Fellowship choices for rural location

[Melkor]

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So, I'm currently an r1 (soon to be r2) and I'm trying to figure out which fellowship I should do. I'm at a mid to upper tier academic place in the north east and during this first year I haven't felt a specialty that has really grabbed me. I don't necessarily hate or love anything at this point. My goal is to work/live out in the middle of nowhere (midwest/south or west although not west coast and not in a city >100k if possible) and just have a decent vacation schedule to visit other parts of the world if I wish. Generally speaking, the smaller the city, the better and I would't want to do locum tenums right after fellowship. I've been trying to think of a specialty that would be the most appealing to groups in this more rural setting but I'm having a hard time. Do you guys have any recommendations.

 

[Doctor D]

Rural practices tend to read everything as general radiologists. You could likely get a job without fellowship. Many groups in small towns have trouble recruiting and I think you would have your choice of where to go. Most people would still choose a fellowship because this is nearly standard. I would suggest a body fellowship as this is the most versatile and bread and butter.

 

[colbgw02]

For the proposed scenario, I don't think there's a wrong choice for fellowship, so just choose what you enjoy the most. Just understand that, as mentioned, you will be practicing as a general radiologist.

 

[qxrt]

Rural practices tend to read everything as general radiologists. You could likely get a job without fellowship. Many groups in small towns have trouble recruiting and I think you would have your choice of where to go. Most people would still choose a fellowship because this is nearly standard. I would suggest a body fellowship as this is the most versatile and bread and butter.

Body MRI is pretty specialized and typically concentrated at tertiary medical centers or in bigger cities. Not sure a rural practice would be seeing many of them. Same with pediatrics, thoracic, and nuclear medicine. I'd consider a more general-purpose fellowship like neuroradiology or mammography to be more useful. MSK or IR could be good too.

 

[badasshairday]

Do whatever you feel weakest at.

 

[DrfluffyMD]

My recommendation would be

1. Neuroradiology
2. Body + mammo or mammo + msk
3. Msk or MSk with light IR

 

[Melkor]

Thanks for the suggestions everyone! Consensus seems to be anything but Nucs, Peds, Chest/Cardiac. Good to know I can't really go wrong with anything else. Haven't done mammo yet but that seems interesting. Is it right to assume there would be enough volume in the rural setting for mammo to justify a year of it vs body/msk/neuro. Don't think I could bring myself to do an IR fellowship so that one is likely out of the question.

 

[DrfluffyMD]

If the rural group has a magnet, both MSK and neuro will pay off.

In my opinion, I feel comfortable reading neuro solo without a fellowship at the level expected for the community, but I don't feel like I am there for MSK yet, so in my opinion MSK is more bang for your buck because most resident now have passable neuro training.

EDIT: there are a lot of high end msk in the community

 

[scootad.]

If the rural group has a magnet, both MSK and neuro will pay off.

In my opinion, I feel comfortable reading neuro solo without a fellowship at the level expected for the community, but I don't feel like I am there for MSK yet, so in my opinion MSK is more bang for your buck because most resident now have passable neuro training.

EDIT: there are a lot of high end msk in the community

Agree 100%. MSK (or MRI) fellowship.