doing the job, comment on the doom and gloom chances of others.

 

[Mad Jack]

Again, that's why it becomes dangerous when people who are disappointed about the match and have little to no experience actually doing the job, comment on the doom and gloom chances of others.

>verifiable outcomes do not constitute actual evidence

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[mwsapphire]

Again, that's why it becomes dangerous when people who are disappointed about the match and have little to no experience actually doing the job, comment on the doom and gloom chances of others.

>verifiable outcomes do not constitute actual evidence

ok.jpg

I think it's split the difference. Some of it is self selection sometimes it's all they could match. Usually when people say there are polar outcomes for things, each person is half correct. With their own experience in either category.

 

[Mad Jack]

I think it's split the difference. Some of it is self selection sometimes it's all they could match. Usually when people say there are polar outcomes for things, each person is half correct. With their own experience in either category.

It's not my experience, I am not going into IM. Probably would've matched quite well into it though, I had more IM interviews than I could shake a stick at before I went all-in on psych. But I've got a lot of people I talk with in my class and at other schools that have had a variety of experiences, some good, some bad. Don't know many that went community by choice.

 

[group_theory]

I'm a subspecialist but I have friends from residency as well as med school who are hospitalists, some in academia, others private practice.

Academic IM hospitalists tends to be clinician/hospitalist first, and the academic part comes with the expectation of covering the teaching services (ie the teams with residents/students), as well as non-service obligations (ie various hospital committees like QA/QI, improvement committees, admission/discharge, etc). There may be expectations of "research" - more clinical or translational than bench research. There are various tracks available - some are pure service obligations (ie renewal contract every few years), some are tenure track (with various definition of requirements, such as research-track, clinician-educator track, etc). You might even be an academic hospitalist but technically belong to a private group (e.g., employed by ABC Hospitalists LLC which contracts with University of ABC Medical Center to provide hospitalist coverage). The rule of thumb is that academia pays less than private practice (although there is always exceptions)

Also remember that there are certain personalities that attracts people into academia (not just medicine, but academia in general) - you might like that environment, you might hate that environment.

In general, turnover for academic hospitalists is high due to low pay (respectively), expectations that an academic university hospital runs efficiency (like a private run hospital) without the resources or commitments of a privately run hospital, etc.

As for DO vs MD for academic hospitalists - for the most part it doesn't matter ... the residency have a bigger role (university setting vs community setting) ... but if you have an LOR from a big wig that happens to be at a community hospital (university affiliated) - that can carry a lot of weight.

But just like all jobs - beggars can't be choosers. If there is a critical shortage of staff for a university hospital (and they need to hire more hospialists - and have the approved funding from the appropriate divisions/department), they won't be too picky about MD or DO as long as you can do the job competently.

 

[NontradCA]

I'm an incoming DO student in Philadelphia hoping to practice locally as a hospitalist someday. I understand my interests are subject to change but at this time I'd really like to work downtown as a hospitalist. Is this realistic as a DO? I appreciate the fact that it's hard to get these gigs as a DO or MD given the location.

Easy to become a hospitalist. The better question would be why would you want to?

 

[sab3156]

Which is why I think a lot of perspectives are skewed. I haven't crunched the numbers to figure out the majority, but I saw many, many, many academic medical center matches this year. And for the ones who didn't match at an academic center, hope at a career in academic medicine is not lost. These types of threads stop being helpful when people commenting are coming from a point of view of disappointment and/or have little to no experience actually doing the job. When the two are combined, the bias does more harm than good.

But let's be realistic, as a lot of these matches aren't at prestigious places or at power-house research centers.

DO degree + low tier ACGME residency program without much opportunity for good research = not exactly the best formula to be in a great position to launch yourself into a career in academic medicine.

 

[Mass Effect]

But let's be realistic, as a lot of these matches aren't at prestigious places or at power-house research centers.

DO degree + low tier ACGME residency program without much opportunity for good research = not exactly the best formula to be in a great position to launch yourself into a career in academic medicine.

Academic medicine means a lot of things. There are a lot of faculty in academia that don't do much research. They do more admin type stuff instead.

 

[AlbinoHawk DO]

Why would you want to work at places with such garbage salaries? I don't understand academic medicine, so much work for so little pay. May as well take half of your paychecks and light them on fire just for the privilege of teaching and research

There is a lot of work in academic medicine? Maybe it's just my experience, but for the most part, these are some of the easiest and relaxed jobs there are. You basically have a small army of residents in charge of doing the leg work, writing your notes and teaching all your medical students. You have postdocs/residents doing all the research while your contribution is a little editing and schmoozing people into handing you cash for your research. You get to work 8 hours or less a day with a long lunch and a pension at the end. Back in their time they probably went to school for tuition worth nickels and dimes. Many of these academic doctors don't have what it takes to survive in private practice or a community hospital setting. It seems like a perfectly great tradeoff.

 

[sab3156]

Academic medicine means a lot of things. There are a lot of faculty in academia that don't do much research. They do more admin type stuff instead.

There are not a lot of those jobs though, and to get there (positions of administration and management at academic centers) usually requires moving up the ladder. There are probably going to be people with better credentials going for those jobs from within the hospital.

 

[Mass Effect]

There are not a lot of those jobs though, and to get there (positions of administration and management at academic centers) usually requires moving up the ladder. There are probably going to be people with better credentials going for those jobs from within the hospital.

Wait until you get there. You'll realize it isn't doom and gloom.

 

[sab3156]

Wait until you get there. You'll realize it isn't doom and gloom.

I mean, if you are arguing that it is possible, sure. But it is obvious there aren't many DOs in academic medicine. That is the reality which is clear as day. You seem to be claiming that it is mainly due to DOs just not wanting to do academic medicine, which seems pretty farfetched. A lot of DOs are just people who basically just missed the cut and didn't get into MD schools. I am not sure I buy the idea that they overwhelmingly just made the choice to not go into academia.

 

[Mass Effect]

I mean, if you are arguing that it is possible, sure. But it is obvious there aren't many DOs in academic medicine. That is the reality which is clear as day. You seem to be claiming that it is mainly due to DOs just not wanting to do academic medicine, which seems pretty farfetched. A lot of DOs are just people who basically just missed the cut and didn't get into MD schools. I am not sure I buy the idea that they overwhelmingly just made the choice to not go into academia.

Depends on your definition of "many." There are more MDs in academic medicine, but there are more MDs in general, so of course there will be more in academics. Plus, MDs do residencies at academic hospitals, so again, of course those are the ones most likely to go into academics. But to suggest that DOs can't or that it's an uphill battle is just not true, based on my experience.

 

[W19]

There aren't many DO in academic medicine... If DO for instance make up 20%-25% of the physician workforce, <10% are in academic medicine in few programs I rotated in the south and the Northeast

 

[Postictal Raiden]

There aren't many DO in academic medicine... If DO for instance make up 20%-25% of the physician workforce, <10% are in academic medicine in few programs I rotated in the south and the Northeast

That’s because people who go into DO schools aren’t as academically driven for the most part.

Most of us couldn’t care less about winning the Nobel prize. A larger portion of us are older, have families and buried in debt than our MD counterparts. We just want to finish our education/training and get into the real world ASAP where we can be handsomely compensated for the work we do.