ConfusedAboutEverything

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Medical school has taught me the importance of lifestyle. I realized that I no longer have the interest to work too hard. So I'm soul searching.

I'm thinking FM because of the flexibility and the sheer volume of job offers in primary care (3-4 day work weeks, no call, no inpatient, no OB, no nights, no weekends) in desirable locations. There is no shortage of primary care jobs. All for the same pay as a hospitalist. Is primary care easier than hospitalist?

I keep hearing medicine is "not chill". Is this true? Is being a hospitalist stressful, very work intensive and you burn out more easily? Is the job heavily intellectually demanding (I do like repetitiveness and being on autopilot) or do you get the hang of things and just automatically work?

Also:

Who is better at inpatient: IM or FM?
Who is better at outpatient: IM or FM?

Why would someone choose IM over FM if they want to be a hospitalist? They both can do it. Doesn't FM give you more flexibility?
 
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CCM-MD

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Right out of residency FM definitely gives you an edge on the outpatient side and IM will give you an edge on the inpatient side. The differences probably even out after one practices it for a while. Both can work as hospitalists but it might be easier to get a job in as IM. Many institutions prefer IM trained, especially in popular locations. I have worked in community/community-academic hospitals the northeast, midwest, and south - all the places I have worked at have had IM trained hospitalists. This is obviously anecdotal as there are many FM hospitalists out there, but its another piece of information if it helps you. FM will also give you the ability to see kids and do OB. Both give you access to various fellowships, I believe IM is better in this regard. I wouldn't say hospitalist is a "chill gig", but you can definitely make it a chill gig by working less.
 
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Chemist0157

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Medical school has taught me the importance of lifestyle. I realized that I no longer have the interest to work too hard. So I'm soul searching.

I'm thinking FM because of the flexibility and the sheer volume of job offers in primary care (3-4 day work weeks, no call, no inpatient, no OB, no nights, no weekends) in desirable locations. There is no shortage of primary care jobs. All for the same pay as a hospitalist. Is primary care easier than hospitalist?

I keep hearing medicine is "not chill". Is this true? Is being a hospitalist stressful, very work intensive and you burn out more easily? Is the job heavily intellectually demanding (I do like repetitiveness and being on autopilot) or do you get the hang of things and just automatically work?

Also:

Who is better at inpatient: IM or FM?
Who is better at outpatient: IM or FM?

Why would someone choose IM over FM if they want to be a hospitalist? They both can do it. Doesn't FM give you more flexibility?

I think ease depends on what you enjoy. Do you like inpatient or outpatient? A hospitalist working every other week and a PCP working 5 days a week may work about the same number of hours in a month.

There seem to be a LOT of different hospitalist jobs so it is difficult to lump that altogether. Some seem to be much less chill than others. I think the job allows one to be as intellectually demanding as one would like to be. Can consult sooner or later or not at all, whatever one’s comfort level is and what is medically appropriate. Hospital medicine can burn people out for sure.

I would think IM is better for inpatient and FM for outpatient simply based on training, but it depends on which is spending more time doing hospital work.

Most hospitalists I know are IM trained. Take that for what you will.
 
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Medical school has taught me the importance of lifestyle. I realized that I no longer have the interest to work too hard. So I'm soul searching.

I'm thinking FM because of the flexibility and the sheer volume of job offers in primary care (3-4 day work weeks, no call, no inpatient, no OB, no nights, no weekends) in desirable locations. There is no shortage of primary care jobs. All for the same pay as a hospitalist. Is primary care easier than hospitalist?

I keep hearing medicine is "not chill". Is this true? Is being a hospitalist stressful, very work intensive and you burn out more easily? Is the job heavily intellectually demanding (I do like repetitiveness and being on autopilot) or do you get the hang of things and just automatically work?

Also:

Who is better at inpatient: IM or FM?
Who is better at outpatient: IM or FM?

Why would someone choose IM over FM if they want to be a hospitalist? They both can do it. Doesn't FM give you more flexibility?
maybe you want to consider a non clinical specialty?
 

DrMetal

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I realized that I no longer have the interest to work too hard.

Leave medicine then. The most important characteristic of a good physician is her strong work ethic. The deadliest thing in medicine is a lazy physician.

I keep hearing medicine is "not chill". Is this true?

Yes, that is somewhat true, to be honest. If you're involved in some form of patient care, there will always be some element of stress. You will sometimes have a > 40 hr work week, you might have to work some late nights, some weekends, some holidays. Your work may occupy your mind when you go home. This is the profession. You're not a 9-5 banker. You're dealing with people's lives.
 
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VA Hopeful Dr

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Leave medicine then. The most important characteristic of a good physician is her strong work ethic. The deadliest thing in medicine is a lazy physician.



