Personal Dilemma

[realmadridstorm]

Hi everyone, long time lurker, I've learned a lot from the board over the years from med school through fellowship. I just want to get some comments from your guys about my current situation. After fellowship last year, I joined a private practice group as an employee because I was not keen on the location which is the hub city of a semi-rural region. I am indifferent to the city but an improvement would be nice. The group is cohesive, partners are great and I fit in well. I am content with current pay and amount of vacation both of which are less than full partners. I was offered the partnership track pending the retirement timeline of a senior partner and my long-term plan a few months ago. My main gripe about the current gig is that I trained for peds cardiac anesthesia and I feel I am losing my skills since I don't use that training at all currently. The gf who is long distance, and I talked about moving to her home city, which is better than my current city. I have accepted a peds cardiac position at the local academic center in gf home city for slightly less pay and less vacation than my current gig. Financially I am fairly frugal and I have paid off my student loans 9 mo into practice. Currently just have a 0.9% APR car loan left, <15K. I understand the board heavily favors private practice, but my main questions to all the veterans out there is am I making a major life mistake by giving up the perks of potential private practice partnership with more money/vacation/future income potential for a better personal life with potential higher professional satisfaction in the unknown waters of academia?

Just another dumb Real fan

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[vector2]

Your post says you already accepted the position, so I take it you're having some butterflies before signing the contract? My advice is to rid yourself of your doubts. It would be a different story if you had an extravagant lifestyle and were up to your eyeballs in debt, but my guess is you're going to be significantly happier moving to a city you like, not doing long distance with the gf, and actually practicing the kind of anesthesia which you presumably trained an extra 2 years for.

 

[Hoya11]

Hi everyone, long time lurker, I've learned a lot from the board over the years from med school through fellowship. I just want to get some comments from your guys about my current situation. After fellowship last year, I joined a private practice group as an employee because I was not keen on the location which is the hub city of a semi-rural region. I am indifferent to the city but an improvement would be nice. The group is cohesive, partners are great and I fit in well. I am content with current pay and amount of vacation both of which are less than full partners. I was offered the partnership track pending the retirement timeline of a senior partner and my long-term plan a few months ago. My main gripe about the current gig is that I trained for peds cardiac anesthesia and I feel I am losing my skills since I don't use that training at all currently. The gf who is long distance, and I talked about moving to her home city, which is better than my current city. I have accepted a peds cardiac position at the local academic center in gf home city for slightly less pay and less vacation than my current gig. Financially I am fairly frugal and I have paid off my student loans 9 mo into practice. Currently just have a 0.9% APR car loan left, <15K. I understand the board heavily favors private practice, but my main questions to all the veterans out there is am I making a major life mistake by giving up the perks of potential private practice partnership with more money/vacation/future income potential for a better personal life with potential higher professional satisfaction in the unknown waters of academia?

Just another dumb Real fan

Take the job near the GF. See how it goes. You will always wonder what if if you did not. You are a single guy with loans paid off, figure out the rest of your life....

If the GF doesnt work out or the passion for pedi hearts is gone or you dont like this new job, move on to the next thing. Wherever you go you will always make good money for a single guy and have decent vacation

I can sense the excitement of you moving on to this new job near the GF. You have every right to do that and you should go on that adventure. Dont let the little bit of extra money and vacation make you feel bad for doing whats in your heart

 

[Ezekiel2517]

You can't take it with you. The Egyptians learned that. You can't bury it and take the treasures with you.

Go where you will be happier.

 

[Aether2000]

Go practice in what you were trained to do, and don't give it a second thought.

 

[MoMoGesiologist]

Unless if the money and vacation is a lot more, sounds like it makes sense to live in a better city with your SO doing what you love and trained for. Unless if it's a difference of a couple weeks vacation or >50k. Then I feel like the new job may be a downgrade.

 

[psychbender]

If you're not happy with what your day to day job is in your private group, and you think you will be happier with the academic group, then go with the academic position. You've paid off your loans, the money is less of an issue.

 

[cchoukal]

Any reason to question whether the GF is the source of the hesitation?

 

[MoMoGesiologist]

Why did you take a job not doing peds cardiac out of fellowship? Did you really not care for doing what you trained in or was the job offer that good? Just curious

 

[Planktonmd]

A move from private practice to academia is definitely a very smart move and offers significant job security, which is important considering the uncertainties surrounding this field.
Your private practice group could very easily lose their contract with the hospital to an AMC at any point in time, and if that happens later in your career you will find yourself forced to accept less than ideal situations.
The private practice model is no longer a viable business model in anesthesia.

