Pre-fellowship gap year

[URHere]

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I’m a resident graduating in 2020, but for personal/family reasons, I’m delaying at least 1 year before applying to fellowship. At this point, I’m about 95% sold on doing a PICU fellowship, just looking for advice on the best way to spend my gap year(s).

I know there are a few programs out there that hire PICU hospitalists. Has anyone done one? I’m assuming you function like a resident or NP, but honestly don’t know much more about them.

Alternately, would it be a huge red flag to do something unrelated? I’m Med-Peds trained and could pretty easily find an IM job in a community hospital making 230k+ for a year or two. The money is tempting, but I don’t like the idea of being away from kids for that long.

Any advice?

 

[SurfingDoctor]

I’m a resident graduating in 2020, but for personal/family reasons, I’m delaying at least 1 year before applying to fellowship. At this point, I’m about 95% sold on doing a PICU fellowship, just looking for advice on the best way to spend my gap year(s).

I know there are a few programs out there that hire PICU hospitalists. Has anyone done one? I’m assuming you function like a resident or NP, but honestly don’t know much more about them.

Alternately, would it be a huge red flag to do something unrelated? I’m Med-Peds trained and could pretty easily find an IM job in a community hospital making 230k+ for a year or two. The money is tempting, but I don’t like the idea of being away from kids for that long.

Any advice?

Yes, PICU hospitalists generally function as a senior resident.

As to what to do, in my opinion, it doesn’t matter. It probably doesn’t help nor hurt your application whatever you pick. The only advantage I could see if you are a PICU hospitalist, you could get good references (or be a top candidate at that program), but I honestly don’t think it’s any significant advantage outside of the program you are a hospitalist at.

 

[Stitch]

Take a high paying job doing something else. On top of being able to save some money, there's a huge maturity/confidence that comes with being an attending and truly having to make your own decisions. There's no real down side and it shouldn't hurt your PICU application. I did peds EM and urgent care for three years. My wife was a hospitalist for three years prior to her fellowship.

 

[bjackrian]

Take a high paying job doing something else. On top of being able to save some money, there's a huge maturity/confidence that comes with being an attending and truly having to make your own decisions. There's no real down side and it shouldn't hurt your PICU application. I did peds EM and urgent care for three years. My wife was a hospitalist for three years prior to her fellowship.

Strong agree with Stitch. Our PICU fellows who come in after having worked as an independent attending for a year or more seem to have more confidence in what they know and better recognition of what they don't know. We've definitely had excellent straight through fellows as well, but I think if you're taking a year off from training, you'll get more preparation out of an independent job than out of a PICU hospitalist job where you're often closely supervised.

 

[BigRedBeta]

PICU hospitalist is certainly a good option.

Consider locum tenens depending on your circumstances.
In addition to the independence/decision making, I found my time doing locums (albeit after I completed PICU fellowship and before I started in my permanent job) has been valuable just in terms of being familiar with the process and having options for additional income when something major comes up - like when my wife and I were thinking we were going to do IVF. Maybe it's just me, but I'm always hesitant to jump into something new if I don't necessarily need to, so clearing that hurdle was important.