Great Practice vs. Great City

[jbernar1]

Trying to make a decision on where to practice. Basically trying to decide between a great practice opportunity in a small town with absolutely nothing to do vs. a subpar job opportunity in a big city with tons of things to do for my family. Salary and benefits are the same.

Would like to get some opinions on the subject.

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[mlw03]

there's no right answer for this. gotta do what's best overall for your family. just how bad is "nothing to do?" some people prefer small town life. there are so many factors to consider i don't know where to begin. but if it were me and i thought i and my family would be miserable outside work, i'd take the subpar job in a place i liked living.

 

[2012mdc]

Trying to make a decision on where to practice. Basically trying to decide between a great practice opportunity in a small town with absolutely nothing to do vs. a subpar job opportunity in a big city with tons of things to do for my family. Salary and benefits are the same.

Would like to get some opinions on the subject.

Why is it subpar? Longer hours? Not exactly what you want to practice? Longer partnership track?

How far is the small town from a big city?

Without a lot more details it's hard to say.

 

[jbernar1]

Nothing to do means Walmart is the best shopping place in town and the best of ~10 restaurants is Bob Evans restaurant. Closest big city is 2 hours away.

Subpar means really old equipment and small office space, multiple locations required to practice, building the practice volume essentially from scratch, and on call a lot.

 

[mlw03]

Is there a third job option that is in between? You are describing a tough choice.

 

[jbernar1]

No third option that I am willing to take. That's what is making it so hard.

 

[Qex]

Go with the 'Nothing to do' city. Because if you enjoy your job, you can easily *find* things to do with your family. There's got to be a park to go play sports in, or a swimming pool, right? Netflix/DVD/VOD can provide movie nights. There are lots of things you can do, even in a nothing city. Also, on the weekends, you can do a day trips to a bigger city, as a treat. Once you have established a track record in your good job, you can then try to parlay that into another good job in a better city. Ask yourself what would be the biggest stressor - finding things to do in a 'nothing' city, or building a practice from scratch, and go with the lowest stressor option.

 

[45408]

"Nothing to do" job. You can get a lot of good experience and probably put yourself in a better position to get a job that you want in a place that you want, once you're a more seasoned applicant.

 

[OlderMDAlmost]

Having lived in large cities for 30 plus years (Los Angeles, Omaha, New Orleans, New York and back to Los Angeles} as well as 25 plus years in a small town of 600 souls in rural California, I can tell you there is plenty to do in a small town (assuming you do not live at the Mall). You can be busy every day, if you wish. In addition, having your children raised in an environment where doors are not locked, crime is minimal, gangs non-existent, and public (therefore free) schools with clean class rooms and 8 students, is priceless.



That is why I am seeking a Family Medicine residency with a rural emphasis. To return home and practice medicine.

 

[colbgw02]

Gotta go with great job over great location. I've known a lot of people that adjusted to living somewhere they initially didn't like because they liked their job and their coworkers. Conversely, I've known a handful of people that chose a city and got whatever job they could. Those folks were unhappy and ended up changing jobs (and locations) as quickly as they could. Obviously, there are plenty of details to your situation that are beyond the scope of an internet post that could alter the calculus, but as a general rule, I'd go with the better job.

 

[nitemagi]

I would go with the great location. A subpar job can be worked temporarily while contacts are made and you get to know the lay of the land. Then you can transition to the dream job in the dream city when the opportunity arises, or you choose to create the opportunity (private practice). If that isn't a realistic possibility in that city, ever, then I agree with others, stay with the small town. Write a novel.

 

[mlw03]

I would go with the great location. A subpar job can be worked temporarily while contacts are made and you get to know the lay of the land. Then you can transition to the dream job in the dream city when the opportunity arises, or you choose to create the opportunity (private practice). If that isn't a realistic possibility in that city, ever, then I agree with others, stay with the small town. Write a novel.

don't many group practices in large city write non-compete clauses into their new-hire contracts to explicitly prevent this from occurring?

