Fellowship that pays well/Future jobs

[tiredradsres]

I'm looking for a fellowship program (don't care about subspecialty, all the same) that would pay me well.

I know the ACGME programs will lock the salary at PGY6 level. I guess I am more interested in the non ACGME ones.

Is there any fellowship program that would appoint you at Clinical Instructor level and pay you at that rank (usually around 250 000$)?

Alternatively, are there any cush highly reputed well paying programs (ie hidden gems)? For clarity, I'm not interested in moonlighting that would add extra work on top of an already exhausting low-paid subspecialty training program.

Job-wise, is it possible to secure an assistant professor position prior to finishing residency on the condition that you complete a subspecialty fellowship? Have you heard this being done? Is it common?

I am really tired of training and honestly would even forego fellowship if I could. I find this trend of heavy sub specialization in medicine aberrant.

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[GoPelicans]

I also hate that we are bascially required to do fellowship in radiology, I would happily take a little less pay to be a generalist.

 

[guytakingboards]

I'm looking for a fellowship program (don't care about subspecialty, all the same) that would pay me well.

I know the ACGME programs will lock the salary at PGY6 level. I guess I am more interested in the non ACGME ones.

Is there any fellowship program that would appoint you at Clinical Instructor level and pay you at that rank (usually around 250 000$)?

Alternatively, are there any cush highly reputed well paying programs (ie hidden gems)? For clarity, I'm not interested in moonlighting that would add extra work on top of an already exhausting low-paid subspecialty training program.

Job-wise, is it possible to secure an assistant professor position prior to finishing residency on the condition that you complete a subspecialty fellowship? Have you heard this being done? Is it common?

I am really tired of training and honestly would even forego fellowship if I could. I find this trend of heavy sub specialization in medicine aberrant.

You're clearly tired, cuz none of what you're saying makes much sense logically.

-No, I'd strongly doubt there's a fellowship out there that pays even $100k without substantial after hours work.

-Seriously you don't care at all about the subspecialty? That's bonkers. At minimum that has a huge influence on your job market much less the rest of your career.

-Job-wise, right now yea i bet academic shops are considering interviewing 4th years for positions just based on the market. That's already being done on the private practice side. The bigger question is, if you're really in it for the money why would you want an academic job?

 

[elanmorin]

I don't think he's in the for the money per se. It sounds like OP is tired of training and wants a laid back job that pays "well enough" without having to work resident/fellow hours.

 

[2brads]

Doesn't exist. 2nd year of 2 year fellowships have "attending-lite" pay, but that's the opposite of what you want.

 

[tiredradsres]

To answer some of the above replies, I am repulsed by how fully-fledged specialist physicians like us end up being treated. I am looking at multiple fellowship programs and many of them do not even list salary information (eg; ''information about salary will be provided on the day of interview''). Note that this was even written before COVID, so residents had to fly there to get more info about this!!! This is all compounded by a match process that was recently enforced. Add all the hassle of moving to some random city for a single year without any guarantee of a job. Seriously, are we not too old to play this game again?... How does all of this fly by us? We all end up being jaded old and poor physicians by the time the hustle ends. Why is no one outraged by this? I don't personally care about the big money. I like the idea of academia, having a stable job, finding a loved one, settling into a community once and for all.

Anyway, back to the main point of discussion, does anyone at least know of some decent fellowship programs with light day work and little call? Or at least the fellowship programs that pay overall better? I see the fellows in my institution being exhausted, overworked, paged all the time; I want to take a break from this and at least be able to enjoy the city where i'll spend this random year of my life.

 

[guytakingboards]

To answer some of the above replies, I am repulsed by how fully-fledged specialist physicians like us end up being treated. I am looking at multiple fellowship programs and many of them do not even list salary information (eg; ''information about salary will be provided on the day of interview''). Note that this was even written before COVID, so residents had to fly there to get more info about this!!! This is all compounded by a match process that was recently enforced. Add all the hassle of moving to some random city for a single year without any guarantee of a job. Seriously, are we not too old to play this game again?... How does all of this fly by us? We all end up being jaded old and poor physicians by the time the hustle ends. Why is no one outraged by this? I don't personally care about the big money. I like the idea of academia, having a stable job, finding a loved one, settling into a community once and for all.

I get where you're coming from. The process is unpleasant, for sure. Yet a lot of what you're expressing sounds more like burnout and/or lack of perspective.

Salary transparency is not just a issue for the fellowship hunt; it's an issue for attending jobs as well (academics or PP). Don't expect to have a good idea of attending job compensation packages until you go interview. A lot of places consider that privileged/competitive information and they only give it out to people they've vetted, invited for interview and are considering offering. ---- AND this is by no means exclusive to medicine. This is how job searches work in several professional fields. It can seem jarring at the point you are in training because you're a lot older than many people who experience it for the first time.... but that's how job hunts go.

