How does Academic Medicine work?

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mechtel

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Hi all,

I've known several academics with the position of "clinical assistant professor." They spend most of their time with patient care, but also conduct research and teach residents.

First, how does one go about getting such a position? After residency, I assume a fellowship is required? Then how does one get an academic appointment? How important is the prestige of medical school attended for securing such positions?

Second, how is pay determined? Are academics paid a flat salary by their institution or do they collect reimbursement from insurance plans? Within specialties, are academic pediatricians compensated much less than academic orthopedic surgeons or is there less of a pay gap than in private practice?

Third, I assume "clinical professors" are free to spend more time on patient care. Must they also do research and who decides how to allocate time? Are they still considered academic physicians?

Lastly, does an academic appointment preclude the possibility of possibility of a part-time private practice.

I apologize for all these questions, but I've been inspired by how the academics I met provided patient care informed by current literature and I see this as a possible career path. But, I've been embarassed to ask such questions as "how much do you get paid?" and "are you a real professor?" to research mentors for obvious reasons!

Thank you all!
 
The academic physicians I shadowed seemed to be typical doctors who just happened to be employed by an academic institution, and would spend a portion of their time teaching med students and residents. I don't think any special fellowship was required.
 
Even most doctors that hold an associate professorship in a med school does not do research. It does not preclude them from getting a private job. In fact most of them do. In this med school they get 1 week clinic and 1 week free time that they can do research or make more money doing private. My shadow told me they usually have "3Ps". 1. Personality 2. Prescription 3. Paper work, that prevent them from getting in private practice. So those positions are quiet different from the big PI at different medical schools.
 
Hi all,

I've known several academics with the position of "clinical assistant professor." They spend most of their time with patient care, but also conduct research and teach residents.
Universities are always looking for volunteer faculty with whom students may do their outpatient rotations. If you are in private practice, you can still be a clinical assistant professor.

First, how does one go about getting such a position? After residency, I assume a fellowship is required? Then how does one get an academic appointment? How important is the prestige of medical school attended for securing such positions?
Fellowship training helps but is not necessary. Academic positions are advertised. You apply just like any other job. It helps to do residency or fellowship where you want an academic position.

Second, how is pay determined? Are academics paid a flat salary by their institution or do they collect reimbursement from insurance plans? Within specialties, are academic pediatricians compensated much less than academic orthopedic surgeons or is there less of a pay gap than in private practice?
Salary, speaking fees, and research grants. Generally, your income will be less than that in private practice if you are on salary at the university. It might be 50-60% of what you could earn in private practice.


Third, I assume "clinical professors" are free to spend more time on patient care. Must they also do research and who decides how to allocate time? Are they still considered academic physicians?
No research is necessary if you are a volunteer faculty member.

Lastly, does an academic appointment preclude the possibility of possibility of a part-time private practice.
I know quite a few people who are volunteer faculty and they are in private practice full-time with the exception of a couple of weeks each year of attending rounds at the teaching hospital.

I apologize for all these questions, but I've been inspired by how the academics I met provided patient care informed by current literature and I see this as a possible career path. But, I've been embarassed to ask such questions as "how much do you get paid?" and "are you a real professor?" to research mentors for obvious reasons!

Thank you all!
 
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First, how does one go about getting such a position? After residency, I assume a fellowship is required? Then how does one get an academic appointment? How important is the prestige of medical school attended for securing such positions?
Fellowship training helps but is not necessary. Academic positions are advertised. You apply just like any other job. It helps to do residency or fellowship where you want an academic position.

The term "clinical assistant professor" is vague and historically has been used in one of two ways. First, was a paid faculty member of a medical school who did clinical medicine and teaching, but little if any research and was generally not on the tenure track. This is more commonly referred to nowadays without the word "clinical" and designated within the institution, publicly or privately as "non-tenure track". There are variations on this theme of course.

The second, and what I think the OP and most people posting have been referring to is "voluntary" or non-paid faculty who often are community physicians but who teach med students and may participate (but uncommonly direct) clinical research. The faculty title is somewhat honorary in that case at most places.

Now then, with regard to the above, some faculty positions are advertised, but it is very common for them not to be. The cost of such advertisements is high and commonly when someone finishes specialty or subspecialty training, if they are interested in going to a specific location or work with a specific person/group, they just call and see if there is an opening, etc. It is not in any way necessary to have done residency or fellowship where one gets an academic position. Many do stay both because of the establishment of their research and having a mentor there, as well as personal reasons, but it is not particularly important in most cases.

Salary of academic vs private practice is so variable and difficult to properly calculate due to different benefits, etc, that any generalization is virtually useless, IMO.
 
Correct me if I'm wrong but I get the impression that in order to get grants you basically have to make small, incremental steps from everyone else's work.

What if you had a high-risk, high-reward idea: is it unlikely that you could get a grant in this scenario? One thing that I'm fearful of in academic medicine is that creativity is stifled because of the need to get grants and that I'd be pigeonholed into doing safe but boring work.

Is this a valid point or am I blowing things out of proportion?
 
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