High unfilled numbers this year in pediatrics

Started by oldbearprofessor
This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
Get help with your application

Use all the free resources available to you from SDN: articles, guides, expert advising, forums discussions, and school research.

Browse articles Compare schools My application plan Read Interview Feedback
Practice for interviews Ask an Advisor
oldbearprofessor said:
Okay folks, why let Reddit have all the fun with this topic! Why was there an approximate tripling of the number of unmatched positions in the pedi match this year to about 250? What can be done about this in the future?
Click to expand...
Where is this data posted? Specifically, which programs had unmatched positions and how many went unfilled in each program?
 
Advertisement - Members don't see this ad
Wow, there are a lot of places that I didn't even know had residencies for anything. I do like that the HCA residencies, kinda across the board, got spanked. HCA having residencies is the slimiest thing ever.

There clearly are some geographic preferences in a lot of these programs that didn't fill. But also, there's some terrible leadership choices as well (sorry, I'm not picking on anyone specifically, just generalizing). One program for instance:
Pediatrics: 2024:Q-9, F-0; 2023:Q-6, F-5; 2022:Q-7, F-7; 2021:Q-8, F-3; 2020:Q-8, F-3

If year over year, your median match rate is 4 and in the year after not filling consistently, even at 6 spots, you expand to 9, then of course the outcome is going to be unfilled. And in this case, completely unfilled. This feels like people have no idea on how to read trends.
 
SurfingDoctor said:
Wow, there are a lot of places that I didn't even know had residencies for anything. I do like that the HCA residencies, kinda across the board, got spanked. HCA having residencies is the slimiest thing ever.

There clearly are some geographic preferences in a lot of these programs that didn't fill. But also, there's some terrible leadership choices as well (sorry, I'm not picking on anyone specifically, just generalizing). One program for instance:
Pediatrics: 2024:Q-9, F-0; 2023:Q-6, F-5; 2022:Q-7, F-7; 2021:Q-8, F-3; 2020:Q-8, F-3

If year over year, your median match rate is 4 and in the year after not filling consistently, even at 6 spots, you expand to 9, then of course the outcome is going to be unfilled. And in this case, completely unfilled. This feels like people have no idea on how to read trends.
Click to expand...
im curious as to what they look like after soap. Places that want warm bodies will continue to expand as long as they can fill it with USMG/IMGs that didn’t match
 
DO2015CA said:
im curious as to what they look like after soap. Places that want warm bodies will continue to expand as long as they can fill it with USMG/IMGs that didn’t match
Click to expand...
Oh yeah. I mean, if a program can't read a trend, then they'll just fill it up with whoever... just get APPs to eventually fill the spot.

There were a good number of placed that had consistently filled though and then got hammered. I'm sure no one will learn anything from this through.
 
SurfingDoctor said:
Oh yeah. I mean, if a program can't read a trend, then they'll just fill it up with whoever... just get APPs to eventually fill the spot.

There were a good number of placed that had consistently filled though and then got hammered. I'm sure no one will learn anything from this through.
Click to expand...
I agree that they won’t learn. Academia is out of touch with the real world. I disagree with hiring APP though. They should shrink down spots and hire pediatricians but alas it’s less financially beneficial even though it’s better care
 
Interesting discussion.

I like that people are starting to understand we are overtrained.

In my opinion, med school should only be 3 yrs (18 months + 18 months). Residency like peds, IM, FM should be 2 yrs. I was shocked when the GME director (med-peds physician) where I trained said that.

There is no incentive to change the system because hospitals are getting cheap labor.

Opportunity cost is real these days when most of us graduate with 250-350k student loan.
 
SurfingDoctor said:
You are making $70K/year. Then you need to find a new employer. Unfortunately, Harvard does pay at those rates.

Otherwise, you are saying that a one-time $130K in lost earnings over a lifetime (2 year versus 3 year fellowship is what you are getting at?) is putting you in the poor house? I guess, but I've never personally seen it outside of people who are terrible at managing money and I would suggest anyone who does find a financial advisor.

