Would working as a PCP over a hospitalist hurt my chances of doing an IM Fellowship when I apply in 2 years? I am pursuing Heme onc first…

[sdaccount114445]

So I am debating whether to take a PCP job with a Cush schedule vs a IM Hospitalist either 7 days in and off or 5 days while also thinking about which would be better for my chances to get into fellowship when I apply in two years.

I went to a Community program and had limited research throughout. I am planning to get a lot more research in the form of posters and case reports, possibly publishing some before I apply to Hematology/Oncology next year. I’ll also send out some applications to cardiology having relevant research. Endocrine will be the backup hopefully since I want to do some fellowship ultimately….

Would taking a PCP over a Hospitalist job Burt me when trying to apply for these fellowship programs or should I just get a hospitalist job?

Look I know it was ideal to get a fellowship right out of my PGY3 year, but it just didn’t happen, I didn’t go to a academic residency site and my attendings, mentors, and colleagues did t help in terms of getting me to get reeearch pumped out.

Will I still have a good shot if I have a stronger CV and good experience and lots of research for Hematology oncology, cards, and Endocrine? Thanks.

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[Redpancreas]

I don’t think hospitalist vs. PCP matters. The more important factor is setting yourself up to where you’ll actually do research. First of all, you need to be busting you a** now to publish while you’re still a 3rd year because you’ll be applying prior to even starting the job. Second, if you don’t get in your second time around, the research during your PCP/Hospitalist year will matter. You have a few options.

1.) Consider non-ACGME fellowships: I don’t know if these exist but it’s really your best shot to network and research.
2.) It may be too late for a chief year now, it’s debatable how much it’ll help.
3.) If you must do PCP/Hospitalist to pay the bills, try to find an academic center to work at so that you can network with the faculty and get involved with the research there.

Lastly, as you’ve seen, research at a community program is much more difficult than at some academic ones. You don’t really have faculty/mentors to give you ideas and instead have to figure it all out on your own.

 

[NotAProgDirector]

If you were not able to get research done during residency due to lack of support/infrastructure, then which of these positions will that be different? That's probably the biggest driver.

This assumes that it's the lack of research that's holding you back. Your prior threads suggest you did your PGY-1 at one program and your PGY-2+ somewhere else, the reasons for that may matter. As will your step scores, degree background, etc.

Cardiology is not a backup for HemeOnc. Don't apply to Cardiology.

You would be much better off with LOR's from HemeOnc docs, preferably those involved in a fellowship program.

 

[sdaccount114445]

If you were not able to get research done during residency due to lack of support/infrastructure, then which of these positions will that be different? That's probably the biggest driver.

This assumes that it's the lack of research that's holding you back. Your prior threads suggest you did your PGY-1 at one program and your PGY-2+ somewhere else, the reasons for that may matter. As will your step scores, degree background, etc.

Cardiology is not a backup for HemeOnc. Don't apply to Cardiology.

You would be much better off with LOR's from HemeOnc docs, preferably those involved in a fellowship program.

I have the opportunity to take an academic hospitalist position for less pay but still attending pay which I would be working with residents but there is no in house fellowship program.
There is another inpatient hospitalist position but is non academic and another pcp outpatient like job .

I am assuming the academic hospitalist position would be better, but Idk by how much more.

 

[Gastrapathy]

None of those jobs are really ideal for your goals. Its early in the year (or is it very late?). You might want to expand your search to somewhere you can be a hospitalist on a BMT service or similar.

 

[sdaccount114445]

None of those jobs are really ideal for your goals. Its early in the year (or is it very late?). You might want to expand your search to somewhere you can be a hospitalist on a BMT service or similar.

BOOOO. That's not what I want to hear.... But seriously, doing an academic hospitalist position wouldn't help at all? I could find interesting heme onc / cardio / endo cases to do case reports, posters on, etc.. ? Or even cases I see if I were an independent hospitalist or PCP.

 

[gutonc]

Choose the job that will allow you to get as much research experience, and pubs, as possible.

Anything else is a waste of time as it regards your ability you to match in hem/onc.

 

[Shipofthedamned]

So I am debating whether to take a PCP job with a Cush schedule vs a IM Hospitalist either 7 days in and off or 5 days while also thinking about which would be better for my chances to get into fellowship when I apply in two years.

I went to a Community program and had limited research throughout. I am planning to get a lot more research in the form of posters and case reports, possibly publishing some before I apply to Hematology/Oncology next year. I’ll also send out some applications to cardiology having relevant research. Endocrine will be the backup hopefully since I want to do some fellowship ultimately….

Would taking a PCP over a Hospitalist job Burt me when trying to apply for these fellowship programs or should I just get a hospitalist job?

Look I know it was ideal to get a fellowship right out of my PGY3 year, but it just didn’t happen, I didn’t go to a academic residency site and my attendings, mentors, and colleagues did t help in terms of getting me to get reeearch pumped out.

Will I still have a good shot if I have a stronger CV and good experience and lots of research for Hematology oncology, cards, and Endocrine? Thanks.

Whatever you do don't take a community job in either. You will wind up with 94 rejections as a US MD, essentially donating money to ERAS by applying. Ask me how I know...

 

[HemeOncHopeful19]

BOOOO. That's not what I want to hear.... But seriously, doing an academic hospitalist position wouldn't help at all? I could find interesting heme onc / cardio / endo cases to do case reports, posters on, etc.. ? Or even cases I see if I were an independent hospitalist or PCP.

If you really want to match Heme/Onc and also take a PCP/Hospitalist job (I don't blame you for wanting to pay the bills) I would try to find an Academic job that does have an in-house fellowship program that is low or mid "tier", the larger the better in terms of # of fellows taken per year. Usually I consider those "tier lists" complete baloney, but basically you want to find a program that isn't super competitive for the most overqualified applicants every year.

