How is the first year of PCCM Fellowship?

[Ekimalito]

Good afternoon!

So, I am starting my training this July. I know with this whole ordeal of COVID-19 everything has changed, especially for PCCM fellows. I am sure this will splash over the next couple of years and that it is impossible to accurately predict, however, I would like to know prior to all of this how was the usual first year of PCCM fellowship.

Usually people abstain from asking these questions during interviews as to not sound I guess "lazy". I am a dog, I work as much as I need to. I am trying to kind of get an idea as to how often are you working weekends, which rotations are the lighter ones in your experience (I know this is different from place to place, but they must be similar in some way). My program's fellowship manual says they guarantee a weekend every 2 weeks? dont know if one day and one day or what? I recall asking one of the third year fellows when I interviewed and he said he worked only 12 weekends during his third year of training.. but I'm sure they have it much easier.

The only reason I ask is because I am gonna have 3 hours of distance between me and my family and I wanna guesstimate how things will be, etc.

Thanks!

Disclaimer: Up ahead I apologize if anybody feels offended by me asking for time off before even starting. I assure you that I am well aware of what I'm signing for and that I am the type of person who likes to put himself out there and do things when others usually choose to go home or take the easy way out.

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[jdh71]

Good afternoon!

So, I am starting my training this July. I know with this whole ordeal of COVID-19 everything has changed, especially for PCCM fellows. I am sure this will splash over the next couple of years and that it is impossible to accurately predict, however, I would like to know prior to all of this how was the usual first year of PCCM fellowship.

Usually people abstain from asking these questions during interviews as to not sound I guess "lazy". I am a dog, I work as much as I need to. I am trying to kind of get an idea as to how often are you working weekends, which rotations are the lighter ones in your experience (I know this is different from place to place, but they must be similar in some way). My program's fellowship manual says they guarantee a weekend every 2 weeks? dont know if one day and one day or what? I recall asking one of the third year fellows when I interviewed and he said he worked only 12 weekends during his third year of training.. but I'm sure they have it much easier.

The only reason I ask is because I am gonna have 3 hours of distance between me and my family and I wanna guesstimate how things will be, etc.

Thanks!

Disclaimer: Up ahead I apologize if anybody feels offended by me asking for time off before even starting. I assure you that I am well aware of what I'm signing for and that I am the type of person who likes to put himself out there and do things when others usually choose to go home or take the easy way out.

I mean every fellowship is going to be different, but in general, fellowship is front loaded. So year one is the ass kicker and not too bad year two and three. You'll probably be on call every other night and every other weekend first year. I didn't sleep in the same room as my wife for a year. You'll get up early. You'll go home late. You will write all the consult notes (probably - maybe you'll get a resident on the service?). You will do all the bronchs after setting them up. Fellows usually don't accept admits to the ICU any longer - attending level decisions - but you will probably hold the consult pager and take one bull**** consult after another. You'll write all your own clinic notes, and any sub-subspecialty clinics you go to, you will be writing the attending notes (they love that). It's kind of brutal to be honest. Good luck.

 

[PCCMapplicant]

Currently a first year fellow at mid-sized university program. Here's my experience.

Our program is front loaded like most. 1st year is 10 months of consults/MICU and 2 months of educational/nonclinical rotations. 2nd and 3rd years are evenly split between research/electives and clinical rotations including IP, ICU, sleep and consults.

1st year call schedule is 1 weekend per month as well as the first years splitting the calls for all holidays, meaning once per month I am working 12 days straight (Monday until the second Friday). There's no in-house overnight coverage so the weekend call shifts include home-call with a few calls per night and occasionally getting called in for an urgent procedure that the residents can't do. In addition to weekends/holidays we have 1-2 weekday nights per month that we are on home-call (mostly covered by senior fellows).

My weekdays are usually 11-12 hours of work regardless of service, sometimes shorter sometimes longer. Days are generally busy so they go by quickly. Lots of procedures for both MICU and consults (IP gives most thoras and easy bronchs/chest tubes to general pulm).

Don't feel bad about asking about this type of stuff, there's a difference between being informed versus complaining about working hard. If people think you're lazy because you want to know your schedule then that's their problem and indicative of a toxic culture that needs to go away. Gone are the days of the physician father being expected to work any and all hours while the stay-at home mom is home watching the kids. Many/most people have non-work related responsibilities by this point in their life. If your spouse works and you have children then you have to be able to plan ahead to a certain degree.

You will work hard during fellowship, especially first year. That being said, at least for me it hasn't seemed as tiring as residency because you're getting to focus on what you're really passionate about, despite still working significant hours.

 

[Ekimalito]

Currently a first year fellow at mid-sized university program. Here's my experience.

Our program is front loaded like most. 1st year is 10 months of consults/MICU and 2 months of educational/nonclinical rotations. 2nd and 3rd years are evenly split between research/electives and clinical rotations including IP, ICU, sleep and consults.

1st year call schedule is 1 weekend per month as well as the first years splitting the calls for all holidays, meaning once per month I am working 12 days straight (Monday until the second Friday). There's no in-house overnight coverage so the weekend call shifts include home-call with a few calls per night and occasionally getting called in for an urgent procedure that the residents can't do. In addition to weekends/holidays we have 1-2 weekday nights per month that we are on home-call (mostly covered by senior fellows).

My weekdays are usually 11-12 hours of work regardless of service, sometimes shorter sometimes longer. Days are generally busy so they go by quickly. Lots of procedures for both MICU and consults (IP gives most thoras and easy bronchs/chest tubes to general pulm).

Don't feel bad about asking about this type of stuff, there's a difference between being informed versus complaining about working hard. If people think you're lazy because you want to know your schedule then that's their problem and indicative of a toxic culture that needs to go away. Gone are the days of the physician father being expected to work any and all hours while the stay-at home mom is home watching the kids. Many/most people have non-work related responsibilities by this point in their life. If your spouse works and you have children then you have to be able to plan ahead to a certain degree.

You will work hard during fellowship, especially first year. That being said, at least for me it hasn't seemed as tiring as residency because you're getting to focus on what you're really passionate about, despite still working significant hours.

Frankly, I had forgotten about the post! Lol

Well, like you said, from what the info they've provided it's gonna be 12 days on and 2 days off.. so yo basically get a weekend every 2 weeks. I am excited to join, although, I must admit it worries me a bit to see my family once every 2 weeks... I guess that's the sacrifice you opt for when going for these type of specialties. I come from a bit laid down program with a very decent census and lots of spare time and will be going into a heavily academic program in a major city.. I feel that my biggest learning curve will be working around our new reality with this COVID ordeal and understanding how large centers with lots of fellowships work. We have some fellowships in our program but there's no fellowship culture. You see those guys hiding in the echo room or on the background waiting for some crumbs to be dropped. I really dont even know what their role is... aren't they supposed to be consultants with supervision? GI does a better job at my hospital, but still a bit to be desired... lol

Anyways, if you all have any further wisdom to share please feel free!

Thanks a lot for you answers!