Quit job to do another fellowship....crazy???

[travis78]

Hey everyone...long time lurker here. I was hoping to get some advice on my situation.

I'm currently a practicing pathologist (close to 2 years) at an academic institution. My only fellowship training is in surgical pathology. My desire is to transition to a private practice type job closer to relatives (hate academics). I've been perusing pathoutlines/CAP/etc for job listings for quite some time and it seems that every surgical pathology job wants someone with a subspecialty fellowship such as GI, GU, Derm, etc. I don't think I've ever come across an ad looking for a pathologist who completed a surgical pathology fellowship and nothing else.

So, even though it may sound crazy (and risky), I am considering doing a fellowship in a subspecialty area, something marketable like GI. Of course this would mean I would have to quit my job and adjust to a fellow's salary for 1 year, not to mention risk not being able to find a job when it's all said and done.

Even though I feel very competent in surgical pathology, I feel I need something on paper (like documentation of a fellowship) to be competitive. Having an "interest" in some subspecialty area is not quite the same as having completed a fellowship in that area, I'm presuming.

Any advice?

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[Pingu]

I think quitting your job to do another fellowship might raise more red flags in your employment search than just going out and looking for a job in your desired geographic area.....especially since you don't know what a specific group will want when you finish your fellowship.

I would suggest getting off CAP/pathoutlines for job searches and figure out what groups are in the area you want to live. Is it a bunch of private groups or an ameripath megalab situation? Do you know anyone working in any field of medicine in your desired region that can get you an introduction?

I have know a few pathologists who have gone back and done a fellowship years later, but it was out of passion for that subspecialty.

 

[schrute]

I guess it depends on your personal situation, the timing of applying, and how long you've been applying.
Being that it's April, what kind of time-frame are you looking at for applying & how wide would you be seeding your applications?
In the interim, you will continue to work & presumably do some hardcore job searching, which might pan out. Having a GI or GU or derm fellowship makes you more marketable as a general rule, but a few years of genuine experience would be a more practical "plus" to some groups...
My gut is to NOT go back for a fellowship at this point, but that's easy for me to say because I'm in a different position. Depends on where you want to live, what kind of non-academic job you'd be content with, etc...

 

[Thrombus]

I recommend doing another residency where you can get a good, stable job in a field that actually recruits you (has demand). You will thank me in 5 years.

 

[travis78]

I think quitting your job to do another fellowship might raise more red flags in your employment search than just going out and looking for a job in your desired geographic area.....especially since you don't know what a specific group will want when you finish your fellowship.

I would suggest getting off CAP/pathoutlines for job searches and figure out what groups are in the area you want to live. Is it a bunch of private groups or an ameripath megalab situation? Do you know anyone working in any field of medicine in your desired region that can get you an introduction?

I have know a few pathologists who have gone back and done a fellowship years later, but it was out of passion for that subspecialty.

Mainly private groups in the area. In fact I applied to two of them and have heard nothing. Both had job ad's posted (pathologist with subspecialty training/interest). I'm sure they got flooded with CV's, many of which undoubtedly had exactly what they were looking for. Don't really know anyone there, unfortunately, as I did my training in another state.

I did not consider the possibility of raising red flags by quitting my job to do another fellowship. I'll keep that in mind. Thanks!

 

[travis78]

I guess it depends on your personal situation, the timing of applying, and how long you've been applying.
Being that it's April, what kind of time-frame are you looking at for applying & how wide would you be seeding your applications?
In the interim, you will continue to work & presumably do some hardcore job searching, which might pan out. Having a GI or GU or derm fellowship makes you more marketable as a general rule, but a few years of genuine experience would be a more practical "plus" to some groups...
My gut is to NOT go back for a fellowship at this point, but that's easy for me to say because I'm in a different position. Depends on where you want to live, what kind of non-academic job you'd be content with, etc...

If I did consider it, it would be for 2017, which I realize is still late in the application process. At least by that time, student loans would be completely paid off. For fellowship, I wouldn't restrict myself geographically. I'd apply broadly and hope to get in somewhere.

