Private practice is more centered around patient care and building relationships with patients. It gives more freedom in terms of how the practice is organized and working hours, and provides the ability to perform ambulance and office-based surgeries.  Institutional practice is working full-time with a hospital or clinic, allowing you to deal with rarer cases. The administrative side of the business is already in place, as well as the rules. Lastly, it already provides the required insurances, healthcare coverage, and retirement saving programs.