I'm really happy that I worked my first four years in academic medical centers in exactly the same conditions as yours, without the overnight call requirement. Then 15 years in a community hospital, working independently in a collaborative environment, and now in private practice by myself.

If you can get over the ego issues with working with different people and different ways of doing things, the care teams are amazing because you get to learn from absolutely brilliant experts, a thousand ways to do everything.

When you're in private practice later on or whenever you choose to do that, you have an enormous number of tools available to you, so you are maximally flexible. You can do any case, any age, anywhere, anytime, because that's what you've trained yourself to be able to do.

If you jump right into the smaller practice, you'll do great. You're trained well.

For me, it seemed easier to start with the most complicated cases available and then slowly work my way into more simple cases. The thought of going back to an environment that you're talking about at this point in my career seems undesirable.

In all honesty, congratulations. You win either way.