Fellowships

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A fellowship provides subspecialty training after residency.

Without a fellowship, (but after three years of residency) you might be an Internist. With a fellowship you could specialize in cardiology, allergy, pulmonology, nephrology, GI, oncology, etc.

OR without a fellowship you might be a general surgeon (after 5 years of residency), but with one you could be a cardiothoracic surgeon, vascular surgeon, plastic surgeon, trauma surgeon, etc.

OR without a fellowship you could be a pediatrician (after three years of residency), but with one you might become a geneticist, neonatologist, peds allergist, peds cardiologist, peds GI, peds oncologist, infectologist, etc.

OR without a fellowship you might train as an OBGYN (with a four year residency). With a fellowship, you could be a fertility specialist, gyne cancer specialist (pelvic and reconstructive surgery, or specialist in disorders of pregnancy (I forget the name of it).
 
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Stratego said:
A fellowship provides subspecialty training after residency.

Without a fellowship, (but after three years of residency) you might be an Internist. With a fellowship you could specialize in cardiology, allergy, pulmonology, nephrology, GI, oncology, etc.

OR without a fellowship you might be a general surgeon (after 5 years of residency), but with one you could be a cardiothoracic surgeon, vascular surgeon, plastic surgeon, trauma surgeon, etc.

OR without a fellowship you could be a pediatrician (after three years of residency), but with one you might become a geneticist, neonatologist, peds allergist, peds cardiologist, peds, GI, peds oncologist, infectologist, etc.

OR without a fellowship you might train as an OBGYN (with a four year residency). With a fellowship, you could be a fertility specialist, gyne cancer specialist (pelvic and reconstructive surgery, or specialist in disorders of pregnancy (I forget the name of it).
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oh thanks a lot bro ! what would i need to do if i just want to become an internist / family doctor / general practitioneer ?
 
Stratego said:
A fellowship provides subspecialty training after residency.

Without a fellowship, (but after three years of residency) you might be an Internist. With a fellowship you could specialize in cardiology, allergy, pulmonology, nephrology, GI, oncology, etc.

OR without a fellowship you might be a general surgeon (after 5 years of residency), but with one you could be a cardiothoracic surgeon, vascular surgeon, plastic surgeon, trauma surgeon, etc.

OR without a fellowship you could be a pediatrician (after three years of residency), but with one you might become a geneticist, neonatologist, peds allergist, peds cardiologist, peds, GI, peds oncologist, infectologist, etc.

OR without a fellowship you might train as an OBGYN (with a four year residency). With a fellowship, you could be a fertility specialist, gyne cancer specialist (pelvic and reconstructive surgery, or specialist in disorders of pregnancy (I forget the name of it).
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Nice post. But how long would the fellowships take?
 
General practioner just takes one year of training after med school. You can't get board certified if you do this. The only place you could practice is the armed services, VA hospital, or walk-in clinic (to my knowledge). I doubt you could get hospital privileges anywhere. Well, maybe N. Dakota twenty years ago (one person I know).

Internist and Family doctor each take three years of residency training to be board eligible/certified.
 
Global Warming said:
Nice post. But how long would the fellowships take?
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Two to three years for everything except maybe some of the surgical subspecialties (which I'm not sure about), like neurosurgery probably takes longer.
 
so in order to just open up my own clinic , take care of my patients diagnosis them , give them medicine, take blood , urine samples from them i would only need 1 year of residency after medical school ? no fellowship needed ?
 
After the year of training, you have to pass Step 3 of the USMLEs to get independently licensed and have prescription writing privileges. (In residency I think you write prescriptions under the license of the training institution).

I'm not sure if you could buy medical malpractice insurance on your own. It might be hard to find a vendor that will sell it to you with only one year of training. That's why people work for the government in this situation.
 
Genetic said:
so in order to just open up my own clinic , take care of my patients diagnosis them , give them medicine, take blood , urine samples from them i would only need 1 year of residency after medical school ? no fellowship needed ?
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Sounds pretty scarey, huh?
 
Stratego said:
Sounds pretty scarey, huh?
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now i know for sure who to go to when i need help in the future. my dream is to become a general practitioner. i just like helping familys while proscribing medicine while im at it. thanks a lot stratego 👍
 
now i know for sure who to go to when i need help in the future. my dream is to become a general practitioner. i just like helping familys while proscribing medicine while im at it. thanks a lot stratego 👍
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Good for you - and for everyone else

There's a dearth of GPs in this world
 
Stratego said:
A fellowship provides subspecialty training after residency.

