Yes, it is true that this is when you have the most amount of academic knowledge. What you don't have is real patient experience.
You are probably thinking about looking for a job or doing a fellowship.
I did both when I finished my third year at UMDNJ. I ended up doing a fellowship in
Sports Medicine and Surgery of the Foot and Ankle in Irvine, CA.
The main reason I did a fellowship was because I wanted to obtain the highest level of education possible for my field. I am now in solo practice. I started out as an associate and am now a partner in the process of purchasing out the practice.
I'll try and go over the main things to look for when considering both.
Let's start with a job. The most important thing to ask is where will this job lead? Do you have the ability to become a partner? How much will it cost you to become a partner? How long will you be an associate? There are of course lots of other questions, but the ones I stated should be the main focus.
Maybe you don't want to have your own practice and would like to work for someone. The main things to consider there is can you live in the area? Will your spouse agree? Is the patient flow what you want? What are the benefits? Salary, vacation, sick time, 401k, car, bonus...
What should a first year associate make?
This all depends on the volume of patients you see. Your salary can range from $70,000 to $160,000 first year out. There should be a bonus clause in there. Let's say you agree on a $100,000 salary. The bonus can kick in once you collect a revenue of $250,000
at a percentage. The percentage is between 5%-50%. So, let's say for the year you collected $300,000 and your bonus percentage is 20%. You will make $110,000 for the year. Keep track of your patients and the EOB's
Taxes?
Are you an independent contractor or employee?
Starting your own practice?
This is very doable for the entrepreneur physician. I have lot's of experience with that if you have questions. My knowledge is in California, but it applies to most states.
Fellowship
When considering a fellowship, you must think about the step after. Do you want to do the above or work for an academic center? If you want to do the above I would highly advise on doing a fellowship in an area you are interested in settling down in. This will make your job search later on much simpler.
If you want to teach at an academic center then you should do a very specialized fellowship. Diabetic Limb salvage is usually the top choice.
Please feel free to post questions on my Google+ or FB page.
I've been through this and will be glad to offer advice.
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Dr. Gennady Kolodenker