Hii
I am a second-year IM resident, looking for hospitalist jobs from July 2023.
Is anyone else like me searching??
If so, what are the factors you guys are considering? Pay, location, open/closed ICU..
Probably a bit too early to search but I suppose it can't hurt (especially if you want to get some of the more desirable positions which tend to fill early). But a few important (but not exhaustive list of factors) to consider:
-Census: for a typical 12-hour rounding shift having more than 20 patients is probably busier than most people like. And if it's around 20 patients that's reasonable only if there's good ancillary and subspecialty support at your hospital. And always take the census numbers given by recruiters with a grain of salt since census depends on a variety of factors such as hospital volume and staffing.
-Ancillary and sub-specialty support - is it nearly full support, or is it more of a critical access hospital with minimal services and almost everything falls on the hospitalist? how good is the nursing, Case Management, pharmacy etc...? For example, will someone else help with med recs on on admissions or does the hospitalist have to do it themselves every time? Is there Palliative Care service available to do the lengthy GOC discussions with patients' families, or does this also fall on the hospitalist? Are there services to do simple procedures like lines or paracenteses?
-Pay structure. Is it only base salary or is there also a RVU or quality bonus? I strongly don't recommend taking a position that is only salaried position with no RVU/productivity bonus, unless there's also a hard census cap written into the contract (otherwise you could get stuck doing a lot more work when patient volumes go up and not get compensated any more for it)
-Can you round and leave a bit early and take call from home on your rounding shifts? Having to stay in house for a full12 hrs for every single shift can be unsustainable in the long run.
-How much night, admitting, swing shifts are required? These shifts can be more unpredictable and you have have to usually have to stay inhouse for the whole shift? Are the night shifts paid at a different rate?
-Location: the more desirable the area, generally the less desirable the offers and the less leverage you have to negotiate (if at all)
-Open/Closed ICU - I would only take an open ICU position if you're really comfortable doing critical care work (eg intubating/extubating patients, managing vent settings, placing central lines) with only IM training; otherwise it can be a major liability. The open ICU jobs tend to be either in more remote or smaller hospitals or nocturnist jobs as the hospital doesn't want to hire a full time CC attending, and are only worthwhile if they pay near the rate of CC attending.
-PA/NP supervision - how often and to what extent. You should only do it if you're getting some type of compensation if it's in addition to your regular census (eg RVU bonus for signing their notes).
-Do they offer visa sponsorship? If you don't need it, I would try to avoid any job that offers visa sponsorship since some of these positions can be malignant and take advantage of IMGs (they know that those who need visas have limited job opportunities so have little incentive to offer good working terms/conditions)