Pulm/cc job outlook?

[Whatsyourname]

Interested in fellows currently applying for jobs in pulm/cc to tell us about their insight into job outlook? Offers, salaries, etc

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[Whatsyourname]

I'm a resident btw, haven't updated my account in a while...just pointing that out before I get a bunch of "wait til you match" replies.

Thank you

 

[maverickdoc]

Our 3rd year class have all signed between 280-440000 in pp depending on where and how much they were willing to work, one guy who will stay at our home institution as an attending :180 and some change

 

[jdh71]

Interested in fellows currently applying for jobs in pulm/cc to tell us about their insight into job outlook? Offers, salaries, etc

I'm not looking at any major metro areas (mainly midwest, moutainwest, and swouthwest), but there's plenty and they are paying well.

 

[Whatsyourname]

does one need to do a sleep fellowship to practice sleep medicine after a pulm residency?

 

[jdh71]

does one need to do a sleep fellowship to practice sleep medicine after a pulm residency?

yes (and it's pulm fellowship)

the day's of "grandfathering" are over

sleep is it's OWN unique thing and should be, and it's only a year after IM (or psych, or neuro, or ENT, or anesthesia, or FP - I think all of those are generally considered specialties), so not too obnoxiously long for a fellowship

 

[souljah1]

It completely depends on what type of job you are looking for..

While few people in my fellowship eventually go into private practice after fellowship those that do have multiple offers. I get at least 4 or 5 e-mails a day from physician recruiters so my over impression is that there is a demand for us in the private sector.

Academic clinical jobs are tight. Half of my fellowship class is looking around the country to academic/clinical educator type jobs in Pulmonary & Critical Care and the impression is that places are hiring less than in the recent past. Our program director just got back from some meeting (with other program directors) and said that it's tight not only for external candidates but for internal candidates as well. We have historically kept at least half our fellows every year, but now it is much more difficult to do so. With clinical revenue down across most academic centers, it has become more difficult to make an argument to hire more people. The exception would be an institution that just hired a division chief or something like that because they usually get a pot of money to grow certain areas.

Jobs in academic that are more research focused are obviously primarily dependent on grants, e.g. NIH, AHQR, PCORI. The funding lines for these agencies are, for the most part, at historic lows. Meaning, it is much more difficult to get a large career development award to assist in your fellow-to-faculty transition now than it was say 10 years ago. That means that it is increasingly likely that you may have a year-to-year job as an instructor as you desperately try to acquire a grant to come on as faculty. Because physicians with large grants only work no more than 20% clinical, it is easier for a division or department chair to find clinical opportunities for them.

Having said all of this, I don't think anything that I've said is specific to pulmonary and critical care. Many of my friends in other subspecialties are facing similar realities - all of which are better than what most people face in their daily lives.

Hope that this is helpful.

 

[Whatsyourname]

That was an awesome reply, thanks!

My two biggest interests are pulm/cc and heme/onc. I love teaching but don't mind doing private if I had to, but I'm worried due to decreased demand for some fields, for example it's harder and harder to find a heme/onc job in any desirable location. I personally like the IcU more (and I don't mind pulm clinic), I'm currently a 2nd year so ill have to be deciding pretty soon, and I'm basing the decision on job outlook. Problem is I have no idea what that'll be 5 years down the line, just trying to gauge it using existing data

 

[DIce3]

I'm basing the decision on job outlook.

Might not do it that way. The job market will change in unexpected ways. Between Heme and Pulm, might try to figure out which you like better. One is very heavily inpatient with terrible hours and the other is very heavily outpatient.

 

[jdh71]

Might not do it that way. The job market will change in unexpected ways. Between Heme and Pulm, might try to figure out which you like better. One is very heavily inpatient with terrible hours and the other is very heavily outpatient.

If you mean pulm/crit is heavily in-patient with terrible hours, that really isn't true.

I mean I suppose you can always find some practice set-ups where people are working stupid, but most pulm groups have you in the unit one week and in the clinic the rest of your time, with those weeks split between members of the group. Most intensivists are either moving to shift work, or, having the hospitalists admit at night, with consultation from home. So the hours really are not that much worse, and most of pulmonary is done in the out-patient setting.

Though, I do agree that OP needs to choose which specialty he likes best.