Incidentally, this all reminds me of my division chief who makes nearly double of all of us in the group, but 1) has been divorced and pays lots of alimony, 2) has a lot of kids, 3) goes on expensive vacations and 4) complains they have no retirement because of the former. Yeah...

Anyway, I'm not here to convince you that physicians are bad money managers (there's enough articles on this already), nor am I going to try to convince you that throwing more money at people who can't manage money is going to fix the problem (which also has a lot of articles), so we can move on from this point and get back to the real topic at hand... too many programs and slots despite a lack of reasonable demand.
Click to expand...

Agree with others that I’m not sure what all this is about.

Yes, many physicians are bad at managing money.

No, not all of them are.

Yes, most physicians can’t replace a light socket - but find me a single electrician that can do any of what we do on a daily basis. I’m waiting.

Losing $100k in earnings for training is meaningful, and for a specialty as poorly paid as peds it’s even more meaningful than elsewhere in medicine.

Bottom line is that peds pays horribly and has several other weird issues (this “hospitalist fellowship” thing, no autonomy for trainees, etc) that completely scratched it off my specialty list as a medical student. If you want to attract quality applicants, you need to start fixing these things.
 
Splenda88 said:
Interesting discussion.

I like that people are starting to understand we are overtrained.

In my opinion, med school should only be 3 yrs (18 months + 18 months). Residency like peds, IM, FM should be 2 yrs. I was shocked when the GME director (med-peds physician) where I trained said that.

There is no incentive to change the system because hospitals are getting cheap labor.

Opportunity cost is real these days when most of us graduate with 250-350k student loan.
Click to expand...
Eh I think it depends. If you’re forcing a hospitalist fellowship then I agree. Do gen peds in 2 years then they can stay for a 3rd to get a hospitalist fellowship. I think any of the 3 you mentioned that are doing both inpatient and outpatient then 3 years is good. But with this whole choosing environment then I agree.
 
DO2015CA said:
Eh I think it depends. If you’re forcing a hospitalist fellowship then I agree. Do gen peds in 2 years then they can stay for a 3rd to get a hospitalist fellowship. I think any of the 3 you mentioned that are doing both inpatient and outpatient then 3 years is good. But with this whole choosing environment then I agree.
Click to expand...
Maybe a 2 + 1 is better. In my IM residency, we were semi independent as PGY2 and supervision was almost non existent as PGY3. I work with 3 of my co-residents as hospitalists and I asked them separately if they think PGY3 was needed to do the job and they all said no

How long is peds hospilatist program? It's really insulting if it 2-yrs. They talked about that same concept in IM, but only 1-yr and people said "hell no".

I am part of a hospitalist group in FB and couple of weeks ago, someone posted she was looking for someone to fill a "hospitalist fellowship" position, and everyone chastised her before she deleted her post.
 
Splenda88 said:
Maybe a 2 + 1 is better. In my IM residency, we were semi independent as PGY2 and supervision was almost non existent as PGY3. I work with 3 of my co-residents as hospitalists and I asked them separately if they think PGY3 was needed to do the job and they all said no

How long is peds hospilatist program? It's really insulting if it 2-yrs. They talked about that same concept in IM, but only 1-yr and people said "hell no".

I am part of a hospitalist group in FB and couple of weeks ago, someone posted she was looking for someone to fill a "hospitalist fellowship" position, and everyone chastised her before she deleted her post.
Click to expand...
The issue is peds residency is more than solid to train someone to be a peds hospitalist. The problem is they’re forcing it then changing acgme requirements for peds residency to be more outpatient focused to legitimize the fellowship. The fellowship is 2 years (some places 3) with half being research
 
DO2015CA said:
The issue is peds residency is more than solid to train someone to be a peds hospitalist. The problem is they’re forcing it then changing acgme requirements for peds residency to be more outpatient focused to legitimize the fellowship. The fellowship is 2 years (some places 3) with half being research
Click to expand...
How is salary for peds hospitalists working 7 days on/off?
 
Advertisement - Members don't see this ad
Splenda88 said:
Is it < 225k?

Is it difficult to find a peds hospitalist job without doing the fellowship?
Click to expand...
It depends where you are. The issue is most children’s hospitals are academic so you have that pulling down salaries. There are large community hospitals that will hire pediatricians and they tend to get paid a little more. Depends what part of the country but 200-240 is expected.

