PhD/PsyD Private Sector vs. Federal Employment

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corticalatrophy

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Folks, I am at a unique crossroads where I need to choose between federal employment and private sector work. Anyone here leave federal work and never look back and want to tell me how it was for them out there in the real world?

Private sector job is really a great fit- probably a 50% more work load increase in the same 40 hour work week but also with anywhere from 30-40% higher pay. Benefits such as $4k for conferences, travel, professional memberships. Fancy office. Fancy high profile coworkers. Very cool city.

Federal Job: Fat benefits (low health care premiums, pension plan), Very low clinical load/productivity requirements, adequate pay...stability. It's not such a great place to live but I already own a house here and I'm no spring chicken.

I did a calculation...I'd have to be retired on a federal pension for 15 years before I'd even break with the money I'd be making in this private sector job and that's just the base pay (not including productivity bonuses).

Hoping to here some "I escaped the feds" success stories or alternatively, "the grass isn't greener, stay in gov't work"

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Folks, I am at a unique crossroads where I need to choose between federal employment and private sector work. Anyone here leave federal work and never look back and want to tell me how it was for them out there in the real world?

So, so much better. Higher pay that more than makes up for the loss of federal pension, especially with the increase in how much federal employees pay into their pension. I work 30-35 hours/week, and can make my own schedule. So, I often load up early in the week so I can leave by 1-2 later in the week, or just not come in Friday at all. Obviously, this isn't all jobs, and I am my department, so I get to make most of the rules. YMMV depending on job constraints. But, in the end, I'll take higher pay and flexibility over more security.
 
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Notice all those people that got rich working as an employee for the federal government?

Me either.
 
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I wish I left sooner (public state employee/faculty at AMC) for 100% private practice. I work less, make a lot more, and I have more flexibility overall. It’s not perfect, as I have to do regular networking and the bottom line is the final say...but i’d still recommend it.
 
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I HIGHLY recommend private practice.

1) There’s a weird thing in our field where VA or AMCs are considered a great job. I love that some people love the academic life, and I benefit from their work. But the money isn’t that good, there’s tons of political stuff, and you’re not in control of your life. I also am weirded out by how often VA docs seem to move. Seems evidence to the contrary that it’s a steady job.

2) In PP you:

A. Make your own schedule. Random days off are awesome. I’m assuming they are even better if you have kids or a spouse. This also means you can go on vacation when you want. No one approves your request. You just do it. Or lunches. Etc.

B. Get to write some things off that are kinda awesome. I like to write off books. If you work at it, you get to go to awesome places for conferences. At more advanced levels, it get MUCH better.

C. Retirement stuff is insane. Your pension might be nice, but an IRA can be passed along to your children. If you want to leave, your retirement isn’t at risk, unless you are a ***** who doesn’t save.

D. Choose how you practice. Including if you wanna respecialize.
 
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I also am weirded out by how often VA docs seem to move. Seems evidence to the contrary that it’s a steady job.

Some of this is someone taking a job in the VA wherever they can get it and then waiting until a job opens up in a place that they want to move to within the VA. I've known more than a few people do this. It may mean living several years in a place that you do not want to live, but some people seem ok with that to stay in the VA system. Additionally, I've known a few people who have switched VA jobs following a huge management turnover at their site, which happens often, and the environment became untenable to them. In either case, less than ideal.
 
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Just to offer a bit more balance to the discussion with private practice you do not get paid for cancelations or no shows, need to deal with insurance companies or pay someone to do so if you plan to take insurance, do not get paid holidays or paid vacations, and need to take out your own insurance policy (unless you have a spouse with one). There is group practice but then 40% of what you make goes to cover expenses (although the percentage may vary). I know people who work at the VA or AMC and then have a small practice on the side. To me, that seems like the best of both worlds.
 
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Notice all those people that got rich working as an employee for the federal government?

Me either.


I do not think I could name many who got rich in this field in general.
 
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Just to offer a bit more balance to the discussion with private practice you do not get paid for cancelations or no shows, need to deal with insurance companies or pay someone to do so if you plan to take insurance, do not get paid holidays or paid vacations, and need to take out your own insurance policy (unless you have a spouse with one). There is group practice but then 40% of what you make goes to cover expenses (although the percentage may vary). I know people who work at the VA or AMC and then have a small practice on the side. To me, that seems like the best of both worlds.

Yea, see patients all day then come home and see more patients. Sounds awesome, lol.
 
I do not think I could name many who got rich in this field in general.

