Can you later pivot from primary care work (after completing general internal medicine training) to something else as a European physician?
I'm not seriously asking for myself, I'm too old to switch continents. But marketing that route would increase the number of physicians in the US, which would lead to some trickling down to primary care on a longer-term basis.
Alas, I don't think primary care shortage can be filled by physicians, maybe mid-levels is the answer? Or blasting open the doors to med school, so you don't have to be outlier on diligence, motivation, or talent to get in? That would allow for recruiting people whose traits don't make them strongly prefer the hospital specialties.
Physicians who have trained as PCPs can subsequently train for a specialty, but there are practical barriers. For instance, it's hard to agree to a 75% pay cut and working fellowship hours when you're in your late 30s or older and often have family and a home mortgage. Clearly advance practice clinicians (PAs and NPs) are filling much of the gap. Bloomberg has recently done sobering reporting on poor clinical training in some NP programs.
An easier route to move to a specialty would likely lead to worsening of the PCP shortage.
Right, the workload in the US is a very real downside. Sure, the compensation before taxes, insurance, and other costs is high, but getting those telomeres back is a pain. And what if you develop a condition from the stress and exhaustion? All in all, practising in Europe looks like the better way, esp. if you're a trained specialist, already.
Perhaps some combination of the patient googling at home and mid-levels + AI really is the way. I'd feel bad for not doing a great job of <patient with problem I saw last in training>. So, on some level, practise in rural Finland where you sometimes amputate extremities, sometimes deliver babies, would be stimulating (new situations all the time!). However, that's not optimal for patient outcomes... And risk aversion coupled with high diligence, low assertiveness is pretty common in med students nowadays.
And what PC here is all about nowadays is management of chronic illness and paperwork. So much boilerplate paperwork. They've had to increase salary offerings, but still they can't get people to even take longer contracts, never mind specialising in PC.
In many ways, PC seems to me like the worst of all worlds, except compensation. What's the draw for non-mavericks?
Can you later pivot from primary care work (after completing general internal medicine training) to something else as a European physician?
I'm not seriously asking for myself, I'm too old to switch continents. But marketing that route would increase the number of physicians in the US, which would lead to some trickling down to primary care on a longer-term basis.
Alas, I don't think primary care shortage can be filled by physicians, maybe mid-levels is the answer? Or blasting open the doors to med school, so you don't have to be outlier on diligence, motivation, or talent to get in? That would allow for recruiting people whose traits don't make them strongly prefer the hospital specialties.
Physicians who have trained as PCPs can subsequently train for a specialty, but there are practical barriers. For instance, it's hard to agree to a 75% pay cut and working fellowship hours when you're in your late 30s or older and often have family and a home mortgage. Clearly advance practice clinicians (PAs and NPs) are filling much of the gap. Bloomberg has recently done sobering reporting on poor clinical training in some NP programs.
An easier route to move to a specialty would likely lead to worsening of the PCP shortage.
https://www.bloomberg.com/news/features/2024-07-24/is-the-nurse-practitioner-job-boom-putting-us-health-care-at-risk
Right, the workload in the US is a very real downside. Sure, the compensation before taxes, insurance, and other costs is high, but getting those telomeres back is a pain. And what if you develop a condition from the stress and exhaustion? All in all, practising in Europe looks like the better way, esp. if you're a trained specialist, already.
Perhaps some combination of the patient googling at home and mid-levels + AI really is the way. I'd feel bad for not doing a great job of <patient with problem I saw last in training>. So, on some level, practise in rural Finland where you sometimes amputate extremities, sometimes deliver babies, would be stimulating (new situations all the time!). However, that's not optimal for patient outcomes... And risk aversion coupled with high diligence, low assertiveness is pretty common in med students nowadays.
And what PC here is all about nowadays is management of chronic illness and paperwork. So much boilerplate paperwork. They've had to increase salary offerings, but still they can't get people to even take longer contracts, never mind specialising in PC.
In many ways, PC seems to me like the worst of all worlds, except compensation. What's the draw for non-mavericks?