Internal Medicine vs specialty (pain management)

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Hello,

I am in need of some advice. I am a newly board certified FNP. I was just interviewed by a pain management clinic with urgent care (on the side) and was "unofficially hired" by them. I will also be getting an interview for an internal medicine outpatient clinic on thursday. If both would like to hire me, which one should I choose? Both are willing to train a new grad like me. And I do not have any idea yet of the starting salary they would offer me. Is starting in a specialty a good idea for a new NP?

Thanks!!!

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Specializes in allergy and asthma, urgent care.

All things being equal, I would choose internal medicine. It would give you a good, comprehensive experience that you could use in the future to move into a specialty, if you so desire.

If you choose pain management, make sure it is a reputable practice that offers multiple modes of treatment, not just pharmaceuticals.

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Internal medicine all day every day. Not eager to top out on the Michigan top prescribers of opiates list.

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IM. Pain medicine is sketch. Plus, your skill set, knowledge base and future job prospects will be waaaaay better in IM.

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Specializes in Adult Primary Care.

Internal Medicine !!!!!!!!

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Thank you so much for the input guys! These advice just made me more motivated to choose IM if this would be offered. Cross fingers! :)

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IM for the fact that if you ever leave the pain practice people will be not so eager to high you since you only have pain management experience. To them this may mean writing narcs 40x a day with little other role (which may or may not be true)

IM will give you a good foothold and plenty of experience and marketability for the future.

Of course the devil is in the details so...

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Hi guys, so I just got the contract from pain management and I just have to say yes or no. The company is a great place that offers lots of modalities and treatments for pain other than just medications (e.g. PT, aquatic therapy, wellness center, procedures, surgery). Meanwhile it has been 3 weeks from my interview with the IM group and still haven't heard from them (ugh so frustrating!). I think I may just have to accept the PM job as I fear if I don't hear anything from IM then I may miss my chance to finally have a job. Maybe I could like pain management too as my end goal really is sports medicine and PM has some components that I could use for that. Any thoughts?

Thanks!

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Specializes in allergy and asthma, urgent care.
Hi guys, so I just got the contract from pain management and I just have to say yes or no. The company is a great place that offers lots of modalities and treatments for pain other than just medications (e.g. PT, aquatic therapy, wellness center, procedures, surgery). Meanwhile it has been 3 weeks from my interview with the IM group and still haven't heard from them (ugh so frustrating!). I think I may just have to accept the PM job as I fear if I don't hear anything from IM then I may miss my chance to finally have a job. Maybe I could like pain management too as my end goal really is sports medicine and PM has some components that I could use for that. Any thoughts?

Thanks!

Have you called the IM office to see if you're still being considered? I'd do that first before making any decisions.

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Hi guys, so I just got the contract from pain management and I just have to say yes or no. The company is a great place that offers lots of modalities and treatments for pain other than just medications (e.g. PT, aquatic therapy, wellness center, procedures, surgery). Meanwhile it has been 3 weeks from my interview with the IM group and still haven't heard from them (ugh so frustrating!). I think I may just have to accept the PM job as I fear if I don't hear anything from IM then I may miss my chance to finally have a job. Maybe I could like pain management too as my end goal really is sports medicine and PM has some components that I could use for that. Any thoughts?

Thanks!

When I stated take the IM position over pain, I state that with the presumption all things are relatively equal. With the right group and appropriate focus on improving pain with minimizing use of opiate therapy, you can absolutely use a broader scope of your skill set and perhaps become more versed in an area many pcps are lacking. Obviously I would follow up with internal medicine, but if the offer was right and the practice had a serious multimodal focus to pain management, it would be one of the most important fields of our time just given the pure numbers of patients who need the therapy. Seek out the I'M position, but don't let them take you away from a potentially lucrative alternative. But again, REALLY seek out and understand the position on how the pain clinic practices.

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Specializes in ER, Med/Surg, LTC, Nursing Informatics.

First, islandsyndrome thank you for the excellent question, because I am (and I expect many others) are in a similar boat! I very much agree with djmatte's above response. I would like to add to it as well. I have noticed that many new NPs are not in their first job for very long. I expect there are a number of reasons for this, but one major one would be unrealistic expectations. What is the expected number of patients you will see in the IM and pain management positions? Obviously, I would expect more in the pain management, because it would typically be less comprehensive. For this position, or any position you take in your career, you should ask questions at the end of the interview to determine if the doctor or direct report is someone you can work well with. Finally, I think many NPs leave their first job because organizations say they are willing to hire a new NP, but then they realize how little hands-on experience we get in clinicals (~550 hours total), but expect us to work at a 4th year resident level (15,000 + hours hands-on experience as a resident). Then everyone gets frustrated and upset. The NP leaves and goes somewhere else, where they build on the knowledge they gained in that frustrating environment or go to a "lesser job". At least this is my perspective about what is happening...viewing from a far, because I am applying for my 1st jobs too. There seem to be A LOT of hospitalist jobs, but I realize that is one of the toughest jobs in medicine. That is why it is being offered to us NPs. I am strongly leaning toward a comprehensive pain management clinic. I was concerned, at first, that I would be limiting myself. However, pain is universal, but there has been very little training devoted to it...even for doctors. Not only can I use this to springboard to a more generalized position, but I will not be overwhelmed. I will be able to pick and choose where I want to go. From what I can see these positions mostly just want SOME NP experience. I will have that, when I want to "move up". Or I can open up my own pain clinic, should I choose.

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Yes I have reached out and told me they're still interviewing other candidates too. :(

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