I think it’s important to know that there are possible ways to get rich. Not knowing limits ones goals.

The most helpful, non self aggrandizing response I can offer:

1) I could name several and I am 100% positive of their income.

2) Most are not psychologist “famous”.

3) The ways to make money in this field seem to be:

A. to hire people and pay them less than they generate,

B. or to find a higher than average revenue stream and bill the ever living hell out of it.

C. or to make some product that is bought by non-psychologists. Books mostly don’t count.

4) That the rich ones don’t advertise their income should tell you something about their ethics in their hiring practices or their security of their revenue.
 
Yea, see patients all day then come home and see more patients. Sounds awesome, lol.

I guess I mean those lucky enough to work part time at a VA job and then have a small practice on the side. My postdoc supervisor had this and it seemed ideal for her. She even managed to have a life and go kayaking after work several days per week in the summer. However. it seems that part-time positions that offer benefits are disappearing with the government.
 
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I think it’s important to know that there are possible ways to get rich. Not knowing limits ones goals.

The most helpful, non self aggrandizing response I can offer:

1) I could name several and I am 100% positive of their income.

2) Most are not psychologist “famous”.

3) The ways to make money in this field seem to be:

A. to hire people and pay them less than they generate,

B. or to find a higher than average revenue stream and bill the ever living hell out of it.

C. or to make some product that is bought by non-psychologists. Books mostly don’t count.

4) That the rich ones don’t advertise their income should tell you something about their ethics in their hiring practices or their security of their revenue.

I am sure it is possible and good to know that you have the secrets. However, I guess my point was that most of us do not study clinical psych with the end goal of getting rich. There are fields that would require less work in order to do so.
 
I am sure it is possible and good to know that you have the secrets. However, I guess my point was that most of us do not study clinical psych with the end goal of getting rich. There are fields that would require less work in order to do so.

1) Its possible that if everyone in this field expected more in income, then we would make more in general. When jobs with a high school diploma make more than us, and the median income isn't keeping pace with inflation, then the field is dying. It'd be a lot easier to work half time if the median income was $200k. That's not even psychiatry pay.
2) I completely understand. I do not expect people to hustle. See #1.
3) There are extremely few secrets in making money here.
 
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1) Its possible that if everyone in this field expected more in income, then we would make more in general. When jobs with a high school diploma make more than us, and the median income isn't keeping pace with inflation,




I agree with this. I would like to see the income data change as well, which does require a change on our part. The stats I see regarding pay are quite scary and the fact that professional schools are flooding the job market does not help.
 
I agree with this. I would like to see the income data change as well, which does require a change on our part. The stats I see regarding pay are quite scary and the fact that professional schools are flooding the job market does not help.

It has ZERO to do with flooding the job market and EVERYTHING to do with how much we are getting paid hourly by third party payors.

Example A: Say psychotherapy is paid at $300/hr. You'd need to work 16hrs/week to generate $230k in revenue. I'd have a phone bank working to offer $190k to anyone who would answer the phone, regardless of education at that price point.

Example B: Say psychotherapy pays $50/hr. At 30hrs/week of revenue generation, I have limited profit to make even if I paid well below market.

I have come across both of these numbers in the last 10 days from real psychologists.
 
It has ZERO to do with flooding the job market and EVERYTHING to do with how much we are getting paid hourly by third party payors.

Example A: Say psychotherapy is paid at $300/hr. You'd need to work 16hrs/week to generate $230k in revenue. I'd have a phone bank working to offer $190k to anyone who would answer the phone, regardless of education at that price point.

Example B: Say psychotherapy pays $50/hr. At 30hrs/week of revenue generation, I have limited profit to make even if I paid well below market.

I have come across both of these numbers in the last 10 days from real psychologists.


When psychologists are a dime a dozen (which professional schools contribute to), our value decreases.
 
I wouldn't say it has zero to do with the flooding of the job market. Because of the proliferation of masters and diploma mills, there are simply less jobs to go around and more people willing to accept lower paid jobs. Heck, in our hospital system we don't even hire psychologists to do therapy any more. In the PP therapy world, if you take insurance, you're right there with the dozens of masters/SWs/etc who are also doing therapy and accept insurance. You can go cash only, but that's where business skills are more important and there is still a saturation problem in some areas.
 
the one's I know that hustle make that bank, easily in 7 figures. im at weird point in my life where I don't know if hustling is worth it for me. I realllllly love chilling. but I think that might be a generational thing too maybe?
 
