Ranking for PP

[nittanylion]

Hello all, I'm a current applicant interested in generalist private practice and would appreciate some insight on factors when ranking programs. I wanted to get some input from those working out in the community.

-It seems having a fellow's continuity clinic is a big deal if you want to go into PP. Do employers ask about this and will it hurt your competitiveness if your fellowship doesn't have one? Some programs have fellows act as primary for a cohort of patients within attendings' clinics for a certain period of time instead of a fellow's clinic.

-Are clinically busier programs with more inpatient months better prep for covering consults as an attending? Some programs have multiple inpatient months during the third year versus none.

-Do fellows who trained at larger CCC programs outside of their desired practice region have an advantage on local mid-tier university grads in hiring for PP jobs? Interested in a suburban or rural setting in the future, not a big city.

Any other thoughts on important factors to consider are appreciated! Thanks everyone!

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[HemeOncHopeful19]

- It’s important for your learning IMO but I haven’t had it come up on interviews. My program did a mix of both and I felt like there were pros/cons to both systems.
- Inpatient consults are overrated by start of third year you should be able to handle most inpatient consults independently *especially* Onc consults. We’re an outpatient subspecialty.
- Go where you want to end up living. Nobody is going to hire an MD Anderson grad over someone local that the younger partner track docs can personally vouch for because they were cofellows IMO. If you’re talking about getting hired for a big hospital system then it’s more of a “who is willing to take our lowball offer and not make waves, we don’t care where they’re from”

 

[gutonc]

I generally agree with @HemeOncHopeful19 's assessment.

Nobody's going to ask about your clinic setup in interviews, but IMO an independent continuity clinic supplemented with specialty clinics is the "best" option for both learning and ultimate independence.

Inpatient consults were ~10% of my total volume at my last job and are maybe 2% of my current job. Most of them consist of calming down either the hospitalist/surgeon/ICU doc or the patient/family and very little was added to the patient's care by me extracting my pound of flesh from CMS/insurance. The less inpatient time you have, the better, unless you intend to do leukemia/BMT.

Go where you'll be happy/thrive.

 

[osprey099]

I'm a third year fellow who signed for a private practice job. I chose to rank my current fellowship above several "Ivy League" programs and I think it was definitely the right decision for me.

My goal coming into fellowship was to work in the community hospital setting or in a private practice. If that is your goal, I think you'll be much happier and have an advantage going to a place where you can see yourself living/settling down in after fellowship. The reason is because during fellowship, and especially if you go to a NCI designated comprehensive cancer center (CCC) your attendings will get a ton of referrals from the community, and they can make phone calls for you etc when it comes time to find a job. Many of the places I interviewed at had already called some of my attendings (who they commonly refer patients to) to inquire about me and you basically have a leg up on other applicants to the same job if you have existing relationships with specialty specific folks at the local mothership (NCI CCC) who you can maintain referral patterns with.