stay in academics or go private

[Jeff05]

after residency (and pain fellowship) is it worth it to stay in academics for a couple of years, get my feet wet as an attending and then go private OR
dive right into private practice immediately? would i have an advantage applying for pp jobs as an attending with some experience vs. new grad? your thoughts/pros/cons...

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[Mister Mxyzptlk]

Academic experience won't make you any more marketable, and the value of being an academic attending as preparation for private practice is dubious at best.

If you want to enter private practice just go to it directly. Many generations of your predecessors have survived the process without a warm-up.

 

[PMR 4 MSK]

Academics is too sheltered from the real world. I never see the kinds of patients I saw in residency (Thank God...). Go right into the real world, get your feet and the rest of you wet (I love mixing metaphores ). Money's better too!

 

[drusso]

Go private first.

Academic opportunities will always be available to you. When I reflect on my training and the mentors who mattered most, they were more often than not the "late comers" to academic practice---those attendings who spread their wings and got some "real world" experience before climbing back into the Ivory Tower. The "straight shots" from residency/fellowship --> assistant professor always seemed to me to be a little "cloistered" and interpersonally odd...

 

[Jeff05]

thank you all for your input.

 

[Tenesma]

plus i have seen a few academic-private practice transitions be total nightmares...

a group i know hired an assistant professor from a big-shot program - at that program he was doing all kinds of cool interventions, etc... he went into private practice for the money.

he couldn't handle the idea of seeing more than 15 patients a day

he couldn't handle the fact that he had to see those patients without a fellow or resident to sort through the muck

he couldn't handle the fact that he had to dictate his notes and then edit them for errors

he couldn't handle the fact that he had to actually take call and "talk" to patients

he couldn't understand why he had to visit referring doctor's visits

he pissed the practice off royally because he would discharge patients from his practice if they cancelled under 24 hours or were more than 1 minute late for their appointment - a habit from his academic practice -especially cause some of those patients were VIPs and/or had great insurance

he lasted 2 months

i also know a few guys who went academic for prestige after they made tons-o-bucks - it was like a cakewalk for them... they couldn't be happier with that transition (probably for the above reasons).

i also agree that those people who went from fellowship to academics without private practice exposure live a cloistered life and have some definite oddities going on...

 

[stonemountain]

I stayed in academics to do research and teach residents/fellows for about 4 years before going into private practice. I think it is reasonably easy to go either direction. How you go depends on what motivates you (money, teaching, research, etc.).

Once kids are done with schooling, I may go back to academics.
Go where you will be happiest.

 

[stim111]

Academics does not prepare you for private practice other than the knowledge base. It does not enhance the ability to see many patients quickly and private practice is all about keeping costs down, increasing efficiency and seeing as many patients as possible while keeping sane. You hope that the money is worth all of this. Academic medicine pays less because you are not generating as much. We all know what academic medicine is like. If this is your bag, go for it.