Practicing while also working in a non-clinical setting part time?

[Brotatorcuff]

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[IMGASMD]

I would suggest during those non clinical years have a Locum or PRN jobs, so you won’t be totally without any clinical experience for five years.

 

[Zifish]

You would need to complete the required CE credits in order to maintain your license during that time. Something you could do is be on-staff as a medical adviser for a plasma donation center, or medspa, or something where they just need your MD license to keep their doors open but don't actually require your services. Or could do LOCUM work once a month, or maybe do telemedicine from time to time?

 

[dadaddadaBATMAN]

Hey all,

I'm an M3. I'm not very interested in practicing since I want to try to work for a startup, or work in policy, or try one of the many other jobs outside of clinical medicine. I am interested in trying for a wide-scale impact beyond practicing, since our medical system has many problems.

However, at this point it makes financial sense to just go through and do residency, since it's only 3-4 more years for attending income as a fall back. I am not interested in academics or administration. I plan on going into EM or IM, fields that make it easier to do part time if need be.

If I finished residency, then directly try non clinical jobs for 5+ years, and decide to go back to clinical med, would I be able to get an attending job? Or would it be a red flag to not have practiced for 5+ years?

I'm aware my credentials may be weak for non clinical jobs - if these fail, I would like to hopefully be hired as an attending and still have that attending income to fall back on. I would be fine with taking a large pay cut for a year or so if my employer doesn't "trust" me or I seem rusty at that time.

Thanks for your input everyone! Sorry if it's a dumb Q. I know it may seem dumb to have practice as my fallback.. but that's where I stand for now.

If you legitimately leave for five years straight out of residency you’re going to undergo a ton of skill atrophy and you’re going to forget a lot of stuff.

Think back to ochem right now. Would you pass those tests if you were handed them without review? Maybe, but you’re probably not gonna do great.

Now imagine the entire field undergoes multiple shifts that change your practice in that time, and that the field is in large part determined by clinical gestalt that depends on experience. It’s actually worse than something discrete and relatively fixed like ochem.

A better approach is part time work, although this would be easier and safer after a few years full time as an attending.

You will also require several years to develop the skills to be useful to a start up unless you have a prior background that helps. That will be hard to do in residency

 

[TheSingularity]

The problem you are going to run into is getting malpractice insurers to insure you after a prolonged period of not practicing.

Also, Doximity is a cesspool.

 

[Sleepingdoc]

I suggest do not go completely out of clinical practice.

 

[jdh71]

No. No one is going to hire you with a five year gap in clinical practice.

 

[Med Ed]

If you legitimately leave for five years straight out of residency you’re going to undergo a ton of skill atrophy and you’re going to forget a lot of stuff.

Think back to ochem right now. Would you pass those tests if you were handed them without review? Maybe, but you’re probably not gonna do great.

Now imagine the entire field undergoes multiple shifts that change your practice in that time, and that the field is in large part determined by clinical gestalt that depends on experience. It’s actually worse than something discrete and relatively fixed like ochem.

A better approach is part time work, although this would be easier and safer after a few years full time as an attending.

You will also require several years to develop the skills to be useful to a start up unless you have a prior background that helps. That will be hard to do in residency

There are reentry programs to deal with these situations: Physician Reentry Program Links

If you're going to commit to doing a residency then I strongly suggest you spend at least a year practicing before you pursue other interests.

 

[MedicineZ0Z]

You would be grossly incompetent if you left for that long. Even a year would cause you to atrophy.

 

[IMGASMD]

The solution is not inside clinical medicine, it is in a technology application to medicine or another field somewhat related to clinical med IMHO.

Maybe this can all wait until 1 year out of residency... too bad that's 5 years away. And an MD without residency isn't very useful. (

I respectfully disagree.
I “grew up” in the era of EMR Integration. In short we are not there yet and created more problems in the last 10 years. I cannot count how many times the patients get annoyed with me and tell me to just check the chart.

The best medicine is actually time. The time you spent with the patients to educate, to be compassionate, to listen.

“Ain’t nobody got time for that...”. Is probably going through your mind. I can assure you, those patient who are most resistant to changes, will not be aided by technology. They are either too smart, dr. Google tells me to do this, that way; or they’re too uneducated, even if you throw them the best gadgets, they will not know how to utilize them if their lives are depend on it.

