is it easy for a DO to become a hospitalist?

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aspiring20

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i just became aware of this 200k+ specialty, and after doing some research, it does seem appealing to me.

so to qualify for a hospitalist position, you just got to do a 3 year IM residency, right?

if you are a DO that can only match into a low/mid tier residency, will you be a competitive applicant for a hospitalist position? to my knowledge, it doesnt seem like a competitive specialty.

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Yes. Pretty much any internal medicine residency will do.

Additionally, if you didn't know, many hosptilists work 1 week on and 1 week off. However, sometimes it's 2 weeks on and 1 week off, or 3 weeks on and 1 week off. Nevertheless, it's rare to actually work every day as a hospitialist.
 
Yes. Pretty much any internal medicine residency will do.

Additionally, if you didn't know, many hosptilists work 1 week on and 1 week off. However, sometimes it's 2 weeks on and 1 week off, or 3 weeks on and 1 week off. Nevertheless, it's rare to actually work every day as a hospitialist.
it sounds like a great career option. so why isn't this super competitive?
 
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Because it's not about the residency, it's about the job structure afterwards. Many folks don't like living in the hospital every day. I gave up hospitalist because of all the new regulations forcing doctors to input all the orders (the ward clerk used to do that) and other things that I don't agree with. Some people don't like working ICU or doing lines or managing vents.

Be aware that once you are looking for hospitalist jobs you can be FP or IM to do the job. They will never ask about what "tier" residency you went to. What matters is that you are board certified without malpractice issues.
 
it sounds like a great career option. so why isn't this super competitive?

Hah, its what many, if not most, non-fellowship trained internal medicine doctors do. It's not a unique career or anything.

People, at least me, do not like internal medicine because of the social bull**** you deal with, as well as all the paper work and notes.
 
Hah, its what many, if not most, non-fellowship trained internal medicine doctors do. It's not a unique career or anything.

People, at least me, do not like internal medicine because of the social bullcrap you deal with, as well as all the paper work and notes.
You don't enjoy hour long family meetings? You don't enjoy having to try and admit your patients for "inpatient" criteria X 3d so they can get Medicare SNF placement?

C'mon man, live the dream! 😉

The only way I want to do inpatient in the future is if I end up at an academic program and have to cover a week at a time. Otherwise, no way, Jose.

Edit: all that said, I'll have to deal with the "crap" in the office anyways.
 
Hah, its what many, if not most, non-fellowship trained internal medicine doctors do. It's not a unique career or anything.

People, at least me, do not like internal medicine because of the social bullcrap you deal with, as well as all the paper work and notes.
Because it's a soul crushing grind.
 
Hah, its what many, if not most, non-fellowship trained internal medicine doctors do. It's not a unique career or anything.

People, at least me, do not like internal medicine because of the social bullcrap you deal with, as well as all the paper work and notes.


Does a FP residency prepare you for a career as a hospitalist? Are FPs ready to treat very sick acute patients, do mot FP residencies have enough ICU time?
 
Does a FP residency prepare you for a career as a hospitalist? Are FPs ready to treat very sick acute patients, do mot FP residencies have enough ICU time?

Yea, I think so. Many FM residencies are mostly inpatient medicine (9 months inpatient and 3 months outpatient per year). I don't know much about FM, Bacchus and cabinbuilder will be able to answer the question better.
 
it sounds like a great career option. so why isn't this super competitive?
Basically you work as a cog in a soul-crushing bureaucracy. You don't get much respect from any of the specialists or subspecialists in the hospital. If you aren't down with block scheduling, your life can suck. You also have virtually no autonomy.

Personally, I'd take hospitalist work over outpatient primary care any day though. They're both grinds, but I'm used to the hospital one, I'm perfectly fine being an employee, I'm used to not getting a whole lot of respect, and grunt work and bureaucracy don't bother me all that much. It is not, however, a dream job.
 
Hah, its what many, if not most, non-fellowship trained internal medicine doctors do. It's not a unique career or anything.

