Each year, around the time of AIPG counseling, I get a fair number of emails asking about PSM as a career option. These question are mostly from students who have not really considered PSM as a career, and hence, do not have the information or evidence needed to take an informed call. I usually try my best to provide what I think is my evidence based opinion (yeah, that is an oxymoron right there!). This is the seventh post in the “PSM as a Career Option” series. Read the previous posts here:

PSM as a Career Option: #1 Why Choose PSM?

PSM as a Career Option: #2 Is Delhi the Best Place for Doing MD in PSM?

PSM as a Career Option: #3 What do we Learn in MD PSM and does it Help Later in Life?

PSM as a Career Option: #4 Will I Regret Choosing PSM if all I Want is a Clinical Branch?

PSM as a Career Option #5: Community Medicine Senior Residency in AIIMS

PSM as a Career Option #6: 7 Strategies to Beat the 6-month itch!

PSM as a Career Option #7: Finding the right job after MD PSM/Community Medicine – A 7-step Guide

Disclaimer: Please note that I am not liable for the outcomes of any decisions (whether positive or negative) that you have taken based on the information I provide in this blog. This is my opinion and for all practical purposes, they may be off base and totally wrong. Please do not judge everything I say here to be the ultimate truth. 

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In my last post, I talked of ten broad categories of jobs. In that post, I also promised to write in more details about these jobs, from my very personal, and likely very biased, viewpoints. In this post I will try to summarize the major different job profiles, and try to build on the concepts to show the different kinds of jobs available to MD PSM/Community Medicine folks. As usual, if you feel like I have missed out on any major classes or have misrepresented something, feel free to reach out and inform me. Leave a comment for me below, write me an email, tweet at me or send a note with a carrier pigeon. All acceptable modes of communication.

I will break up the ten job profiles and cover them over the next few posts. Initially, I thought I could do it in a single post, but as I kept writing, the post started to become quite large and bulky. I decided that rather than cut down on the quantity and lose out on materials (that I took the trouble of thinking and typing out) I would split it into multiple posts.

All opinions personal, delivered with a heavy dose of sarcasm and humor. You might start feeling a little offended as you keep reading, and if you do, ignore that feeling and go ahead. Just take it as the ramblings of a jaded mind and don’t hate on me…

Also, the salary amounts are very ball-park figures that I have included based on very rough discussions with friends and colleagues and fairly unstructured Google searches. They are NOT meant to be very accurate, just a very broad, big picture type of guideline. 

1. Academia:

Job Summary:

You would typically join an academic PSM/CM job after completing your Senior Residency and start with a position of Assistant Professor. In some states, you might start one grade lower, as a Resident Medical Officer or Clinical Tutor or Demonstrator. Your main responsibility is teaching PSM/Community Medicine to a largely uninterested and unengaged group of MBBS students. Usually, you can find interested MD residents – but it is up to you to ensure that they don’t grow prematurely jaded with the discipline. Also, major drawback, you may end up teaching the same topic year after year after year. Sometimes, this might become a little boring too.

Job Pathway:

You would need to complete a certain number of years as a Senior Resident before you can join. Once you become an Assistant Professor, in most cases, your progression is smooth, and over time, you will become an Associate Professor, an Additional Professor and then, a full Professor. Expect a healthy dose of administrative work as you progress along the career ladder (this is true for all medical teaching specialties).

Starting Salary:

Depends on the type of institute you are working in. In most state-administered medical colleges, you will start with a salary of around Rs 80,000 to 100,000. With central institutes, like AIIMS, this might be significantly higher. An excerpt from the AIIMS Raipur site seems to indicate that for the Assistant Professors appointed on a contractual basis, the salary is around Rs. 140,000. For those appointed under regular recruitment, this might be higher than that, based on the complicated workings of the pay commission calculations. Spare me the pain and ask a senior or friend for their salary slip to get the exact amount! Here’s a look at an AIIMS Raipur vacancy notice which is incredibly helpful and outlines the salary amounts very clearly.

