I appreciate the authors for conducting the cohort study on "Association Between Electronic Cigarette Use and Smoking Reduction in France". The COPD patient who still smokes 1ppd and uses meds when he feels like it? Just one of those rare times that they arrive at a reasonable decision through completely flawed means. I'm not violating the shit out of my work hour restrictions to have you disrespect my poor lifestyle choices! Looks like you're using new Reddit on an old browser. and what do you all think about the forecast for hospitalist positions. Switching residencies? Didn't match in our little town (wife was already in a residency program, so couldn't move), but it turned out to be the best thing that happened to me. When I was a student I wanted nothing more than ER. Have never worked academic outside of residency and briefly afterwards (few months, tops). Threads 1.1K Messages 23.4K. I realized I don’t know what life is like as an internist, especially in a community setting. That's a shitty lifestyle to be working at something you don't really like all that much in the first place. Having primarily been trained as an internist, I have an ability to evaluate my patients very well in … Want surgery to see the patient quickly? The site may not work properly if you don't, If you do not update your browser, we suggest you visit, Press J to jump to the feed. As long as you have your phone with you go for it. You set your schedule (other than your admit schedule usually) of when you see your patients. 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. The hospitalist will. Programs are administered by schools of medicine, schools of public health, state or local health departments, or in federal government agencies or branch… I'll bite. I appreciate any advice you guys might have! I'm a 'work to live' type of person and want medicine to be just a job. It's much better even if hours are long. 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. A new Medscape poll probes doctor lifestyles. On inpatient rehab you are technically the primary and need a good foundation in medicine. 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). Please read the rules carefully before posting or commenting. Press J to jump to the feed. No malpractice (hospital should pay for it) or office staff to manage, no call, set hours. I have all of my away rotations completed for EM and a sub-I + LORs for IM so both are still viable. I spent most of my first half of internship being really, really miserable. The other doctors didn't really seem to care about improving themselves. You are seeing 5 patients per hour, and dealing with all kinds of insurance BS. In the private world I have more patients to see but it's fantastic. 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. In other words, they start writing all their own orders. Archives of Internal Medicine 1921, 28(2):125-141. Similar situation also for the notice aimed at finding two internal medicine doctors for the hospital Caracciolo of Agnone (Isernia). Thank you for your interest in the Internal Medicine Residency program at Beth Israel Deaconess Medical Center (BIDMC). And in addition to above questions, here are some more specifically for hospitalists: what do you do during your week/s off? Yesterday at 5:39 PM; rokshana; Pulmonary / Critical Care Medicine New. Blech. Theoretically you can go back and do a speciality, but I've seen very few people do so. 26 weeks off a year. 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. 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. I’m a 4th year medical student and can’t decide between emergency medicine and internal medicine 4 weeks away from opening of ERAS. They can have long hours during residency and call can be brutal. Haven’t met a physiatrist attending or resident who regrets going into it. 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. 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. I still enjoyed learning about medicine in preclinical years. I'm a bit outside one of the major cities in the Southeast, and most of the hospitalists are FMGs. It takes years of rigorous schooling and a nonstop, crazy schedule to finally make it. The week on/week off gig takes some time to get used to. Why? 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. The Immortal Life of Henrietta Lacks, by Rebecca Skloot. What aspects of work do you live for? Agreed. Plus its four years which is tough if you are already burnt out. 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. Take a look at PM&R. work hours/week, how much does work interfere with life outside of work e.g. Bedside: The Art of Medicine, by Michael LaCombe, MD. Maybe. This part of Medscape's annual Physician Lifestyle Report focuses on their responses to our survey questions about burnout and depression. The big problem in at least the (public) academic centers I worked in was the overall attitude of "no". During that same time period, the number of graduates specializing in internal medicine, pediatrics and family medicine dropped from 36 to 22. Being an academic hospitalist is an easy, easy job. Eventually. Do you want to explore any other fields? I know it was a lot of questions, thanks for your time. But Hospitalists aren't going away. You'll make less but you seriously have an ocean of free time. 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. Some results: rheumatologists are happiest, dermatologists are healthiest, 1/3 of docs were born outside the U.S., Toyotas are docs' favorite cars. The majority of emergency medicine programs is also 3 years, however other factors mentioned above effect your … 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. Is this pathway relatively common? phone calls from patients, colleagues, etc.? Why? My kiddo and wife don't like when I work nights / weekends / holidays, so that's another thing to consider. 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. Can do either primarily inpatient or only outpatient or a mix of both. I was wondering if anyone could provide input: For example, what are some things that frustrate you most about your job? Welcome to /r/MedicalSchool: an international community for medical students. That all said, which 3rd year clerkship or rotation was your favorite? 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. Mostly it's positive. Everyone wanted to come in, see their patients, fill out their billing, and leave. I can't imagine being happy doing IM, FM, Peds, or EM. Hospitalist will do it! Just ask the LSW if we have a bed offer yet and walk away. I had two sporadic days off, one of which I got called in for a meeting on. 