How hard is it to get academic positions? Can you switch from Comm to Acad?

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EMP2B

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I'm a 4th yr student who just matched into EM at one of the newer 3yr community programs with no reputation as of yet since it has had no graduates. I know it's early but I have some questions about how much my residency affects my chances at getting the type of job I want. I would really appreciate any information, thanks!

1. What are my chances of landing an academic position based on the fact that my residency isn't at a big name 4yr academic institution? I'm not necessarily interested in working at one of these uber academic places or even doing research, but I think that I would like to teach and be in an environment with sufficient pressure to keep up my skills and knowledge. Would I have to do a fellowship or be chief to be considered? I think my ideal job would be clinical faculty(no research) at a community program.

2. I have been told that if you go into community/private practice, the longer that you are in that setting(and away from academics), the academic places will consider you to be "out of touch" and would not want to hire you. Is this true in EM? Is experience in the community considered a negative rather than an asset if one were to try to transition to an academic job after a few years in the community?

3. An Optho attending told me that some private docs out there are really terrible and do the exact same thing they did when they finished training 20yrs ago. She said that this often happens outside of an academic setting as it is hard to motivate yourself to keep current, and without other docs around to discuss new developments in medicine. How much does this apply in EM community practice? Are community EM docs able to keep up their knowledge and skills or do they gradually fall behind their academic colleagues? If this is the case, what can the community docs do to stay current and sharp?
 
Plenty of views but no reply.... Anybody have any insights into these topics? Maybe it's not a very comfortable topic for some, I don't know. But I think it would really be helpful for those of us choosing residencies or early in our residency to know what we need to shoot for or accomplish during our training to have the career we want or at least to keep our options open. Also, what it really means to choose a career in community vs academic.
 
1. Any sufficiently motivated person can get an academic job by demonstrating the proper attributes and having a few connections. Where that initial job ends up being may have more to do with the "name" of your residency, however. Or, you can do a fellowship someplace you'd like to work to try and impress them.

2. Community experience can be an asset. After all, most residency graduates go into community practice, and it can be helpful to bring a community perspective to training. Several of our faculty spent extended periods of time in non-academic settings before returning to teach.

3. I see terrible community docs and I see awesome community docs. I see great academic physicians and bullheaded academic ones that never change. Anyone who wants to read literature and stay current can do so regardless of their setting, short of involvement in "cutting edge" research.
 
Money is a big factor in going from community to academics. I've heard that the problem is once you do community, and are pulling in $300k a year, it's really hard to change your lifestyle/expectations to be happy with 180K a year, much easier to go the other direction. The other problem is that academic is often a track (assistant prof, associate prof, full professor.) You need a certain amount of publication to move to the next rung. Some people are probably less excited to start on that pathway when they've been in the community for awhile, since they are already farther into their career (ie do you want to spend 10 years trying to become a full professor if you only have 20 years left in your career rather than 30)
 
1. what xaelia said.
2. True. the longer you are in the community, the harder it will be to go academics. The criteria to get in are tougher and hard to maintain in the community. Publications, service, teachign etc.
3. depends on the doctor, the community etc.
 
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