What makes you think you won’t have to deal with this as a hospitalist? In many places, hospitalists are the dumping ground for everyone.
First few weeks of heme/onc fellowship, like many others I was new to the institution, don’t know anything, anxious, etc.
But you have only known them for 2 weeks…
Maybe for some of cards subspecialists like interventional or EP, but harder to say sure how much general cardiology really comes out ahead of IM/FM hospitalist once all factors considered. Namely, the higher pay comes mostly from longer work hours (usually 55-60 hrs week as an attending from what I hear, which ends up being a lot more work than the typica 7-on/7off hospitalist) and the higher RVUs that are generated as result. The hourly pay for employed general cardiology comes out only slightly higher than employed hospitalist. Once you factor in the 3 year training time, and the high tax brackets physicians are in, the post-tax money may only be slightly more with the break even point later in career.
I don’t know. I worked pretty damn hard as a fellow, and a lot of the stuff I had to do was either scut work or aspects of my specialty I detested dealing with. Now, as an attending, I do “more work” but it’s the kind of work I like doing. Plus, I can set up the clinic my way, I have staff that specifically work to help me accomplish things (including scribes!), and I’m not personally handling any scut work - none of which were true in fellowship. So even though the volume of work is “bigger”, I think it’s actually much easier to deal with (and much more pleasant).
agree with others here- sounds like your concerns aren't about cardiology as much as self doubt and a tough environment.
I am not sure that IM/FM hospital medicine (HM) is really getting saturated with the # of calls I am getting everyday. If it is, there must something attractive about HM. I will say that again, the most attractive thing about HM is flexibility.
He just started PGY5, so he has close to 2 more years to go.
Can you elaborate a bit more regarding the lifestyle ?
I mean, you dont need me to tell you. Look at the life of any cardiology attending, academic or private. They may be raking in the cash, but for what? Long hours, stressful cases, between those consults plenty of sinus tach and trop one point above normal consults, always busy and on call (yes even when not scheduled if you are someones cardiologist, you are getting called), and the literature changes by the minute so you have to keep up with it on top of that. Thats what I can name off the top of my head. It sucks! Contrast that with a hospitalist: shift work, half the month off, can have very easy days, the work gets to be mundane after a while (which is nice, despite what the make you believe in residency), scale up on shifts if you want more $, and can acutally enjoy the money and life otuside of work.
Typical full time cardiologist works 55-60 hrs per week, unless it's a vacation week. They usually have both inpatient and outpatient responsibilities, and rotate in overnight call with their colleagues (and they get called a lot more by the ED and hospitalists than most other specialties). That's a lot more work than the typical FM/IM hospitalist, and hence higher RVUs and higher pay. Though on a per hour basis, generally cardiologists on average make only slightly more than FM/IM hospitalist, despite having 3 more years of training.
i think you forgot the terrible lifestyle of reading echos from home 9-5.
I work ~65 hrs every other week for 350k/yr. I can request schedule changes anyway I want to if I make the request 2 months in advance. For instance, I requested to work beginning and the and of this month so I can get 2 wks in between to travel. No problem/issue.
This actually would be a nice gig.
Not sure such a full time job would exist outside of large academic institutions. Would probably need a lot of volume to justify one person just doing cardiac imaging full time, which you usually only get at academic medical centers or large health systems. And would probably come with a significant pay cut if they were only working 40 hrs. In PP, would be unusual for the partners to let only one person work 9-5 and get out of rotating through the night/weekend pool.
It's not healthy. I think you should get out.
You’re definitely smart enough.
It’s only been 6 weeks…you have had what? 1 rotation?
Yeah, just reading this thread you’ve gone from thinking you wat to quit fellowship to become a hospitalist, to now saying you don’t think you cannot be a cardiologist…so it seems like it may be more mental at this point. It seems like you have at least come to the realization that you do want to be a cardiologist, so its good you didn’t quit outright. It sounds like the program itself is the challenge and that you are under the microscope, which makes for a stressful situation. It’s probably good you are talking with the PD so that you can develop a game plan for improving. It’s never good to develop a reputation and be under the spotlight, but if you show improvement, you should end up ok. I would be open to feedback and figure out how to best improve (talk to attendings, is there daily reading/studying you can do to help, etc).
Hmm.. this is coming from a hospitalist on steroid aka CCM.
Yeah, you are right.
Well you have to admit, you are a bit of a cheerleader…been there, done that and I’m glad I’m an endocrinologist…10 years ago hospitalist was doable… now? Hard to sustain that life.
I am. I happen to like my job. I work with people who have been doing for over 10 years that are actually more gung ho than me.
Which just shows you that the are different options… one is not the end all be all specialty.
I agree, I think I’d be miserable as a hospitalist. (Rheum now.)
I just happen to be ok with my job. The stuffs that bother some hospitalist (eg,. social issues, surgical specialties dumping on you, OB calling you to fix a postpartum elevated BP etc...), don't bother me that much.
No ACGME protected work hours during fellowship so you work as long as they need you. It is more taxing and harder than a tough IM residency. Frequent long calls. Q2-4 24 hour shifts often lasting longer than 24 hours. STEMI call? Yeah no thanks lol
Perhaps I am misunderstanding, but ACGME work hours apply to all fellowships exactly the same as residency. Unless you're referring to a non-ACGME fellowship. Or work after training?
Probably referring to “home call”