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@psychrat

I’m not familiar with that method of determining RVUs. Can you show me that? Or are you saying that the hourly cost of our services are immaterial and employers are not taking those into account?


@WisNeuro

You’re talking about jobs. I’m talking if the hourly fee for psychologists was widely accepted as much higher. I would argue if anyone could make $40-100k off of a provider, they would. If your hospital system made $100k per psychologists who provided psychotherapy, would you think that your system wouldn’t hire many many more?
 
@WisNeuro

You’re talking about jobs. I’m talking if the hourly fee for psychologists was widely accepted as much higher. I would argue if anyone could make $40-100k off of a provider, they would. If your hospital system made $100k per psychologists who provided psychotherapy, would you think that your system wouldn’t hire many many more?

Fair, if we had advocated to keep reimbursement higher, we'd be in a different boat now. But, that ship has sailed. I'm not really certain any amount of lobbying will change CMS reimbursement rates, and by extension private insurer rates at this point to any significant degree. We're at the point now where the saturation and midlevel creep has definitely affected pay and job availability.
 
Just to offer a bit more balance to the discussion with private practice you do not get paid for cancelations or no shows, need to deal with insurance companies or pay someone to do so if you plan to take insurance, do not get paid holidays or paid vacations, and need to take out your own insurance policy (unless you have a spouse with one). There is group practice but then 40% of what you make goes to cover expenses (although the percentage may vary). I know people who work at the VA or AMC and then have a small practice on the side. To me, that seems like the best of both worlds.

There are other private practice options. I work in a large group private practice. I receive a good salary and benefits, with paid time off, flexible and self-managed schedule, employer contributed insurance and retirement, student loan reimbursement, licensure/board certification fee reimbursement (with 3 licenses and and 1 board certification, fees can add up), and the ability to adjunct in an affiliated graduate training program (with additional compensation). It's a somewhat (but not too much!) specialized area of practice. We actually have a difficult time finding qualified psychologists.
 
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...there are simply less jobs to go around and more people willing to accept lower paid jobs. Heck, in our hospital system we don't even hire psychologists to do therapy any more.

I think this is on point- the psychologist who train for general outpatient stuff generally compete with mid-levels and themselves. With similar outcomes, they can't command more than their less expensive brethren.

I have, on the other hand, observed first hand the difficulties of finding (and keeping) better trained, more specialized psychologists.
 
Lobby for a return to psychologists being able to bill E/M codes. Boom, we are back in business. That would run each person in the field what? $500 if everyone contributes?

Want more? Physician status with CMS, just like chiros.

Even more? Rxp.

@WisNeuro you wouldn’t accept such fatalism from patients.
 
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Lobby for a return to psychologists being able to bill E/M codes. Boom, we are back in business. That would run each person in the field what? $500 if everyone contributes?

Want more? Physician status with CMS, just like chiros.

Even more? Rxp.

@WisNeuro you wouldn’t accept such fatalism from patients.

Well, I wouldn't, but I don't trust some of our lesser trained colleagues with boatloads of debt who are willing to take whatever they can get. Also, haven't we been lobbying for physician status through CMS for years? I support our lobbying bodies monetarily, and am very active in contacting my representatives when bills come up that affect our field, but my action comes with a healthy dose of skepticism and pragmatism.
 
Our value has been eroded over the past few decades and reimbursements are way down when inflation is included. There are more hoops and roadblocks through “managed care”, yet psychologists just sit there and take it.

The scenario above is bad, but now add in a flood of mid-levels willing to work for less and salaries further decrease. Then add in fringe to poorly trained psychologists willing to take mid-level jobs, and now there is a surplus of clinicians willing to work for peanuts.

I’d rather go work a non-clinical job than accept <$100k for a clinical gig. I know my value, but it seems most don’t. If you don’t know your cost/overhead, revenue, and thus what your employer makes off of you....that puts you at a disadvantage.
 
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I go back and forth at times. I do not miss the VA at all, per se, but my health insurance was better there for sure. Beyond that, I miss working with students and interns, as well as some of the predictability of the setting and overall job. I think this is also what made it boring, however.

I don't miss working with suicidal patients, vague complaints of "anxiety" or "problems sleeping."
 
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Notice all those people that got rich working as an employee for the federal government?

Me either.

While I agree with you on most things, there are gov employees that know how to work the system with six figure pensions at 65. The VA also can make a nice day job from which to start a business on the side.

Granted, you won't be rich if you spend a career working there and going home. However, you will be more comfortable than many employed colleagues in private settings. Private work can often be boom or bust. For all those that make more than me, there are those grinding it out making $80k.
 
