Doing a child fellowship after residency?

[lemonlove]

Hi,
PGY2 here. I had wanted to do Child fellowship before starting residency and love children. However, I'm just at the point I guess where I am in debt and really exhausted in terms of my work/personal life. I really just want to finish my program and be BC/BE, work for a few years, and then possibly consider fellowship.

Has anyone ever done this?

I'm on the older side of the spectrum and I really want to have my own children, do other things, etc. I have absolutely no interest in research and I don't want to do it just to get into a fellowship.

I'm currently stable and happy in my community based psychiatry residency and don't feel like leaving it before finishing all 4 years.

Any tips? There are also some days where I say, I really like addiction, so possibly addiction disorders in adolescent population?

I seriously can't believe how much in debt I am! Medical School loans are frightening.

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[lemonlove]

Hi,
PGY2 here. I had wanted to do Child fellowship before starting residency and love children. However, I'm just at the point I guess where I am in debt and really exhausted in terms of my work/personal life. I really just want to finish my program and be BC/BE, work for a few years, and then possibly consider fellowship.

Has anyone ever done this?

I'm on the older side of the spectrum and I really want to have my own children, do other things, etc. I have absolutely no interest in research and I don't want to do it just to get into a fellowship.

I'm currently stable and happy in my community based psychiatry residency and don't feel like leaving it before finishing all 4 years.

Any tips? There are also some days where I say, I really like addiction, so possibly addiction disorders in adolescent population?

I seriously can't believe how much in debt I am! Medical School loans are frightening.

I realize I wrote this after a 24 hour long call. I was wondering if those who did not do any fellowship regret their decision?

thanks

 

[TexasPhysician]

There are child fellowships that allow moonlighting. If it is truly a passion, I'd consider starting child after PGY-3 and moonlighting to start working off the debt.

While I considered a 2nd fellowship (addiction and forensics) after child, I can't imagine returning to training for significantly less pay. Once you get accustomed to a higher salary, it is hard to return.

 

[PistolPete]

Agreed. Do all the training in a row, as painful as that is. Once you're done you won't want to go back.

 

[DD214_DOC]

child work is more intense, draining, time consuming, and frustrating than general psych. Both during fellowship and after. Given what you've said, I would pass on it.

 

[Merovinge]

I seriously can't believe how much in debt I am! Medical School loans are frightening.

They can be, and if you went out of state/private I am sure they dwarf mine, however starting salaries can be pretty high and you should be able to pay your loans off in roughly 5 years of attendingdom if you live like you are on a resident salary during that time while still having a reasonable life style.

I think the 4th year of general psych is pretty much a fellowship as is, at least if you are at a good program, and you will not lose much if you take it to off to go into C/A. Many C/A fellowships allow moonlighting, and in your second year you can moonlight as an attending in general psych. The patient population is so much better in C/A if you like children that the one extra year will be completely worth it. This is the rest of your life's practice here, don't skimp on 1 year just because of loan fear, because if you have remotely reasonable spending habits you will pay it off in much shorter order than most.

 

[milesed]

I trained with a psyc who completed her residency, worked in her pvt practice for a few years, went back to do 2 years of child while she cont to run her practice (scaled back).

 

[MacDonaldTriad]

Once you stop training, you are finished training with very few exceptions. Once you stop training you are by no means done learning and improving. Fear of loans isn’t very high on the list of factors that determine this decision. You will earn enough as a child psychiatrist to pull yourself out of debt. I have noticed that there are generally two kinds of psychiatry residents. There are those that would rather push sharp pins in their eyes than do child psychiatry, and then there are those that do child and adolescent fellowships. Almost no one stays on the fence for very long. Best of luck with your decision, you really should do some child psych and then decide this.

