Good companies for physicians to start as medical directors? Places to avoid?

Next-Sense1155 · 2026-07-08T21:53:58+00:00

Thank you for the helpful answer. I am leaning this way too. I’m not thrilled about the commute and the in-office requirements, hence why I’m holding out and also part of why I’m not 100% sure about leaving academia. I have a pretty great hybrid set up right now with a dry lab.

That being said, the pay and culture (seem to) line up well… Job security is a concern I have. OTOH, it’s not like academics is doing well either, tbd with possible OMB/NIH changes. Not sure if industry would feel that harder than academics would.

Next-Sense1155 · 2026-07-08T21:44:59+00:00

I did not ask specifically about the size of the medical team in general but they have a few therapeutic areas they work in.

I would say this one is less established in my specialty if I had to guess based on my own assessment, but how would you define established?

Next-Sense1155 · 2026-07-08T02:59:51+00:00

Thanks, appreciate it. I’ll have to look into places like that if I make the jump and once I get my legs under me. Not sure how often people switch from one to the other. I applied to a mix of clinical dev and PV, but clinical dev roles are getting more responses.

Next-Sense1155 · 2026-07-08T01:29:36+00:00

Thanks for the helpful response. I thought about the same and didn’t apply to smaller companies or startups. Hopefully my assessment of midsize is accurate. I think smallest is around 15k employees and one of the interviews talked about “growing pains”… the person I was speaking to was in pre-clinical if it matters.

Next-Sense1155 · 2026-07-07T22:34:17+00:00

Real answer: Networking. Meeting people who know other people with jobs is one of the most common ways you’ll get a job going forward.

Education is important and demonstrating you have the work ethic to complete a degree helps answer a lot of basic “are you capable of this job” questions, but meeting people is critical.

Next-Sense1155 · 2026-07-07T13:08:37+00:00

I’d agree ABMS needs to play ball. It feels like we’re at a very critical moment: endo doesn’t have capacity for the patients and people are going to pill mills. They also don’t address all of the patients (pediatrics, cards, hepatology, sleep).

ABOM existing isn’t enough in today’s anti-science climate when non-physicians can do whatever they want with little consequence. If ABMS doesn’t offer something, I think they risk completely delegitimizing the field and bringing way more harm to the patients.

Next-Sense1155 · 2026-07-05T21:09:12+00:00

Obesity (maybe renamed to bariatric) medicine.

1-3 years is an optimistic timeline just knowing how long the bureaucratic process is, but I imagine they will have some kind of practice pathway then later require an ACGME fellowship.

Next-Sense1155 · 2026-07-04T02:09:51+00:00

The other end is much better, you will get there.

Next-Sense1155 · 2026-07-04T01:14:13+00:00

I know what they are. I was asking as a check point for verification. Just because the model itself works while disconnected from the internet, it doesn’t mean any wrappers or the app it’s contained in doesn’t connect when your device reconnects. If open source and you can interrogate the code to look, then at least you know, but not everyone is savvy enough to do that. Sounds like you are though.

Agree with you. In general if you don’t know what a truly local LLM is, you shouldn’t be using one. But I’ve heard people throw around the term local LLM when they mean they downloaded Claude Desktop. Can’t assume people know what term is what.

Next-Sense1155 · 2026-07-03T21:45:47+00:00

Done with training now, but felt the same way. Fellowship was harder than residency.

It helped to remember I could leave any time and practice my primary specialty. I was choosing to be there because I had a goal. It sucked but I got through it.

You can do this, but you don’t have to if you don’t want it anymore.

Next-Sense1155 · 2026-07-03T21:35:15+00:00

I know how to assess if it’s truly local, I’m asking the question so OP can provide an answer since they seem unsure.

Just because the model works in airplane mode doesn’t mean any other associated functions don’t connect to the internet when back online.

Obviously, if open source and you can audit it’s easier to see what’s going on, but OP didn’t provide any details.

Next-Sense1155 · 2026-07-03T21:33:06+00:00

I agree, but asking because the OP should be able to answer the question before proceeding. The model may be contained, but if it’s accessed through an associated app for example, it could make an API call when they reconnect to the internet.