People, at least me, do not like internal medicine because of the social bullcrap you deal with, as well as all the paper work and notes.
What kind of social crap? I have heard this before but don't really know specifics
 
Yea, I think so. Many FM residencies are mostly inpatient medicine (9 months inpatient and 3 months outpatient per year). I don't know much about FM, Bacchus and cabinbuilder will be able to answer the question better.
I'd recommend if you want to be an FP hospitalist you should probably go to an unopposed program because of the amount of experience you get. That said, I'm at an opposed, dually-accredited program and I get one month of ICU intern year and another month 2nd year. I have one month of hospital service as an intern, then a 2nd, and finally a third year. You do a month of night float each year. There is also 2 months of inpatient pediatrics split between 1st and 2nd year. If I had to wager, I'd say my classmates at unopposed programs will be better prepared for hospital work than myself, although I wouldn't be "underqualified."
 
What kind of social crap? I have heard this before but don't really know specifics
There's a patient on our service who will be in the hospital for several weeks in order to get a bed because of the patient's state insurance. The county representative has to see the patient and then the state representative does.

Per Medicare guidelines, a patient has to meet 3 days worth of inpatient criteria in order to have Medicare pay for placement at a Skilled Nursing Facility (SNF).

Want your Medicaid patient to leave on a certain drug their insurance doesn't cover? Tough luck. Maybe you'll be able to converse back and forth with case management to find something that is 1) appropriate and 2) covered.

The same goes for trying to get the patient seen as an outpatient by certain specialists. They don't take Medicaid? Oh well, better figure something out.
 
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What kind of social crap? I have heard this before but don't really know specifics
When you're dealing with discharge planning, the social issues of the patient become a problem. Do they have a safe place to go home to? Are they homeless? Do they even have a ride to get home? How will they get their medication? Do they have anyone to help them while they recover? Oh, they don't? Well does their insurance cover ECFs? Oh it doesn't? Well what the hell do we do now!?

I'm assuming he's referring to that sort of stuff.
 
Yea, I think so. Many FM residencies are mostly inpatient medicine (9 months inpatient and 3 months outpatient per year). I don't know much about FM, Bacchus and cabinbuilder will be able to answer the question better.
My FP residency I had a total of 9 months of hospitalist service over 3 years that included ICU. Our ICU was small - 13 beds. I was at an unopposed program. I didn't really learn vent management because we had a staff pulmonologist who managed those cases. I can do all other ICU care but don't take care of the vent management portion just because it's a safety issue for the patient. I do the rest though. Unlike bacchus, we didn't have ped admission at our hospital due to children's hospital in town. So I have zero inpatient peds in residency, only outpatient.
 
Oh, I guess the training is more different than I thought. I do 4 months ICU my intern year and 3 to 4 months every other year. The ICU type varies from cardiac, medical, surgical and CT ICU.
 
My FP residency I had a total of 9 months of hospitalist service over 3 years that included ICU. Our ICU was small - 13 beds. I was at an unopposed program. I didn't really learn vent management because we had a staff pulmonologist who managed those cases. I can do all other ICU care but don't take care of the vent management portion just because it's a safety issue for the patient. I do the rest though. Unlike bacchus, we didn't have ped admission at our hospital due to children's hospital in town. So I have zero inpatient peds in residency, only outpatient.
Although I always complain about it on call, when you have 3 pending peds admissions a night, which isn't too uncommon for us, you learn your peds pretty quickly. It's been a good experience.
 
I'm shadowing a hospitalist right now and he wishes he done Dermatology. He's over worked as a Hospitalist and can easily see 30+ patients in this hospital. But for some reason, I like hospital medicine.
 
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I'm shadowing a hospitalist right now and he wishes he done Dermatology. He's over worked as a Hospitalist and can easily see 30+ patients in this hospital. But for some reason, I like hospital medicine.

doesn't a hospitalist and a dermatologist both make in the 200 k range?
 
All these things I read on this forum about IM and being a hospitalist is:

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doesn't a hospitalist and a dermatologist both make in the 200 k range?
Working conditions are more important than pay. In fact, most complaints on here from doctors seem to be issues with working conditions, more so than their pay. For instance, there are some radiologists making 350-500k (great money) but the pace at which they are pressured to work make them feel like they're in a sweatshop.
 
