Hello,
I am new to this website and had a few questions regarding fellowship training in critical care. I am an IM resident and definitely want to pursue a critical care fellowship, but am not sure that I would like to pursue the pulmonary portion of the fellowship. I know that typically residents apply for pulmonary/critical care. Why is that? Is it that people are typically interested in both?
I'm interested in rheumatology and critical care and would rather be double boarded in rheum/ccm, instead of pulm/ccm. Is this a bad idea?
One last question: Is it a bad idea to pursue the 2 year ccm fellowship instead of the 3 year pulm/critical care fellowship? What are the advantages of doing the third year and getting the double board certification in pulm and cc?
Sorry for all of the questions at once. Thank you for your help.
Often times, yes the applicants that are interested in Critical Care also are interested in Pulmonology. Sometimes more interested in Critical Care than Pulm, but not always. This is of course applicant-dependent. I am intersted in both. Still with that said, I like critical care more, but I like the variety of pathology of pulm and the variety of practice that being certified in pulm/CC brings. Most people apply for pulm/CC instead of CC to get double board certified (and often times they like both). Certified in both allows for both for greater variety in your future practice as well as makes you look better to recruiters when it comes time to get a job. This is because when you finish fellowship, you will often look to join an existing Pulm practice that has both an office-based practice, in-patient service coverage (often, but not always) as well as ICU coverage. If you are only CC trained, you cannot cover the clinic and do pulm consults on the in-patient service and so they would much rather hire a recent pulm/cc grad who can cover both.
I've never heard of a rheum/cc combination (there are active combined fellowships for ID/CC and you can do Renal/CC, Neuro/CC fellowships out there). Nothing is stopping you from doing a rheum fellowship (2 years) and then applying for a CC fellowship and doing another 2 years for that fellowship (as long as someone takes you). The issue is because it's not common, program directors may be questioning your motives (ie. why would I take this guy who is finishing a rheum fellowship when I can take a guy who just wants to do CC and be a full time intensivist). It's just my opinion, but it would seem that people may have their questions about your motives.
If you would do both rheum and then CC, would you have a rheum practice and then occasionally do CC shifts? Would you do them half-half? how do you see that working? If it's half/half, any rheum practice that you would want to join may have doubts about your commitment and motives as well from their point and whether you would be a consistent partner. Again, just my opinion.
Advantages of 3 year pulm/cc over 2 year:
- certified in both pulm and CC
- variety in practice
- better job applicant out of fellowship --> more $$$ and better practice/perks possible
- later in career when you may want to do less CC (? burnout, tired, kids, family, etc.), you can do less CC by hiring newer grads and do more clinic/bronch/in-pt service (= less stress).
- often if you want to be in an academic setting, you need combined fellowship training.
I'm sure there are more, but that was off the top of my head.
