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Need a job and willing to work in Dallas (2)?

Discussion in 'Anesthesiology' started by UTSouthwestern, Dec 18, 2005.

  1. UTSouthwestern

    UTSouthwestern 1K Member
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    For those interested in this job opportunity and not the arguments on the other hijacked thread:

    Hey everyone, sorry I haven't been posting as frequently as before, but as the title implies, I and my group have been ridiculously busy and are looking to hire locums, permanent, etc.

    I have kind of maxed out my connections trying to find quality candidates so I wanted to open the gates for anyone who might be interested in living in Dallas.

    First and foremost, however, is that you have to have great skills and be personable and REASONABLE/LOGICAL. There is a story behind the latter that I will have to type up one day.

    Although we have a heavy cardiac practice, the locums people will not be responsible for that and we can work out an arrangement for a permanent hire that does not want to do cardiac.

    Bottom line is we are busy, BUSY, B U S Y and we need good people.

    PM me with any questions.


    Originally Posted by apma77
    ofcourse now the question no one wants to ask..what kinda $$$?



    It depends on what you are willing to do. If you do not put any limitations on what cases you will do, as a partner you will make high six figures. We have created a new contract for those unwilling to do cardiac in which your income would be less, but still 400-500+ as a partner. It's a three year partnership track but the work load is shared equally and I have only been in the hospital on three times on weekend home call in 6 months. No overnight in house call. No OB. No trauma. We are a hard working group but we also know where our priorities are and we have managed to create a high paying yet lifestyle conscious business situation that has both us and our surgeons happy. We just keep adding more surgeons and we need more quality us.

    We are also hiring for two Fort Worth groups at two hospitals we have exclusive contracts at. Salary there is 400K from the start.

    PM me for more details.


    Originally Posted by aredoubleyou
    What kinds of things are turning you off from candidates after looking at them closely? What things are you worried about affecting productivity?



    Mostly it's when we follow up with the references listed. We do actually call them and ask questions and some give a very different description on the phone compared to the letters they have written. We also have friends among both the anesthesia and surgery faculty at many major institutions and we try to confirm that the candidates are good candidates.

    "He's got all of the skills and his knowledge base is impressive, but he's lazy, tries to find every way to do as little as possible, and passes off work to other residents whenever possible." That's a direct quote from one professor I spoke to. I don't always take one view as the gospel but when two others also voiced their hesitation to fully endorse him, we knew we had to move on.

    It's not a difficult set of criteria: We want young, enthusiastic, and easy going people who work hard, are team players, and know how to provide fast and safe anesthesia. Cardiac experience/desire is a plus, but not a necessity.
     
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  3. jetproppilot

    jetproppilot Turboprop Driver
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    UT,

    at this VERY moment I'm talking with my boss about your opportunity.

    I'd love to live in Dallas. Have spent some memorable nights in Deep Ellum (sic?)

    Unfortunately, my wife is married to New Orleans as much as she is married to me...

    BUT I'M KEEPING THE PRESSURE ON.

    ONE MORE LEVY BREACH AND I'M GONNA BE NORM'S PARTNER, WIFEY OR NO WIFEY. :smuggrin:
     
  4. UTSouthwestern

    UTSouthwestern 1K Member
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    Jobs aplenty here. I'd love to have you here Jet.
     
  5. davvid2700

    davvid2700 Membership Revoked
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    does texas consider a locums texas license or do you have to have a full texas license?

    I asked this question before jetpropilot accosted me...
     
  6. UTSouthwestern

    UTSouthwestern 1K Member
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    I believe a full Texas license, but I have asked that question of my office and should get a response today.
     
  7. UTSouthwestern

    UTSouthwestern 1K Member
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    License question appears to be locums license is OK.
     
  8. canjosh

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    You spelled 'Ellum' correctly my man. And you actually remember being there...impressive. Are the memories at least a little fuzzy? :D
     
  9. jetproppilot

    jetproppilot Turboprop Driver
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    HAHAHA...nah, didnt do any drinking binges there...although I did have some sake with my sushi...
     
  10. imnodr

    imnodr Junior Member
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    Theres's a place down there called DEEP SUSHI that's owned by a couple of surgeons I used to work with.
     
  11. LADoc00

    LADoc00 There is no substitute for victory.
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    You make me sick. Im gonna have to pummel some anesthesia residents to make up for insecurities now.
     
  12. UTSouthwestern

    UTSouthwestern 1K Member
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    Careful what you say, now. One may be carrying a stick of Sux.
     
