Will doing a hospitalist fellowship allow for more hospitalist job opportunities?

[FiveRivers]

I was searching for jobs online, and I was wondering if doing a hospitalist fellowship post FM residency will benefit a candidate for more job opportunities. Has anyone here completed a hospitalist fellowship? Did you think it was worth it? Thanks for any input.

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[cabinbuilder]

You should get plenty of hospitalist work in residency. If that is what your goal is then you should make sure you go to a medicine heavy program. My program we did 12 months total of medicine over 3 years (5+4+3). No need to do fellowship, I had enough training and never found it to be a problem. Be sure you keep your patient logs to prove you know what to do. Learn vents and ICU management in residency.

 

[VA Hopeful Dr]

If your program is inpatient light, then yes. It might also be helpful at getting into hospitals that are primarily internist places.

 

[VenusinFurs]

Some of the jobs I've peeped on say they want "hospitalist experience," so maybe a fellowship would help you out in that sense.

 

[galactus]

In my residency 1-2 residents a year go into 100% hospitalist work right after they graduate. I had heavy inpatient training during residency (university based) and if I wanted to become a hospitalist, I would not even bother to do a fellowship. The private practice hospitalist group in the hospital is actually under the FM department, and residents have the option to moonlight with them for extra cash/experience.

 

[cabinbuilder]

Some of the jobs I've peeped on say they want "hospitalist experience," so maybe a fellowship would help you out in that sense.

You should have patient logs for residency. all you would have to do is submit the logs to show how much experience you had in residency.

 

[babdoc]

My program we did 12 months total of medicine over 3 years (5+4+3).

Dang...did that include nights or were you on a traditional overnight call schedule? My internal medicine program has 11 months of inpatient medicine plus night float (granted that's another 4 months over 3 years)

 

[VenturaResident]

Dang...did that include nights or were you on a traditional overnight call schedule? My internal medicine program has 11 months of inpatient medicine plus night float (granted that's another 4 months over 3 years)

Our Family Medicine program has 13 months of inpatient medicine (counting Medicine + ICU) in three years, including both traditional call and night float rotations: 5 months first year, 4 1/2 months second year, 3 1/2 months third year. Some people trade extra OB months for ICU time to get an extra month of ICU nights in as well. Lots of our grads do part or full time hospitalist work after graduating.

 

[cabinbuilder]

Dang...did that include nights or were you on a traditional overnight call schedule? My internal medicine program has 11 months of inpatient medicine plus night float (granted that's another 4 months over 3 years)

My program did not have a night float, we had a traditional call. However, since our medicine months were the hardest and heaviest work load, the folks on medicine did not take call. Everyone else on the easy rotations did the over night call for the month. We had 17 residents so it came out to about 4 nights per person. Our call wasn't that hard.

We did not have an "ICU" rotation. Our ICU was 10 beds and if we had a patient there we just followed them in the ICU. It was incorporated into our medicine service.

 

[styphon]

Dang...did that include nights or were you on a traditional overnight call schedule? My internal medicine program has 11 months of inpatient medicine plus night float (granted that's another 4 months over 3 years)

My program also included about 13 months of inpatient, 3+4+4 and 2 months ICU. We did not do nights, we did call until 9-10 pm in house, then went home and would come in for emergencies/admissions.

our teams were often short on residents and would run into the NY state work hour limits for residents so non-inpt residents would have to do guest calls about 2 times a week. I traded almost all my "guest calls" for OB calls (which of course people disliked) which worked out for everonye.

This thread makes me wish I kept a patient log...

 

[Mac311]

I was searching for jobs online, and I was wondering if doing a hospitalist fellowship post FM residency will benefit a candidate for more job opportunities. Has anyone here completed a hospitalist fellowship? Did you think it was worth it? Thanks for any input.

Are you in the process of looking for a position?

 

[NurWollen]

What is a typical number of inpatient months in an FM residency? When I look at residency websites it looks like very few have more than 6-8, not counting ICU or peds inpatient months. Am I reading these websites wrong?

 

[VenturaResident]

Are you asking about how many Medicine months (adult, inpatient, not ICU, not surgery, not ER, not peds, not OB)?

 

[NurWollen]

Are you asking about how many Medicine months (adult, inpatient, not ICU, not surgery, not ER, not peds, not OB)?

Yes, although if it's not just the strict medicine months that help you develop inpatient skills, then maybe I should be asking about all those months as well. I'm just an MS2 who is interested in FM, trying to make sense of how an FM residency works.

 

[drcrispmd]

It will depend on the program. Some have more than others.

My program you spend 18 weeks on adult inpatient as an intern. The ICU was open so that included taking care of your patients in the ICU as well. PGY 2 you spend 6 week of adult inpatient. All calls are in house and taking care of the service over the weekend (and being senior to the OB/peds intern). They also spend a total of 6 weeks of night float again taking care of inpatient. Night float is also senior for the OB/peds intern. They also do a 1 month ICU rotation with the critical care team. PGY 3 spend 6 weeks of inpatient, 2 weeks of night float and a few weekend calls. There are options of doing more inpatient for electives.