As an anesthesiologist, I am tired of having DNR/DNI discussions with the family, because their PMD never had the time to properly explain it while they’re still able to comprehend. How heartbreaking it is when I see a demented DNR/DNI 90 year old comes to the operating room, because the family did not have “the conversation” with the PMD?
Technology is not the answer. I digress.

Second part of your concern..... you can still do a lot without residency, if you don’t want to practice clinical medicine. I am sure there are plenty of threads out there for this topic. However, I command you for looking into your options now. You’re still young/new to medicine. I had a few classmates who only wanted to do one year of medicine so they can just get licensed to practice and do something else with their degree, then decided to stay in medicine. I also know people who did an IM residency, then go straight to administration with their MBA/MPH.

Keep an open mind, don’t box yourself in this early in your career.

You keep doing you....
good luck.

 

[RangerBob]

I agree with the above-5 years out of practice is a huge red flag. Just as big of a red flag is not even working as an attending once you finish residency. I do not think you’d want to work at most places that would still consider a resume with that history.

If your goal is to maintain clinical skills/MD income potential, then do locums every few weeks. You will lose your skills if you’re not practicing medicine regularly.

 

[shemer77]

I would suggest during those non clinical years have a Locum or PRN jobs, so you won’t be totally without any clinical experience for five years.

This is the only way you'd even have a chance of being hired again

 

[Emmet2301]

For the most part you can always work in policy/advocacy, but you can't always do residency.

Why not complete residency, work for a while in clinical medicine then get into policy/advocacy?

 

[CyrilFiggis]

No prior experience in these “non-clinical” areas and 4 years of medical school debt, not sure this is a financially viable situation.

 

[deleted480308]

Thank you everyone for the responses and thank you Med Ed for the info on Reentry Programs, very useful!

I enjoy EM, but as we all know, many of those ER visits could have been prevented weeks/months before the visit, with proper education and care.

Before you say I should do primary care - I have worked in PCP offices and they don't have the resources or time to fix the problems. The solution is not inside clinical medicine, it is in a technology application to medicine or another field somewhat related to clinical med IMHO.

Maybe this can all wait until 1 year out of residency... too bad that's 5 years away. And an MD without residency isn't very useful.

If you think tech is a universal solution to bad decision making and apathy/laziness you have a lot to learn about both health and tech

 

[Brotatorcuff]

After further thought, I've realized that I was falling for the "grass-is-greener" fallacy, and that non-clinical areas have many of their own flaws. And I coincidentally spoke to several people who told me they were disillusioned with their non-medical career and they wished they had applied to medical school, which helped me think of the many positives of medicine.
So as of right now I am planning to go to residency and practice, and maybe see what other skills I can pick up on the side after that.

 

[IMGASMD]

After further thought, I've realized that I was falling for the "grass-is-greener" fallacy, and that non-clinical areas have many of their own flaws. And I coincidentally spoke to several people who told me they were disillusioned with their non-medical career and they wished they had applied to medical school, which helped me think of the many positives of medicine.
So as of right now I am planning to go to residency and practice, and maybe see what other skills I can pick up on the side after that.

It is after all a job. Albeit a good job. Not many jobs out there can guarantee a six figure salary right off the bat.
And it’s almost recession proof....

Good luck op. Thank you for giving us the update.

Interviews? What field?

 

[guytakingboards]

I dunno if IM is exactly like my field but i assume the generality would be true that your first few years out of training serve to solidify your knowledge/skills and identify gaps that needs to be addressed immediately.

Doubtful anyone rolls out of training fully formed. Add a 5 year pause on that and it'd be a doctor I wouldn't want to see.

 

[Dr G Oogle]

I work with a number of startups in helping design their studies for validation or proof of concept where at least one of the founders is a practicing doc (most relatively recent out of training) and working on a Tech startup Of my own while having a busy surgical practice and 20% protected time. I and the other MD founders all have non clinical skills like coding, MBA, etc; I developed mine during residency and fellowship but at the time goal was to get better at research not start a business. Most people I know who are in it to win it and focus primarily on startup work clinically at least 1-2 days per week but this is in academic settings where they maintain an association, don’t know anyone who does this in PP (obvious selection bias on my part).

TLDR; can do no clinical work, probably need to have one foot in clinical medicine to not lose skill set/license expires.