 

[souljah1]

Agree, I would not choose a specialty based primarily on job outlook. It is much more important to choose a specialty that you would be most happy doing for at least two decades or more.

re: Horrible hours. That, again, depends on what sector you are speaking about. Most private practice jobs are very busy, period. Depending on the institution, academic educators have a pretty decent lifestyle. A research-driven job is very busy but also very flexible.

Commonly, the later two options pay less than private practice - though I think that the private sector will see a decrease in wages as we focus more on efficiency, transition from fee-for-service to value-based purchasing, and fund more comparative effectiveness research, etc. Academic salaries will most likely remain unaffected, though it may be a bit more difficult to actually secure an academic position. Obviously, this is all speculation and one man's opinion.

 

[Whatsyourname]

Any other experiences by current fellows on finding work in this market?

 

[VJWDO]

I am currently negotiating a position in Northern California. Private practice, salary will be about 350K with all the bonuses etc and I can partner after 2 years. After you partner pay is much higher (>500K). I plan to do 50% clinic 50% inpatient (ICU/Pulm consults). Agree with the assessment that pay is higher in less desirable areas. I have friends in rural places making more but you have to live in rural places 🙂

I like California so I knew pay would be a little less.

Hope that helps.

 

[redy]

I am currently negotiating a position in Northern California. Private practice, salary will be about 350K with all the bonuses etc and I can partner after 2 years. After you partner pay is much higher (>500K). I plan to do 50% clinic 50% inpatient (ICU/Pulm consults). Agree with the assessment that pay is higher in less desirable areas. I have friends in rural places making more but you have to live in rural places 🙂

I like California so I knew pay would be a little less.

Hope that helps.

350k in california sounds awesome. Although does it have something to do with being northern cali? And you earn more after you partner and more if you go rural? Didn't know it was this good.

 

[VJWDO]

350k in california sounds awesome. Although does it have something to do with being northern cali? And you earn more after you partner and more if you go rural? Didn't know it was this good.

Yeah typically the less desirable places (not bay area or SoCal) in Cali pay more.

rural will always pay more because they have to lure you there.

Partnering requires that you buy in and not all practices will offer this.

 

[ShakooMakoo]

This is well above average salary, I'm in a rural area (j1 waiver area) pulmonologist here signed up for 300K.

 

[jdh71]

This is well above average salary, I'm in a rural area (j1 waiver area) pulmonologist here signed up for 300K.

Disagree. Almost all the gigs I'm looking at have base around 350.

Though some places with lower bases salaries have higher production structures. If you're getting 300 for median wRVU in a rural spot you are being underpaid.

 

[desijigga]

What kind of offers would you expect in the bigger cities? 200K, 250K? Talking cities like Chicago, St Louis, Detroit, NYC, Dallas... Just wondering regarding private practice, academics I know would be sub 200K

 

[jdh71]

What kind of offers would you expect in the bigger cities? 200K, 250K? Talking cities like Chicago, St Louis, Detroit, NYC, Dallas... Just wondering regarding private practice, academics I know would be sub 200K

You should still be between 250-300 even in the cities I think. Though you don't really have to go that far outside to find higher pay from places like Chicago, St. Louis, Detroit, or Dallas. The burbs in all those places pay really well.

NYC is is own piece of ****, and you're a weirdo if you want to work there and are not from there, just my humble opinion. Heh.

 

[Doc Doc Doc Goose]

I am currently negotiating a position in Northern California. Private practice, salary will be about 350K with all the bonuses etc and I can partner after 2 years. After you partner pay is much higher (>500K). I plan to do 50% clinic 50% inpatient (ICU/Pulm consults). Agree with the assessment that pay is higher in less desirable areas. I have friends in rural places making more but you have to live in rural places 🙂

I like California so I knew pay would be a little less.

Hope that helps.

When you say 50:50, does that mean per month: week of ICU/consults 7am-7pm? Then two weeks of clinics? How many hours a week are these? Then a week off?

trying to understand the general schedule of a pccm doc in private practice? I recognize it can vary greatly on many factors like group size.

 

[lafamilia]

MGMA continues to cite that there will be a great "absolute demand" for Pulmonologists, considering that this specialty has the greatest percentage of physicians 55 years and older per the 2018 report. How is the job market currently now that volume is returning to pre COVID levels? Aside from having an interest in sleep medicine, will it translate to a significant increase in salary?