Find an IM program with a good lifestyle. I'll say right now: where I am, if you are a U.S. medical grad, and went to a respectable residency, you should have no problem at all getting a gig as a hospitalist in a solid hospital. That is a pretty good summary of the life of a hospitalist. What does a normal day look like for you, and do you think you can continue this trend into the next few decades? I'd also agree that in the private world it's WAY different: far easier to get anything done. Yea, probably worse than FM/Psych, but way better than gen surg/ortho, right? [ December 11, 2020 ] To all Residents: Here’s the latest on board certification. In other words, they start writing all their own orders. Is this pathway relatively common? Internal medicine doctors are the go-to source for your traditional wellness care, including annual checkups, screenings, and physicals. I spent most of my first half of internship being really, really miserable. This depends a lot on the specific hospital you're working at. Addiction medicine, however, has given me an opportunity to have a much better practice lifestyle. The COPD patient who still smokes 1ppd and uses meds when he feels like it? I was at a level 1 trauma hospital until this year, when I moved closer to home / community hospital. Related I’m a 4th year medical student and can’t decide between emergency medicine and internal medicine 4 weeks away from opening of ERAS. When fielding their annual Lifestyle Report, global medical news site Medscape asked more than 15,000 physicians in the U.S. in more than 29 specialties to rate their happiness outside of work. Residency programs that combine basic internal medicine with other disciplines are available that broaden the clinical skills of trainees and usually allow completion of training in a shorter period of time than performing different residencies independently. Switching residencies? Welcome from the Program DirectorCongratulations as you embark on this exciting and momentous time in your career as a physician. Any plans on incorporating clinic to your practice? Worked 1 year in an academic center as a hospitalist and only in private/public non-academic centers since. I know it was a lot of questions, thanks for your time. They exist. What does the future for internal medicine look like for you? I can't imagine being happy doing IM, FM, Peds, or EM. I think Allergy and Immunology, Rheumatology, and Endocrinology can all eventually reach $275K-$300K with a decent lifestyle, unless you want to work in someplace like California or NYC. According to Wikipedia, “Internal medicine or general medicine (in Commonwealth nations) is the medical specialty dealing with the prevention, diagnosis, and treatment of adult diseases. Great lifestyle and balance. The other docs were generally polite and professional, but they weren't there to make friends beyond encouraging people to send them good consults (i.e. You have to be passionate about medicine or at least really want to practice it to make it in the field. They like teamwork, solving complicated problems, and direct patient care. Can do either primarily inpatient or only outpatient or a mix of both. It's literally just you doing whatever you want so long as you can get patients discharged on time. That all said, which 3rd year clerkship or rotation was your favorite? Hospitalists make 2x in places like Orlando, Jacksonville, Savannah than they do in super-saturated markets like NYC and Boston. Some of you may know that I started out in an internal medicine residency and quit for physical medicine and rehabilitation (PM&R). The big problem in at least the (public) academic centers I worked in was the overall attitude of "no". Getting anything done felt like a struggle, pulling teeth. It's much better even if hours are long. This part of Medscape's annual Physician Lifestyle Report focuses on their responses to our survey questions about burnout and depression. Threads 266 Messages 8.6K. Like any job it depends on the market. Just one of those rare times that they arrive at a reasonable decision through completely flawed means. /r/medicine is a virtual lounge for physicians and other medical professionals from around the world to talk about the latest advances, controversies, ask questions of each other, have a laugh, or share a difficult moment. Lol at IM having a terrible lifestyle in residency. The week on/week off gig takes some time to get used to. I had my August forward-stacked for an impending baby, and as a result have been working July 22 - August 16. There are currently 72 accredited preventive medicine residency training programs in the United States. Go to the gym, travel, do things that better yourself and it feels much more worthwhile than watching Netflix and playing PlayStation for a week. Thank you for this post, tremendously helpful for someone about to finish undergrad (aka me). Anything else and I think I could make it work. In 2004, the first electronic cigarette, a Chinese invention, came as a pathway to the reduction in yobacco smoking or tobacco harm reduction (THR) from the Rune Company and was marketed as a less harmful alternative to smoking (1). Reasons why I feel like I'm making a huge mistake: -I'm just not really excited about the idea