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Working conditions are more important than pay. In fact, most complaints on here from doctors seem to be issues with working conditions, more so than their pay. For instance, there are radiologists making 350-500k (great money) but the pace at which they are pressured to work make them feel like they're in a sweatshop.
My mom works with the sister of a radiologist who is never at work(she gets very jealous I hear). He gets films sent to his computer at home and he loves it. Paid very well. His kids wreck cars and breaks new iPhones and he will just go out and buy another one.
 
i understand working condition is very important. but the location-based pay gap can be very severe it seems
 
The old saying of if it sounds too good to be true....

There is a reason you need to give a week off every other week to fill many of these jobs.
 
i just became aware of this 200k+ specialty, and after doing some research, it does seem appealing to me.

so to qualify for a hospitalist position, you just got to do a 3 year IM residency, right?

if you are a DO that can only match into a low/mid tier residency, will you be a competitive applicant for a hospitalist position? to my knowledge, it doesnt seem like a competitive specialty.

Yes, you can be a hospitalist as a DO....because a lot of people don't want to do it.
 
I'm shadowing a hospitalist right now and he wishes he done Dermatology. He's over worked as a Hospitalist and can easily see 30+ patients in this hospital. But for some reason, I like hospital medicine.

But...COULD he do Dermatology.
 
I'd recommend if you want to be an FP hospitalist you should probably go to an unopposed program because of the amount of experience you get. That said, I'm at an opposed, dually-accredited program and I get one month of ICU intern year and another month 2nd year. I have one month of hospital service as an intern, then a 2nd, and finally a third year. You do a month of night float each year. There is also 2 months of inpatient pediatrics split between 1st and 2nd year. If I had to wager, I'd say my classmates at unopposed programs will be better prepared for hospital work than myself, although I wouldn't be "underqualified."
What is an unopposed program?
 
There's a patient on our service who will be in the hospital for several weeks in order to get a bed because of the patient's state insurance. The county representative has to see the patient and then the state representative does.

Per Medicare guidelines, a patient has to meet 3 days worth of inpatient criteria in order to have Medicare pay for placement at a Skilled Nursing Facility (SNF).

Want your Medicaid patient to leave on a certain drug their insurance doesn't cover? Tough luck. Maybe you'll be able to converse back and forth with case management to find something that is 1) appropriate and 2) covered.

The same goes for trying to get the patient seen as an outpatient by certain specialists. They don't take Medicaid? Oh well, better figure something out.

Well doesn't that patient need help either way? That's the system you work in; that's surprising? Is it possible to be an advocate for these patients as well and make somewhat of a difference?
 
When you're dealing with discharge planning, the social issues of the patient become a problem. Do they have a safe place to go home to? Are they homeless? Do they even have a ride to get home? How will they get their medication? Do they have anyone to help them while they recover? Oh, they don't? Well does their insurance cover ECFs? Oh it doesn't? Well what the hell do we do now!?

I'm assuming he's referring to that sort of stuff.

I don't get this comment. How are social issues bs? "What??! Some people can't afford our vastly overpriced class based healthcare system?"
 
I don't get this comment. How are social issues bs? "What??! Some people can't afford our vastly overpriced class based healthcare system?"
It is completely inefficient for an MD to do the majority of these tasks, but without an army of social workers, you have to do them to "move the meat"
 
I don't get this comment. How are social issues bs? "What??! Some people can't afford our vastly overpriced class based healthcare system?"
I never referred to them as BS. I was giving examples of how nightmarish the social side of discharge planning can be. It isn't about money, it's about difficulty. What do you do with a guy that is unable to take care of himself, has no insurance so no ECF will take him, has no family that can take care of him, and the hospital is telling you he has to be discharged because he no longer needs inpatient treatment?

