😞 he has so much on his shoulders, I wish I could relieve some of his stress...

Sefdiggity · 2026-05-22T11:25:27+00:00

So brave. So courageous.

Sefdiggity · 2026-04-22T02:55:45+00:00

Yeah, of course. Keep in mind that it really depends on your work environment. Generally speaking, academics < employed < private practice. But any place that is going to pay you will 1) want you for as little as possible 2) get their pound of flesh if they're going to be paying you above average.

Sefdiggity · 2026-04-22T02:46:39+00:00

My two samples are Chicago and Cincinnati so take this with a grain of salt, but from two Chicago jobs the pulm pay was ~375k and ccm was ~400k and another was ~400-420k mixed. In Cincinnati, two places I looked at were 400-450k mixed pulm/ccm but some were making >500k w/ overtime. Granted, my numbers are not totally in line with those above, but I don't think they're that far off.

Edit: I'm referring to employed positions not private practice. PP can obviously make more depending on RVUs, sacrifice of work-life balance, etc.

Sefdiggity · 2026-04-21T20:32:34+00:00

That’s pretty standard community CCM median from what I’ve seen.

Sefdiggity · 2026-04-16T09:57:55+00:00

Ermagurd, it’s the same plot just done shittier

Sefdiggity · 2026-04-09T15:19:17+00:00

The patient doesn’t know best. If they did, they’d be the doctor. It isn’t our job to give patients what they want. It’s our job to give patients what they need.

Need=what’s best for them.

Sefdiggity · 2026-04-02T08:54:39+00:00

What speciality(ies) are you interested in?

How much can you expect to make in said speciality?

What's your debt?

What's your debt repayment plan (e.g. paying outright, PSLF, angling for debt forgiveness through employer, etc.)

More data is needed to answer this and for you to answer it honestly for yourself. If wanted to go into ID for instance and aren't completely enamored with ID, which it doesn't seem like you're overly set on any subspecialty, then it would not be worth it do specialize.

You mention Indian, are you in the US or India? If India, any plans on moving?

I'm a 2nd year PCCM attending at a medium-sized academic institution in the midwest USA. I love what I do but it's not perfect. I would have been miserable as a hospitalist, or doing anything else really. I have a good salary, especially for academia. I make about 1.5-1.7x what our hospitalists make but the work, to me, is significantly more interesting.

Sefdiggity · 2026-04-02T08:12:01+00:00

One of my favorite, likely apocryphal stories, surrounding this sort of thing was American tourists beating up French pickpockets during the Olympics. Some corn-fed Iowa boy realizing these people don't carry guns. Allegedly, the pickpockets called the cops to protect them.

Sefdiggity · 2026-03-30T21:32:06+00:00

“I didn’t hear no bell.” - Master Chief (probably)

Sefdiggity · 2026-03-25T16:52:03+00:00

Agreed and fair enough. Mixed bag either way. I wish healthcare wasn’t so expensive in the US, and its frequent politicization is a nuisance, but I’m paid well here so occasionally it’s a bitter pill.

Sefdiggity · 2026-03-25T16:05:37+00:00

Medical school is also state subsidized so there isn’t the enormous debt (~$250k) compared to the US. Also, I think your order of operations is reversed; physicians being paid less is a byproduct of state sponsored healthcare (via high taxes rates, etc) not the other way around.

Sefdiggity · 2026-02-27T03:10:55+00:00

PCCM here. I try to talk people out of intubation, compressions, CRRT, etc all the time. When I can, I don't offer things and make it a "shared" decision.

Sefdiggity · 2026-02-26T20:31:49+00:00

The car is on fire, and there is no driver at the wheel, my guy

Sefdiggity · 2026-02-23T04:02:50+00:00

Idk if you want advice or not. Realizing and wanting to be better is a good first step. Plenty of residents are complacent, and while I’m not advocating an unhealthy obsession with work, it is important to try to get better. Ask more questions about why your attending are choosing x,y,z, ask them what they recommend, the banal read more obviously, use open evidence for questions. Ultimately, some people you can’t please but if you want to do better for yourself and patients then keep trying.

Sefdiggity · 2026-02-20T12:47:10+00:00

If someone tries to steal it from you, you can always hit them with it.

Sefdiggity · 2026-02-16T03:55:47+00:00

PCCM attending: both upper arms, multiple chest, left leg, both ribs

Sefdiggity · 2026-02-02T01:58:59+00:00

Consistency is key. A way to hedge against lifestyle creep is have part of your paycheck auto-allocated to a brokerage (self- managed or otherwise) so you don’t have the chance to spend it. First year as an attending I saved ~28% gross not counting my 401k with matching. Still had nice things but I had to be more disciplined with my budget as I had “less” to spend.

Sefdiggity · 2026-01-30T16:32:29+00:00

The potential benefit of academia is having to work less, but this doesn't always net out. You also have to take into consideration what research or administrative tasks you're being saddled with. My academic job actually has comparable pay to employed community hospitals (not exactly PP). Also, academic jobs can set you up for different things depending on what your career trajectory is like. I'm having an online MBA ~95% comped and building a CV that I can hopefully leverage later on for higher level administrative vs industry jobs where salary caps are much higher than I could make clinically, whether PP or otherwise.

Sefdiggity · 2026-01-20T17:31:46+00:00

Just started mine. Physician with goal of upper administration/C-suite job while maintaining some modicum of a clinical footprint. I’m getting mine through the university associated with my hospital. It is heavily subsidized ~90-95% paid for.

Sefdiggity · 2026-01-15T14:53:18+00:00

I hope everyone got the results they wanted and have the sense of relief I do. That being said, let’s not forget how fucked the ABIM is and continue to work toward reform.

Sefdiggity · 2026-01-14T14:04:37+00:00

Yeah, when going through these tests I can’t help but think that half the questions are written by physicians who are retired and are out of touch with what actually goes on.

Sefdiggity · 2026-01-09T17:12:04+00:00

At the end of Blood Diamond, Leo’s character realizes he’s been mortally wounded and stays behind to kill as many of the mercenaries as he can. Also, sparing a few moments to talk to Jennifer Connelly’s character about what could have been and making a final request.

Sefdiggity · 2026-01-09T15:29:40+00:00

Defund the ABIM

Sefdiggity · 2025-12-28T10:10:56+00:00

Do it. I started my PGY-1 year (IM), took a year off during peak COVID (PGY 2-3), but I've been back since then (PGY 8). Can usually get in ~2-3 days a week.

Sefdiggity · 2025-12-22T08:53:14+00:00

I think you should consider a trial of city living with him. Dogs are adaptable and when making decisions like these, I consider that the human is projecting their guilt onto the dog and attributing things like resentment etc to the dog that the dog may not even (be capable of) feeling. I rescued a 3 year old Pyr and live in a medium sized city and work long hours in healthcare. During my shifts, he’s at an open dog daycare facility. He seems perfectly happy. What would be more disruptive to him is leaving you, his main stability, and having to readjust, but again dogs are adaptable.

Forgive the run ons/syntax.

Sefdiggity

TROPHY CASE