Hybrid practice?

[blankette]

Approaching my last year of residency and debating whether to apply for HPM now vs. wait.
I've done several rotations in palliative medicine, enjoy it greatly and envision myself practicing it at some point in my career. However, I would like maintain a strong foothold in general medicine and do hospitalist work post-residency - ideally it would be a little of both. How common is it for those who've trained in HPM to continue practicing their original field? I'm a little worried that it will be hard to get back into the hospitalist mindset after a year in fellowship - any tips for staying fresh? Maybe a little moonlighting?
Thanks in advance.

---

Members don't see this ad.

 

[PinkLithe]

Interesting question. While I don't have any answers, I feel very similarly. I really enjoy palliative medicine, but also want to maintain my skills in a more traditionally "medicine" sub-specialty, specifically pulmonary medicine. I don't mind taking 3 or 4 years to do the fellowships, and I figure (hopefully correctly) that adding palliative medicine will make me more marketable.

For staying fresh, I don't think a one year fellowship in HPM will make you so far removed from general medicine that you have to be overly concerned. I think regular reading and some moonlighting will go a long way to keeping skills sharp.

 

[tec]

I am starting my HPM fellowship in two weeks. I interviewed at four programs and at each of them there were faculty who split time between their primary specialty or subspecialty and HPM.

Another thought is that even if you practice internal medicine, HPM will give you a skill set that will make you a better physician overall. Just a thought.

 

[letsdoit]

Hello. I trained in Family Medicine and Hospice and Palliative medicine. I have a hybrid practice. I do 2.5 days family medicine clinic, 0.5 day palliative care clinic and 2 days Palliative inpatient consultation. I will say that it depends in your employer. If you look hard enough and you are flexible about location, you should be able to have a hybrid practice especially if your primary specialty is also in demand. I know people who do hybrid Geriatrics and Palliative, ER and Palliative as well. I also know people who stuck to their primary specialty after fellowship training in HPM but they still apply some of the skills from HPM fellowship in their primary specialty. For e.g. they use their interviewing skills to conduct better goals of care discussion or do better job with medical pain and symptom management. Good luck to you in your future endeavors.