starting a thread discussing Bone Marrow Transplant

[NEMC]

Here as a beginner with hem/onc interests, noticed national shortage of bone marrow transplant physician, reasons that I come up with:
1. Intense life style and sicker patient
2. Less paid?
3. Extra training another year of training..

Does Obama care also make BMT field more a dump ground?
Although transplant makes huge difference and academic funding also research opportunities, could anybody shine some lights on possible changes in the near future?

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[gutonc]

Here as a beginner with hem/onc interests, noticed national shortage of bone marrow transplant physician, reasons that I come up with:
1. Intense life style and sicker patient
2. Less paid?
3. Extra training another year of training..

Does Obama care also make BMT field more a dump ground?
Although transplant makes huge difference and academic funding also research opportunities, could anybody shine some lights on possible changes in the near future?

Yes to 1 and 2. Not really to 3. BMT isn't an accredited fellowship and the vast majority of transplanters didn't do a BMT fellowship.

The vast majority of transplants (allos anyway, an auto is just inpatient chemo, a trained monkey can do that) take place at academic medical centers. Academic salaries are less than PP. And yes, the workload is intense, the patients are sick as hell (even the ones doing well are one sneeze away from the ICU half the time) and depending on the patient population, you're dealing with a 20% or so treatment-related mortality rate for a theoretically curative treatment.

Our BMT chief asked me the other day what it would take for me to work FT on the BMT inpatient service. I told him that if he paid me double what he takes home (he is a full professor and has an endowed chair) and I only had to work 1 week a month that it still probably wouldn't be worth it to me.

But the people who love it, love it. I'm happy they exist.

 

[NEMC]

Thank you, gutonc. I just did a BMT month and feel transplanters are wicky smart. But yeah, work extra hours, and everyday will be average 1-2 very sick patients. Kind of like the thinking complexicity of this field, how lower the pay salary do they offer? Your BMT chief should have salary paritally from his funding I guess. Do you work academic or private? Yes, happy those people exist who dedicate for the BMT, thus the medicine can move forward..

 

[gutonc]

Thank you, gutonc. I just did a BMT month and feel transplanters are wicky smart. But yeah, work extra hours, and everyday will be average 1-2 very sick patients. Kind of like the thinking complexicity of this field, how lower the pay salary do they offer? Your BMT chief should have salary paritally from his funding I guess. Do you work academic or private? Yes, happy those people exist who dedicate for the BMT, thus the medicine can move forward..

You must have worked in a small/low acuity transplant unit then. The unit at my institution (where I sometimes moonlight) carries between 30 and 40 patients regularly (currently 41, 5 of whom are in the ICU). 2 attendings, 3-4 mid-levels and one fellow to run this (residents long ago bugged out of that rotation).

Salary differential is going to be the same as any academic/PP differential. Somewhere between 1/3 - 2/3 of local PP salary for academics. Transplanters don't make more than a solid tumor person at the same institution (at the same level), except perhaps if they have an RVU production bonus.

Honestly, nearly everyone I know who has come out of med school or residency thinking they wanted to do BMT has changed their mind after actually doing it in fellowship. Not everybody of course, but most.

 

[NEMC]

Yes, we have three in ICU currently and overall 20-30 daily count. Only one attending and 3-4 mid-levels, sometimes fellows but not all year around..I apparently have no idea about RVU production bonus... not everywhere I guess.
You last sentences kind of scared me now. I am definitely long way out of med school but not long since fellowship starts.. money is not big issue but life style make it hard for me. Unless they only need a few months a year. Here attendings do average 2-3 months per year. other times research and outpatient.

 

[jackets5]

1/3-2/3rd's PP salary in academics? In gerneralmwhat are the benefits in academics over PP. Ballpark what are starting salaries in academics compared to private practice?

 

[gutonc]

1/3-2/3rd's PP salary in academics? In gerneralmwhat are the benefits in academics over PP. Ballpark what are starting salaries in academics compared to private practice?

Starting salaries are more like 3/4 differential but the upside of PP is much higher than academics.

What are the benefits? That's up to you to decide. I will say that one significant upside of academics is having residents and fellows to do the bulk of the grunt work for you. In PP, all the work is on you. The upside of that is that in PP, you just see the patients, do the work and go home. No teaching, no cleaning up the little messes that the house staff leave behind, etc. I was dead set on an academic career. That's not what I have and I couldn't be happier.

 

[qv3755]

especially if you come out of the top 10 programs? can anyone provide me with a list of the top 10 programs in the country?