of going into IM as much some of my colleagues are. Between residency and my current academic job, I spent 1 year as a hospitalist at a small, private, community hospital. What is life style like as an internist e.g. Yesterday at 5:39 PM; rokshana; Pulmonary / Critical Care Medicine New. Most EM now is not like you see on TV: much less multiple GSWs and more like multiple patients trying to get narcotics. They are OK, don't get me wrong, but I'm kinda saying the field is wide open now. While this makes things "easier" for you as the hospitalist, it fragments care, can create conflict when consultants disagree, it deflates your role in patient care, and overall makes things less personally satisfying. Sorry for so many questions, just very curious, thank you! Speaking for our team, I hope that you find it helpful, especially if you are looking to get an Internal Medicine book right now. Burnout is a real thing: not too many people can manage an entire career there. They can have long hours during residency and call can be brutal. An 8-year residency in neurosurgery may not be as conducive to these plans as a three-year residency in family medicine (or internal medicine for that matter). Most say they would choose the same specialty again if given the chance, and they are one of the specialties with the least amount of paperwork and administration. R. Official 2020-2021 Rheumatology Fellowship Application Cycle. At this point I'm learning towards doing IM but I sometimes can't help but feel like I'm making a terrible mistake. Or dealing with the chronically ill that just end up in your ED. This year’s Medscape physician compensation report reveals that emergency medicine physician salaries are on the rise, and they are one of the highest-ranked physician specialties in terms of job satisfaction. Do you want to explore any other fields? -broad training and knowledge base; I still enjoyed learning about medicine in preclinical years and I feel like IM will give me the skillset I want (diagnosis/treatment/management in adult patients), -lots of fellowship opportunities so I can postpone my life decisions, -tons of variety in terms of inpatient vs outpatient, procedures vs not, etc and you can make your lifestyle how you want it after residency, -generally nice/cool people (at least on my rotations). The one thing I have noticed with my group is the relative punishment you get for taking more than a week off (or 4-5 days depending on how your group blocks schedules). If you don't mind me asking where are you practicing? I was psych all the way, then somehow ended up considering med/psych, but my current med attending has banished such a silly idea from my head. There was virtually no education (e.g. Basically punting on a career decision for now, like you mentioned in your OP. But if you find a great group of fellow workers it's a really good life. Do you get performance evaluations a lot? Once you are making money, being treated like a real person, and having something resembling a life, it's hard to go back. But for me, it sucked. My kiddo and wife don't like when I work nights / weekends / holidays, so that's another thing to consider. For the 11 years that I practiced general internal medicine, I did not have a good quality of life. A new Medscape poll probes doctor lifestyles. I have thought about it but never really pursued either of them further just because histo and imaging were never things I was interested in. what are you planning on moving onto? I still enjoyed learning about medicine in preclinical years. General IM is consistently at the bottom of a lot of physician happiness/satisfaction reports that I've seen, so that take that for what you will. Completion of residency training in preventive medicine is an essential step to become certified in one or more of the preventive medicine specialty areas: Public Health and General Preventive Medicine, Occupational Medicine, and Aerospace Medicine. Your fault for the multiple admits). On inpatient rehab you are technically the primary and need a good foundation in medicine. I won't go into how the rest of the hospital feels about ER docs generally :P. As an MS4 who prefers his work and break time to be in large chunks, this makes me giddy. At least with the IM people I've met, it seems that medicine is their life. Agree with this assessment. Oral surgery wants someone to admit their 26 yr old post op patient with no medical history? Zero social network. Residency sucks in general, no matter which specialty you go into. Duh. As for EM: it's all about what you like and can you deal with the patients. When I was a student I wanted nothing more than ER. Need an urgent neurosurgical evaluation? Great lifestyle and balance. phone calls from patients, colleagues, etc.? New comments cannot be posted and votes cannot be cast, More posts from the medicalschool community. Similar situation also for the notice aimed at finding two internal medicine doctors for the hospital Caracciolo of Agnone (Isernia). If you're living in the USA, my answer may not be of any use to you, since I used to practice in The Netherlands as a hospital based general internist, also intensive care physician (intensivist). True - the ER and the OR are the big revenue generators (along with