Does your medical specialty before going into HPM affect what kind of career you can have in HPM after finishing your fellowship?

[IndieFranco]

Does your medical specialty before going into HPM affect what kind of career you can have in HPM after finishing your fellowship or does being boarded in HPM put everyone on somewhat of an equal footing? Do people who went from EM -> HPC normally end up in the same roles as someone who did IM -> HPC or Pediatrics -> HPC? Could someone who did EM -> HPC work in a hospice or see pediatric patients?

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[Frazier]

Peds is largely separate than adult palliative. While a pediatritian can complete an adult or peds HPM fellowship and go on to work a peds palliative job... someone that did one of the other ~10 gateway residencies is typically not going to be admitted to a peds HPM fellowship (example exemption would be someone that did psych and a child psych fellowship subsequently being eligible).

Hospice covers all age range and there is generally no particular "peds hospice" outside perhaps a children's institution happening to have their own hospice... say St. Jude's had it's own hospice. No idea if they do.

Whether you see peds patients as an adult palliative doc depends on the hospital culture and structure. If there is no peds palliative team, then it will likely be you.

Everyone does some peds rotation in HPM fellowship. I am EM trained so see kids in that setting. Many of the congenital issues and life limiting diseases of young children encountered during my HPM peds rotation in fellowship were novel to me. Eponyms galore. I would likely not be the best option for a peds team. I think the best primary specialty to take of the palliative needs of pediatric patients is a pediatrician with peds HPM training.

Otherwise everything is fair game when it comes to adult palliative jobs, assuming that they aren't looking for someone to function simultaneously as a hospitalist or geriatrician, etc (in which case IM/FM are likely going to be required).

So, yes, you can work in hospice coming from EM.

 

[visceral0775]

Does your medical specialty before going into HPM affect what kind of career you can have in HPM after finishing your fellowship or does being boarded in HPM put everyone on somewhat of an equal footing? Do people who went from EM -> HPC normally end up in the same roles as someone who did IM -> HPC or Pediatrics -> HPC? Could someone who did EM -> HPC work in a hospice or see pediatric patients?

I am trained in EM currently doing my HPM fellowship. On my interview trail last fall, I met people in a variety of fields such as EM, surgery, PM&R. The diversity of backgrounds is a very nice thing about our field.