performing at a fellowship level important during residency?

[suckerfree]

do you think it is a big deal or trustworthy when a PD says, "we will have you functioning at a fellowship level during your residency." I am interested in heme path and little else. I have heard the opposite thinking from my advisors that, "Just focus on the basics during residency. You'll learn fellowship material during your fellowship."

Thanks for any advice.

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[Pathologenius]

To argue the opposite side of your advisor, if you learn fellowship material in residency... perhaps you would not need to do the fellowship! Could the PD have meant that they have an extremely high volume and diversity of specimens seen so more experience equals fellowship-like training.

Also, I am curious which region this school was in and if they offer fellowships or not...

 

[suckerfree]

It was in the Northeast. Yes, they have a large volume of specimens and multiple specialists practicing only heme path. And they do have an in house fellowship. My thinking is this...in the long run, you set the basis for your life long education during residency and fellowship. I feel like if you want to really be a virtuoso, then you need to have the right grooming at your early devlopmental stage. So I'm really thinking especially highly of programs that get you to a fellowship level during residency. Then you will be that much better during fellowship. Then you will be that much better later on in your career. One might think that in the long run, everyone averages out and reaches the same level of function. I'm not so sure about that though.

 

[Gut Shot]

This is just another one of those lines they feed you.

 

[Gene_]

This is just another one of those lines they feed you.

Exactly. Despite what anyone tells you, like medical school, you get out of it what you put into it. I don't know what "fellowship level" is. We have had fellows at our program that are almost as good as experienced staff, and others that are equal to about a 3rd year resident in our program. Which of these "fellowhip levels" would you like to be at after residency?

 

[listeriaismfb]

do you think it is a big deal or trustworthy when a PD says, "we will have you functioning at a fellowship level during your residency." I am interested in heme path and little else. I have heard the opposite thinking from my advisors that, "Just focus on the basics during residency. You'll learn fellowship material during your fellowship."

Thanks for any advice.

This PD sounds like he's trying to sell you a load of crap.

If you are interested in heme and you would like to boarded in heme then you must do a hemepath fellowship.

Was this PD trying to imply that you didn't need the fellowship to do hemepath in practice? I suppose it's not absolutely required, but most advertised hempath positions call for board certification or eligibility.

What I am saying is that you can't just go out into the job market and say that you've been functioning "at fellow level" during residency and expect to get a job. Most times it won't work.

 

[Ale]

What they mean by that is that you are going to be grossing, organizing paper and slides, answering the phone and calling physicians with results. Then when all that !@#$ ends, you can look at your slides. There are not a lot of differences between the responsibilities of a 3-4th year resident and a fellow.

 

[caffeinegirl]

What they mean by that is that you are going to be grossing, organizing paper and slides, answering the phone and calling physicians with results. Then when all that !@#$ ends, you can look at your slides. There are not a lot of differences between the responsibilities of a 3-4th year resident and a fellow.

Hmm...unless you're in a fellowship with no grossing responsibilites, which is most fellowships, I think. As for functioning as a hemepath fellow without a fellowship...don't fall for it. An ACGME fellowship in hemepath is far superior to a pseudo fellowship during residency IMHO...having a year to just focus on hemepath, go to clinics, be co-signed on hemepath signout, and look at personal consults I think is very different than being a third-fourth year resident who takes a hemepath elective. At least where I'm at, there's a huge difference, since there's much less scut as a fellow, you get time to really learn the multiple facets of the specialty (flow, molecular, cytogenetics, bone marrows, lymph nodes, coag) and rotate through all of these labs too.

I would ask about the "graduated responsibility" that is present within the program that would allow them to make their claim. Is there less grossing as you get more senior? Can you work up your cases with stains/etc prior to signout? That sort of thing...

 

[suckerfree]

what i took it to mean is that you will have the level of knowledge during residency that most people attain after a good amount of time in the fellowship. To me, that is the most important. I don't care as much about not doing scutwork such as organizing slides, etc.

 

[HbyHA]

do you think it is a big deal or trustworthy when a PD says, "we will have you functioning at a fellowship level during your residency." I am interested in heme path and little else. I have heard the opposite thinking from my advisors that, "Just focus on the basics during residency. You'll learn fellowship material during your fellowship."

Thanks for any advice.

i call shenanigans on that statement...

 

[deschutes]

To argue the opposite side of your advisor, if you learn fellowship material in residency... perhaps you would not need to do the fellowship!

I agree. There are those who for various reasons put off till fellowship what they could/should have learnt in residency. That is fine, as long as they are doing a fellowship instead of going straight into practice...

Also, I second caffeinegirl's comment about the details of of graduated responsibility. Best to ask residents in private about this.

I have to say, I'm really enjoying my 4th year AP/hemepath rotations - I feel as if entities which have for so long eluded me are finally starting to gel.

 

[green mantis]

I've learned that if your residency program doesn't have any fellowships, you basically function at fellow level. Here are some examples for you.

At most of the SP fellowships I interviewed for, the fellows were responsible for presenting a tumor boards. I did this multiple times as a resident because there was no one else available. Attendings generally don't present, & many don't even attend.

I also covered frozen section call. The residents at my current program don't do this.

These things are variable, as each program distributes duties differently.


----- Antony