Academic places want the fellowship yet there aren’t enough so people are still being hired without it. Large community hospitals don’t care. My wife didn’t do a fellowship and is too young to be grandfathered in. She’s at a large community hospital. There have been a few academic places that will hire her now that she has a few years experience. But with that comes a drop in money


Edit: autocorrect/grammar lol
 
Last edited by a moderator:
DO2015CA said:
What’s bad about PICU that makes them hate it?
Click to expand...
You’d have to ask them. I frankly choose not to engage in their complaints and as time has gone on, I realized my mental health was better when I minimized all interactions with them.

I find it’s generally not a good idea to surround yourself with negative people.

If I had to guess though, they would rather have money but work less than have personal fulfillment at work. But that’s just a guess. Ironically, the people who complain the most about money are the ones least willing to do overtime to get more money. I mean I worked the most overtime shifts in my entire group, but I don’t complain about work and cleared the biggest bonus that easily could have been any of theirs. Because in the end they complain about money, but that’s not the real problem.

The CCM forum isn’t active as it used to be… but I (and others) have left my thoughts in this thread…
forums.studentdoctor.net

There are too many burnouts in this job

Seriously, I'm sure they are all good people, but there are too many burnouts in this profession. They are miserable to be around and the apathy toward patients is just annoying at this point. Figure something else out, because I'm tired of being around people like that and they need to find a...
forums.studentdoctor.net forums.studentdoctor.net
 
Last edited:
DO2015CA said:
There are 5ish programs in the country you can. The post-pediatric portal program.
Click to expand...

Yes but if you know you want to do child psych it's much more efficient to do a psych residency and fast track to a child psych fellowship so you get it done in 5 years total AND can go to anywhere that has a child psych fellowship rather than being limited to the handful of peds portal programs. Peds portal program is more useful for people that are trying to pivot more from peds into child psych.
 
calvnandhobbs68 said:
Yes but if you know you want to do child psych it's much more efficient to do a psych residency and fast track to a child psych fellowship so you get it done in 5 years total AND can go to anywhere that has a child psych fellowship rather than being limited to the handful of peds portal programs. Peds portal program is more useful for people that are trying to pivot more from peds into child psych.
Click to expand...
Agreed
 
calvnandhobbs68 said:
Yes but if you know you want to do child psych it's much more efficient to do a psych residency and fast track to a child psych fellowship so you get it done in 5 years total AND can go to anywhere that has a child psych fellowship rather than being limited to the handful of peds portal programs. Peds portal program is more useful for people that are trying to pivot more from peds into child psych.
Click to expand...
Same with PEM (EM->PEM rather than Peds->PEM), but that doesn't seem to stop people from taking the long route.
 
Advertisement - Members don't see this ad
calvinhobbes said:
Child psych has a very high earning potential, pays well with great lifestyle, the same as most adult fellowships
Click to expand...

Why is the earning potential for child psych so good when the pay for everything else in peds is 🗑️ in comparison?

Can someone solve that riddle for me? Is it that child psych types can go cash only?
 
dozitgetchahi said:
Why is the earning potential for child psych so good when the pay for everything else in peds is 🗑️ in comparison?

Can someone solve that riddle for me? Is it that child psych types can go cash only?
Click to expand...
Poor children don't get psychiatrists. They get social workers, school guidance counselors... or mostly, nothing.
 
dozitgetchahi said:
Why is the earning potential for child psych so good when the pay for everything else in peds is 🗑️ in comparison?

Can someone solve that riddle for me? Is it that child psych types can go cash only?
Click to expand...
Because it’s a subspecialty of psychiatry, not pediatrics, and insurance reimburses higher for psych than for peds coding, plus psych docs bill for therapy when they do it, in addition to regular visits. And there is a shortage of child psych so demand is high and supply is low, thus salaries are high and always negotiable. and the cash practice part of it, rich moms will pay top dollar to be seen quickly for little Timmy’s autism and adhd evaluation, instead of poor moms that have to wait 6 months to a year from a Medicaid assigned clinic. Psych is also hard work as it’s more than just med management. And inpatient psych pays because if a kid isn’t doing better emotionally and isn’t safe to go home, they won’t be discharged, no matter what the insurance company says, bc it’s a liability, if a kid is still suicidal or homicidal, can’t be sent home. Hard job, pays well if you have the heart for it.
 