  13. LADoc00

    LADoc00 There is no substitute for victory.
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    Dude, hire me. Im triple boarded in pathology, can read specimens, do autopsies when you kill people and make a damn mean vanilla latte. I only ask 400K and a Porsche Carrera, nothing more. I can expedite your blood product requests too.
     
  14. UTSouthwestern

    UTSouthwestern 1K Member
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    Send me a CV and I'll get creative with it and forward it to my partners. :D
     
  15. jetproppilot

    jetproppilot Turboprop Driver
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    UT, you could put the Dude in the eye room and he'd do just fine. Give him one of those med alert necklaces with a button on it to push if anything goes wrong. :laugh:
     
  16. UTSouthwestern

    UTSouthwestern 1K Member
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    At this point, that may be an option we have to consider. We had to give away TWO columns of work today and it was a light day today. Two columns of privately insured neuro spine, ENT, and sports med ortho. It kills me to see that.
     
  17. jetproppilot

    jetproppilot Turboprop Driver
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    Geez. I feel ya. Giving away primo cases is like pouring a glass of 1999 Silver Oak Alexander Valley Cabernet , swirlin' it a cuppla times, and handing it to your caterer.... :scared:
     
  18. UTSouthwestern

    UTSouthwestern 1K Member
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    A $25,000 bottle of Cabernet.
     
  19. Monty Python

    Monty Python Icelandic (see avatar) doesn't translate well.
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    This is asked strictly out of curiosity of how you run the board, not out of business noseyness.

    To whom do you give away two columns of work? Are there other anesthesia groups there who get the leftovers? Are there several competing groups at your hospitals and the surgeons indicate who their preferred group is for any particular case?

    My main hospital has one group that gets everything (with very rare exception). Just wondering how other hospitals with multiple anesthesia groups working simultaneously do it.
     
  20. UTSouthwestern

    UTSouthwestern 1K Member
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    We give cases to guys who have helped us in the past and who have asked us for help in the past (not just dumped sick as **** patients on us that they were too afraid to do). Sometimes we have to give them to other groups, but most of the time, we give them to independents or specific individuals in other groups who may have credentials at the hospital of interest but don't frequently practice there.
     
  21. Lonestar

    Lonestar Senior Member
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    Hell ya, where do i sign up? Oh wait, i got 2.5 years to go. Oh well, better luck next time. :rolleyes:
     
  22. UTSouthwestern

    UTSouthwestern 1K Member
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    Work your ass off and do as many sick patients as you can in residency and you will have more options than you can possibly dream of having.
     
  23. Khalid

    Khalid Junior Member
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    Hi all, I'm just coming off the job hunt trail (I complete my residency at a Top 10 med center in June) where i recently consumated my first contract. Yippee!

    I conducted a NATIONWIDE job search and Dallas was VERY much in the mix of locales i was interested in going to (great vibe, growing, sports, excellent housing options). However, here was my experience with Dallas if I remember correctly (its been a couple of months):

    Dallas appears to be a collection 17 or so groups fighting for market share in the large, growing, Dallas Metroplex using one management company to do its recruiting. If I recall, its mostly fee for service groups ("eat what you kill!") meaning the more you work the more you make essentially. Its a dog-eat-dog mentality I pictured with those partners at the top of the ladder really controlling the flow that really turned me off.

    Here's the kicker though--they all appeared to have a ridiculous 3 year partnership track and the starting salaries was only $170 Grand. In addition to the ridiculous 3 year track, stories are rife in "eat what you kill" environments about groups NOT extending partnership offers once your 3 years of servitude are complete.

    So ask yourself this, why would such vibrant cities as Dallas (and to an even larger extent Phoenix) have such difficulties attracting great potential partners??? The truth is in the details, and places with largely fee for service environments are really hurting it would appear.

    UT's group may be (and probably is!) much different, but I thought I'd share my view of Dallas for anyone interested..
     
  24. toughlife

    toughlife Resident
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    I never liked the idea of working for a group. Why would I want to let another dude make money off me?
     
  25. bullard

    bullard Senior Member
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    So that when you're a partner, you can make money off of somebody else and have more free time. It's not complicated.
     
  26. Khalid

    Khalid Junior Member
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    True, Bullard, but there is no gurantee you'll be offered partnership once they've milked you. Of course, this is true in ANY group with a partnership track, but fee-for-service groups are particularly notorious for doing this. There is all the incentive to do just this unfortunately.
     
  27. UTSouthwestern

    UTSouthwestern 1K Member
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    I know which groups you interviewed with. :D

    Eat what you kill is primarily one group. That group is a big group but functions more as a combination of independent practitioners under one corporate billing/credentialing/management structure.

