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Navigating the Job Market: Exploring Academic vs Private Practice Models Jennifer Ahjin Kim, MD, PhD Becoming an attending neurointensivist is the ultimate goal for most trainees coming out of Neurocritical care fellowship. We work hard through medical school, residency and then fellowship, achieving all the academic benchmarks set out by the credentialing bodies. As we near the end of fellowship, many are suddenly faced with having to choose the type of work environment and division of time that were never previously under our control. The uncertainty of multiple options is compounded by the lack of exposure of most trainees to non-academic settings of practice. Even within academics the practice models of Neurocritical care vary immensely. While the AAN has highlighted some of the differences in practice environments for general neurology, specific information related to Neurocritical care practice tends to be primarily by word of mouth. As graduating trainees begin to envision their careers, being informed about the various options can be immensely helpful. To that end, we have interviewed six thriving neurointensivists, to demonstrate the diversity of options for practicing neurocritical care. Marion Buckwalter: Associate professor at Stanford University Medical Center. She attends in the Neurocritical care unit (6 wks/yr) and runs a basic research lab working on how neurinflammation affects outcomes after stroke. She is also Director of admissions for Stanford’s Neurosciences PhD program. Jeffrey Fletcher: In private practice at Bronson Neuroscience Center. His clinical time is a 1 week on, 1 week off model. He also works on AAN guidelines and journal editorial boards. David Greer: Vice chairman of the Dept of Neurology at Yale University. He attends in the Neurocritical care unit (8-10 wks/yr) and has research interests in stroke prevention and outcomes from coma and cardiac arrest. Chad Miller: System medical chief and Medical director of Neurocritical care at OhioHealth. He is the co-chair of the ENLS committee and on the Board of Directors of NCS. Max Mulder: In private practice at Abbott Northwestern Hospital. He is Medical director of the Neurocritical Care Unit and Chair of Allina Health Neurocritical Care Council. Wendy Ziai: Associate professor at Johns Hopkins University and director of the neurovascular laboratory. (Of note, most responses are paraphrased due to space limitations) What do you consider advantages of working in academics or private practice Neurocritical care? MB: I really enjoy being a mentor and a teacher. Being in academics allows me to train fellows, residents postdocs, graduate, and undergraduate students. I want to make discoveries that will help my patients and academics allows me to do so. JF: In private practice, I enjoy interacting with other intensivists and stroke colleagues. There is more collaboration and cross-coverage across divisions than I experienced in academia. Salaries also tend to be higher in private practice than academics. DG: Being in academics allows you to be a critical thinker and work on furthering the field. You have the flexibility and resources to be able to work on projects to investigate critical questions. It also provides educational opportunities to teach and guide future generations of the field. CM: My health system does a tremendous job of short and long term strategic planning. Growth and development of the service line is very orchestrated.  Physician input is highly valued.   MM: Private practice has less rigid departmental and structure allowing for more flexibility to work in different settings. Private practice emphasizes productivity. Schedules are generally more flexible, but you are often doing all the work on your own, which can be a pro or con. WZ: In academics, there are prestige and challenges that come from so many opportunities. Collaborations across institutions allow us to be a part of changing how medicine is practiced. You are doing something different every day, which keeps things interesting. 20


eMag_264548_NCS Currents_December2016_3
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