After reading this thread, I say we can all agree that the elephant in the room is that taking care of patients is difficult, time consuming, and at times seems pointless. It is literally a never-ending task. More people should treat their MD like what it is - a doctorate degree - and engage in research. Nothing has been better for my quality of life than to transition from clinical training to an 80 / 20 academic appointment. You get to take care of patients in small doses to feel that human connection and help individuals, but the great professional satisfaction and self-controlled work hours that comes with scientific pursuit
 
SurfingDoctor said:
Poor children don't get psychiatrists. They get social workers, school guidance counselors... or mostly, nothing.
Click to expand...

Poor children also tend to get a peds NP....I mean it's that way for the entire healthcare system. Hell even patients with good commercial insurance end up seeing the NP in a lot of peds practices.

Medicaid patients generally get subpar care across the board because of course medicaid reimbursement rates are trash.

I take multiple commercial insurance plans along with Tricare and see patients from all SES levels (a decent amount of poor kids parents ya know work and have insurance) and I'm doing just fine.
 
Last edited:
calvnandhobbs68 said:
Poor children also tend to get a peds NP....I mean it's that way for the entire healthcare system. Hell even patients with good commercial insurance end up seeing the NP in a lot of peds practices.

Medicaid patients generally get subpar care across the board because ya know medicaid reimbursement rates are trash.

I take multiple commercial insurance plans along with Tricare and see patients from all SES levels (a decent amount of poor kids parents ya know work and have insurance) and I'm doing just fine.
Click to expand...
Maybe. In urban areas, the poor get residents backed up by attendings, and sometimes NPs. In rural areas, the poor tend to get physicians. The real problem that most people use urgent cares (and ERs) for a significant part of their care and there, they are definitely getting an NP.

And yes, the poorer you are, the lower the reimbursement and the less likely people are going to take care of you. "Wealth" of physicians is intimately tied to the "wealth" of the patients they choose to see.
 
Rumalum said:
After reading this thread, I say we can all agree that the elephant in the room is that taking care of patients is difficult, time consuming, and at times seems pointless. It is literally a never-ending task. More people should treat their MD like what it is - a doctorate degree - and engage in research. Nothing has been better for my quality of life than to transition from clinical training to an 80 / 20 academic appointment. You get to take care of patients in small doses to feel that human connection and help individuals, but the great professional satisfaction and self-controlled work hours that comes with scientific pursuit
Click to expand...

I was miserable in academia, and most other docs feel this way too.
 
Rumalum said:
After reading this thread, I say we can all agree that the elephant in the room is that taking care of patients is difficult, time consuming, and at times seems pointless. It is literally a never-ending task. More people should treat their MD like what it is - a doctorate degree - and engage in research. Nothing has been better for my quality of life than to transition from clinical training to an 80 / 20 academic appointment. You get to take care of patients in small doses to feel that human connection and help individuals, but the great professional satisfaction and self-controlled work hours that comes with scientific pursuit
Click to expand...

I agree with the part on finding balance with the academic lifestyle. What field are you in, if you don’t mind sharing? And how much research were you doing before the switch?
 
Rumalum said:
After reading this thread, I say we can all agree that the elephant in the room is that taking care of patients is difficult, time consuming, and at times seems pointless. It is literally a never-ending task. More people should treat their MD like what it is - a doctorate degree - and engage in research. Nothing has been better for my quality of life than to transition from clinical training to an 80 / 20 academic appointment. You get to take care of patients in small doses to feel that human connection and help individuals, but the great professional satisfaction and self-controlled work hours that comes with scientific pursuit
Click to expand...
If I wanted to bury my head in research for the majority or significant portion of my time then I would have gotten a phd. Doing research doesn’t equal an increased quality of life lol.
 
