COVID affecting fellowships?

[TheGreatestTrochanter]

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Hey all,
just curious if/how the current landscape is affecting fellowships? most if not all sporting events are cancelled, at least at my institution almost all outpatient non-urgent appointments (essentially all sports med appointments) are cancelled for the time being, or being moved to telehealth. Will this get in the way of some of the graduation requirements for fellowship? how about job searching now? Just curious what things are looking like for everyone.

 

[timisdaman]

A lot of hospital systems are closing outpatient services and moving to telemedicine.

Thankfully, this part of year is not so busy sports-wise compared to the fall.

 

[Poor Applicant!]

I have a question:

My fellowship asked fellows to do the hospitalist job due to COVID-19.
But they do not want to compensate/pay as hospitalist for this time period!

Hospital is not seeing patients for free, and also they are receiving money from government, but they are not willing to pay fellows working as hospitalists. I think they are using this crisis to make money because otherwise they have to pay 2,000-2,500$ a shift for moonlighting.

This is not a communist country that they can force us to do things without paying!

Any thoughts?

 

[Caribgrad]

I have a question:

My fellowship asked fellows to do the hospitalist job due to COVID-19.
But they do not want to compensate/pay as hospitalist for this time period!

Hospital is not seeing patients for free, and also they are receiving money from government, but they are not willing to pay fellows working as hospitalists. I think they are using this crisis to make money because otherwise they have to pay 2,000-2,500$ a shift for moonlighting.

This is not a communist country that they can force us to do things without paying!

Any thoughts?

My NON crit care fellowship is doing the same. Not fair by any means. Right now it is on a volunteer basis but there are whispers of making it mandatory.

I am no lawyer but looked over my contract in detail. Not sure how they can legally do this. Other programs geographically surrounding mine are doing the opposite ... Distancing fellows from COVID exposures. I am very confused and concerned.

 

[Dr L Vuitton]

what would be the harm in saying"no"?

 

[Poor Applicant!]

My NON crit care fellowship is doing the same. Not fair by any means. Right now it is on a volunteer basis but there are whispers of making it mandatory.

I am no lawyer but looked over my contract in detail. Not sure how they can legally do this. Other programs geographically surrounding mine are doing the opposite ... Distancing fellows from COVID exposures. I am very confused and concerned.

It is all about money! hospitals can recruit moonlighters and pay them. I receive emails about 2500$ a shift for moonlighting 7am-7pm for COVID-19 patients (one week on, one week off). However fellowship programs are not willing to pay that money and also ACGME gave the green light: "residents/fellows can be redeployed". However ACGME does not talk about money and compensation and apparently left it to programs. Some programs like Loyola and Northwell "may" compensate.

"Congress has already approved an $8.3 billion bill for health agencies"
ref: What's in the $2 trillion coronavirus bill? Here's how it could help you.

So if hospitals receiving money from government, and also they charge patients, why some are not willing to pay and recruit moonlighters?
are they using this crisis to make more money?

Does our contract say they can force us do the moonlighting job in crisis without paying?

These are legitimate questions, and if ACGME is not willing to response (I called many times, and they refer me to IM department which is an answering machine now), we can possibly ask some legal experts or something.

I feel I am in a communist country. "work as a hospitalist, but we do not pay you as the hospitalist, and don't ask about money, just be nice while we use this crisis to make more money".

Sadly my attending do not want to take the sub=speciality calls either, so beside working as hospitalist I have to cover the calls too.
Cliche of abusing fellows/residents. You can not object cause they may fire you, or at the end you need their LORs to find a job! vicious cycle.

 

[Poor Applicant!]

what would be the harm in saying"no"?

You may get fired at worse,

No good LOR in future...

and giving you tough time here and there, you know how fellowship works.

 

[Dr L Vuitton]

You may get fired at worse,

No good LOR in future...

and giving you tough time here and there, you know how fellowship works.

TBH its only 1 year and you are paying about 150k to do a fellowship. Do not do anything you don't want to do. You should be a licensed physician by now. Residency is over.

 

[n3xa]

I know of at least one program that recommended deferring for 1 year.

 

[Waterlover]

I know of at least one program that recommended deferring for 1 year.

How do you think it'll affect applying a year from now? I just decided (right before everything shut down lol) I want to pursue the fellowship and didn't do much intern year except for a sports rotation I did right before Corona, I'm worried now about getting involvement over the next year. What should I do?

 

[galactus]

How do you think it'll affect applying a year from now? I just decided (right before everything shut down lol) I want to pursue the fellowship and didn't do much intern year except for a sports rotation I did right before Corona, I'm worried now about getting involvement over the next year. What should I do?

Well what year of residency are you in? If you are applying for the 2022 Match, then you have time this next academic year to do research, cover games, go to AMSSM, etc.
If you are planning on applying to the 2021 Match next year, well ERAS opens in July...you should already have some experience/exposure. Interviews start in the fall and the match is in January....

 

[Waterlover]

Well what year of residency are you in? If you are applying for the 2022 Match, then you have time this next academic year to do research, cover games, go to AMSSM, etc.
If you are planning on applying to the 2021 Match next year, well ERAS opens in July...you should already have some experience/exposure. Interviews start in the fall and the match is in January....

I'm finishing PGY1 applying for 2022, so I'm applying 1 year from now. Just concerned about when stuff will actually open again. Also, do you know how likely sports becoming 2 year fellowship will happen in the next couple years?

 

[galactus]

I'm finishing PGY1 applying for 2022, so I'm applying 1 year from now. Just concerned about when stuff will actually open again. Also, do you know how likely sports becoming 2 year fellowship will happen in the next couple years?

You got time.

I guess you were listening in to the fellowship webinars at AMSSM lol. Honestly the task force to see if SM can be extended to 2 years is just a task force. In order for it to work, about >95% of all program directors have to agree to it, and right now I know a lot of programs are not fans of it. One it's funding. Some programs are funded by CMS, others are privately funded, or funded by hospitals, etc. If it goes to 2 years, a good amount of programs will close.

My 2 cents: It's not going to happen, at least not anytime soon.

 

[calvnandhobbs68]

TBH its only 1 year and you are paying about 150k to do a fellowship. Do not do anything you don't want to do. You should be a licensed physician by now. Residency is over.

Right. Fellows are in much better positions than residents. You could walk today and go get paid top rate for those moonlighting shifts. If you’re going to have increased hazardous exposure you should be being paid accordingly. You didn’t do this fellowship to learn COVID patient management.

 

[futuredrdo]

any thoughts on how COVID is affecting incoming fellows? will it dilute the training with no coverage and clinic volumes down?

 

[runfastnow]

If organized sports are completely shut down through the end of the calendar year then it could have an impact on your sideline training - particularly if your program has you cover HS football in addition to being integral in a collegiate program.

Reckless speculation: The NCAA and NFL are going to find a way to have a fall football season even if it means have no (or extremely limited) fans at the games. High school sports are going to be extremely variable and state by state - almost certain that any schools in the midwest and south are going to have a football season, but in the denser areas of the northeast they may cancel.

However, clinics should start opening in the next 4-8 weeks and hopefully be fairly up to speed by the end of the summer (if not sooner in some parts of the country - midwest and south).

Bottom line: unless there is a major second wave or you are doing your fellowship in NYC/surrounding areas you should still have appropriate experiences and training. This year's fellows are probably more impacted with the cancellation of the entire spring season.