Sabbaticals in Emergency Medicine

[Mecidimes]

Hey everyone, M2 here with a question for currently-practicing EM physicians.

As an ER doctor, would you ever have a reasonable opportunity to go on an extended sabbatical to get another degree? For instance, I have heard of a handful of ER doctors who went to the six-summat months of police academy as well. How feasible is a sabbatical as an attending ER doctor?

Thanks.

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[WilcoWorld]

Hey everyone, M2 here with a question for currently-practicing EM physicians.

As an ER doctor, would you ever have a reasonable opportunity to go on an extended sabbatical to get another degree? For instance, I have heard of a handful of ER doctors who went to the six-summat months of police academy as well. How feasible is a sabbatical as an attending ER doctor?

Thanks.

It is probably more practical for an EP than it is for almost any other specialty. That being said, few do it.

 

[HooliganSnail]

When you are an attending physician you can do anything you want, almost anywhere you want. If you don't want to work for 6 months....you can do that.

However, you still have bills to pay, and loans to pay off, and any job you had before will not likely be waiting for you when you are done. It's not hard to find another place to work when you are BC/BE EM, but it can be tricky in desirable locations.

The other element is that, by the end of med school and residency, you are all trained out. Most just want to enjoy the career they spent so long training for.

 

[coachB]

[QUOTE="The other element is that, by the end of med school and residency, you are all trained out. Most just want to enjoy the career they spent so long training for.[/QUOTE]

In reality, at this point your training is only beginning. Training in our specialty is ongoing with no "finish line." If you fail to recognize this, your patients will suffer. Of course we all see this mentality, and the accompanying results, every day.

 

[WilcoWorld]

When you are an attending physician you can do anything you want, almost anywhere you want. If you don't want to work for 6 months....you can do that.

However, you still have bills to pay, and loans to pay off, and any job you had before will not likely be waiting for you when you are done. It's not hard to find another place to work when you are BC/BE EM, but it can be tricky in desirable locations.

The other element is that, by the end of med school and residency, you are all trained out. Most just want to enjoy the career they spent so long training for.

In reality, at this point your training is only beginning. Training in our specialty is ongoing with no "finish line." If you fail to recognize this, your patients will suffer. Of course we all see this mentality, and the accompanying results, every day.

I can still enjoy a couple hours of CME, but I have been surprised at how unappealing the idea a day of lectures seems now - especially given that I used to have no problem going to school from 8a-4p and then studying from 6p-10p 5 days a week.

 

[HooliganSnail]

[QUOTE="The other element is that, by the end of med school and residency, you are all trained out. Most just want to enjoy the career they spent so long training for.

In reality, at this point your training is only beginning. Training in our specialty is ongoing with no "finish line." If you fail to recognize this, your patients will suffer. Of course we all see this mentality, and the accompanying results, every day.[/QUOTE]


Thanks for the platitude.....

We are discussing leaving medicine to pursue FORMAL TRAINING in something else.

We are NOT talking about staying up to date with new literature and the latest in our specialty.

If you're not going to pay attention, you are going to miss things, but then again WE ALL see this mentality, and the accompanying results, everyday.

 

[goodoldalky]

Hey everyone, M2 here with a question for currently-practicing EM physicians.

As an ER doctor, would you ever have a reasonable opportunity to go on an extended sabbatical to get another degree? For instance, I have heard of a handful of ER doctors who went to the six-summat months of police academy as well. How feasible is a sabbatical as an attending ER doctor?

Thanks.

