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I think it would be too long to tag everyone so I’ll just try to summate:

It took me a really long time to figure out if it was just my program I disliked or peds in general. I’ve concluded it’s both. For my program it is indeed quite malignant. Rumors daily. Admin who believe rumors and then discipline residents based solely on the rumors, etc. I could really go on for days but I don’t see the point. All I know is that the scheme is investigating us due to how malignant it is and our acgme surveys so there’s that…

As far peds in general: I do love children and I really enjoy being goofy with them. But that’s where the buck stops as far as my enjoyment of the job. Rounding is like dying by a million paper cuts, notes hell followed by more notes hell (useless notes mind you). I don’t do anything. Literally what do we do????? Intervention is next to nothing. It’s mostly social work. I’m convinced peds residency doesn’t need to be 3 years long. I miss doing procedures. So much. I love working with my hands (I was torn between peds and anesthesia in med school). Figured I’d go into icu but I think maybe I just had a good? Med school experience but the amount of procedures is not nearly as often as I expected or want. To really cram home this point I asked my wife if she’s noticed I’m ever happy about work. And she, a non-medicine person, said, “I’ve only seen you happy after you got to do a procedure.”

I don’t really have a peds “personality” and the constant passive aggressive bull**** runs me up a tree (I think I have a more cut and dry what you see is what you get type of personality). Sure people can say to focus on the work and not the people but stereotypes exist for a reason and I cannot see myself working with such a group for my professional career. I desire the environment with an undying passion. Even a post here is what I would call passive aggressive, unhelpful, and, imo, the typical abusive response seen often in a pediatric residency. Just ain’t for me.

I like the OR, resus, and procedures of nicu but the rounding was a HARD stop and small set of diseases seems like it would get boring

I liked the acuity of PICU but don’t enjoy the bread and butter of asthma. Also rounding.

Considered PEM but it basically seems like urgent care which is ok but I don’t want to waste 3 more years to do what I consider to be urgent care….

At this point I don’t really know what to do…. I think anesthesia might be a good fit but worried about doing the match all over and really what is diff about my app compared to being a med student? It would be a finished residency and an obligated residency research project. Maybe that will matter to PDs? Unsure. Also don’t know if I could stomach 4.5 more years of residency and then 5.5 total possibly (peds anes?).

But besides that idea at a loss. Really a huge loss.

The situation just makes me sad tbh. Perhaps it’s my own fault for being naive about how medicine really is. Dunno

I know a lot of people who switched to anesthesia from various fields, so I think PDs would be open to your situation.

That being said, what about something like allergy, where you can ultimately treat both kids and adults once you're in practice and not have any inpatient rounding to do? It would mix things up for you as far as patient variety and may be a shorter path to finishing training. Or maybe something like peds PMR and helping kids with prosthetics and other unique needs? I would think you'd get credit for your peds training but admittedly know very little about this field. Just throwing out some options where your peds training would be useful.

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I know a lot of people who switched to anesthesia from various fields, so I think PDs would be open to your situation.

That being said, what about something like allergy, where you can ultimately treat both kids and adults once you're in practice and not have any inpatient rounding to do? It would mix things up for you as far as patient variety and may be a shorter path to finishing training. Or maybe something like peds PMR and helping kids with prosthetics and other unique needs? I would think you'd get credit for your peds training but admittedly know very little about this field. Just throwing out some options where your peds training would be useful.

Peds PM&R is 6 years in addition to whatever training OP has done already. Also very niche, and has very limited job options, always must be tied to an academic center. And pay is not very good.
 
I think it would be too long to tag everyone so I’ll just try to summate:

It took me a really long time to figure out if it was just my program I disliked or peds in general. I’ve concluded it’s both. For my program it is indeed quite malignant. Rumors daily. Admin who believe rumors and then discipline residents based solely on the rumors, etc. I could really go on for days but I don’t see the point. All I know is that the scheme is investigating us due to how malignant it is and our acgme surveys so there’s that…

As far peds in general: I do love children and I really enjoy being goofy with them. But that’s where the buck stops as far as my enjoyment of the job. Rounding is like dying by a million paper cuts, notes hell followed by more notes hell (useless notes mind you). I don’t do anything. Literally what do we do????? Intervention is next to nothing. It’s mostly social work. I’m convinced peds residency doesn’t need to be 3 years long. I miss doing procedures. So much. I love working with my hands (I was torn between peds and anesthesia in med school). Figured I’d go into icu but I think maybe I just had a good? Med school experience but the amount of procedures is not nearly as often as I expected or want. To really cram home this point I asked my wife if she’s noticed I’m ever happy about work. And she, a non-medicine person, said, “I’ve only seen you happy after you got to do a procedure.”

