fellowship 7 years out due to health issues???

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la gringa

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I've posted previously about considering leaving EM due to a back injury - I had a very successful disc replacement surgery 4.5 years ago, and that in of itself is a non-issue, save for my inability to get LTD at a rate that makes any sense.

what IS an issue, however, is that I have a lung problem leading to recurrent and increasingly severe bouts of pneumonia. may or may not be related to newly diagnosed connective tissue disorder. yeah, never going to qualify for ANY individual LTD even at jacked up rates once ehlers-danlos type IV (hypermobility type) is in my chart, which it is. i've been out of work for 6 weeks due to complications from a bilateral bacterial and viral pneumonia.

the writing is on the wall that my 5-7 year plan to get out of community EM needs to have its timeline shortened. my original plan was to transition into academia in some capacity, likely via hospice or teaching fellowship.

there is nothing i enjoy about EM more than caring for patients - i am a fierce patient advocate, am bilingual in Spanish, and have won patient satisfaction awards. in short - this is breaking my heart.

as i look at future plans, however... hard to imagine how to get a CV together to do say a health policy fellowship when i finished residency in 2009 with NO spectacular features. I wish i could say i'm on strong financial ground, but the back situation cost me $250k easily. just now out of that debt.

I post this because I am hoping one of you either has gone through something similar, or knows someone who has. I am horribly, horribly afraid of what may happen the next time I contract a nasty viral URI or have pneumococcal pna for the then 3rd time. I know of folks doing insurance chart reviews, which is drying up and sounds like torture to me.

I am reasonably skilled and interested in informatics, sports med, hospice, health policy/advocacy, tox (though nonclinical or minimally clinical jobs are rare), would have no issue returning to school for a 2nd degree but would need to take a temp job for serious, serious bank.

(if anyone knows of a place paying beaucoups $$$... i may be interested, even if it sucks. i need a parachute!)

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Could you get into things like medical directing nursing homes? Basically oversite type roles?
 
as i look at future plans, however... hard to imagine how to get a CV together to do say a health policy fellowship when i finished residency in 2009 with NO spectacular features.

I applied for (and got) a fellowship after being out of residency for 8 years. Maturity is incredibly valuable as is seasoned clinical skills. You'll likely be more sought after than a brand-new baby doctor. Don't sell yourself short. Plus, there's nothing I can see more valuable to put in a CV, or to explain in interviews, than this, from your OP:

"there is nothing i enjoy about EM more than caring for patients - i am a fierce patient advocate, am bilingual in Spanish, and have won patient satisfaction awards. in short - [the thought being out of clinical medicine] is breaking my heart."

That right there, is more valuable than most of the hollow resume-builders many applicants put in their CVs, for the purpose of nothing more than benefitting the CV itself. Life forces our hand sometimes and the fact that you're trying to stay with something you love, will shine through and help guide you through. Private message me if any other (more detailed) questions.

Good luck.
 
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I'm sure you could get into a fellowship. Most are minimally comepetitive.
The bigger question in my mind is what are you trying to accomplish?
 
A few comments:

# 1 It's not clear to me how much a fellowship is going to help. You're saying your recurrent PNAs and Ehler's Danlos will not allow you to do EM but you'll be able to do some kind of public health work? You know the details, but seems squirrelly.

# 2 You can and should get some disability insurance. Many group plans from employers and associations don't ask many health questions. Look into everything possible- AMA, ACEP, AAEM, your employer, a new employer etc.

# 3 I think that with appropriate financial planning, any EP can retire with dignity 10 years out of residency. You didn't share enough financial details to really give anything specific, but let's just make some stuff up for illustration.

Let's say you have $300K saved for retirement and have paid off your student loans. Let's also say you're working hard in a job that pays reasonably well and can generate $400K. Now, let's assume you're paying $100K in taxes. Could be more, could be less. That leaves $300K. Let's say you live on the median household wage in this country- $50K. That leaves you $250K with which to build wealth. In 5 years, your $300K plus $250K a year growing at 5% real should equal $1.8M. $1.8M will support a lifestyle of about $70K a year, indexed to inflation, for the rest of your life. Being financially independent seems to solve your issue a lot better than a fellowship does in my mind but again, you have more details than I do.
 
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