IM fellowship

[xz8]

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I want to ask the benefit of doing fellowship. I have tried to do little research just to get some idea how easy to get a job in IM subspecialties, and also how much money you can make vs. general IM. May be I am wrong but there are no adequate openings in IM sub like endocrine, hemo/onco, rheumatology, etc. At the same time they make almost the same as a general IM doc. The only subspecialties that I can come up with in terms of income is cardio and GI. Even in this area, there are no enough openings also. I saw so many openings for FP and general hospitalist/general IM off course but the income is not that attractive. In my observation, most people who are doing IM residency are not to be a general IM doc but to do fellowship. If that is correct, do you think spending additional 2-4 years for fellowship worth? May be better for lifestyle as hospitalist/general IM has a lot of stress and heavy in paperwork but in my understanding the income is so low. GI and cardio are awesome but every one wants these and hard to get in.
So, what do you think? Do IM then fellowship to get relief of stress and heavy paperwork and live with low income or do FP, without worrying fellowship and stress live with low income?
Thank you for your feedback

 

[jdh71]

I want to ask the benefit of doing fellowship. I have tried to do little research just to get some idea how easy to get a job in IM subspecialties, and also how much money you can make vs. general IM. May be I am wrong but there are no adequate openings in IM sub like endocrine, hemo/onco, rheumatology, etc. At the same time they make almost the same as a general IM doc. The only subspecialties that I can come up with in terms of income is cardio and GI. Even in this area, there are no enough openings also. I saw so many openings for FP and general hospitalist/general IM off course but the income is not that attractive. In my observation, most people who are doing IM residency are not to be a general IM doc but to do fellowship. If that is correct, do you think spending additional 2-4 years for fellowship worth? May be better for lifestyle as hospitalist/general IM has a lot of stress and heavy in paperwork but in my understanding the income is so low. GI and cardio are awesome but every one wants these and hard to get in.
So, what do you think? Do IM then fellowship to get relief of stress and heavy paperwork and live with low income or do FP, without worrying fellowship and stress live with low income?
Thank you for your feedback

Yeah . . . this post is so chock full of misconceptions and errors, I don't even know where to start.

 

[Pkboi24]

I want to ask the benefit of doing fellowship. I have tried to do little research just to get some idea how easy to get a job in IM subspecialties, and also how much money you can make vs. general IM. May be I am wrong but there are no adequate openings in IM sub like endocrine, hemo/onco, rheumatology, etc. At the same time they make almost the same as a general IM doc. The only subspecialties that I can come up with in terms of income is cardio and GI. Even in this area, there are no enough openings also. I saw so many openings for FP and general hospitalist/general IM off course but the income is not that attractive. In my observation, most people who are doing IM residency are not to be a general IM doc but to do fellowship. If that is correct, do you think spending additional 2-4 years for fellowship worth? May be better for lifestyle as hospitalist/general IM has a lot of stress and heavy in paperwork but in my understanding the income is so low. GI and cardio are awesome but every one wants these and hard to get in.
So, what do you think? Do IM then fellowship to get relief of stress and heavy paperwork and live with low income or do FP, without worrying fellowship and stress live with low income?
Thank you for your feedback

Solution: Be an ortho spine surgeon and make tons of money.

Where are you from? Few countries have physician salaries higher than the US, if you think $200-300k for IM is low then I would love to see what it's like where you come from.

Assuming that you are from another country...

 

[azq]

Yeah . . . this post is so chock full of misconceptions and errors, I don't even know where to start.

I am not sure the information is reliable or not but every job opening I looked on the internet, there is no significant income difference between general IM, FP, and IM subspecialties except cardio and GI. So,this is the reason why I asked the question to know the advantage of doing fellowship for extra 2-4 extra years. At the same time I didn't find that many openings for IM subspecialties comparing with general IM and FP. As I said, my resource was internet and may be not enough to come up to this conclusion.
Sorry if I am wrong

 

[Pkboi24]

I am not sure the information is reliable or not but every job opening I looked on the internet, there is no significant income difference between general IM, FP, and IM subspecialties except cardio and GI. So, my question was to know the advantage of doing fellowship for extra 2-4 extra years. At the same time I didn’t find that many openings for IM subspecialties comparing with general IM and FP. As I said, my resource was internet and may be not enough to come up to this conclusion.
Sorry if I am wrong

Why in the world do you have two accounts?

 

[Pons Asinorum]

Why in the world do you have two accounts?

OP's/AlternaOP's best post so far:

Is it possible for FP's to do another residency like Rad or Ortho after 4 or 5 years of service? My choice of specialities are Rad and Anes. but I am just wondering which route is best to get in to Rad or Anst? GMO first then apply to Ortho or Rad vs. Do FP first and apply to Rad or Ans after 4/5 yrs after residency. I am just afraid that both Rad and Ans are still difficult to get in to even after GMO, so I am just thinking an alternative.

Thank you for your input

 

[NRAI2001]

One point/question the OP had that I was also wondering about was that it seems outside of card, GI, or heme it seems like the rest of the IM fellowships do not make more than general IM? Why do people do endo, rheum, neph, pulm when they do not make substantially more (obviously outside of a strong interest in the field)? Is it bc of better hours and lifestyle (probably not so for neph and pulm)?

 

[Pkboi24]

One point/question the OP had that I was also wondering about was that it seems outside of card, GI, or heme it seems like the rest of the IM fellowships do not make more than general IM? Why do people do endo, rheum, neph, pulm when they do not make substantially more (obviously outside of a strong interest in the field)? Is it bc of better hours and lifestyle (probably not so for neph and pulm)?