    170K starting in Dallas is not the offers I got (ranged from $200K to 70-80% of what you bill or more, with benefits and incentives/overtime for those offers at the lower end - sell a week of vacation time for $10-15K to a partner, take extra call, etc.). You interviewed with Pinnacle Anesthesia Consultants using their recruiter/recruiting service. They used to be the big ape on the block, but the non associated groups have grown while Pinnacle has stagnated. You were probably "directed" to specific groups based on the information you provided the recruiter. While I think that is fine, I would have recommended you interview with at least a dozen non Pinnacle groups that I suspect would have made you a better offer and offered you better locations to work at.

    I'd say the majority of practices here are some type of lump and divide business practice - partners paid equally or paid a prorated rate based on points, time, etc.

    It isn't difficult for the groups to attract people here to work. I guess for my group, it's the pickiness with which our group screens candidates. Of the candidates that have PM'd me with CV's, only two so far have been offered an invitation to interview out of more than two dozen CV's so far. All are good candidates and three will be interviewing for our Fort Worth groups, but we are still looking for some more candidates for the main group.

    As for the other groups in town, the people they have hired this year alone are a veritable who's who collection, with people ranging from residents of programs across the nation to multiple chief residents and fellows to a chairman of cardiac anesthesia from a west coast program and a number of strong faculty from strong programs including three from my own program's faculty.

    I wish you had contacted me so that I could have given you some recommendations on other groups to interview with besides Pinnacle and TXAN.
     
  28. UTSouthwestern

    UTSouthwestern 1K Member
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    I hope that's not all you think a group is good for. Back up, shared calls, benefit of lower liability insurance and health insurance costs, shared overhead costs, billing and management issues handled by office staff that is not likely affordable as an independent contractor, etc.
     
  29. bullard

    bullard Senior Member
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    Sure. Taking advantage of economies of scale. But less call is the sweetest part of all that. :D

     
  30. rs2006

    rs2006 student
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    Hi,

    Happy holidays everyone. I hope everything is going well this holiday season. Not to sound entirely disrespectful to the post above (thanks UT Southwestern, JPP, militarymd, etc for all the great advice you have provided over the years), but 170k/yr does not seem that bad and I am suprised that a salary figure like that is being complained about in this forum. Given the fact that there are many other specialties out there that make similar amounts of money, I do not feel that you should be complaining. After all, $170k is enough to put food on the table, have a nice house, car, etc. My main question which I have for all of you attendings here is what the reality is of billing in anesthesia-- I have heard from many docs in other specialties that it is quite common for docs to end up actually collecting a relatively small percentage of what they bill for-- how does it work in anesthesia (and other specialties if you have any insight)-- do you have to bill for much more money to get a little-- Also, given that medicare patients are only going to be increasing (population is aging), how does one bill medicare for their services since I have heard that their compensation is poor to say the least-- is it still possible to earn the kind of money quoted above working with medicare patients? Any thoughts would be much appreciated and I apologize if I have antagonized the poster above. Merry Christmas.
     
  31. jetproppilot

    jetproppilot Turboprop Driver
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    RS,

    I've posted several lengthy posts on this subject...try searching the anesthesia forum first and I'll bet the posts will pop up.
    If you dont have ant luck with that, say so and we'll give another rundown.
     
  32. MedicinePowder

    MedicinePowder Senior Member
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    Spoken like a true naive, idealistic, and egocentric individual. Everything is relative, and under the current market the value is on the lower-end. Lastly, don't tell people how much money they should be happy with---go to a communist country for that.
     
  33. CameronFrye

    CameronFrye Senior Member
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    I agree that 170k/yr is a nice sum of money, but currently for anesthesia, it's garbage.
     
  34. Noyac

    Noyac ASA Member
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    Not just for anesthesia is it garbage but for any MD/DO field, IMHO.
     
  35. Monty Python

    Monty Python Icelandic (see avatar) doesn't translate well.
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    Unless everyone keeps up the pressure on Congress to reverse the upcoming 4+% cuts in Medicare reimbursements, 170K/yr may go down as well.

    http://www.asahq.org/Newsletters/2005/12-05/washReport12_05.html

    Keep those cards and letters going to YOUR elected officials.
     
  36. toughlife

    toughlife Resident
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    I hear you, but I would feel more comfortable, and could look at co-workers(other physicians) in the eye knowing that we all work the same and earn the same and no one is taken advantage of. Who knows maybe I will learn to be a shark as time goes by just to survive but it is just not right in my book to milk others like that.
     
  37. Noyac

    Noyac ASA Member
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    Just curious and I am not condoning the practice but if you had built a practice with the help of a few others, would you give everyone wanting to join your practice equal standing? If not, how would you go about designing a partnership track?
     
