The Resident’s Decision - Hospital or Private Practice

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The Resident’s Decision - Hospital or Private Practice*

For residents, one of the biggest decisions to be made when completing medical education is whether to join a private practice or accept a hospital position.

The decision is not unlike the decision that many MBAs face when graduating from the top MBA schools. Should they go into industry/financial services or join a top consulting firm. These consulting firms have strict up or out policies. If you are not promoted to the next level after three years, you are counseled out of the firm (often with outplacement advice). The same process happens at 6 and 9 years, so that less than 10% of entering MBAs will make partner levels in these top consulting firms. Graduating MBAs consider the first three years as the best way to obtain practical experience in preparation for a more substantial career in industry.

Graduating medical students may want to consider hospital employment in the same manner – as a way to obtain practical experience, learn procedures/protocols, and pay down debt. If the hospital environment feels comfortable, then stay. If you are looking for bigger challenges, more freedom of practice, and independence, you can switch to private practice after the first contract expires. You will certainly be more valuable to that private practice with three years of experience under your belt.

The down sides? Separating from the hospital after three years may entail a physical move with the impact on the family. One must also consider any “non-compete” clauses signed with the hospital. The time to negotiate those clauses is before you sign, not 3 years after the fact.

W. J. Best, MD
[email protected]

*Additional reading: Hospital Employment vs Private Practice: What Makes Sense for Orthopaedic Surgeons


DISCLAIMER: Statements of fact and opinion are the responsibility of the authors alone and do not imply an opinion or endorsement on the part of the officers or the members of WOA unless such opinion or endorsement is specifically stated. Materials may be reproduced only if Touches and the Western Orthopaedic Association are credited.

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Comments on "The Resident’s Decision - Hospital or Private Practice"

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Robert R. Slater Jr. - Tuesday, October 24, 2017

Bill Thanks for providing this viewpoint. The business analysis skillset is not typically included in the training pathway for most of us in surgery, so getting help from a business expert for whom this kind of analysis is more routine and familiar is extremely valuable. - Bob Slater

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