Without a fellowship, (but after three years of residency) you might be an Internist. With a fellowship you could specialize in cardiology, allergy, pulmonology, nephrology, GI, oncology, etc.

OR without a fellowship you might be a general surgeon (after 5 years of residency), but with one you could be a cardiothoracic surgeon, vascular surgeon, plastic surgeon, trauma surgeon, etc.

OR without a fellowship you could be a pediatrician (after three years of residency), but with one you might become a geneticist, neonatologist, peds allergist, peds cardiologist, peds GI, peds oncologist, infectologist, etc.

OR without a fellowship you might train as an OBGYN (with a four year residency). With a fellowship, you could be a fertility specialist, gyne cancer specialist (pelvic and reconstructive surgery, or specialist in disorders of pregnancy (I forget the name of it).
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Maternal fetal medicine (perinatology)
 
now i know for sure who to go to when i need help in the future. my dream is to become a general practitioner. i just like helping familys while proscribing medicine while im at it. thanks a lot stratego
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I think there may be a bit of a misunderstanding of terms here. If you want to practice "general medicine," I would highly recommend a residency in internal medicine or family practice. After you have invested 4 years in college, and 4 years in med school, what is the difference between a 1-year and 3-year residency? Not that much. A 3-year residency will make you a better doctor, it will make the bureacratic licensing-stuff easier, it will give you more pay (for the most part), etc.
 
Genetic said:
so in order to just open up my own clinic , take care of my patients diagnosis them , give them medicine, take blood , urine samples from them i would only need 1 year of residency after medical school ? no fellowship needed ?
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Stratego said:
Sounds pretty scarey, huh?
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It seems to me the point here is that having only one year of post-med school training doesn't give you optimal preparation to give the best service to your patients. OP, if you do a Family Medicine residency for three years, you can better provide for the needs of your patients as a GP, you'll be trained to care for all age groups, you can become board certified, you can get hospital privileges and appropriate malpractice insurance.

You could practice with only one year of residency and passing all the Step tests, but why not get fully trained so you can do a better job?
 
Catalystik said:
It seems to me the point here is that having only one year of post-med school training doesn't give you optimal preparation to give the best service to your patients. OP, if you do a Family Medicine residency for three years, you can better provide for the needs of your patients as a GP, you'll be trained to care for all age groups, you can become board certified, you can get hospital privileges and appropriate malpractice insurance.

You could practice with only one year of residency and passing all the Step tests, but why not get fully trained so you can do a better job?
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that is true. my main goal is to really take good care of my patients. i'd probably want to make sure i don't mess up so i'd probably do family residency.
 
Catalystik said:
It seems to me the point here is that having only one year of post-med school training doesn't give you optimal preparation to give the best service to your patients. OP, if you do a Family Medicine residency for three years, you can better provide for the needs of your patients as a GP, you'll be trained to care for all age groups, you can become board certified, you can get hospital privileges and appropriate malpractice insurance.

You could practice with only one year of residency and passing all the Step tests, but why not get fully trained so you can do a better job?
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How common is it to only complete one year of residency (only intern year)? I was under the impression that everyone did a full residency (shortest is 3 yrs) with the exception of military docs in special situations.
 
I don't think it's very common these days. I know of several older doctors who did this. One went into the navy and became a General Medical Officer. One emigrated to Israel and joined a kibbutz. One couldn't pass his Step III and moved to the Caribbean where he's allowed to practice. And the last has worked in a walk-in clinc for 25+ years. I know of two others who dropped out of their residencies after a year due to, ahemmm, political differences with the administration, who felt so limited by their lack of training that they eventually completed a residency elsewhere, over ten years later.
 
Do most internists do fellowships following three-year residency training? I see a lot of cardiologists, oncologists, GI, etc but I don't see just pure internists. Is this because the fellowship specialists get much more compensation than pure internists?
 