  38. militarymd

    militarymd SDN Angel
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    Right now, our group offers all workers equal pay from day one. The only difference is that non-partners do not have a say in the operations of the group.

    So it is possible that in the future, the "partners" may change how the pay is distributed.
     
  39. jetproppilot

    jetproppilot Turboprop Driver
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    In my first gig I had a 2 year partnership track with minimal monetary buy-in. I thought it was fair; the 3 anesthesiologists I was joining were in fact there before me and had started what eventually became a very good thing for all of us.
    Especially for new grads, its impossible for you (which was me at the time) to contribute on the same level as someone who has been there longer, assuming the guys that have been there longer are hard, motivated anesthesiologists, are well liked/respected, etc.

    So I think there are groups out there that offer fair partnership tracks.

    That being said, there are many groups that offer unfair partnership tracks...and the word "unfair" is open for opinion...I'd say most groups, not all, that require more than two years plus 100-150K buy-ins are on the high side...

    The deals are so variable out there it is hard to generalize.

    My opinion is that it is reasonable for a new clinician to do some type of buy-in, but I differ in that I do not think one should have to do time-at-a-salary plus a huge sum of money, say three years partnership at 300K plus 150K buy-in. The time spent at a lower income is enough.

    Just a note on monetary buy-ins for clarification for the residents out there...even though I dont believe in them...it is not like you are paying that amount of money and will never see it again. In many groups opinion, it is your contribution...and you may either benefit or lose.

    The groups that do monetary buy-ins for new partners are requiring you to contribute what they have contributed previous to you to the company's accounts receivable, to the groups (hopefully) stellar reputation, etc... because when you leave the group as a partner, you will be entitled to a "buy-out" which usually amounts to your percentage of 90 days of accounts receivable. Your "buy-out" is like a stock...if your accounts receivable doubles by the time you leave, you will receive twice the amount of your buy-in...if business is half of what it was when you bought in, you will receive half of what you bought in for.

    The nebulous part is...how much is it worth for a new clinician to work on a salary for 1-2 years? IMHO that should be the buy-in, because typically you are working for about 50-60% of what the partners make.

    SO, if a group is requiring you to do time-plus a large sum of money, in my opinion, that is unfair. But it is common practice.
     
  40. toughlife

    toughlife Resident
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    I would emulate militaryMD's model. Equal pay, equal call, with less decision making power for the newbies. I prefer that you earn what you work for. If you are out there killing yourself taking call, working weekends and holidays and I am just at home scratching my balls, why do I have the right to earn more than you?

    I do not like the idea of salaries because it promotes complacency. If you work you eat, if not then you starve. Simple.
     
  41. jetproppilot

    jetproppilot Turboprop Driver
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    I too agree that equal call is a must from day one to keep the respect of your new colleagues.
     
  42. jetproppilot

    jetproppilot Turboprop Driver
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    Point very well taken, but the sum of money is kinda irrelevant. I think whats more important is the market in general...no matter what your trade.

    In other words, if you were a drywall guy in a certain region of the US, you were making twenty bucks an hour, but most guys around your area were making thirty five bucks an hour, after a while you'd be looking for better compensation.
     
  43. pmichaelmd

    pmichaelmd Senior Member
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    I know I'm still 18 months away from finishing but have been getting pressure from my consultants to start getting fellowship applications in and I've been going through the "fellowship vs job" debate in my head.

    Some of my friends who are CA-3s have been out interviewing and have gotten starting salary quotes anywhere from $175k (Florida) to $250k (Michigan) plus benefits. I always assumed that the difference in salary between what you'd make when you first came to a group and the partners was the buy-in. JPP says it's common practice to get $$$ from new hires up front as well? That kinda sucks! Yes, I know that sounds naive, but that's why I'm here, to soak up the pearls from all of you well-learned, working types :)

    I have also seen several job posting from the Dallas/Ft. Worth area and they always seem to be offering exceptional compensation packages (starting >$225k) but with 3 year partnership tracks (gaswork.com). Is this the norm in Dallas? Seems like a great market, one I'll be looking at in 2007 (assuming I don't do a peds fellowship).

    Thanks UTSW et al for all of the guidance you guys offer those of us up-and-coming.

    PMMD
     
  44. jetproppilot

    jetproppilot Turboprop Driver
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    Pmichael, you're already ahead of the game. I didnt know s hit about all the business in-and-outs of the anesthesia business when I accepted my first contract.

    Like I've said previously, the anesthesia game is totally dependent on location. Location probably plays a larger role than any other variant.

