How common or difficult is it to get into fellowship many years after residency?

[chewy2008]

Random Q, but curious about how common it is to see internists or those from another sub-specialty apply to fellowship positions after having practiced medicine for several or many years. I'm asking because let's say I start as a primary care physician and raise a family w/ kids, then by the time they go to college I want to earn more money and sub-specialize (e.g. cards or pulm).

Is it more difficult for these type of applicants to get a fellowship position?

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[IM2GI]

1-2 years: Common, no big deal
3-5 years: Possible
6-10: Unlikely anything competitive
Wait till my kids are in college: Dear God why

 

[chewy2008]

1-2 years: Common, no big deal
3-5 years: Possible
6-10: Unlikely anything competitive
Wait till my kids are in college: Dear God why

Lifestyle reasons? I'm assuming the hours as a PCP are more M-F 8-5 than most subspecialties.

 

[IM2GI]

Lifestyle reasons? I'm assuming the hours as a PCP are more M-F 8-5 than most subspecialties.

You have time to figure these things out. Just start your residency and see what you like. No one is going to take a 55 year old pulm fellow. You dont have the stamina to be abused like a fellow, you are set in your ways, and its not worth the effort to train you when your future timeline is limited.

 

[drfunktacular]

If you want to be a primary care internist, embrace that and be a primary care internist (Lord knows we need more of them). You will still be a doctor, and you will still make more money than 98% of the population

If you want to specialize in something because it especially interest or excites you, bite the bullet and specialize now. You will *never* get accepted into a pulm or cards fellowship as a 45 year old parent of 3 whose residency training is 15 years out of date

Making a major life/career decision with the intention of reversing it at some ill-defined point in the future is a recipe for unhappiness

 

[IMreshopeful]

So I know of one guy that did an ID fellowship about 10-15 years post residency. He loved the specialty and absolutely loathed the fellowship- he had been an academic attending for so many years that he had lost simple habits like returning pages and writing detailed notes. It was humiliating to become a fellow after literally having fellows cater to you.

I think it’s generally a bad idea and pretty much impossible for specialties like cards/GI/pulm cc

 

[DBV]

Outpatient cards is pcp hours

 

[chessknt]

As an attending you can set any schedule you want... With a pay cut

 

[IMreshopeful]

Outpatient cards is pcp hours

Ehhh yeah can be but also factor in reading echos, nucs, weekend call coverage, inpatient consults etc and the days are definitely longer

 

[Jinxapotato]

I think it'll also depend on why you took the time off and what did you do in those years.
I am a Canadian who wants to eventually subspecialize. However for VISA issues, I will likely have to work in an underserved area for 3 years after my residency. Hence there will inevitably be a 3 years gap in my education....I hope this doesn't doom me for cardio since I really liked it on my rotations.

 

[IMreshopeful]

I think it'll also depend on why you took the time off and what did you do in those years.
I am a Canadian who wants to eventually subspecialize. However for VISA issues, I will likely have to work in an underserved area for 3 years after my residency. Hence there will inevitably be a 3 years gap in my education....I hope this doesn't doom me for cardio since I really liked it on my rotations.

Cardiology is competitive - the other option is completing fellowship, then working in an underserved area for 3 years. It will definitely be harder to match after 3 years gap unless you can demonstrate that you *used* the time wisely - ie research etc - simply working as a hospitalist probably won’t net you’ve any brownie points.

 

[Milotic]

Lifestyle reasons? I'm assuming the hours as a PCP are more M-F 8-5 than most subspecialties.

Life is about making sacrifices. If Lifestyle is more important than fellowship then choose the lifestyle and don't look back.

 

[Jinxapotato]

Cardiology is competitive - the other option is completing fellowship, then working in an underserved area for 3 years. It will definitely be harder to match after 3 years gap unless you can demonstrate that you *used* the time wisely - ie research etc - simply working as a hospitalist probably won’t net you’ve any brownie points.

Yeah I understand what you said is the optimal way of doing it. However it's the Canadian government that's causing all this trouble - they will only sponsor a visa for your fellowship if you have a full license in Canada (which requires 4 years of IM, so you can't do this straight out of residency), or you bypass this by becoming a US PR (via the 3 year underserved area work).

 

[Raryn]

It depends on the fellowship. Ex: Plenty of people practice for a decade and then decide they want to do palliative care. I swear there I knew more older palliative care fellows than ones straight out of residency.

Very few people practice for more than a year or two and end up in GI or cardiology.

 

[NewYorkDoctors]

Nephrology is very easy to get into as an older fellow . Question is why would you want to do that ?

 

[siliso]

People do cards and pulm around here after working a few years to get their visa sorted or their research straight. 3-5 yrs not uncommon. Haven’t seen it done for lifestyle reasons as you suggest. Much more common to just have kids in residency if you’re at that stage of life and sort out the childcare arrangements. Women with kids are in all kinds of specialties.
The money thing may or may not work out in your favor in terms of dropping back from attending to fellow salary and working your way back up. Getting an additional credential and working into administration more common and feasible if your goal is more money and climbing the ladder.