travel after residency

Discussion in 'Anesthesiology' started by junebugjohnson, Apr 12, 2007.

  1. junebugjohnson

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    Hello everybody,

    Thought I would add a thread here to stray away from the recent string of CRNA and ´anesthesia is doomed´ threads.

    I am a current resident and am about half way done with my training. I have always loved to travel abroad, and used to do some travel writing prior to med school. In fact, being able to participate in mission trips was one reason I chose anesthesia (among many others).

    I have always wanted to take an around the world trip. Since I am not getting any younger, and I am currently not tethered by a wife or kids, I have been toying with the idea of doing this once I finish residency and pass the boards. The trip would likely be 6 months to 1 year. I have contemplated and crunched the financial issues entailing this type of decision, and in many ways it is still worth it to me. I am passionate about travelling, it makes me happier and more satisfied with my life.

    So, I was wondering if any of the attendings on this forum could comment on how this may affect my ability to land a good job when I return. Also, if anyone has taken a hiatus from practice, did you feel your skills came back to you easily, or that your abilities were damaged by the gap in practice. I have thought about helping with various mission trips as part of my travels, but I know that these can be tough to land a spot with as many people want to help.

    I am currently at a program that is considered to be one the ¨best¨ in the country, for what that´s worth.

    Please comment if you have any insight...

    thanks, JBJ
     
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  3. huron

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    Every hospital privileges application I have ever seen requires a complete account of all time since medical school. Any time not accounted for is assumed to be something you are trying to hide. Spending time in the third world will be likely immediately considered suspect by the bean counters.

    If you took a job that allowed you to take lots of time off you could hide your time in the third world as vacations from your primary job.
     
  4. junebugjohnson

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    Thanks for the reply. I have heard of the potential credentialing issues that arise once a leave of absence of sorts is taken by someone. However, couldn´t I explain what I had done and why (especially if some of the trip involved some free service in the third world). Also, if my pedigree is strong and my explanation is well-reasoned, would this still be an issue?

    This is an annoying aspect of being a medical professional. If any significant time or energy is diverted into a non-medical pursuit, many assume you are incompetent or they demand that you thoroughly explain yourself. I like medicine, but I like other things as well.

    Also, while taking week-long trips here and there is better than nothing, it´s the total removal from your element that makes travel so rewarding. I´d rather have a longer period of immersion, then get back and start my career. Otherwise I feel as though I am taking a vacation, not travelling, if you know what I mean.
     
  5. militarymd

    militarymd SDN Angel
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    Big practices and academic practices can easily absorb the inefficiency of someone being gone for a prolonged period of time.

    Small practices will find it harder to allow someone to take that kind of time off, but if your partners are OK with it, then no big deal....but if your partners expect you to pull your weight, then you will likely lose your job..or lose a LOT of money by having to pay for locums to cover your hiatus.

    Remember, while you're gone, the job still needs to be done....so it means the following for a small group:

    1) no vacation for anyone else
    2) work post call day
    3) hire locums
    4) hire someone new who will be let go when you return
    5) shut down ORs
     
  6. junebugjohnson

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    thanks for the reply MilitaryMD,

    That is good info to have for someone already out there practicing who may be comtemplating something like this.

    However, do you have any perspective as to how this would affect your consideration of someone fresh out of residency. I am still a resident, and I was thinking of doing this after I finish training and before I start in a big group or academic setting.

    If I came to you for a job after returning from my trip, would you write me off as a result of my having taken this considerable amount of time right after residency? Assuming I bring excellent things to the table otherwise (outstanding residency program, good personality fit, etc)?
     
  7. urgewrx

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    If you feel you need to do it, do it. You'll get a job somewhere. Try talking to your chairman now to see if he will offer you a job when you come back. I think networking with people who know you might be your best chance. Talk to your senior residents.
     
  8. militarymd

    militarymd SDN Angel
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    I'm sure you are familiar with the "360" look at evaluations...the latest rage.

    So...I hate to say it....someone like you would not be a good fit for our group....and the reason is your need for travel and possible prolonged absences in the future.

    It is just a small portion of the 360 pie, but it is a part of it.

    As we all know....good grads are easier and easier to come by.

    Don't forget...there's always Johnkrieks' type of practice.
     
