What is lifestyle like on post-residency fellowship?

[spacecadet]

I'm curious about sub-specialty fellowships and what the lifestyle is like. Basically, I'm wondering what the going salary is, as well as what the time committment and levels of responsibility are.

I know this will vary a lot between fellowships, but can you tell me if it is basically like residency all over again, or more like being out of residency?

I don't know exactly what specialty I'm thinking about (and it's kind of early for me still), but how about pediatric surgery or REI as examples (or whatever you know about).

Thanks!

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[droliver]

Fellowship hours vary signifigantly by field. Most traditional surgery fellowships that involve trauma & emergent cases work a brutal # of hours (cardiothoracic, vascular, plastic surgery, Peds surg) while some of the others tend to have less or elective case schedules only (Surg. Oncology, Breast surgery, colo-rectal surgery, laparoscopy, critical care).

I've never noticed that the medicine fellows really have that hard a time. Sometimes cardiology & renal will have to do some middle of the night work on sicker patients, and some cardiology fellowships are notoriously diffucult depending on how busy the cath lab is. It's a lot easy for Internal medicine residents to hold down the fort with the fellow @ home than it is for gen surg. junior residents due to the emergent surgical procedures required quite often.

 

[Sanman]

out of curiousity, what are the best and worst lifestyle specialties in IM.

 

[Future GI Guy]

Actually, Cardiology fellows can be more overworked than Medicine or Surgical Interns.

Invasive Cardiologists are a bit like trauma surgeons in that, they're always on call, their procedures are done rather emergently to preserve myocardium, and they're not yet treated with the same respect that attendings are (one can see this both financially and in how people treat one another).

Other IM fields like GI or Renal don't have the same kind of hell as fellows.

Emergent situations in these fields, like acute renal failure or overwhelming diarrhea leading to dehydration, can be managed by the Internal Medicine resident on call. In other words, they can wait until the next day when the ancillary staff can arrive to assist in any necessary procedures. If you're at an institution where peritoneal dialysis can't be performed by a medicine resident, something's wrong.

As for rheumatology, hem-onc, allergy and immunology, pulmonary, and endocrinology, any emergent problems (diabetic ketoacidosis, etc) can be managed, too, by the internal medicine resident, and thus, fellows in these fields have a pretty cushy call schedule.

Infectious diseases might be another sub-specialty that comes in at night, specifically if someone has an acute sepsis with no identifiable infectious agent. But these situations would be rare.

Acute Myocardial Infarctions, however, are not rare, and these days, they're almost always managed by Interventional Cardiologists, and if that fails, by the CT Surgeons.