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Stuck B/W Hospitalist and Fellowship

Da Boy

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Jun 18, 2020
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Hi everyone,

So I am a 2nd year (almost 3rd year) IM resident and have always wanted to pursue a specialty. Recently, some personal things have happened that have kind of pushed me in the direction of being a Hospitalist for financial purposes to help my family (but not totally). I am on a J-1 visa and most of the “good” Hospitalist jobs for us are taken in Sept/Nov when the J-1 waiver applications start rolling in. This would complicate things for the fellowship match that happens in December. I would start as a Hospitalist or fellow on July 2021 by the way (J-1 holders find jobs well in advance) so I wouldn’t break any Hospitalist contract before I start working. It’s more of an ethical dilemma I guess and whether something bad can happen to my visa status.

So my question to you is, could I go for both and then if I match into a fellowship pull out of my Hospitalist contract? Or if you guys were in my situation, would you go for a fellowship and then if you don’t match “settle” for whatever Hospitalist jobs are left - there are some states that never fill their J-1 spots, but are probably not the “best jobs”.

Thank you.
 
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BoardingDoc

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Hi everyone,

So I am an IM resident and have always wanted to pursue a specialty. Recently, some personal things have happened that have kind of pushed me in the direction of being a Hospitalist for financial purposes to help my family (but not totally). I am on a J-1 visa and most of the “good” Hospitalist jobs for us are taken in Sept/Nov when the J-1 waiver applications start rolling in. This would complicate things for the fellowship match that happens in December.

So my question to you is, could I go for both and then if I match into a fellowship pull out of my Hospitalist contract? Or if you guys were in my situation, would you go for a fellowship and then if you don’t match “settle” for whatever is left - there are some states that never fill their J-1 spots, but are probably not the “best jobs”.

Thank you.
It depends on the language in your hospitalist contract. Generally speaking, there is a required amount of notice that you must give before you can leave the job, typically it's 90 days. E.g. if you sign a contract and start working tomorrow, you can't stop working there for 3 months without risking a lawsuit.

In your case, you'd probably be fine. You would start working in say, Nov and would know in Dec whether you would be quitting the hospitalist job in July of the following year. That gives you plenty of lead time. Just make sure that you know exactly low much notice time your contract requires before signing anything.

Also keep in mind that if you don't tell your new employer that you are looking to match and that this might be a very short-term assignment for you, you could lose any chance of ever being hired by that group / hospital again. You certainly don't need to tell them this, but it's something to consider if you ever plan on working in the area after you complete your fellowship.
 
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Da Boy

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Jun 18, 2020
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It depends on the language in your hospitalist contract. Generally speaking, there is a required amount of notice that you must give before you can leave the job, typically it's 90 days. E.g. if you sign a contract and start working tomorrow, you can't stop working there for 3 months without risking a lawsuit.

In your case, you'd probably be fine. You would start working in say, Nov and would know in Dec whether you would be quitting the hospitalist job in July of the following year. That gives you plenty of lead time. Just make sure that you know exactly low much notice time your contract requires before signing anything.

Also keep in mind that if you don't tell your new employer that you are looking to match and that this might be a very short-term assignment for you, you could lose any chance of ever being hired by that group / hospital again. You certainly don't need to tell them this, but it's something to consider if you ever plan on working in the area after you complete your fellowship.

I forgot to mention that I would be starting the hospitalist job in July 2021. J-1 visa holders typically find jobs well in advance so that we can get the waiver.
 
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gutonc

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I forgot to mention that I would be starting the hospitalist job in July 2021. J-1 visa holders typically find jobs well in advance so that we can get the waiver.
The advice is similar. Get yourself a hospitalist job. Work on deciding if you want to do fellowship or not. If you do, and you apply, interview and match, cancel your contract. In that case, the likelihood of anything bad happening is quite low. Especially since your Match would be known well in advance of a 90 day out for the hospitalist contract.
 