You so make more and also you work less hours with endo and rheum. Most of Rheum is outpatient. Onc is also very lucrative since they get paid to administer chemo. Neph has their dialysis clinics and Allergy/Immunology has their desensitization therapies. Pulm does a ton of procedures. Just ask around, people will tell you what they're doing to get paid.

Surgeons get paid for procedures. Medicine gets paid for everything else. You just have to be good at business and build a good patient base.

 

[sacrament]

Why do people do endo, rheum, neph, pulm when they do not make substantially more (obviously outside of a strong interest in the field)? Is it bc of better hours and lifestyle (probably not so for neph and pulm)?

Some people (including myself) find the notion of doing general IM so odious that, if it were necessary, they would gladly take a pay cut for the opportunity to do a sub-specialty. I could easily restructure your question thusly: "Why do people do general medicine when, for only another few years of training, they can be a specialist and make the same amount of money?!"

 

[gutonc]

^^^ This is why.

I could certainly suffer through life as a hospitalist (I could NOT do primary care, but mad props to those who do) but I'd much rather be an oncologist. I'd do it for no increase in pay too.

Of course, I'm primarily a researcher, so I'll never make anything near what a PT private practice PCP does anyway.

 

[jdh71]

One point/question the OP had that I was also wondering about was that it seems outside of card, GI, or heme it seems like the rest of the IM fellowships do not make more than general IM? Why do people do endo, rheum, neph, pulm when they do not make substantially more (obviously outside of a strong interest in the field)? Is it bc of better hours and lifestyle (probably not so for neph and pulm)?

Why? Because you WANT to! General IM clinic and/or hospitalist work would make me want to kill myself. I love pulm and the unit.

Plus, I promise Pulm/CC makes much more than general IM. Some of the offers I'm already seeing, and I haven't even started fellowship yet are for 350k to 500k per year. That's ok money . . . of course things may change if we all get foisted the Obama nonsense in its current form on us, but the future of Pulm/CC is nice going into the future as there is demand and will likely continue to be demand probably until 2020 (or thereabouts, depends on who you're asking)

EDIT: I should read the whole thread before reflex posting . . . oh well . . .

 

[Crazy Diamond]

One point/question the OP had that I was also wondering about was that it seems outside of card, GI, or heme it seems like the rest of the IM fellowships do not make more than general IM? Why do people do endo, rheum, neph, pulm when they do not make substantially more (obviously outside of a strong interest in the field)? Is it bc of better hours and lifestyle (probably not so for neph and pulm)?

BECAUSE they don't only consider THE MONEY.

 

[NRAI2001]

BECAUSE they don't only consider THE MONEY.

That's why I said "outside of a strong interest in the field".

Going into a field purely for the financial gain is obviously a bad idea (lifes too short to hate your job everyday).. But to completely ignore salary, weekly hours, and the time you can afford to give to your family is also a bad idea... Just wondering out of curiosity; if money was all I cared for I would do whatever it took to become an IR.

IMO if you want a relatively secure job with similar pay to a physician you should go into tax law like my cousin or the other myriad of professions out there offering many of the benefits of medicine.

 

[WorkaholicsAnon]

I want to ask the benefit of doing fellowship. I have tried to do little research just to get some idea how easy to get a job in IM subspecialties, and also how much money you can make vs. general IM. May be I am wrong but there are no adequate openings in IM sub like endocrine, hemo/onco, rheumatology, etc. At the same time they make almost the same as a general IM doc. The only subspecialties that I can come up with in terms of income is cardio and GI. Even in this area, there are no enough openings also. I saw so many openings for FP and general hospitalist/general IM off course but the income is not that attractive. In my observation, most people who are doing IM residency are not to be a general IM doc but to do fellowship. If that is correct, do you think spending additional 2-4 years for fellowship worth? May be better for lifestyle as hospitalist/general IM has a lot of stress and heavy in paperwork but in my understanding the income is so low. GI and cardio are awesome but every one wants these and hard to get in.
So, what do you think? Do IM then fellowship to get relief of stress and heavy paperwork and live with low income or do FP, without worrying fellowship and stress live with low income?
Thank you for your feedback

I was very recently struggling with this dilemma actually, because I like most aspects of medicine, and couldn't decide which one i want to dedicate myself to over the others. I also seriously considered primary care.

I talked to a couple of my mentors who were very supportive of whatever I choose to do, but the consensus I got from my discussions with them is it basically all comes down to having the option of doing research. If I want to do translational, bench sort of research (which is my preference), then I pretty much HAVE to do a subspecialty fellowship. One of my mentors said, just pick one and since I like em all, at least I'll know that no matter what I pick, I'll like it.

The other thing is that plenty of people who completed a subspecialty fellowship go on to practice general medicine, if they want to. Some practice their subspecialty in addition to being a PCP for a subset of their patients. Some actually go completely general. I agree that probably being a subspecialist to some extent does make for better hours theoretically because you probably dont have to see as many patients to meet your overhead costs. But I am not sure on that one.

The major thing I disagreed with in your post is where you state that there are no job openings in endocrine, heme/onc, and rheum. Endocrinologists are actually in very high demand. I would think heme/onc's are as well, seeing how patient overloaded they are. Cant comment on the rheums, but the rheums can bill for procedures (joint aspirations, injections).