Fellowship programs with good work-life balance?

[step3taken]

applying into GI this upcoming cycle and wondering if there is information out there re: what programs have a good work-life balance, and conversely terrible balance? obviously we can't be that picky in applying, but I'm already feeling the burnout of putting life on hold for training. I know the best thing would be to assess during interviews or ask fellows at different programs, but it'd be helpful to know where applications should be directed. also, realistically most of us don't know fellows at most programs we're interested in

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[rd31]

applying into GI this upcoming cycle and wondering if there is information out there re: what programs have a good work-life balance, and conversely terrible balance? obviously we can't be that picky in applying, but I'm already feeling the burnout of putting life on hold for training. I know the best thing would be to assess during interviews or ask fellows at different programs, but it'd be helpful to know where applications should be directed. also, realistically most of us don't know fellows at most programs we're interested in

If this is one of your top criteria I suggest that you don't apply to GI. GI fellowship is about learning GI and learning to scope, not taking it easy.

 

[DoctwoB]

Dude chill a bit. One can get good training in a program that isn’t a hellpit or has a culture or covering for one another so the person not on call gets out at a good hour. One can also make an informed decision that they want to prioritize time with family over getting every last scope they can do, knowing that their skills may not be quite what they were if they had lived at the hospital. Different strokes for different folks, as long as competence is achieved.

 

[step3taken]

interesting - definitely not my top criteria and hopefully most fellowship programs will get you to a place where you're able to practice competently. competence doesn't directly come from being worked 24/7 and regardless of where one trains it's going to be difficult. I agree that it's just one more piece of information to make an informed decision.

hopefully we're moving away from the culture of trainees being overworked for the sake of being overworked and placing more weight on intentional learning/training.

 

[AlteredScale]

applying into GI this upcoming cycle and wondering if there is information out there re: what programs have a good work-life balance, and conversely terrible balance? obviously we can't be that picky in applying, but I'm already feeling the burnout of putting life on hold for training. I know the best thing would be to assess during interviews or ask fellows at different programs, but it'd be helpful to know where applications should be directed. also, realistically most of us don't know fellows at most programs we're interested in

Probably should look at picking a program with more fellows (like 4-6). More fellows usually means less call. Also maybe focus on more academic type places where research time is protected and there are advanced fellows to do the advanced scopes.

Theres a reddit GI interview excel sheet with breakdown of the call schedules each program too.

 

[1Cor1557]

interesting - definitely not my top criteria and hopefully most fellowship programs will get you to a place where you're able to practice competently. competence doesn't directly come from being worked 24/7 and regardless of where one trains it's going to be difficult. I agree that it's just one more piece of information to make an informed decision.

hopefully we're moving away from the culture of trainees being overworked for the sake of being overworked and placing more weight on intentional learning/training.

Shop around best you can and closely probe the current fellows for subtle and overt cues, the miserable ones will flat out manifest dread, training will be a worthy challenge but you can avoid the sweatshop programs which will make a big difference

 

[nolayup]

I went from a busy residency to a fellowship with amazing balance. im at a community program. would ask about call structure.

 

[Elixir6]

It depends on what you consider as balanced - probably most people would not consider GI fellowship balanced. But if you want to have more of a balance, I would consider typical time of arrival and departure on different services, and how frequently you have to do weekends.

I'm at a very large academic center with very sick patients, and very infrequently have to go in overnight. Institutional culture probably plays a role, but there are only like 5 things in GI that pull you in overnight, and so I wouldn't let the amount of night call weigh in too heavily.

 

[slopes23]

Probably should look at picking a program with more fellows (like 4-6). More fellows usually means less call. Also maybe focus on more academic type places where research time is protected and there are advanced fellows to do the advanced scopes.

Theres a reddit GI interview excel sheet with breakdown of the call schedules each program too.

Have struggled to find this despite extensive searches. Do you have a link or more specific to this excel sheet? Thanks

 

[giapplicant2020]

Probably should look at picking a program with more fellows (like 4-6). More fellows usually means less call. Also maybe focus on more academic type places where research time is protected and there are advanced fellows to do the advanced scopes.