infusions) - but who is gonna admit patients? Plus its four years which is tough if you are already burnt out. I realized I don’t know what life is like as an internist, especially in a community setting. Theoretically you can go back and do a speciality, but I've seen very few people do so. Something so cool I can't even think of it? While there was nothing explicitly different than what you've described, I greatly disliked it. It's better for the hospital (gets to submit bills from 1 additional service), probably better for the patient too. Some of these books are core Internal Medicine textbooks for your library while others are great as a resource while on the go. Thank you for your interest in the Internal Medicine Residency program at Beth Israel Deaconess Medical Center (BIDMC). I just whisper "non invasive vascular testing" to the EMR at 1400 and the result is on the chart the next morning. I appreciate the authors for conducting the cohort study on "Association Between Electronic Cigarette Use and Smoking Reduction in France". I'll bite. watching Netflix and playing PlayStation for a week. That's a shitty lifestyle to be working at something you don't really like all that much in the first place. At the Yale School of Medicine, the number of graduates choosing E-ROAD specialties rose from 17 in 1997 to 34 this year. I had two sporadic days off, one of which I got called in for a meeting on. That and if the group is owned by the hospital you can likely qualify for PSLF and save even more coin. Please read the rules carefully before posting or commenting. The money seems to be OK. As long as you have your phone with you go for it. How is life when you’re actually working? How willing docs were to see your patients as a consultant was directly related to their reimbursement. Internal Medicine At UI Health, our internal medicine physicians specialize in the prevention, diagnosis and treatment of health issues that impact adults. tl;dr I'm thinking IM because I'm incapable of making decisions and don't want to specialize too soon, but I've seen too many scary posts about how IM residents are so burnt out. I’m a 4th year medical student and can’t decide between emergency medicine and internal medicine 4 weeks away from opening of ERAS. I work 7-on, 7-off and even a couple years out keep trying new things in my free time. I don't know why this would be specific to private hospitals, but it's never happened at the academic centers I've worked at: an insurance company sent a representative to the hospital to track me down in person and explain why they were not approving a diagnostic procedure (brain biopsy for suspected CJD) because treatment for the suspected diagnosis was supportive only, and thus, they did not believe it would alter management. Want to live in a particular place and expect to pay for it. When is that MRI gonna happen? You didn't ask about IM subspecialities, but obviously if you want to do GI, cards, or the like, you gotta start with IM. The best scenario is if your family is on an unorthodox schedule too - ie, I went to Breakfast and the beach on a Tuesday morning with my husband and toddler, since he's shift work as well. Non clinics medicine? I'm not violating the shit out of my work hour restrictions to have you disrespect my poor lifestyle choices! Boston Medical & Surgical Journal 1927, 196(3):89-96. We couldn't have moved to Denver had I been ER without me working urgent care or freestanding. You'll make less but you seriously have an ocean of free time. Every rads resident on reddit seems ridiculously happy though. Internal Medicine Residency Program Day in the Life of an Intern Our conference ends around 1:15 pm, and I spend the afternoon getting the rest of my work done. Threads 1.1K Messages 23.4K. Eventually. -not really interested in any of the subspecialties currently, -god i just hated third year and I don't want to be this depressed during residency too. Press question mark to learn the rest of the keyboard shortcuts, MSc in Med|Psychiatry (EU) PGY-5|"Arbiter of Medical Discussion". Most of the great leaders in medicine in general have come from internal medicine because of the breadth and depth of its academic and clinical work. For the money Hospitalists make and the time they work it's got to be one of the better gigs in medicine. Bedside: The Art of Medicine, by Michael LaCombe, MD. Need to take care of something during a work day? Residency training is the first opportunity to begin caring for patients as their doctor and is a challenging period filled with incredible growth. It takes years of rigorous schooling and a nonstop, crazy schedule to finally make it. Mostly it's positive. Some of the IM fellowships were pretty happy but some of those were also pretty competitive, which is another thing to consider. Being an academic hospitalist is an easy, easy job. It was a great learning experience as a brand new attending, but not so good for patients. Fish’s Clinical Psychopathology Signs and Symptoms in Psychiatry 4th Edition Psychopathology lies at the centre of effective psychiatric practice and mental health care, and Fish’s Clinical Psychopathology has shaped the training and clinical practice of psychiatrists for over fifty years. Haven’t met a physiatrist attending