Peds heme onc job thoughts

[Katheudontas parateroumen]

Hello,
Just wanted to see some thoughts about career opportunities anyone may know or options I hadn’t thought about.

Graduating peds heme/onc fellow this year. Married and hoping to start a family soon. Since my SO has a very good job and all are family are here, moving isn’t really an option at this time. I won’t go into details, but I didn’t think the full time job at my current fellowship was for me. Therefore, I was only offered an IC job to fill in days etc. I still want to work clinically but I am open to other non clinical work too.

My thoughts are to do peds hospitalist and fill in as IC for the heme/onc department until I find a heme onc job that fits my life better. I just feel a little stuck and disheartened that this track may prohibit me from going back into heme/onc. Idk what other people experiences are. Also, are places hiring peds hospitalists without that fellowship? I assume that doing a heme onc fellowship would suffice?

Other options are going into big pharma or clinical research type things. I don’t have much experience with those types of jobs. I always thought I’d do clinical work. But everyone I know who transitioned into such roles are really happy with their life although they do miss patients.

Just looking in for some guidance. Thank you for your time.

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[GoSpursGo]

The peds heme/onc job market is rough. Just for clarification—what is IC? Are you saying that this was the only job you were offered, or you were offered a full time faculty position but you turned it down? Answers to these may help guide responses

 

[DO2015CA]

My wife is a peds hospitalist without a fellowship. Form her recent job search, it is extremely easy to get a hospitalist job without a fellowship recently… even at a facility that had a fellowship. It seems the pendulum might be swinging back the other way. Even for a place that required a fellowship, I would feel strongly that a heme/onc fellowship would meet that requirement seeing as yall run your own service and often times they are much sicker patients than hospitalist services.

 

[Katheudontas parateroumen]

The peds heme/onc job market is rough. Just for clarification—what is IC? Are you saying that this was the only job you were offered, or you were offered a full time faculty position but you turned it down? Answers to these may help guide responses

IC as in independent contractor. I made my demands clear that I did not want a full time position so it was not offered. I was offered a contract position where I could fill in the needs. My plan was to ask to primarily do clinic and fill in inpatient as needed but that’s TBD. At this point, they seem to only want me to pick up the left over stuff no one wants which doesn’t really move the needle for me. That’s why I’m looking at other avenues, picking up as I see fit to stay connected.

Is the job market tough? How do you think? So few people are going into heme onc nowadays.

 

[Katheudontas parateroumen]

My wife is a peds hospitalist without a fellowship. Form her recent job search, it is extremely easy to get a hospitalist job without a fellowship recently… even at a facility that had a fellowship. It seems the pendulum might be swinging back the other way. Even for a place that required a fellowship, I would feel strongly that a heme/onc fellowship would meet that requirement seeing as yall run your own service and often times they are much sicker patients than hospitalist services.

Thanks for the info. Yes we have our own primary team and primary patients so I would hope it counts for something good 😅

 

[GoSpursGo]

Alright, let's tackle a few options as I understand it.

Option 1 is doing peds hospitalist with IC work. Chances are that long-term you're going to eventually transition full-time to being a peds hospitalist. Additionally, you are really and truly going to get the crap that nobody else wants to do, without any of the ownership of the patients that you would likely want. As an IC, they are going to have zero interest in helping you with career development, and frankly you should have no expectation they will since this is what you asked for. On the plus side you'll be seeing patients, which is clearly important to you.

Option 2 is exploring if you could do pharma or clinical research while also doing IC prn. Many pharma companies have some provision where you can still maintain a clinical practice 0.5-1 day per week, so if you could work it out to fill in some clinic days. Advantage here is you'll almost certainly make more money than anything where you would be fully clinical. Maintaining some clinical practice makes it theoretically plausible you could transition back to clinical down the road.

Option 3 is pharma full time without IC. It's the same as option 2. You may burn out less by not having your attention divided, but you likely won't be able to return to being a clinical heme/onc physician if you leave clinical practice straight out of fellowship. Some people do successfully manage to bounce between clinical and nonclinical, but they usually practice as an attending for at least a few years first.

Option 4 doesn't really sound like an option to you, but you may want to consider it... would your current institution be willing to give you a full time job? It sounds like you're worried about burning out if you take this as you're going to still get a bunch of undesirable work... but this is honestly the best and most realistic option to continuing to practice peds heme/onc clinically. If you join faculty, they're basically required to offer some opportunity for career development and pathway toward promotion. You can build up experience as an attending and other points of academic progress to make yourself desirable elsewhere in the future.

Option 5... seek out one of those sub-subspecialty fellowships (neuro-onc, sarcoma, BMT, etc) or ask if you can extend your fellowship to continue research. The downsides of remaining in training with a fellow salary are self-evident, but there are advantages to carving out a clinical niche and drawing out your protected time.

Underlying all of these assessments is that, again, the peds heme/onc job market is rough. I honestly think that the idea of being an IC and looking for a heme/onc job that fits your life better, when you're restricted geographically, is unrealistic--the job market is what it is, and it isn't going to get better by spending a few years primarily as a peds hospitalist or by working in pharma. On the flip side, if you think you're open to a pharma job, this is also probably your best opportunity to get into that line of work as again you're not going to become more desirable by spending years primarily as a peds hospitalist.

Sorry for a mostly negative assessment of your options. If it helps at all, at least one positive of heme/onc is that you do actually have the opportunity to leave clinical medicine and increase your earning power. I do agree that all of my colleagues who have left clinical medicine do love their lives.

Best of luck.