Some programs do not have this much. Each patient encounter now has to be logged as of July 1. I am not for sure if they have set the number of inpatient encounters requires for all 3 years yet. We have had residents from my program do hospitality work after residency without doing the fellowship.

 

[Kahreek]

My program did not have a night float, we had a traditional call. However, since our medicine months were the hardest and heaviest work load, the folks on medicine did not take call. Everyone else on the easy rotations did the over night call for the month. We had 17 residents so it came out to about 4 nights per person. Our call wasn't that hard.

We did not have an "ICU" rotation. Our ICU was 10 beds and if we had a patient there we just followed them in the ICU. It was incorporated into our medicine service.

what's the difference between nightfloat and trad

 

[galactus]

what's the difference between nightfloat and trad

You'd be hard pressed in finding a program that is still "tradiotional" anymore because of duty hour rules.

Traditional is straight up 30 hour call (24hr +6hr transition of care). When I was an intern we were the last class to have this situation prior to new duty hour regulations in 2011. New duty hour rules pretty much forced night float, as interns can only work 16 hours max (upper levels I believe is 24+4).

Night float in terms of residency is you covering your hospital service at night for a certain number of days in a week, generally 5-6 days. Traditional is someone being on during the day and night (see above). Typically you'll see the traditional call being held by upper levels, and generally on weekend coverage. Then again every program is different.

 

[KnuxNole]

It will depend on the program. Some have more than others.

My program you spend 18 weeks on adult inpatient as an intern. The ICU was open so that included taking care of your patients in the ICU as well. PGY 2 you spend 6 week of adult inpatient. All calls are in house and taking care of the service over the weekend (and being senior to the OB/peds intern). They also spend a total of 6 weeks of night float again taking care of inpatient. Night float is also senior for the OB/peds intern. They also do a 1 month ICU rotation with the critical care team. PGY 3 spend 6 weeks of inpatient, 2 weeks of night float and a few weekend calls. There are options of doing more inpatient for electives.

Some programs do not have this much. Each patient encounter now has to be logged as of July 1. I am not for sure if they have set the number of inpatient encounters requires for all 3 years yet. We have had residents from my program do hospitality work after residency without doing the fellowship.

Which, for the record, is a huge pain in the behind

 

[drcrispmd]

Which, for the record, is a huge pain in the behind

I am sure it is. I'm so happy I finished before that went into effect.

 

[VenturaResident]

You'd be hard pressed in finding a program that is still "tradiotional" anymore because of duty hour rules.

If you mean "traditional" like all classes to do 24+ hr call for all rotations, agreed, but otherwise, I don't think it's that rare; I think many places do a mix. For us, Medicine is still traditional call for upper levels. The second-years take turns doing 24+4 hour shifts throughout the month. Interns, who aren't allowed to work that long (in ACGME residencies - interns CAN take 24 call still in AOA residencies) take 14 hour call with their second year, go home to sleep, then come back the next day to do the post-call work along with the third year. There is a night-float intern who helps out with admissions overnight, working most nights of the week with whichever second year is doing their 24+4 hour call that evening.

Our surgery, OB, and ICU rotations are more of a mix. During the week there are day shift residents and night shift residents who trade off every 12 hours. On the weekend (either one or both days depending on the rotation) an upper level steps in to take 24+ hour call to give the other folks a break and a day off for the week. Our ER rotations are exclusively shift work without any 24 call (longest is a 16 hour shift occasionally during intern year.)

 

[galactus]

If you mean "traditional" like all classes to do 24+ hr call for all rotations, agreed, but otherwise, I don't think it's that rare; I think many places do a mix. For us, Medicine is still traditional call for upper levels. The second-years take turns doing 24+4 hour shifts throughout the month. Interns, who aren't allowed to work that long (in ACGME residencies - interns CAN take 24 call still in AOA residencies) take 14 hour call with their second year, go home to sleep, then come back the next day to do the post-call work along with the third year. There is a night-float intern who helps out with admissions overnight, working most nights of the week with whichever second year is doing their 24+4 hour call that evening.

Our surgery, OB, and ICU rotations are more of a mix. During the week there are day shift residents and night shift residents who trade off every 12 hours. On the weekend (either one or both days depending on the rotation) an upper level steps in to take 24+ hour call to give the other folks a break and a day off for the week. Our ER rotations are exclusively shift work without any 24 call (longest is a 16 hour shift occasionally during intern year.)

I agree with the mix, and I did mean traditional in the sense that everyone did 24+ hr call (those were the days lol). When I was an upper level we still had the 24 hour thing on weekends, but due to duty hour rules you pretty much have to implement a night float system for coverage. When I was an intern we had NO night float system in place so everyone regardless of PGY status did 30hr q3-4 calls during inpatient months. Man those were painful.