I don’t really have a peds “personality” and the constant passive aggressive bull**** runs me up a tree (I think I have a more cut and dry what you see is what you get type of personality). Sure people can say to focus on the work and not the people but stereotypes exist for a reason and I cannot see myself working with such a group for my professional career. I desire the environment with an undying passion. Even a post here is what I would call passive aggressive, unhelpful, and, imo, the typical abusive response seen often in a pediatric residency. Just ain’t for me.

I like the OR, resus, and procedures of nicu but the rounding was a HARD stop and small set of diseases seems like it would get boring

I liked the acuity of PICU but don’t enjoy the bread and butter of asthma. Also rounding.

Considered PEM but it basically seems like urgent care which is ok but I don’t want to waste 3 more years to do what I consider to be urgent care….

At this point I don’t really know what to do…. I think anesthesia might be a good fit but worried about doing the match all over and really what is diff about my app compared to being a med student? It would be a finished residency and an obligated residency research project. Maybe that will matter to PDs? Unsure. Also don’t know if I could stomach 4.5 more years of residency and then 5.5 total possibly (peds anes?).

But besides that idea at a loss. Really a huge loss.

The situation just makes me sad tbh. Perhaps it’s my own fault for being naive about how medicine really is. Dunno
I know exactly zero about this because I am in pathology, but what about a full scope family medicine program? Lots of procedures?
 
I know exactly zero about this because I am in pathology, but what about a full scope family medicine program? Lots of procedures?

FM really doesn't have a lot of procedures. Maybe in rural areas more so, but in larger cities, procedures tend to stick with specialists.
 
I know exactly zero about this because I am in pathology, but what about a full scope family medicine program? Lots of procedures?
As I recall, one definition is doing OB, uncomplicated deliveries. Also, doing uncomplicated appendices and choles (but, I don't know what happens/happened when you get in there, and it's, all of a sudden, complicated).
 
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FM really doesn't have a lot of procedures. Maybe in rural areas more so, but in larger cities, procedures tend to stick with specialists.
Nonsense. I'd say on average I do 1 procedure a day and there's a fair number of things I do send to specialists. You can do better than that if you work UC or, as you say, rural. Or refer less than I do.
 
Nonsense. I'd say on average I do 1 procedure a day and there's a fair number of things I do send to specialists. You can do better than that if you work UC or, as you say, rural. Or refer less than I do.
Ok, educate me please. What kind of procedures do you do daily? And ot the person who said above that they would do choles or appendices as a FM, there is no better way to get sued than doing that. that would be utter insanity.
 
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Ok, educate me please. What kind of procedures do you do daily? And ot the person who said above that they would do choles or appendices as a FM, there is no better way to get sued than doing that. that would be utter insanity.
Joint injections, skin biopsies/lesion removal, cryo, toenail removal mainly. Have a partner who does IUDs/Nexplanon.
 
Ok, educate me please. What kind of procedures do you do daily? And ot the person who said above that they would do choles or appendices as a FM, there is no better way to get sued than doing that. that would be utter insanity.
Why are you so combative? That was in the past, just like, in the past, people did one year and hung up a shingle, or surgeons were surgeons and obstetricians, or rheumatology didn't exist as a subspecialty. "Utter insanity" is hyperbole. And, there are much better ways to get sued.

I'm not FM. I don't know if those are still being taught. But, they were, and, were I to go on tour in rural America, I bet I would find FM docs still doing deliveries.
 
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Why are you so combative? That was in the past, just like, in the past, people did one year and hung up a shingle, or surgeons were surgeons and obstetricians, or rheumatology didn't exist as a subspecialty. "Utter insanity" is hyperbole. And, there are much better ways to get sued.

I'm not FM. I don't know if those are still being taught. But, they were, and, were I to go on tour in rural America, I bet I would find FM docs still doing deliveries.