Rumalum said:
After reading this thread, I say we can all agree that the elephant in the room is that taking care of patients is difficult, time consuming, and at times seems pointless. It is literally a never-ending task. More people should treat their MD like what it is - a doctorate degree - and engage in research. Nothing has been better for my quality of life than to transition from clinical training to an 80 / 20 academic appointment. You get to take care of patients in small doses to feel that human connection and help individuals, but the great professional satisfaction and self-controlled work hours that comes with scientific pursuit
Click to expand...
Hi - speaking as an academic attending for well over 30 years, who tended to work more or less 80/20 over the decades (clinical time usually eats into academic time in this scenerio), I'd say this is a bit idealized and challenging to do for a whole career. There are relatively few 80/20 (or "triple threat") academics among young faculty anymore as getting and maintaining the type of funding needed for this is very difficult to do over a period of decades. As you move from a training grant to R01 and renewal, the grant writing process and promotion challenges get more not less frustrating, and, in my experience in hiring folks, etc, more tend to move out to greater clinical time (or admin) than to more research time. The work hours over a successful academic career are often less well-controlled in research than in clinical work, but it's variable.

So, 80/20 is a great option and is satisfying, but it is poorly paying compared even to pediatric full-time clinical care and very difficult to maintain currently over a career. Not an option for most right now unfortunately and I encourage those going down this pathway to be sure of their true commitment to a research career. It's awesome for some, but it's not going to be a common pathway for most or realistic. @GoSpursGo might have some thoughts on this as well.
 
oldbearprofessor said:
Hi - speaking as an academic attending for well over 30 years, who tended to work more or less 80/20 over the decades (clinical time usually eats into academic time in this scenerio), I'd say this is a bit idealized and challenging to do for a whole career. There are relatively few 80/20 (or "triple threat") academics among young faculty anymore as getting and maintaining the type of funding needed for this is very difficult to do over a period of decades. As you move from a training grant to R01 and renewal, the grant writing process and promotion challenges get more not less frustrating, and, in my experience in hiring folks, etc, more tend to move out to greater clinical time (or admin) than to more research time. The work hours over a successful academic career are often less well-controlled in research than in clinical work, but it's variable.

So, 80/20 is a great option and is satisfying, but it is poorly paying compared even to pediatric full-time clinical care and very difficult to maintain currently over a career. Not an option for most right now unfortunately and I encourage those going down this pathway to be sure of their true commitment to a research career. It's awesome for some, but it's not going to be a common pathway for most or realistic. @GoSpursGo might have some thoughts on this as well.
Click to expand...
I would disagree with this. In a research career, you may work more hours and get paid relatively less, but those hours are incredibly flexible. In a clinical career, you work less hours with slightly higher pay, but your time is heavily influenced by multiple external factors like colleagues, patients, hospital demands, etc. I mean, you can schedule your experiments around your kids events, but you can't necessarily just take off to go do whatever if there is no one to cover the patients/service/etc.

Not that any of that really matters, because frankly, even at large academic institutions with high NIH directs, the number of people who actually do academic research is incredibly small (<10%).

Personally, I've always thought the one thing money can't buy is time.

Promotion pathways are also highly dependent on multiple factors, but that's a different topic.
 
oldbearprofessor said:
Hi - speaking as an academic attending for well over 30 years, who tended to work more or less 80/20 over the decades (clinical time usually eats into academic time in this scenerio), I'd say this is a bit idealized and challenging to do for a whole career. There are relatively few 80/20 (or "triple threat") academics among young faculty anymore as getting and maintaining the type of funding needed for this is very difficult to do over a period of decades. As you move from a training grant to R01 and renewal, the grant writing process and promotion challenges get more not less frustrating, and, in my experience in hiring folks, etc, more tend to move out to greater clinical time (or admin) than to more research time. The work hours over a successful academic career are often less well-controlled in research than in clinical work, but it's variable.

