Heme/Onc vs. Endo

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KRMC

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I’ve been a PCP for 4 years and have made the difficult decision to go back for fellowship. My main motivators are to narrow my scope of practice, have more intellectually stimulating work, and better long term lifestyle. Although there are things I love about primary care, I just can’t see myself doing this 15 years from now for many reasons.

I did really well in med school and residency. I have really strong board scores, went to a large university program, and have really good recommendations. (I’m not trying to sound boastful, I’m just trying to give context).

I’ve been torn between Endo and Heme Onc and I would love other perspectives. These are my thoughts.

Heme/Onc is probably what I feel most passionate about. I have found that through my last 4 years of work, I have been the most invested in my patients with cancer, particularly if I found it. I feel like it suits my personality well, most people who know me would probably say I like to take time with my patients, answer questions, and in general would find me to be very compassionate. I am not a researcher though, and Oncology is extremely research based. It’s just never been my passion although I wouldn’t mind to read and stay up to date on cancer treatments if it were part of my job. I truly don’t know what to expect of a heme/onc lifestyle though and I know it varies depending on location. I would not plan to stay in academics. I would probably pursue more of a community setting and do various solid tumors. Other things that I may need to be transparent about as far as my personality goes. I often second guess myself, even when I know I’m right or did the right thing. Bad patient encounters can be extremely emotional and taxing for me. I can sometimes become too invested in people and not separate home and work life.

Endocrine appeals to me because I think it’s very similar to what I do now, minus the chronic pain/anxiety/paperwork/random catch all that primary care has unfortunately become. I think it would be an easy transition for me and it’s a fairly laid back 2 year fellowship. My main concern with endocrine is money. I know that sounds terrible, but I don’t want to give up an attending salary for 2 years to make less, ya know? I like that it’s fairly problem focused, I actually like managing diabetes, and I love that I could remove some of the less desirable parts of primary care.

Let me know your thoughts! Thanks for reading!

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I’ve been a PCP for 4 years and have made the difficult decision to go back for fellowship. My main motivators are to narrow my scope of practice, have more intellectually stimulating work, and better long term lifestyle. Although there are things I love about primary care, I just can’t see myself doing this 15 years from now for many reasons.

I did really well in med school and residency. I have really strong board scores, went to a large university program, and have really good recommendations. (I’m not trying to sound boastful, I’m just trying to give context).

I’ve been torn between Endo and Heme Onc and I would love other perspectives. These are my thoughts.

Heme/Onc is probably what I feel most passionate about. I have found that through my last 4 years of work, I have been the most invested in my patients with cancer, particularly if I found it. I feel like it suits my personality well, most people who know me would probably say I like to take time with my patients, answer questions, and in general would find me to be very compassionate. I am not a researcher though, and Oncology is extremely research based. It’s just never been my passion although I wouldn’t mind to read and stay up to date on cancer treatments if it were part of my job. I truly don’t know what to expect of a heme/onc lifestyle though and I know it varies depending on location. I would not plan to stay in academics. I would probably pursue more of a community setting and do various solid tumors. Other things that I may need to be transparent about as far as my personality goes. I often second guess myself, even when I know I’m right or did the right thing. Bad patient encounters can be extremely emotional and taxing for me. I can sometimes become too invested in people and not separate home and work life.

Endocrine appeals to me because I think it’s very similar to what I do now, minus the chronic pain/anxiety/paperwork/random catch all that primary care has unfortunately become. I think it would be an easy transition for me and it’s a fairly laid back 2 year fellowship. My main concern with endocrine is money. I know that sounds terrible, but I don’t want to give up an attending salary for 2 years to make less, ya know? I like that it’s fairly problem focused, I actually like managing diabetes, and I love that I could remove some of the less desirable parts of primary care.

Let me know your thoughts! Thanks for reading!

Academic leukemia doc so take my assessment with a grain of salt. I also interviewed at hybrid groups and full PP. These weren’t for me but being in NYC metro I was very impressed to find hybrid and PP salaries north of 350 (and the full pp was 425 year 1 on Long Island). Leukemia is obviously a very research heavy field even within oncology. I think research has some benefit and it’ll be to your benefit to go to the best training program. Will make getting a job a bit easier and despite your interest in community practice would be worthwhile IMO to explore academic training programs. As far as the comparison with Endo, it is shorter training probably overall less research but also less compensation (but better quality of life) after training. I too love taking care of oncology patients and I find it very rewarding despite a fair amount of bad outcomes. Good luck
 
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I’ve been a PCP for 4 years and have made the difficult decision to go back for fellowship. My main motivators are to narrow my scope of practice, have more intellectually stimulating work, and better long term lifestyle. Although there are things I love about primary care, I just can’t see myself doing this 15 years from now for many reasons.

I did really well in med school and residency. I have really strong board scores, went to a large university program, and have really good recommendations. (I’m not trying to sound boastful, I’m just trying to give context).

I’ve been torn between Endo and Heme Onc and I would love other perspectives. These are my thoughts.