I'm not combative at all. Not sure why you would say that? I"m asking VA poster to educate me on what procedures he does. How is that combative?
 
I'm not combative at all. Not sure why you would say that? I"m asking VA poster to educate me on what procedures he does. How is that combative?
Ok, educate me please. What kind of procedures do you do daily? And ot the person who said above that they would do choles or appendices as a FM, there is no better way to get sued than doing that. that would be utter insanity.
The bolded are aggressive. Say them out loud. The voice can be heard as aggressive. You do you. Maybe I'm wrong (QUITE possible), but, that's how I perceived your post (colored by the tenor of other things that you have posted).
 
The bolded are aggressive. Say them out loud. The voice can be heard as aggressive. You do you. Maybe I'm wrong (QUITE possible), but, that's how I perceived your post (colored by the tenor of other things that you have posted).
Not at all. I actually wanted to know what VA does. So it was helpful for my understanding to actually know what he does, which he kindly explained.
 
You can always look for jobs while still in residency and if you find something then quit. If your mental health can handle it, I agree that you should do your best to finish the last 1.5 years.

After that it is good that you’re in peds because I think you will have a lot if different job options since peds is pretty proud and there’s lots of work out there that’s not directly clinical in regards to childhood and adolescent health if you want to draw parallels to pediatrics and a new career.

I have several per diem/contract jobs that aren’t direct clinical medicine like working in a clinic so depending on your interest there’s stuff out there. This weekend for example I need to finish up writing an article that I was asked to write, 750-1000 words, and I’m getting paid $2,000. Clinical jobs often give a lot of job security but there is something freeing about not being tied to needing 1 clinical job and being a little more creative that I love. There are things out there, good luck!
 
@SmokinJay6 I wouldn't quit unless you were suicidal. If you need to talk to someone, find someone. You have a debt that the large majority of people would not be able to repay if they left medicine. Most of us can't find or create a job with equivalent stability and more importantly, equivalent income. Also, you'll be putting your family in a massive financial hole if you leave medicine. This is difficult to fully grasp now as you’re unhappy and in the weeds, but I imagine things could get worse if you leave medicine, don't find happiness, and then you're unhappy and broke and can't provide comfortably for your family.

I'm an anesthesiologist. It's not perfect - but I like it fine enough to show up everyday and make a great income that provides for me and my family and hopefully will give us a decent retirement. I like caring for patients. I don't like being tied to the hospital or working nights and weekends. If you don't want to do that you can find outpatient jobs where you don't have to but they don't pay as well. But they still pay plenty.

If you like procedures give anesthesia a look. You'd almost surely find a decent match if you apply being on track to finish your program. You're halfway there. Keep your head down, work hard, have some people in your program willing to speak well of you, and finish it out. My guess is you'd probably enjoy anesthesia. We do a ton of procedures and there is most often conclusion to the problem patients enter the hosptial with. Certainly you'll feel like you've helped them. Give it a look. We have minimal paperwork and I've never, ever talked to social work about anything. But definitely, finish your program.
 
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@SmokinJay6 I wouldn't quit unless you were suicidal. If you need to talk to someone, find someone. You have a debt that the large majority of people would not be able to repay if they left medicine. Most of us can't find or create a job with equivalent stability and more importantly, equivalent income. Also, you'll be putting your family in a massive financial hole if you leave medicine. This is difficult to fully grasp now as your unhappy and in the weeds, but I imagine things could get worse if you leave medicine, don't find happiness, and then you're unhappy and broke and can't provide comfortably for your family.

I'm an anesthesiologist. It's not perfect - but I like it fine enough to show up everyday and make a great income that provides for me and my family and hopefully will give us a decent retirement. I like caring for patients. I don't like being tied to the hospital or working nights and weekends. If you don't want to do that you can find outpatient jobs where you don't have to but they don't pay as well. But they still pay plenty.

If you like procedures give anesthesia a look. You'd almost surely find a decent match if you apply being on track to finish your program. You're halfway there. Keep your head down, work hard, have some people in your program willing to speak well of you, and finish it out. My guess is you'd probably enjoy anesthesia. We do a ton of procedures and there is most often conclusion to the problem patients enter the hosptial with. Certainly you'll feel like you've helped them. Give it a look. We have minimal paperwork and I've never, ever talked to social work about anything. But definitely, finish your program.

