Frazier

Palliative Emergentologist
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Hey everyone,

What is the difficulty of matching to a palliative fellowship straight out of an EM residency?

This would not be for a peds hospital.

I know most of these are through IM/FM departments.

Assuming the letters, scores, and CV are in order... is it still an uphill battle?

And, yeah, I know it pays less than straight EM... Such is life. :)
 
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Apr 2, 2018
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Hey everyone,

What is the difficulty of matching to a palliative fellowship straight out of an EM residency?

This would not be for a peds hospital.

I know most of these are through IM/FM departments.

Assuming the letters, scores, and CV are in order... is it still an uphill battle?

And, yeah, I know it pays less than straight EM... Such is life. :)
I'd love to know this, too. I know others will flame me, but EM is such a scam. I wish students would realize.
 

Whatyousay

A few loose screws
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Have not had issues getting interviews to my top choices as someone going straight from residency to fellowship. Most of the programs appear to be very receptive towards emergency physicians, and most have had either current or recent fellows who were EM trained (some of whom were fresh grads).

Can't speak to how the match process will turn out, but at least from an interview side of things I've received more offers than I can handle. Doing an elective with your hospital's palliative service will obviously help out your application
 
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Have not had issues getting interviews to my top choices as someone going straight from residency to fellowship. Most of the programs appear to be very receptive towards emergency physicians, and most have had either current or recent fellows who were EM trained (some of whom were fresh grads).

Can't speak to how the match process will turn out, but at least from an interview side of things I've received more offers than I can handle. Doing an elective with your hospital's palliative service will obviously help out your application
Thanks! Is going straight from EM to Palli a thing now? How did you come to your decision? Why palli, not pain, occ med etc?
 
Oct 1, 2018
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Ohio
Hey everyone,

What is the difficulty of matching to a palliative fellowship straight out of an EM residency?

This would not be for a peds hospital.

I know most of these are through IM/FM departments.

Assuming the letters, scores, and CV are in order... is it still an uphill battle?

And, yeah, I know it pays less than straight EM... Such is life. :)
Based on my experience with the interview trail this year, EM is the 3rd most common specialty (behind fm&im). If you have good letters and a personal statement which explains your motivation to go into the field, you should be good.

Best of luck!
 
Apr 2, 2018
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Attending Physician
Based on my experience with the interview trail this year, EM is the 3rd most common specialty (behind fm&im). If you have good letters and a personal statement which explains your motivation to go into the field, you should be good.

Best of luck!
I'm really interested in hearing more about EM--> Palli. Is this the result of EM being oversold to medical students? Or older docs transitioning out? Seems like a new trend....
 

Whatyousay

A few loose screws
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Aug 9, 2009
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Thanks! Is going straight from EM to Palli a thing now? How did you come to your decision? Why palli, not pain, occ med etc?
Witnessed enough bad deaths that I wanted to learn a little bit more about end of life care. Was ultimately drawn to the pragmatism of the field, and it's refreshing to actually have the time to talk to patients and their families. I love working in the ED, but there are certain aspects of EM which I recognize will likely lead to burnout down the road if I don't diversify my clinical practice early on
 
Oct 17, 2018
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Have not had issues getting interviews to my top choices as someone going straight from residency to fellowship. Most of the programs appear to be very receptive towards emergency physicians, and most have had either current or recent fellows who were EM trained (some of whom were fresh grads).

Can't speak to how the match process will turn out, but at least from an interview side of things I've received more offers than I can handle. Doing an elective with your hospital's palliative service will obviously help out your application
Can you PM me some places that interviewed you, or offered II, as an EM candidate? I do EM-Palliative care but did not do a formal fellowship, and will be advising residents from our EM program who want to apply to fellowship. I know that some of the fellowships have never taken an EM applicant, and my resident advisees might be better off not applying to places who might have a bias against EM (as opposed to IM, FM, etc).
 
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Can you PM me some places that interviewed you, or offered II, as an EM candidate? I do EM-Palliative care but did not do a formal fellowship, and will be advising residents from our EM program who want to apply to fellowship. I know that some of the fellowships have never taken an EM applicant, and my resident advisees might be better off not applying to places who might have a bias against EM (as opposed to IM, FM, etc).
We'd all love this info...
 

