Thinking About Leaving My Job...

[SpiritiualDuck]

I just graduated residency and I'm working at a private hospital in the south and the work is okay, many soft admissions, axis 2 stuff, and substance abuse.

3 months into my job and I'm bored and missing academia.

Recently, I was invited to come back to an academic setting, a moderate size university based program with a decent residency program.

I like teaching, I enjoy residents, and the challenge and fun of being in an academic setting.

However, my salary will be at least 40 thousand less, mabe more. I'm married, we have a little girl, and I have a fair amount of loan debt. I'm just not sure what to do.

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[xlithiumx]

First step is to get a new avatar that is not freakishly huge.
Next step, figure out what you care about more, money or teaching.

 

[billypilgrim37]

Being bored sucks.

 

[Doctor Bagel]

What does your spouse think?

 

[SpiritiualDuck]

My spouse is open to me taking an academic job. Having a huge amount of loan debt sucks, but it's managable too. And either salary would have seemed great a couple of years ago, but having such a cut in salary when I have such a huge amount of debt makes it feel prohibitive to take a lower salary.

Honestly, I feel that salary is not enough of a reason to stay. The folks that I work with are close to retirement, this is the last step on their career journey and a few of them were in academic places before they came here.

Also, because the admissions are soft, I seldomly get real bipolar or psychotic patients. I get the "I see shadows" and "I hear voices in my head" folks with trauma and substance abuse histories. And a few of them have picked up a few diagnoses like schizoaffective or bipolar, but nothing about their presentation or story is consistent with those diagnoses. Lot's of axis 2 and substance abuse. Patients routinely say, "You don't think I have bipolar? Everyone tells me that I'm so bipolar. I'm moody and irritable and I break things and I'm a bitch."

So, I am a bit bored.

And the reason why we don't see folks of higher acuity is because of staffing and because this is a private hospital so we screen out any folks that are not minimal risk. We don't have the staffing to cover the unit. I've never had a patient end up in our seclusion room. And not that I want that, but I would like to have a variety to my practice.

But I do like the weather in the south though.

Thanks for the replies.

 

[OldPsychDoc]

...Patients routinely say, "You don't think I have bipolar? Everyone tells me that I'm so bipolar. I'm moody and irritable and I break things and I'm a bitch."

So, I am a bit bored.
...

Sounds like an invitation to do some patient education...

Either make a move, or retool your hospital for crisis stabilization and DBT-based PHP.

 

[Doctor Bagel]

My spouse is open to me taking an academic job. Having a huge amount of loan debt sucks, but it's managable too. And either salary would have seemed great a couple of years ago, but having such a cut in salary when I have such a huge amount of debt makes it feel prohibitive to take a lower salary.

Honestly, I feel that salary is not enough of a reason to stay. The folks that I work with are close to retirement, this is the last step on their career journey and a few of them were in academic places before they came here.

Also, because the admissions are soft, I seldomly get real bipolar or psychotic patients. I get the "I see shadows" and "I hear voices in my head" folks with trauma and substance abuse histories. And a few of them have picked up a few diagnoses like schizoaffective or bipolar, but nothing about their presentation or story is consistent with those diagnoses. Lot's of axis 2 and substance abuse. Patients routinely say, "You don't think I have bipolar? Everyone tells me that I'm so bipolar. I'm moody and irritable and I break things and I'm a bitch."

So, I am a bit bored.

And the reason why we don't see folks of higher acuity is because of staffing and because this is a private hospital so we screen out any folks that are not minimal risk. We don't have the staffing to cover the unit. I've never had a patient end up in our seclusion room. And not that I want that, but I would like to have a variety to my practice.

But I do like the weather in the south though.

Thanks for the replies.

Hmm, it sounds like you've mostly made up your mind. If you like the south better, though, could you find an academic job down there? Or actually any job in a higher acuity unit? With the loan repayment programs, the debt should be less of an issue anyway unless you've got a lot of private debt.

 

[Sirimboi]

Had the same problem 3 months ago. Opted for academia, happy with my decision. If money is really a problem, you can do some moonlighting or, even better, seeing private patients on the side. Having "assistant professor" and a big name institution on you card will allow you to charge at the top of market value.