 

[WEBB PINKERTON]

Network, network, network. Only do a fellowship as a last resort.

 

[jp123ok]

The idea of quitting an academic job you hate in order to do another fellowship and make yourself more marketable is a really difficult decision. Among the questions that you need to consider are how easy was it for you to find your current job?

It's probably not possible under ACGME rules but I wonder whether you can somehow combine your current job with fellowship training, maybe doing both part time. If this is not an option and you have a family with young kids or lots of med school debt I'd recommend that you stick with your current job. If you do decide to quit try though, try and find a fellowship in the local area where you want to end up and network as much as possible.

 

[kchan99]

The idea of quitting an academic job you hate in order to do another fellowship and make yourself more marketable is a really difficult decision. Among the questions that you need to consider are how easy was it for you to find your current job?

It's probably not possible under ACGME rules but I wonder whether you can somehow combine your current job with fellowship training, maybe doing both part time. If this is not an option and you have a family with young kids or lots of med school debt I'd recommend that you stick with your current job. If you do decide to quit try though, try and find a fellowship in the local area where you want to end up and network as much as possible.

I've seen faculty in part-time fellowships. Specifically pertaining to pathology, in a midwest program, there is a part-time attending doing a part-time cytopathology fellowship that she is sharing with another attending.

 

[Mace1370]

The idea of quitting an academic job you hate in order to do another fellowship and make yourself more marketable is a really difficult decision. Among the questions that you need to consider are how easy was it for you to find your current job?

It's probably not possible under ACGME rules but I wonder whether you can somehow combine your current job with fellowship training, maybe doing both part time. If this is not an option and you have a family with young kids or lots of med school debt I'd recommend that you stick with your current job. If you do decide to quit try though, try and find a fellowship in the local area where you want to end up and network as much as possible.

I have also seen this, although it was not clear to me if it was technically allowed by the ACGME.

 

[Gene_]

I think the fellowship will help, especially if it's at somewhere reputable. Private groups are increasingly looking to appease their clients and are moving toward subspecialty signout, or at least bringing in subspecialty trained pathologists to boost the expertise of the group.

I met one faculty member during my fellowship interviews that had quit private practice after a few years to do a fellowship. It worked out well for her. If you think you want to do a fellowship, I would move on it sooner rather than later. The longer you're out of training, the harder it's going to be.

 

[coroner]

Is your desire to quit more motivated by your disdain for academics or desire to be in a particular geographic location near relatives? Because going to a targeted area is going to be more of a challenge than making a transition PP that is non-locale specific.

If you go back and do a fellowship, my opinion is to do something board certifiable e.g. derm, heme, cyto. Even if you do an AP subspecialty fellowship in GI, GU, Breast, etc. some groups scoff at this because they feel they’re just as good signing these cases out as someone who did a non-boarded fellowship on paper. But, there’s others that are high volume in those type of specimens where that piece of paper is good enough even though there’s no BC for it. Find out what PP groups in that area would value for their respective practices.

Having said that, there is no way I would consider going back to fellowship unless I ended up jobless or a group told me “go back and do X fellowship and we will guarantee you $750K/yr in writing…”. I did a surg path fellowship myself and got a PP job. The location is fine, though not at the top of my list. If I were in your shoes, I would attempt to first get an academic job in the desired geographic area. This may be easier already being in academia and wanting to re-locate to the said location instead of waiting for a PP job to open up when an 80 y.o. partner dies from a PE from spending a lifetime sitting behind a microscope. Once you are established in geographic area no matter how big the city is, the pathology community is still relatively small and most people are familiar with each other. Make it a point to get to know other pathologists in the area. So when something in PP does open up, hopefully you will have established the connections and reputation to land the position you seek and get the best of both worlds…

 

[Torsed]

I'd go back and do it while you can.
All those boards and titles and crap doesn't mean you have a brain in your head nor will show up to work everyday.
That's what I look for in an pathologist.