How is life during fellowship?

[PossibleEMapplicant]

Trying to mentally balance the ideas of a family/kids. How is life during fellowship? How are the hours - like IM where it's like 6am-5pm Monday through Friday?

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[HoldTheCoffee]

First year of most fellowships in IM are generally regarded as tougher than intern year of residency though in my personal experience, it wasn't actually as bad. It'll depend on your program and your call schedule, but generally while I was on outpatient I'd be starting clinic around 8-9 and then getting home sometime after 7PM. Inpatient rotations vary depending on the census and if you have consults to see.

Just as an aside, I'm not sure where the hours you cited (6AM - 5PM) are coming from... that's not the norm at all (at least not for residency), unless you're talking about being an outpatient PCP. Even then it seems unlikely to me that you'd have everything done by 5PM every day taking into account following up on tests, calling back patients, appointments running late, finishing your paperwork etc.

 

[PossibleEMapplicant]

First year of most fellowships in IM are generally regarded as tougher than intern year of residency though in my personal experience, it wasn't actually as bad. It'll depend on your program and your call schedule, but generally while I was on outpatient I'd be starting clinic around 8-9 and then getting home sometime after 7PM. Inpatient rotations vary depending on the census and if you have consults to see.

Just as an aside, I'm not sure where the hours you cited (6AM - 5PM) are coming from... that's not the norm at all (at least not for residency), unless you're talking about being an outpatient PCP. Even then it seems unlikely to me that you'd have everything done by 5PM every day taking into account following up on tests, calling back patients, appointments running late, finishing your paperwork etc.

Ahh a place where I did my IM rotation had IM residents in by 6 and out by 5. Granted it was a small community program. What were your hours like during residency for IM?

 

[gutonc]

Ahh a place where I did my IM rotation had IM residents in by 6 and out by 5. Granted it was a small community program. What were your hours like during residency for IM?

So...wait...you're not even a resident yet?

Come back and ask again if/when you are.

 

[PossibleEMapplicant]

Well can you comment on how fellowship and residency was for you? Instead of me having to ask in the general IM forum. Senseless comments like yours are such a waste.

 

[gutonc]

Well can you comment on how fellowship and residency was for you? Instead of me having to ask in the general IM forum. Senseless comments like yours are such a waste.

Of course I can comment. But I'm unlikely to do so now.

My first year of fellowship was overall more stressful than my intern year (with the exception of trading 30 hour in-house calls every 4 days for 72 hour home calls every 6 weeks...not sure which was worse). Every program (residency and fellowship) will be different though. My experience is not even modestly generalizable.

 

[RainerMaria]

Probably the most stressful part of fellowship is rotating through the sub-sub-specialty clinics and feeling like you are drinking out of the firehose again. "Here's 20 papers you needed to have read by yesterday," rinse and repeat. Good learning, but it's easy to feel overloaded. In a clinical program, this is the first 1-2 years of your time. The last year and a half of your time is when you get to focus on what you are good at and what you want to do, and you feel competent, whether that's research or clinical care.

So, in conclusion, the first half or more of your fellowship you will feel incompetent, and that's normal. Call stinks but also gets easier with time, goes from frightening first year to more of an annoyance afterwards. Patient calls are actually nice because you get to help patients through difficult times, often times you are allaying fears, whereas ED calls is mostly playing traffic cop for admissions and mostly administrative.

P.S. The above cycle repeats itself in your first job after fellowship

 

[Phase1Phase2]

Trying to mentally balance the ideas of a family/kids. How is life during fellowship? How are the hours - like IM where it's like 6am-5pm Monday through Friday?

In general, the first year of fellowship resembles the first year of residency (ie intern year) in so far as you are writing lots of notes for the team/attending. While you are more secure with yourself as a ABIM boarded physician, you are learning a new specialty with a fast learning curve. Also, fellowship is far lonelier than residency by virtue of the fact that is less team oriented. It is often just you and the attending working together. This is enjoyable in many respects, but there is not the dynamic of med student + intern + resident + attending on the team. I have been a first year fellow twice in my life, and the work requirement is highly dependent on the fellowship program.

 

[CatFactorial]

Trying to mentally balance the ideas of a family/kids. How is life during fellowship? How are the hours - like IM where it's like 6am-5pm Monday through Friday?

First year fellow. 12 hour clinical days. Down time devoted to taking care of kids and canine. Maybe an hour and a half open time for reading. Home call once or twice a week. Working usually one weekend a month, sometimes two. Research responsibilities and the time sink that goes into VA longitudinal clinic, in addition to mandatory wastes of time of morning conference presentations that happen every month or so.

Fun stuff.

 

[whoknows2012]

I’m a 2nd year at a large academic center. 1st year was busy with a lot of responsibility. Home call one night a week working one whole weekend a month (off the other 3). 8-5, at worst 8-6 so total hours per week weren’t terrible. Getting disturbed in the middle of the night by an inexperienced intern, or an ED provider (usually PA) with an FYi page at 3am started to wear on me by the end of the year. 2nd year is all research no weekday call and working 7 weekends for the entire year. This year my schedule is essentially 8:30/9-4:30/5.

 

[PossibleEMapplicant]

First year fellow. 12 hour clinical days. Down time devoted to taking care of kids and canine. Maybe an hour and a half open time for reading. Home call once or twice a week. Working usually one weekend a month, sometimes two. Research responsibilities and the time sink that goes into VA longitudinal clinic, in addition to mandatory wastes of time of morning conference presentations that happen every month or so.

Fun stuff.

How many days a week do you have 12 hour clinical days? That's brutal and almost impossible to have a family like that.

 

[gutonc]

How many days a week do you have 12 hour clinical days? That's brutal and almost impossible to have a family like that.

Usually 5 in fellowship, 6 in IM residency. And the 12 hours are usually more like 14.