Flexible time in rheum fellowship

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mdjo

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So for my second year of rheum fellowship, we get a bit of flexibility in deciding our schedules. I have 2 days a week I can fill however I want--research/flex time, continuity clinic, ultrasound/injection clinic, other subspecialty clinics. I've had such a busy first year that I'm kind of inclined to just use it all for research/flex and get to relax for once (I do have enough research projects to fill that time). But I also wonder if I'm missing out on being a better rheumatologist by giving up chances to learn during extra clinics, or if being certified in ultrasound would be helpful in my career (I won't get another chance to spend so much time learning it). I guess I'm just not sure how to balance my time. I think there's a 70% chance I'll end up in academia as some kind of clinician educator, but a 30% chance that won't work out in the geographic area I'd like so could end up in PP.

How would you divide that extra time? FWIW during the other three days a week I will be doing didactics, 2 other continuity clinics, and 1-2 subspecialty clinics (myositis, rheum-derm, etc), so those extra 2 days would be in addition to this.
1. Do you wish you had had more clinical time in fellowship or should I take it easy?
2. Do you wish that you had gotten formal ultrasound training? (I think MSK US is diagnostically really cool but I've only done it like 5 times in clinic this whole year, so is it worth spending an afternoon a week for a year training in it?)
3. How helpful would it be to spend a ton of time in the myositis clinic (or whatever) and leverage that as special training/expertise in that rheum subspecialty?

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Is there any reason you can't mix it up over the course of the year? Like have those 2 days be flex/research for the first 2-3 months, then add another half/full clinic day later in the year if you want to?

Pretty much every 2nd year fellow (non-cards/GI) that I knew slacked off for the first 2-3 months of 2nd year, then buckled down after that.
 
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