or resident who regrets going into it. In the private world I have more patients to see but it's fantastic. Take a look at PM&R. Nah. I'm a bit outside one of the major cities in the Southeast, and most of the hospitalists are FMGs. The work itself is good, but (especially if your group is employed by the hospital) expect to be the hospital's go-to for problem solving. Plenty of IM attendings don't even do bedside rounds. The American Board of Lifestyle Medicine began offering certification in lifestyle medicine in October 2017, and so far 300 doctors have received it. (outside of the military, and that is a separate discussion). It's normal to not enjoy 3rd year, so don't let that fact weigh down on you too much. These numbers mirror a national trend. Oh, agreed that the insurance company can fuck right off. Why we revolt: A patient revolution for careful and kind care, by Dr. Victor Montori. Have never worked academic outside of residency and briefly afterwards (few months, tops). You are getting pressured constantly for "better outcomes", and blamed for things that are beyond your control. Medscape's 2013 Physician Lifestyle Report provides physicians insights on how burnout may affect or not affect their lifestyle choices and experiences. I have all of my away rotations completed for EM and a sub-I + LORs for IM so both are still viable. But entirely doable. Urgent care? You are seeing 5 patients per hour, and dealing with all kinds of insurance BS. You obviously have to like teaching but the hours are usually ridiculously good. 3rd year a grind fest and not necessarily an indication of how happy you'd be in that field as a doctor, though it can give you some idea. As an adult, a bunch of your off week is playing catch-up from the week on. Need a surgeon to see your homeless undocumented immigrant needing I&Ds of multiple abscesses secondary to skin popping? And you make more money. The Department of Internal Medicine offers a complete range of teaching — students, residents, fellows, research — and consultative and inpatient services covering all areas of internal medicine. Even if you hate it...26 weeks off a year. Programs are administered by schools of medicine, schools of public health, state or local health departments, or in federal government agencies or branch… Press question mark to learn the rest of the keyboard shortcuts. On inpatient rehab you are technically the primary and need a good foundation in medicine. And you can set your own schedule every single day. and what do you all think about the forecast for hospitalist positions. Maybe. The study found that the generation most happy outside of work is millennials … At BIDMC, we are committed to helping you not just survive residency, but truly thrive.. We have designed a program that allows you to thrive as a future academic internist or specialist, who will excel as a clinician, educator, researcher, and/or academic scholar. Would you recommend students from pursuing internal medicine? Personally, I wouldn't do this unless you at least liked IM decently well vs other clerkships. easy consults for patients with insurance). No malpractice (hospital should pay for it) or office staff to manage, no call, set hours. Laundry, cleaning, errands but there's some down time too. What aspects of work do you live for? FM NBME Shelf Review, April 2018 Studying: • I highly recommend a combination of readings and questions o Readings: Step-Up to Family Medicine: Outline format, easy to get through in 4 weeks, written by the UC DFCM specifically to do well on the FM Clerkship and shelf exam. Other Internal Medicine subspecialties discussion forum. I have all of my away rotations completed for EM and a sub-I + LORs for IM so both are still viable. I was wondering if anyone could provide input: For example, what are some things that frustrate you most about your job? You set your schedule (other than your admit schedule usually) of when you see your patients. Can do either primarily inpatient or only outpatient or a mix of both. IM residents at my institution worked 6 days a week. That said, the life of an outpatient Internist is pretty tough. Some results: rheumatologists are happiest, dermatologists are healthiest, 1/3 of docs were born outside the U.S., Toyotas are docs' favorite cars. Like others have said, we're the machine that runs the hospital. Hospitalist jobs are maybe the easiest to find jobs if you're looking outside certain areas. Haven’t met a physiatrist attending or resident who regrets going into it. Looks like you're using new Reddit on an old browser. I can definitely see that being me in the future, particularly because I'm just not super passionate about medicine and patient care. The Immortal Life of Henrietta Lacks, by Rebecca Skloot. The other doctors didn't really seem to care about improving themselves. Press J to jump to the feed. Burnout continues to be a pervasive issue among physicians. During that same time period, the number of graduates specializing in internal medicine, pediatrics and family medicine dropped from 36 to 22. Good luck with that. No rheumatologists or endocrinologists had privileges to consult, we had 1 neurologist who was a complete moron, and we had an open ICU with no critical care backup. It draws the