When it comes to finding a better paying job opportunity, does it REALLY matter where you do your residency?

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Thumpar

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I'm not sure how far along everyone on this forum is, maybe there aren't many people with the job-hunting experience who can answer this.

If you go to a top PM&R program will it open up doors to better (for me better means higher paying) job opportunities, or do you just get to feel special because you did your residency in a schnazzy, well-known program?

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I can be more succinct: no
 
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My mentor said it makes getting a pain fellowship easier which would see your pay increase. Also it helps build connections to get first choice on cushier jobs in a saturated area.
 
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If you want to go into academia, it’ll help.

I think most of the higher paid physiatrists probably do not come from name programs-mostly because people from name programs gravitate more towards fellowships/academics.

I can rattle off many well-paying jobs right now (mostly inpatient) that would love to have any doctor with a valid medical license and a heartbeat.

Here’s what I can say as a medical director: I don’t care at all what program someone went to. I just care whether they are competent, reliable, and if I can work with this person as a partner.

Still-go to the best program you can. Going to RIC or UW is certainly not going to hurt you. They will only open more doors.
 
Wouldnt it help in getting a pain fellowship which would affect your potential earnings
 
Wouldnt it help in getting a pain fellowship which would affect your potential earnings

Depends on whether you do procedures.

If you want to make money in PM&R, procedures is the way to go. Independent inpatient, with a medical director stipend, also pays very well.

Most fellowships (SCI, TBI, peds, and in many cases even sports) do not lead to a higher salary. Many lead to the opposite as they tend to push you more into academics/county/VA jobs.

Not that there’s anything wrong with that-I think the VA is still one of the best gigs. Great hours, pretty good pay, great benefits, generally grateful patients.
 
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Fellowship, outside of pain, is probably a poor financial decision. But there’s more to life than money. When deciding to do fellowship, you have to be getting something for your time and money. You should be buying a skillset or patient population that you’d otherwise not have. For instance...if you want to do academic medicine...you may need a fellowship. If you want to manage high level athletes, you may a Sports fellowship. You want to stick needles into people’s spine...get a pain fellowship. But understand that it will likely be a financial LOSS so you really need to know what you are buying. I suspect that there are people that do fellowships because they are achievers and that’s what they should do. That’s stupid.
 
I still don't understand why pain and spine are different fellowships. It sounds like you do very similar procedures, but one is ACGME-accredited and opens up many more doors (pain).
 
Fellowship, outside of pain, is probably a poor financial decision. But there’s more to life than money. When deciding to do fellowship, you have to be getting something for your time and money. You should be buying a skillset or patient population that you’d otherwise not have. For instance...if you want to do academic medicine...you may need a fellowship. If you want to manage high level athletes, you may a Sports fellowship. You want to stick needles into people’s spine...get a pain fellowship. But understand that it will likely be a financial LOSS so you really need to know what you are buying. I suspect that there are people that do fellowships because they are achievers and that’s what they should do. That’s stupid.

What about a sports and spine fellowship? I don't know a whole lot about it but it seems very similar to a pain fellowship so I assume your income potential would be similar

Edit: seems like Thumpar had the same question as me
 
What about a sports and spine fellowship? I don't know a whole lot about it but it seems very similar to a pain fellowship so I assume your income potential would be similar

Edit: seems like Thumpar had the same question as me

Spine procedures = $$$. The sports procedures can be performed by people without Sports fellowship.
 
Spine procedures = $$$. The sports procedures can be performed by people without Sports fellowship.

So essentially if I wanted to for example do outpatient general msk with ultrasound guided peripheral joint injections and EMGs or something like that, I can do that straight out of residency no fellowship? And if I wanted to do any spine stuff, I'll have to do a 1 year pain or spine fellowship?
 
Spine procedures = $$$. The sports procedures can be performed by people without Sports fellowship.
So if going to a larger name residency opens doors in fellowship and increases your chance of getting a pain fellowship wouldn't going to a more prestigious residency help you financially. Still kinda confused
 
There’s a difference between what you can do and what you should do. Could you do pain procedures with only a PM&R residency under your belt? If you can get credentialed for it...absolutely. There are PM&R physicians who have been doing the procedures for decades before they even had fellowships and they do a good job. But realize that there is a shifting medicolegal landscape, credentialing is tightening up, and I think you have a responsibility to be competent when direct needles toward your patient’s spinal cord. I don’t personally feel comfortable with the liability, especially knowing that my patients have access to a competent pain training physician. If I lived in a remote area with poor access, my opinion would probably change.

Regarding, EMG...you should be competent to do EMG directly out of residency. Shoot..I had enough cases to fulfill my first part if board eligibility. It’s a low risk procedure. You will probably be better trained than the significant majority of Neuro residents. I’d get a fellowship if you want to do the high level procedures such as MEPS, single fiber, or diaphragm...especially if you want to go to an academic center.

Regarding ultrasound...there are a ton of people without decent formal training doing ultrasound guided procedures. The learning curve is very steep...have a very high level of skepticism regarding prospective residency programs ultrasound training. Few programs will allow you to be competent after finishing residency. You could be credentialed for doing your 10-20 injections...but you won’t be good. Residents who tell you they are great at ultrasound are probably naive. With that said...there are some programs that are very good at ultrasound...perhaps better than most sports fellowships. If you go to one of those programs, you don’t need a fellowship (though it certainly doesn’t hurt). If you plan on using ultrasound heavily for ultrasound diagnostics, I’d recommend one of the handful of sports fellowships that train that skillset well...because liability raises with diagnostics.
 
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So if going to a larger name residency opens doors in fellowship and increases your chance of getting a pain fellowship wouldn't going to a more prestigious residency help you financially. Still kinda confused

Absolutely it does.
 
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There’s a difference between what you can do and what you should do. Could you do pain procedures with only a PM&R residency under your belt? If you can get credentialed for it...absolutely. There are PM&R physicians who have been doing the procedures for decades before they even had fellowships and they do a good job. But realize that there is a shifting medicolegal landscape, credentialing is tightening up, and I think you have a responsibility to be competent when direct needles toward your patient’s spinal cord. I don’t personally feel comfortable with the liability, especially knowing that my patients have access to a competent pain training physician. If I lived in a remote area with poor access, my opinion would probably change.

Regarding, EMG...you should be competent to do EMG directly out of residency. Shoot..I had enough cases to fulfill my first part if board eligibility. It’s a low risk procedure. You will probably be better trained than the significant majority of Neuro residents. I’d get a fellowship if you want to do the high level procedures such as MEPS, single fiber, or diaphragm...especially if you want to go to an academic center.

Regarding ultrasound...there are a ton of people without decent formal training doing ultrasound guided procedures. The learning curve is very steep...have a very high level of skepticism regarding prospective residency programs ultrasound training. Few programs will allow you to be competent after finishing residency. You could be credentialed for doing your 10-20 injections...but you won’t be good. Residents who tell you they are great at ultrasound are probably naive. With that said...there are some programs that are very good at ultrasound...perhaps better than most sports fellowships. If you go to one of those programs, you don’t need a fellowship (though it certainly doesn’t hurt). If you plan on using ultrasound heavily for ultrasound diagnostics, I’d recommend one of the handful of sports fellowships that train that skillset well...because liability raises with diagnostics.

Thank you for the detailed reply. It really helped!
 
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