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New grad, 2 offers, very conflicted

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Minor detail changes.

Offer 1: ortho surgery. M-F 8a-5p. Weekend rounds and call once every 5-6 weekends. OR 2-2.5x a week. Outpt clinic the rest of the week. Inpt rounding and helping out if I’m done with a case early. Great inpt team. Outpt team would consist of me and one other awesome APP. Great crew overall.

Offer 2: cardiac unit. 90% inpt, 10% outpt clinic. M-F 8a-5p. 2 weeks on inpt service followed by 1 week outpt clinic and then 1 week dedicated to answering emails and pt calls/messages (goal is to have this done from home so I’d only be commuting 3 out of 4 weeks a month). Great team. APPs are my age. 

These are both under the same large hospital system, just different locations. Offer 1 is a 50 minute 40 mile drive one way, Offer 2 is a 35 min 10 mile drive one way. Bennies and salary are basically the same for each.

I want OR time and think Offer 1 sounds good in that it hits all areas (inpt, outpt and OR) and a good team is a priority. I feel like I’d eventually get bored with the work in Offer 2 and am afraid no OR time may hinder me in the future if I try to switch specialties and an competing against someone who’s had OR time.

I am so grateful to be given this “dilemma” but am also truly conflicted. I feel like I can be happy in either setting. Though I’ll say that Offer 1 really wants someone to start working whereas Offer 2 was more laid back and not in a rush.  

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You have essentially answered your own dilemma.  IF offer one ends up not being what you were hoping for you can ask for a transfer to offer 2.  But you know in your gut which one you have assessed as the best job for you. 

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Because in the way my brain works it's easier to learn procedural skills than it is to retain and relearn medicine. How much of a medical component can an orthopedic practice have? 

I don't ask that in a demeaning fashion, a very large proportion of Ortho services utilize the inpatient teams to manage pre-op clearances, post-op meds and discharge. Ortho could definitely prove helpful down the road in an UC/ED setting for sure. If you are actually managing your admitted patients rather than consulting the medicine teams then that sounds like a unique opportunity.

Maybe some of our ED/FM colleagues could weigh in on which skill set would be helpful moving into their respective fields down the road.

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  • 3 weeks later...

If you love ortho, then do it. But if not and you end up leaving, it can pigeon hole you. You will find that you will quickly lose a lot of medicine that you just spent so much time and effort learning. Now if you admit and manage your own patients, that will allow you to put your training into practice, which will help. You can also consider doing UC PRN, which can also help you to retain some of your general medical knowledge as well as supplement your income.

Congrats and good luck!

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