Sadly, salaries are more heterogeneous in private colleges and can be at or below the level of state colleges, depending on the college, location, how badly they want to hire you, and often, how close their MCI/NMC inspection is. Here is a very unhelpful vacancy notice from KMC Manipal, one of the most premier private medical colleges in the country, which provides so little information, that it is almost pointless. It is entirely possible that there is a more detailed advertisement out there, that I have not been able to find. But even that is a pretty sad indictment, given that it was so easy to find the AIIMS advertisement with such detailed information on remunerations and salary levels.

Pros:

1. Very safe, secure job. Gives you plenty of time, if you so choose, to build up skills in many different things, or have a chill lifestyle.
2. Lots of opportunities to innovate when it comes to teaching and learning, administration, and community-based work. The main barrier is motivation.
3. If you are in a research-oriented organization, with a supportive Departmental Head (I am told that is a rare thing to have – I was fortunate to have two of the most amazing teachers and mentors I know as two Departmental Heads during my MD training), you can do lots of interesting stuff. RD Gardi Medical College, AIIMS New Delhi, PGI Chandigarh – lots of great examples there.
4. For those that value it, a tag of Professor can carry a significant amount of social and other intangible benefits, especially if they are employed at one of the bigger centers.

Cons:

1. Very safe, secure job. Yeah, this can be a bit of a double-edged sword. It is so safe and secure, you may not feel the need to push yourself to break glass ceilings.
2. It might get stagnated, especially if you are unable to branch out into research and policy activities.
3. In some states, there is a lot of churn in medical college faculty, with a lot of transferring and moving around that may make it difficult to incubate long term research projects.
4. Sometimes it is difficult to engage in consultancies or other activities with other agencies. This is could especially be true for young faculty who do not have a very supportive cadre of seniors.

Examples:

Dr. Sudip Bhattacharya, Assistant Professor, AIIMS Madurai: An incredibly humble, kind and generous person, Sudip-da is also quite helpful. For those wondering about the landscape of faculty level jobs in India, he would be a brilliant resource. An extremely resourceful and prolific publisher, I am looking forward to his new book on global health case studies.

There are many incredible faculty members who are always eager to help us out with advice and support – please do go through LinkedIn and reach out to the ones that resonate with your personal preferences.

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2. Research:

Job Summary:

You will be conducting research, or dealing with working on data collection, management, or analysis. In many cases you will also be expected to write proposals, raise funding, generate grants, or undertake some form of administrative duties. These jobs can be with government institutes, like the ICMR institutions, or with private research organizations.

Job Pathway:

There are two groups of jobs in this category – private and government. Let me start with the latter, because I have more experience with that.

Within government research jobs, you can either join in as permanent staff or as a contractual research project employee. I will use the example of ICMR jobs, for both the permanent and contractual positions. For ICMR institutes, after your MD, you are eligible to start as a Scientist C, but may be employed as a Scientist B. You then continue along the gradual climb through the alphabetical musical chair, and eventually, reach the highest position, which, currently, stands as Scientist H. For a contractual position, you may be eligible for a Scientist C or Consultant or Project Manager type of role, and the salary may vary within a small range.

For private agencies, again, there is no standard nomenclature, but after my MD, I joined PHFI as a Senior Research Associate. It is entirely possible that the name of your position as well as the salary associated with your position are contingent on the conditions and resources made available through the grant under which you are being employed. It may even be possible that two people, with the exact same qualifications, and executing the exact same job responsibilities, are accorded two very different sounding positions, having two different levels of compensation.