 

[BobA]

Couldn't you do public service loan forgiveness?

http://www.studentaid.ed.gov/repay-loans/forgiveness-cancellation/charts/public-service

 

[TexasPhysician]

Had the same problem 3 months ago. Opted for academia, happy with my decision. If money is really a problem, you can do some moonlighting or, even better, seeing private patients on the side. Having "assistant professor" and a big name institution on you card will allow you to charge at the top of market value.

Many academic jobs do not allow moonlighting on the side.

 

[sunlioness]

Life's too short and too much of it is taken up by work not to work at something we enjoy when the option is there.

 

[vistaril]

Had the same problem 3 months ago. Opted for academia, happy with my decision. If money is really a problem, you can do some moonlighting or, even better, seeing private patients on the side. Having "assistant professor" and a big name institution on you card will allow you to charge at the top of market value.

1) Many/most academic positions don't allow for moonlighting on the side, or within a radius that would make it easy to do so
2) having "assistant professor" as a title most certainly(in most areas) does not make it easier to attract clients or do a cash pay service on the side

The problem i have in deciding academic vs non-academic is that it isn't only the 40k pay difference in bay salary that comes into play. It's the 40k base difference and the 30-40k extra in 'sweet moonlighting gig' difference on top of that for very occasional easy work that makes the pay difference real....so in most cases you arent talking about 150-155k vs 190k but rather 150-155k vs 230k.....

 

[vistaril]

I just graduated residency and I'm working at a private hospital in the south and the work is okay, many soft admissions, axis 2 stuff, and substance abuse.

3 months into my job and I'm bored and missing academia.

Recently, I was invited to come back to an academic setting, a moderate size university based program with a decent residency program.

I like teaching, I enjoy residents, and the challenge and fun of being in an academic setting.

However, my salary will be at least 40 thousand less, mabe more. I'm married, we have a little girl, and I have a fair amount of loan debt. I'm just not sure what to do.

I think you underestimate how mindless, boring, and routine many admissions are at 'academic centers'.......

 

[OldPsychDoc]

...2) having "assistant professor" as a title most certainly(in most areas) does not make it easier to attract clients or do a cash pay service on the side
....

It doesn't even get me discounted football tickets...and it's my alma mater...

 

[TexasPhysician]

It doesn't even get me discounted football tickets...and it's my alma mater...

Deal breaker

 

[OldPsychDoc]

Deal breaker

eh...it's definitely not as big a deal here as it would be in Texas.

 

[siked]

So, I am a bit bored.

And the reason why we don't see folks of higher acuity is because of staffing and because this is a private hospital so we screen out any folks that are not minimal risk. We don't have the staffing to cover the unit. I've never had a patient end up in our seclusion room. And not that I want that, but I would like to have a variety to my practice.

Pretty much just described my dream job.....are most community hospitals like this?

 

[SpiritiualDuck]

I appreciate all the feedback.

I've decided to take the university based job. Not an easy decision, but being around residents, and actually having departmental grand rounds, teaching, etc, is fun.

 

[BobA]

I appreciate all the feedback.

I've decided to take the university based job. Not an easy decision, but being around residents, and actually having departmental grand rounds, teaching, etc, is fun.

Thanks for posting this.

I'm currently evaluating jobs - nice community hospital vs. academic job and there is a large pay difference. I'm also leaning towards the academic job (but it also happens to have a better location).

 

[NYCMS2]

Thanks for posting this.

I'm currently evaluating jobs - nice community hospital vs. academic job and there is a large pay difference. I'm also leaning towards the academic job (but it also happens to have a better location).

A dumb question, but do these academic/university jobs typically involve research responsibilities, or just dealing with patients and some teaching?

I ask because I frankly don't know...thanks.

 

[splik]

most faculty are clinical track so it is based on clinical care and teaching for the most part, likely administration. there might be a research component but you are not employed on that basis.

few are research track where you are essentially there to bring in grants, be a PI on multiple investigations, publish, and then also teach and do a day a week of clinical work etc.

 

[nancysinatra]

I appreciate all the feedback.