 

[northernpsy]

I actually do know of a psychiatrist who went back for an Addiction fellowship after having worked as an attending for a while, so there's really nothing stopping you from going back to do a fellowship after you graduate if you decide it is something you feel strongly about...but I agree that the majority of people probably would find it very hard to go back to do a 2 year fellowship once they've had a taste of attending life. If you're not sure you want to do child psych, then it might make sense to just finish your 4 years and then see if you still miss working with children later on down the road, but I really think it is more efficient to just do the 3 year + 2 year path to child if you are sure you want to work with children.

Oh,and don't worry too much about the loans. You should be able to find employers who are happy to offer substantial loan repayment if you just do a little bit of looking around and negotiating. I also strongly agree with the advice to keep living like a resident for a little while after you graduate so you can use a large portion of your attending money to either pay off loans or start saving for retirement.

 

[swifteagle43]

Here is a secret: If you choose to leave after 1 year of child, you are still eligible to sit for the adult psychiatric boards! Meaning - you are a full adult psychiatrist, even if you completed 3 years of adult and 1 year of child. Try child fellowship for for a year and if you don't like it, leave - you will lose nothing.

 

[OldPsychDoc]

Here is a secret: If you choose to leave after 1 year of child, you are still eligible to sit for the adult psychiatric boards! Meaning - you are a full adult psychiatrist, even if you completed 3 years of adult and 1 year of child. Try child fellowship for for a year and if you don't like it, leave - you will lose nothing.

...except potentially the love of your fellowship director, and of your adult program director who "highly recommended" you without reservations for that fellowship!

(Not that you should stay in a situation where you are miserable...but do keep in mind that there are some ramifications to utilizing this path.)

 

[swifteagle43]

also the child residency director will still have to sign you off for the year, without which you will not be able to sit for the boards! So don't go pissing anyone off...

Nobody said to burn the place down on exit. Give your PD time to find someone else. I know many people who finished child fellowship and don't see ANY children. They come up with all sorts of reasons to justify spending a golden year of their life in misery.

 

[swifteagle43]

some PDs are that vindictive. I was told of a PD who refused to sign off a fellow who was there the whole time! Medicine is a toxic game. They can always hurt you more...

(not that I am advocating staying in something if you're miserable, but it is a bad idea to go into a fellowship you're unsure about with the idea that you can always leave if you want.)

The saying goes: "gotta know when to hold em', when to fold em', when to walk away and when to run." That fellow mighta done better leaving after 1 year instead of staying the "whole time." Two things may have happened in that scenario:

1) The fellow might not have been good at getting early reads on malignant narcissistic people. The fellow may have misread the PD.

OR

2) The fellow lacked self-awareness that s/he would have made a terrible child psychiatrist and the PD did the world a favor.

Either way, an early leave could have been beneficial for the example you gave. Ultimately all life decisions come down to knowing yourself and reading the situation.

 

[inveggar]

...except potentially the love of your fellowship director, and of your adult program director who "highly recommended" you without reservations for that fellowship!

(Not that you should stay in a situation where you are miserable...but do keep in mind that there are some ramifications to utilizing this path.)

Can you elaborate on the ramifications one might face if they left C&A fellowship after one year? Would that affect their licensing and credentialing applications later on?

Thanks

 

[OldPsychDoc]

Can you elaborate on the ramifications one might face if they left C&A fellowship after one year? Would that affect their licensing and credentialing applications later on?

Thanks

Just the loss of trust that I mentioned. Probably no effect on credentialing, etc., unless you did something actually wrong and reportable -- misconduct, impairment, probation, etc.

 

[inveggar]

Just the loss of trust that I mentioned. Probably no effect on credentialing, etc., unless you did something actually wrong and reportable -- misconduct, impairment, probation, etc.

I thought somehwere I had read that there are questions on licensing apps that ask if you have ever left, withdrawn or not completed a program for any reason?

 

[hamstergang]

I thought somehwere I had read that there are questions on licensing apps that ask if you have ever left, withdrawn or not completed a program for any reason?

Ok, so they ask -- why does that worry you? Just because you answer yes to a wuestion doesn't mean your application gets denied. That would be ridicilous.