Nephrology vs hospitalist

[Hellangel2000]

I trained as a nephrologist and have done some hospitalist work as well in the past. Currently thinking of if to continue working in nephrology or switch to hospitalist. I work 24 to 26 days a month and get paid quite less than a hospitalist plus the work involved is very laborious with driving to multiple places. Kindly give suggestions.

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[gutonc]

I trained as a nephrologist and have done some hospitalist work as well in the past. Currently thinking of if to continue working in nephrology or switch to hospitalist. I work 24 to 26 days a month and get paid quite less than a hospitalist plus the work involved is very laborious with driving to multiple places. Kindly give suggestions.

You've done both. Do the one you like more.

 

[Hellangel2000]

What would be a better choice if you compare income/lifestyle between the two?

 

[gutonc]

What would be a better choice if you compare income/lifestyle between the two?

You've done both...what do you think is a better choice?

 

[aus1ander]

I think you need to reflect on your training and current job and decide if your truly love the specialty and patient population or not. Hospitalist work could be rewarding if you really enjoy the work, but most of our residency graduates that do hospitalist work only end up staying a hospitalist for a couple years before doing something else. The ones that stay on long term are usually involved in other things that break up the work (research, teaching, etc). Nephrology gives you a varied practice of inpatient, outpatient, chronic dialysis, medical leadership in dialysis units, transplant.

I am a nephrologist and would not choose anything else to do. Also, the partnership model for private practice does require a couple years of being paid like a hospitalist, but with an enormous upside once you make partner and share in the medical directorship, JV, and other contract income not directly related to RVUs. Most of the nephrologists in our area make 350k plus. I don't know any hospitalists making that kind of money.

If you are on a partnership track in your practice, you should wait it out if the terms are good. If you are not on a partnership track, you need to get out of that practice and choose something else. We are in the upper midwest and nearly every practice here is looking for help. I guarantee if you start looking for other nephrology jobs and widen your search, you will find a better job that pays you a lot more.

 

[IM.MD]

Do 1 year CC fellowship.

 

[Prehealth1011]

Do 1 year CC fellowship.

Aren't they competitive? I don't think you can just jump to it without research, extra-curriculars etc.

 

[IM.MD]

Aren't they competitive? I don't think you can just jump to it without research, extra-curriculars etc.

It's worth a try if one likes CC.

 

[spacegun]

Aren't they competitive? I don't think you can just jump to it without research, extra-curriculars etc.

If you’re already nephrology, ccm is one year (its two years from general IM that is without a fellowship), and ccm only if youre willing to go anywhere isn’t competitive from what I hear.

 

[Rupesh36]

I am in the same position don't know what should I continue.
In terms of workload and salary, seems like hospitalist is better.

 

[Renal_Prometheus]

Its' a common outcome in nephrology. Don't be too hard on yourself. Many of my friends have ended up back as hospitalists.
At least you recognize financial reality. Applicant's need to be better informed of what they are signing up for.

 

[Chemist0157]

I am in the same position don't know what should I continue.
In terms of workload and salary, seems like hospitalist is better.

I would be curious to know what your current position is like, what the challenges and upsides are.

 

[doctornephron]

Here is my honest word for everybody reading this forum with all pros and cones, always remeber it is your decision to make not the pthers to make it for you

Nephrology has challnges and is not lucurative specialty compared with Pulm/cc, cardio, GI and hem onc . but still better than endocrinology , ID , geriatrics and I think rheumatology.
I did work hospitalist for many years before doing the fellowship , I witnessed that almost all of my colleauges I started working with non of them stayed jn hospital medicine longer than 5 years and it look like hospital medicine is a kind of bridge job in this country as even people who are very entheuthiastic to hospital medicine initially , they change their mind after some time specially after few years of working as a residents to ortho, GS , GI and cardiology.
I did one year of CC with nephrology and it really give many work spectrum and higher pay compared to general nephrology , but alwyas remeber that if you do CC you can not do nephrology in the same time but you always can do some nephrology moonlighting just to prevent burn out from CC.most of your income and finacial stability will come from CC which pays as high as cardiology and GI with only 15 days a month work. in CC no papaer work and no scut work for surgeon and other specialist so it is much better tahn hospitalist.
I think nephro CC could be number 4 after GI, cardio, pulm CC , and it is much better than straight 2 years CC alone.As you always you have a back up specialty.
But remeber, It is very tricky to find one year of CC fellowship after nephrology , so do not assume that going to nephrology fellowship will gurantee spot for you.
This is my honest advice that I developed from first hand experience. I never regreted about doing the fellowship , I would be very sad if i stayed in hospital medicine.

 

[Renal_Prometheus]

Here is my honest word for everybody reading this forum with all pros and cones, always remeber it is your decision to make not the pthers to make it for you

Nephrology has challnges and is not lucurative specialty compared with Pulm/cc, cardio, GI and hem onc . but still better than endocrinology , ID , geriatrics and I think rheumatology.
I did work hospitalist for many years before doing the fellowship , I witnessed that almost all of my colleauges I started working with non of them stayed jn hospital medicine longer than 5 years and it look like hospital medicine is a kind of bridge job in this country as even people who are very entheuthiastic to hospital medicine initially , they change their mind after some time specially after few years of working as a residents to ortho, GS , GI and cardiology.
I did one year of CC with nephrology and it really give many work spectrum and higher pay compared to general nephrology , but alwyas remeber that if you do CC you can not do nephrology in the same time but you always can do some nephrology moonlighting just to prevent burn out from CC.most of your income and finacial stability will come from CC which pays as high as cardiology and GI with only 15 days a month work. in CC no papaer work and no scut work for surgeon and other specialist so it is much better tahn hospitalist.
I think nephro CC could be number 4 after GI, cardio, pulm CC , and it is much better than straight 2 years CC alone.As you always you have a back up specialty.
But remeber, It is very tricky to find one year of CC fellowship after nephrology , so do not assume that going to nephrology fellowship will gurantee spot for you.
This is my honest advice that I developed from first hand experience. I never regreted about doing the fellowship , I would be very sad if i stayed in hospital medicine.

Everything you said is fair and true. But there are still a percentage of nephrologists like the OP who will end up worse off than a hospitalist. Are they allowed to go back in time and not waste those years? Do you think they would have still chosen nephrology if the they know what they do now?
Should applicants be better informed of the potential risks they are taking? There's both sides of coin here. How a nephrologist end up financially can vary drastically.

 

[Tenesmus83]

Everything you said is fair and true. But there are still a percentage of nephrologists like the OP who will end up worse off than a hospitalist. Are they allowed to go back in time and not waste those years? Do you think they would have still chosen nephrology if the they know what they do now?
Should applicants be better informed of the potential risks they are taking? There's both sides of coin here. How a nephrologist end up financially can vary drastically.

I feel bad for the OP as well. But let's be realistic here. I don't think anyone who applies to this specialty doesn't know that fellowship positions are unfilled. They are unfilled for a reason. Nobody is expecting to walk into Cards or GI. Again, I feel bad for those nephrologist who feel like they are worse off than hospitalist. But they need to take some accountability for their own decisions. I do support applicants being more informed of what they are getting into as I do see many nephrologists in my region choosing to not practice nephrology.