How necessary is a fellowship if you want to do inpatient?

[Mr. Jess]

---

Members don't see this ad.

I'm currently a PL-2 and, like most people at my level, I'm trying to figure out what I'm going to be doing after I graduate. I love the PICU and enjoy the ER to some extent, but I'm a bit older (almost 34) and the thought of doing 3 more years of training is daunting. I kind of just want to get started with my life and make a real salary. My question is: if my interests lie in more acutely ill patients, how hard will it be for me to find a job in an inpatient or acute care setting if I don't do a fellowship? I went to a job fair last week and was a bit disheartened that most of the jobs being offered were outpatient (which I can't see myself doing). Thanks in advance for your help!

 

[michigangirl]

If you want to take care of acutely ill children, then a fellowship is the most common route (PICU, NICU, ED). It is possible to be a hospitalist in a PICU setting but keep in mind you will serve more as a front line provider (similar to resident or NP role) in that setting. Can also be a hospitalist on a general peds floor if that suits you.

 

[oldbearprofessor]

38 or so isn't so old to become an attending specialist. You won't starve on a fellow's salary (well, you might in NYC, but "Go West young man" and you'll find cheaper living arrangements) and you have a lot of time ahead of you to do the career you want to do. Lots of opportunities in the PICU world. Michigangirl is correct about the hospitalist jobs. Not a bad gig, but might not be what you really want.

 

[Stitch]

Agree with the others in that if you want to work in the ED or PICU, it's best to be fellowship trained. The gen peds jobs in both of those settings are drying up. You could certainly be a hospitalist on a general peds ward without fellowship training, and make decent money doing it. There are hospitalist fellowships which teach you administration and academics as well as more inpatient focused medicine, but I don't think it's necessary to do that (yet) in order to find a job.

 

[Perrotfish]

I'm currently a PL-2 and, like most people at my level, I'm trying to figure out what I'm going to be doing after I graduate. I love the PICU and enjoy the ER to some extent, but I'm a bit older (almost 34) and the thought of doing 3 more years of training is daunting. I kind of just want to get started with my life and make a real salary. My question is: if my interests lie in more acutely ill patients, how hard will it be for me to find a job in an inpatient or acute care setting if I don't do a fellowship? I went to a job fair last week and was a bit disheartened that most of the jobs being offered were outpatient (which I can't see myself doing). Thanks in advance for your help!

I'm in the same place, though a tad younger (29). I'm leaning towards ER if only because the training seems much lighter on hours: ICU sounds a lot more like three back to back Intern years. I have definitely seen a Peds ED that is run by Pediatricians rather than Peds ED docs, and I have rotated through several Children's hospitals where the hospitalists were just general Peds without a fellowship. I'm honestly not sure what the trends are nationally in terms of percentage of Peds EDs with fellowship trained docs.

 

[jonb12997]

I'm a peds hospitalist at a small hosptal, gen peds by training, no fellowship. I'm the only pedi in house while I'm working. I'm the PICU doc, NICU doc (we keep 32 wk unvented babies), general pediatrician, and sometimes even pedi psych doctor all rolled up into one. Granted we send away any babies or kids that are really sick to the "real ICU's", but i've had my share of sick pedi patients that i've managed while awaiting ICU transport.
I sometimes get sad when I have to transfer a sick NICU baby that i've taken care of for 2 hours waiting for the transport team to arrive in the middle of a snowstorm, but then I remind myself, you could have gone to fellowship if you wanted to, and then I go back to my call room and watch TV. 😉