While I agree with you on most things, there are gov employees that know how to work the system with six figure pensions at 65. The VA also can make a nice day job from which to start a business on the side.

Granted, you won't be rich if you spend a career working there and going home. However, you will be more comfortable than many employed colleagues in private settings. Private work can often be boom or bust. For all those that make more than me, there are those grinding it out making $80k.

But, depending on which VA you are at, you might be comfortable with salary but also be subject to high caseload demands that don’t compensate you for the extra work. If you look at the new RVU structure, you might be compensated better outside of a facility like the VA, if you consider the billing that you take in.

VA salary is high floor for ECPs, and low ceiling later in your career.
 
Private sector job is really a great fit- probably a 50% more work load increase in the same 40 hour work week but also with anywhere from 30-40% higher pay. Benefits such as $4k for conferences, travel, professional memberships. Fancy office. Fancy high profile coworkers. Very cool city.

Federal Job: Fat benefits (low health care premiums, pension plan), Very low clinical load/productivity requirements, adequate pay...stability. It's not such a great place to live but I already own a house here and I'm no spring chicken.

It sounds like the private sector job offers a lot of the perks and structure that people usually seek from state/federal employment. It sounds like a pretty nice gig if you ask me. But it comes down to what you want. Know yourself. I will say, though, that I have yet to meet a psychologist who left government employment and ended up regretting it.

I went the AMC route and I think for many people that is a sort of middle way. The pay ceiling is generally higher than at a VA, and it is not unheard of for psychologists to move into administrative roles if that's your thing. I have mouths to feed and not-huge risk tolerance so the institutional security holds some appeal for me. I also enjoy the scientific work and I could see myself turning to pharma or other industry before full-time private practice.

What psychologists can’t do that physicians can is be average in school, take an average path as a clinician and make 300k a year.

Indeed! I don't know any high earners in the field who are phoning it in (even passive income really isn't passive).
 
I think it’s important to know that there are possible ways to get rich. Not knowing limits ones goals.

The most helpful, non self aggrandizing response I can offer:

1) I could name several and I am 100% positive of their income.

2) Most are not psychologist “famous”.

3) The ways to make money in this field seem to be:

A. to hire people and pay them less than they generate,

B. or to find a higher than average revenue stream and bill the ever living hell out of it.

C. or to make some product that is bought by non-psychologists. Books mostly don’t count.

4) That the rich ones don’t advertise their income should tell you something about their ethics in their hiring practices or their security of their revenue.

Agreed with the above, but you need to be careful that you are being hired to be A and undervaluing yourself. This is especially true if they are pushing B on you. PP can be great or terrible depending on the individual deal.
 
But, depending on which VA you are at, you might be comfortable with salary but also be subject to high caseload demands that don’t compensate you for the extra work. If you look at the new RVU structure, you might be compensated better outside of a facility like the VA, if you consider the billing that you take in.

VA salary is high floor for ECPs, and low ceiling later in your career.


Agreed somewhat. Being in Geriatrics, I am not stuck in the new RVU/grid structure. That said, it really depends on who you are. If you like to work alot, find a good PP deal. If tend toward working less, enjoy the high floor on salaries at the VA and don't take on too much when there.
 
Random thoughts:
1) This sounds like a very personal decision. Nothing wrong with choosing stability. Nothing wrong with choosing the money. Depends on your personal circumstances what makes sense.
2) I think AMCs (and VAs to a lesser extent) make great sense for folks who want substantial research or educational involvement. Infrastructure needed doesn't scale down these days, though I guess it somewhat depends on what your research entails. The list of government-employee millionaires is likely vastly longer than the list of recent nobel laureates without an academic affiliation. I think it makes much less (financial) sense if you want a heavily clinical career.
3) Still far from the worst that is out there clinically. 100k is easily attained in a medical center even by junior folks (took me 1.5 years past post-doc to hit that in a very modest COL area). It is outrageously high for many other salaried psychology positions. I'm not saying its right or that it isn't possible to make more than that. Just that being in an AMC making 100k is probably better than being in a counseling center making 50k. Which is an actual salary I have seen for licensed psychologists.
4) Don't overestimate how much happiness money buys. I'd take a fairly sizable pay CUT in exchange for a more reasonable work-life balance. I'd rather be happy working for 30 years than miserable working for 15 followed by a longer retirement.
5) Don't underestimate how much happiness money buys either. Especially if you have loans, live in a high COL area, have a family, etc.
 
