I am a 3rd year internal medicine resident. I loved my time in the ICU and am definitely considering doing a pulm/CC fellowship. However, I decided to work as a hospitalist for 2 years in order to get some life experience, travel, exercise autonomy, start paying back loans, ideally gain perspective into whether I really want to pursue pulm/cc fellowship. I have an awesome nocturnist job lined up at my home academic institution which I am really looking forward to starting. I just was approached by the pulm/cc PD at my home institution who offered me a spot as a 1st year pulm fellow starting this july b/c someone dropped out. Now I'm torn. On one hand, this is an incredible opportunity and it would be amazing to not have to go through the match and interview process. On the other hand, I was really looking forward to being a hospitalist for a couple years and gaining some perspective. Would it be crazy to pass up this opportunity? Is it really that hard to come back to do fellowship after a couple of years as a hospitalist?
take pulm/cc fellowship offer vs hospitalist gig?
- Thread starter vonte
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What an offer! From what I've heard from my seniors, and those that have graduated, coming back after being a hospitalist is a bit more difficult. Especially after making a decent salary, and paying your student loans. Some of my academic attendings, just graduated from residency <2-3years ago, and are contemplating fellowship now. I'm sure there are some programs that would prefer fresh graduating residents, than those who are in the hospitalist field. But there are always exceptions. Some places may see the hospitalist experience as an advantage. If I were you, I would take the fellowship now. You still have the energy to study, push yourself through the rigors of calls, and be motivated.
Agreed. The general advice I've always received is to get your training out of the way earlier in life. In your case, it seems like it's also right there for the taking. Might as well jump on it. Great position to be in.
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Take it man. I didn't have to go through the match for my CCM spot and I can say I definitely saw significant stress with interviewing and the anxiety of the match on my co-residents (though certainly not as much as residency match). Having a guaranteed fellowship spot in Pulm-CCM is a great gift provided that you were planning on doing it anyway and aren't burnt out. You can moonlight as a fellow and still make some payments on your loans so they don't continue to accrue at a ridiculous rate. Just keep your lifestyle otherwise controlled and get it done. Financially and professionally it will end up working out for you.
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Take the fellowship. You won't come back if you take the nocturnist position.
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And your income potential is higher with CC right now.
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Vonte,
Coming from a current hospitalist working as a nocturnist, let me tell you, there is no such thing as an awesome nocturnist job. Sure, there is a spectrum of sh**tiness, but rest assured, they all suck. I would respectfully disagree with neusu when they say that you won't go back to fellowship after taking a nocturnist gig. I feel the contrary is true, I think you'd be kicking yourself for not taking the fellowship if you took the nocturnist gig. Sure, the money is nice out of residency and I certainly agree that taking some time out from training does allow you to do other things you have been unable to do in your life and also gives you a fresh perspective. That being said though, there is a lot not to like about being a nocturnist. First, the hours are terrible, the assault on our natural circadian rhythms quickly becomes apparent. Also, as a nocturnist, you never really get to integrate and be a part of the group the way you would if you were working days, you are always an outsider in a certain sense. You also don't have the level of support available at night that is present during the day, so if things go south, and they will, as a nocturnist you bear the brunt of that burden.
If I were you, I would take the fellowship. I was like you, and always wanted to do Pulm/CC, but after residency my financial situation was in need of some STAT resuscitation. Now that I have been able to do that I will be applying for fellowship this year. In the end, I think whatever decision you make will work out and be beneficial in it's own right, just opting for fellowship and without having to apply will save you some pain.
Coming from a current hospitalist working as a nocturnist, let me tell you, there is no such thing as an awesome nocturnist job. Sure, there is a spectrum of sh**tiness, but rest assured, they all suck. I would respectfully disagree with neusu when they say that you won't go back to fellowship after taking a nocturnist gig. I feel the contrary is true, I think you'd be kicking yourself for not taking the fellowship if you took the nocturnist gig. Sure, the money is nice out of residency and I certainly agree that taking some time out from training does allow you to do other things you have been unable to do in your life and also gives you a fresh perspective. That being said though, there is a lot not to like about being a nocturnist. First, the hours are terrible, the assault on our natural circadian rhythms quickly becomes apparent. Also, as a nocturnist, you never really get to integrate and be a part of the group the way you would if you were working days, you are always an outsider in a certain sense. You also don't have the level of support available at night that is present during the day, so if things go south, and they will, as a nocturnist you bear the brunt of that burden.
If I were you, I would take the fellowship. I was like you, and always wanted to do Pulm/CC, but after residency my financial situation was in need of some STAT resuscitation. Now that I have been able to do that I will be applying for fellowship this year. In the end, I think whatever decision you make will work out and be beneficial in it's own right, just opting for fellowship and without having to apply will save you some pain.
I am taking a nocturnist job next year (July 2015). I was wondering if you matched and how did the whole process look like? was it hard to get interviews? did you have your job in a big place/name? did you do some research while in job?
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I did end up matching at my #1. The whole process looked pretty similar to if I was just coming out of residency, except I was able to schedule interviews on my days off, so I didn't have to scramble to get people to cover me. I also felt the financial burden of applying a lot less than I would have when I was a resident. It wasn't hard to get interviews. My job certainly did not have a big name in the academic world. I did do a research project with people from residency while I was working and presented it at CHEST this past year.
Overall, I think the nocturnist job will serve you well, it will help you develop your clinical acumen and decision making. It should also pay you well! I still stand by my previous stance that nocturnist jobs suck, and doing this job may only strengthen your resolve to do fellowship. Which I think is also very beneficial, because you'll be going into fellowship with a different perspective and you won't always be wondering what it's like on the other side, once you're done with training, because you'll already know.