I agree. I couldn't imagine more misery for OP and OP's family than being in a mountain of debt and broke. No job is perfect. I have to say that I considered quitting residency countless times but glad I stuck it out.

After a numerous of trial and errors with a few jobs, I found a job that I can not only tolerate but frequently enjoy -I like seeing patients walk out of my rehab hospital when they came in in a stretcher, I love seeing patients leaving without PEGs and trachs and back to the community, and I like the positive influence I can make in people's lives.
As you say it's not perfect and there are plenty of days I want to pull my hair out - but in addition to helping people and making a difference as a doctor, I bring in an amazing income that I don't think I would be able to bring in 99.9% of other professions. Medicine is far from perfect and has tons of issues - but even with all the nonsense we put up with and the struggles, few jobs provide the financial stability and security Medicine does - particularly with a mountain of debt.
 
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I do not enjoy any of the peds ICUs tbh. I like when procedures happen and acuity is present but that’s about it. I hate the hours, the rounding, the long as crap notes, etc… I feel a part of my soul drain every time I have to do any of those

I’ve thought about re applying to PMR but my program won’t let me do a rotation in it so there is no way for me to get a LOR. I did allergy earlier in the year and was bored out of my mind.

Thank you for this! Quite frankly I don’t even know how to go about finding such jobs? I feel like whenever I hear about an attending talk about this they got the job by happenstance usually due to already being an attending and blah blah. Hopefully I’m wrong, but no clue how to even find such opportunities
I’m not sure which jobs you’re referring to, but the internet is your friend. There’s tons of places that list job openings. You can also just go straight to organizations and company websites to see if they’re hiring. So whatever your interest are I’d just start by making a list of places you could apply.
Also networking is key. So again if there’s a specific interest you have look online for groups, meetings etc. With Covid a lot of things are online these days.

I’m not sure if you worked before med school and residency but in general job hunting is not a sit on the sideline kind of sport…you have to be active in looking and putting your name out there. Good luck!
 
Thanks for your input. One thing I’ve recently come across is that it may be difficult for me to find a spot do solely to IRP and having reduced funding? Unsure what % of programs this matters for. But I cold called 5 and all 5 said they don’t consider applicants who wouldn’t be fully funded: so that’s been fun

In theory if you finish your residency you could apply for a pain fellowship (it's generally people in anesthesia/PM&R but other fields like EM, FM, and neuro also do it).

The funding thing is gonna be an issue for any program which is not well-funded, and even then they may not be inspired to take you- so maybe focus more on calling the anesthesia programs which have good peds anesthesia?
 
Huh. I’m stumped. Never knew you could do that from peds…. Gonna guess chances are slim LOL. I appreciate your response. I will focus on that!

I don't believe you can do a pain fellowship from Peds-also even if you could you wouldn't be able to be board certified.
 
I believe he/ she meant pediatric pain, which some do offer to peds applicants from my limited searching so far
Don't know much about pain fellowship, but peds applicants can do palliative care, which is actually in relatively high demand right now in pediatrics. A lot of that would be treating pain and spasticity.
 
My heart goes out for your situation. I don't have any specific advice, however whatever happens will be the best decision.
 
Ok, educate me please. What kind of procedures do you do daily? And ot the person who said above that they would do choles or appendices as a FM, there is no better way to get sued than doing that. that would be utter insanity.
I did primary care in a prior life…I did joint injections, OMT, warts, skin tags, suturing lacerations, and ingrown toenails. None of the procedures were very invasive but they were procedures…and I did lots of them. From the above, I would probably do two per day.
 
Thank you very much. I know you switched fields (from perusing this forum) so any advice would be very appreciated. I’m assuming you didn’t have the same funding issue since you went from 5 years to X field?
I did do some investigating on the Medicare funding for residency positions. I believe there may be a cap on the total number of years of training paid for by Medicare, however not all positions are funded by Medicare. Many larger residency programs may have the VA pay for a residency position or the department itself might pay for a spot if their case numbers are high enough. I wouldn't really let that stop you from reapplying. It sorts itself out from an institutional level. Be sure to keep us posted on what you decide. I don't think there are enough happy stories on these forums.
 
