What is the process like for switching or reapplying to a different fellowship?

[Captdoc]

Hi all

I have a question regarding fellowship. I am open to all answers and advice I can get and I appreciate the help up front.

I am going to be starting a medicine fellowship in July. I was quite excited about the field and the future while applying and was grateful and
excited when the news came that I matched. In the last year I worked as a hospitalist and had some more exposure in my field of speciality. I have now thought about whether or not I made the right decision or not regarding the fellowship I selected

I understand it's close to starting. And yet I feel like I should begin and see maybe that things are different. But I have two important questions just in case I see that this is not for me

I would really appreciate a program directors advice if
Possible.

If I or anyone begins a fellowship and say after several months it's not for me, can I :
1. Stop the fellowship and apply for something else for the following academic year
2. Continue and complete the year and apply via eras during the year as an active fellow

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[gutonc]

If I or anyone begins a fellowship and say after several months it's not for me, can I :
1. Stop the fellowship and apply for something else for the following academic year
2. Continue and complete the year and apply via eras during the year as an active fellow

As with residency, to fulfill your Match agreement, all you need to do is show up on July 1. If you want to tender your resignation at 8am that day, you're all good as far as NRMP goes. You will have earned the ire of your new PD and co-fellows, but that won't keep you out of the Match again. You will also have some sort of notification clause on your fellowship contract that states that you have to give them X weeks/months notice before you quit (and they likewise have to give you that notice before firing you) but it's generally not worth the trouble to try to enforce those things.

As to applying for a different fellowship, you can do that whether you quit or not. But you'll need new LORs which may be difficult to get for a specialty you don't have experience with. Also, anybody interviewing you is going to want a letter from your current fellowship PD stating at the very least that you're in good standing academically (or were when you resigned).

 

[asprin81]

As with residency, to fulfill your Match agreement, all you need to do is show up on July 1. If you want to tender your resignation at 8am that day, you're all good as far as NRMP goes. You will have earned the ire of your new PD and co-fellows, but that won't keep you out of the Match again. You will also have some sort of notification clause on your fellowship contract that states that you have to give them X weeks/months notice before you quit (and they likewise have to give you that notice before firing you) but it's generally not worth the trouble to try to enforce those things.

As to applying for a different fellowship, you can do that whether you quit or not. But you'll need new LORs which may be difficult to get for a specialty you don't have experience with. Also, anybody interviewing you is going to want a letter from your current fellowship PD stating at the very least that you're in good standing academically (or were when you resigned).

I think letting your PD Before hand (now) that you will be resigning on july 1st, will reduce his anger and will help him recruiting a new fellow from market. Because if you let him know on july 1 st that your are resigning will make him more furious and he will have problem in finding coverage......

Anpther thing is that exposure you have with that speciality may not be a universal truth about that speciality and if you share what speciality you are planning to quit, people may share a different view of that speciality with you............my 2 cents

 

[Captdoc]

Thank you all for the quick response and advice, I found it helpful

I would like to know what the process is like just in case I don't think the fellowship is for me.

I plan to work hard and excel in my fellowship and keep an open mind during the training. The fellowship in question is heme/onc. The reservations include a difficult emotional challenge which I thought I would be ready for but apparently it's harder than I imagined. I also tend to miss procedures now that I'm out of residency, something which I thought I would not be an issue

 

[onc2b]

Before making such a drastic decision why not explore other people's practices and not base your decision on what you have seen at just your one facility. The great thing about medicine is that you can design you practice according to what you want.

Heme/onc is a great field for that purpose. If your worried about emotional taxing illness then specialize in more treatable disease, there is a big difference between testicular/thyroid cancer and pancreatic cancer.

Also, some docs focus on hematology and other practitioners would love to have a heme focused doc in their practice. It would make you a very desirable applicant. I also wouldn't be surprised if your fellowship would adjust your training to fit your goals.

Just some unsolicited advise, hope this helped some

 

[Captdoc]

Thank you onc2b for the reply. I've had some experience at 3 different sites, the first two included a teaching hospital and a private practice. They were both great and really drove me to apply. Even then the reservation regarding emotional stress was their, I was hoping it would dissipate. I think that's why Ive decided to begin the fellowship and see how it goes. I have nothing to lose, only to gain an education and perhaps see a different light.

I was wondering if you had any thoughts regarding any future training encouraging more procedures? Interventional onc perhaps with direct chemotherapy etc. I know IR does mostly such things now, any medicine onc programs doing any work as stated above

 

[asprin81]

Thank you onc2b for the reply. I've had some experience at 3 different sites, the first two included a teaching hospital and a private practice. They were both great and really drove me to apply. Even then the reservation regarding emotional stress was their, I was hoping it would dissipate. I think that's why Ive decided to begin the fellowship and see how it goes. I have nothing to lose, only to gain an education and perhaps see a different light.

I was wondering if you had any thoughts regarding any future training encouraging more procedures? Interventional onc perhaps with direct chemotherapy etc. I know IR does mostly such things now, any medicine onc programs doing any work as stated above

After your training you can have following different tracks after hemonc fellowship:

Leukemia Doc or BMT Doc at a decent size academic center: Do 5 bone marrow day, 5 LP with IT chemo, few IT Chemo through shunt in brain...with pace of your life like surgeon, cardiologist...having tachycardias while getting each young 'NEW LEUK'

Lymphoma Doc at a decent size academic center: Again lot of young pt with Hodgkin even Non hodgkin will be cured giving you lot of satisfaction tat you fixed something

Solid tumer at a decent size academic center: doing 2 full day clinic with research or fun in rest of days with hospitalist dealing with in patient care on your admitted pts.

Private Practisioner dealing with all kind of tumer working your ***** of but making 1/2 million dollar

As hospitalist you might be getting all sick hospice dying cancer pts making you think you are dealing with death but 90% of real Onc is out pt, dealing with walking, talking pts and not as depressive as you preceive as hospitalist.....but still most of your pts will die (like heart failure, renal failure, AIDS, and vent dependent pts in other specialities)

One way to avoid all emotional challenges is that change field...start a business