Peds heme/onc vs pulm

[OhHello99]

I can't make up my mind and I obviously really need to. Like yesterday. So if anybody floating around this forum has done either fellowship and wants to let me in on the pros and cons, I'd be eternally grateful.

My interest in both is enjoying working with kids with chronic/life-threatening/life-limiting disease. I think both oncology and cystic fibrosis are super interesting, just from a science standpoint. My concern with heme/onc is less flexibility in the job market and the possibility of having to do an extra year of post-fellowship training to further subspecialize and make myself a viable job candidate. My concern about pulm is that cystic fibrosis is really my primary interest and I'm concerned I'd get bored with the other aspects of it.

---

Members don't see this ad.

 

[SurfingDoctor]

I can't make up my mind and I obviously really need to. Like yesterday. So if anybody floating around this forum has done either fellowship and wants to let me in on the pros and cons, I'd be eternally grateful.

My interest in both is enjoying working with kids with chronic/life-threatening/life-limiting disease. I think both oncology and cystic fibrosis are super interesting, just from a science standpoint. My concern with heme/onc is less flexibility in the job market and the possibility of having to do an extra year of post-fellowship training to further subspecialize and make myself a viable job candidate. My concern about pulm is that cystic fibrosis is really my primary interest and I'm concerned I'd get bored with the other aspects of it.

I don't know how young you are but the concept of curable genetic diseases will probably proceed you. I would suggest focusing on diseases hat interest you that can't be CRISPR'd in the next 40 years...

But that's just my opinion....

Interestingly... CAR T cell therapy has revolutionized leukemia...

 

[DeadCactus]

I haven't done either fellowship. All things being equal, I would lean toward the pulmonology route. To me, the financial and personal sacrifice of a heme/onc fellowship without even knowing that you will have a full-time job as a heme/onc pediatrician isn't worth the risk if it's not something you just need to have in your life to be happy. If CF is really the only thing you're interested in, maybe a pulm fellowship isn't for you but if other chronic pulmonary diseases, severe asthma, vent management, bronchoscopy, etc are interesting to you, it could be rewarding career. But at least there will be a job waiting for you, the job will generally pay a little more than gen peds (unlike heme/onc), and the fellowship and post-fellowship lifestyle generally won't be as brutal.

A third option to consider would be sticking with general pediatrics but working in a multidisciplinary medical home for children with complex medical needs. Even just trying that for a year or two to decide if you really need a fellowship for your life goals might be a good route to go...

 

[mvenus929]

There are plenty of people who take time off between residency and fellowship to give themselves more time to figure out what they want to do. It's actually fairly common out of my program--probably half of those who go on to fellowship take a year or two off. Sometimes they ultimately don't want to go back to fellowship because they like the attending lifestyle, but many do.

 

[GoSpursGo]

I can't make up my mind and I obviously really need to. Like yesterday. So if anybody floating around this forum has done either fellowship and wants to let me in on the pros and cons, I'd be eternally grateful.

My interest in both is enjoying working with kids with chronic/life-threatening/life-limiting disease. I think both oncology and cystic fibrosis are super interesting, just from a science standpoint. My concern with heme/onc is less flexibility in the job market and the possibility of having to do an extra year of post-fellowship training to further subspecialize and make myself a viable job candidate. My concern about pulm is that cystic fibrosis is really my primary interest and I'm concerned I'd get bored with the other aspects of it.

I'm finishing a peds heme/onc fellowship. I absolutely love what I do. The research I do is very interesting, and it's cliche but yes there's something that's just really cool about meeting someone with a new diagnosis, following them through the lows of chemo, and then seeing them come out the other end totally cured.

That said, while I don't think you should decide your future career solely based on the job market, if you choose heme/onc you should be prepared to be somewhat flexible in terms of where you eventually end up. If you graduate from a good program, you will in all likelihood be able to find a job at a good institution, but maybe not at any one specific institution; if you NEED to wind up in a specific city long-term and not winding up there is a dealbreaker, then you should be aware of this. Furthermore, it's certainly possible that a 4th (or 5th) year of fellowship to complete research or do sub-subspecialty training may make you more attractive, so whether that's something that you'd be realistically open to should also factor into your decision.