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Agreed somewhat. Being in Geriatrics, I am not stuck in the new RVU/grid structure. That said, it really depends on who you are. If you like to work alot, find a good PP deal. If tend toward working less, enjoy the high floor on salaries at the VA and don't take on too much when there.
There are VAs out there that promote a culture of operating very high above the RVU floor to meet clinical demand and directives regarding wait lists. This can translate into compromising your practice in terms of frequency of sessions/EBTs or abbreviating your assessments if your administration doesn’t hire enough clinicians to meet the demand. “Don’t take on too much when there” has different potential meanings.
 
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There are VAs out there that promote a culture of operating very high above the RVU floor to meet clinical demand and directives regarding wait lists. This can translate into compromising your practice in terms of frequency of sessions/EBTs or abbreviating your assessments if your administration doesn’t hire enough clinicians to meet the demand. “Don’t take on too much when there” has different potential meanings.

Exactly, I always had a lower productivity load with neuro while in the VA. But, I knew therapy and PCMH people with crazy high workloads getting bogged down by documentation demands pushing their workweeks into the 50 hour/week range.
 
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There are VAs out there that promote a culture of operating very high above the RVU floor to meet clinical demand and directives regarding wait lists. This can translate into compromising your practice in terms of frequency of sessions/EBTs or abbreviating your assessments if your administration doesn’t hire enough clinicians to meet the demand. “Don’t take on too much when there” has different potential meanings.

Oh, I don't doubt it. Hence the idea that when you know one VA, you know ONE VA. Same is true for the private sector. There are great jobs and those run by slave drivers. My point is that it depends on the individual position and local environment in either case. I currently make more money for less work in my VA position than I did in the private world. That was largely due to the economics of the area, low medicare reimbursement rates, and lots of compliance overhead ( most of the competitors kept salaries close in my area; 50-60% billables with benefits). There are areas of the field that will be the opposite (as PSYDR mentioned, bill the hell those and you can mint money)
 
Random thoughts:
1) This sounds like a very personal decision. Nothing wrong with choosing stability. Nothing wrong with choosing the money. Depends on your personal circumstances what makes sense.
2) I think AMCs (and VAs to a lesser extent) make great sense for folks who want substantial research or educational involvement. Infrastructure needed doesn't scale down these days, though I guess it somewhat depends on what your research entails. The list of government-employee millionaires is likely vastly longer than the list of recent nobel laureates without an academic affiliation. I think it makes much less (financial) sense if you want a heavily clinical career.
3) Still far from the worst that is out there clinically. 100k is easily attained in a medical center even by junior folks (took me 1.5 years past post-doc to hit that in a very modest COL area). It is outrageously high for many other salaried psychology positions. I'm not saying its right or that it isn't possible to make more than that. Just that being in an AMC making 100k is probably better than being in a counseling center making 50k. Which is an actual salary I have seen for licensed psychologists.
4) Don't overestimate how much happiness money buys. I'd take a fairly sizable pay CUT in exchange for a more reasonable work-life balance. I'd rather be happy working for 30 years than miserable working for 15 followed by a longer retirement.
5) Don't underestimate how much happiness money buys either. Especially if you have loans, live in a high COL area, have a family, etc.


After reading all the discussion I think the choice is clear - I just need to get up the nerve to make a change and not be daunted by the heavier demands of private sector work. It is true you cannot put a price on happiness/work life balance...take it from me, I've worked pretty hard my whole life and feel I've really reached a place where I really don't have to work all that hard anymore to live a very comfortable life. In contrast to others, I also think the VA has been a very good place to work and it is a satisfying job. For most non-specialist, junior career types it does offer good salary with mostly a fair workload. For me though, I feel grossly underpaid by the feds (AT LEAST 30K+ off of where I could/should be and my other offers).

This job I am considering is probably twice the number of cases I am now seeing weekly but the money is excellent for the area and really good even for my specialty. The location is also excellent if you like to downhill ski, hit the beach, hike, bike to work, breathe clean air, etc. Good schools. Where I am at now is a suburb built on top of a corn field in Trump Country. I guess you can't always have it all - a good easy going VA job while also having high pay and a great location.
 
After reading all the discussion I think the choice is clear - I just need to get up the nerve to make a change and not be daunted by the heavier demands of private sector work. It is true you cannot put a price on happiness/work life balance...take it from me, I've worked pretty hard my whole life and feel I've really reached a place where I really don't have to work all that hard anymore to live a very comfortable life. In contrast to others, I also think the VA has been a very good place to work and it is a satisfying job. For most non-specialist, junior career types it does offer good salary with mostly a fair workload. For me though, I feel grossly underpaid by the feds (AT LEAST 30K+ off of where I could/should be and my other offers).

