What would you do...

[Dog_luver]

I need some advice fellow PMR'ers.

I am applying for pain fellowships now, we'll see how that goes. At the same time I have applied for some other jobs and have 2 offers. One is in a city I love and would love to go back to for 300k - it's a high end community, outpatient, seeing about 20 patients/day. The other is a medical director job - guaranteed of 300k + >100k med director stipend.

I am very torn as to whether I should continue in my pain track or pursue one of these jobs. While I really like pain I'm also stressed out about the whole application process. I also don't know how the match will go.

If you all were in this position, what would you choose?

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[Syndicate]

I need some advice fellow PMR'ers.

I am applying for pain fellowships now, we'll see how that goes. At the same time I have applied for some other jobs and have 2 offers. One is in a city I love and would love to go back to for 300k - it's a high end community, outpatient, seeing about 20 patients/day. The other is a medical director job - guaranteed of 300k + >100k med director stipend.

I am very torn as to whether I should continue in my pain track or pursue one of these jobs. While I really like pain I'm also stressed out about the whole application process. I also don't know how the match will go.

If you all were in this position, what would you choose?

How are you getting 300k for PM&R?? I'm only a MS4 but I've been told by PM&R attendings that average salaries even after years of being an attending is only like 200-250k..

 

[Dog_luver]

How are you getting 300k for PM&R?? I'm only a MS4 but I've been told by PM&R attendings that average salaries even after years of being an attending is only like 200-250k..

You have been grossly misinformed. Avg starting salaries for gen rehab is 200-220k. Add other stuff msk, injections, lead role and you are at 300k range

 

[RangerBob]

What's more important--going into interventional pain or living in the city you really like?

If what will ultimately make you happy is interventional pain, then you need a pain fellowship to do that. If you just want to do non-interventional pain management, then the fellowship isn't needed. I had some friends that applied to pain and they didn't feel it was that bad of a process. I applied to SCI, which isn't as competitive and all the programs were able to interview me at ASCIP to save me travel time/money. However, I don't think that's an option for competitive fellowships like pain or sports.

If what you really want is to move back to the city you like, and job openings there are rare, then well, take the offer if it's a job you'll enjoy. It's rare to find a perfect job in the sense of perfect job description/duties, perfect salary, and perfect location. You have to decide what's most important for you.

$300k starting salary is quite generous though! Most of my senior residents had starting salaries ranging from $170k (academic/VA) to $250k. For the prior poster, I don't know any residents who went into non-academic/VA jobs that didn't start at about $200-220k or higher. Granted, my sample size is around 10 or so. They all went into a mix of things (inpatient/outpatient mix, consults, MSK with a lot of procedures, MSK with a lot of EMGs, etc.)

 

[Dog_luver]

What's more important--going into interventional pain or living in the city you really like?

If what will ultimately make you happy is interventional pain, then you need a pain fellowship to do that. If you just want to do non-interventional pain management, then the fellowship isn't needed. I had some friends that applied to pain and they didn't feel it was that bad of a process. I applied to SCI, which isn't as competitive and all the programs were able to interview me at ASCIP to save me travel time/money. However, I don't think that's an option for competitive fellowships like pain or sports.

If what you really want is to move back to the city you like, and job openings there are rare, then well, take the offer if it's a job you'll enjoy. It's rare to find a perfect job in the sense of perfect job description/duties, perfect salary, and perfect location. You have to decide what's most important for you.

$300k starting salary is quite generous though! Most of my senior residents had starting salaries ranging from $170k (academic/VA) to $250k. For the prior poster, I don't know any residents who went into non-academic/VA jobs that didn't start at about $200-220k or higher. Granted, my sample size is around 10 or so. They all went into a mix of things (inpatient/outpatient mix, consults, MSK with a lot of procedures, MSK with a lot of EMGs, etc.)

170k? Yikes I don't know if anyone who started that low. I think your colleagues who got that were low balled! I don't think even primary care makes that these days. I'm torn! What is ASCIP btw?

 

[cbest]

300K for inpatient rehab seems too good to be true, especially if it's in a desirable location. I'd be more focused on what type of job is going to keep me interested and engaged for the next 30-35 years.


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[RangerBob]

170k? Yikes I don't know if anyone who started that low. I think your colleagues who got that were low balled! I don't think even primary care makes that these days. I'm torn! What is ASCIP btw?

VA and academic physiatrists typically start closer to $170-180k or so. My understanding is that's pretty universal for academia/VA regardless of where you are. All my colleagues that went into non-academia started above $200k.

ASCIP= Academy of Spinal Cord Injury Professionals. It's the main professional society and conference for SCI.

 

[nvrsumr]

I would take the job paying 400k and go to courses to learn basic injections to incorporate in your practice as it grows.

 

[RM38]

I honestly would be wary of a job that wants to pay you 300K to start in a desirable area doing MSK with no fellowship training and only expecting you to see 20 patients a day. I took a guarantee slightly less than that and I am a Pain fellow. I also expect to see more patients that a day. Other jobs weren't offering different guarantees unless they were in a rural area and I know other fellowship trained sports guys that are getting a good amount less than me. Other non-fellowship trained folks got even less. By saying 300K they are likely including the total package including your compensation and all of your benefits, meaning your actual salary will likely be much less, or they are just trying to draw you in and may change things up big time after you start. Watch out for a policy that f you don't produce XYZ amount, that you would have to pay part of your salary back to them because places with high bases will sometimes structure contracts that way. Truly desirable places that want to pay well typically don't need to hire over a year out because they can just hire somebody fairly quickly when they are ready. Also if you are a PGY-3, why would you be in a rush to just take another job and not just let the application process play out? It is still super early and you may get more interviews than you think you will even at this point. You can also explore the unaccredited route too as you will certainly pick up better skills than you likely developed in residency (if any at all) or would in a couple of weekend courses. Also if you really want to do interventional stuff, many jobs want you to have completed a fellowship, even if it is an unaccredited one.