I'm considering doing a hospice/palliative medicine fellowship. Goals are to leave EM permanently or make it a side job.
Wondering if anyone's made the transition and what it's like post-fellowship? Can you comment on job market? Job satisfaction? Schedule? Stress level? Any regrets? Things you wish you knew before making the switch?
I did see a thread about it in 2020 but wanted some recent thoughts about it.
I practiced em for <5 years and left for a hpm fellowship after covid turbocharged both my burnout and patients going (even more) insane.
I now do exclusively hospice in a primarily inpt setting: despite there being two people on this thread doing it, this is not a common setup in hospice. I might go back to doing palliative at some point if my job becomes less cushy, because I actually prefer it. Having a few full code patients sprinkled in makes things more interesting.
Pay is ~250k with 401k/bonus included, I could have made it ~300 or a little more at a harder job.
my job has very little call and I prefer that to chasing dollars (which are higher in em anyway). I have a ridiculous amount of vacation, the exact details of which I cannot give without a full dox of myself, but it’s more than enough to have a week off every month. I do work weekends but that’s mostly by choice as it allows me more flexibility in scheduling.
I am thanked at least 4-5x a day, which is more than I got in most months in the Ed. I don’t have to tolerate abuse, I work exclusively days, I see my children every single day and sleep in my bed every single night. I enjoy my work a great deal.On my worst day I am never as stressed as the dread of beginning a new em shift run. Amusingly, your stress threshold does reset at some point and I occasionally get worked up about stupid **** before I realize “at least I’m not in the Ed” and then I feel content/warm fuzzies.
While there are occasionally thought stimulating patients with complex symptoms and weird solutions, it is much less intellectually stimulating than EM or really anywhere that your patients will come out alive. It is much more emotional management and communication: if these are weak points, you will not be happy in this job.
Despite how much I hated it, the hardest part of the transition was letting go of em for me. Partially an ego thing, partially that I liked procedures, and partially just plain old Stockholm syndrome. I loved it and hated it all the time, but I am very glad to be out with some distance from it.
Job market was and is fine where I am, it’s a rapidly expanding area, but there’s a lot of midlevels and new fellowships, so who knows what it will look like in future. My spouse also makes good money, and I don’t need much to be happy.