It depends, but is probably doable in most circumstances. A couple of caveats:

1. There is no 6 month degree that I am aware of that is worth an EP getting.
2. Taking 6 months off of work to do XYZ will cost you in the neighborhood of $180,000 in lost earnings. (Which, whether you are looking at student loans/interest or investment gains, costs you a lot more than 180K in the long run.)
3. The feasibility of doing this will depend on your employer. If you are SDG pre-partner, those 6 months will not count toward your sweat equity time, delaying partnership. If you are in an academic program, unless you have a buy down on time, it is unlikely that you will be able to do this without some concessions. Some academic programs provide you with time for a sabbatical, once you have put 10, 15 years in (the number of years varies). If you work in a private practice community setting, your employer may or may not be willing to pay for your benefits while you do this, and may or may not choose to hire someone to take your job as opposed to scrambling to cover all of your shifts. A sabbatical is much easier to do if you are in a locums type arrangement where you do not have a significant commitment to your employer.

Most EPs that I know that go back to get useful degrees (such as an MBA), for the 2+ years this requires, will get the degree and continue working full-time, which is quite painful but much easier than the alternative. You should have a really, really, really good reason for doing this. I have never heard of an ER doctor taking 6 months off to go to the police academy. Unless they can somehow make up the 180K of lost earnings plus opportunity cost/interest it's a financially losing decision, and there should be some other really important justification. (A lot of the above logic, in my opinion, applies to fellowships as well.)

 

[The White Coat Investor]

You could do it but you will likely have to quit your job to do so.

My democratic group occasionally discusses figuring out a way for us to take a 3 month sabbatical, one at a time. We've never figured out a good way to do it. The main issue is only a minority of us are interested and there is a significant burden shifted to the others if we do.

 

[Hercules]

You could do it but you will likely have to quit your job to do so.

My democratic group occasionally discusses figuring out a way for us to take a 3 month sabbatical, one at a time. We've never figured out a good way to do it. The main issue is only a minority of us are interested and there is a significant burden shifted to the others if we do.

Same here. We've looked at sabbaticals for quite some time. The reality we came to is that you would essentially have to hire extra personnel (and accept the resulting decrease in pay) to staff at the same level you currently do.


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[Janders]

We've had a load of docs who will work a year at roughly 2/3's clinical time, and get an MPH at the same time (working a lot of nights and weekends). They do, say, 8-9 shifts a month during the true school year, picking up extra shifts in mid summer and over the winter break to partially make up for it. Perhaps averaging out 10-11 shifts/mo over the course of the year. This keeps the income pretty high, allows you to stay fresh with your clinical work, and is a small enough change that the group as a whole can deal with it.

I can imagine being able to pull off the same thing over 1-2 years for MBA programs as well, or some other masters level degree if you found it interesting and your group was flexible with scheduling and you were willing to sacrifice overnights and weekends to make your schedule work.

An actual 6mo sabbatical is very tough in a smaller, democratic group. Who is going to pick up the slack while you are gone? Certainly it is POSSIBLE but it wouldn't be easy, depending on the market. Obviously you would take a big loss of revenue for this. Now... could you go to school during the week, and work every saturday and sunday and thus do 8-9 shifts a month, and keep your position? That might be easier to pull off in a small group / tough market, but obviously would have effects on your life.

 

[GeneralVeers]

We considered "paid sabbaticals" at one group I worked for. It was voted down, because not everyone wants to take 2-3 months off, and with staffing always thin, it would have been a burden every time someone chose to take one. Plus you would essentially be paying someone to not work, which would drive down reimbursement for everyone.

 

[gman33]

Work locums and you could do whatever you want.

A permanent position would likely show you the door if you wanted 6 months off.

Staffing for the remaining docs becomes a problem with an extended leave.

 

[Deuce Doc]

My group is definitely an outlier in that we have a sabbatical program. It is not paid however because we are a democratic group. You understand that if we paid, it is just a shell game of moving your money around adding to the opacity of your finances. You just have to budget for it. The impact to the group is really only that we hire to accommodate it. At any time we have 1 more doctor than we need to staff the place so that someone else can be on sabbatical. This also means you don't necessarily get your first choice for a vacation month every year. The nice part is that it avoids you having to split a trip across 2 scheduling blocks or cram a bunch of shifts into part of the month.

But it ain't 6 months off.

