Hi.

I'm a doctor from South America.

How do you manage your patients info when you have 30-35 hospitalized patients you see every day?

I can understand some don't need extra help and can memorize everything, but i need a little help with notes related to personal data, past medical history, surgeries they had, meds they use, lab tests, imaging studies, plans, etc etc.

Some use Google Sheets, but i find it hard to use on my phone, unless you have a system that works well for you i'd be happy to know about it.

I've been using Notion and i find it great on PC, but it's not great on mobile. Also the fact that it doesn't have an offline mode is starting to be a problem (but it's not a deal breaker).

Thanks in advance for any reply

Have people been able to create sustainable outpatient practice models that are focused and NOT full primary care without a fellowship? Can you focus on diabetes management only, longevity and performance only, etc. without being the care coordinator you are as a PCP? Ideally making >$300k. What focus area did you build, how long did it take, what are your hours, and what's the salary?

Any residents/attendings or even current applicants willing for mock residency interviews? EST time zone.

As stated above, why did you pick IM over anesthesia and are you happy? I’m debating between the two. I love the science of anesthesia and general OR vibes, but the life/death and need to do procedures under duress worries me, and that element alone is pushing me towards IM where you have more time to make decisions. I’m not particularly passionate about all of the IM content but I much prefer the workflow and do like that you feel more like a doctor. I also recognize anesthesia pays way more. If I did IM, I’d likely become a hospitalist. Has anyone wrestled with similar thoughts?

Hey everyone!

Its been a dream of mine to move out west and work for the IHS on a native American tribe. Currently in rheum fellowship, but I also love primary care. Ideally would like to work a mix of both PCP and rheum for an IHS site (wyoming, Montana, NM, Arizona). Anyone have any experience working with the IHS? Flexibility of work days? anything appreciated.

thanks!

Hello,

What site do you guys use to look for jobs?

Anyone work for KP? How competitive is it to get a position with them and how is their compensation? Any pros and cons of working for KP?

Hello,

I just got accepted to some med schools and it seems that regardless of MD or DO, FM, IM, and EM are some of the most common types of residencies for students. I personally do not know what type of doctor I want to be yet, and IM confuses me because I don't know what most people do with this speciality? Like do most become Internists and treat people that way? Do people further branch off becoming Cardiovascular physicians, Oncologists, or Nephrologists to name a few?

Hi everyone, looking for advice on how to leave my current job. I'm a california hospitalist, fresh out of residency. I was desperate for a job that would allow me to work immediately as I was moving from another state. I've found this group is extremely abusive. Managing over 25+ patients daily (probably closer to 30) with admits and constant calls about transferring patients. I'm getting fed up with the work load and my leadership. I have another offer to do some per diem work with a much better group however that will take a few months to credential.

I guess I'm looking for advice on how to approach my leadership as I am signed on for a two year contract. In california we have to give a 3 month notice if we want to quit. I'm considering just asking to go per diem/ part time with them in a few months so as to not completely break from the group. But I'm dreading this conversation with the leadership as they are just pushy people who are moneyhungry.

I just feel so unhappy with the volume and stress, I can't keep doing this kind of medicine.

Got this job by email I just think it appears to be burnout risk +++.

Never seen such a relentless schedule

What Hospitalist schedules are the best? Classic 1 on, 1 off? 2 in, 2 off? Is M-F with weekends off VA style absolutely the way to go?

Would be great to prioritize lifestyle, but wouldn’t want to sacrifice too much in compensation or benefits. How viable is taking a pay cut for 1 week on - 2 weeks off?

Applying for Internal Medicine, Not looking for fellowship, one that has work-life balance and one that I can do moonlighting in PGY2 while being in a nontoxic environment.

1. Trinity Health Ann Arbor
2. Henry Ford Detroit
3. Beaumont Dearborn
4. Henry Ford Macomb
5. Henry Ford Providence (Ascension)
6. Western Michigan University Homer Stryker MD School of Medicine Program
7. DMC/WSU
8. Parkview Fort Wayne
9. Mclaran Macomb/Flint/Oakland
10. Ascnesion Genesys
11. Lakeland regional Health, FL
12. Baycare Health Tampa
13. Henry Ford Jackson
14. SOUTHWEST INDIANA INTERNAL MEDICINE RESIDENCY PROGRAM
15. The MetroHealth System/Case Western Reserve University
16. NORWALK HOSPITAL/YALE UNIVERSITY PROGRAM
17. Stamford Connecticut

Help me decide one vs the other

Pros of Hospitalist: Shift work Salary increase Broad range of medicine

Cons of Hospitalist: Dealing with hospital BS Social work ++ Dealing with nursing

Pros of nephrology: I like the material No social work and no hospital/ RN BS

Cons of nephrology: Pay cut Full time / no shift work

Any advice on whether the Mayo-Arizona or USC Internal Medicine residency program is better? Esepcially if potentially interested in fellowship. Thank you

Is it possible to match into a fellowship years after residency? I could see myself doing CC but have family kids and want to finish residenecy and just have a stable work like in IM until the kids are older.

