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Doc Lightning
GOLD Member since May 2001

Doc Lightning

HOP Mad Doctor
Location: San Francisco, CA, USA

Total posts: 13920
Posted:Well, this topic has been bandied about a bit lately, but it's a bit different for me. See, I'm a doctor, so a career change is not really much of an option.

So at age 31, I have completed four years of university, a year for my M.S. in molecular biology, four years of medical school, and three years of residency.

My plan had been to do a fellowship, which is an additional training in a subspecialty, to become an adolescent medicine specialist. Now I've started the fellowship, which was my dream, and it's not all it's cracked up to be.

First of all, it's three years long, which is completely unnecessary. However, the American Board of Pediatrics mandates that all subspecialties must have three year fellowships. During those three years, I am making peanuts. In fact, I'm making less money now than I was in residency.

And now I've learned that when I'm done with my fellowship, my expected salary is LESS than what it would be if I didn't do my fellowship and just went straight into general pediatrics.

On the one hand, I want to be a professor of adolescent medicine and teach medical students and residents. In this day and age, that's almost impossible to do without a fellowship.

On the other hand, the fellowship treats us as slaves, puts completely unreasonable demands on us that force us to provide inferior care to our patients, and works us through absolutely insane hours. To make things worse, the workload, which is supposed to go down after the first year, might actually go UP due to issues within our department.

I don't know if I can take three years of it. The sooner I get out, the less damage I do to myself.

But... I don't even know where to start looking for jobs as a general pediatrician in the SF Bay area (and leaving SF is not an option, end of discussion). And if I do find that job, am I ready to give up my future as a professor of medicine? I want to be the best doctor I can be and I find that many community docs get rusty, don't stay up to date on the latest treatment recommendations, and thus do some bad medicine.

Ugh...

...advice?


-Mike )'(
Certified Mad Doctor and HoP High Priest of Nutella

"A buckuht 'n a hooze!" -Valura

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Irinus
BRONZE Member since Apr 2006

enthusiast
Location: London, United Kingdom

Total posts: 222
Posted:What's most important to you?

Will you be able to survive happily on your prospective salary?

Will you ever be able to have as great an impact on your field as you would like without a Professorship?

Will you ever be able to have as great an impact on training in your specialty - to make things better for your colleagues - if you do not become a Professor?

I don't think you would have gone into such a young and unique subspecialty in the first place without having good reason / inspiration (you could try to be the best doctor you could be in general paeds). If you can put your finger on what it was that first inspired you to go down this path, compare it to the negatives that you've listed.

I'd be interested to hear what you find.


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Pyrolific
BRONZE Member since Jan 2001

Returning to a unique state of Equilibrium
Location: Adelaide, South Australia

Total posts: 3289
Posted:Ah Doc, I feel for you. I'm in a similar position - advancement leading to increasing workload and expectations...I want to be the best I can be in what I do, but I also don't want to turn into a workaholic (would be pretty easy for me to do, and characterises senior management in my industry).

Hard to make that call between professional commitment and maintaining yourself as a well-rounded human.

*hugz*


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natasqi


natasqi

addict
Location: Perth

Total posts: 489
Posted:*sigh* I don't think I've known more than a dozen doctors that are actually happy with their career! And so many people think "wow! A doctor, that's the best thing ever"

Even though I haven't graduated, this year off was the best thing for me to do.

I think with our obsessive Type A personalities, we expect ourselves to be the best at the best career that we can do and to do it fast etc.

Can you not be a professor of paediatrics without the fellowship? You would still be teaching though right? Do you have teaching hospitals and non-teaching hospitals? Do you want to lectre at the university and be university staff or be a doctor that gets given students on their team?

i would have to say thst most professors don't make that much of an impact on our teaching. They're so bogged down in research and uni-bullshit paperwork etc and organising rotations and reading assignments that they never actually teach. The rolemodels are the 'normal' doctors on the wards who put in lots of time to teaching and let the student do all the procedures etc. I believe these people make the most impact on medical teaching.. not the profs.

