Blogging with The Doctor Job

Today’s post will be a quick discussion of fellowship programs. There are three main reasons that physicians enter fellowship programs, and only one of them is a good reason. Read along and see if you agree.

Reason 1: Because the resident can’t find a job

You would be simply amazed at how many residents go into fellowship in specialties like Geriatrics, Critical Care or Infectious Disease because they don’t think they can find a job after graduating from residency and so they get worried. This is NOT a good reason to do this!

Every resident can find a job where he or she wants to be before graduating. Every. Single. One. If a physician is using recruiters and talking to their program and still can’t find a job, then get aggressive. Network, go to conferences, and get your name out there. Even if you don’t use a service like The Doctor Job, there are many avenues that a physician can pursue before giving up and joining a fellowship for the wrong reason.

What The Doctor Job has discovered is that these fellows tend to be more dissatisfied and have this illusion that when they get out of fellowship, they’ll easily find a job practicing what they want. However, the reality is that most physician employers will get confused. “Why do you want to practice Internal Medicine if you just spent that last year doing Infectious Disease?” they’ll ask. And the fellow will not have a good answer. It actually makes the physician’s career choices more difficult and is more likely to result in a bad working environment for any physician who gives up and doesn’t put forth the necessary effort into finding a job after residency.

Reason 2: Because the physician wants more money

With some exceptions, this is also the wrong reason to go into fellowship. First of all, let’s examine the logic of the situation. Let’s take an Internist who has been practicing for two years, making an annual salary of $155,000, plus bonuses and benefits of another $25,000. He decides that if he was in Pulmonary Medicine/Critical Care, he’d make much more money, so he quits and joins a Pulmonology/Critical Care fellowship program, where he gets an annual stipend of $36,000. For three years, he struggles to care for his family, losing $144,000 each year of his fellowship. By the time he graduates, he has lost $432,000 that he would have earned if he had just stayed at his current job at the same salary.

Once he gets out, he starts a new job as a Critical Care physician, making an annual salary of $200,000. While this sounds like a good raise, the physicians at his old practice who started with him and didn’t quit to go to fellowship actually make $175,000 plus bonus of $25,000, now. So not only are they making almost the same amount of money, but they didn’t lose $432,000 in potential income!

Now, this isn’t the case with all situations, but if a physician expects a serious lifestyle change and significant income increases, make sure to research before embarking on a fellowship.

Reason 3: Because the physician wants to sub-specialize

Now here is a good reason. Many physicians feel unfulfilled in their current job. If they continue working in their general specialty, they will eventually burn out and leave the practice of medicine completely. Rather than having that happen, going to a fellowship program for a sub-specialty is a good way to revitalize their practice of medicine.

It’s important for the physician to avoid randomly choosing a sub-specialty. Moving from one type of practice to another without researching it will make it just as likely that the physician will be unhappy in the new job. However, if the physician takes the time to research the different fellowship programs that are available and makes a decision based on the area that is the most interesting, there is a much higher chance of continued happiness in the medical profession.

So, in conclusion, if you decide to go to a fellowship, be smart about it. Don’t do it for the wrong reasons, because you’ll likely find yourself in a worse position than before. But if you do it for the right reasons, you should be happy and fulfilled in your career.