It's also about resources. What can you do? You sure as hell aren't going to take him home with you and go to the pharmacy and get his meds and rehabilitate him yourself. So who is? The government won't. You can't just drop him on the doorstep of an ECF or rehab facility with a note. His family is nonexistant. But he surely cannot take care of himself. And yet you are expected to somehow make resources appear out of thin air to provide this gentleman with a comfortable transition to independent living. And when patients, particularly Medicare and Medicaid patients, don't make that transition, you and the hospital are on the hook, no matter how hard you tried.
 
I never referred to them as BS. I was giving examples of how nightmarish the social side of discharge planning can be. It isn't about money, it's about difficulty. What do you do with a guy that is unable to take care of himself, has no insurance so no ECF will take him, has no family that can take care of him, and the hospital is telling you he has to be discharged because he no longer needs inpatient treatment?

It's also about resources. What can you do? You sure as hell aren't going to take him home with you and go to the pharmacy and get his meds and rehabilitate him yourself. So who is? The government won't. You can't just drop him on the doorstep of an ECF or rehab facility with a note. His family is nonexistant. But he surely cannot take care of himself. And yet you are expected to somehow make resources appear out of thin air to provide this gentleman with a comfortable transition to independent living. And when patients, particularly Medicare and Medicaid patients, don't make that transition, you and the hospital are on the hook, no matter how hard you tried.

Why not discharge him and say your hands are tied?
 
It is completely inefficient for an MD to do the majority of these tasks, but without an army of social workers, you have to do them to "move the meat"
Well what happens if you put them on the street and skip the social issues?
 
I don't get this comment. How are social issues bs? "What??! Some people can't afford our vastly overpriced class based healthcare system?"
You must really believe that most people who got into medicine is because they want to help people! I remember the chief anesthesiologist where I work was complaining in the OR how it is going to be difficult for him to pay his bills because of 10% decrease reimbursement for GAS Doc... He was complaining in front of surgical tech, rad tech ect (people who make $15-20/hr). The sad part about it is that his wife is an anesthesiologist too. They might have a combined income of 800k+/year. When that guy left the room, the ortho surgeon blasted him.
 
Negligence claims and/or lawsuit if there is a bad outcome post discharge.
So why isn't the administration responsible if they're the ones pushing the discharge?
 
You must really believe that most people who got into medicine is because they want to help people! I remember the chief anesthesiologist where I work was complaining in the OR how it is going to be difficult for him to pay his bills because of 10% decrease reimbursement for GAS Doc... He was complaining in front of surgical tech, rad tech ect (people who make $15-20/hr). The sad part about it is that his wife is an anesthesiologist too. They might have a combined income of 800k+/year. When that guy left the room, the ortho surgeon blasted him.

No not at all. I just believe that people should know what they're getting themselves into. And I think anyone, regardless of salary, would be bitching if their salary was decreased.
 
Why not discharge him and say your hands are tied?
Because if he goes out and dies because you wrecklessly discharged him you're on the hook for it. Discharge planning is a part of patient care and your job as a physician. If you don't do it right and something happens that can be traced back to you, your ass can be on the line. So you kind of have to do whatever you possibly can to make sure your patient finds some level of acceptable care post discharge.

(Edited because I read your post wrong the first time lol, thought you said why don't you not discharge him.)
 
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What is an unopposed program?
It means there are not other residency programs there so you wouldn't have to fight for procedures on patients. Where I went to residency it was just family practice so we did everything and took care of every aspect of the patients. So if a person needed a central line in the ICU or on the floor, we did the line, not an IM resdent.
 
What is an unopposed program?

Basically refers to a Family Medicine program in which there are no other residency programs at that hospital, meaning no other Internal Medicine or Pediatrics or General Surgery etc residents taking away from your educational experience. Usually these programs are more rigorous because you're doing a lot of things that in other hospitals the other residents would be doing.
 
Well doesn't that patient need help either way? That's the system you work in; that's surprising? Is it possible to be an advocate for these patients as well and make somewhat of a difference?
Am I surprised? No. There's a caste system in the health insurance world. It's more a reflection of my disgust of having to "play by their (insurance company) rules" than provide my patient the care I think he or she deserves.
 
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