Where to do IM residency that will set me up for an Endocrine Fellowship?

[RosenthalFiber]

Hey guys! Really interested in Endocrine and doing research in it now as an MS4. I was wondering if you know of any programs that will "set me up" well when it comes time to apply for fellowship.

There are so many programs out there and I can't get a feel for it....thanks!

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[gutonc]

Hey guys! Really interested in Endocrine and doing research in it now as an MS4. I was wondering if you know of any programs that will "set me up" well when it comes time to apply for fellowship.

There are so many programs out there and I can't get a feel for it....thanks!

Anywhere. Endocrine is not at all competitive on the whole. If you want an endo spot, you'll get one. If you want a "top" fellowship spot (like you want to be at the Joslin for your research years) then you'll want to go somewhere that has a fellowship program so you can get some research in as a resident. But if you just want a fellowship, you'll get one coming from most anywhere as long as you perform well.

 

[RosenthalFiber]

Anywhere. Endocrine is not at all competitive on the whole. If you want an endo spot, you'll get one. If you want a "top" fellowship spot (like you want to be at the Joslin for your research years) then you'll want to go somewhere that has a fellowship program so you can get some research in as a resident. But if you just want a fellowship, you'll get one coming from most anywhere as long as you perform well.

This has me feeling a lot better. I've wanted to do endocrine since high school....still think there is a possibility Heme/Onc or GI could come into the mix- but based on research/experience in the field I think endocrine is probably where I belong and where I'll go.

Good to hear it's not that competitive. Thanks bud

 

[Bostonredsox]

Graduate from any IM program and have a pulse and you'll get a slot.

Endocrine requires two years at a fellows salary and you make substantially less money than a hospitalist. Not exactly a line of people bowling over each other for those spots.

 

[RosenthalFiber]

Graduate from any IM program and have a pulse and you'll get a slot.

Endocrine requires two years at a fellows salary and you make substantially less money than a hospitalist. Not exactly a line of people bowling over each other for those spots.

Actually, I know plenty in the field who make 250k and have a much better lifestyle than a hospitalist (9-4). Or you can make 150k doing basic stuff or 120k at an academic play...a lot of variance within the field. You just need to make the right niche and not do diabetes all day long is the advice they gave me

 

[rokshana]

Graduate from any IM program and have a pulse and you'll get a slot.

Endocrine requires two years at a fellows salary and you make substantially less money than a hospitalist. Not exactly a line of people bowling over each other for those spots.

was that your experience applying to Endo? its certainly was not mine...

yes, in general endo is not as competitive as gi, cards, or hem/onc, but every IM subspecialty seems to have picked up in competitiveness and endo has a good lifestyle and decent money (as mentioned its possible to make 200+ and still have decent hours with little call), so to just say go to any IM program and you will match endo is probably not the best advice.

Yes, one can still have a good shot at getting an Endo spot coming out of IM, but to optimize your chances, try to do IM at a place that has an Endo fellowship...it will give you a chance to meet people in the field, get a chance to do research and come application time, you will have people to speak on your behalf...and in fellowship application WHO you know can very well trump WHAT you know (its a small world....they all know each other...).

 

[Extracts]

was that your experience applying to Endo? its certainly was not mine...

yes, in general endo is not as competitive as gi, cards, or hem/onc, but every IM subspecialty seems to have picked up in competitiveness and endo has a good lifestyle and decent money (as mentioned its possible to make 200+ and still have decent hours with little call), so to just say go to any IM program and you will match endo is probably not the best advice.

Yes, one can still have a good shot at getting an Endo spot coming out of IM, but to optimize your chances, try to do IM at a place that has an Endo fellowship...it will give you a chance to meet people in the field, get a chance to do research and come application time, you will have people to speak on your behalf...and in fellowship application WHO you know can very well trump WHAT you know (its a small world....they all know each other...).

To each his own, I would rather do endocrine or rheum for less money than a hospitalist. However, I didn't want to deal with fibromyalgia or uncontrolled diabetes. Now I deal with patients with phantom allergies.

 

[Bostonredsox]

Actually, I know plenty in the field who make 250k and have a much better lifestyle than a hospitalist (9-4). Or you can make 150k doing basic stuff or 120k at an academic play...a lot of variance within the field. You just need to make the right niche and not do diabetes all day long is the advice they gave me

250k is about the average rate for hospitalists. You sure your lifestyle is better? You work 9-4, 5 days per week (20 shifts per 28 days, 140 hours per 28 days) for 250k. I work 7-7 for 7 on 7 off (14 shifts per 28 days, 168 hours per 28 days) for 250k......and your starting down 400k from the 2 fellowship years plus whatever interest your loans accrued.

