After you practice as a physician for a few years, is it difficult to get a fellowship?

[PaprikaLeapt]

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Or this is common?

Ex: practice internal medicine or family medicine for a few years and then do a fellowship in sports medicine?

Is this seen as a negative that you got rejected the first time and have done things unrelated to the fellowship you are interested in?

 

[Fatalis]

depends but I doubt someone would want to take the pay cut of making 200k/yr to 50k/yr

 

[BoolaHI]

Both wife and D, did it—both in CC. Wife did it after 10 years of practice and was close to 40–so it’s doable. And the numbers worked out, as she makes pretty close to double what she previously made prior.

 

[wysdoc]

I know someone who after 10 years in rural family practice went back for an entire second residency in ophthalmology, then returned to his dinky town and did very well. Worth the time for him!

 

[Osteosaur]

I have a kind of related question:

I see a lot of posts where people who graduated medical school and did something else (consulting, got sick, got pregnant, could not match) had a lot of trouble obtaining a resident once they entered the match. The explanation usually given is their skills declined after being out of the game so long. Is this a phenomenon?

Are people who have been in practice a number of years more successful at entering the match again if they want to retrain? I'm sure this is more rare.

 

[Raryn]

Depends on the fellowship. I can only speak to IM subspecialties.

Very competitive fellowships like Heme/Onc, Cardiology, GI? Probably pretty damn hard unless during that time you spent a fair bit of effort doing research.

Moderately competitive fellowships like Rheum, Endocrine? Eh, it's a minus, but not insurmountable

Fellowships like palliative, ID, geriatrics, sports med, sleep? It's not a problem at all. Not only are these not particularly competitive, they're also ones that have a number of mid-career folks who do them for whatever reason. Particularly palliative.

 

[Slack3r]

Depends on the fellowship. I can only speak to IM subspecialties.

Very competitive fellowships like Heme/Onc, Cardiology, GI? Probably pretty damn hard unless during that time you spent a fair bit of effort doing research.

Moderately competitive fellowships like Rheum, Endocrine? Eh, it's a minus, but not insurmountable

Fellowships like palliative, ID, geriatrics, sports med, sleep? It's not a problem at all. Not only are these not particularly competitive, they're also ones that have a number of mid-career folks who do them for whatever reason. Particularly palliative.

Is rheum really moderately competitive? Genuine curiosity. It’s nearly impossible to find a half decent rheum in my town, figured nobody wanted to do it.

 

[Raryn]

Is rheum really moderately competitive? Genuine curiosity. It’s nearly impossible to find a half decent rheum in my town, figured nobody wanted to do it.

The programs all fill and there's about 50% more applicants than there are spots for rheum. It's actually more competitive with regards to # of applicants than pulmonary/critical care, though lower competitiveness when measured by things like board scores from what I call. There's a shortage but it's because there's just not that many programs around.

 

[LookForZebras]

Is this seen as a negative that you got rejected the first time and have done things unrelated to the fellowship you are interested in?

It doesn't matter so much that your work has been unrelated to the fellowship you're interested in, because you haven't had training in that subspecialty field yet. As long as you can demonstrate your interest in other ways.. maybe research projects, committees you've been on, a thoughtful personal statement, etc.

 

[sanfran256]

Is rheum really moderately competitive? Genuine curiosity. It’s nearly impossible to find a half decent rheum in my town, figured nobody wanted to do it.

https://mk0nrmp3oyqui6wqfm.kinstacdn.com/wp-content/uploads/2019/02/Results-and-Data-SMS-2019.pdf

There are a lot of IMGs applying as well. Only 17 US MDs did not match.
Versus Pulm/Crit 51 did not match, 70 in GI

From what I can see, If you are a US MD, go to a decent residency program, and apply broadly you have an excellent chance of matching.

 

[PaprikaLeapt]

Do spo

depends but I doubt someone would want to take the pay cut of making 200k/yr to 50k/yr

Thanks. I guess it sounds like its hard to go back to a residency/fellowship salary after making 6 figures.

 

[Sephirakra]

Do spo


Do sports medicine doctors typically make about 50k$ / year? I'm surprised, I hear alot of sports medicine doctors being satisfied with their career and don't mention this

I think they meant that regarding the change in salary going from being a practicing attending to a fellow.

 

[PaprikaLeapt]

I think they meant that regarding the change in salary going from being a practicing attending to a fellow.

Yeah, whoopsie daisy I fixed it but too late

 

[PaprikaLeapt]

Both wife and D, did it—both in CC. Wife did it after 10 years of practice and was close to 40–so it’s doable. And the numbers worked out, as she makes pretty close to double what she previously made prior.

Out of curiosity, what might be some things you would do while practicing full time to improve the resume/prove interest in the new residency they are practicing in?

I don't imagine full time doctors have that much free time to prove their interest in a field like PM&R or sports medicine (what I'm looking into) while doing something relatively unrelated like internal medicine, would they? What would they do to improve their resume?

 

[rheumomaniac]

Perhaps a case report. Or give a lecture at a noon conference about a topic in the field they are interested in. but yes, it is hard if you are a full time doc to work on this stuff. unless maybe you are a hospitalist with 1 week on and 1 week off.

 

[operaman]

It definitely makes it harder for many surgical fellowships. I think the concern is operative ability may decline once in practice because you just aren’t doing enough of the high level cases as a brand new general practice attending in most places.

 

[Bacchus]

I know this thread got bumped but regardless of academics financially there’s a good chance it’s not possible.

 

[IlDestriero]

Do spo


Thanks. I guess it sounds like its hard to go back to a residency/fellowship salary after making 6 figures.

I did it after 3 years. It was fine. I had no debt and plenty of cash. I just supplemented my income with savings and continued “living my best life”. That’s what all the kids are doing now, right? I must have been a trend setter.
Fortunately anesthesia fellowships are only a year and my wife had a good job.
I was actually living better than the Jr attendings, who had debt, etc. There were a few people that were jealous of my situation, my luxury vehicles, vacations. I just avoided them, left the area when people started bitching about money, and never invited anyone to the house I was renting. It’s not my problem that they were broke. They didn’t have to live in one of the most expensive areas of the country. That was actually the only negative. Some people suck, but that’s their problem.
The biggest concern with the faculty at all of my interviews was, “how will you feel going from being independent and a department head to being a trainee again and taking direction from attendings, some of which may have less experience than you?” Make sure you can answer that. I was in practice for 3 years and was the medical director and department head at a small hospital. It’s actually nice to dump your leadership obligations, paperwork, committees, etc. and just do patient care for a while. Of course as I get older, I’m happy to do the opposite.

 

[Mass Effect]

I have a kind of related question:

I see a lot of posts where people who graduated medical school and did something else (consulting, got sick, got pregnant, could not match) had a lot of trouble obtaining a resident once they entered the match. The explanation usually given is their skills declined after being out of the game so long. Is this a phenomenon?

Are people who have been in practice a number of years more successful at entering the match again if they want to retrain? I'm sure this is more rare.

I think it depends on the fellowship and reason for going back. The example above about the rural FM attending going back for ophthalmology makes sense if he framed it as: I'm the only FM doc for miles and miles and want to learn these skills for my patients. It also likely doesn't hurt that as a rural FM attending, he likely was managing minor ophthalmic issues already so it isn't like it was a completely unrelated field or something.

I've known people who've done this in different fields -- my own, psych, as well as critical care and one in palliative care. It does happen. You just have to frame it right.