Hospitalist Positions

[bustbones26]

I have noticed that many hospitals are now hring hospitalist. I have a slight interest in being a hospitalist because I think that outpatient medicine woudl drive me crazy. However, I do see one problem with hospitalist-----

Some hospitals I have seen offer hospitalist jobs offer the docs that take these jobs a nice schedule, e.g. 7 days on, seven days off, "you only have to work 15 days per month", etc etc. This is much like ER physician hours.

And while I do not see IM becoming a competitive residency to get into like EM, DERM, RADS, etc. I do predict much competition amongst IM's for hospitalist positions after residency training.

So any thoughts on how to get a leg up on this? I mean some job ads I have seen for hospitalist give preference to those that did med-peds, or did a CCM fellowship, etc etc.

Do you think increases your chances of landed a hospitalist position vs. somebody that just completed IM?:

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[avendesora]

I don't get the impression that hospitalist positions are "competitive" per se. There is an increasing demand, and among most internists I don't think being a hospitalist is that desirable. You're an employee vs. your own practice, more like shift work, etc. Takes a certain kind of personality. Some places I inteviewed had a hospitalist track, and I believe there may be some hospitalist fellowships??

I can see Med-Peds being desirable at smaller private hospitals so they can hire only one person to cover kids and adults.

On a related note -- I was chatting with one interviewer about why I wanted to do IM vs FP etc -- and he insisted that some FPs are getting into hospitalist medicine. Anyone else hear of this? I wouldn't think they would have the inpatient experience.

 

[dread]

There is an FP hospitalist service at one of the private hospitals that I rotated on while doing IM. Historically, FP's used to manage their patients whenever they were admitted, so they do have some inpatient experience. I would never reccomend that anyone do an FP residency where there is a large IM service though, because if they are anything like my school, FP usually only gets called by the ER for "uncomplicated" admitting cases, per several ER residents at my school. Not a very good way to train. Community programs are the best centers for FP inpatient training IMO. And regarding the question on hospitalists marketability, they do have hospitalists fellowships that they offer. You can't be board certified in hospitalist medicine yet because they don't have a board, but it's just something to improve your training and to put on your CV. Most recent grads of residency programs have no difficulty getting hospitalists positions though, because group practices hire them because they know that IM residents get extensive inpatient training so the new residents should be up to date on new inpatient medicine, plus as stated previously, there is currently a shortage of physicians for hospitalist positions. One reason is that it's mainly younger physicians who are filling the hospitalist positions since it's a relatively new specialty, so it's taking a while to fill all the new positions. A CCM fellowship would make you more marketable as well, since you could then cover your ICU patients as well (ICU pays more then the general floor admissions).

 

[bustbones26]

I suppose my point is, right now, since hospitalist is such a new thing, yes, there is a shortage. But I predict this will not be for long.

I know somebody said earlier that shift work and being an employee of the hospital would be undesireable, but these are the reasons why EM is so competitive. YEah, shift work, but 15 days off per month and no beeper. $150-165K for only working half the year??

For these reasons, I see hospitalist becoming competitive in the near future.

As far as FP's. They do have to manage inpatient medicine during their residency. If they never want to do it again after residency, that is their business. But I suppose if an FP fresh out of residency could argue that they did months of inpatient care during residency and are up to date on it and maybe could be a hospitalist.