Planning beyond medical school

[clinicallabguy]

So like most I don't know exactly what specialty I will pursue, but I know I am interested in internal medicine and pathology. I may find some other interests in medical school as well. I have some questions about what happens after medical school and residency.

If by chance I pursued internal medicine and wanted to do a sub-specialty, how does one pursue a fellowship?

Let me clarify my question....

Do residents typically go directly into a fellowship (if they so desire), or do they work in their residency field for a while? Or, is this one of those things that are different for everybody? If so, why would some choose one way and some choose another?

How does the application system to a fellowship work? (I feel like I understand the match somewhat for residency, but application to fellowship is more cloudy to me).

Fellowships are interested in those that have done research in the field, correct? When do many perform this research? Medical school? After residency?

I ask these questions because I'm interested in learning more about Hematology/Oncology and would like to learn more about the pathway to IM subspecialties.

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[p30doc]

I *think* you typically apply the year before your last year of residency, and it is match type system like residency was.

 

[LizzyM]

So like most I don't know exactly what specialty I will pursue, but I know I am interested in internal medicine and pathology. I may find some other interests in medical school as well. I have some questions about what happens after medical school and residency.

If by chance I pursued internal medicine and wanted to do a sub-specialty, how does one pursue a fellowship?

Let me clarify my question....

Do residents typically go directly into a fellowship (if they so desire), or do they work in their residency field for a while? Or, is this one of those things that are different for everybody? If so, why would some choose one way and some choose another?

Fellowship offers you additional preparation for the career you want so it is likely you will go directly from residency to fellowship. Why would you establish a practice in internal medicine and then, after a few years, leave your patients and go back for several more years of full-time training?

 

[Blade28]

Most fellowships (not all) go through a similar Match-type system during your last 1-2 years of residency. Often you'll apply and interview during your penultimate year.

But this is very far in advance to be worrying about this!

 

[MILK07]

I also think I am interested in pursuing a fellowship. The only reason I might wait a few years between residency and fellowship would be to have some babies. I think it is ok to take time off between the two. There have to be some people who realize after a few years they really like one thing better than most and decide to pursue a fellowship then?

Just my 2 cents as a pre-med though. You can do research in med school and residency. I think some people even take an extra year in the middle of residency to do research, but that might be more common in things like neurosurgery and ENT.

Maybe post your question in the residency forum, as they are much better informed than us!

 

[ACSurgeon]

I also think I am interested in pursuing a fellowship. The only reason I might wait a few years between residency and fellowship would be to have some babies.

I don't think it is common to take time off at any point (between med school/residency or residency/fellowship or fellowship/practice). However, many specialties and programs are very accomodating to women that want to have babies during their residencies.

There have to be some people who realize after a few years they really like one thing better than most and decide to pursue a fellowship then?

I'm sure most pepople realize DURING residency that they are more interested in one thing more than other things. MOST people won't want to take a pay cut as an IM attending to go back to being a fellow making less than half (or even a third) of the amount. Once you start practicing, start a family, buy a house, start paying back your loans... etc it will be hard to go back to being a fellow.

Just my 2 cents as a pre-med though. You can do research in med school and residency. I think some people even take an extra year in the middle of residency to do research, but that might be more common in things like neurosurgery and ENT.

I'm sure any specialty you go into will have certain programs that will require/allow a year or two do full time research. This is something you would have to look into before applying to residency programs.

 

[NTF]

Fellowship offers you additional preparation for the career you want so it is likely you will go directly from residency to fellowship. Why would you establish a practice in internal medicine and then, after a few years, leave your patients and go back for several more years of full-time training?

It's not the usual way, but I do have a few friends who were in practice for several years and then decided they'd be happier subspecializing. One went to Heme/Onc. One went to Hospice/Palliative. The other did Sleep Medicine.

 

[clinicallabguy]

I'm sure most pepople realize DURING residency that they are more interested in one thing more than other things. MOST people won't want to take a pay cut as an IM attending to go back to being a fellow making less than half (or even a third) of the amount. Once you start practicing, start a family, buy a house, start paying back your loans... etc it will be hard to go back to being a fellow.

Are fellows' salaries similar to residents? Do they make a slight amount more, or does it vary?

But this is very far in advance to be worrying about this!

True, but it's not irrelevant. Knowing may help me orient myself as I make my plans for the future.

 

[Rabbit36]

True, but it's not irrelevant. Knowing may help me orient myself as I make my plans for the future.

I think the point is that you'll have more than enough time during med school and residency to find out about these things organically. Good to have initiative and want to explore options early, but things change big time over the course of 7 or so years. Be prepared but maybe don't plan too much. Go with the flow

 

[Archdelux]

if someone was planning to match into a competitive fellowship in oncology, would they also need to do some sort of oncology-related research in med school (as they would have if oncology was a residency and not a fellowship)? Or is it sufficient to do research in any field so that one gets a great IM residency which may help them to get the fellowship? (I assume IM residency programs aren't strict as to what type of research they prefer, as opposed to say, ENT which may prefer ENT research in med school)

I ask this since it seems that one may know they want to go into an IM specialty, but not know which until residency..would they be at a disadvantage?

 

[Blade28]

True, but it's not irrelevant. Knowing may help me orient myself as I make my plans for the future.

Possibly. It's always good to plan ahead for the future...and especially for competitive fields, starting to make contacts early (and potentially get involved in field-specific research) doesn't hurt.

On the other hand, while you're still applying to med school, it's a little early to be worrying about fellowships, no? Hell, some of my co-residents still aren't quite sure about fellowship options yet.