Interviewed at both these institutions and love both. Had a slightly better interview day at UCSF (only bc the faculty interviewers at UCSF knew my application so well) but have an existing mentor at Stanford. Interested in GI fellowship. Now just trying to think about what to rank #1.

Thoughts on these programs in terms of clinical training and lifestyle? What would you rank higher and why?

Hi there,

I work in the AI field and would like to help physicians in Internal Medicine quickly access the information they need from research papers.

My wife has been an internist for several years, and I’ve often noticed how much time she spends searching for the right information in the right papers.

I’m curious—have you faced similar challenges in your practice? If so, would you be interested in using a conversational AI tool designed to help you find the right information more efficiently within research papers?

I guess the push back is hard enough by withholding $$$, they listen. Still no evidence that MOC in the current form improves patient outcomes compared to CME format.

ABIM MOC

If you happen to be gearing up for contract negotiations soon for 2025, I wanted to share some helpful resources I’ve come across while prepping for my own contract talks with my practice group.

A lot of private employers say they use MGMA data, but it’s tough to access unless you’re willing to pay for it—and honestly, it’s created by employers for employers, so I don’t completely trust all the numbers. MGMA surveys also come out early in the year—so if you’re negotiating now, you’re looking at data that’s already a year old, maybe even two by the time your contract kicks in. (For those in academic settings, AMGA is usually the go-to source.)

No matter the source, averages are just that: averages. If your group pays better than average (like mine does), you’ll probably want to know what the top percentile is earning to give you more leverage.

I found a helpful google doc that pulls benchmarks from different sources, which has been very useful. What was even more useful in spot-checking these averages were specific salaries…the sheet contains these “crowd-sourced” anonymous salaries in the first column, which was great for getting a clearer picture of what’s really out there at the high-end including shifts and benefits data. If you put in your own salary, you get to see individual provider stats. https://marit.fillout.com/t/vfyw8PEHj2us

Sharing a sample of the data I found here: Anesthesiology Averages - Community Data-set - $518k, MGMA - $515k, Doximity - $494k, Medscape - $515k, AMGA - ??, AMN - $460k

Emergency Medicine Averages - Community Data-set - $378k, MGMA - ??, Doximity - $399k, Medscape - $379k, AMGA - ??, AMN - $404k

Internal Medicine Averages - Community Data-set - $336k, MGMA - $311k, Doximity - $312k, Medscape - $282k, AMGA - 329k??, AMN - $271k

Link to the entire Google doc: https://docs.google.com/spreadsheets/d/1ph4r3UL4mcshs6v-zs-PP257JsqNVTo775wH2SPFeBo/edit

Does anyone else have any tips that have worked for you for increasing comp?

Has anyone encountered any IM careers that overlap with pathology? For example doing heme and then transfusion medicine, or ID and then clinical microbiology. I am interested in a career that is both patient facing and also involved in lab medicine, and am already committed to internal medicine. Thanks for the help!

Hello any one gave interview at leonard??

If you take a 2-year gap primarily doing non-clinical work in industry after IM residency while picking up a couple shifts a month, can you still be competitive for fellowship match after those two years?

Hi, I'm looking for a study partner for my first time ABIM test. I want to go through U world and then take a review course hopefully in the spring of next year. Looking to do a first time U world review in depth and understand the concepts thoroughly.

Hi all,

I’m a PGY-1 IM resident (non-US IMG), and I’m interested in Allergy/Immunology. However, I’ve heard that it can be quite competitive since IM candidates often have to compete with Ped and Med/Peds applicants.

I’m wondering how difficult it is for an IM path to match into this specialty. Any advice, insights, or experiences would be greatly appreciated!

Thanks in advance!

Hey guys, just a lowly M4 here trying to decide where to spend the next few years, hoping this sub would be more helpful than r//medicalschool. Rank lists are due a couple months from now, but I’m already struggling to decide between UCI and Harbor for a few reasons.

I’m set on pursuing cardiology, potentially interventional, so I’m trying to figure out which program would better position me for fellowship. Since both programs mainly match fellows internally, the decision really comes down to which has the stronger cardiology fellowship and offers the better chance of matching internally.

The issue with UCI is the lack of transparency. Their cardiology fellowship website barely provides any information, while Harbor’s site is much more detailed. Harbor also seems to have a stronger track record of taking home residents into cardiology (one year, they took 5 in-house residents for cards) and consistently accepts internal candidates for interventional. I found UCI’s fellowship match list on their Instagram page, but even then, it seems they’ve only taken a maximum of 3 internal residents per year into their cardiology program (even though they have a larger residency class than Harbor!), while Harbor has taken up to 5 per year. This makes me hesitant to rank UCI higher despite its academic reputation. Harbor also has a building dedicated to research while I've heard UCI residents have some trouble finding research?

