Academic Medicine Shaping the Future of Your Specialty

Medical students who want to be leaders in their specialty should consider a career in academic medicine. A much smaller percentage of physicians work at university hospitals than in the private sector. Academicians serve as medical school faculty members in their specialty's department and also provide patient care at their affiliated teaching hospital. With less emphasis on patient volume and turnover, the pace of academic medicine is more relaxed than that of private practice. Although the job market for new faculty physicians is quite strong, the tertiary care medical centers are usually in major metropolitan areas. This limitation means that academic physicians—whether pediatricians or interventional radiologists—have less geographic flexibility than their counterparts in the private sector.

Whereas private practitioners deliver patient care to the masses, academic physicians in every specialty and subspecialty have a set of three universal—and equally important—responsibilities.

1. Teaching: Every doctor receives residency training in a teaching hospital. By staying there to practice, academic physicians instruct generation after generation of specialists. Much of this time is spent supervising and teaching fellows, residents, and medical students. Through hours of mentorship, academic physicians can make a meaningful difference in their charges' professional lives by shaping their formative years of clinical training. These inexperienced young doctors will pepper you with lots of probing questions, keeping you sharp in your specialty. Most faculty members recruited out of residency or fellowship start teaching at the level of Assistant Professor. Promotion and tenure—just like in nonmedical fields — are directly related to your ability to teach and conduct ground-breaking research.

2. Research:Through cutting-edge clinical and basic science research, academic physicians are responsible for advancing their specialty. They generate new knowledge, develop procedures and drugs, and evaluate the effi cacy of different types of treatment. For instance, a general surgeon might conduct a study looking at the best time to take out a chest tube, and an internist investigates the outcomes of treating diabetic and renal failure patients with ACE inhibitors. Academic physicians also have to teach their colleagues in private practice about the latest advances in their specialty. They do so by writing up their findings in medical journals and giving lectures at national conferences. To carry out any research project, academic physicians have to obtain the necessary funding—by submitting grants themselves or by receiving money from their department. In the world of academia, the number of papers published and amount of federal research grants received confers prestige on a university medical center. (In a certain weekly news magazine, the formula used to rank US hospitals and medical schools gives the greatest weight to research awards from the National Institutes of Health.)

3. Patient care:In every specialty, academic physicians provide the latest and most innovative medical care. Tertiary medical centers draw a diverse mix of patients, from the indigent (most teaching hospitals are historically located in underserved city neighborhoods) to the very wealthy (e.g., Saudi princes who fly in for the most advanced treatment). Most patients receive care directly from residents and fellows, who are supervised by their attending physicians, of course. Compared to private practitioners, full-time faculty members generally take less call, devote fewer hours to patient care, and earn less money. All revenue generated from clinical practice goes directly to the medical center instead of counting as personal income. In turn, the hospital pays each faculty physician a fixed salary that is directly proportional to the type and volume of medicine he or she practices. This is why academic pediatricians earn less than an academic cardiothoracic surgeon.

Academic medicine is perfect for doctors inspired by working with some of medicine's greatest minds — the authors of well-known textbooks, the renowned researchers who develop new drugs and vaccines, the innovators who figured out how to surgically separate two newborns sharing the same brain. Because teaching hospitals are part of major referral centers, academic physicians are the ones who manage most of the rare and complicated cases. You will take care of diseases and conditions on a level that few physicians ever surpass. This career path, therefore, gives you the autonomy to become a true leader in your specialty.

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