IM playing devils advocate as I signed on to be a critical care hospitalist for 2 years but I'm ultimately doing a pulm/CC fellowship. My point was compared with cards GI and the other higher paying subspecialtys, endocrine and ID pay much less on average. Most people who do it are doing it because they truly love it and not because there expecting a big payday like cards, this is one of the reasons it's far less competitive.

 

[Bostonredsox]

To each his own, I would rather do endocrine or rheum for less money than a hospitalist. However, I didn't want to deal with fibromyalgia or uncontrolled diabetes. Now I deal with patients with phantom allergies.

Ha. I had a patient tell me they were allergic to epinephrine the other day. IM assuming this is theoretically possible if they have an allergy to one of the filler substances that its mixed with in the vials. Struck me as quite funny though at the time

 

[rokshana]

250k is about the average rate for hospitalists. You sure your lifestyle is better? You work 9-4, 5 days per week (20 shifts per 28 days, 140 hours per 28 days) for 250k. I work 7-7 for 7 on 7 off (14 shifts per 28 days, 168 hours per 28 days) for 250k......and your starting down 400k from the 2 fellowship years plus whatever interest your loans accrued.

IM playing devils advocate as I signed on to be a critical care hospitalist for 2 years but I'm ultimately doing a pulm/CC fellowship. My point was compared with cards GI and the other higher paying subspecialtys, endocrine and ID pay much less on average. Most people who do it are doing it because they truly love it and not because there expecting a big payday like cards, this is one of the reasons it's far less competitive.

won't the loans accrue interest over those 2 years, regardless?

having worked as a hospitalist for the last 2 yrs, those 12 hour shifts 7 days in a row are a bit exhausting and i rarely did anything but work and then go home to eat and sleep...looking forward to a more normal schedule (will let you know in a few years if im still liking the regular schedule!).

i don't think anyone would say its as competitive as gi, cards, or hem/onc, but i don't think you can just wake up 3rd yr and say "i think ill apply to endo (or rheum) today"...like you said, people go into the less competitive, lower paying subspecialties because they love the field...those that are selecting the next generation are looking for the same love...sure you can probably demonstrate that coming out of any ole IM program, but its makes your life easier if you have access to things (research, mentors, so forth) that will help programs see that.

have to say though, don't wait too long to go back to fellowship...its going to be a LOT harder to go back to the training mentality and routine after being out...you get use to the money and more importantly (at least for me) the flexibility of your schedule (going from essentially 26 weeks off to FOUR!)!

 

[Bostonredsox]

Yes they accrue, but they accrue less as the principal balance that they are accruing on is diminishing significantly as your paying on them during those two years. And we do 12 on 2 off 12-14 hour shifts as a resident on hospital medicine. 7 on 7 off for what's mor like 11.5 hour shifts will be a massive improvement and will be a nice lifestyle IMO. I feel a day at work is a spent day, away from family, not being able to take a trip, etc. thus I would much rather work 14 twelves than 20 eights in a month schedule. To me yeah your more tired on on your "on days" , but not even in the same universe to how tired you were as a resident doing the same thing only a year earlier, and you gain 6 more days completely free from any work obligations.

 

[RosenthalFiber]

250k is about the average rate for hospitalists. You sure your lifestyle is better? You work 9-4, 5 days per week (20 shifts per 28 days, 140 hours per 28 days) for 250k. I work 7-7 for 7 on 7 off (14 shifts per 28 days, 168 hours per 28 days) for 250k......and your starting down 400k from the 2 fellowship years plus whatever interest your loans accrued.

IM playing devils advocate as I signed on to be a critical care hospitalist for 2 years but I'm ultimately doing a pulm/CC fellowship. My point was compared with cards GI and the other higher paying subspecialtys, endocrine and ID pay much less on average. Most people who do it are doing it because they truly love it and not because there expecting a big payday like cards, this is one of the reasons it's far less competitive.

250k total is probably the most I've heard of a hospitalist making (180-200k base + bonuses, incentives, loan forgiveness). I have relatives who are hospitalists- they all loved it in their youth- but as they approach 45 yrs old+ they are a tad sick of seeing CHF exacerbations and MI's over and over again and handing off a lot of the "cool" stuff to the specialists. It is certainly a great option and trust me I'm not dogging it-

Honestly if I really wanted to I could find somewhere to do endocrine/critical care in a 3 yr set up...then if I hate my life I could be a CC doc working 7 on 7 off.

Not saying any option is better- because they all have pro's and con's.

After all- I'm sure many chose IM because of the variety of options in the field

 

[Bostonredsox]

I agree with everything you said except the pay. Amongst my offers right out of residency the average was 240-250k. Low of 215 high of 290. VA, NC, SC, NY were the locations.