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Jun 17, 2019
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Hi everyone,

So I am an IM resident and have always wanted to pursue a specialty. Recently, some personal things have happened that have kind of pushed me in the direction of being a Hospitalist for financial purposes to help my family (but not totally). I am on a J-1 visa and most of the “good” Hospitalist jobs for us are taken in Sept/Nov when the J-1 waiver applications start rolling in. This would complicate things for the fellowship match that happens in December. I would start as a Hospitalist or fellow on July 2021 by the way (J-1 holders find jobs well in advance) so I would break any Hospitalist contract before I start working. It’s more of an ethical dilemma I guess and whether something bad can happen to my visa status.

So my question to you is, could I go for both and then if I match into a fellowship pull out of my Hospitalist contract? Or if you guys were in my situation, would you go for a fellowship and then if you don’t match “settle” for whatever Hospitalist jobs are left - there are some states that never fill their J-1 spots, but are probably not the “best jobs”.

Thank you.
It's not an ethical dilemma it's a legal one.

You'll be sued and responsible for hefty amount of money for breaking your contract with no reason.
 
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NotAProgDirector

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I think the OP is asking this: I'm currently finishing my PGY-2, will start my PGY-3 this July. Can I both look for a hospitalist job which usually involves signing a contract in Nov, and try to match in Dec and then "cancel" my job if I get a spot?

The answer somewhat depends on what you "can" do and what you "should" do. If you do this, you could run into several problems:

1. Your employment contract could penalize you for cancellation. Usually this would be to reimburse the program for the costs of onboarding you. Whether they would actually try to do so is unclear. Also mentioned is a non-compete - if you have one and then you match inside your non-compete radius, that could be a problem (although most non-compete's are not enforceable).
2. It's possible you could end up with visa problems. If your new employer submits paperwork to start the J Waiver program, I don't know what happens if you try to cancel that. Probably nothing, but I don't know.
3. The match requires you to certify that you do not have another commitment at the same time. If someone were to complain to the NRMP, that could cause lots of problems.

Bottom line is that you probably can do this, but probably shouldn't do this.
 
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CCM-MD

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I know someone who signed a J1 waiver job and was subsequently offered a fellowship position. He wanted to join the fellowship but was unable to do so because his job had already submitted his waiver paperwork.

Once you get a waiver you cannot go back to training on a J1. Keep that in mind. You should consult an immigration attorney before finalizing your plans.
 
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Da Boy

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Jun 18, 2020
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I think the OP is asking this: I'm currently finishing my PGY-2, will start my PGY-3 this July. Can I both look for a hospitalist job which usually involves signing a contract in Nov, and try to match in Dec and then "cancel" my job if I get a spot?

The answer somewhat depends on what you "can" do and what you "should" do. If you do this, you could run into several problems:

1. Your employment contract could penalize you for cancellation. Usually this would be to reimburse the program for the costs of onboarding you. Whether they would actually try to do so is unclear. Also mentioned is a non-compete - if you have one and then you match inside your non-compete radius, that could be a problem (although most non-compete's are not enforceable).
2. It's possible you could end up with visa problems. If your new employer submits paperwork to start the J Waiver program, I don't know what happens if you try to cancel that. Probably nothing, but I don't know.
3. The match requires you to certify that you do not have another commitment at the same time. If someone were to complain to the NRMP, that could cause lots of problems.

Bottom line is that you probably can do this, but probably shouldn't do this.

Thanks for the reply. In a perfect world I would have a good, unsigned, Hospitalist contract in my hand in early December then see what happens with the match. I will probably just apply to a fellowship and start looking for a Hospitalist job in October-November to try and achieve that.

Bottom line, I won’t sign until after the match and will take my chances with whatever Hospitalist jobs are available then.
 
Jun 17, 2019
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Hospitalist jobs are not that hard to find...even ones with that give a j1 waiver...why not just wait until you know if you match.

Also depends on what you are looking to apply to...ID? Probably won’t have a problem matching...GI? Well...
I disagree.

J1 waiver Hospitalist positions are becoming notoriously difficult to get.

Tough competition, slow painful process, most states prefer PCPs and consider Hospitalists specialists.
 
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