I also slightly prefer Harbor’s location, but I don’t want that to be my main deciding factor. I'm essentially just basing my decision on their respective cardiology programs.

TL;DR: I'm deciding between UCI and Harbor for residency, focusing on cardiology fellowship prospects since both primarily match in-house. UCI is more academic but lacks transparency about its cardiology program, and they seem to take fewer in-house residents for fellowship compared to Harbor, which has a stronger track record (up to 5 residents per year). While I slightly prefer Harbor’s location, my decision is ultimately based on which program offers better cardiology fellowship opportunities (for matching in-house, stronger program), and less likely to require a chief year.

If anyone has advice or insight, I’d really appreciate it!

I was talking with my IM friend in private practice, who just audited his patient charts for the top chronic conditions he manages. He realized he needed to follow the most current guidelines for about ~10-20% of these conditions, depending on the condition. Made me wonder - is this common? How do you all stay current with the constantly changing guidelines?

Day hospitalist position 7 on 7 off , FTE is 182 days Closed ICU , no procedure Round and go , usually leave by 4-5 pm All sub specialist support is there Avg 18-20 census , 1-2 admissions . Medium size city 300k southwest

They have a two tier payment model.

1. 135/hr for 12 hr shift for 182 days . ~295k per year . No rvus .

Or

2. you make 70/hr base rate for 12 hour shift + 15$ per total rvu (not wrvu).

Either you are compensated based on 1) or on 2) whichever one is the highest .

Reasoning being that if census falls really low you make atleast 295k always . On the current average census they said you almost always make 2) and that works out to around 330-340k per them .

Do you guys have any idea what would be the total RVUs I would be making at a job like this with the above given censuses working 7on7off . I needed some help with the

And what do think about this offer in general.

Thanks!

Job 1:

• 9 clinical sessions (36 patient contact hours / week)
• Mandatory 4 hour admin session working
• Strict 8-5 schedule, 4.5 days, M-F. no evenings/weekends
• Call every 16 weeks (Just call)
• Salary Base: 230k
• 12.5k sign on bonus
• RVU structure: For every wRVU beyond 4841 you get 50$/wRVU up until 5702 at which point the wRVU becomes 20$ / wRVU up to 6556 at which point everything beyond becomes 15$/wRVU
• Quality / Patient Care Bonuses (5k + 5k) =10 K total
• State of the art facility
• 2 designated patient rooms / provider
• 15 min follow-ups
• Likely 18-22 patients / day
• all care done in the room from phlebotomy to injections by designated nursing staff
• State of the art very new modern building
• 23 days vacation / year (built up over time)
• 4 personal days / year (build up over time)
• 15 minute commute

Job 2:

• 9 Clinical Sessions (36 total patient contact hours)
• No designated Admin time
• Flexible starting hours, 8 or 9 am
• 4.5 days, M-F, no evenings/weekends
• Base salary: 235k
• 33.5k sign on bonus
• RVU structure: RVU Threshold @ 5500 to maintain salary. For every % of that RVU threshold you achieve beyond that RVU threshold, you get that % of your salary. So for example, if you bill 7000 RVUs, that would be about 27%, so you get 27% of your salary as a bonus (235k x 0.27 = 64k in bonus)
• Flexibility in patient times 40:20 min / 30:30
• No designated vacation time or time off requests, you just tell them when you want off (within reason and scheduling) and you will not be recorded, as long as you mean your RVU threshold they are okay with how much time you take off
• Only 1 patient room per physician, patient's are pre-checked in by MA but sent to sub-waiting area where the physician has to go grab them to bring them to the room
• phlebotomy in house but not done in the patient rooms
• no in-house X-ray
• More older building but has a lot of renovations done to it
• Would be walking distance from my future apartment

Everyone I met at both were so nice and I am having a really hard time teasing out the difference. Job 1 had such a nice facility in I very cool uppity part of town whereas Job 2 is in a more quaint area and would be within walking distance of all the major things I want to be in and from the future apartment I want to be at. I think I'm leaning toward job 2 at this point just given the convenience of the location and the increased flexibility in time off and more control over patient scheduling and the larger sign-on bonus which to me at this stage in my life is very enticing as I have a lot of debts and the relocation of all of this is is going to be so expensive. The job 1 clinic is far more beautiful and runs so efficiently and that is such a turn-on to me but I'm thinking that the slightly increased control over my work flow may be more attractive over time, and again, being walking distance from my work.

Can anyone speak to the difference in wRVU vs. RVU?