So, 80/20 is a great option and is satisfying, but it is poorly paying compared even to pediatric full-time clinical care and very difficult to maintain currently over a career. Not an option for most right now unfortunately and I encourage those going down this pathway to be sure of their true commitment to a research career. It's awesome for some, but it's not going to be a common pathway for most or realistic. @GoSpursGo might have some thoughts on this as well.
Click to expand...
Yeah I agree with much of this. As an 80/20 person myself, I am easily the least paid person in our division--I'm just never going to rack up the RVUs to make a meaningful clinical bonus. I do value the flexibility afforded by being a primary research faculty member in that I can largely be present for my kids, but it comes with the price of working 8-11 or 12 at night most nights catching up on papers, grants, etc. It also means more travel than I would like. And as I get to the end of my 3 year window of being protected I'm swiftly going to need to start protecting an increasing amount of my time and salary--in January 2025, I currently have only about 50% of my salary support paid by external grants, and while I assume I'll get supported for the other 30% I'm beginning to feel the heat to get more grants in. Maybe even more daunting, I worry about continuing to support the people who I have hired in my lab. Obviously if my grants stop funding I can always go back and take care of patients, but it really weighs on me when I think about funding others' livelihoods.

It's also important to recognize this was only an option for me because I did two additional "super-fellowships," meaning I was a fellow for 5.5 years before I could get an 80/20 appointment. I absolutely needed that protected time to become the kind of scientist I need to be to warrant this kind of position, but given how we all agree that 3 year fellowships are already not appealing there are many trainees who understandably do not find that path appealing.
SurfingDoctor said:
I mean, you can schedule your experiments around your kids events, but you can't necessarily just take off to go do whatever if there is no one to cover the patients/service/etc.
Click to expand...
I agree with your point that this path isn't open to many people anyways, but this is I think a misconception, particularly for clinical trialists. If you have a patient on a clinical trial who undergoes a significant complication, it doesn't matter if you're on call or not you have to be available to figure out what to do about it. You frequently get feedback from the FDA with like 48 hours to reply. As above, when one grant runs out you'd better have another one lined up to keep paying your salary and keep the lights on in the lab. Juggling all of these things together takes a lot of time management (which I honestly struggle with), and while sure nobody can "make" you do any of these things other than take care of your patients, if you don't do the things then you're not going to keep getting your time protected indefinitely.
 
GoSpursGo said:
I agree with your point that this path isn't open to many people anyways, but this is I think a misconception, particularly for clinical trialists. If you have a patient on a clinical trial who undergoes a significant complication, it doesn't matter if you're on call or not you have to be available to figure out what to do about it. You frequently get feedback from the FDA with like 48 hours to reply. As above, when one grant runs out you'd better have another one lined up to keep paying your salary and keep the lights on in the lab. Juggling all of these things together takes a lot of time management (which I honestly struggle with), and while sure nobody can "make" you do any of these things other than take care of your patients, if you don't do the things then you're not going to keep getting your time protected indefinitely.
Click to expand...
I don’t do clinical trials and most NIH funded research isn’t clinical trials. In fact, most of it is not and for good reason.

And yes, to be successful at research it takes 3 key ingredients 1) time prioritization but also 2) persistence, and the most important ingredient 3) dumb luck (which can only be slightly mitigated by numbers 1 and 2).
 
Last edited:
SurfingDoctor said:
I don’t do clinical trials and most NIH funded research isn’t clinical trials. In fact, most of it is not and for good reason.
Click to expand...
Yes I obviously know that, though I suspect that a decent chunk of MDs who get NIH funding have a clinical trial aim because otherwise you're not "innovative enough." Plus, not all research is NIH-funded. Regardless, I am giving my perspective, but the other pieces that I mention about funding running out is still relevant.
 
Advertisement - Members don't see this ad
GoSpursGo said:
Yes I obviously know that, though I suspect that a decent chunk of MDs who get NIH funding have a clinical trial aim because otherwise you're not "innovative enough." Plus, not all research is NIH-funded. Regardless, I am giving my perspective, but the other pieces that I mention about funding running out is still relevant.
Click to expand...
Clinical trial? No. Clinical samples? Yes.

But then again, so do successful PhDs. They just make the right connections to get samples, as opposed to MD and MD/PhDs that can get them directly.
 
As an aside, nearly every single person in my division has 20% protected “research” time. Most of them use it to go on vacation or go “drink Diet Pepsi with the medical students” as the department chair used to say.