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Thank you very much. I know you switched fields (from perusing this forum) so any advice would be very appreciated. I’m assuming you didn’t have the same funding issue since you went from 5 years to X field?

Someone else posted this in the first page, but look into Preventive Medicine and Occupational Medicine programs. Funding won't be an issue, there will be significantly less patient interaction, hour are basically 9-5 MF during residency, you'll get a new degree (MPH) which you could use to branch out into other fields, and you'll still be eligible for board certification. After residency, especially if you are not tied down to a particular area, you will have plenty of options to continue clinical medicine or leave it behind entirely.
 
Update: absolutely miserable every second I’m at work. I get nauseous just thinking about that toxic and malignant place.

I appreciate all inputs so far but does anyone have any input regarding what I’m actually interested in? Heck, even saying it’s not possible is an answer. I simply want to know what careers would be an option that could possible pay off my loans while still living in a safe neighborhood. I care much more for happiness than money.

Thanks so much.
Well, what are you really interested in? Haven’t really gotten that from your posts… just that you hate peds…
 
That is a fair question. I’m not someone who is able to contemplate such things unless I know that having an alternative career is a possibility.

I work hard and am willing to do anything to pay off my debt and live a moderate life. Just no clue what my options are. I’ve looked into consulting, and pharmaceuticals. But both seem to only want BC/ BE.

Interest is a ginormously distant third for me. Just want to find something that checks the first two boxes (if it’s even possible). Then go from there
so frankly, if interest is distant 3rd...would complete the residency...yes it sucks, and yes, you have no real interest in the specialty...but being able to finish the residency and become BC, gives you options...pharma, consulting, hospital administration, etc will be an option if you do...may be able to give you the money you need to pay off your loans.

any interest in EMR, informatics, or IT? could then maybe consider working for EPIC...have no idea how much money they make, but they m/l can use someone with medical experience. There are fellowships in informatics i believe.

can you write? maybe a medical publication staff?

or maybe work with one of the medical societies out there? you may be overqualified with an MD degree, but may get you a job.
 
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Options:

1. Stick it out in Peds, try to find some part of it you like to practice in. Sounds like that's a dead end for you.
2. Swicth fields. Already mentioned is PM/OM. Unlikely you'd be happy in path. You haven't mentioned what makes you miserable, so it's hard to give advice.
3. You could quit and try to find a job. You might be able to work for a state insurance commission, or by processing prior auths for an insurance company. But I wouldn't expect to make much more than $100K with those positions, and your options will be very limited. These types of jobs are not easy to find. But they are 9-5 with no nights or weekends, if that's what you are looking for.
4. People talk about "consulting". But these types of jobs are often very pedigree driven. You need skills, or connections
5. Be creative. If you got into medical school, you're smart. So you can do something else. But there's no easy path here. Find some way to leverage your medical knowledge in business, tech, etc. People won't come knocking on your door -- you'll need to find your own way and impress them.
6. You could "go for PSLF". Quit residency. Join the peace corp, or something else that qualifies. Could you find something that allows you to do some clinical work with only an intern year? Maybe, although not much. But you then put your loans into a repayment plan. They are capped at some amount of your salary -- since your salary is small, your payments are small. 10 years later, if all goes well, your loans are forgiven. But in the meantime you should expect a pretty minimal salary.

The problem, as already documented by others, is that most of the non-practicing pathways are not well paying, and not guaranteed in any way. Sure, you can pay off that debt with a sub $100K job -- but you won't be able to afford much else. You'll end up in a repayment plan, which will end in 10 years (with a public service job) or 25 years. Will that job be enough to "provide for your family"? Depends upon your definition of "provide".
My post from earlier on the thread. Your options haven't changed.

There are definitely things you can do outside of clinical medicine. But they aren't easy -- you'll need to forge your own way.

Someone on SDN posted awhile ago about dropping out of clinical medicine and working for a state insurance office, reviewing prior auths and whatnot. M-F 9-5 (or shorter), minimal stress. Not exciting work but paid reasonably well. if anyone remembers whom / has a link to the thread, my search skills have failed to find it.
 
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There aren’t many careers with our income potential but public service in some capacity has the ability to get your loans discharged. Maybe something like this?