 

[deleted50478]

Hi everyone, long time lurker, I've learned a lot from the board over the years from med school through fellowship. I just want to get some comments from your guys about my current situation. After fellowship last year, I joined a private practice group as an employee because I was not keen on the location which is the hub city of a semi-rural region. I am indifferent to the city but an improvement would be nice. The group is cohesive, partners are great and I fit in well. I am content with current pay and amount of vacation both of which are less than full partners. I was offered the partnership track pending the retirement timeline of a senior partner and my long-term plan a few months ago. My main gripe about the current gig is that I trained for peds cardiac anesthesia and I feel I am losing my skills since I don't use that training at all currently. The gf who is long distance, and I talked about moving to her home city, which is better than my current city. I have accepted a peds cardiac position at the local academic center in gf home city for slightly less pay and less vacation than my current gig. Financially I am fairly frugal and I have paid off my student loans 9 mo into practice. Currently just have a 0.9% APR car loan left, <15K. I understand the board heavily favors private practice, but my main questions to all the veterans out there is am I making a major life mistake by giving up the perks of potential private practice partnership with more money/vacation/future income potential for a better personal life with potential higher professional satisfaction in the unknown waters of academia?

Just another dumb Real fan

Unless you will make so much money in your current practice over the next 5 years that you won’t really care about future job opportunities, do peds cardiac. You can always switch to general but you won’t be able to get a job doing peds cardiac in a year or two if you don’t do it now.

 

[DirtDocMD]

In 5 years, that private gig (as it exists currently) may not be around. You say you don’t care much for the town (or at least indifferent). Do you really want to do peds cardiac?? Do you really care deeply for your girlfriend?? Any reason she hasn’t moved out there with you?? Do this because YOU want to, NOT because she’s forcing you to (unless, perhaps, she has a much better job than yours).

In 5 years, you could possibly be an associate (rather than assistant) professor.

Pretty rare for an academic program to get SMALLER. Few layoffs, stable employment, stable pay, very little liability..... Money’s great, but it’s not everything....

 

[Mr.S]

In 5 years, that private gig (as it exists currently) may not be around. You say you don’t care much for the town (or at least indifferent). Do you really want to do peds cardiac?? Do you really care deeply for your girlfriend?? Any reason she hasn’t moved out there with you?? Do this because YOU want to, NOT because she’s forcing you to (unless, perhaps, she has a much better job than yours).

In 5 years, you could possibly be an associate (rather than assistant) professor.

Pretty rare for an academic program to get SMALLER. Few layoffs, stable employment, stable pay, very little liability..... Money’s great, but it’s not everything....

If you pick the right private practice you can make in 5 years what the academics make in 8-10 years..

 

[DirtDocMD]

If you pick the right private practice you can make in 5 years what the academics make in 8-10 years..

You’re right, but his pedi cardiac skills will be gone, the GF will be gone, and the group may be gone by then. Decisions....

 

[Mr.S]

You’re right, but his pedi cardiac skills will be gone, the GF will be gone, and the group may be gone by then. Decisions....

Skills are never gone
I havent ridden a bycycle in at least 7 years. I bet you i can still do it

I havent done adult cardiac in a while, I still have people ask me if i am interested in getting back into it.

GF... 1/2 the population are girls. find one of them..

 

[deleted444089]

So one can make $750,000 while also getting out at 3 PM most days and almost no weekends? My upcoming academic gig pays about half that with those hours. That would be a pretty sweet PP arrangement.

If you pick the right private practice you can make in 5 years what the academics make in 8-10 years..

 

[Man o War]

So one can make $750,000 while also getting out at 3 PM most days and almost no weekends? My upcoming academic gig pays about half that with those hours. That would be a pretty sweet PP arrangement.

Close. Keep in mind post call days off. I like taking more frequent call so I get the next day off.

 

[2Fast2Des]

Skills are never gone
I havent ridden a bycycle in at least 7 years. I bet you i can still do it

I havent done adult cardiac in a while, I still have people ask me if i am interested in getting back into it.

GF... 1/2 the population are girls. find one of them..

I'd love to hear your pick up tricks, do you carry a pokeball around?

 

[deleted444089]

I guess it’s just really hard to compare jobs like that because hours/culture/etc. also dictate how happy you’ll be beyond just $$$$. With kids a postcall day after a busy night in the OR can be pretty much worthless. OP, you’ve already made your decision so second guessing yourself and asking a bunch of strangers who don’t know your particular situation is less than ideal. Respectfully, the fact that you were looking for another job while still seemingly content in your current situation means you’ve answered your own question.