You don't have to move for fellowship unless there is literally no fellowship program in your current city. Especially considering you'd do ANY subspecialty fellowship, your local options shouldn't be that limited.

Sidenote: right now is as good a time as ever to sign the first attending contract before you even go to fellowship. 1 out of my 6 co-fellows had his attending job already signed before he started and anecdotally it seems to be becoming more frequent as the job market tightens.

Once you find your job, get settled, find your loved one, etc... this will all be an unpleasant memory. But maybe/hopefully you'll find the juice was worth the squeeze.

 

[2brads]

I can't think of a single person who took salary into account when picking a fellowship. Generally speaking, you should be looking for a program in your specialty of choice in a city you don't despise at a reputable institution. There is not much differential in fellowship salaries. You'll all be making like $70k +/- 10%. A lot of public institutions post PGY salary scales, which are non-negotiable and have COLA raises baked in.

Lowest call/night fellowships would be MSK since there are almost no MSK emergencies. High call would be neuro and peds.

 

[Neopolymath]

I can't think of a single person who took salary into account when picking a fellowship. Generally speaking, you should be looking for a program in your specialty of choice in a city you don't despise at a reputable institution. There is not much differential in fellowship salaries. You'll all be making like $70k +/- 10%. A lot of public institutions post PGY salary scales, which are non-negotiable and have COLA raises baked in.

Lowest call/night fellowships would be MSK since there are almost no MSK emergencies. High call would be neuro and peds.

What is breast fellowship like workload-wise? Are most of these folks taking a lot of general call?

 

[2brads]

Oh yeah. Breast would also be low call. A lot of programs require all fellows to do some general/ER call as well though.

 

[Cognovi]

Lowest call/night fellowships would be MSK since there are almost no MSK emergencies. High call would be neuro and peds.

That's not generalizable. MSK fellowship at my institution includes nighttime calls for septic joint aspiration, and weekend calls involving reading 100 MR/CTs over two days. It's not cush.

 

[2brads]

Never said cush. Plus, how many septic joints coming in after hours could you have? 1 per month? That is literally the single MSK emergency.

 

[Cognovi]

Job-wise, is it possible to secure an assistant professor position prior to finishing residency on the condition that you complete a subspecialty fellowship? Have you heard this being done? Is it common?

I have seen this occasionally. It's not outrageous given that most people secure jobs just a few months after finishing residency anyway.

 

[CorneliaSt]

Never said cush. Plus, how many septic joints coming in after hours could you have? 1 per month? That is literally the single MSK emergency.

Septic joint rule out aspirations are pretty common. Usually several a week afterhours at my institution. One time I did 3 in one night!

 

[2brads]

Septic joint rule out aspirations are pretty common. Usually several a week afterhours at my institution. One time I did 3 in one night!

At my fellowship, ortho (or peds) did them after hours so I got called zero times as a fellow.

 

[maxxor]

That's not generalizable. MSK fellowship at my institution includes nighttime calls for septic joint aspiration, and weekend calls involving reading 100 MR/CTs over two days. It's not cush.

I took call for 11 weeks my msk fellowship. I came in multiple times every week for aspirations. You get real good at doing them on crappy GE fluoro tables while half asleep.

And yes it was 80-100 CT/MR over the weekend.

 

[Rad2013]

To answer some of the above replies, I am repulsed by how fully-fledged specialist physicians like us end up being treated. I am looking at multiple fellowship programs and many of them do not even list salary information (eg; ''information about salary will be provided on the day of interview''). Note that this was even written before COVID, so residents had to fly there to get more info about this!!! This is all compounded by a match process that was recently enforced. Add all the hassle of moving to some random city for a single year without any guarantee of a job. Seriously, are we not too old to play this game again?... How does all of this fly by us? We all end up being jaded old and poor physicians by the time the hustle ends. Why is no one outraged by this? I don't personally care about the big money. I like the idea of academia, having a stable job, finding a loved one, settling into a community once and for all.

Anyway, back to the main point of discussion, does anyone at least know of some decent fellowship programs with light day work and little call? Or at least the fellowship programs that pay overall better? I see the fellows in my institution being exhausted, overworked, paged all the time; I want to take a break from this and at least be able to enjoy the city where i'll spend this random year of my life.

I know of a program that pays non-ACGME fellows close to 100k (I think). But, they work hard.

If you are interested in working nights, you may be able to find a night gig with a PP group without a fellowship. I know of someone who did that.

You’re not going to find a fellowship paying 250k. But you may be able to find a fellowship that is relatively light work wise. Likely academic programs that are bloated with more attendings, residents and fellows than you can shake a stick at. Or a program that is considered resident-driven where the residents get leaned on heavily and the fellows are seen as back up.

Lastly… for simplicity-sake, can you just do a non-ACGME fellowship where you are doing residency and just sign on outside of the match and skip that nonsense entirely?