 
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A friend recommended the company Signify Health. Many doctors use it as a way to make a little extra money. I applied and was accepted recently and will start in Jan. Basically you do in house home assessments. It requires a medical license and it more like a contract job in relation to benefits but the pay is pretty good. More than residency but less than if you were a practicing physician.
 
A friend recommended the company Signify Health. Many doctors use it as a way to make a little extra money. I applied and was accepted recently and will start in Jan. Basically you do in house home assessments. It requires a medical license and it more like a contract job in relation to benefits but the pay is pretty good. More than residency but less than if you were a practicing physician.
Has that become mosly telehealth with COVID? I applied back in May and it took until August to get credentialed and they sent me the links to do all the modules and I when I started sending emails about when the iPad, badge, etc was coming... crickets. Eventually I just stopped trying to reach them. That was 3 months ago and I haven't heard a word from them.
 
Has that become mosly telehealth with COVID? I applied back in May and it took until August to get credentialed and they sent me the links to do all the modules and I when I started sending emails about when the iPad, badge, etc was coming... crickets. Eventually I just stopped trying to reach them. That was 3 months ago and I haven't heard a word from them.
It was telehealth but now they're back to in home. Maybe try following up again. They sometimes are slow to respond. It took me a while to get started too and by the time I started my other job had finally came through so I only ended up doing a couple weeks of tele visits before I called it quits.
 
Has that become mosly telehealth with COVID? I applied back in May and it took until August to get credentialed and they sent me the links to do all the modules and I when I started sending emails about when the iPad, badge, etc was coming... crickets. Eventually I just stopped trying to reach them. That was 3 months ago and I haven't heard a word from them.
It's in person, now at least. I am scheduled to go see patients next week. Were you formally approved? They sent me an approval and a bunch of links for payment. I also received an email and spoke with a representative who will be my contact for the company. I'd be persistent and try to contact someone through the phone.
 
It's in person, now at least. I am scheduled to go see patients next week. Were you formally approved? They sent me an approval and a bunch of links for payment. I also received an email and spoke with a representative who will be my contact for the company. I'd be persistent and try to contact someone through the phone.
Yeah, they sent me what I assume was everything. Modules, log-in info, confirmation of credentialing approval, asked for address to send the iPad so they could get that sent out, asked me to give them available dates for the following week so they could put me on the schedule, etc. Replied with all the info, emailed again, and again. Nothing. I wasn't terribly suprised since my contact there was always slow to respond. Most of the time it was weeks and weeks before I'd get a reply. My "real job" situation at the time improved so I no longer needed the work, but was admittedly a little put-off by the experience.
 
Yeah, they sent me what I assume was everything. Modules, log-in info, confirmation of credentialing approval, asked for address to send the iPad so they could get that sent out, asked me to give them available dates for the following week so they could put me on the schedule, etc. Replied with all the info, emailed again, and again. Nothing. I wasn't terribly suprised since my contact there was always slow to respond. Most of the time it was weeks and weeks before I'd get a reply. My "real job" situation at the time improved so I no longer needed the work, but was admittedly a little put-off by the experience.

Don't they pay very little? Like 100 bucks per encounter? I think Medicare pays like 300 bucks per assessment. Doctors get ripped off all the time
 
Yeah, they sent me what I assume was everything. Modules, log-in info, confirmation of credentialing approval, asked for address to send the iPad so they could get that sent out, asked me to give them available dates for the following week so they could put me on the schedule, etc. Replied with all the info, emailed again, and again. Nothing. I wasn't terribly suprised since my contact there was always slow to respond. Most of the time it was weeks and weeks before I'd get a reply. My "real job" situation at the time improved so I no longer needed the work, but was admittedly a little put-off by the experience.
That sounds pretty frustrating. Glad everything ended up working out.
 
Don't they pay very little? Like 100 bucks per encounter? I think Medicare pays like 300 bucks per assessment. Doctors get ripped off all the time
Yeah $100 per encounter. But's it's more money than if I just sat on the couch. Is there a way to be hired through Medicare to cut out the middle man?
 
Yeah $100 per encounter. But's it's more money than if I just sat on the couch. Is there a way to be hired through Medicare to cut out the middle man?
Taht's what these companies do - they get $ direclty through medicare. I know some PCPS in particular do this directly but dont have direct first hand knowledge of how.
 