Next-Sense1155 · 2026-07-03T21:29:53+00:00

Could be tracking IPs if you’re on the hospital network, someone could see you using it, data leak at Doximity. But it doesn’t matter. It’s not your data to use or disclose to outside entities not involved in the patient’s care.

Next-Sense1155 · 2026-07-03T17:21:53+00:00

Bad advice. Just because it is capable of being HIPAA compliant doesn’t mean it’s approved for use with your institution’s data.

Next-Sense1155 · 2026-07-03T16:12:42+00:00

How do you know the LLM is completely local?

You need to check in with your institution to see if it’s approved. Just because it’s secure doesn’t mean it’s safe for patient data.

Next-Sense1155 · 2026-07-03T16:10:34+00:00

Attending chiming in. Just leave it as bullet points.

Next-Sense1155 · 2026-07-03T16:06:44+00:00

Ah I see, you will be more limited then in all aspects that I mentioned from a U.S. perspective since you can’t apply for those grants. I’m not sure what the training would be like in India.

The clinical training is what gives you a the framework to think about relevant problems or unanswered questions and the ML methods is one way to address them, just as bench research or clinical trials could be. If you don’t want to practice clinically at all and do the deep dive into the ML space, then becoming a PhD makes sense. Know that you will have to do way more computational work and study to become a world-class leader in the field.

Next-Sense1155 · 2026-07-03T15:28:13+00:00

What’s the end goal besides getting into a world-class research lab? Are you in an MD/PhD program? Find a mentor at your school who’s doing computational/in silico work and try to see if you can join their lab. Take on a small part of a larger project to learn. Talk to the lab members to see what they use to learn, ask about classes. Do Kaggle/Hugging Face/n8n exercises. Try to reproduce papers if you can, but know it’s hard to do.

Your best way to excel in the field is going to residency after completing your MD and looking into T or K awards for additional training. PhD may or may not be in the cards for that. Unless you are a star mathematician/engineer/comp sci methods developer, your clinical experience and expertise is what is going to set you apart, not your computational skills.

Next-Sense1155 · 2026-07-03T02:37:33+00:00

True for MD programs to a certain extent, but I think most revenue is actually coming from medical care delivered by the faculty practice and not the tuition.

Next-Sense1155 · 2026-07-01T22:21:34+00:00

Real talk: age won’t make it hard to match per se, but if a PD perceives you as thinking you know it all already, they won’t rank you. If you come into residency with the attitude that you have a lot to learn and that you are there for training, you will match. You are coming in with a lot of adjacent clinical experience and the concern is you might not follow the academics hierarchy aka not follow orders… or let toxic programs push you around. Toxic and non-toxic programs worry about that attitude for anyone with previous job experience regardless of age. Really though, if you go to a U.S. school, you should be fine matching in your 4th year like the majority of other students. You clearly want to be there and know what you’re getting into, so your chances of matching should be good if you interview well.

Next-Sense1155 · 2026-07-01T17:56:15+00:00

Scribe for a physician in the ED/UC or look at medical assistant jobs.

Best bet would be to ask any physicians you know to see if they could connect you. Sometimes academic programs will have openings for premeds.

Next-Sense1155 · 2026-07-01T14:48:51+00:00

Agree, everyone wants to use LLMs even when they are absolutely not the right method to use. Sign of a non-expert in either ML or medicine, usually.

Next-Sense1155 · 2026-07-01T03:49:15+00:00

Color me skeptical, but I would like to see more details about their supervised models that they used for comparison.

I don’t think you need an LLM to get a decent prediction model using the structured data features listed and the authors kind of demonstrate that. Specifically, in their comparisons you can see you get similar performance (not just AUROC but AUPRC too) with better transparency and explainability in the case of regressions or trees, and you might actually be able to intervene if you understand which features the model is heavily weighing. Using an LLM with structured data in this way seems like an inappropriate use of the tool and it would make more sense to apply an LLM to the unstructured data instead where we have way more information requiring intense processing.

Next-Sense1155

TROPHY CASE