C3PO2

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Oct 13, 2014
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I was fortunate that most placed that I liked on paper offered interviews. I did not feel that there was a bias on the trail, and I enjoyed sharing personal stories from EM residency with strong Palliative overlap. I think your strong interest - shown with the personal statement, letters of rec and activities - will carry you along.
 
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Cinclus

Es un pájaro.
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I am interested in going back to do an HPM fellowship after being an attending for a few years. I have finished residency and am working in EM. I don't think straight EM will be sustainable for me. I was someone also very interested in psychiatry as a medical student, and I love spending time with and talking to patients, which is not very possible in EM. There are also many other aspects of EM that are going to burn me out pretty badly; these were tough to appreciate as a medical student and started to become easier to appreciate as a resident - now extremely easy to appreciate as an attending. I unfortunately did not do an HPM elective in residency, though I was exposed to HPM in pretty much all of my inpatient/ICU rotations and am still constantly exposed to patients who would benefit immensely from HPM. Anyone have any recs for strengthening my future application? Try to follow along with the HPM team at my facility, maybe?

Just wanted to add that I am not concerned about the drop in pay. I am most concerned with preserving my sanity and not dreading work.
 

pgy0246

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Jun 4, 2016
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palliative medicine is not a competitive fellowship

how about or EM---> sports medicine or EM--> ICU-critical care.
 

ERDude

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Jun 9, 2010
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I'm also strongly considering EM to Palliative as a mid-career shift. I'm closing in my 10 year recertification and will definitely recertify but I don't know if I can do another decade of ED work - the pace and schedule continues to be a grind.

I love the idea of sitting and spending time with patients and families to craft meaningful palliative treatment plans.

The things I am most concerned about are:
1) I really don't have an option to move and my city has only one program so I'd be reliant on getting in to that program
2) By the time I actually made this leap I anticipate I'll be at least 12-15 years out of residency - will this be a negative, positive or neutral?
3) I know this will constitute a pay cut (I'm fine with that) but it still seems hard to find reliable data on Palliative care physician salaries - is upper 200k typical for FT community gig?
 
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Frazier

Frazier

Palliative Emergentologist
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I am interested in going back to do an HPM fellowship after being an attending for a few years. I have finished residency and am working in EM. I don't think straight EM will be sustainable for me. I was someone also very interested in psychiatry as a medical student, and I love spending time with and talking to patients, which is not very possible in EM. There are also many other aspects of EM that are going to burn me out pretty badly; these were tough to appreciate as a medical student and started to become easier to appreciate as a resident - now extremely easy to appreciate as an attending. I unfortunately did not do an HPM elective in residency, though I was exposed to HPM in pretty much all of my inpatient/ICU rotations and am still constantly exposed to patients who would benefit immensely from HPM. Anyone have any recs for strengthening my future application? Try to follow along with the HPM team at my facility, maybe?

Just wanted to add that I am not concerned about the drop in pay. I am most concerned with preserving my sanity and not dreading work.
Congrats! It will be a great decision. The surveys show 99% of graduating fellows are pleased with their decision to pursue HPM.

Join the EM organization palliative interest groups. See if there are any QI projects you can get involved with this year. Try to attend AAHPM or another conference.

...you'll prob match doing none of those things, but it is good to have some material of active interest for interviews.

I went on like 10 interviews... 90% of those had other EM candidates there that day too... from graduating chief residents, to attendings PGY-15... there is a nice cozy place for you in HPM!
 
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Frazier

Frazier

Palliative Emergentologist
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Nov 12, 2009
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I'm also strongly considering EM to Palliative as a mid-career shift. I'm closing in my 10 year recertification and will definitely recertify but I don't know if I can do another decade of ED work - the pace and schedule continues to be a grind.

I love the idea of sitting and spending time with patients and families to craft meaningful palliative treatment plans.

The things I am most concerned about are:
1) I really don't have an option to move and my city has only one program so I'd be reliant on getting in to that program
2) By the time I actually made this leap I anticipate I'll be at least 12-15 years out of residency - will this be a negative, positive or neutral?
3) I know this will constitute a pay cut (I'm fine with that) but it still seems hard to find reliable data on Palliative care physician salaries - is upper 200k typical for FT community gig?
Suicide matches as they call them sometimes working out! Prob important for you to try to start building some connections early.

Some programs favor folks that have been out of residency for awhile.

The average is more like 220-240k

There is a big pay difference from EM. But it also is a vastly different job than EM
 
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