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?