I've decided to take the university based job. Not an easy decision, but being around residents, and actually having departmental grand rounds, teaching, etc, is fun.

If being around residents and going to grand rounds is what floats your boat, would you mind coming here and signing in for me? My attendance has been slipping lately.

 

[NYCMS2]

most faculty are clinical track so it is based on clinical care and teaching for the most part, likely administration. there might be a research component but you are not employed on that basis.

few are research track where you are essentially there to bring in grants, be a PI on multiple investigations, publish, and then also teach and do a day a week of clinical work etc.

Thanks, splik, for clearing up my confusion.

 

[Therapist4Chnge]

It doesn't even get me discounted football tickets...and it's my alma mater...

Bummer. We get a decent discount here, though GETTING season tickets is tricky bc to get tickets everyone goes through a lottery (based on a formula that combines position rank and seniority). Football is serious business!

 

[sunlioness]

We get discounts here too, I think. Though I'm not really interested in the local team. I'm not any kind of professor though (yet, it might be in the works). I think we get them because the health system is a team sponsor.

 

[BobA]

A dumb question, but do these academic/university jobs typically involve research responsibilities, or just dealing with patients and some teaching?

I ask because I frankly don't know...thanks.

I'm looking at clinical track jobs - just teaching, etc.

The research track jobs typically require a strong background in research and at least at my institution new research track professors have a strong history of bringing in their own funding.
The research and clinical jobs are really quite different.

 

[NYCMS2]

I'm looking at clinical track jobs - just teaching, etc.

For clinical track jobs, do academic institutions favor people who trained at another academic program, or is it kosher to have trained at a community program? How much does the perceived pedigree of the program where you trained come into play?

 

[BobA]

For clinical track jobs, do academic institutions favor people who trained at another academic program, or is it kosher to have trained at a community program? How much does the perceived pedigree of the program where you trained come into play?

I'm not sure. However, I can speak to my own experience. I happen to train at an academic center, and my PD has many contacts. As soon as my PD contacts places, I'm getting interviews.

If I were hiring for an academic job, I'd want people who had trained in an academic setting. Kind of like how assistant coaches to the "Great Coach" in sports always get hired away to become head coaches somewhere else.

 

[vistaril]

If being around residents and going to grand rounds is what floats your boat, would you mind coming here and signing in for me? My attendance has been slipping lately.

ha...I havent gone to a grand rounds for over a year.....

a while ago(before I stopped going), I told myself the following: I'm going to go 5 straight weeks, and if anything remotely useful is said in any one grand rounds over that 5 week period, I'll continue to go to grand rounds. Nothing good was said, so I stopped going...

 

[nancysinatra]

ha...I havent gone to a grand rounds for over a year.....

a while ago(before I stopped going), I told myself the following: I'm going to go 5 straight weeks, and if anything remotely useful is said in any one grand rounds over that 5 week period, I'll continue to go to grand rounds. Nothing good was said, so I stopped going...

Don't they keep track at your program?

 

[digitlnoize]

ha...I havent gone to a grand rounds for over a year.....

a while ago(before I stopped going), I told myself the following: I'm going to go 5 straight weeks, and if anything remotely useful is said in any one grand rounds over that 5 week period, I'll continue to go to grand rounds. Nothing good was said, so I stopped going...

Don't they keep track at your program?

This explains a lot.

 

[nancysinatra]

This explains a lot.

What does it explain?

 

[OldPsychDoc]

What does it explain?

Not so much explains as confirms a general impression that vistaril doesn't think that anyone else has anything to teach him.

 

[Sirimboi]

I'm an inpatient attending and in my contract says I have 90% patient careand 10% teaching responsibilities. No research specified. Which is ridiculous,as I spend more than half my time supervising and discussing the cases withresidents. Also occasionally do screening and psych evals for a clinical studyI'm involved in.

Bottom line, academic life is very flexible and you pretty much can to whatyou like most (I'm told some attendings disappear from the floor right aftermorning rounds).

 

[digitlnoize]

Not so much explains as confirms a general impression that vistaril doesn't think that anyone else has anything to teach him.

Also speaks to the quality of program...which apparently doesn't care if residents come to grand rounds or not. Top 10 my ***...