Yes, that is somewhat true, to be honest. If you're involved in some form of patient care, there will always be some element of stress. You will sometimes have a > 40 hr work week, you might have to work some late nights, some weekends, some holidays. Your work may occupy your mind when you go home. This is the profession. You're not a 9-5 banker. You're dealing with people's lives.
That doesn't have to be true. Part time is quite common these days in lots of fields. My IM wife worked 32 hours/week and would have kept doing that except our new contracts remove most of the bonuses for part-time physicians.

You have to work hard while at work no argument there, but its not hard at all to work less than 40 hours/week. Heck, I only work 36 hours per week.
 
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DrMetal

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That doesn't have to be true. Part time is quite common these days in lots of fields. My IM wife worked 32 hours/week and would have kept doing that except our new contracts remove most of the bonuses for part-time physicians.

You have to work hard while at work no argument there, but its not hard at all to work less than 40 hours/week. Heck, I only work 36 hours per week.

Fair enough. But I want to make more money, and I have expensive hobbies (I'm expanding my guitar collection, and I need new golf clubs).
 
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disorder

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I think the term you were looking for was "work-life balance".
 
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Trousseau

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Depends. I've had offers from chill places, and places with average daily census of 24 (which is madness). I'm fine with chill-medium censuses, and I balked at the 24 one.
 

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Leave medicine then. The most important characteristic of a good physician is her strong work ethic. The deadliest thing in medicine is a lazy physician.

One of the great things about SDN is having role models to impart invaluable wisdom to us like this

Truly invaluable :)
 
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Splenda88

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Depends. I've had offers from chill places, and places with average daily census of 24 (which is madness). I'm fine with chill-medium censuses, and I balked at the 24 one.
What is a reasonable census? I think 14-16 is reasonable but people have told me hospitalist jobs with 14-16 daily census are rare...

Covid-19 has messed up everything. I would like to get a FT job in a suburb with a daily census ~ 15 patients, 12 days/month (7a-7p); it's been over a month since I have talked to 2 recruiters and neither one for them has gotten back to me. Mostly looking in the south.
 
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DrMetal

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One of the great things about SDN is having role models to impart invaluable wisdom to us like this

Truly invaluable :)

It's pretty disheartening to see medical students asking how they can do less work. I get it coming from the clinician who's worked for 25 years. People need to make better choices about their career paths in life. Not many physicians under the age of 40 are working less than 50 hours a week, I'd bet on that. You're not allowed to slack as a student or a trainee. And as a young attending, you're trying to build your practice, make some money and pay off loans. This job isn't for the lazy and/or faint-hearted. I'm sorry, but that's the brutal honest truth.
 
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VA Hopeful Dr

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It's pretty disheartening to see medical students asking how they can do less work. I get it coming from the clinician who's worked for 25 years. People need to make better choices about their career paths in life. Not many physicians under the age of 40 are working less than 50 hours a week, I'd bet on that. You're not allowed to slack as a student or a trainee. And as a young attending, you're trying to build your practice, make some money and pay off loans. This job isn't for the lazy and/or faint-hearted. I'm sorry, but that's the brutal honest truth.
Depends. If you mean across all specialties, you're probably right. If you mean just in IM then I'll take that bet. My wife's former hospitalist group does 12 shifts per month. At 12 hours per shift across 4 weeks that's 36 hours/week. It's actually less than that as staying the full 12 hours every single day was rare and most months have slightly more than 4 weeks. The hospitalist group here where we live now does the traditional 7 on 7 off which gives you somewhere in the 40s depending on how each month falls. Our outpatient internists work at most 8-5 M-F. Even if they work through lunch that's still only 45 hours.
 

CCM-MD

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Depends. If you mean across all specialties, you're probably right. If you mean just in IM then I'll take that bet. My wife's former hospitalist group does 12 shifts per month. At 12 hours per shift across 4 weeks that's 36 hours/week. It's actually less than that as staying the full 12 hours every single day was rare and most months have slightly more than 4 weeks. The hospitalist group here where we live now does the traditional 7 on 7 off which gives you somewhere in the 40s depending on how each month falls. Our outpatient internists work at most 8-5 M-F. Even if they work through lunch that's still only 45 hours.

The hospitalist group where I am does 16, 8 hour shifts per month. The “rounders” can leave when they are done unless they are on call. They get about 300k. Probably average 35h per week. Pretty good gig.
 

Trousseau

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It's pretty disheartening to see medical students asking how they can do less work. I get it coming from the clinician who's worked for 25 years. People need to make better choices about their career paths in life. Not many physicians under the age of 40 are working less than 50 hours a week, I'd bet on that. You're not allowed to slack as a student or a trainee. And as a young attending, you're trying to build your practice, make some money and pay off loans. This job isn't for the lazy and/or faint-hearted. I'm sorry, but that's the brutal honest truth.

I think it's fine. I had a similar attitude in medical school. I grew out of it by the second month of residency (am a PGY3 now). Medical school can be demoralizing for a lot of people, but residency is different.
 
