As oportunidades de trabalho para médico especialista nos EUA podem ser bastante diferentes do Brasil. Conheça a rotina do Stefan, especialista em Clínica Médica que atua hoje em NYC!
What my daily life is like as a Hospitalist in the United States
When you finish Internal Medicine residency in the United States, there are several paths you can take. First, you can decide to do a fellowship. Some of these can be difficult to get, like Cardiology, Hematology/Oncology, Gastroenterology, and Pulmonology/Critical Care. You will either need to come from a top Internal Medicine program or perform very well and do lots of research if you go to a less competitive program. You can also work as a primary care doctor in an outpatient clinic. Some people like this because you get weekends off, and they prefer working in a clinic versus a hospital. The third option is to become a Hospitalist, which is what I do.
Hospitalists work exclusively in the hospital and usually work 7 days in a row and 7 days off. This is a really incredible schedule for people who love to travel and have other hobbies, but it can be tough for people with families who don’t want to miss half of the weekends per year. If you really want to work as a hospitalist with weekends off, you can usually negotiate a schedule that lets you work Monday through Friday. Another good thing about being a hospitalist is that no matter what Internal Medicine program you graduated from, you can always find a Hospitalist job wherever you decide to move to. There are always job openings all over the place, and it is not hard to find extra shifts if making a lot of money is your main goal.
With that being said, let me tell you about what one of my days looks like. I arrive in the morning and will usually have between 15 and 20 patients on my list that I will take care of for the entire day. I first log onto the computer and print out my list of patients. I look at all of the things that happened to my patients since I left the hospital the day before and I look at their labs, vital signs, and any new notes from other specialists who are following the patient. I think in my mind about all the things I want to do for my patients that day and I think about which people I want to discharge from the hospital. I then go and round on all of my patients, which usually takes several hours. I ask the patient how they are feeling, examine them, and tell them what my treatment plan is for that day. Sometimes I will call family members from the room to give them updates as well. After this, I go back to the computer and put in all the orders I need and begin to write all of my notes. Unfortunately, writing notes is a significant part of my day and usually takes several hours. In the United States you need to write pretty detailed notes since you need to protect yourself legally in case one of your patients decides to sue the hospital at some point. These detailed notes can also be a good thing, though, if you get a new patient and see that another doctor has already written a detailed note on them. Once I am done writing notes and have made sure that my patients are well taken care of, it is usually time to go home. Even though these days during my “7 on” can be tough, I still will have time when I get home to have dinner with Leti and enjoy part of the night.
Usually shifts are about 12 hours per day, but a lot of hospitalist jobs out there will pay you for a 12-hour day and let you go home once you finish seeing all your patients and writing all your notes (which are often called “round and go” shifts). However, I would guess that only about half of the hospitalist jobs out there allow you to do this. Some will make you stay the full 12 hours that you are getting paid for. When it comes to finding hospitalist jobs, like I said before, you can basically find a hospitalist job anywhere you decide to move to. The only thing is that in the more popular places to live (like major cities), the jobs might be more work for less pay since so many people want to live in these cities and there are only so many hospitals there. If you want to live in a more rural place, you can make a ton of money for way less work. And, in case you were curious, the average salary for a hospitalist in the United States is about $330,000 USD per year.
The main point I want to emphasize is that if this type of job sounds like a dream to you with all the free time and flexibility, then don’t worry because even if you get into the least competitive Internal Medicine residency program in the entire country, you can still graduate and work as a hospitalist almost anywhere. You don’t need to come from a prestigious program or background to work at a job where you make over $300,000 USD working only half the days of the year. So next time you feel unmotivated while studying for the USMLE exams or feel frustrated with the process, remember that there is light at the end of the tunnel!