 

[nitemagi]

don't many group practices in large city write non-compete clauses into their new-hire contracts to explicitly prevent this from occurring?

http://physicianentrepreneur.com/?p=50

It's not forever.

 

[mlw03]

http://physicianentrepreneur.com/?p=50

It's not forever.

and what does one do to earn an income during those two years? i think suggesting this guy/gal goes to the big city's sucky job with the hope of transitioning easily to a better job in that city within a short time frame is just unrealistic given the contractual obligations that'll be mandated.

 

[nitemagi]

and what does one do to earn an income during those two years? i think suggesting this guy/gal goes to the big city's sucky job with the hope of transitioning easily to a better job in that city within a short time frame is just unrealistic given the contractual obligations that'll be mandated.

I'm not suggesting the OP takes a job they hate that they work for free. But taking a mediocre job with fair pay while getting established in a new environment, setting up contacts is a common practice in some specialties. They should read the contract and not take it if it's unreasonable.

You're talking about a hypothetical job and hypothetical contract for a job that doesn't exist, with no known real parameters, but I'm unrealistic?

 

[QofQuimica]

Having lived in large cities for 30 plus years (Los Angeles, Omaha, New Orleans, New York and back to Los Angeles} as well as 25 plus years in a small town of 600 souls in rural California, I can tell you there is plenty to do in a small town (assuming you do not live at the Mall). You can be busy every day, if you wish. In addition, having your children raised in an environment where doors are not locked, crime is minimal, gangs non-existent, and public (therefore free) schools with clean class rooms and 8 students, is priceless.

Gotta go with great job over great location. I've known a lot of people that adjusted to living somewhere they initially didn't like because they liked their job and their coworkers. Conversely, I've known a handful of people that chose a city and got whatever job they could. Those folks were unhappy and ended up changing jobs (and locations) as quickly as they could. Obviously, there are plenty of details to your situation that are beyond the scope of an internet post that could alter the calculus, but as a general rule, I'd go with the better job.

I agree for the same reasons. I chose great med school over great city and great residency over great city, and once you adjust, you can find things you like about living anywhere. Plus, one thing no one had pointed out yet is that your standard of living will be much higher in the small town. You'll be able to afford to take vacations with your family, save for college and retirement, etc. more easily.

 

[HondoCrouch]

Trying to make a decision on where to practice. Basically trying to decide between a great practice opportunity in a small town with absolutely nothing to do vs. a subpar job opportunity in a big city with tons of things to do for my family. Salary and benefits are the same.

Would like to get some opinions on the subject.

If "something to do" to you = shopping and restaurants maybe you need to expand your interests and explore the world a little. Sounds like a miserable existence if your interests revolve around shopping and eating out.

 

[nitemagi]

I agree for the same reasons. I chose great med school over great city and great residency over great city, and once you adjust, you can find things you like about living anywhere. Plus, one thing no one had pointed out yet is that your standard of living will be much higher in the small town. You'll be able to afford to take vacations with your family, save for college and retirement, etc. more easily.

I think this brings up the crux of the issue -- definition of "standard of living." Size of house/apartment? Do you need to own? Are vacations important? Do you like a variety of cultures readily available (moreso in a big city)? Restaurants and a variety of cuisines? Academic centers? Music scene? Arts? Other hobbies that require a lot of people or diversity? Or are you outdoorsy and need a lot more nature? Is your specialty one in demand that career mobility is viable?

I went to medical school in a smaller city in a less desirable location, primarily for the superior curriculum, but I went to residency in an area I wanted to work. Still picked a good program, of course. If the OP is doing pathology, it's a bit different of a job market than say EM or my field (psychiatry).

 

[jbernar1]

Restaurants and shopping are important to my family's quality of life but in the end, decided to go with the great practice. I'll let you know how it turns out in a few years.

 

[Buzz Me]

It's often been said, when choosing your job...

*Great location
*Great pay
*Doing what you love

Pick two of three