Our group has made accommodations for people to give up their membership for a year in order to work or travel. Then you can get your membership back after the year (as long as there is a spot for you), and we hire to allow for that. It sounds like from the above comments, this didn't make sense for other groups. That is the real reason to be in a democratic group, in my view. You decide what the rules will be.

 

[Apollyon]

Our group has made accommodations for people to give up their membership for a year in order to work or travel. Then you can get your membership back after the year (as long as there is a spot for you), and we hire to allow for that. It sounds like from the above comments, this didn't make sense for other groups. That is the real reason to be in a democratic group, in my view. You decide what the rules will be.

The bolded sounds like kinda a BIG gamble.

 

[tkim]

Our group allowed one guy to take 18 months off to go to NZ to work there. Since we have a robust moonlighter list because of an affiliation with the local residency/fellows to take the schedule hit, it wasn't too bad for the rest of us. Not sure it will become a regular thing, though, as I was mildly interested and said it was probably not going to happen again.

 

[deleted109597]

We've had a load of docs who will work a year at roughly 2/3's clinical time, and get an MPH at the same time (working a lot of nights and weekends).

It's called "fellowship", except they're paid at less than 2/3rds value.

 

[deleted109597]

Our group has made accommodations for people to give up their membership for a year in order to work or travel. Then you can get your membership back after the year (as long as there is a spot for you), and we hire to allow for that. It sounds like from the above comments, this didn't make sense for other groups. That is the real reason to be in a democratic group, in my view. You decide what the rules will be.

As opposed to not having a contracted number of hours a month, so nobody depends on you, and you can leave whenever you want?
I mean, there are pros and cons to both sides of the argument, but "democratic groups" have already voiced here that "you" never decide the rules. "We" decide the rules, and if you're the only one, you don't get what you want. Maybe if everyone is like minded, but clearly that isn't so, as evidenced by other groups above.

But it ain't 6 months off.

Then it isn't a sabbatical. It's vacation.

 

[Mecidimes]

Thanks for the replies everyone!

 

[Janders]

It's called "fellowship", except they're paid at less than 2/3rds value.

You are correct-- you can do a fellowship and get an MPH and get paid fellow rates with a schedule built around your MPH program. I would assume you also get some other academic benefits from said fellowship.

But in my group we've ALSO had... 3? that I can recall... docs who worked at full attending rate (i.e. eat-what-you-kill, all the benefits, all the bonuses, just like the rest of us) while getting an MPH and just dropping their shift load.

 

[The White Coat Investor]

Same here. We've looked at sabbaticals for quite some time. The reality we came to is that you would essentially have to hire extra personnel (and accept the resulting decrease in pay) to staff at the same level you currently do.


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Well, yea. I mean, were you expecting a paid sabbatical? That's just math. You could even have a paid sabbatical, but it means you're working for less the rest of the time. But just having the possibility to do an unpaid sabbatical would be cool. But surprisingly few docs can go without income for 3-12 months, even at mid-career. And by then, the kids are in school and activities etc.

 

[Venko]

So very unlikely anyone else has this opportunity, but if I want to get extra training in something that will fix a need for our hospital / department, and my chairperson will endorse this, there is a chance for me to:

- get the time for the training
- get paid my existing salary and benefits
- also get any pay from the experience (i.e. Fellowship salary)

It's a really uncommon and hard to take advantage perk.

Alternatively, I could potentially stack my shifts before and after to try and get the time off and maintain salary and benefits. In this scenario I would likely have to continue my research and administrative duties during the sabbatical though.

Also, I could try and find a grant or award / gift to augment my salary and allow me to take a leave of absence. I would want to make sure my group is okay and not overly taxed during my absence though.


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[CCmetal94]

I scribed for an ER doc that took 3 months off to translate an ancient German text he had purchased. The dude also dresses up in full midieval garb and falcon hunts boars with a spear (I promise you that not one iota of this is exaggeration).