Burn out rate is high but isn't it high in everything? 20-30 years of any field has to get tiring

 

[rokshana]

250k total is probably the most I've heard of a hospitalist making (180-200k base + bonuses, incentives, loan forgiveness). I have relatives who are hospitalists- they all loved it in their youth- but as they approach 45 yrs old+ they are a tad sick of seeing CHF exacerbations and MI's over and over again and handing off a lot of the "cool" stuff to the specialists. It is certainly a great option and trust me I'm not dogging it-

Honestly if I really wanted to I could find somewhere to do endocrine/critical care in a 3 yr set up...then if I hate my life I could be a CC doc working 7 on 7 off.

Not saying any option is better- because they all have pro's and con's.

After all- I'm sure many chose IM because of the variety of options in the field

eh, i've seen higher than 250...but not in the NE...the NE, overall, sucks for docs and pay isn't any different...hospitalists there will make in the neighborhood of 160-180k.

 

[Bostonredsox]

eh, i've seen higher than 250...but not in the NE...the NE, overall, sucks for docs and pay isn't any different...hospitalists there will make in the neighborhood of 160-180k.

IM from upstate NY. Have many friends in the 250+ range there and. I have had multiple offers myself in that range. Depends on where your talking when you say NE. NYC, Boston? Pay sucks there . Lot of areas are much higher though still in the NE

 

[rokshana]

IM from upstate NY. Have many friends in the 250+ range there and. I have had multiple offers myself in that range. Depends on where your talking when you say NE. NYC, Boston? Pay sucks there . Lot of areas are much higher though still in the NE

true, upstate NY, western Mass, central PA are exceptions to the NE pay scales, but overall NJ, CT, Downstate NY, Philly area...the pay is crappy...i know plenty of people who live in those areas that do locums to make up pay...

 

[JaggerPlate]

Any thoughts on matching ACGME Endo fellowship from AOA (DO) IM program? I know most say to go ACGME for IM residency to increase fellowship odds, but wondering if anyone knew anything specific about Endo.

Thanks!

 

[VentdependenT]

I was offered 250k to be a hospitalist here in Louisville.

 

[Instatewaiter]

250k is about the average rate for hospitalists. You sure your lifestyle is better? You work 9-4, 5 days per week (20 shifts per 28 days, 140 hours per 28 days) for 250k. I work 7-7 for 7 on 7 off (14 shifts per 28 days, 168 hours per 28 days) for 250k......and your starting down 400k from the 2 fellowship years plus whatever interest your loans accrued.

I'd say outpatient Endo is much easier than being a hospitalist. The hours are just easier.

Any thoughts on matching ACGME Endo fellowship from AOA (DO) IM program? I know most say to go ACGME for IM residency to increase fellowship odds, but wondering if anyone knew anything specific about Endo.

Thanks!

If I remember correctly, ACGME recently made a requirement that people going into ACGME fellowships did an ACGME IM program. Now this may be a moot point since there is going to be a single accredidation body soon but it may throw a wrench in the works. There is no reason not to shoot for an ACGME IM program unless there is a really compelling reason not to.

 

[JaggerPlate]

If I remember correctly, ACGME recently made a requirement that people going into ACGME fellowships did an ACGME IM program. Now this may be a moot point since there is going to be a single accredidation body soon but it may throw a wrench in the works. There is no reason not to shoot for an ACGME IM program unless there is a really compelling reason not to.

Hey Man!

Long time no talk. Hope residency is treating you well.

I think the proposed ACGME/AOA merger came as a result of the ACGME stating that it would no longer take AOA residency trained physicians into ACGME fellowships. I believe the merger prevented this from actually going through, and, like you said, it should become a semi-moot point when the merger thing happens.

Fairly certain I will be applying both ACGME/AOA, but have a few compelling reasons for really considering some AOA residencies in a certain geographic locale.

 

[Instatewaiter]

Hey Man!

Long time no talk. Hope residency is treating you well.

I think the proposed ACGME/AOA merger came as a result of the ACGME stating that it would no longer take AOA residency trained physicians into ACGME fellowships. I believe the merger prevented this from actually going through, and, like you said, it should become a semi-moot point when the merger thing happens.

Fairly certain I will be applying both ACGME/AOA, but have a few compelling reasons for really considering some AOA residencies in a certain geographic locale.

Long time no see! For me, residency is done and I'm starting fellowship in a week or so.

Realistically, endocrine is not competitive compared to most IM specialties for a number of reasons: pay, dealing with type 2 DM instead of the more interesting endocrinopathies, extra time compared to hospitalists with lower pay. I think you should be fine doing an AOA program because of the merger just make sure they have sent some residents into endo in the past. If the PD or dept chair has connections and they have sent residents to that fellowship in the past, it makes a world of difference if they pick up the phone and say, "this guy is great, you should take him."

Good luck.