Great Opportunity But...

[SubmersibleSandwich]

've been offered a position as a new grad at a very large teaching hospital with great pay and incredible benefits which I'm thrilled about but it's for speciality that I've never been that interested in to be quite honest. I always said I wouldn't specialize right out of school, but the offer is for a surgical ortho position. I don't say this to offend anyone in the specialty, but I can't shake the feeling that I would be throwing away all the knowledge that I accrued while in school. It's something that bothers me quite a bit actually considering I've always wanted to end up in critical care medicine whether that be ED or ICU. The position would be a great experience though and is a mix of clinic, OR, inpatient rounding, ED consults, and the potential for traumas as well. So the day to day would be highly variable. Obviously, there's a ton to learn within the specialty itself and I'd be sure to devote myself to all things ortho to become as proficient as I can be, so that I can provide the best care possible to my patients. But, would it be wrong to accept the position because of the pay/benefits as well as the doors it would open for future career goals, if I'm not crazy about the specialty?

[EMEDPA]

Any chance you could transition to critical care at the same facility in a few years and keep seniority and benefits? 

[SubmersibleSandwich]

1 hour ago, EMEDPA said:

Any chance you could transition to critical care at the same facility in a few years and keep seniority and benefits? 

I’m sure internal transfers are definitely possible.

[EMEDPA]

18 minutes ago, SubmersibleSandwich said:

I’m sure internal transfers are definitely possible.

You should do a little under the radar reconnoiter of the ED and ICU there and talk to a few folks off the record. If you could spend a year or 2 on ortho and get to know folks there then transition to ED or ICU and keep the pay and benefits it might be worth considering. If transfers within depts are frowned up, think carefully about doing a job you don't want...

[Apollo1]

4 hours ago, SubmersibleSandwich said:

I’m sure internal transfers are definitely possible.

Sorry, but had to laugh at that. 

Ortho won't prepare you for EM/CC; having an exit plan before starting is a red flag.

[EMEDPA]

20 minutes ago, Apollo1 said:

Sorry, but had to laugh at that. 

Ortho won't prepare you for EM/CC; having an exit plan before starting is a red flag.

Sounds more like an ortho hospitalist position, so the individual would get some exposure to real medicine 

(had an ortho doc tell me in jest recently that the purpose of the heart is to bring ancef to the bones)

granted, it is not the best EM training, but this place takes new grads and I imagine would take someone from their system with a yr of ortho/hospitalist before taking an unknown new grad.

In a perfect world, the OP would do an EM or Critical care fellowship, then find their dream job. 

[CAAdmission]

41 minutes ago, EMEDPA said:

in jest

"In jest." Yeah, right. 

OP, if you are going to go into ortho, you need to immediately get jacked. Continue upper body workouts PRN until you look like you are carrying around two invisible suitcases everywhere. 

[SubmersibleSandwich]

2 hours ago, EMEDPA said:

Sounds more like an ortho hospitalist position, so the individual would get some exposure to real medicine 

(had an ortho doc tell me in jest recently that the purpose of the heart is to bring ancef to the bones)

granted, it is not the best EM training, but this place takes new grads and I imagine would take someone from their system with a yr of ortho/hospitalist before taking an unknown new grad.

In a perfect world, the OP would do an EM or Critical care fellowship, then find their dream job. 

Rather than fellowship, what about those EM boot camp series? Obviously not as desirable I’m sure as a fellowship, but I have to imagine it’d be tough to go from making a nice salary to fellowship living stipends.

[EMEDPA]

The boot camps are fine as CME, but the hands on aspect is minimal to none. You need to do lots of ultrasounds, reductions, cardioversions, paracentesis, thoracentesis, chest tubes, codes, intubations, etc on real patients in a structured learning environment. That doesn't happen in a 2-5 day cme course. 

[SedRate]

19 hours ago, SubmersibleSandwich said:

But, would it be wrong to accept the position because of the pay/benefits as well as the doors it would open for future career goals, if I'm not crazy about the specialty?

No, a lot of people do that.

Some thoughts:

A. Would it be a good first job with many opportunities to learn? Who's going to be training you, the residents or the attendings? 

B. Teaching hospitals have residents so they may say OR time but that's only if a qualified resident isn't available. It could be a situation where you're mainly in clinic, rounding, and doing H&Ps and discharges, so not many opportunities to learn actual medicine or procedures which I think would be a disservice to you as a new grad and your future critical care interests. 

C. As someone who went into Ortho trauma as a new grad, yes, I did throw away a lot of knowledge. With some extensive review, connections, and training, I was able to switch to CTS surgery and trauma/surgical critical care. So it's not impossible to move into a different specialty but requires connections and/or a company that is willing to work with and train you.