I say you should research whats available in the Paediatrician area.. at which hospitals.. what kind of teaching could you do... could you expand your role in that area etc... Research the alternative so you're well informed when you make the choice.

and *hugs* I understand how crappy med can be when you actually make it.


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Dentrassi
GOLD Member since Apr 2003

Dentrassi

ZORT!
Location: Brisbane, Australia

Total posts: 3044
Posted:ah! the conundrum of universities and alike!

Ive often thought about going back to uni for the sheer joy of teaching and a bit of research on the side.

but to complete my doctorate, a pre-req to being granted a professorship, i would have to go back to uni for 3 years - at 1/4 of my present salary.

Thats a bit call to make - not even considering the pain of dealing with another 3 yrs of uni beaurocracy.

And even then, ill probably have to work for another 5-10 years to get up to what im presently earning. unfortunately thats the reality of payscales in education vs professional/corporate jobs.

but i suppose in my profession it is easy to do consultancy work on the side.


In general in find ive worked in for the following reasons

- Location
- Pay
- Enjoyment
- Potential for career advancment

unfortunately, most jobs only will tick 2-3 of those boxes.


How hard would it to work for a couple of years to build up a bit of capital then head back? sorry to hear it hasnt turned out as you hoped hug

EDITED_BY: Dentrassi (1238142417)


"Here kitty kitty...." - Schroedinger.

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Mr Majestik
SILVER Member since Mar 2004

Mr Majestik

coming to a country near you
Location: home of the tiney toothy bear,...

Total posts: 4693
Posted:surely experience in general paeds could be retrospectively applied to a fellowship?

in our paper the other day there was a story about the uni saying they were looking at a shortage of teachers, and i thought "no bloody wonder", i find dealing with the uni as a student frustrating enough. i'd have to find a pretty nice position and be at the right time in my life to consider doing something like teaching.

dont forget you are only 31, could you handle doing a few years of general paeds and then re-evaluate your position? or once you quit would you not be allowed back in?


"but have you considered there is more to life than your eyelids?"

jointly owned by Fire_Spinning_Angel and Blu_Valley

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newgabe
SILVER Member since Mar 2005

newgabe

what goes around comes around. unless you're into stalls.
Location: Bali, Australia

Total posts: 4030
Posted:Ya I would far rather be taught by an older professor who had many years of real world experience behind him. Who was more financially secure and therefore less vulnerable to bureaucratic bullying. Work, earn some decent money, learn from the patients and enjoy what you're doing in the moment, Doc! Teaching's for later, skater!

.....Can't juggle balls but I sure as hell can juggle details....

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Spanner
BRONZE Member since Feb 2003

Spanner

remembers when it was all fields round here
Location: in the works... somewhere..., ...

Total posts: 2790
Posted:Originally Posted By: Doc Lightning
On the one hand, I want to be a professor of adolescent medicine and teach medical students and residents. In this day and age, that's almost impossible to do without a fellowship.


So without one, what could the alternative route towards reaching that professorship involve?
How have the rare exceptions achieved this?

I think if anyone could do that, you could (but I don't mean to say that's because you could burn yourself out for it, nor that you should).

hug


"I thought you are man, but
you are nice woman.

yay,

:R"

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Doc Lightning
GOLD Member since May 2001

Doc Lightning

HOP Mad Doctor
Location: San Francisco, CA, USA

Total posts: 13920
Posted:Originally Posted By: natasqi*sigh* I don't think I've known more than a dozen doctors that are actually happy with their career! And so many people think "wow! A doctor, that's the best thing ever"


But I love medicine and I love my job. I love taking care of the patients. I get such a rush out of it.

Know what I hate? Presenting to attendings. I'm sorry but I'm a Board-Certified pediatrician. I'm sick and tired of not being able to make my own decisions. I'm sick of being treated like a kid, being condescended to, having my judgement second-guessed, and having people assume that they must know more than me just because they're older than I am.