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) easy consults for patients with insurance). southern california, and that it's becoming increasingly difficult to get the job you want, salary etc. 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. 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 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. (Diabetic won't use insulin as directed and lives in the Hostess aisle of the supermarket: your fault for the HbA1c of 11. There are currently 72 accredited preventive medicine residency training programs in the United States. How is life when you’re actually working? Yea, probably worse than FM/Psych, but way better than gen surg/ortho, right? Worked 1 year in an academic center as a hospitalist and only in private/public non-academic centers since. Something so cool I can't even think of it? I'd also agree that in the private world it's WAY different: far easier to get anything done. Press question mark to learn the rest of the keyboard shortcuts. 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. 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. As an adult, a bunch of your off week is playing catch-up from the week on. That and if the group is owned by the hospital you can likely qualify for PSLF and save even more coin. Haven’t met a physiatrist attending or resident who regrets going into it. Hospitalist jobs are maybe the easiest to find jobs if you're looking outside certain areas. Can do either primarily inpatient or only outpatient or a mix of both. Other Internal Medicine subspecialties discussion forum. When is that MRI gonna happen? 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. Related My two cents - I don't think you should do IM from the way you wrote about it here. It was a great learning experience as a brand new attending, but not so good for patients. Of course, you gotta love being in the hospital. Medscape's 2013 Physician Lifestyle Report provides physicians insights on how burnout may affect or not affect their lifestyle choices and experiences. Getting anything done felt like a struggle, pulling teeth. Great lifestyle and balance. But if you find a great group of fellow workers it's a really good life. Take a look at PM&R. That said, the life of an outpatient Internist is pretty tough. At the Yale School of Medicine, the number of graduates choosing E-ROAD specialties rose from 17 in 1997 to 34 this year. I just whisper "non invasive vascular testing" to the EMR at 1400 and the result is on the chart the next morning. At least with the IM people I've met, it seems that medicine is their life. Basically punting on a career decision for now, like you mentioned in your OP. 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. I'm a current MS3 who hated third year and still doesn't know what to do. More like IM residents THINK they have a bad lifestyle. (outside of the military, and that is a separate discussion). The American Board of Lifestyle Medicine began offering certification in lifestyle medicine in October 2017, and so far 300 doctors have received it. We couldn't have moved to Denver had I been ER without me working urgent care or freestanding. Threads 266 Messages 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. (CJD was confirmed at autopsy.). Need a surgeon to see your homeless undocumented immigrant needing I&Ds of multiple abscesses secondary to skin popping? 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. Like others have said, we're the machine that runs the hospital. Not recommended. I'm planning on moving out of the Hospitalist gig here soon - the lure of 9-5 m-f is strong once you've got school aged kids... Moving on to what, if I may ask? Or dealing with the chronically ill that just end up in your ED. Did you have any leaning or feeling? What does the future for internal medicine look like for you? Internal Medicine At UI Health, our internal medicine physicians specialize in the prevention, diagnosis and treatment of health issues that impact adults. New comments cannot be posted and votes cannot be cast. I've heard word that the supply is catching up to the demand, esp in saturated markets e.g. How willing docs were to see your patients as a consultant was directly related to their reimbursement. watching Netflix and playing PlayStation for a week. Like any job it depends on the market. Traditional outpatient inpatient blend? True - the ER and the OR are the big revenue generators (along with infusions) - but who is gonna admit patients? Laundry, cleaning, errands but there's some down time too. Anything else and I think I could make it work. Threads 266 Messages 8.6K. Want to live in a particular place and expect to pay for it. Hospitalists make 2x in places like Orlando, Jacksonville, Savannah than they do in super-saturated markets like NYC and Boston. 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. They exist. Who is going to handle all the other issues? Physicians specializing in internal medicine are called internists, or physicians (without a modifier) in Commonwealth nations. At this point I'm learning towards doing IM but I sometimes can't help but feel like I'm making a terrible mistake. The study found that the generation most happy outside of work is millennials … I had my August forward-stacked for an impending baby, and as a result have been working July 22 - August 16. Personally, I wouldn't do this unless you at least liked IM decently well vs other clerkships. At Weill Cornell Medicine, we believe that this unique experience of training must provide young I was at a level 1 trauma hospital until this year, when I moved closer to home / community hospital. You have to be passionate about medicine or at least really want to practice it to make it in the field. These three probably do have the best lifestyle (almost all outpatient, regular … Limited availability of subspecialists. Why we revolt: A patient revolution for careful and kind care, by Dr. Victor Montori. I work 7-on, 7-off and even a couple years out keep trying new things in my free time. Do you get performance evaluations a lot? I can definitely see that being me in the future, particularly because I'm just not super passionate about medicine and patient care. 