Rank fellowships in terms of difficulty

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FunnyDocMan1234

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What are the hardest and easiest fellowships after IM, workload and lifestyle-wise? To me it seems like GI is the most draining and Rheum the easiset. What do you guys think based on your experiences and talking with fellows?

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What are the hardest and easiest fellowships after IM, workload and lifestyle-wise? To me it seems like GI is the most draining and Rheum the easiset. What do you guys think based on your experiences and talking with fellows?

Rheum - Easy
Cards - Bad
 
As expected, rheum and endo are usually light in terms of workload and weekend/night coverage. All others pretty much suck especially in first year. It also depends if you're going to a research-oriented program or a clinical-oriented program. And of course, alot of program-specific logistics (inhouse vs home call, number of fellows, protected research time, continuity clinic responsibilities, involvement of staff, residents helping out on heavy services ....etc)

I'm finishing up my hem/onc fellowship and I can tell you that my 1st year of fellowship was worse than my IM internship. I had fewer weekends and more calls. on top of that you're preparing for the boards and you're trying to learn your new specialty. Things got better half way through fellowship with more research and electives but overall, and contrary to common misconception among IM residents and med students, your lifestyle and workload is not going to be all that different in fellowship compared to residency.
 
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Interesting thread. I'd say the hardest during fellowship is cards, nephrology (they work the hardest at our hospital), pulm/crit care. GI and heme Onc follow those. The next tier which is dependent on consults/call schedule is probably ID rheum and endo. The easiest probably is allergy (I don't even know if they rotate inpatient) preventative medicine and gim. Not sure where palliative care goes in that group.

After training, I'd say that the fields that are inpatient focused have the worst lifestyles such as pulm crit care and cards (interventionalist) and the ones with the best schedules have mostly outpatient work.

I'd keep in mind that you should choose the field that you find interesting and fun. You need to love the field enough to be engaged for the next 30+ years. A 16 hr cards shift for some is draining while others barely realize the day went by. Likewise, some of us would feel like a half day in endo clinic felt like a 28 hr call. Almost all the fields have their thing that captures their type of personality. An example, pulm crit care people love fixing someone at deaths door in the ICU while I'd probably argue an allergy immunology fellow would hate to be put in that position haha.

Best of luck
 
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From what I've seen and heard: It's very hospital dependent, but generally cards and p/ccm are going to be uniformly difficulty. Endocrine, rheum are going to be uniformly chills. GI, Renal and Heme/onc can be moderate or very busy depending on the hospital. I still don't really know what ID does other than say you're not allowed to use certain antibiotics, so I really don't know how busy they are.....

As gutonc said, you have to love what you do. Most PCCM fellows would gouge their eyes out if they had to do 5 days a week of rheum.
 
I still don't really know what ID does other than say you're not allowed to use certain antibiotics, so I really don't know how busy they are.....

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Palliative isn't bad either. Great hours and manageable workload.
 
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