Taht's what these companies do - they get $ direclty through medicare. I know some PCPS in particular do this directly but dont have direct first hand knowledge of how.
Not to beat a dead horse, but this is why you should complete residency and become board certified.
 
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It would take a bit more time, but look into Preventive (or occupational) med. I think preventive more than occ, because you could apply your peds experience to it more readily.

You need to do an intern year to enter preventive, but they might count your first peds year as that. The link below says "12 months in ACGME residency", so I think you'd have that prereq done...and that's all you would need to apply. You'd have to get something together expressing your interest in that field if you apply.

Typically the preventive residency will get you an MPH (accelerated timeline) and you'll do rotations, but it is generally a more non-clinical field (under the assumption that clinical work is what is getting you down). It is its own boarded specialty, so you would technically be double boarded right away: Peds and preventive (assuming you finish peds and take boards). You may let your peds boarded status lapse if you don't do anything in it clinically, but it would make sense to at least get your initial board status in peds if you ever went back in that direction in the future.

I'd agree with above advice to finish off peds since it's not too long of a residency. If you can stomach another few years with a resident's salary, look into preventive. If you are halfway through peds, you could hopefully get an app together and apply.

I'm not sure if you apply a year ahead or the year of prospective start. You'd have to find that out. If it's the year of, you're good...just apply next year during 3rd year of peds residency. If you have to apply a year ahead (meaning the normal start timeline accounts for doing the intern year), then you'd have to apply this year/early 2022, but you'd still make it so you could start right in at the end of your peds residency. You'd have to contact someone to be sure of the timeline as I don't want to tell you either way since I'm not entirely sure on that one.



Someone I graduated med school with and who was a fellow intern went this route. I always low key liked the idea of it (I already had gotten an MPH/MD combined degree) and if I didn't luckily land where I am now, was starting to think about doing it.
I'd just like to chime in with what I know about Preventive Medicine. When I was an undergrad I did a certificate program in public health and met a Preventive Medicine resident who kind of became a mentor to me. From what he told me, he and his co-residents all struggled to get non-clinical jobs after residency. I looked him and the other residents I knew up about a year ago, and all were back in clinical medicine. The types of jobs that pay even comparable to a physician will be extremely hard to get. Becoming a medical director of a large health department or a leadership position in health organization is better suited for a DrPH or MBA type with more real world experience.

A Preventive Medicine residency will not prepare you for a purely research physician scientist position in academics either (you would need a PhD or a research focused fellowship for that, along with actually getting NIH funding). So you are kind of stuck in no-man's land with a Preventive Medicine residency. Where I think they can work is if you are willing stick with clinical and use the PM residency as a spring board to gaining PM experience into your current clinical job (it would like make you attractive to sit on certain boards/committees). Then at the right time later in your career, you may have the opportunity to switch over to non-clinical. But you can go to a few of the PM residency websites and look at the previous grads and google to see what they are doing now. It will give you some insight that PM residency is not a quick ticket to a non-clinical job.

Of course there are always exceptions, but based on what I know, I would be realistic about Preventive Medicine going in. Especially if you are $400K in debt. That will easily balloon to $800K if you don't start paying it off, and you don't want to lose clinical skills and not be able to find a job that will pay enough to pay off your med school debt. Unfortunately, at that level of debt, you really need a clinical physician job to be able to pay it off.
 
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Not to beat a dead horse, but this is why you should complete residency and become board certified.

I agree with your statement completely - completing a residency even if someone never does a clinical day post residency is essential.
 
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I'd just like to chime in with what I know about Preventive Medicine. When I was an undergrad I did a certificate program in public health and met a Preventive Medicine resident who kind of became a mentor to me. From what he told me, he and his co-residents all struggled to get non-clinical jobs after residency. I looked him and the other residents I knew up about a year ago, and all were back in clinical medicine. The types of jobs that pay even comparable to a physician will be extremely hard to get. Becoming a medical director of a large health department or a leadership position in health organization is better suited for a DrPH or MBA type with more real world experience.