Once you get there I would work hard and develop a good reputation as a solid/friendly hospitalist, and at some point reach out to the Heme/Onc program and express your interest in working on a project if anything is available.

 

[Mehena]

If you really want to match Heme/Onc and also take a PCP/Hospitalist job (I don't blame you for wanting to pay the bills) I would try to find an Academic job that does have an in-house fellowship program that is low or mid "tier", the larger the better in terms of # of fellows taken per year. Usually I consider those "tier lists" complete baloney, but basically you want to find a program that isn't super competitive for the most overqualified applicants every year.

Once you get there I would work hard and develop a good reputation as a solid/friendly hospitalist, and at some point reach out to the Heme/Onc program and express your interest in working on a project if anything is available.

Spot on, I second this.

Whatever you do don't take a community job in either. You will wind up with 94 rejections as a US MD, essentially donating money to ERAS by applying. Ask me how I know...

Hematology-Oncology, without substantial research experience, is difficult to match compared to specialties like Gastroenterology and Cardiology.

As AMGs and US IMGs, there is little opportunity to compete with applicants who have spent a year or two on research, completed a postdoc, earned MD/PhDs, or worked in a lab before applying for residency. This doesn't necessarily mean the research is useful or worth anyone's time; often, it's just to pad the CV, which makes the programs eager to recruit these candidates. I believe there is also a research publication racket going on, where even a simple case report or retrospective study includes 15 authors.

Until AI tools like ChatGPT level the playing field or programs learn to sift through the irrelevant details, it will remain challenging. However, I see high school students starting research now, aware of the uphill battle ahead.

 

[LymphomaMaven]

As PD at an academic program I can tell you we generally count hospitalist time or any gap time as a negative factor as it usually means you are not really focused on an academic career. If you want a research career than spend your gap time doing research full time. Fluff output like case reports and reviews are pretty transparently just fluff. We defintely look for research output when we screen candidates, but when the applicant has 25+ papers thats also a red flag. Better to have 1-2 papers with a focus that you can talk passionately about, with a letter from the senior author/mentor confirming your role in the published work, than a ton of output in a variety of areas.

Perhaps PDs from clinical/community programs see it differently, I can only speak from my perspective.

 

[gutonc]

As PD at an academic program I can tell you we generally count hospitalist time or any gap time as a negative factor as it usually means you are not really focused on an academic career. If you want a research career than spend your gap time doing research full time. Fluff output like case reports and reviews are pretty transparently just fluff. We defintely look for research output when we screen candidates, but when the applicant has 25+ papers thats also a red flag. Better to have 1-2 papers with a focus that you can talk passionately about, with a letter from the senior author/mentor confirming your role in the published work, than a ton of output in a variety of areas.

Perhaps PDs from clinical/community programs see it differently, I can only speak from my perspective.

With all due respect, it's hard to take the opinion of a brand new member whose status is listed as "fellow" but claims to be a PD at an academic program seriously.

I have no interest in outing or doxing you. I really don't care who you are. But when you come here, out of nowhere, and speak with such a voice of authority, you owe it to the members you claim to be counseling to either earn their trust over time as many people here have, or state your bona fides and be able to back them up.

 

[Gastrapathy]

@LymphomaMaven

You could start by getting verified as a physician at least.

 

[LymphomaMaven]

With all due respect, it's hard to take the opinion of a brand new member whose status is listed as "fellow" but claims to be a PD at an academic program seriously.

I have no interest in outing or doxing you. I really don't care who you are. But when you come here, out of nowhere, and speak with such a voice of authority, you owe it to the members you claim to be counseling to either earn their trust over time as many people here have, or state your bona fides and be able to back them up.

Sure. Thanks for noticing the fellow tag, that was a mistake, I updated to attending. I dont see a way to get "verified" in the profile menu--would be happy to do that. Yes, clearly I am a new member, and I didn't realize the rules of the forum. I didn't claim any authority, I just was speaking from my experience. I did caveat my statement as such and specifically regarding academic vs community programs. I am not sure how one earns trust on an anonymous forum, but its not like anything I said is a secret. I would say that and have said the same to residents who have asked my opinion.

Happy to just listen for now.

 

[osprey099]

Neither PCP nor Hospitalist at a "kush" job will fly.

IMO, the best option you have is to do a non-ACGME accredited fellowship like a 1 year transfusion medicine fellowship or something like that to beef up your resume. During this fellowship, your goal is to smooch with the heme onc attendings who are highly pubmed cited and try to get involved/published in research.

If you need money, the alternative (and weaker) option is to take a job as a Heme Onc Hospitalist at a major academic center. My former fellowship center had something like this. They hired a full time nocturnist to babysit the entire cancer center at night and do admissions. Obviously you'll be trying your best to get involved in research as well during this time.

 

[gutonc]

Neither PCP nor Hospitalist at a "kush" job will fly.

IMO, the best option you have is to do a non-ACGME accredited fellowship like a 1 year transfusion medicine fellowship or something like that to beef up your resume. During this fellowship, your goal is to smooch with the heme onc attendings who are highly pubmed cited and try to get involved/published in research.

If you need money, the alternative (and weaker) option is to take a job as a Heme Onc Hospitalist at a major academic center. My former fellowship center had something like this. They hired a full time nocturnist to babysit the entire cancer center at night and do admissions. Obviously you'll be trying your best to get involved in research as well during this time.

You should probably shmooze, not smooch the attendings. Wait until after you've graduated from the fellowship before you start that.