 

[clutch21]

Barrow is one to look at. Pay is similar to everywhere else, but you’re given an “academic day” every week. I know prior fellows who have taken advantage of that day off to do external moonlighting in the area. ~150k+ on the year would probably be doable without even working extra weekends.

 

[Rad2013]

I just checked out the Barrow website. 7am-3pm with one academic day a week sounds AMAZING.

 

[Hippocrates II]

I also hate that we are bascially required to do fellowship in radiology, I would happily take a little less pay to be a generalist.

I've interviewed at a few programs where grads were going straight into PP. I'm sure it's very regional but it seems like the opportunities are there for non-fellowship trained PP radiologists throughout the Midwest. Can't speak to other places

 

[Neopolymath]

I've interviewed at a few programs where grads were going straight into PP. I'm sure it's very regional but it seems like the opportunities are there for non-fellowship trained PP radiologists throughout the Midwest. Can't speak to other places

The problem to me is when you want to change jobs and it's not a hot market and medicine is even more (ridiculously) over-specialized. Seems more painful and inflexible than just biting the bullet and doing another year of training now.

 

[maxxor]

The problem to me is when you want to change jobs and it's not a hot market and medicine is even more (ridiculously) over-specialized. Seems more painful and inflexible than just biting the bullet and doing another year of training now.

This is also entirely referring dependent. Your practice could always get a new contract that demands subspecialty trained interpretations and the “general” rads are banned from that work.

This literally happened in my previous job. New Ortho mri contract; all former MSK readers except those with MSK fellowships not allowed to read the new work.

 

[Hippocrates II]

The problem to me is when you want to change jobs and it's not a hot market and medicine is even more (ridiculously) over-specialized. Seems more painful and inflexible than just biting the bullet and doing another year of training now.

Yeah, I agree, I wouldn't do it personally. After speaking with a few senior residents heading off to fellowship, it sounds like you can do some really lucrative moonlighting as a fellow and earn a pretty substantial salary. Maybe not attending-level, but enough that the sting of fellowship isn't too bad financially.

 

[MadRadLad]

This is the trend at most places. Most of our referring clinicians prefer subspecialty reads. We get so many calls for subspecialty overreads that it's not worth it to have non-fellowship trained people read, because eventually those calls make the subspecialists have to do much more unpaid work and decreases throughput. Some clinicians (usually big ortho groups, surgical groups etc) put in a facesheet for outpts stating the study MUST be read by a subspecialty trained rad.

n=1 but every major health system in my area will not hire non-fellowship trained rads unless it's for some tiny hospital/very basic outpatient coverage job that literally nobody else wants. I'm sure this doesn't hold up as much in rural and less competitive locations. But as a resident at this point if you don't do a fellowship you might be fine for a few years but if the market dips again you are going to be bottom of the list for hiring and one of the first to get laid off. Most likely even you won't get a job (or interview) at most major medical centers or large private practice unless you have some ties.

 

[starwarsfan123]

I can't think of a single person who took salary into account when picking a fellowship. Generally speaking, you should be looking for a program in your specialty of choice in a city you don't despise at a reputable institution. There is not much differential in fellowship salaries. You'll all be making like $70k +/- 10%. A lot of public institutions post PGY salary scales, which are non-negotiable and have COLA raises baked in.

Lowest call/night fellowships would be MSK since there are almost no MSK emergencies. High call would be neuro and peds.

what if your home program (mid-tier) provides home workstation which you can moonlight from and generate 200k+ from home (Afterhours) during fellowship. Would you take that over a "prestigious" program in a high cost of living city, long hours, without much time to breath, being uneccesarily exploited because they can get away with it due to their name/national reputation? Would that hurt you in the long run if you decide to go to academia after a few years in pp?

 

[PhysMatMan]

It depends because sometimes being able to moonlight means having to moonlight. Sometimes moonlighting means being paid far below your worth as an attending to do an attending job. Mid-tier fellowship shouldn't prevent you from being able to go into some academic job though. Obviously a higher power academic fellowship will make you more desirable for higher power academic jobs, but it's not an all or none situation.

 

[Smallfishtinypond]

-No, I'd strongly doubt there's a fellowship out there that pays even $100k without substantial after hours work.

I did a fellowship 15 years ago in MSK and Body with a salary on $120K and $8000 bonus. 3 weeks vacation, 1 week CME. Trained us well. We read for a NBA and a MLB teams at one location and another at a transplant center. Such things do exists.

 

[Feelgood MD]

I haven't heard of fellowship gigs where anyone gets close to 250k. Granted I know little about this stuff but I cant imagine a number like that is common. I do know of a private practice fellowship (mostly MSK) with no call, no gen rad at $130k base. Optional moonlighting available in contrast coverage or gen rad. 12 months duration.