quitting fellowship

[mikey1982]

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[BLADEMDA]

like some advice, 6 months into fellowship in icu. hate it, don't ever see myself doing it in practice. Im losing potential income right now, and really don't see myself gaining much from it in terms of practicing anesthesia. Im more worried about my residency program director recommendations, and implications it may have in finding a job . Anyone have any experience with this?
thank you

My advice is to complete the fellowship then look for private practice jobs doing O.R. Only. Ask if you can get any TEE time in 2015. I think quitting now makes little sense as you are 1/2 way done. The fellowship still helps for some groups looking for people to do hearts and sick adults.

Now, if you find a great job starting in March then go for it. Remember, most jobs take about 90 days to get you licensed and credentialed. If you have a license in that state already it make take only 30-60 days. Either way you wouldn't start before March 01. Yes, you could do some locums work but your application looks better having completed the fellowship.

The way I see it completing the fellowship at this point costs you 3 months of income.

 

[Mman]

I'd agree with Blade and say finish it. Even if you don't ever use it again, you are already half way done and wouldn't be starting until March or April at earliest anyway. Only way I'd say to drop out is if you had some great opportunity in PP that wouldn't be there in July.

 

[deleted171991]

+1

You will have to explain quitting fellowship to future employers for a long time. You need to have a really good reason. It's probably not worth it at this point. Even if you end up not practicing CCM, it's a great catastrophic insurance for the future, if this specialty goes South.

Funny thing is that I am going into a CCM fellowship next year, and this is exactly the situation I am most afraid of. Are you doing CCM right after your residency?

 

[mikey1982]

yes i did it right after residency; after one month the only thing that motivated me was it was an insurance policy, but id quit medicine before i do ICU now.

 

[deleted171991]

That's sad. At this point, I would focus on passing my boards, and trying to get the best out of the fellowship till July (Echo skills etc. that could be useful for an anesthesiologist). Whatever doesn't kill you makes you stronger.

May I ask why you chose CCM in the first place? Did you love it during your residency?

 

[Sirach38]

Is it really an insurance for the future though? If you finish fellowship and end up doing only OR work for lets say, 10 years. Then all of a sudden in 10 years gas sinks to the bottom of the ocean. Will one be able to go back and do CCM or will all those critical care skills be lost after not practicing for a long time?

 

[mikey1982]

I think if u keep up with ccm certification the jobs are there. I liked it during residency

 

[deleted87051]

Agree with above.

Only thing I would add is not to burn bridges by half-assing your remaining months of fellowship. One year really is just a blip.

 

[Icefrog]

I think if u keep up with ccm certification the jobs are there. I liked it during residency

Hi, I just wanted to say that to keep your CCM certification, you have to continue to do something like 20-25% ICU time averaged out per year. I forget the hard numbers but the fact is that you have to continue to practice CCM to qualify for the 10 year recertification.

Of course, you can pass board certification for CCM by taking the exam in the fall after you finish fellowship, but in 10 years if you haven't practiced any CCM, you won't be eligible for recertification. You may also have trouble convincing an employer you are still capable of practicing ICU if you haven't done it in years and years.

 

[urge]

Im more worried about my residency program director recommendations, and implications it may have in finding a job .

I'm not sure what this means. Do you mean the recommendation to do an icu fellowship without you really wanting to do it?

I don't think a fellowship would interfere with OR jobs. You are just as green as anyone coming out of residency.

I don't see you doing icu 10 yrs from now if you hate it at the moment. Your back up plan failed long time ago.

I would not quit. Quitting is a red flag in medicine. Your character will be questioned forever. I think that would interfere with future jobs the most.

 

[deleted171991]

This fellowship will be pretty useful, even if you end up not practicing CCM. A lot of what you are learning will make you a better anesthesiologist, the kind that uses evidence to back up his/her decisions, the kind that knows internal medicine, the kind that feels comfortable with sick patients. Every day, try picking the sickest of your patients and imagine her having some complicated procedure, then devise a mental anesthetic plan, including the most likely complications. It will help you, even if just for the oral boards.

 

[Ezekiel2517]

Sorry but you have to be pretty clueless to do 6 months of icu as a resident and then realize you can't stand it as a fellow

 

[G-Man82]

I'm sorry you don't like the ICU at all. What about it specifically bothered you? I personally enjoy the ICU a lot; I have a rare opportunity to do a few blocks of my rotation in an SICU completely managed by Anesthesiologists, and the parallels to OR culture are pretty strong. For instance, I've done a few epidurals here for pain management in people post-op who failed conventional therapy. I've even placed a thoracic or two in the few rare traumas with rib fractures we get. The other day, a patient hemorrhaged into his chest, and a bunch of Anesthesiologists came to assist in his management in the unit.

On top of that, the fellowship makes you more capable of speaking with other physicians about evidence behind diagnostic choices and therapies, etc. It's pretty cool. I'm just hoping that I can find a job that allows me to practice both Anesthesiology and CCM.

 

[Hoya11]

Everyone (3-4) I know who went from Anesthesia to CCM had similar feelings as you, why did I do this fellowship again? Half way through Id say stick it out, its a feather in your cap and you should be applying to groups now. I would think leaving would be a minor red flag, but it all depends, if your miserable doing it and youve got to get out then bail. but if its tolerable i would strongly recommend sticking it out, your practically done. Then go back to the OR, and whatever happens with that extra training, be it part time ICU work or nothing, so be it.

 

[yancantcook]

I agree with sticking it out for the year. Quitting is a big red flag and may make people think that you may quit again in the future with another group/opportunity/etc if things get tough or not the way you want, especially since you signed a 1 year contract with the fellowship. Good luck.

 

[Morzh]

So what about CCM is different as a fellow than what you experienced as a resident? What would you say to your past self or others who are considering an ICU fellowship?

 

[BLADEMDA]

So what about CCM is different as a fellow than what you experienced as a resident? What would you say to your past self or others who are considering an ICU fellowship?

Choose the right CCM Fellowship Program. Like many things it isn't just the specialty/subject but rather the working conditions of his/her particular program which can make or break your view of it.

 

[urge]

Choose the right CCM Fellowship Program. Like many things it isn't just the specialty/subject but rather the working conditions of his/her particular program which can make or break your view of it.

Words of wisdom.

The people around you can inspire you into greatness or into ****.

 

[seinfeld]

You quit the fellowship and then you'll have to explain it for the rest of your life. Every job interview will find you suspect and things being equal would hire a person who doesn't have that history.

Remember that PP CCM is a much different animal than being a resident or fellow in an academic institution. I rounded on 12 patients today in SICU. Rounds took 45 minutes. Wrote my notes and then went to MICU and was a second attending in declaration of patient brain death. Started my day at 8am and was home at 1pm.

 

[norwood]

So what about CCM is different as a fellow than what you experienced as a resident? What would you say to your past self or others who are considering an ICU fellowship?

I'd still really like to hear this. Is there something malignant about the fellowship itself? Or you were expecting CCM to be something totally different?