Private practice after training at top tier academic program

[chahn85]

3rd year resident, will be doing a chief year and applying next year. I've been successful with research with multiple first author publications/oral presentations, and my mentors have been telling me that I will have a decent shot at renowned top tier academic institutions. While I am certainly happy to hear that I will have good options, most of them seem very academic and research heavy (obviously). While I do like research, it's not something I want to keep doing for my whole life. I also have practical financial concerns as well.
My question is, will the PDs from these program frown and consider you to be a disgrace to the program if you just decide to get a good paying private practice job after fellowship? Can somebody give a general breakdown of what % of fellows from the top tier institutions remain in academia vs go into private practice? Would you recommend that I just aim instead for a community program with good clinical/procedural exposure?

Thanks.

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[IM2GI]

You will annoy some people but that is their problem not yours. Always brand yourself as best you can. You don't owe anyone anything. Some will consider you a disappointment, so just know there will be some awkward moments, but who cares.

A lot of people go from "top tier" into private practice.

 

[fasteddie911]

Kudos to you for being open to the idea of private practice. I think a lot of times students/residents can get sucked into the academic bubble, especially at bigger institutions, where they put research and academics on a pedestal and look down on private practice. This is despite the fact that most people go into private practice, or at least a sort of PP/teaching setup. Best advice is to have as strong an app as possible that would make you a strong candidate across as many programs as possible, apply broadly, interview and see what you think of a program. Maybe an academic program might still grab your attention and provide just enough clinical exposure to meet your needs. Or you might like a clinically heavy program that offers more autonomy and volume with less academics. Typically, it's easier to go from academics to PP vs the opposite, so if you have the slightest feeling you may potentially want to be in academics even for just a little while after fellowship, maybe lean more towards an academic program. In the end, look out for your own interests and ignore the noise.

 

[jhamaican]

always go to the "best" program you can, other concerns aside.

It is relatively easy to go from academic to private practice. The opposite not so much.

Name brand matters even in PP. In my home town, highly desirable area, the top PP group almost all trained from "top" academic places.

 

[GastriqueGraffin]

Unlike with residency and medical school, I was very honest when I told them on interviews that I am looking for a strong clinic program and I have little interest in performing research when they would ask. A PD at a bigger name place with a renowned research reputation even asked me if my research was primarily for the purposes of getting into fellowship and I said yes. He seemed to appreciate my answer and even thanked me for it. Many interviewers then go on to explain the success their graduates have had in PP and the clinical strengths of their fellowship.

 

[IM2GI]

Unlike with residency and medical school, I was very honest when I told them on interviews that I am looking for a strong clinic program and I have little interest in performing research when they would ask. A PD at a bigger name place with a renowned research reputation even asked me if my research was primarily for the purposes of getting into fellowship and I said yes. He seemed to appreciate my answer and even thanked me for it. Many interviewers then go on to explain the success their graduates have had in PP and the clinical strengths of their fellowship.

Ballsy approach. There are surely places that appreciate the honesty but other places that will probably not rank you. Gotta know your audience.

 

[Gastrapathy]

Jobs after fellowship are regional or even local. It's harder to go far even from a great program (not impossible).

 

[GastriqueGraffin]

Jobs after fellowship are regional or even local. It's harder to go far even from a great program (not impossible).

Is that true for both PP and academic jobs?

 

[Gastrapathy]

Is that true for both PP and academic jobs?

Yes. But it's also sometimes harder to advance academically at your fellowship institution so you may have to move after getting established.