Agree that call schedule makes a huge difference in work/life balance -- I'd further qualify this to say that the number of WEEKENDS you work per month probably makes a bigger difference than the number of weeknights you're on call. As someone else said above, weeknight home call is way different than what you experienced in internal medicine in-house call. Most places you'll have to go in infrequently overnight and depending on institutional culture (and how competent your ER/IM docs are) you may not even get paged much.

I don't know that an academic program with more research months always = better work life balance. I'm sure you'll hear about "front loaded" programs a million times if you haven't already, but the trade off of more research months is usually a really busy first year. If you want to power through 1st year with less work life balance to have free time 2nd/3rd year, then looking for a place with more research months is definitely a good idea.

Will say though if you hate research and/or find research stressful, a more clinically-focused program may be a better fit (even if you don't get those cushy "research months") than a place where you'll feel pressure to produce research on topics you're not interested in.

 

[step3taken]

thanks for all the replies, this is really helpful for me and future applicants. I haven't considered differentiating between weekend vs. weekday night call

Have struggled to find this despite extensive searches. Do you have a link or more specific to this excel sheet? Thanks

here's the sheet from last year:

 

[giapplicant2020]

here's the sheet from last year:

Take this with a grain of salt you guys. I looked over the "interview impressions" from the places where my friends ended up and some of the comments on the spreadsheet are pretty off base (one program with a great impression that a friend hates, and one with a scathing impression that a friend loves). So do your own due diligence!

 

[sallyhasanidea]

thanks for all the replies, this is really helpful for me and future applicants. I haven't considered differentiating between weekend vs. weekday night call


here's the sheet from last year:

can you post the link to this? How and where can we access this?

 

[step3taken]

can you post the link to this? How and where can we access this?

not sure why it automatically embedded the sheet. https://docsDOTgoogleDOTcom/spreads...Es0C9ytdGF1kc9b0fhHxBLBjy4/edit#gid=801130335

I'll try to put together a sheet for this upcoming cycle. not sure when the official thread will go up? @ShiShiMD

 

[JP2740]

Look for programs with a higher number of fellows. That’s really all I can think of.

 

[JP2740]

It depends on what you consider as balanced - probably most people would not consider GI fellowship balanced. But if you want to have more of a balance, I would consider typical time of arrival and departure on different services, and how frequently you have to do weekends.

I'm at a very large academic center with very sick patients, and very infrequently have to go in overnight. Institutional culture probably plays a role, but there are only like 5 things in GI that pull you in overnight, and so I wouldn't let the amount of night call weigh in too heavily.

I agree there are very rare reasons to actually come in overnight and see a patient. However, some academic programs require their fellows to come in for every single consult and see every patient and write a note. It’s stupid but that’s how it is some places.

 

[Scope guy]

I agree there are very rare reasons to actually come in overnight and see a patient. However, some academic programs require their fellows to come in for every single consult and see every patient and write a note. It’s stupid but that’s how it is some places.

As someone who trained in a large fellowship program, this is very accurate. really depends on culture of the place and more so an attending. At the end of the day, fellow taking call is taking on behalf of the attending, so a very low threshold attending will want you to go in for everything and then there are chill attendings who want you to go in only for those who need immediate scoping

 

[Elixir6]

I agree there are very rare reasons to actually come in overnight and see a patient. However, some academic programs require their fellows to come in for every single consult and see every patient and write a note. It’s stupid but that’s how it is some places.

Woah... If I had to go in for every consult for stable GI bleeding or LFT abnormality, I'd never be home before midnight, let alone dysphagia, IBD flare or diarrhea.

I probably would have been too afraid as a first year, but as a senior fellow if an attending wanted me to see those consults, I'd be certain to call them to staff at 2AM. We should learn something in medicine from surgical subspecialties and know what needs action and what can wait till tomorrow.

I guess I'd ask about the program culture about how often you need to go in on night call.

 

[JP2740]

Woah... If I had to go in for every consult for stable GI bleeding or LFT abnormality, I'd never be home before midnight, let alone dysphagia, IBD flare or diarrhea.

I probably would have been too afraid as a first year, but as a senior fellow if an attending wanted me to see those consults, I'd be certain to call them to staff at 2AM. We should learn something in medicine from surgical subspecialties and know what needs action and what can wait till tomorrow.

I guess I'd ask about the program culture about how often you need to go in on night call.

Some places that’s the institutional policy, not just an attending specific thing. I agree it’s ridiculous.