Guillemot

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Back in residency I felt ambivalent about pursuit of a fellowship and therefore decided against it. I'm liking some aspects of PP, but other things such as limited intellectual stimulation are less appealing.

Has anyone returned for fellowship in an anesthetic subspeciality after being out of the ivory tower for a while?

How would letters of recommendation work?

How would lack of significant exposure to that subspecialty for several years work?
 

IMGASMD

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Back in residency I felt ambivalent about pursuit of a fellowship and therefore decided against it. I'm liking some aspects of PP, but other things such as limited intellectual stimulation are less appealing.

Has anyone returned for fellowship in an anesthetic subspeciality after being out of the ivory tower for a while?

How would letters of recommendation work?

How would lack of significant exposure to that subspecialty for several years work?
Plenty here returned for CC. Few returned for cardiac. Don’t remember anyone talked about peds or pain. Know of one went back for region IRL.
 

pgg

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I went back for a cardiac fellowship after being out for 7 years. I think I got LORs from my old program director, current department chair, and our cardiac division chief. However, I applied outside the match, and as a military guy I brought my own funding, and the program I wound up got a temporary complement increase from ACGME to take me as a free laborer ... maybe I could've supplied LORs from my neighbor's dog?


How would lack of significant exposure to that subspecialty for several years work?
To be honest, it was difficult for the first couple months. I hadn't done any cardiac anesthesia or touched a TEE probe in years. Most of my co-fellows were coming off CA-3 years in which they'd done a bunch of cases, and spent some elective time doing more cases. So despite being board certified and absolutely comfortable working solo, I began the year somewhat behind them. But the fellowship was structured such that little expertise was expected on day 1, and the faculty did their job and taught me things, and I muddled through.

The year is a grind no matter when you do it. Around January you'll be asking yourself "WTF was I thinking leaving my cushy attending life to do this for" ...

I'm glad I did it. I'm a better anesthesiologist for it, no matter what cases I'm doing on any given day. It's opened a number of doors for me that would be closed otherwise. It's only a year. The Social Security actuarial table says you're going to live to be 83 or something like that, so go for it.
 

chocomorsel

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I did. After 6 years. And I felt behind at first as well compared to fresh CA3s. But I am caught up and almost done.

LORs were from colleagues as CCM is not competitive. Did not bother with my old program.
 
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psychbender

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Went back to CCM after four years. LORs were from former residency PD, current department chief, and the third varied (had letters from the ICU chief and one of my colleagues).

I felt way behind at first, as I'd been out of the unit for so long. However, I was ahead procedurally, with echo, and confidence dealing with sick patients.

Diving back in sucks, but if it provides something for which you are searching, then it will be worth it.

If you're just craving cerebral stimulation, though, you may be better served with a job that has some academic affiliation. Perhaps not a full on University hospital, but maybe an affiliated hospital with a private group that takes some residents. My last job had some occasional residents from a nearby small program come through both the ICU and OR, so I was able to continue teaching a little.
 
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AdmiralChz

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One of the cardiac fellows during residency was out ~ 10-15 years and then came back for a fellowship. He trained in, for the most part, the pre-modern TEE era and he was VERY behind the ball in that regard. Since we had a supervisory fellowship, he very rapidly improved and worked on his skills everyday but he would be the first to admit it was a brutal transition back to training.
 

chocomorsel

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that's exactly it. but damn I regret not having done peds.
Seriously though. Save up, cut back and suck it up for a year.

It’s not exactly minimum wage if your hours are reasonable. And you could always moonlight.

I went thru a divorce during it and my worse for wear ass ain’t living under a bridge. I do live in a much more modest older house though, but that’s more to do w the divorce than the fellowship.

So do what you want if it makes you happy. Live on half to 2/3 of what you are living on for a year which for an anesthesiologist is still pretty good. Isn’t that the point of having a nice savings account? So you can do what you want?
 

leaverus

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So do what you want if it makes you happy. Live on half to 2/3 of what you are living on for a year which for an anesthesiologist is still pretty good. Isn’t that the point of having a nice savings account? So you can do what you want?
yeah I get it, and definitely if I were younger I'd do that; but I was already a quite a bit older when I started med school, so at this point in my career the loss of income still slightly edges out the regret.