A fellow's life

[willymtn]

Hey all, I'm just entering my final year of residency. I'm very interested in H&PCM and am trying to decide whether to to apply this cycle. I'm pretty burned out from working resident-hours (though my last year should be much more humane). I don't know if I can do a fellowship right after residency if it will mean another year of 60-80 hour weeks. I hate to be that guy, but...

- What is the lifestyle of a typical H&PCM fellow? E.g., hours worked, frequency of weekend shifts, etc.
- What are some pros and cons of starting fellowship right after residency, vs applying a year or three down the road?

Any input from folks who have gone through this would be appreciated!

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[geripalgal]

Hey all, I'm just entering my final year of residency. I'm very interested in H&PCM and am trying to decide whether to to apply this cycle. I'm pretty burned out from working resident-hours (though my last year should be much more humane). I don't know if I can do a fellowship right after residency if it will mean another year of 60-80 hour weeks. I hate to be that guy, but...

- What is the lifestyle of a typical H&PCM fellow? E.g., hours worked, frequency of weekend shifts, etc.
- What are some pros and cons of starting fellowship right after residency, vs applying a year or three down the road?

Any input from folks who have gone through this would be appreciated!

This will vary based on fellowship and rotation. Most days for me were from 8-5, a little longer on inservice hospice or on days when we had afternoon clinic hours.

We had two fellows, we took weekend call once a month and weekeday call one day per week each (ie i had wednesday nights). Call on weekdays was home (telephonic) call from 5-8 am. Never had to go in, heavy with hospice calls (minimal clinic/hospital pt calls) till usually about 10pm, fairly quiet for the rest of the night unless someone was having a crisis and needed ipu admission. Weekends included rounding at the hospice ipu and palliative consults which could take anywhere from half to a full day, plus call till monday morning. Weekend hospice calls were usually very busy during the day. We always had an attending for backup/second call.

Call is busy, but not anywhere as bad as call as a resident - especially since it was from home. It was fairly representative of my call schedule now as an attending (except now its 1:6, and i have fellows to take first call every now and then!). I made good use of the doximity app as i need to frequently fax scripts while on call.


For comparison, during fellowship - Our hospice had an avg daily census of 200, and the hospital pcm service an avg census of 20-30. Some fellowships dont have their own hospice and dont provide call coverage for them - i imagine call is a breeze for them!!


If you are certain you want to do fellowship, do it right after residency as it will be hard to go back for more training after getting a taste of attending salary!

 

[willymtn]

If you are certain you want to do fellowship, do it right after residency as it will be hard to go back for more training after getting a taste of attending salary!

Lifestyle inflation is exactly why I worry about taking time off before fellowship!

That lifestyle doesn't sound terrible. Thanks for taking the time to respond!