Hospitalist Job VS Going for Fellowship

What is Hospital medicine?: A medical specialty dedicated to the delivery of comprehensive medical care to hospitalized patients.

What is a hospitalist?  A physician who specializes in the practice of hospital medicine.

How to become a hospitalist? Following medical school, hospitalists typically undergo residency training in general internal medicine, general pediatrics, or family practice, but may also receive training in other medical disciplines. Some hospitalists undergo additional post-residency training specifically focused on hospital medicine.

There are also adult hospital medicine boot camps conducted for physician assistants and nurse practitioners through which they can gain knowledge and expertise to become hospitalists.

The decision is very personal. The decision should be based on your personality-what you like to do with your life? What kind of lifestyle you want? Money is not the deciding factor. Having said that, there are definitely some advantages and dis-advantages to being a hospitalist vs being a specialist.

Advantages of being a hospitalist: 

1. Hospitalist Lifestyle. You are at home with no patient responsibilities for 14 days a month. You can pursue your hobbies and other interests. I am able to help others with this site which is my passion just because I could afford free time.

2. Hospitalist average salary. I can say you get a very decent salary. You can easily earn few more thousands by moonlighting. Overall you are looking at 240-260K if you work hard.

3. Lot of flexibility. You can take off on virtually any day if you can arrange an alternate coverage. If census on a particular day is less, you don’t even have to worry about coverage.

4. Support. There is a lot of support clinically and socially. I love my colleagues. They have helped me innumerable occasions. Even specialist support is great clinically. You always have a group to talk to any time.

5. Leadership position. You can easily go up in to administration if you want to. As you are more involved in various committees, you will gain a lot of experience and can do a great job in administration.

Advantages of doing fellowship:

1. Passion. It’s helpful to fulfill your passion.

2. Money. Some specialties earn more than others. Remember, this should not be your idea of doing fellowship.

3. Life style. Waking up early in the morning is one big thing. As a hospitalist, I always wake up at 5:30am. You probably could wake up little late being a specialist. It’s of course not universally true.

Best Things are: Over all, I love the hospitalist work. Your experience will depend on the setting/hospital you are in. Read the things you have to look for in a new job here

1. hospitalist salary. You can earn up to $50K more than your salary by doing moonlighting. Most of the places, the basic hospitalist salary is more than $250K.

2. Hospitalist lifestyle: (7 on, 7 off) It’s like vacation every other week

3. No responsibility when you are off. Anytime you step out of the hospital, you are free totally. Rarely you may get calls from your hospital secretary regarding questions by the recently discharged patients by you.

4. Lot of flexibility for work hours. You can easily get a day off any time by exchanging with a hospitalist who works in your Off-Week. Also, if you feel sick any day, it’s relatively easy to take time-off with out much problem unless the hospital census is high on that day. You can also eat or relax or do whatever you want at whatever time you want as long as you are able to take care of patient issues perfectly and finish by 7 pm. If you take one week PTO, you get 3 weeks off at a stretch. It’s so good.

5. Lot of support by your colleagues both in and out of the hospital both for social and also medical. If you don’t know answer to any particular situation of yours, you can get ready answers from your colleagues.

6. You can go into administrative positions easily.

7. You are a complete doctor knowing a vast majority of medical cases. I personally like a ‘Complete Doctor’

8. You can do lot of moon lighting if you are capable and if the hospital you work at has opportunity. Most of the hospitals need moonlighters. If you want to do a lot of moonlighting, it will be helpful to have extra help at home to help with your kids, cleaning the house etc.

9. The weekends are really nice most of the times. You can finish seeing your patients early on weekends as all the patients are in the floor and not too many people are in the hospital to slow down your work. Week days are busy with more staff, students, testing (patients are off the floor) etc.

10. Good team work. You don’t feel alone. If you have a sick patient or a patient not improving, you can discuss with a group of hospitalists in the morning and help the patient better. Do not reveal patient’s identity to non treating doctors.

11. You can drive the quality initiative in your hospital.

Worst things are:

1. 7 days in a row sometimes can get very tough.

2. Sometimes you may feel like a glorified resident.

3. You might feel other specialties are dumping patients on you. Even private hospitalists (if you are a employed hospitalist) can transfer a patient of theirs to you if their patient fires you because they did not prescribe the narcotics the patients demanded. Now it’s your turn to deal with that situation.

4. Sometimes, there are a lot of hand offs. Its not so much of a problem for you if you are seasoned hospitalist but for the patient, it is not the ideal situation. Lot of times, the hand offs are good because it will help patient by giving second opinion for their medical problems but patients usually prefer the same doctor through out the hospital stay.

5. Your family will definitely miss you the days you are at work. It is worst in the winter when days are shorter. If you are single, hospitalist job is the best.

6. The nurses may reach you for every small things even on private patients sometimes just because you are readily available. I like to know about my own patients but when they call for non-hospitalist patients, it wastes your time. Yes, it happens fairly commonly especially during night time.