A Preventive Medicine residency will not prepare you for a purely research physician scientist position in academics either (you would need a PhD or a research focused fellowship for that, along with actually getting NIH funding). So you are kind of stuck in no-man's land with a Preventive Medicine residency. Where I think they can work is if you are willing stick with clinical and use the PM residency as a spring board to gaining PM experience into your current clinical job (it would like make you attractive to sit on certain boards/committees). Then at the right time later in your career, you may have the opportunity to switch over to non-clinical. But you can go to a few of the PM residency websites and look at the previous grads and google to see what they are doing now. It will give you some insight that PM residency is not a quick ticket to a non-clinical job.

Of course there are always exceptions, but based on what I know, I would be realistic about Preventive Medicine going in. Especially if you are $400K in debt. That will easily balloon to $800K if you don't start paying it off, and you don't want to lose clinical skills and not be able to find a job that will pay enough to pay off your med school debt. Unfortunately, at that level of debt, you really need a clinical physician job to be able to pay it off.
Recent PM grad here. I agree the job path is not as straightforward as other residencies and that if you have significant debt it's not the best option (still better than no residency at all) but there are non-clinical jobs available for the PM resident grad. Some states (Virginia I know for certain) actually require an MD or DO to serve in a local health director job but given the responsibilities of the job you often need more experience past residency to qualify. Government jobs are also an option in FDA or other HHS agencies. Pay is not great for those but they are still physician pay (lower end of course) and the benefits are pretty good (fed holidays, telework, etc).

Myself I got an HHS job a couple months after graduation. Working from home due to pandemic and using my PM skills everyday. For me, it's an ideal situation but not for everyone.
 
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Myself I got an HHS job a couple months after graduation. Working from home due to pandemic and using my PM skills everyday. For me, it's an ideal situation but not for everyone.

What do you do for the HHS?
 
I agree with your statement completely - completing a residency even if someone never does a clinical day post residency is essential.
Totally agree. An MD without a residency is worthless, and will set off all kinds of red flags. I would take it a step further and say completing a residency, getting a full license, and being board certified in a specialty is the safest thing to do, even if you know you don't want to do clinical.
 
Update:

Job is still crazily toxic and malignant. I DREAD going in each day. Anyone know how realistic it is to switch fields with both only 1 year of funding left AND an unsupportive PD?

Thanks all. I don’t know what to do.
How long do you have left? The funding I don't think is that big of an issue. The specialty and how long you have left is though. There are plenty of unsupportive PDs, that's not a deal breaker either.
 
16 months. Well, I presumed his letter would indicate such and that would hurt me when trying to get into something else? Right?

I am open to anything. PMR or FM preferred. I’m assuming PMR has become too competitive. I do have a life long tie to the field so that sucks, but such is life.
What field are you in? I say stick it out starting from scratch blows and it’s hard and yes pmr has filled in the match 100 percent for years so would be hard
 
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There is a high probability I will not be returning. Can DM if you’d like more info.

I will not be practicing the base speciality so if I don’t match fellowship, if I am back in the summer, (highly unlikely given my state of affairs with my PD) then I need to find alternatives. Hence my question.

Yes, sticking it out has been said since I started this thread. And I’ve kindly asked for other, realistic, ideas along the way.

Thank you
Hard to help without knowing full details. Starting over is difficult at best. Can it be done maybe maybe not depends on countless factors. If you quit it’s going to be hard to find something - who would hire a doctor who quit residency half way and doesn’t have a license? That’s why we tell u to stick it out.
 
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Update:

Job is still crazily toxic and malignant. I DREAD going in each day. Anyone know how realistic it is to switch fields with both only 1 year of funding left AND an unsupportive PD?

Thanks all. I don’t know what to do.
Why do you say you have only one year of funding? Even if you finish 2 years of your first residency and have 1 year left, if you match at a different institution would you not be funded? I thought that funding runs out after more transfers and more years of residency than you have. If someone knows more about it than me please correct me.
- Why is your PD unsupportive? I would try my best to mend the PD relationship and secure some LoRs from some other attendings.
- Start cold calling and emailing PDs/coordinators from programs who may have open spots, and I would be broad about it. If your problem is with the program more so than the specialty maybe try to transfer to a different program? you can always blame family circumstances and such
- PM/OM has different funding source so I think you can still get paid there regardless of how much funding you have left
 
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