I'm also sick of being forced into fixed courses of study. At 31 years old and with 14 years of advanced education and training under my belt, I have reached a stage where I feel I am comfortable identifying what my strengths and weaknesses are. I do not like being forced to learn to do stuff I am not interested in doing anymore. I don't want to look at another malfunctioning vagina as long as I live. I don't want to deal with another eating disorder other than knowing how to assess, medically stabilize, and refer to the appropriate specialist. I don't want to see another "chronic pain" case, either.

My skills are men's health, sexual minority issues, and ADHD/developmental/behavioral issues, and mental health. My life is not getting any longer and I am not getting any younger. I command an array of amazingly useful powers and talents and I want to use them to make the world better!

I am entirely over being held back for the "good of my education." ENOUGH EDUCATION! I learn by doing!


-Mike )'(
Certified Mad Doctor and HoP High Priest of Nutella

"A buckuht 'n a hooze!" -Valura

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spritie
SILVER Member since Sep 2001

spritie

Pooh-Bah
Location: Galveston, TX, USA

Total posts: 2014
Posted:Are there any other fellowship opportunities in the SF area, or is this the only one?

If you were to get hired on at a hospital after all your training, would you only be doing your specialty when treating people, or would you see peds patients in general during hospital visits and your regular patients on the side? Sorry, I just don't know how the whole specialty thing works, other than people I work with do have to see people that get admitted to the hospital during their appointed clinical hours, and some aren't fond of it.

And are you really doing this for the pay, or because you love it? If you knew the pay was going to be less at the beginning, would you have still done it?


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Pyrolific
BRONZE Member since Jan 2001

Returning to a unique state of Equilibrium
Location: Adelaide, South Australia

Total posts: 3289
Posted:^^^OMG its spritie!

carry on.


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Help! My personality got stuck in this signature machine and I cant get it out!

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PyroWill
GOLD Member since Aug 2004

PyroWill

HoP's Barman. Trapped aged 6 months
Location: Staines, United Kingdom

Total posts: 4437
Posted:Be a vet.....

I will add something constructive in a bit, I just got in from work and knackered!


An eye for an eye only ends up making the whole world blind

Give a man a fish and he'll eat 4 a day hit a man with a brick and you can have all his fish and his wife

"Will's to pretty for prison" - Simian

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TinyPixie
SILVER Member since Apr 2006

TinyPixie

enthusiast
Location: in the clouds..., United Kingd...

Total posts: 394
Posted:Originally Posted By: Doc Lightning I don't want to see another "chronic pain" case, either.


I empathise dude.

Gabe's got a point, are you sure you want to do a fellowship now? Do you think you would feel differently later? Or would it be worse to do it later?

Also, I think that being a community paediatrician, or GP, does not mean that you will get rusty on your clinical knowledge. I think it's definitely easy to relax and not read as much as you should to keep up, but then again I think that being up to date and focused depends on how you are as a person, not necessarily your specialty.

Though you have to think about what you want to do for the rest of your lifem and it you KNOW it's definitely being a professor then maybe the fellowship is just one of those hurdles. I hate hurdles.

What do you want out of life? now and in the future?

It's always difficult to plan your career and I agree that it's very frustrating in a system as prescriptive (please forgive the pun) as the medical career pathway, but there's always an alternative if you really hate the fellowship...

Hey, how about training in the UK? You'll still earn peanuts, but the training might be shorter? Not sire though...

Good luck Mike!

PS: forgive the fact my post makes little sense, I have, appropriately for this thread, been working some crazy shifts and my brain has gone on strike.


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RichJessen


Member


Total posts: 4
Posted:waveThere is a belief in our society that you have to pick one thing and then stick with it for the rest of your life. Well, if you want to have change in your career then we all know that medicine is a very broad field. There is such a range and the support services available. There is plenty of things to do if you don't want to see patients. Although there are no fast and easy solutions, especially bearing in mind that each person’s situation is going to be unique, there are a number of strategies to prepare for career transitions from a financial point of view. You can consider locum work through an locum agencies like doctorschoiceplacement, staffcare, etc. , creating money saving strategy, budgeting, etc. and alike strategies.

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