This job I am considering is probably twice the number of cases I am now seeing weekly but the money is excellent for the area and really good even for my specialty. The location is also excellent if you like to downhill ski, hit the beach, hike, bike to work, breathe clean air, etc. Good schools. Where I am at now is a suburb built on top of a corn field in Trump Country. I guess you can't always have it all - a good easy going VA job while also having high pay and a great location.


If you are doubling your caseload and not doubling your income (no idea if you are or not), I consider that a pay cut on an hourly basis regardless of what raw money is offered. That said, as you mentioned, there are a number of non-monetary factors here (nice office vs VA office, location, etc) and money is not the only thing that makes the world go round. If you are happier in one setting vs the other, then go for it. The correct thing to do is different for each individual person. Good luck and keep us updated.
 
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Folks, I am at a unique crossroads where I need to choose between federal employment and private sector work. Anyone here leave federal work and never look back and want to tell me how it was for them out there in the real world?

Private sector job is really a great fit- probably a 50% more work load increase in the same 40 hour work week but also with anywhere from 30-40% higher pay. Benefits such as $4k for conferences, travel, professional memberships. Fancy office. Fancy high profile coworkers. Very cool city.

Federal Job: Fat benefits (low health care premiums, pension plan), Very low clinical load/productivity requirements, adequate pay...stability. It's not such a great place to live but I already own a house here and I'm no spring chicken.

I did a calculation...I'd have to be retired on a federal pension for 15 years before I'd even break with the money I'd be making in this private sector job and that's just the base pay (not including productivity bonuses).

Hoping to here some "I escaped the feds" success stories or alternatively, "the grass isn't greener, stay in gov't work"

I'm glad you asked this, as I am having similar considerations about what would be in my best interests in the future. I have just begun thinking about my options and what would be economically feasible, but I am still in the very early stages.

EDIT: I do not work at a VA.
 
I'm glad you asked this, as I am having similar considerations about what would be in my best interests in the future. I have just begun thinking about my options and what would be economically feasible, but I am still in the very early stages.

EDIT: I do not work at a VA.
I am on the cusp of making a very big leap so appreciate this thread a lot. It's reassuring to see so many not regretting the decision to leave VA employment. It's pretty much all I've known, so I'm a bit terrified.
 
Hi everyone- current intern here knee-deep in the postdoc process and was wondering if anyone could shed some light on a question of mine.
I'm currently looking at a few post docs (2 AMCs and 1 private practice). I would love to start my career in a multidisciplinary setting like a hospital or AMC, but the private practice postdoc offers training in a specialty I wouldn't get at the other sites. My question is- am I shooting myself in the foot by going to a private practice for post doc/Would I still be considered competitive for an AMC when looking for jobs?

Thanks in advance!
 
Hi everyone- current intern here knee-deep in the postdoc process and was wondering if anyone could shed some light on a question of mine.
I'm currently looking at a few post docs (2 AMCs and 1 private practice). I would love to start my career in a multidisciplinary setting like a hospital or AMC, but the private practice postdoc offers training in a specialty I wouldn't get at the other sites. My question is- am I shooting myself in the foot by going to a private practice for post doc/Would I still be considered competitive for an AMC when looking for jobs?

Thanks in advance!

Generally speaking, doing a post-doc in a private practice setting would make you less competitive for most AMC jobs, relative to doing a postdoc at the AMC. That is not an absolute, and there are certain assumptions imbedded in that statement, but that’s why I say “generally.” Unlike many 4-year colleges and universities, AMCs very often “hire their own.”

Is the specialty training you would get from the other site really crucial for the career you envision, or is it just a “nice to have” thing? As you move further along in your training, the match between your training setting and your career goals matters more and more.
 
I’d strongly suggest you pursue the AMC fellowships if you want to work at an AMC. An AMC fellowship should check all of the boxes for licensure and boarding. The didactic training will likely be better too.

From a hiring perspective, I likely wouldn't consider hiring someone who completed a PP post-doc year(s) unless the person trained directly w. a big name within your speciality. I’m not saying it is fair, but PP post-docs can be highly variable.
 
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Thank you both so much. That’s what I had been assuming as well- just hadn’t really been able to get a clearer picture until now. I’m thinking the experience specialty I was referring to would be “nice to have” rather than an necessity, especially considering I already have some training in that area.
 
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