Job market for PM&R

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waytogo1

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Med student interested in going into PM&R
How is Job market for PM&R? for inpatient vs outpatient?
I was talking to an attending who told me that inpatient PM&R is now dying out, it's not a "good gig" and that trend is outpatient MSK now.
But isn't outpatient MSK mostly seen by ortho or family med/FM with fellowship in sports med?
I feel like since PM&R is such a small field and also many physicians dont even know about the field, it may be limited which state I could practice in --some states may be less familiar with the field itself.....

Current residents, what do you guys think about the job prospective/market for the field?
thanks!
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waytogo1 said:
Med student interested in going into PM&R
How is Job market for PM&R? for inpatient vs outpatient?
I was talking to an attending who told me that inpatient PM&R is now dying out, it's not a "good gig" and that trend is outpatient MSK now.
But isn't outpatient MSK mostly seen by ortho or family med/FM with fellowship in sports med?
I feel like since PM&R is such a small field and also many physicians dont even know about the field, it may be limited which state I could practice in --some states may be less familiar with the field itself.....

Current residents, what do you guys think about the job prospective/market for the field?
thanks!
Click to expand...

It's a somewhat complex situation I'd say. There are jobs sure, but more and more people want to do outpatient. Are there a ton of outpatinet jobs? In my experience the answer is no. Inpatient jobs sure plenty of them. More and more many outpatient and pain/spine/sports jobs require fellowships. I'd say that if you do have a fellowship then in that case the market opens up significantly and you'dlikely be able to land a good job just about everywhere.

If just doing inpatient and/or in a saturated area you mihgt have to make some concessions. I landed a job in a saturated area, with decent pay for the area, and good hours in order to be close to family, however, certain didn't get mind blowing benefits and had to sacrifice certain things.
With pain my options open up significantly.

So it depends.
 
I was really deciding on FM sports vs PM&R for MSK outpatient. I ultimately decided on FM because I want to live in a saturated big city. For sure you can find a job as pm&r in a big city though. I just wanted to have more options, and felt that FM sports had more opportunities just because of the primary care aspect. Curious as to what others think of this as well
 
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What is the job prospective like for general physiatrist? I see myself doing a mix of inpatient and outpatient work....
 
waytogo1 said:
What is the job prospective like for general physiatrist? I see myself doing a mix of inpatient and outpatient work....
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Depends where you go. If you go to a less saturated state, you'll have plenty of opportunities. Certain states like Tx, FL, OH apparently, etc seem to have quite a few jobs. Certain states and cities are more saturated and compromises need to be made in those instances.
 
sorry to hijack the thread but could anyone chime in on academic medicine for a physiatrist? is this a somewhat protected job market? i'm a md/phd in training, almost certain on doing a fellowship (TBI) with the ultimate goal of being a clinician scientist.
 
soundnin said:
sorry to hijack the thread but could anyone chime in on academic medicine for a physiatrist? is this a somewhat protected job market? i'm a md/phd in training, almost certain on doing a fellowship (TBI) with the ultimate goal of being a clinician scientist.
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Hey. I'm MD-PhD, new resident in PM&R. My impression is that there is a desire in the field for more physician-scientists at the academic centers. Not a ton of competition for those spots from what I can tell. There are many physiatrists practicing in academia but the majority are not doing a ton of research. So I suspect that when the time comes to start your independent career, likely any of the top academic spots would be eager to have a physiatrist and researcher on board. That's at least what I'm hoping for myself :) Depends on funds and leadership of the particular department.
 
drg123 said:
Hey. I'm MD-PhD, new resident in PM&R. My impression is that there is a desire in the field for more physician-scientists at the academic centers. Not a ton of competition for those spots from what I can tell. There are many physiatrists practicing in academia but the majority are not doing a ton of research. So I suspect that when the time comes to start your independent career, likely any of the top academic spots would be eager to have a physiatrist and researcher on board. That's at least what I'm hoping for myself :) Depends on funds and leadership of the particular department.
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Probably SCI and TBI are the 2 areas most prone to research I think in PM&R, however also the lowest paid likely - particularly in academics. Unless you work at the VA, and it might be a reasonable gig at that point. But doing an MD-PhD to end up doing research in PM&R seems not the most financially reasonable. Just a thought.
 
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waytogo1 said:
Med student interested in going into PM&R
How is Job market for PM&R? for inpatient vs outpatient?
I was talking to an attending who told me that inpatient PM&R is now dying out, it's not a "good gig" and that trend is outpatient MSK now.
But isn't outpatient MSK mostly seen by ortho or family med/FM with fellowship in sports med?
I feel like since PM&R is such a small field and also many physicians dont even know about the field, it may be limited which state I could practice in --some states may be less familiar with the field itself.....

Current residents, what do you guys think about the job prospective/market for the field?
thanks!
Click to expand...

