Job market in 2023

[mulberry]

I hate to start a new thread on this but...

I am a PGY3 internal medicine resident who has been deciding between sports medicine and rheumatology. I understand they are quite different subspecialties after doing brief electives in both. There is a great PCSM fellowship at my home program. My end goal would be 100% msk/sports if that is attainable after fellowship.

For those of you that have been looking for jobs recently, how does the market look? Still saturated? I can pretty much go anywhere but I would prefer to stay in the NE.
What starting salary would I expect out of fellowship?
Am I at a disadvantage applying as IM?

Give me reasons NOT to apply to PCSM fellowship...

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[mulberry]

@AJFKPU I know you did IM and had difficulty finding a job while you were in fellowship. Any input to the above would be greatly appreciated.

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[AJFKPU]

I'm an IM trained primary care sports medicine fellowship graduate. I graduated last year in 2022. I also have an experience of working as a teaching faculty with food publications in sports medicine. I'm still doing IM and I didn't find a sports medicine job. The only offer I had was in a rural town earlier this year which I had to turn down because of some kids health and spousal concerns.

Here are some blunt facts which AMSSM doesn't mention when they are selling you this fellowship. I apologize but they need to be considered befor getting into the path of sports medicine. Unfortunately they aren't positives.


1. Sports medicine jobs after IM would be harder to land when compared to FM counterparts.

2. Getting a 100% sports medicine job can be harder than getting a fellowship itself.

3. Fellowship is very competitive. 25-30% of programs will only take FM graduates.

4. Compared to 5 years ago, market is very saturated. If you are not coming out of a very reputable program then the only way to get a job is to know someone. I don't want to say networking because it is a diplomatic way of hiding the truth.. What I'm saying is you need to know someone on the inside who can hire you. This might piss off some people but this is the reality.

5. Even when you are relocating after practicing sports medicine for many years, finding a sports medicine job won't be a piece of cake.

6. Whenever there is an opening in a desirable location, a newly graduated fellow will be the least priority for that job. Everyone would prefere to hire someone who has some years of experience.

7. Salary in NE is from 210-230K right out of fellowship. Consider higher taxes and cost of living. I spoke to a physician in NE who left his D1 affiliated 100% sports medicine job because it was getting hard for him to sustain his physician lifestyle in NY area. (Not sure when was the last time you heard of a doctor struggling to make money). You can get a better salary like 300K if you take a job at an orthopedic practice in midw st but they will really milk you to justify that salary. Very few sports medicine doctors make more than 400K a year. Most of them are employed by the orthopedic practices. Even fewer can cross 600k. But they are all outliers.

8. Your job and (probably your life) will be dictated mostly by orthopedic surgeons. Many of them will consider you their PA. Theoretically it shouldn't happen, but reality is different. They are big money makers of the hospital and hospitalists cannot afford to piss them off. Healthcare systems will not care if they have to kick you out to hire an orthopedic surgeon who can see those patients and do surgeries at the same time.

9. AMSSM is graduating almost 300 fellows every year. There aren't 300 jobs in the country every year.

10. Whenever a job is posted, hiring work is going on behind the scenes. They just want to show that they are playing by the fair labor reporting laws.

11. Keep in mind that you can make 3 times more salary than a sports medicine doctor as a cardiologist, gastroenterologist, oncologist or a pulm/cc doc. You have plenty of options unlike FM docs. You can even retire 8 to 10 years earlier than a lot of sports medicine doctors.

12. Rheumatology can have better compensation and far better job market than sports medicine. There are some places where Rheumatology is killing it. I know someone in Midwest who was make over million $ by his Rheumatology practice. But he was a work horse as well.


IF I HAVE TO DO IT AGAIN : I would pick a different speciality



BOTTOM LINE : If you love sports medicine and cannot imagine your life without it then go for it. Keep in mind that there will be a lot of obstacles with the handful of jobs. Changing jobs between states would not be a piece of cake. If you're looking at security for your family, good income potential and job stability where you can move freely between the jobs and have a lot of patient population with plenty of jobs then sports medicine is not the way to go.

 

[Waterlover]

N=1 but I just graduated with someone who's IM and had 2-3 good options for full sports jobs and that person accepted a pretty sweet gig. I think it's where you wanna be, how aggressive you are about looking for jobs, etc.

 

[I_Cant_tell_you]

N=1 but I just graduated with someone who's IM and had 2-3 good options for full sports jobs and that person accepted a pretty sweet gig. I think it's where you wanna be, how aggressive you are about looking for jobs, etc.

My experience was similar to the user above you.

You need to know someone to get a 100% sports med job.

