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- Mar 4, 2008
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Hello all,
My current situation has left me in a real predicament and has been torturing me the past few months. I'm currently in my last year of Internal Medicine residency, and scheduled to start a Pulm/CC fellowship at my home institution this upcoming July. I enjoyed my CCM rotations 1st and 2nd year, and always thought about going into that field, but never applied for the fellowship...the plan was to be a medicine hospitalist or maybe go to the outpatient setting and do primary care.
After the match, the Pulm/CCM dept approached me about a fellowship spot to start as early as this July. I grappled over it for a few weeks to a month, and ultimately took the position. I figured CCM would allow me to practice Internal Medicine on steroids, without having to deal with all the social BS, less arguments with the ED regarding admissions etc, while Pulmonary would provide me an escape from the hospital and regular hours.
Since that time unfortunately all I have been doing is going back and forth regarding my decision to take the spot. Many have stated that there is not much demand for Pulmonary outpatient and my life will end up being primarily in the ICU, which sounds horrible. Too stressful, and I fear it will give me less time with my family. I'm not worried about the fellowship itself (actually a fairly relaxed fellowship since there are 9 fellows total), but more so about my schedule and lifestyle after fellowship. It has driven me crazy, I havent been able to focus at work, and also havent been able to fully enjoy my time off at home with my family. My poor wife has had to hear about my indecisions every day for the last 2+ months.
What are everyone's thoughts? Would it be possible to work primarily Pulmonary outpatient, or does that not even exist? I would be open to combining that with IM Primary Care if needed. If that's what I end up doing, I'm not sure a 3 year fellowship is worth it.
CONS for going through fellowship:
-Potential for having very limited outpatient work, forced to do much more inpatient than I expected
-Potentially worse lifestyle
-Higher stress job
-3 more years as a trainee when I could have been an attending
PROS for going through fellowship :
-Much more pure medicine, much less of the social issues/scut work of IM
-Higher income potential
-Not a horrible schedule during fellowship
-Even if I dont end up practicing Pulm/CCM, I will have additional certifications that I would think make me more competitive for IM hospitalist or even outpatient jobs. It also gives me flexibility later in life incase I'm not happy in Internal Medicine or things get worse for generalists.
My question to all of you, if I do ultimately decide to not go through with my plans for fellowship, what would be the best way to do it? It was a spot created for myself - they had funding for the spot, but for whatever reason, were prepared to let that spot go unfilled. In other words, its not like I stole that spot from someone through the match. I've been a strong resident, and well liked by everyone throughout the institution. It would kill me if my lasting impression before leaving residency is of someone so indecisive and screwing over a fellowship program.
Everyone's thoughts will be very much appreciated, thank you so much in advance.
My current situation has left me in a real predicament and has been torturing me the past few months. I'm currently in my last year of Internal Medicine residency, and scheduled to start a Pulm/CC fellowship at my home institution this upcoming July. I enjoyed my CCM rotations 1st and 2nd year, and always thought about going into that field, but never applied for the fellowship...the plan was to be a medicine hospitalist or maybe go to the outpatient setting and do primary care.
After the match, the Pulm/CCM dept approached me about a fellowship spot to start as early as this July. I grappled over it for a few weeks to a month, and ultimately took the position. I figured CCM would allow me to practice Internal Medicine on steroids, without having to deal with all the social BS, less arguments with the ED regarding admissions etc, while Pulmonary would provide me an escape from the hospital and regular hours.
Since that time unfortunately all I have been doing is going back and forth regarding my decision to take the spot. Many have stated that there is not much demand for Pulmonary outpatient and my life will end up being primarily in the ICU, which sounds horrible. Too stressful, and I fear it will give me less time with my family. I'm not worried about the fellowship itself (actually a fairly relaxed fellowship since there are 9 fellows total), but more so about my schedule and lifestyle after fellowship. It has driven me crazy, I havent been able to focus at work, and also havent been able to fully enjoy my time off at home with my family. My poor wife has had to hear about my indecisions every day for the last 2+ months.
What are everyone's thoughts? Would it be possible to work primarily Pulmonary outpatient, or does that not even exist? I would be open to combining that with IM Primary Care if needed. If that's what I end up doing, I'm not sure a 3 year fellowship is worth it.
CONS for going through fellowship:
-Potential for having very limited outpatient work, forced to do much more inpatient than I expected
-Potentially worse lifestyle
-Higher stress job
-3 more years as a trainee when I could have been an attending
PROS for going through fellowship :
-Much more pure medicine, much less of the social issues/scut work of IM
-Higher income potential
-Not a horrible schedule during fellowship
-Even if I dont end up practicing Pulm/CCM, I will have additional certifications that I would think make me more competitive for IM hospitalist or even outpatient jobs. It also gives me flexibility later in life incase I'm not happy in Internal Medicine or things get worse for generalists.
My question to all of you, if I do ultimately decide to not go through with my plans for fellowship, what would be the best way to do it? It was a spot created for myself - they had funding for the spot, but for whatever reason, were prepared to let that spot go unfilled. In other words, its not like I stole that spot from someone through the match. I've been a strong resident, and well liked by everyone throughout the institution. It would kill me if my lasting impression before leaving residency is of someone so indecisive and screwing over a fellowship program.
Everyone's thoughts will be very much appreciated, thank you so much in advance.