Close. Keep in mind post call days off. I like taking more frequent call so I get the next day off.

 

[Mr.S]

So one can make $750,000 while also getting out at 3 PM most days and almost no weekends? My upcoming academic gig pays about half that with those hours. That would be a pretty sweet PP arrangement.

No but if you take very little vacation, pick up a lot of weekends and extra shifts... you can make some money.

I understand it is not for everyone

 

[Psai]

I'd love to hear your pick up tricks, do you carry a pokeball around?

Maybe stop talking about pokeballs for one

 

[realmadridstorm]

OP here, I really appreciate all the comments above and it really calmed some of the jitters before I fully commit. The jitters mainly come from have never worked in academia except for training and was very burned out by academia at the end of training. To respond to some of the questions/comments that were raised. I have not signed a contract and accepted only verbally with contingencies depending on terms. The gf will not be able to continue her career in my current city and she is specialized enough that she will have to start over with a different career. It would be unrealistic and selfish to have her move for me. The gf and I are very serious, thus my willingness to explore other options. She even emphasized that don't choose this for her. I joined my current group for several reasons, dislike for academia due to burn out from training, seeing an academic department simply implode, and my current group covered a low volume peds cardiology/cardiac surgery program. Unfortunately, the surgeon lost operating privileges and after a year of working, I've learned our PICU/NICU have enough deficiencies that I would be uncomfortable to have them to care for my more complex patients without significant involvement. I also don't believe the hospital will be able to recruit a good peds cardiac surgeon to the area given the undesirable location and their track record for the last few hires. I agree with all the posters that money is not everything especially potential income that's a few years down the line and second-guessing is pointless due to my irrational concerns about academia as a result of previous bad experiences, not all departments are the same. I guess I just needed a group of really wise strangers on the internet to give me some assurances, haha. But seriously, I appreciate all the replies and wish me luck.

 

[Lecithin5]

Sounds like you’ve mostly made up your mind about joining the academic practice (ie paid off loans; non-flashy lifestyle etc) and are looking for a nudge... well, allow me to nudge you. As I’ve said in a previous post, sacrificing money, even potentially a good chunk of change, for the location and type of practice you want is extremely worth it. I am a living example of it and have never looked back.

 

[WholeLottaGame7]

Skills are never gone
I havent ridden a bycycle in at least 7 years. I bet you i can still do it

I havent done adult cardiac in a while, I still have people ask me if i am interested in getting back into it.

GF... 1/2 the population are girls. find one of them..

LOL you sound like a CRNA. "Peds cardiac, how hard can it really be?" Maybe if he had been doing it for 10 years he could take a few years off and come back to it. If you do a fellowship and then don't use it? Probably hard to come back once you're much past 3 years or so, even harder if he hasn't been taking care of any sick kids at all.

 

[WholeLottaGame7]

I agree with all the posters that money is not everything especially potential income that's a few years down the line and second-guessing is pointless due to my irrational concerns about academia as a result of previous bad experiences, not all departments are the same. I guess I just needed a group of really wise strangers on the internet to give me some assurances, haha. But seriously, I appreciate all the replies and wish me luck.

It's not irrational. The job security is probably higher and the groups are overall more stable, but academia has it's own pitfalls. Academic hospitals tend to be inefficient from top to bottom, there's a lot of bureaucracy/administration getting between you and the patient, there's lots of politics and favoritism and drama, you have to like working with residents, etc. Overall I really like academics, but there are definitely days where being a part of a well-oiled and productive private group are certainly appealing.

 

[anbuitachi]

So one can make $750,000 while also getting out at 3 PM most days and almost no weekends? My upcoming academic gig pays about half that with those hours. That would be a pretty sweet PP arrangement.

honestly wouldnt be surprised. i see attendings at academic centers w/o residents, but turn overs are so slow and they average 3 - 4 cases a day from 8-4, make bit less than half that. theres so much room to make things faster.. turnover is like 30 minutes, surgeons are not that fast.

 

[deleted444089]

Twice the $$ for many more hours and weekends, no thanks. With no student loans (thanks HPSP) I’ll be happy to spend time with my family instead of doing weekend cases. If I were single without a family? Hustling to make that would sound great. Maybe I’m saying all this to justify my own choice to go into academics and make myself feel better losing out on potentially a lot more $$

Close. Keep in mind post call days off. I like taking more frequent call so I get the next day off.

 

[UKEMdoc]

Do you know the guys you’ll be working with?
Are you going to make enough to pay for a decent four bedroom house and support three kids on just one salary?
If your GF leaves you is there anything else that will keep you in the city?