    The easiest way to find a job is to, like you've done, take an interest in the job search VERY early. Then set your priorities. Basically there are 3 trains of thought:

    1) I'm tired of being poor, money is the biggest issue, and I'm willing to live anywhere, as long as I'm maximizing my income potential.

    Great. I respect that. That was me in 1996. The world is your oyster. You'll probably end up in a small town for 5-10 years. BUT, there ARE lucrative practices in big cities. Look at UT's posts.

    2) I'm dead set on a certain city.

    I respect that too. May be good or bad financially.

    3) My Dad is Larry Ellison, so I dont care about my income. I respect that as well. Sounds like 25% of my (jewish) med school class. The world is more your oyster than in 1).

    Pmichael, buy-ins are common, but they are not ubiquitous. Buy-ins bother me...a buddy of mine did a 160k buy-in in Arkansas for a 400K annual salary...you can find that kinda money elsewhere without that big buy in, but again, its all about location...he's from a rich family, emerged from training with NO debt, and really wanted to live in Little Rock, so he's happy.

    Look at Mil's practice...no buy in...

    But sometimes a buy in may be worth it...UT is essentially doing a buy-in, since his pay during his first few years is not equal to a full partner...

    But think about it...if you are joining a kick-a ss company that isnt going anywhere, was established while you were in college chasing chicks, has a great reputation with optimum reimbursement, a buy-in may be worth it...

    but again, one needs to take the "buy-in" subject on a group-by-group basis, since there are many groups out there who take advantage of this.
     
  45. pmichaelmd

    pmichaelmd Senior Member
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    :thumbup: Thanks again, JPP...I appreciate the input. I'm still trying to get my mind made up about the future. I think my 4 years as a GP with pay > than my resident's salary has spoiled me...er, maybe I should say has spoiled my wife, who developed quite the shopping habit while I was plugging away in the Navy. Money certainly isn't everything to me but I do get sick of making $45k/year with bills to pay and 2 mouths other than my own to feed. Geez! Choices!!

    Cheers,
    PMMD
     
  46. UTSouthwestern

    UTSouthwestern 1K Member
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    There are many, many great jobs out there and they don't seem to be slowing down. That is why I don't mind recruiting not only for my group, but for other groups that I have respect for here in Dallas. While we compete with each other for market share, most of the anesthesiologists here have a healthy amount of respect for each other and each other's group so it makes for both a competitive, yet not cutthroat environment and over the past week, I have seen a dozen anesthesiologists from other groups show up on our schedule to help cover private insurance cases. Out of curiosity, I asked one of the surgeons on Friday who worked with a cross covering anesthesiologist if that person tried to recruit him to use his group and he told me with no hesitation, no. That makes me respect that person even more and I have offered to refer anyone here that has PM'd me about a job without hearts to him.

    Don't worry about the job market in terms of being able to find a job. You will be able to find one even in the most competitive markets in the country. You need to make yourself the most attractive candidate you can possibly be primarily with a heavy and diverse case record showing that you can handle the most difficult patients. If you feel that your case load is light and you might not have the most healthy of letters of rec, a fellowship will definitely benefit you. For myself and my co chief, we decided to make our CA-3 years the equivalent of a cardiac fellowship by working extra cases, staying late at the private hospitals, mastering TEE, and always being available to help our fellow residents no matter how tired or frustrated we became. If you can do that, you can save yourself a year of extra training and get job offers that will absolutely floor you.
     
  47. pmichaelmd

    pmichaelmd Senior Member
    10+ Year Member

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    Excellent! For me, I would be doing a fellowship out of personal interest in peds, not for letters of rec. My letters should be very good without that. My quandry is more about spending another year plugging away with wifey putting pressure on to expand our family (my son will be 4 in a few months) before too long. We're both in our early 30s and time slows for no man. I like your idea of putting in the extra time during 3rd year. I have been designing my 3rd year this past week and was going to do a mixture of things to try to diversify. Pehaps I should focus on the more difficult rotations, like cardiac, neuro, transplant. My favorites have been peds, OB, and neuro, but we'll see. To do an extra year or go out and make some $$$ to pay off loans, etc.?? Hmmm.

    I certainly appreciate any and all advice from you as you are a recent grad and frequent contributor. Same for Noyac, MilMD, JPP, Davvid, JWK, etc. I hope to be able to provide others with the same wisdom as time goes along. Please keep it up! :thumbup:

    Regards,
    PMMD
     
  48. Lizard1

    Lizard1 Member
    10+ Year Member

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    UTSouthwestern

    Sent you a PM. I am very interested.

    thanks
     

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