As my division chief says, “it’s the ultimate scam”, but they get to work less with no repercussions. Unfortunately, they also complain about not getting paid as much as the few who do a full clinical FTE, even though they do less shifts. Maybe this is ICU specific which is primarily shift based… but it still seems ridiculous nonetheless.

It’s stuff like this that makes academics seem stupid as hell. I mean, I like academics because it fits my specific hobbies (ie research) into a paid gig, but it can also be utterly ridiculous and creates a vicious cycle of aimless academics training up a future generation to become… aimless academics. And this is me.. is part of the crux of the whole topic of this thread.
 
Last edited:
SurfingDoctor said:
Clinical trial? No. Clinical samples? Yes.

But then again, so do successful PhDs. They just make the right connections to get samples, as opposed to MD and MD/PhDs that can get them directly.
Click to expand...
Regardless, I generally agree that while there is some flexibility in day-to-day work schedule by the nature of a research career, the deadlines imposed by needing to produce deliverables such as funding and publications leads to a different kind of lack of control. And getting to a point where you can do legit research means you either stay in training even longer to get such a position as part of a startup package, or you write grants on top of your clinical FTE to carve out protected time. And you're paid like crap. As @oldbearprofessor , it's incredibly rewarding, but you really need to be sure it's what you want to do before you go down that path.
 
GoSpursGo said:
Regardless, I generally agree that while there is some flexibility in day-to-day work schedule by the nature of a research career, the deadlines imposed by needing to produce deliverables such as funding and publications leads to a different kind of lack of control. And getting to a point where you can do legit research means you either stay in training even longer to get such a position as part of a startup package, or you write grants on top of your clinical FTE to carve out protected time. And you're paid like crap. As @oldbearprofessor , it's incredibly rewarding, but you really need to be sure it's what you want to do before you go down that path.
Click to expand...
Yea, true research careers need addition training. And yes, true research careers need support early on. And unfortunately, neither of those things are desirable from an individual and institutional standpoint, respectively, anymore. I personally view it as a tragedy and one of the several reasons that physicians have become and will continue to be easily replaced by APRNs.

I mean, doing research makes one think critically. Not just in critical illness and acute situations, but globally. But to think critically, you need foundational knowledge. You need mechanistic expertise. All of that has been thrown out though in the modern era. You just follow the recipe (ie protocol). There’s no foundational knowledge or critical thinking skills in any of that, it’s literally following the flow diagram. The physicians’ skill (driven mostly by the business of medicine and top level ineptitude) of emphasizing Press Ganney surveys and not understanding the NADPH replenishment via Pentose Phosphate Shunt has made physicians non-cognitive operators. Maybe there is a reversal in all of that, but frankly, I mostly see physicians and institutions doubling down.

Oh well.
 
Now I’m going to vent. There was an MD/PhD in the lab. They had no school debt. It was paid off to by their PhD department.

This person was brought into the lab and handed a great project. They submitted a K-grant (junior faculty award) with no data they personally generated and it got scored pretty well, but not funded. The biggest driver against the grant was not the science (which is a rarity for a K) but the candidate. That person, instead of improving themselves and their candidacy, left to go into private practice.

I’m not faulting them because frankly, they sucked at research, but they were given an opportunity and pissed it away. And they did it not because they needed the money, but because they wanted more money.

Just another reason this field doesn’t incentivize good citizens and screws it up for those who follow.

/vent
 
You must log in or register to reply here.

Similar threads

B
Pediatrics Hemstology/Oncology 2026/27
Replies
6
Views
1K
ilovesprite
I
P
Fellowships moving to 2 year model
Replies
18
Views
6K
SurfingDoctor
SurfingDoctor
S
Pediatrics Compensation with Rising CoL?
Replies
8
Views
3K
SurfingDoctor
SurfingDoctor
KDVMSPH
Pediatrics BOARDS 2024 - DO- (AOBP)
Replies
34
Views
10K
sm123~
S
J
AOA Board of Pediatrics vs American Board of Pediatrics
Replies
15
Views
8K
calvinhobbes
calvinhobbes