If you don’t know someone you need to be able to move anywhere in the country. Not worth it for me so I do primary care and I’m the sports med guy for my office of 8 “providers”.

 

[Waterlover]

My experience was similar to the user above you.

You need to know someone to get a 100% sports med job.

If you don’t know someone you need to be able to move anywhere in the country. Not worth it for me so I do primary care and I’m the sports med guy for my office of 8 “providers”.

Idk logistics, but can't you just have your scheduler only send you MSK patients? Especially if you have multiple people in your office?

 

[TheGreatestTrochanter]

You need to know someone to get any job... but network and sell yourself and you can find something. I reached out to a group during fellowship and told them what I could add to their clinic.. granted I am PMR and do some EMG and some spine but mostly sports. We have since hired other docs FM sports 100% and neither of them were known by us prior to applying.

 

[I_Cant_tell_you]

Idk logistics, but can't you just have your scheduler only send you MSK patients? Especially if you have multiple people in your office?

Maybe, but I like primary care.

I don't care about having "MSK days" or whatever. I do procedures on the fly anyway. I'll frequently have someone come in for follow up for blood pressure and then be like also my knees hurt and also my shoulder hurts and I'll do a 99214 with three 20610 codes (two knee injections and a shoulder) and do it all in 30 min. It's more fun to do it all in my opinion. I think MSK gets boring.

 

[TheGreatestTrochanter]

Maybe, but I like primary care.

I don't care about having "MSK days" or whatever. I do procedures on the fly anyway. I'll frequently have someone come in for follow up for blood pressure and then be like also my knees hurt and also my shoulder hurts and I'll do a 99214 with three 20610 codes (two knee injections and a shoulder) and do it all in 30 min. It's more fun to do it all in my opinion. I think MSK gets boring.

Good to way manage BP, throw some roids on top of it!

 

[AJFKPU]

The intention was not to discourage @mulberry from doing what he wants to do. He asked a question in the light of his IM background. So I answered accordingly.

Sports medicine is a great field. A group of active individuals highly motivated to get better. Lifestyle is great compared to many other specialties. It's very rewarding. People who love it should stick to it. If he has a passion for it then he should pursue it.


However, he needs to keep in mind that currently less than 35% of the graduates are able to get a pure sports medicine job. Many jobs that advertise themselves as 50/50 sports Medicine and primary care pigeonhole the physicians to do primary care only. If he is lucky and has the right connections then he will land a good job after fellowship. Unfortunately I'm among the remaining 65%. I applied twice for the fellowship. Match is an economic, time and emotional investment. It was a very uphill battle to get a spot out of IM residency. With the same amount of effort I would have gotten any other more economically fruitful fellowship from IM. Same would be true for him since he is an IM graduate. I believe that USA is a great country. But unfortunately decades ago when the idea of marketing and selling was adopted here, people have become too diplomatic and polite. Even to a level that sometimes we don't know who to trust. Yesterday a fellowship program opening was mentioned at AMSSM collaborate. Now think about it logically. Does it make any sense to keep on opening new programs when there aren't even enough jobs?.. Someone has to be transparent and give an honest answer, because people's careers are not a joke.

 

[Waterlover]

The intention was not to discourage @mulberry from doing what he wants to do. He asked a question in the light of his IM background. So I answered accordingly.

Sports medicine is a great field. A group of active individuals highly motivated to get better. Lifestyle is great compared to many other specialties. It's very rewarding. People who love it should stick to it. If he has a passion for it then he should pursue it.


However, he needs to keep in mind that currently less than 35% of the graduates are able to get a pure sports medicine job. Many jobs that advertise themselves as 50/50 sports Medicine and primary care pigeonhole the physicians to do primary care only. If he is lucky and has the right connections then he will land a good job after fellowship. Unfortunately I'm among the remaining 65%. I applied twice for the fellowship. Match is an economic, time and emotional investment. It was a very uphill battle to get a spot out of IM residency. With the same amount of effort I would have gotten any other more economically fruitful fellowship from IM. Same would be true for him since he is an IM graduate. I believe that USA is a great country. But unfortunately decades ago when the idea of marketing and selling was adopted here, people have become too diplomatic and polite. Even to a level that sometimes we don't know who to trust. Yesterday a fellowship program opening was mentioned at AMSSM collaborate. Now think about it logically. Does it make any sense to keep on opening new programs when there aren't even enough jobs?.. Someone has to be transparent and give an honest answer, because people's careers are not a joke.

True, end of the day you can always start your own practice, needs a lot of money, time and effort but if you can't find a sports job, just make the sports job. Yes it's risky, it's not a "quick fix", and you'd have to see how it is for a few years before seeing if it's successful, but the option is there.