BlueElmo said:
Do most internists do fellowships following three-year residency training? I see a lot of cardiologists, oncologists, GI, etc but I don't see just pure internists. Is this because the fellowship specialists get much more compensation than pure internists?
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There are a lot of internists than GI docs and Cardio docs combine. You might not get to know or see them. Fellowship is just having a specialization in one area of medicine... Internists are general practioner so to speak. They take care of everyone except pedriatric patients and pregnant females. However, when they get a complicated case they cant figure out, they refer patient to a specialist like GI docs, Cardio docs, Onco docs ect... who has more knowledge in that particular field. Doing a fellowship like GI, Cardio will increase your earning potential due do insurance reimbursement (very complicated, cant explain that to you). However, not all felllowships will make you earn more money than an internist. For instance, doing a infectious disease fellowship (2 years), will not increase your earning potential much more than an internist. In fact, the average salary in the region that I am leaving now for a ID (infectious disease) doctor is about
170,000/year. Hospitalists (most are internists, few are family docs) in my region are making about $200,000/year.
 
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demayette said:
There are a lot of internists than GI docs and Cardio docs combine. You might not get to know or see them. Fellowship is just having a specialization in one area of medicine... Internists are general practioner so to speak. They take care of everyone except pedriatric patients and pregnant females. However, when they get a complicated case they cant figure out, they refer patient to a specialist like GI docs, Cardio docs, Onco docs ect... who has more knowledge in that particular field. Doing a fellowship like GI, Cardio will increase your earning potential due do insurance reimbursement (very complicated, cant explain that to you). However, not all felllowships will make you earn more money than an internist. For instance, doing a infectious disease fellowship (2 years), will not make you increase your earning potential much more than an internist. In fact, the average salary in the region that I am leaving now for a ID (infectious disease) doctor is about
170,000/year. Hospitalists (most are internists, few are family docs) in my region are making about $200,000/year.
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Do internists work in hospitals or mostly in private practice?
 
BlueElmo said:
Do internists work in hospitals or mostly in private practice?
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Internists do pretty much the widest array of everything as far as work environment goes. Hospital and clinical settings - even your allergist (NOT ENT) is an internist!
 
BlueElmo said:
Do internists work in hospitals or mostly in private practice?
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Let say that most internists or physicians do both... I will explain myself. The majority of physicians including internists have their own practice (or they work in a group). Also, most of them have what they called "hospital privilege" or " staff privilege" depending what part of the country they are. They have that because if they have patients that they cannot manage their illness(es) as an outpatient, they admit them to a hospital where they have privilege. After admitting these patients, they have to make round to see these patients and make proper referrals to other physicians. In addition, these patient receive 24/7 nursing care. In a way, most physicians work in both hospital and private practice.
 
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What exactly is a hospitalist? It sounds like a really broad term...for a doctor who works in a hospital? Or a doc who takes care of hospital patients?
 
FloatOn said:
What exactly is a hospitalist? It sounds like a really broad term...for a doctor who works in a hospital? Or a doc who takes care of hospital patients?
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I think they are internists working in hospitals who mostly deal with inpatients.
 
FloatOn said:
What exactly is a hospitalist? It sounds like a really broad term...for a doctor who works in a hospital? Or a doc who takes care of hospital patients?
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Hospitalist are physicians who work for hospital doing admissions for patients who do not have a primary physician that will follow them during their hospital stay. In the region that I am in now, they work 7a-7p or 7p-7a 3 days a week or 14 days/month for the most part making $190,000+/year.
 
Stratego said:
Two to three years for everything except maybe some of the surgical subspecialties (which I'm not sure about), like neurosurgery probably takes longer.
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A med student can correct me if I'm wrong, but it's my understanding that some of the surgical subspecialties (plastics, ortho, maybe neuro?) have their own residencies, in which you do a general surgery internship year and then move directly into training for your field of choice. This lets you do it faster than 5 years gen surg + 3 years fellowship.

BlueElmo said:
Do most internists do fellowships following three-year residency training? I see a lot of cardiologists, oncologists, GI, etc but I don't see just pure internists. Is this because the fellowship specialists get much more compensation than pure internists?
Click to expand...

In addition to what others have said, I think a fair number of them are in private practice as family physicians.
 
