Part-time work-what is possible?

I'm boarded in IM and doing a fellowship in a subspecialty at an academic medical center. Currently I'm in the research portion of the fellowship. I'm boarded in my specialty because I have met ACGME requirements but remain a fellow doing research full time (getting an additional degree during fellowship).

I am thinking about changing jobs and going part-time because I am not able to spend as much time as I want to with my son. If I were to do this, I would only want to work about 20 hours/week (having to work 30+ hours per week would make the trade-off not worth it to me, since I enjoy my job aside from the hours). My job is actually quite reasonable and flexible for a full-time job but the truth is I just want to be home more while my son is young (we also plan on another child, so for them too).

I understand that leaving academia is probably not a reversible move which is one reason I'm apprehensive and wanting to look before I leap.

What kinds of work could I do part-time as an IM plus specialty boarded doctor? I can think of per-diem work as an outpatient internist or as a hospitalist, or if I was lucky, part-time outpatient work in my specialty (this is what I would ideally like, but jobs in my specialty seem to be scarce in my location). Possibly part time work at Kaiser? What about urgent care (can you do that as IM)?

How does per-diem work? How far in advance is it scheduled, what what would be typical pay per hour for IM? I assume it does not include benefits-how would malpractice work?

Thanks in advance to those who answer. I'm nervous even thinking about dropping out of my program.

Hello!

We're in a similar place, I think. I'm a second year renal fellow, but doing my clinical year this year. Last year I did full time research/MS coursework. I have two sons; my big dude started kinder two days ago and my little dude turns two this fall.

I do some moonlighting these days; generally 1-2 (night) shifts/month as a hospitalist. The money ($1200/9 hours) is useful at this stage in my training, but if this gig was the extent of my professional engagement, I'd find that deeply unsatisfying. I know of another opportunity at a nearby non-trauma ED where I could probably work another 20ish hours/month for a similar hourly rate if I was so inclined/had time. I've talked to other fellows in my program about sub-specialty specific moonlighting (mostly taking call and covering weekend hospital consults) and my impression is that it's a bad deal compared to straight IM moonlighting -- hourly rate is far less and the workload is pretty toxic. And I know of at least one non clinical fellow who is doing clinic at the county hospital FOR FREE to keep her skills up. That blew my damn mind. But obviously YMMV.

Your question about PT at Kaiser cracked me up b/c Kaiser is pretty much my dream job and they are so rarely hiring in my area/field ... getting one of those jobs is like winning the lottery. Part time? Hilarious.

One question: how old is your son? When my firstborn was wee, I was desperate to work part-time. There are multiple posts documenting my endless navel-gazing about trying to negotiate PT at my medicine residency from that time. (Ultimately: flop.) But now that I'm further along in both these gigs (motherhood and medical training), I'm finding my perspective changing somewhat. Now working 40ish h/w is completely acceptable to me, and even desirable. I think 30-40 h/w sounds perfect. I'm planning an F32 submission for this winter and will likely stay in academic medicine. Somewhat surprising. (As an aside, as a stroke of luck, I was able to pick my son up on time from school today. His response: "Hi, Mom. When do I get to stay for aftercare? I want to do robotics." *sigh*)

Anyway, good luck with your discernment. Feel free to navel-gaze.

Thanks for your reply I appreciate the information.

Re: your question about my son's age, he is 21 months. I expected that it would be rough for me at work for a year or so after he was born and then get easier as he got older, but so far that hasn't been the case. I feel like I've missed out on a lot of time with him, and I'm very aware the the years are ticking away until he'll be in school, and I really don't want to miss any more of this precious time. Plus we want at least one more child and I imagine I'll feel the same way with them. I think I'm just different from most of the women in medicine I know...quite a few of them have expressed to me how happy they were to go back to work after their babies were born "to get a break" from the baby and I couldn't feel more the opposite way. I don't think they're wrong for feeling that way, but it couldn't be further from how I feel. I feel almost like I'm a different person since my son was born and the things that were really important to me before, just aren't as important anymore. What I really want is to be home. I want to work enough to preserve my ability to get back to clinical work full-time when my kids are older, but that's about it. If I could swing 20 hours a week, that would be GREAT in my book.

I'm just not sure how part-time it is possible to be as a physician...everything that I find about working part-time is talking about 30+ hours a week, and at that level I'm not sure the trade off is worth it to me. I mostly like the work I'm doing now (research), I just don't like how much I'm doing it (averaging around 40 hours a week, though don't know how sustainable that is...may go up in the future). If quitting my job and going to part-time clinical work is still going to mean 3 long 10-12 hour days a week, I'm not sure that's a huge improvement over my current situation, especially if I like the work less.

I realize I probably sound like I'm complaining and that many women doctors would KILL to be in my position, working 40 hours a week...but nonetheless, this isn't really working for me and I want to look at my alternatives.

Re: Kaiser, I thought of that as an option because my stepmom is a Kaiser doc (in Colorado) and she says lots of women in her department work 0.6 or 0.8 FTE...so I thought it was a common arrangement there. I'm not saying the jobs are easy to get, but if you get them I think they're pretty amenable to part-time. Probably varies based on specialty and location, though.

I don't think you need to feel badly for knowing that 40 hours a week does not work for you. We are here to support all mommds regardless of how many hours we want to work (or not at all). We all have different needs. I can tell you 40 hours is also too long for me.

Thank you, clee. I really needed to hear that. If you don't mind my asking, what is it that you do, and how many hours a week do you work?

I am an anesthesiologist, and I am guaranteed 40 hours (more or less) plus call. When there is enough people, I try to work 30 hours plus call. I also have 7weeks of vacation which helps a lot. I can tell you I am happier when I work less than 30 hours though. For now, I am keeping my working hours because any less than 0.8 FTE is considered part time which will mean less call and vacation. I don't mind less weekend call but I like week day call because I cherish the post call days off and we get out earlier depending on when I was on call last. I also don't want less vacation. If money wasn't an issue, I would just work locums to keep my license current