Starting Salary:

ICMR is incredibly transparent about their salary structure, both for contractual and permanent staff. Without going into the details of the pay commission salary structure, ICMR Scientist B, at entry, would make something around Rs. 120,000 to 130,000. Scientist C would make marginally more money, maybe Rs. 8,000 to 12,000 more. Don’t hold me to these numbers – they are very rough, ball-park figures. Go check out ICMR recruitment rules to see the details and work it out on your own. What goes unsaid within this salary are the retirement benefits and pension scheme contributions that the government adds in. If you enter the job in your early 30s, you may end up working for thirty or more years, and over time, these contributions add up to a significant, hefty amount.

For contractual project staff salary, here is a very helpful summary from a recent vacancy declared by an ICMR institute, looking to employ a Scientist C.

Pros:

1. For those in permanent scientist positions, it is a very safe and secure job.
2. Comes with the ability to conduct your own research project, be the PI on research topics of great impact, and work in institutes which usually have incredible infrastructure already in place.
3. Ease of conducting multidisciplinary research as most institutes already have laboratory, epidemiology and social sciences components. To be honest, one’s imagination and ability to conceptualize research projects is the limiting factor.
4. ICMR has assumed a leadership role in the arena of public health research and policy in the past few years. It has rapidly become a name with instant brand recall.
5. A very structured approach to promotions and increments, quite fair in its implementation.

Cons:

1. For those joining in as Scientist B after their MDs (like I did), this might be a little disadvantageous as they will be employed in a position that they are slightly over-qualified for. Post MD, a Scientist C position would be the most ideal starting point.
2. For those without a doctoral or advanced degree, it might be difficult to find time to prepare for exams and get the mind-space needed to crack a NEET PG or other similar entrance exam.
3. ICMR institutes are largely hierarchical ones, and even at the entry levels you will have to deal with administrative work. This is something that I was not very fond of.
4. In private institutes, there will always be a push to generate funds and that can get tiring after a while. In comparison, in most ICMR institutes, there are some intramural grants or resources available, which can be leveraged to conduct investigator-driven research projects.
5. For those who love teaching, the opportunities for direct didactic activities may be limited. There are plenty of research conferences, workshops and speaking opportunities that may arise, but it is not the same as working in a dedicated teaching position.

Examples:

Government Institutes

Dr. Tanveer Rehman, ICMR RMRC Bhubaneswar, Scientist B: A dear friend and colleague from Medical College Kolkata, a recent entrant into the ICMR system. An incredibly hard-working person, I wonder how much he will miss teaching though!

Dr. Jaya Singh Kshatri, ICMR RMRC Bhubaneswar, Scientist C: A dear friend, who sometimes will have vociferous debates vehemently differing with me! An incredibly hyper-productive researcher (just look at his profile!).

Dr. Richa Garg, is the regional advisor at Novo Nordisk right now, and I was fortunate enough to work with her on an incredibly complex clinical trial (publication forthcoming!).

Private Institutes:

Dr. Soumyadeep Bhaumik, co-Director, Meta Research and Evidence Synthesis Unit, George Institute of Global Health (his blog/site): A great friend, colleague and wise person overall. Often my confidante, especially when I am going through difficult times. Also a great advice giver!

Dr. Bireshwar Sinha, Clinical and Public Health Fellow at DBT/Wellcome Trust India Alliance & Scientist at Society for Applied Studies, New Delhi, India: A childhood friend, we literally grew up together! I have seen his career metamorphose and bloom right in front of my eyes, as he graduated a year ahead of me from the Delhi University ecosystem and grew into the incredible public health researcher and advocate that he is today.

Dr. Ranadip Chowdhury, Scientist at Society for Applied Studies: One of the most productive, knowledgeable, and incredibly helpful people I know. The breadth and depth of his knowledge, his consistent record of conducting high-value research and publishing in high-impact journals is, simultaneously, inspiring and awe-inducing.

(Yes, I preferentially named my friends. My blog, my rules!)

Since this post is now approaching 1500 words, and I need a break from typing (and better internet connection to be able to add links), I will break off at this point and continue along in the next post. Stay tuned to read more ramblings from me soon!