Fellowship Lifestyle

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zeloc

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I am at the point where I am trying to decide between doing a fellowship and working as a hospitalist or some other pathway and I'm wondering what the lifestyle is during fellowship. As an intern I'm working 80 hours/week and after 4 years of medical school and 2 more years of residency I'm starting to think more about lifestyle which I did not consider as a medical student going into IM (o/w I probably would've given some consideration to ophtho, derm, anesthesia, etc). Is being a fellow similar to being a resident than attending and how many hrs/week is it? I'm thinking about renal and cardio, possibly CC. Thanks!
 
It will be better hours than an intern works...LOL!

I haven't started the clinical part of my fellowship, but have been told by friends in fellowship that it's, "Much better than residency". I think this stems more from the lack of menial responsibilities, like writing a plethora of daily progress notes and discharge summaries, and returning innumerable nurse pages between midnight and 5 a.m., than from super-cushy hours, though. Cards and critical care definitely have worse hours than most other medicine fellowships, including renal, but a lot depends on where you train as well.

Hospitalists actually work pretty hard, but it's still not on the level of residency since you would rarely if ever be there for more than 14 hours or so. I had a friend who did hospitalist year and sometimes had a census of 30 patients (for just herself). They did have an NP to help out with certain admissions and discharges, but that's still a damn lot of patients.

If you aren't sure, can always do a hospitalist year after you graduate, then apply to fellowship, but that might make it a bit harder to get in.

If you're an intern you still have plenty of time to decide.
 
I am a first year cardiology fellow. Your hours will depend on your location of practice. Some fellowships require in-house call (mine for instance), and others don't. From my experience, I work more as a fellow than I did as a resident. However, the work is more substance and less scut/social work/etc, and is thus more enjoyable and tolerable. Bye the way, you do not have plenty of time to make up your mind if you chose to enter a competitive fellowship right after residency. You need to be finding research opportunities now to position yourself for the interview process which happens midway through your second year. Good luck to ya.
 
I am at the point where I am trying to decide between doing a fellowship and working as a hospitalist or some other pathway and I'm wondering what the lifestyle is during fellowship. As an intern I'm working 80 hours/week and after 4 years of medical school and 2 more years of residency I'm starting to think more about lifestyle which I did not consider as a medical student going into IM (o/w I probably would've given some consideration to ophtho, derm, anesthesia, etc). Is being a fellow similar to being a resident than attending and how many hrs/week is it? I'm thinking about renal and cardio, possibly CC. Thanks!

Being a fellow is probably closer to being a resident than an attending. After all you will still be in training. How hard you work will depend on where you do your fellowship and the fellowship that you choose. For example, I think that the cardiology fellows at my home program work harder than the interns at the same program. Think about it. You move from top of the residency food chain to the bottom of your subspeciality. Scut work? That is your job to do as well. Renal will probably be much better.

This being said, I think that a lot of hospitalists work very hard as well. I really don't know how anyone can do that work for the rest of their lives and not get burned out.

Keep in mind that fellowship ends after 2-3 years.

Good luck,

boF
 
I dont know why people say that hospitalist work harder or they burn out quicker when what I have seen is that everyone in medicine works pretty hard the only difference is the pay at the end of the day. I have seen cardiologist in my program come in early in the morning and leave late at night and also with Pulm and renal docs.

In the GI elective at my program people tend to get out at 6-7pm.

Everyone in medicine works hard, you just have to find what you like for the hours to go by pretty fast!! IF not is going to be hell.
 
<Everyone in medicine works hard>

It's true that if you want to be good at anything in medicine, you have to be willing to work at it. However, I have friends who are fellows in ID/rheum/endocrine, etc. as well as friends who are psych docs and there is no comparison between that and doing some fellowship like cardiology or pulm/critical care, or being a surgeon, for example. There is orders of magnitude more work involved in being something like a neurosurgeon vs. being a psychiatrist. That doesn't mean that both aren't important or that you don't have to do some hard work to be a good shrink, but they just aren't the same. Liking your work does make the time seem to pass faster, but for some people (who like more free time, or have small kids, etc.) there isn't any amount of interest or "coolness" of the work they are doing that could make up for working the longer hours needed for some specialties.

I think the hours as a cards fellow really can vary a ton depending on where you train. The cards fellows where I did residency didn't work nearly as much as a medicine intern would work, but they did work pretty hard on call.
 
It's curious to me that some specialties "require" more hours than others because it seems to me that someone should be able to choose the number of hours he/she works and accept less pay for working fewer hours, regardless of what field they are in. But the reality of the situation seems to be that there are only contracts available for x number of hours, x being a lot, in certain specialties, and there is no way to get around it?
 
I am at the point where I am trying to decide between doing a fellowship and working as a hospitalist or some other pathway and I'm wondering what the lifestyle is during fellowship. As an intern I'm working 80 hours/week and after 4 years of medical school and 2 more years of residency I'm starting to think more about lifestyle which I did not consider as a medical student going into IM (o/w I probably would've given some consideration to ophtho, derm, anesthesia, etc). Is being a fellow similar to being a resident than attending and how many hrs/week is it? I'm thinking about renal and cardio, possibly CC. Thanks!

Well, you've chosen 3 of the 4 worst specialties in terms of lifestyle during fellowship. Cards works a ton where I am (they have in-house call) and the first year fellows in particular get worked pretty hard. Renal has home call but they get paged constantly at night for every crazy lab value on dialysis patients. They also tend to have a pretty large consult service, plus they have to see everyone getting HD. CCM is nice is that, in general, when you're in the hospital you're working and when you're home, you're off. That said, they tend to be busy while in the hospital and the hours are variable and you'll do a lot (half-ish) of night shifts.

