Most of the time I think Academic Medicine is not for me. However... unless you are HIGHLY self motivated.... that teaching element is what keeps you current, fresh and sharp. I just hate so much academic political bs and bureaucracy. The turf wars. The unfair decisions made without regard to merit. Not that that doesn't happen everywhere to some extent. But in academic institutions its the worst.
Then there's the idea of private practice. Ok. Not happening, since I want to do EM and I'm not interested in opening some urgent care center somewhere. Not to mention I don't want the pressure of having to run a business.
Private Hospital. Lots of money. Cushy schedule usually. May or may not have residents to alleviate the workload. Patient disease processes are usually less diverse because the population generally has private insurance, and is a more affluent demographic in general. Which in my opinion is a negative. However, this might not matter as much in EM or Anesthesiology. I mean, sedation is sedation and an emergency is an emergency. Right? Maybe.
So that leaves my rural option. I grew up in a tiny town of less than 4,000 people. My entire life all I could focus on was getting the eff out and doing something bigger and better. I've lived in DC, Boston, Phoenix, Miami, San Diego, and LA since then. Maybe it's time to give up the city. I don't know. I know I would love to stay in or at least near the city I am now. That would be my ultimate dream. But what about living an hour or three out? Working a week rurally and three here? Or six months out, six months in. Would I be happy out there? I have absolutely no idea.
Thoughts?
Couldn't you do a combination of academic/private hospital and international EM stuff?
ReplyDeletei have no idea. i guess theoretically i could do anything.. .have any specific ideas?
ReplyDeleteSimilar to my plans for "one day".
ReplyDeleteI feel like EM doesn't really offer many choices but I don't see myself in anything else, except MAYBE infectious diseases. Time will tell...
Good luck with your plans!
Well, there are several attendings at my institution who continue to do work abroad on a quasi-regular basis (Botswana, Haiti, Iraq, for instance). Not sure how funding works for that, but they seem to have been able to make it work. Of course then you'd have to work in academics, but maybe it could be worth it. Alternatively, if you're making $$ at a private hospital, you could probably arrange to not work certain months of the year and do international work then, and subsidize yourself. Just saying, there seem to be a TON of options. You just need to keep your eyes open. If you want to do international work, maybe you could try to do an elective abroad your 4th year. A lot of students at my institution go to Botswana for 8 weeks, and most of them have said it has been completely worth it.
ReplyDeleteI've always figured I'd do academic/private hospital, but the idea of rural medicine for a couple years is kind of appealing in some ways.
ReplyDeleteEM in a private hospital might offer more true "emergencies." I swear the ED at our teaching hospital (only non-private hospital in city) is about 50% primary care dr appts ... sore throat, htn because they don't have anymore meds since last ER visit etc. When I was at the ED down the street from my house (private/swanky) it was full of real accidents/emergencies. Don't know for sure though ... just based on 2 hospitals. haha! :)
ReplyDeleteA family doc that I know combines his interests in different areas by spending some of his time in private practice, some of his time on a Northern reserve, and then a few months every year overseas. One of the nice things about medicine is that if you make yourself aware of the different opportunities, you can combine different things to create the career that you want (for the most part).
ReplyDeleteI'm not a med student (yet) but I want to do traveling rural peds. And then spend two months a year in Ghana, you could travel around that way you never have that 'stuck in the middle of nowhere' feeling. I hate that feeling, but I don't like cities either.
ReplyDeleteCome back to the Bay Area! We need people who can both save lives and bake the world's most mouth-watering-looking blueberry pie (from someone who dislikes pie).
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ReplyDeleteHope everything is alright with you.
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