Help Needed! High-ranked fellowships vs community training

[Rueonc]

Advertisement - Members don't see this ad

Hi! I am a current resident at a top IM program, and have spent the past decade training in high academic settings. We are affiliated with a top academic oncology program. While, I have been loving the training of research and sub-specialization, I very much want to keep the door to community practice open. This seems hard since, when I apply to fellowship, it seems I may have to restrict the kinds of programs I apply to in order to get adequately trained for all malignancies. It is tough because most of the alumni from my program seem to go into the top academic onc centers - if I were to do this, would it restrict what practice I can do eventually? Feeling frustrated with the system of training and pay discrepancies - wish there was flexibility with where you can go after fellowship. Hoping that I can get some clarity from people in the field. For those who went into community practice, what kinds of fellowships did you go to and did any of you come out of academic centers that were research focused?

 

[HemeOncHopeful19]

It’s not a bad thing to put that you trained at <insert cancer center your grandma would recognize> on your private practice website

 

[gutonc]

It’s not a bad thing to put that you trained at <insert cancer center your grandma would recognize> on your private practice website

^This.

If you want to go into community practice from an "academic powerhouse", you can always spend your 3rd year rotating in as many clinics as you have time for and get a job based solely on the strength of your fellowship program, even if you're a total d-bag who can't hold a 5 minute conversation with a stranger (not saying that's who you are, but I've interviewed a f-ton of those people and they always get good jobs).

If, OTOH, you wind up wanting to be a sub-specialized physician-scientist or clinical trialist, it's damn near impossible to do that coming from a community program with no research to speak of.

So, choose the program that fits you best and will support the "highest aspirations" you have. The rest will fall into place.

I've shared this before, and my experience is wildly out of date since it's been almost 20 years since I interviewed for fellowship, so I can't say this remains "true". But the "academic powerhouses" where I interviewed (UCSF, NW, MSKCC, FHCC, DFCI) all readily admitted that roughly half of their fellows went into community practice and they all supported that for them. The smaller, less famous programs (including the one I graduated from) all pretended that anyone who graduated from there and didn't go into academics was an anomaly and they weren't sure how they managed to get into the fellowship in the first place (despite the fact that 50-80% of their fellows went to non-academic jobs every year).

 

[Rueonc]

So so helpful and very grateful! Worried I have to decide pre-fellowship when I’d want to keep my options open. Hoping it wouldn’t be looked down in these programs if I end up deciding community practice down the line. Tough and appreciate again!

 

[HemeOncHopeful19]

So so helpful and very grateful! Worried I have to decide pre-fellowship when I’d want to keep my options open. Hoping it wouldn’t be looked down in these programs if I end up deciding community practice down the line. Tough and appreciate again!

It might be looked down upon, but you’ll dry your tears with dollar bills