We are always hiring. Have grown from 3 Physiatrists to 160 over the last 7 years. Plenty of jobs out there if you want to do inpatient. Outpatient jobs are limited in big cities and the pay is usually a lot lower vs rural. Inpatient rehab is going through an adjustment phase but it will survive in academic and large hospital systems.
Outpatient MSK is usually seen by ortho and family med primarily because there are a lot more of them. Physiatrist are the ideal gate keepers for MSK pain. You can practice in any state and most recruiters and hospitals know what we do.
I would not worry about jobs as much as your desire to be a physiatrist.
 
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Big cities are pretty much saturated in every specialty. That’s not specific to PM&R.

There are tons of jobs out there in PM&R for generalists and fellowship trainees. The more specific you get, the more challenging placement becomes. If you want to be a TBI MD/PhD that works in academics in NYC...it’s certainly possible, but I’ll wish you luck. Those who are willing to be more flexible in regards to their work environment and location are typically rewarded.
 
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soundnin said:
can you clarify why you think this?

edit:

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Learn more about average brain injury medicine physiatrist Salaries on SimplyHired. Compare average salaries by job title and skillset.
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is this real?
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I doubt that is real. Brain injury jobs that are exclusively brain injury are really hard to come by. Most people end up doing a mixed type of gig, maybe at a very high end academic place you might be able to swing that but again it's highly doubtful. Maybe VA potentially.

MD-PhD takes a ton of work and effort, and you won't get the return financially speaking of doing other specialties bc you'll essentially end up at the VA or at an academic place.
 
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j4pac said:
Big cities are pretty much saturated in every specialty. That’s not specific to PM&R.

There are tons of jobs out there in PM&R for generalists and fellowship trainees. The more specific you get, the more challenging placement becomes. If you want to be a TBI MD/PhD that works in academics in NYC...it’s certainly possible, but I’ll wish you luck. Those who are willing to be more flexible in regards to their work environment and location are typically rewarded.
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That's not entirely correct of saturated cities. In my city and vicinity there was not a single outpatient job in PM&R without a fellowship when I graduated. Now with fellowships there might be a handful.

Sure if you are in OK or KY or TN you might be able to find those. But in certain cities outpatient jobs will be harder to come by.
 
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soundnin said:
can you clarify why you think this?

edit:

brain injury medicine physiatrist Salaries | SimplyHired

Learn more about average brain injury medicine physiatrist Salaries on SimplyHired. Compare average salaries by job title and skillset.
www.simplyhired.com www.simplyhired.com
is this real?
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That’s wrong. There are compensation guides out there that are helpful. AAPMR puts out a specialty specific guide for its members. Making less than $200,000 in PM&R is a joke and is really only reserved for those working part time or those right out of residency doing academics/working in a competitive city such as NYC/Chicago. If someone offered me $100,000 I’d literally laugh at them.
 
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Piebaldi said:
That's not entirely correct of saturated cities. In my city and vicinity there was not a single outpatient job in PM&R without a fellowship when I graduated. Now with fellowships there might be a handful.

Sure if you are in OK or KY or TN you might be able to find those. But in certain cities outpatient jobs will be harder to come by.
Click to expand...

That’s why I mentioned that if you are incredibly selective on location it can be VERY challenging. But the same holds true of most other specialties as well. There are less PM&R physicians, so there are less total jobs. But there is typically less competition for those jobs because there are less of us.

When I was searching for a job in late fall in my city of interest, there was only ONE job listed (and the job sucked). I networked and reached out to all the groups in the city and I end up with multiple good job offers. Many good jobs are not listed. And as you said there really are lots of jobs outside of the major cities that I could landed if I didn’t find one in a major city.
 
j4pac said:
That’s why I mentioned that if you are incredibly selective on location it can be VERY challenging. But the same holds true of most other specialties as well. There are less PM&R physicians, so there are less total jobs. But there is typically less competition for those jobs because there are less of us.

When I was searching for a job in late fall in my city of interest, there was only ONE job listed (and the job sucked). I networked and reached out to all the groups in the city and I end up with multiple good job offers. Many good jobs are not listed. And as you said there really are lots of jobs outside of the major cities that I could landed if I didn’t find one in a major city.
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Yes, the point is that in PM&R sure you can find a reasonable job but it's not as abundnat as other things. For example in FM, Psych, IM there are tons of jobs in multiple suburbs even and in the main city here. While there has been a more recent significant increase in PM&R jobs, generally it can be a challenge because it's soooooo saturated.
 
Piebaldi said:
I doubt that is real.
Click to expand...
j4pac said:
That’s wrong. There are compensation guides out there that are helpful.
Click to expand...

that's fine then. i know what medscape and AAPMR figures are like, so even if we take 40-50% of those averages by doing research part time in an academic center, nobody is living in poverty.

i was freaking out for a hot second if we were talking about taking 40-50% of $75k. that's like... a little more than my stipend as a MD/PhD student lol.
 