JimmerJammerMrK said:
A med student can correct me if I'm wrong, but it's my understanding that some of the surgical subspecialties (plastics, ortho, maybe neuro?) have their own residencies, in which you do a general surgery internship year and then move directly into training for your field of choice. This lets you do it faster than 5 years gen surg + 3 years fellowship.
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Yes, it is possible to do it this way for some of the surgical subspecialties. These programs exist, and are highly desirable because they take less time, but everyone doesn't know where their interests will lie until they've entered a general surgery residency. So both paths are possible.
 
JimmerJammerMrK said:
In addition to what others have said, I think a fair number of them are in private practice as family physicians.
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I think that Family Physicians, by definition, take care of kids too. Internists are not trained in pediatric care, so at most, they might see teens from the lower age range.

Most Internists do not do a fellowship. Fellowships are competitive and spaces are limited. My neighbor tried to get into a Pulmonary Fellowship after his Internal Med residency, applied to 40 programs, and didn't get in anywhere. Instead, he became a hospitalist making $250,000/year with no additional training. Nice, huh?

Becoming a subspecialist is desirable because of the greater income. A higher income tends to be linked to doing procedures. Thus, an Infectologist tends not to make more despite additional training, as they don't (generally) do procedures.
 
Stratego said:
Yes, it is possible to do it this way for some of the surgical subspecialties. These programs exist, and are highly desirable because they take less time, but everyone doesn't know where their interests will lie until they've entered a general surgery residency. So both paths are possible.
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Thanks for the clarification.

Stratego said:
I think that Family Physicians, by definition, take care of kids too. Internists are not trained in pediatric care, so at most, they might see teens from the lower age range.

Most Internists do not do a fellowship. Fellowships are competitive and spaces are limited. My neighbor tried to get into a Pulmonary Fellowship after his Internal Med residency, applied to 40 programs, and didn't get in anywhere. Instead, he became a hospitalist making $250,000/year with no additional training. Nice, huh?

Becoming a subspecialist is desirable because of the greater income. A higher income tends to be linked to doing procedures. Thus, an Infectologist tends not to make more despite additional training, as they don't (generally) do procedures.
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That's true. I guess I meant more of a general practitioner (for adults).
 
FYI, neurosurg is usually a 7 year residency...not including fellowship training.

I can only speak to the Army residency programs...in my understanding, for more specialized surgical programs you match into your specialty, but your intern year is likely to be fairly similar to what the general surg interns are doing in their intern year
 
Stratego said:
Most Internists do not do a fellowship. Fellowships are competitive and spaces are limited. My neighbor tried to get into a Pulmonary Fellowship after his Internal Med residency, applied to 40 programs, and didn't get in anywhere.
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As you said, fellowships are exceedingly competitive...it's also not uncommon for docs to practice as internists for a couple years and then go on to do fellowship training. I think it would be foolish to extrapolate your neighbor's fellowship application experience immediately after residency to a representation of fellowships in general though. No offense to your neighbor, but as a med student, I would imagine it fairly unlikely that you can gauge his competitiveness for the positions he was applying to
 
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AnnaBananax said:
As you said, fellowships are exceedingly competitive...it's also not uncommon for docs to practice as internists for a couple years and then go on to do fellowship training. I think it would be foolish to extrapolate your neighbor's fellowship application experience immediately after residency to a representation of fellowships in general though. No offense to your neighbor, but as a pre-med student, I would imagine it fairly unlikely that you can gauge his competitiveness for the positions he was applying to
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I think Stratego is a med student.
 
BlueElmo said:
I think Stratego is a med student.
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Thanks, corrected...but you're kind of missing the forest for the trees...my point was simply that unless he's worked with the neighbor and a bunch of other applicants for pulmonology fellowships, it's unlikely that an isolated experience with one resident is indicative of the fellowship application process in general
 
AnnaBananax said:
it's unlikely that an isolated experience with one resident is indicative of the fellowship application process in general
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Very true. At the time I did not ask him about his Step scores, IM residency evaluations, or other pertinent factors. Still, the situation demonstrates that a fellowship isn't available to all comers.
 
Question: If you do decide to do a fellowship after IM residency, do you get payed like an IM doctor while you are doing your fellowship or are you still stuck with ****ty pay?
 
You still get low pay, a bit better than residency. But not by much.
 
doxycycline said:
Question: If you do decide to do a fellowship after IM residency, do you get payed like an IM doctor while you are doing your fellowship or are you still stuck with ****ty pay?
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$60,000+/year... not bad
 
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