Heme/Onc is probably what I feel most passionate about. I have found that through my last 4 years of work, I have been the most invested in my patients with cancer, particularly if I found it. I feel like it suits my personality well, most people who know me would probably say I like to take time with my patients, answer questions, and in general would find me to be very compassionate. I am not a researcher though, and Oncology is extremely research based. It’s just never been my passion although I wouldn’t mind to read and stay up to date on cancer treatments if it were part of my job. I truly don’t know what to expect of a heme/onc lifestyle though and I know it varies depending on location. I would not plan to stay in academics. I would probably pursue more of a community setting and do various solid tumors. Other things that I may need to be transparent about as far as my personality goes. I often second guess myself, even when I know I’m right or did the right thing. Bad patient encounters can be extremely emotional and taxing for me. I can sometimes become too invested in people and not separate home and work life.

Endocrine appeals to me because I think it’s very similar to what I do now, minus the chronic pain/anxiety/paperwork/random catch all that primary care has unfortunately become. I think it would be an easy transition for me and it’s a fairly laid back 2 year fellowship. My main concern with endocrine is money. I know that sounds terrible, but I don’t want to give up an attending salary for 2 years to make less, ya know? I like that it’s fairly problem focused, I actually like managing diabetes, and I love that I could remove some of the less desirable parts of primary care.

Let me know your thoughts! Thanks for reading!

Hem/onc is definitely research based; treatment options are changing constantly and needs to be constantly u pdates. Lot of hem onc programs like to train fellows for academic oriented careers but fellows do go for practice as well and practice will be a mix of oncology and mostly benign hematology; malignant hematology tends to be handled in academics typically. Progression talks and new diagnosis can be emotional encounters but patient relationships are highlight of hem onc cause you are helping them defeat cancer with curative intent or palliate symptoms with treatment if metastatic disease. Primary care experience will come in handy cause you sometimes end up dealing with some pcp things too.

Endocrine is a fine field; you can develop long term relationships since most of the pathologies is chronic. Money tends be lower as you pointed out and maybe less heavy on research compared to hem onc.

From a monetary standpoint, hem onc would be ideal but is three years compared to endocrine which is two as you point out. Hem onc is harder to match compared to endo so should take that into consideration.
 
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Academic leukemia doc so take my assessment with a grain of salt. I also interviewed at hybrid groups and full PP. These weren’t for me but being in NYC metro I was very impressed to find hybrid and PP salaries north of 350 (and the full pp was 425 year 1 on Long Island). Leukemia is obviously a very research heavy field even within oncology. I think research has some benefit and it’ll be to your benefit to go to the best training program. Will make getting a job a bit easier and despite your interest in community practice would be worthwhile IMO to explore academic training programs. As far as the comparison with Endo, it is shorter training probably overall less research but also less compensation (but better quality of life) after training. I too love taking care of oncology patients and I find it very rewarding despite a fair amount of bad outcomes. Good luck
All really great points! Thank you for your input. I really appreciate it.
 
Hem/onc is definitely research based; treatment options are changing constantly and needs to be constantly u pdates. Lot of hem onc programs like to train fellows for academic oriented careers but fellows do go for practice as well and practice will be a mix of oncology and mostly benign hematology; malignant hematology tends to be handled in academics typically. Progression talks and new diagnosis can be emotional encounters but patient relationships are highlight of hem onc cause you are helping them defeat cancer with curative intent or palliate symptoms with treatment if metastatic disease. Primary care experience will come in handy cause you sometimes end up dealing with some pcp things too.

Endocrine is a fine field; you can develop long term relationships since most of the pathologies is chronic. Money tends be lower as you pointed out and maybe less heavy on research compared to hem onc.

From a monetary standpoint, hem onc would be ideal but is three years compared to endocrine which is two as you point out. Hem onc is harder to match compared to endo so should take that into consideration.
Thank you so much for your insight! I so appreciate it!
 
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I know you posted this in the hem/onc forum but as endocrine, you need to really like the specialty...because the money is not any more than being a pcp...and you probably would take a pay cut...job security though is good, since endocrine is in demand.

If all you want to do is diabetes... there are 1 year diabetes fellowships out there...non ACGME but you could focus on it and only have to do a year fellowship.

I don’t know if I would call endo fellowship chill...since there are few fellows a year...1-2/ year, you do have a number of months as inpt and depending on how busy a service , you can be on a lot...it’s not gi or cards, but can be tiring.

Do what you are going to enjoy doing.
 
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I know you posted this in the hem/onc forum but as endocrine, you need to really like the specialty...because the money is not any more than being a pcp...and you probably would take a pay cut...job security though is good, since endocrine is in demand.

If all you want to do is diabetes... there are 1 year diabetes fellowships out there...non ACGME but you could focus on it and only have to do a year fellowship.

I don’t know if I would call endo fellowship chill...since there are few fellows a year...1-2/ year, you do have a number of months as inpt and depending on how busy a service , you can be on a lot...it’s not gi or cards, but can be tiring.

Do what you are going to enjoy doing.
All great points and thanks for the info about the diabetes only fellowships, I didn’t even know that was an option. And definitely agree on fellowship, I didn’t mean to imply it was easy, I was just making a generalization between endo compared to other fellowships (GI, Cards, etc).
 
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