Nevergiveupok said:
This is anecdotal - this isn't me but someone I know who works in a PP PM&R group - he kind of lucked into a really lucrative group at the right time (it's a booming practice owned by a doc whose considered the go to guy for PP). Also had a fellowship in either spine+sports or pain - I forget which.
1. It doesn't seem as hot to be perfectly honest as FM/IM hospitalist/outpatient. From my understanding, the offer he accepted blew away the rest of what he was getting at coastal cities but it took him awhile to fish out a great gig through contacts (~300K, FM/IM in my neck of the woods usually start at 220-240K if they're lucky).
2. Yes. A former IM hospitalist told me that inpatient PM&R is pretty much dead. Same said doc said PM&R inpatient in the 1990s was probably the cushiest gig in medicine (finding a PM&R doc still in the hospital after 4pm was very rare).
3. So this I'm not entirely sure. I feel a lot of FM sports I know do very similar things as outpatient MSK BUT they can't do certain procedures. The PM&R doc I know does a ton of procedures.

So I don't want to insult PM&R but it requires a certain taste. I know someone who was gun-ho about PM&R until one of his away rotations. Now he's a PGY-4 Anesthesia.
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I don't understand the "inpatient PM&R is dying," comments. Yes, it probably was a better gig when we were able to take elective joints. Our patients are more complicated now. At the same time, now we generally have hospitalists to manage medical issues. So it's actually easier in a sense because now they get called for a BP or blood sugar issue, respond to rapids, etc. If you're without a hospitalist, then life is hard right now.

I see a general trend with inpatient PM&R patients to get sicker and sicker, and for any IRF currently without a hospitalist to be bringing them on board for all patients. With the new CMS rules, it wouldn't surprise me to see more IM as IPR medical directors because there's a shortage of inpatient PM&R physicians. But with the boomers retiring, we'll see more and more strokes and other neuro cases.

I think the future of IPR is pretty solid.
 
A lot of FM-Sports opt out of doing sports medicine exclusively. I KNOW a lot of FM sports doing urgent care because PCSM gets paid less.

I am curious to know how kaiser pays to PCSM vs outpatient adult general physiatry
 
From what I've seen in the last couple of years, seems like inpatient is swinging back into demand. I know a few people getting very reasonable gigs covering IPR in the community. Previously noted guidance on saturated areas is accurate to what I've seen; if you can get out of the major city you can often get a healthy compensation for it.
 
Agree with much that has been said. If you want to be very narrow in your search, it may be tough to get what you want if it a popular area that has nearby training programs that have people wanting those jobs. I live in a desirable area and drive pretty far (>1hr) to less desirable areas to live, but not bad areas to actually work. There is much less competition and I am getting busy quickly. If things keep going this way I will likely end up making a lot more than at my old practice. As people always say on here pick 2/3 things. Location, pay and lifestyle. Some areas that are really popular you may only get 1-1.5 of those.
 
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Hey Guys,

I want to apply for PM&R. Can anyone tell me some starting compensation on the east coast? or lead me toward a direction where I can find out more

I have heard something around 180 K starting.
 
GamerTheRock said:
Hey Guys,

I want to apply for PM&R. Can anyone tell me some starting compensation on the east coast? or lead me toward a direction where I can find out more

I have heard something around 180 K starting.
Click to expand...

By east coast do you mean NYC or Boston? If so...yes. If no...you should make over $200k.
 
p6917 said:
Any Idea what starting salaries would look like in the DC area?
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I haven’t known anyone looking in that area. As a general rule of thumb based on what I’ve read and heard...you should expect to make at least $205,000 out of training...perhaps unless you are in a very competitive market such as NYC, Chicago, etc...then you could get paid a little less even though the COL is insane. You can definitely make more than $205,000. In Pain...expect to make way more.
 
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Nevergiveupok said:
To some RVUs are not as important to providing optimal care. Most of the FM residents I communicated with were frustrated about how "rushed" they felt in urgent care clinics they rotated at.



From my understanding, starting around 220-240K is a really really good gig in NYC area (Northwell starts hospitalists at that level and they are widely considered one of the best hospital systems in the area).
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While I think all of us would agree providing optimal care is important, at the end of the day you need to learn efficiency while delivering quality care so that you can earn a paycheck. Yes care may be best if I only see 12-15 people a day (outpatient), but in private practice you might struggle to keep the lights on in that situation much less make a reasonable amount for take home income. Even if you are employed they are not hiring you to lose money or break even. As much as we don't like to admit it, at the end of the day medicine is a business. If you don't believe that, ask the residents from Drexel whom just lost their main training hospital. I am in pain and most of us certainly make >250 to start, but in some places that are really popular like San Fran I know people whom have been offered much less. Incomes vary by situation and much of it depends on how busy they expect you to be from the start. Most academic places pay less. Some hospitals pay great and some don't. I do well, but I am in a very busy practice and work hard M-F in addition to all of the traveling I do to and from work. I sacrificed lifestyle, but got the other 2 things I wanted most. Also I think having a good guarantee is nice, but having an attainable bonus structure that properly incentivizes you to work hard is one of the most important things to look for in a contract if you want to do well financially. Also to counter point the urgent care situation, docs are not going to fix a lifetime of medical issues in 1 urgent care visit. They are there for a specific reason and they should be evaluated and treated for that and sent back to their pcps for long term management. Thus those visits really should not take forever and if they are truly very sick they should be sent to the ER.
 
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