Switching Fellowships

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Captdoc

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Hi all

I had a question regarding switching from one fellowship to the other.

I have just started a fellowship in Heme/Onc and am in my 4th month now

I do enjoy the faculty and my co fellows but the subject matter has been very hard for me to handle in terms of the emotional aspect of seeing sick and dying patients daily. I thought I would get used to it and maybe be able to handle it but it hasnt seem to change. I applied to the fellowship because I was interested in the medicine behind it, research etc but I cant get over the clinical aspect of seeing such sick patients. In a 3 day period I saw multiple patients of mine die and i just dont see myself doing this for the rest of my life anymore.

I do enjoy clinical work so I cant see myself working in research in this particular field. I am willing to finish the year so the program doesnt feel the stress of not having a fellow.

My question is will it be difficult to switch by reapplying to another fellowship?

Do programs dislike a fellow who has left a program in the past?

Help would be appreciated. I havent discussed the matter at my program as the subject is sensitive and I havent made it public yet before I hear my options.

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Based on your previous posts, you have been leery of this specialty for quite some time. I'm curious why you went ahead and did it rather than giving up your spot and letting one of the hojiggity thousand other applicants who didn't get a spot have it. Did you somehow think that getting to hang out with more dying people would make things easier? BTW, I completely understand going into the field because of the science behind it, I did the same thing.

But to your actual question, the biggest problem you're going to have with switching specialties is that you (presumably) have no letters/rotations/experience in any other specialty. So getting an LOR for GI (since that seems to be your area of interest) is probably going to be difficult/impossible and since there are, again, hojiggity thousand applicants for GI with multiple specialty-specific letters, you're in kind of a bind in that respect.

As I see it, your best route is as follows. Finish out the year (or don't...you don't owe your program anything but it's definitely common decency to do so and will result in a much better LOR from your current PD if you do), get a job as a hospitalist for a year or two (preferably in an academic institution with a GI or whatever fellowship) and find somebody to do research with part-time. Pump out a paper or two, get a letter from your research mentor (who needs to be a clinician...the research itself can be clinical, translational, whatever but the research mentor needs to be an MD) and then apply.

I don't think having left a previous program will be that much of a red flag, esp when compared to not having any relevant LORs, as long as you leave on good terms.
 
Hi all

I had a question regarding switching from one fellowship to the other.

I have just started a fellowship in Heme/Onc and am in my 4th month now

I do enjoy the faculty and my co fellows but the subject matter has been very hard for me to handle in terms of the emotional aspect of seeing sick and dying patients daily. I thought I would get used to it and maybe be able to handle it but it hasnt seem to change. I applied to the fellowship because I was interested in the medicine behind it, research etc but I cant get over the clinical aspect of seeing such sick patients. In a 3 day period I saw multiple patients of mine die and i just dont see myself doing this for the rest of my life anymore.

I do enjoy clinical work so I cant see myself working in research in this particular field. I am willing to finish the year so the program doesnt feel the stress of not having a fellow.

My question is will it be difficult to switch by reapplying to another fellowship?

Do programs dislike a fellow who has left a program in the past?

Help would be appreciated. I havent discussed the matter at my program as the subject is sensitive and I havent made it public yet before I hear my options.


If you are planning to complete 1 year anyway, I would suggest asking your PD that you want to do single board oncology (intead of hem/onc). For that you do a couple of extra month of clinical work in second yr and rest of yr research (which you can spend on GI research). You can try to work with GI Oncology attending more and these letter can help you for GI medicine down the road..............At least my program allows fellows to switch from hem/onc to med/onc
 
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If you are planning to complete 1 year anyway, I would suggest asking your PD that you want to do single board oncology (intead of hem/onc). For that you do a couple of extra month of clinical work in second yr and rest of yr research (which you can spend on GI research). You can try to work with GI Oncology attending more and these letter can help you for GI medicine down the road..............At least my program allows fellows to switch from hem/onc to med/onc

If possible at your program, this is not a bad idea. This way you avoid the "quitter" label since you did finish your fellowship. You also have time to get some GI (or whatever other sub-specialty) specific research done and maybe a clinical elective rotation (I've been invited into the endoscopy suite and the OR by attendings) in as well.
 
Thank you all for the words of advice. I was interested in GI when I began my medicine residency so I do have some research, case reports and perhaps attendings that would still be willing to write me a letter of rec. Why I didnt apply at that time is still hard to answer. I do like the idea of perhaps consider med/onc and then considering GI afterwards. I will look into this.

I thank you both for the help!
 
It may be a small suggestion, but there are several other career routes to consider after you finish heme or onc single-board. It sounds like the rough part is almost over. I would finish it out, because there are more opportunities than going back to square 1.

With heme board, you could become a blood bank director or fellow. With onc board, you could do fellowship program at NCI. You can also do fellowship at a pharma oncology division. All of these are gateways into a career that doesn't involve looking after the dying. Best wishes.
 
Focus on Heme. I am sure you can do the vast majority of your clinical months in this field and walk away with certification. Then you can move on to something else
 
Focus on Heme. I am sure you can do the vast majority of your clinical months in this field and walk away with certification. Then you can move on to something else

Uggh. Benign heme makes me want to pull out my fingernails with pliers. And if you have to do both benign and malignant heme, there is nothing more depressing than BMT. It's one thing to watch your patients slowly die because of their disease that you can't do anything about. It's something completely different to watch them slowly die because of what you did to them.

But...assuming you can tolerate the heme side of things, this is no worse an idea than the onc single boarding.
 
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