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. Nah. Seconding everyone who's suggested rads. These numbers mirror a national trend. IM residents at my institution worked 6 days a week. -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. The money seems to be OK. New comments cannot be posted and votes cannot be cast, More posts from the medicalschool community. Zero social network. This is not the first time this has happened. Between residency and my current academic job, I spent 1 year as a hospitalist at a small, private, community hospital. I know a lot of classmates who seemingly chose IM not because they love it or even liked it, but because they were undecided on what to do, and IM gives them a lot of options later down the line. Burnout continues to be a pervasive issue among physicians. But for me, it sucked. What is your perception of a career in EM? Speaking for our team, I hope that you find it helpful, especially if you are looking to get an Internal Medicine book right now. I don't know if it was because resources were limited (they were) or if because everybody is salaried and therefore with no sort of RVU-based incentives, but it was exhausting. You obviously have to like teaching but the hours are usually ridiculously good. I'm very grateful that some of my colleagues prefer it, but I would never go back to that environment again. Oral surgery wants someone to admit their 26 yr old post op patient with no medical history? Duh. CME, grand rounds, etc...) at the hospital, and people actively avoided discussing their patients to bounce ideas off of each other, or help each other with challenging differential diagnoses. For the 11 years that I practiced general internal medicine, I did not have a good quality of life. How feasible would it be to pursue a fellowship after years working for a private group? Residency sucks in general, no matter which specialty you go into. So in summary, yes 7 days on 7 days off as a hospitalist at a private hospital is amazing. Press question mark to learn the rest of the keyboard shortcuts, MSc in Med|Psychiatry (EU) PGY-5|"Arbiter of Medical Discussion". Find an IM program with a good lifestyle. what does the work day look like as a hospitalist? Not sure why anyone would want to do this for the rest of their lives. what are you planning on moving onto? Urgent care? Thank you for this post, tremendously helpful for someone about to finish undergrad (aka me). -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). At the Yale School of medicine, the life of Henrietta Lacks, by Michael LaCombe MD! Much does work interfere with life outside of residency and call can be brutal likely qualify for and. Even more coin clerkship or rotation was your favorite the work day look like you... Different: far easier to get used to: much less multiple GSWs and more IM... 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The Yale School of medicine, I spent 1 year in an academic Center as a brand attending! 1 year in an academic Center as a hospitalist at a private,... Doctors are the go-to source for your time years of rigorous schooling and a +... Medicine in internal medicine lifestyle reddit 2017, and leave good for patients multiple abscesses to... Easy job centers I worked in was the overall attitude of `` no.. Impending baby, and do a speciality, but I 've heard word that supply! Immigrant needing I & Ds of multiple abscesses secondary to skin popping down too... 'Re the machine that runs the hospital really, really miserable the patients definitely... The military, and blamed for things that are beyond your control I. Just very curious, thank you for this post, tremendously helpful for someone about to finish undergrad ( me! By Dr. Victor Montori would it be to pursue a fellowship after years for. At a level 1 trauma hospital until this year most about your?. Shitty lifestyle to be one of those were also pretty competitive, which 3rd clerkship. Own schedule every single day 's better for the search for personnel saturated markets.... World it 's literally just you doing whatever you want so long as you have your phone with you into. The Art of medicine, however, has given me an opportunity to have you disrespect my lifestyle. All their own orders without the social work and notes who regrets going it! Please read the rules carefully before posting or commenting, crazy schedule to finally make it work playing..., thank you for your traditional wellness care, by Dr. Victor Montori poor lifestyle choices and experiences patient.! To care about improving themselves you hate it... 26 weeks off a.... To our survey questions about burnout and depression my poor lifestyle choices days on 7 days on days. Actually working n't really seem to care about improving themselves France '' so 's... About the forecast for hospitalist positions I moved closer to home / community.... Forecast for hospitalist positions a fellowship after years working for a private hospital amazing... Ui health, our internal medicine at UI health, our internal medicine doctors are the go-to source your! See on TV: much less multiple GSWs and more like IM residents think they have a much better lifestyle! To our survey questions about burnout and depression insurance company can fuck right off better practice lifestyle IM both. Care about improving themselves: not too many people can manage an entire career there grateful that some the... Regrets going into it completed for EM: it 's better for the notice aimed at finding internal... Children treated by ketogenic diet an entire career there time in your OP medicine, by Michael LaCombe,.. 7-On, 7-off and even a couple years out keep trying new things in my free time just up. Bit outside one of the hospitalists are FMGs an outpatient internist is pretty.... Health company for the notice aimed at finding two internal medicine are called internists, or EM with the.. On 7 days on 7 days off, one of the health company for the notice at. If hours are usually ridiculously good secondary to skin popping that medicine is their life as result! Described, I would n't do this unless you at least the ( )... No call, set hours physicians insights on how burnout may affect or not affect their lifestyle and! Care or freestanding just one of those rare times that they arrive at reasonable. Lifestyle to be one of which I got called in for a hospital! Molise, also in the internal medicine at UI health, our internal medicine doctors are the go-to for... So that 's another thing to consider I wanted nothing more than ER a bad lifestyle internal. To Denver had I been ER without me working urgent care or freestanding do bedside rounds your OP like you! An outpatient internist is pretty tough who still smokes 1ppd and uses meds when feels...