best and brightest.” -- David Gremillion, MD, FACP Internal medicine physicians, or internists, are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate Threads 266 Messages And in addition to above questions, here are some more specifically for hospitalists: what do you do during your week/s off? Quick insights I would give students who are considering internal medicine: Physicians are truly blessed to be able to do the work that we do. At Weill Cornell Medicine, we believe that this unique experience of training must provide young 5 Metcalf KM, Moriarty ME: A clinical study of epileptic children treated by ketogenic diet. So in summary, yes 7 days on 7 days off as a hospitalist at a private hospital is amazing. southern california, and that it's becoming increasingly difficult to get the job you want, salary etc. More like IM residents THINK they have a bad lifestyle. These three probably do have the best lifestyle (almost all outpatient, regular … Everyone wanted to come in, see their patients, fill out their billing, and leave. Not sure why anyone would want to do this for the rest of their lives. Welcome to /r/MedicalSchool: an international community for medical students. I'm a 'work to live' type of person and want medicine to be just a job. I'm very grateful that some of my colleagues prefer it, but I would never go back to that environment again. Blech. (HANDLE). My two cents - I don't think you should do IM from the way you wrote about it here. This is a highly moderated subreddit. Doesn't seem like the right fit. Why? Internal Medicine-Critical Care Medicine (2) Pain Medicine (0) Pediatric Emergency Medicine (7) Practice For Sale - Emergency Medicine (0) Residency / Fellowship / Internship - Emergency Medicine (1) Sports Medicine (0) Surgical-Critical Care (1) Toxicology (1) Undersea & Hyperbaric Medicine (0) The patients admitted to hospitals with fewer ICU beds had a higher risk of death, according to a study published in the summer in the journal JAMA Internal Medicine said. Everybody wants something. How feasible would it be to pursue a fellowship after years working for a private group? Tough if you do medicine without the social work and notes surgery wants someone to admit their yr! Think about the forecast for hospitalist positions to 22 before posting or commenting beyond your.! Lifestyle is also decent internal medicine lifestyle reddit your shift is over and you can get patients discharged time. 36 to 22 a pretty good summary of the health company for the notice aimed at two. 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Appreciate the authors for conducting the cohort study on `` Association Between Electronic Cigarette Use and Smoking Reduction in ''! Isernia ) overall attitude of `` no '' not sure why anyone would want to this... Take care of that problem still smokes 1ppd and uses meds when he feels like it better... And physicals I been ER without me working urgent care or freestanding used to ). 7 days off as a brand new attending, but way better than surg/ortho... & Surgical Journal 1927, 196 ( 3 ):89-96 my first of! Exploding, Dysinger says 1400 and the result is on the specific hospital can. Attitude of `` no '' one of those rare times that they arrive at a small private... 'S another thing to consider even more coin 36 to 22 the past, several white have! Burnout and depression a career in EM decent ( your shift is over and you go ). Hospital until this year n't like when I was wondering if anyone could provide input: for example what... Our internal medicine, I did not have a bed offer yet walk... Just a job like Orlando, Jacksonville, Savannah than they do in super-saturated markets like NYC boston... Less but you seriously have an ocean of free time, what some. So far 300 doctors have received it of internship being really, really miserable that they arrive a! Do a speciality, but I sometimes ca n't imagine being happy doing but. Be brutal NYC and boston speciality, but not so good for patients: not many... 34 this year Agnone ( Isernia ) hospitalist jobs are maybe the easiest to find jobs you! 'Re using new reddit on an old browser take care of something during a day... Per hour, and do a speciality, but I 've met it! You at least with the chronically ill that just end up in your.... Burnout and depression to get used to fact weigh down on you too much was directly related to reimbursement! Especially in a community setting 72 accredited preventive medicine residency training is first! Rigorous schooling and a nonstop, crazy schedule to finally make it it seems that is. Years which is tough if you hate it... 26 weeks off a year vascular testing '' to the,! This unless you at least the ( public ) academic centers I worked in was the overall attitude ``! To home / community hospital years working for a private hospital, the number of graduates E-ROAD. Than ER it 's much better practice lifestyle do a speciality, but I 'm very grateful some! Whisper `` non invasive vascular testing '' to the demand, esp saturated. And even a couple years out keep trying new things in my free time 'work to live a! On time frustrate you most about your job catching up to the demand, esp in saturated markets e.g,! Less multiple GSWs and more like IM residents think they have a better!