  9. junebugjohnson

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    Well, thanks for the info. Although, I gotta say that I am sorry to hear it.

    Like I said earlier in this thread, it is unfortunate in many ways that when someone deviates slightly from the type A path of a ´medical career´ there must be such repurcussions. I´m not attacking you or anyone, but I think it is a bit silly. If anything, having alternative experiences only enriches your abilities and refreshes your motivation. And I suppose that if your group philosophy frowns upon something like this, despite an applicant´s otherwise sterling credentials, then we would not be a good fit for each other.

    In my case, I definitely feel it is something I may need to do. I will simply have to let the chips fall where they may afterward. It´s not something I intend to do regularly in the future. I am sure a family will ultimately take priority over this and stabilize my living situation. Not to mention that I have to pay off my debt.

    Also, I have to think that having been a great student and coming from a top notch program would help to overcome any obstacles. Ultimately, I would think that being a good guy who is better able to work with others as a result of the experiences that travel affords would also be beneficial. Perhaps it´s wishful thinking...

    We shall see...
     
  10. mille125

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    You should do what makes you happy. In all likelihood you will still be able to find a job. However, some will view your absence with suspicion. I would have to say if I were interviewing you it might be a red flag. Of course there are many variables to consider and you must look at the total person. Also consider:

    1) State medical boards will require a long explanation about your absence. This could slow your license application processing which is now up to 6-8mos in many states for "clean applications".

    2) Anesthesiology, rather we like it or not, is a specialty that has an above average rate of physician impairment and illicit substance abuse (ie narcotics). Current data suggest that the incidence may be in the 11-13% range (which I find staggering). Many times applicants that have had trouble in the past have taken time off. This is a known red flag. I am not saying that this is right, but physician impairment would cross my mind for anyone who has taken a nontraditional path. With that said, my wife spent time in central american during medical school to learn Spanish (she is now fluent). She went into Pediatrics. This has never been an issue in her specialty even though she did have to write a detailed letter for the state licensing board.


    I still think that you should do the travelling if you desire. However, you should know all of the pluses and minuses of the decision. On the plus side, I think that it would be very enriching on a personal and professional level. Good luck.
     
  11. urgewrx

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    Sounds like your job is in peril...






















    Just messing with you :D
     
  12. militarymd

    militarymd SDN Angel
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    No...you're right....not only is my job in jeopardy......EVERYONE's is.

    The next decade will be interesting as each of us jockey for position in the market.
     
  13. junebugjohnson

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    Mille,

    Thanks for the great post.

    Ultimately, I am trying to flesh out the pluses and the minuses of making this decision. Or, perhaps more accurately for me, I am trying to assess the stature of the minuses. I am aware of the pluses and I am pretty sure they will outweigh any minuses for me. Thus, I just need to make sure I am aware of the possible adversities I may face. The only way that it wouldn´t be worth it would be if I was completely unable to get a decent job afterwards, which I doubt will happen.

    As far as drug abuse goes, I hardly drink. I would hope that having a clean record in this regard as well as references that can attest to my character would help allay any employer´s suspicions or fears.

    If anyone else has some insight, I´d really appreciate it. I think the info on this thread is interesting, and it´s been very helpful for me!

    thanks again, JBJ
     
  14. urgewrx

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    junebugjohnson, you can always go to Australia or New Zealand for 6 mo. I know somebody who did. He really enjoyed it.
     
  15. junebugjohnson

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    Hey UrgeWrx,

    Do you mean work in Oz or NZ as an anesthesiologist? Is this feasible, given the different licensing requirements and training processes?

    How did your friend arrange this, and do you know any of the details (pay, type of work, location, etc)?

    Or were you just suggesting that I go to Oz or NZ to travel?

    thanks, jbj
     
  16. urgewrx

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    jbj,

    You can work as an anesthesiologist in Australia or NZ for 6 months without many visa issues. They have a shortage of anesthesiologists and this is one way to alleviate it. You have to be board certified before going. Check A+A or Anesthesiology journal. They have ads almost every month. Pay is not super, like 80k/year US if I'm not wrong (so really 40k in 6 mo.) but they provide housing. There are several cities you can choose. My friend was on some nice beach having a good time. Usually home by 3. He even thought about moving there in the future. It sounds great. I have considered doing it myself.
     