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FM or radiology would be my suggestion. Radiology residency call can be brutal (or so I heard), but their daily residency schedule seems pretty good. You will have to study... but you got into medicine so studying shouldn't be an issue. Plus, the enormous vacation time is a plus as an attending. Derm obviously might be your style...

I don't see how your medical school lifestyle is so hard either. Aren't you a M2 or M1???? I would much rather be doing this (studying 3-6 hours a day while getting average + scores) and having lots of free time (which will go away 3rd 4th year) than some accountant 9-5.
 

Clockdoc89

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I think it's fine. I had a similar attitude in medical school. I grew out of it by the second month of residency (am a PGY3 now). Medical school can be demoralizing for a lot of people, but residency is different.

That is nice to hear. I feel very demoralized ever since mid-point of third year. I am hoping residency will be better.
 

Splenda88

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That is nice to hear. I feel very demoralized ever since mid-point of third year. I am hoping residency will be better.
Marginally better just because you won't be standing pretending you care. Hours are brutal man.
 
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Clockdoc89

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Marginally better just because you won't be standing pretending you care. Hours are brutal man.

Well, I guess it's better to go in expecting it to suck and be proven right rather than expect it to be good and be...brutally proven wrong.
 
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jacksparrow82

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Medical school has taught me the importance of lifestyle. I realized that I no longer have the interest to work too hard. So I'm soul searching.

I'm thinking FM because of the flexibility and the sheer volume of job offers in primary care (3-4 day work weeks, no call, no inpatient, no OB, no nights, no weekends) in desirable locations. There is no shortage of primary care jobs. All for the same pay as a hospitalist. Is primary care easier than hospitalist?

I keep hearing medicine is "not chill". Is this true? Is being a hospitalist stressful, very work intensive and you burn out more easily? Is the job heavily intellectually demanding (I do like repetitiveness and being on autopilot) or do you get the hang of things and just automatically work?

Also:

Who is better at inpatient: IM or FM?
Who is better at outpatient: IM or FM?

Why would someone choose IM over FM if they want to be a hospitalist? They both can do it. Doesn't FM give you more flexibility?

Hospitalist for 10 years here. Is hospitalist work "chill?" Depends entirely on where you work. My first job out of residency was brutal in a lot of ways. Way harder than residency. Very busy practice, very busy call days, got burnt out fairly quickly and left. I now work in a semi-rural location. Job is mostly very chill. Today I have only 11 patients on my census and my NP is seeing 3 of them. 2 of them are in the ICU and the Intensivitist does all of the work and fields all the phone calls for them. I'm on call either 7-1 or 1-7 every day. We usually only admit 3-5 in the afternoons and 1-2 in the mornings. And I'm currently being paid a very good rate for the area because they were desperate for physicians and I negotiated it. I've consistently made over 300k the last several years here. So yeah, my job is CHILL. It's not very hard for me to see patients after 10 years of experience and our patients are relatively low acuity so rounding is very fast. I'm usually quite bored at work though and can't wait to get out of here each day. Fortunately we're able to leave when we're not on call. It would be torture to sit here all day when not on call.

HOWEVER...the job is unstable. The hospital is a money losing entity and has been bought up by a bigger health care system in the region, in part because of the whole pandemic. They take over soon and will probably bring a lot more business here. There's a good chance this place will no longer be chill for much longer, which is the general trend in hospital medicine...big corporate money comes in and starts squeezing docs hard. Add to this the fact that I'm not board certified and I'm no longer board eligible (as of this year) so my job outlooks are not great. I probably won't be offered a job with the new hospital system once they are fully up and running (which could be a few years down the road). Fortunately for me, I didn't want to continue this career for much longer anyway. So, I'm planning on looking for a new, non-medical career once this job dries up. In the mean time, I'm saving pretty aggressively and have enough cash on hand to pay the bills for quite some time while searching for a new career.

If you're a med student and already saying you don't want to work too hard, my advice to you is this: Save nearly every dime you make immediately. Pay off your student loans immediately. Do NOT increase your lifestyle at all. Do NOT buy a house. Do NOT buy a new car. Do NOT spend anything more than you spend now as a student. You will burn out very quickly and be unable to work for very long in today's medical system. Start thinking of new career opportunities for yourself now, because likely you'll be searching for a new career within about 5 years of practice (you may not even survive residency to be honest). Also, the only thing that matters these days in medicine is "board certification" If you can't pass IM or FM boards, you will be nearly unemployable as a physician. This will be even more true by time you finish residency. So, don't waste any time trying to be academic or even bother being a good person. Employers won't even consider you or look at your application unless you have passed one of those pointless multiple choice memory games. Spend all your time starting now memorizing board review questions and figure out how to pass. I can't tell you how many TERRIBLE physicians I know and have worked with who are "board certified" Nothing else matters. Seriously.

Being a student is fun and easy. Working in the real world is usually neither of these things.
 
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