Personally I love to teach, but I found the academic environment to be stifling. There were a lot of great people in it, but even in a fairly happy and functional place like the one I trained at, there was still a lot of annoying politics and passive-agressive behavior. And I didn't enjoy research at all.
My compromise? I went into private practice (outpatient/primary care), but on a volunteer basis I do a lot of work with residents and med students in my office. I also give a few lectures each year to the residents at the nearby hospital where I trained. I feel like I get the best of both worlds: I still get to teach, but I also get to focus my days on the type of clinical work I enjoy, set my own schedule, and be my own boss. Making nearly three times as much as I would in academia doesn't hurt either. What I lose in "prestige" I feel I more than make up for in autonomy, income, time for my family, and great relationships with my patients.
As for legacy, a colleague in my practice passed away recently after a 30+ year career. More than 500 of his patients showed up at his wake. A number of them who I've inherited on my panel have broken down in my office crying when remembering the care and concern he showed for them and their families during his career. If I leave that kind of legacy behind me I'll be content.
On the flip side, I have friends who have really thrived in the academic tract. Like everything else in medicine and life, it ultimately comes down to personal preference.
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Academics as a career?
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