  17. iron

    iron Member
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    I volunteered in Africa directly after residency. I applied for my medical license before I finished residency, thus no explaining to do about my travel gap. Granted it was only two months. I also arranged for my job to begin in September.

    Given that board certification takes about a year, at a minimum, after graduating Australia/New Zealand might have to wait.
     
  18. nimbus

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    If you have wanderlust, a big group can usually accommodate you better than a small one. We have several partners who take off for extended leaves and we can usually accommodate them. We do this because we recognize that good people are not a dime-a-dozen and want to retain them. Some leave to have/raise kids, others for travel, business or research sabbaticals.

    One of our ex-partners use to spend 3 months in Paris every year until he moved there permanently.

    One of our current partners

    http://mednews.stanford.edu/stanmed/2002fall/md-antarctica.html
     
  19. VolatileAgent

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    the NZ option is a good one.

    you continue to get experience, and you can satisfy your need to "get away" for awhile. plus, i think the coolest way to travel and see the world is to absorb yourself in another culture. i'd hire you in a heartbeat when you came back. you'd have a rarer perspective on things that not every candidate comes with.

    just my $0.02
     
  20. junebugjohnson

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    This is the kind of stuff I was hoping for. Thanks for all the great information.

    Iron, what kind of experience did you have in Africa? How did you go about setting it up? Was it an issue that you wanted to begin working back home in september instead of august? Are you glad you took this opportunity, or did the opportunity-costs end up outweighing the benefits for you?

    Nimbus, what general sort of size does a group need to be in order to accommodate such scheduling? Is this something that can be arranged shortly after residency, or is it something that only more senior partners can typically manage? Did your Paris doc just work gruelling hours for 9 months to carry his weight and then take off for three months each year? Loved the link. I think having a career or life such as this guy would be ideal. It would keep you more satisfied in your life and work.

    Volatile, that is the sort of perspective I was hoping would be present in some attending docs out there. I agree that it would be ideal to combine work and education with travel. This is what I have tried to do throughout undergrad, med school and now even residency.

    How about doing fellowships abroad? I have heard of some folks doing a fellowship in NZ, Australia or the UK. Would this training be regarded as equivalent to doing a fellowship here in the US?

    Again, thanks for all the great responses. Feel free to post again if you can expound on any of the above issues...

    jbj
     
  21. iron

    iron Member
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    I went to Africa with the ASA Overseas Teaching Program. I really lucked in to it because someone backed out a few months beforehand and I knew the organizer. She mentioned it and I jumped at the chance. There is also a scholarship thru Health Volunteers Overseas for anesthesia residents/recent grads. The deadline has passed for this year. It helps to have prior experience, which I did.

    As for my job, I told them that I'd be starting after Labor Day. There wasn't any negotiation about it so as far as I can tell it wasn't a problem!
     
  22. supahfresh

    supahfresh un paradis du gangster
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    It's very frustrating to hear about the problems one might encounter with taking time off. I think taking time off for a big trip is a fantastic idea. One to two weeks at a time is just not enough. I have many friends from Australia, NZ, and the UK who take off for 6 months at a time and sometimes more. They essentially work so they can travel.

    I personally need at least 4 months or so for my everest expedition and I cant honestly believe that I should have accredation issues for travel.

    SF
     
  23. huron

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    You can cover up all your time off with the right job. All you need to find is a job where you will cover for a solo anesthesiologist who usual uses locums for his 10-12 week of vacation per year. You would be credentialed at that hospital and work on average one week per month. You work the first week of the month then take the next 7 weeks off and work the last week on the next month. That way you could cover up a 7 week vacation. With the assistance of the anesthesiologist you are covering you can truthfully say you were working the entire time, you worked there both months. Your four month expedition to Everest could be covered the same way just add two months of vacation in the middle.
     
  24. nimbus

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    My group has 180 members working at 10 hospitals and a few other sites. Some of our new hires don't start for up to one year. They are often doing a fellowship or are waiting for spouses to finish whatever they are doing but this time could also be used for travel. We have a few docs in our internal locums pool who work only when they want. Many are moms with young kids. The Paris doc worked in my subgroup at a large level-1 trauma center. He worked a regular schedule when he was on. We are compensated strictly on productivity so he earned less than the average. He scheduled his time off from Aug to Oct which is a low vacation demand time on our calendar.
     

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