Working in academic hospitals as Non-academic

[adoggie]

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Is it possible to work in reputable hospitals like Johns Hopkins or MGH, etc., without being on the faculty? I want to have more free time, even if it's just a day or two a week, and I think I will miss out on this if I become a medical school affliated doctor because of the academic calendar/curriculum in addition to seeing other patients.

This being said, if it is possible, are there more faculty than non-faculty at these hospitals, or is it the other way around?

 

[W06]

Many academic hospitals do allow 'outside' neurosurgeons to operate at their facilities, and with resident involvement. They are often considered affiliated faculty, or "clinical associate professor of neurosurgery" or something like that.

But to answer your overarching question, academic neurosurgeons often have better hours than the private guys. They have residents buffering them from the ER/calls, they often are part of larger groups and thus split call more widely, and don't have the same revenue stresses that private guys have. There's a mix though, certainly some academic guys pull crazy hours, and some private guys that don't.

 

[adoggie]

I'm actually glad to hear that. Going into academic medicine is actually looked at more favorably, I think, than not because of the need to teach future doctors. I just assumed it involved teaching in a classroom for a substantial time rather than exclusively operating on patients.

Do these clinical faculty need to conduct research? What is the typical work-week like?

 

[YouNeverKnow22]

you ask some really ridiculous questions that strike me as someone who is naive, especially concerning neurosurgery

maybe you aren't aware but places like Hopkins has a high number of attendings/fellows and residents. Everyone is competing for cases, do you really thinking it'd be possible for some adjunct surgeon to scrub for cases? No way. Concerning hours--you can't have the fame and glory working at a rigorous specialty like neurosurgery without putting in the blood, sweat and tears.

You should probably consider shadowing a neurosurgeon if you are considering this specialty and hang around the department for a week, a lot of your questions will most likely be answered.

 

[kitsunepixie]

The best way to answer your question is to shadow an academic neurosurgeon at one of those institutions and see for yourself how things run, and a point to consider that was brought up on the www.uncleharvey.com forum for neurosurgery is that life as an attending is very dependent on the attending's own personality and drive (and of course the pressures of the practice he/she joins). I know private practice neurosurgeons who put in 60 hour weeks because they're content making less and doing less cases and then I know an academic complex spine surgeon who probably puts in 100-120 hour weeks mostly spent in the OR or clinic. Usually private practice neurosurgeons are the heavy operators and the academics are buffered from pages by we residents.

As for my institution, 99% of the teaching is done in the clinical setting, i.e. the attendings teach the resident how to do a surgery while we're operating (the resident reads on his/her own prior for preparation of course), or management points when we staff patients with them. No classrooms, and thank heavens for that. Weekly lectures are usually done by physicians from other services or our attendings rehashing old lectures with updated points year-by-year, or it's just we residents presenting difficult cases to our attendings and picking their brains about what to do. We occasionally have cadaver labs to teach different surgical approaches but it is sporadic. A few staff give lectures to the med students, and for the one who is most involved in that endeavor it means one hour in the classroom per month on the same topic every time as the students rotate through their neuroscience rotation. You'll find a lot of med student teaching for neurosurgery is done on clinical rotations by residents more than attendings during the students' clinical years (same for all specialties really--the attending just leads rounds and dishes out some teaching points but by large the residents do the evaluating and teaching where I'm at), and for the first two non-clinical years, the teaching is done largely by non-physician PhDs.