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Likelihood of landing a job w/o fellowship?

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I'm currently considering potential back-up plans in case I don't land the fellowship I want. One possibility I've considered is trying to get a job straight out of residency. Is this still done, or do you have to do a fellowship now that residency has been reduced to four years? I will be AP/CP.
 

yaah

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Not much experience with this since last year's class was the first one to be able to go right into practice after 4 years. I know of one person who did this successfully (and this is the only person I know of who attempted it). Others probably did, I don't know. Seems to me like most people are doing fellowships still, and at the USCAP last year people seemed to be saying that those who did fellowships would be more successful in job hunts. But then again, who knows what that means for the individual candidate.
 

CameronFrye

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I'm currently considering potential back-up plans in case I don't land the fellowship I want. One possibility I've considered is trying to get a job straight out of residency. Is this still done, or do you have to do a fellowship now that residency has been reduced to four years? I will be AP/CP.

We've had a couple, but they were going back to the rural (undesirable?) areas where they grew up.
 

pathdawg

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Also remember that just because someone lands a job after residency (without a fellowship), it doesn't mean that they won't soon be back on the market looking for another job. Most people leave their first position within 3-5years. Even after landing that first job, you'll again find yourself competing against those with fellowships, and you'll be at a disadvantage. I know a few people who got jobs sans fellowships, but, in my estimation, they will later regret not persuing post-residency training.

Its kind of funny when I hear residents talking about people scoring jobs as if its a permanent Pope-like (or Supreme Court-like) gig. Couldn't be further from the truth.
 

trent05

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I agree some fellowships will make you more marketable for a job particularly a boarded one (Derm, heme, cyto). I also think someone who has done a fellowship in something like surg path will be at an advantage compared to someone only AP/CP, if both were straight out of training with no work experience. But many potential employers will also value work experience. Thus if you do get a job and work for 3-5 years and decide to get a different job, you will be at an advantage over someone with a non-boarded fellowship and no work experience. I think that if you are not interested in something like Heme, derm, cyto, etc and are able to get a job you are happy with and feel ready, then only doing 4 years AP/CP is a REAL option for private practice. Of course academics seems to really want the fellowship year.
 

PathOne

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Well, apart from agreeing with trent05, it's also a question of personal preference. Do you really feel comfortable signing off independently after four years of combined AP/CP? If you have ability, and have received good training, you might be that lucky. But for a lot of people, a surg path fellowship really helps them get more confidence in their dx'ing skillz.

Apart from that, some fellowships will, of course, all other things being equal make you more attractive, and thus more expensive to hire. Both as a greenhorn and down the road. That includes the boarded subspecs and certain non-boarded, like GU. That's not to say that you can't lead a long and happy life without such training, but something which should be taken into consideration. Think of it this way:

Group A: AP/CP generalists only. Can get a lot of primary stuff, but also needs to send a lot off for consults.
Group B: Has a core practise equal to Group A, but can additionally look at consults in GU/GI/Heme/Gyn/Derm, because they have the necessary subspec skillz within their group.
Which one would have the higher, and probably more profitable, volume? And couldn't it be argued, that referring physicians might as well ship to Group B in the first place, as they're likely to look at it anyway, sooner or later?
 

pathdawg

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I agree some fellowships will make you more marketable for a job particularly a boarded one (Derm, heme, cyto). I also think someone who has done a fellowship in something like surg path will be at an advantage compared to someone only AP/CP, if both were straight out of training with no work experience. But many potential employers will also value work experience. Thus if you do get a job and work for 3-5 years and decide to get a different job, you will be at an advantage over someone with a non-boarded fellowship and no work experience.

First, someone with no fellowship experience but 3-5 years of job experience may not necessarily have an advatage over a newbie coming off a fellowship. It would depend on what the employer is looking for. My point, however, is that the person with 3-5 years experience and no fellowship isn't just competing against newbies. He/she is also competing against candidates who also have years of attending experience PLUS a boarded fellowship. In this vain, the non-subspecialized doc is always at a disadvantage, IMHO.
 
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