Keep in mind that those are only during training. You will have more flexibility in your hours as an attending but you may have to choose to work in a larger group/hospital in order to get it.
 
I dont know why people say that hospitalist work harder or they burn out quicker when what I have seen is that everyone in medicine works pretty hard the only difference is the pay at the end of the day.

I don't think anyone said that or made that comparison. Perhaps you need to reread the previous posts?

That being said I find your assertion that everyone in medicine works pretty hard with the only difference being pay...well, just plain ludicrous.
 
It's curious to me that some specialties "require" more hours than others because it seems to me that someone should be able to choose the number of hours he/she works and accept less pay for working fewer hours, regardless of what field they are in. But the reality of the situation seems to be that there are only contracts available for x number of hours, x being a lot, in certain specialties, and there is no way to get around it?

I don't think I really agree with that statement in its entirety. I can think of many systems where you can work less for less pay. This is especially true for hospitalist work. Work more shifts, earn more money. This is actually true for many specialities as well. Now you may not get benefits/insurance if you don't work x hours, but medicine can be fairly flexible.

boF
 
That being said I find your assertion that everyone in medicine works pretty hard with the only difference being pay...well, just plain ludicrous.

so you think its ok for a primary care doctor to earn 150K, in some places less, and compare that to hospitalist which now are making over 200K in alot of places when bonuses are taking into account,or ED attendings with salaries of over 230K to 270K with shift hours?

I really think that in medicine (physicians) everyone works pretty hard.

If you think that my statement is ludicrous that's ok everyone has an opinion but please go into fellowship or you'll be pretty unhappy in primary care!!!
 
Ummm...
I think you just proved his point.
ER docs and hospitalists make more money for less hours of work than traditional primary care. Derm often makes a killing despite normal-type work hours (i.e. 40/week) and pretty much no call. Etc. etc.
 
so you think its ok for a primary care doctor to earn 150K, in some places less, and compare that to hospitalist which now are making over 200K in alot of places when bonuses are taking into account,or ED attendings with salaries of over 230K to 270K with shift hours?

I really think that in medicine (physicians) everyone works pretty hard.

If you think that my statement is ludicrous that's ok everyone has an opinion but please go into fellowship or you'll be pretty unhappy in primary care!!!

Epic Fail!

Your entire post contradicts your central argument.

Please do a better job of communicating what you are trying to communicate or at least make a reasonable logical argument.
 
I don't think I really agree with that statement in its entirety. I can think of many systems where you can work less for less pay. This is especially true for hospitalist work. Work more shifts, earn more money. This is actually true for many specialities as well. Now you may not get benefits/insurance if you don't work x hours, but medicine can be fairly flexible.

boF

So I can specify that I am going to work 40 hours/wk with no call? Are there positions like this available for subspecialists or even hospitalists?
 
Many/most hospitalists don't take "call" per se, since a lot of them work 12 hour shifts. You can't really dictate your hours in most hospitalist job, but there is some wiggle room in a lot of them (i.e. can take more shifts if you want to make more money). I have seen part time hospitalists, but usually they worked out this deal after already having been full time for a few years.

For subspecialists, you generally can't dictate that you won't take call, if you are working for a hospital or group practice. If you go into practice for yourself in something like GI, at least in theory you could refuse to take all hospital call, perhaps, but part of it depends on what are the rules for hospital privileges in the hospital(s) where you want to admit patients. Many hospitals require all docs on staff to take some call - it's not something anybody likes to do, but somebody has to see the consults that come in the ER at night...
I have heard of GI docs who don't take call, however...probably if you don't ever want to admit any patients to a hospital, you could fashion yourself an outpatient-only GI practice, assuming you have some sort of surgicenter or office where you can do stuff like colonoscopies.

If you don't want to take much of any call, then I'd do something like rheum, endocrine or allergy/immuno - for these you'd have very little call, esp. for allergy/immuno.
 
Posting on SDN seems to be a less than direct way to get an answer to your question.

You're a medicine resident - why don't you just ask the specialist fellows and attendings in your institution what their hours are like?
 
What about just moonlighting? is that more of a flexible type of thing if one wants to work part-time after residency? I'm not talking about making >100k per year or anything.
 
👎 - at my program the hospitalists are paid around 200K
- work 1 week on and one week off
- 12 hr shift
- may or may not have residents
- they get to babysit non medical patients especially during out of hours as the "SPECIALISTS" are at home..my program only has Int Med residency so they get dumped with all fractures (non trauma), bowel obstructions,cholecystitis,pancreatitis,and all surgical patients short of a ruptured AAA or aneurysmal bleed under the guise of managing medical co morbidities!!! so the hospitalists see the patient at night start on meds and surgeon walks in next morning does his cutting and manages the post op course for the next few days and hospitalist ends up doing the d/c summaries. they also end up talking to families during post op periods as nurses are more comfortable calling hospitalists and are more scared of surgeons who always have an excuse of being in OR!!!

to put it shortly its like a dumping ground vs managing all inpatients depending on how you look at it.
- even patients don't value your 2 cents and are mostly wanting to be seen by respective specialists for everything when you are looking after them however knowledgeable you are ....it can make you feel like s***

guess I sound too cynical no disrespect to the hospitalists (I'll be one next year for sure)😡😡😡
 
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