Why would you work at an academic hospital?

[ihavelot2saybutlimitedspa]

Hey guys,

M2 here. May be a stupid question. I'm still trying to figure out how the world works.

My understanding is that aside from the clinical duties, you would be researching and/or teaching. However, compared to community or private, academic hospitals pay less. Is the reason for going into academic solely for research/teaching desires? I particularly don't like researching, though I do love teaching. I'm trying to delete academic option for future.

Thank you!

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[Ironspy]

Research and teaching are main reasons. Also access to academic resources like journal subscriptions, grand rounds etc

 

[Dave1980]

In general the job is cushier than PP.

 

[Neuronix]

In some specialties or locations academics may be your only option.

 

[AdmiralChz]

Hey guys,

M2 here. May be a stupid question. I'm still trying to figure out how the world works.

My understanding is that aside from the clinical duties, you would be researching and/or teaching. However, compared to community or private, academic hospitals pay less. Is the reason for going into academic solely for research/teaching desires? I particularly don't like researching, though I do love teaching. I'm trying to delete academic option for future.

Thank you!

Most institutions outside of the ivory-tower Ivies have "clinical-track" as well as "research-track" for attending hires - the emphasis on the former is teaching and may include some protected time to help with that. Of course a "research-track" hire will get more protected time and may (if you're lucky) include a stipend to be used to supplement your work but there is a clear expectation often of productivity.

This is a gross over-generalization and there are definitely academic jobs out there that get absolutely hammered and work more than their PP counterparts for less money. The opposite is true as well but much, MUCH more rare. If you are a specific, niche subspecialist (say, lung transplant pulmonologist) then your only opportunities to truly practice will be in an academic center.

 

[Groove]

Hey guys,

M2 here. May be a stupid question. I'm still trying to figure out how the world works.

My understanding is that aside from the clinical duties, you would be researching and/or teaching. However, compared to community or private, academic hospitals pay less. Is the reason for going into academic solely for research/teaching desires? I particularly don't like researching, though I do love teaching. I'm trying to delete academic option for future.

Thank you!

It depends on your specialty. Many gravitate towards academics because the jobs are often easier and the joy of teaching outweighs the loss in compensation. You have residents to do your work, every specialty at your beck and call, and you get paid for a variety of non clinical duties. You aren't necessarily bound to research (see above). Benefits are often times better. Almost every academic job I've looked into within EM pays less. While I enjoy teaching, I don't enjoy it enough to sacrifice 150K+/yr. Figure out what you want to do first. Worrying about academics vs private practice is something you can save for your last year of residency.

 

[Raryn]

I enjoy teaching and would consider working in an academic environment if it didn't pay so much less. I'm not giving up 30% of my pay for a cushier schedule, residents/fellows to help write notes for me, and the opportunity to teach. But others might find that an acceptable tradeoff.

 

[Mass Effect]

In general the job is cushier than PP.

This is definitely a reason some people do it. The academic jobs I interviewed for were all 32 hour work weeks.

Most institutions outside of the ivory-tower Ivies have "clinical-track" as well as "research-track" for attending hires - the emphasis on the former is teaching and may include some protected time to help with that. Of course a "research-track" hire will get more protected time and may (if you're lucky) include a stipend to be used to supplement your work but there is a clear expectation often of productivity.

What makes you think you can't be on a clinical track at the Ivies? I entertained jobs from 3 different Ivies as an attending and all were straight-up clinical.

 

[AdmiralChz]

What makes you think you can't be on a clinical track at the Ivies? I entertained jobs from 3 different Ivies as an attending and all were straight-up clinical.

I'm sure it depends on institution. I interviewed at one huge name place and they had a "research track" which basically meant you are expected to lead or co-lead a lab (more for MD-PHD types) or a "clinical track" which had a very similar research productivity expectation just more clinical or translational based. Of course, this could just be the openings they had at the time in my specialty. Not sure. They did have non-tenure track "instructor" positions... the pay was laughable.

Elsewhere this didn't hold up and the expectations of a tenure-track clinical person was much more relaxed than one leading a lab. YMMV.

 

[Dave1980]

I interviewed at 1 ivy. Almost all the new hires were clinical track. It seemed like getting a "research track" offer was reserved for MD-PhDs.

 

[FrkyBgStok]

You also have to weigh in the prestige. To many, it doesn't mean anything, but in a field where prestige has mattered for years and years, people want to work at that ivory tower.

I did residency in a community program treated as PP mainly and am doing fellowship at an academic institution. Things that I have noticed:
- the community center is incredibly more efficient in everything they do. But this is an environment that wants to move meat. The ED needs to get through patients, the floor needs to discharge as soon as possible, and the patients need to get minimal tests to keep costs down. often I feel like the academic centers have all the time in the world and use it.
- less focused education in PP. With the academic setting, there are always lectures and everyone is taking the time to teach. Some people learn volume, but in residency during a busy shift, I didn't have time to read about the patient's diagnosis prior to going in. I didn't have hours to get a note done. this is the same in practice as you have the time to teach thoroughly. you can still teach in the PP environment but it can be harder at times.
- the academic jobs have the research component that some people love. in addition, the academic responsibilities come with less clinical responsibilities. For example, an academic EM job may be 80% clinical (at about 1100 hours per year) and 20% academic (which can be done at home) whereas the PP may be 100% clinical at 1500 hours per year. these numbers are made up, but as you can see, with the slower shifts and the less hours, it can be cushy. but it comes at a cost.

for me, I love the clinical side and want to work in the PP field more than the academic. I often wonder why anyone would choose academic for so little money. but I loathe the bureaucracy of it all. committees, sub-committees, and research teams are miserable time wasters. if I am work, I want to be working. if I am not working, then I am really not working.

 

[jurassicpark]

If you have a love of teaching, take on students in the real world as a clinical preceptor or adjunct prof of clinical medicine. You get a fancy certificate, something to put on your resume and you get students to mold into your very own image. All while making the big bucks of real-world attending.