what happens after family medicine residency?
there are several things you can do after completing a Family Medicine residency :
- do a fellowship
- work as a hospitalist
- work in the ER
- join a group practice
- open a solo practice
- go back to school
- or get a non-clinical job
i’ll go over each example.
contrary to popular belief, family doctors can do fellowships too! it’s not like specializing in gastroenterology or infectious disease, but rather, specializing in niches of primary care. for instance, we can become specialists of musculoskeletal medicine, HIV, underserved medicine, rural obstetrics, and much more. a fellowship can last a year or two. it depends on what you like, what you want to do. do you want to cover the entire scope of family medicine or just a branch of it? do you want a variety of patients coming to your door or just a subset? you may see a salary increase when you specialize too. is that an incentive for you? see my post here for more possibilities in family medicine fellowships.
working as a hospitalist is a possibility. hospitalists are doctors that work in the hospital only. it is shift work, meaning you are never on call and generally the salary is higher. most of the shifts i’ve read about are where you work 7 days on, then 7 days off. so essentially you get half of the year off!! doesn’t sound like too bad of a deal. it can be tough to get this position though, as many of the jobs prefer Internal Medicine residents. i believe this is because Internal Medicine residents get much more critical care training which is very important in hospital medicine. but, with that said, there are places that will hire a Family Medicine doctor as a hospitalist. do you like the 7 on, 7 off lifestyle?
there are a lot of Family Medicine residents who work in Emergency Rooms after residency. they may not be big city ERs but it’s still an ER. the pay is very very generous, in the 250′s or more. their schedule is also shift work with no call. i’ve heard of schedules being something like 7, 24 hr shifts per month or 14, 12 hr shifts. do you like the intense nature of the ER ?
joining a group practice after residency is probably the most common route people take. starting pay is generally in the 150s unless you head into a rural area. group practice can be divided into with or without ob and also into inpatient plus outpatient or outpatient only. taking call is common. but if you are in an outpatient only practice, then you will only be taking Phone Call. most offers will give you a guaranteed salary for X amount of years and afterwards you’ll be responsible for your own production according to the amount of patients you see daily. some offers will give you a chance to buy in and become a partner in the practice.
opening your own practice is the route less traveled. it requires a lot of work, good practice management skills, and startup funding. when you are coming out of residency, your medical school loans are no longer deferred. starting your own practice means you will be in the red for a long time while you are waiting for patients to come see you. how will you pay your loans, rent, utilities, cell phone, car, gas, insurance, malpractice insurance, your office rent, office utilities, office supplies, office equipment? well, you can get a loan to offset your costs. when your practice is full throttle, you will definitely be making a good salary. but the average to building a successful practice is 2 years. are you comfortable putting yourself in more debt for 2 years? do you desire entrepreneurship and autonomy? is that worth the risk and instability?
going back to school may be the last thing you want to do. after all, we went through 4 years of college, 4 years of medical school, and then 3 years of residency. that’s 11 years of schooling !! but an advanced degree can help you in your medical career by giving you business experience. it can help you rise the corporate ladder and gain titles such as a chief medical officer, chief executive officer, chief medical information officer. many of the doctors successful in these titles have gotten advanced degrees in masters in business administration, masters in public health, or a masters in medical informatics. many of these programs are available as part-time evening courses, and some are even offered as completely online courses. do you want to advance in your career as a family doctor?
which leads me to the last possibility, non-clinical careers. the above mentioned CEO, CMO, CMIO jobs are some examples of non-clinical careers. but there is MUCH much more. if you like to write, there are jobs in medical editing/medical writing. if you like research, then there are jobs where physicians oversee clinical trials. with the advent of the Electronic Medical Record being required in practices, i’ve seen a lot of companies hiring physicians to either work to enhance their EMR or to sell that EMR to offices nationwide. if you want to see more opportunities in non-clinical careers, i suggest you go to Dr. Joseph’s Kim’s blog, or go to a Medical Fusion conference. also check out an old post i wrote about ten non-clinical alternative careers for doctors.
so what’s in store for me after residency?
i don’t know.
i’ve always wanted to open up my own practice, using the principles and goals of the Ideal Medical Practice model and then power the practice with Hello Health‘s practice management software. but, as i inch towards the end of residency, the fear of being broke and increasing debt is getting stronger. there’s a lot to be said about the stability of getting a job. another thing that i don’t talk about on my blog as much is the fact that i do want to go back to school. i want to get an MBA or a masters in medical informatics. i could then use that knowledge to engage my entrepreneurial side and open my own business or advance in my career. but how can i go to school and open a practice at the same time? that’s double debt !! so i just don’t know yet.
thankfully, i still have some time to decide.
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