Intern interested in endo and rheum fellowship

[bachow]

Hi, I am an intern now in a community hospital. Most of my friends told me to decide the subspecialty now so that I can work on my CV. I am interested in endocrinology and rheumatology. Could anyone tell me the pros and cons of each specialty? And is it really true that their salary will stuck at ~$220k ? Thank you
I am aware that in endo most of the pt will be diabetes, and this year the competitiveness of rheum is like heme-onc (according to NRMP statistic). What would be the future of endo and rheum?
And especially for endo community practice, why choose this subspecialty rather than PCP. I think the scope of practice and patients are pretty similar?and even the salary is also quite similar (most of the time diabetes?)

And can anyone give me insight about superfellowship? I have heard about nephro transplant (which is a superfellowship of nephrologist), but have no idea about endo and rheum superfellowship.

Thank you
*edit = have read the post from rokshana about endo, but really want to know any recent changes in the field. thank you

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[rokshana]

Hi, I am an intern now in a community hospital. Most of my friends told me to decide the subspecialty now so that I can work on my CV. I am interested in endocrinology and rheumatology. Could anyone tell me the pros and cons of each specialty? And is it really true that their salary will stuck at ~$220k ? Thank you
I am aware that in endo most of the pt will be diabetes, and this year the competitiveness of rheum is like heme-onc (according to NRMP statistic). What would be the future of endo and rheum?
And especially for endo community practice, why choose this subspecialty rather than PCP. I think the scope of practice and patients are pretty similar?and even the salary is also quite similar (most of the time diabetes?)

And can anyone give me insight about superfellowship? I have heard about nephro transplant (which is a superfellowship of nephrologist), but have no idea about endo and rheum superfellowship.

Thank you
*edit = have read the post from rokshana about endo, but really want to know any recent changes in the field. thank you

Lol...I finished fellowship in 2015...exactly how fast do you think the field changes?

 

[Crayola227]

omg not $220k!

 

[mszzeta]

Hi, I am an intern now in a community hospital. Most of my friends told me to decide the subspecialty now so that I can work on my CV. I am interested in endocrinology and rheumatology. Could anyone tell me the pros and cons of each specialty? And is it really true that their salary will stuck at ~$220k ? Thank you
I am aware that in endo most of the pt will be diabetes, and this year the competitiveness of rheum is like heme-onc (according to NRMP statistic). What would be the future of endo and rheum?
And especially for endo community practice, why choose this subspecialty rather than PCP. I think the scope of practice and patients are pretty similar?and even the salary is also quite similar (most of the time diabetes?)

And can anyone give me insight about superfellowship? I have heard about nephro transplant (which is a superfellowship of nephrologist), but have no idea about endo and rheum superfellowship.

Thank you
*edit = have read the post from rokshana about endo, but really want to know any recent changes in the field. thank you

I am applying to rheumatology this year.

Both endo and rheum share something in common: intellectual specialty, both requires very solid base from general medicine, good lifestyle (almost never go to the hospital in the middle of night), less procedure (though rheum can do MSK procedures in community settings. Some endo programs train fellow to do thyroid FNA but I am not sure how much they use it in community settings)

For the bread and butter (which most community docs see everyday), there will probably be lots of DM and thyroid disease for endo, and non-autoimmune MSK problem/gout/OA/fibro for rhuem (both are boring to my opinion)

Rare diseases are interesting and exciting in both field but they are overall uncommon.

For rheum, there will be a lot of brightness in the future field as more biologics are coming. The diagnosis of rheumatic diseases is also fascinating to me. Most of the rheumatic diseases have no established diagnostic criteria (classification criteria is not the same as diagnostic criteria), due to their complexity.

For endo I am not very familiar, but it seems that it is already pretty well developed specialty.

Both of them are not making a lot of money in trade of their good lifestyle. But general medicine (either PCP or hospital medicine) has very good lifestyle as well (but with their pitfall of course)

For rheum, it is getting much more competitive than 3-4 years ago but still much easier than hem/onc and cards because the applicant pools are very different. But you will go to a university program because there are overall very few community programs with rheum fellowship (unlike cards and GI)

For endo, it is much easier to match into a prestigious academic center.

I know there are people doing obesity fellowship after endo fellowship. Obesity is certainly pandemic in this country but I personally doubt what role a non-surgical physician can play (they should make up their mind to loose weight, or they should get bariatric surgery to avoid a million complications that hospitalist or ICU docs will have to deal with later)

There are 3 or 4 centers in the country with vasculitis fellowship after rheum fellowship. These are exceedingly rare conditions that no way community rheumatologists will see much in their practice

Personally, I choose rheum because I love interesting rare diseases. And I hope to practice in an academic center in the future (hopefully, and I know it can be difficult)

 

[Aspyn]

I did my first rheum rotation (outpatient) and it was not near as exciting as I hoped.. the inpatient side is definitely exiting, but I prefer outpatient medicine.

For what its worth, if you want to do endo, you can probably match at your #1 with no research.

 

[rokshana]

FYI, neck ultrasounds and FNAs are core requirements for Endo fellowship so every fellowship must train their fellows to do FNAs and U/S.

 

[GitoEndo]

I did my first rheum rotation (outpatient) and it was not near as exciting as I hoped.. the inpatient side is definitely exiting, but I prefer outpatient medicine.

For what its worth, if you want to do endo, you can probably match at your #1 with no research.

"you can probably match at your #1 with no research." - How do you know?!

 

[bronx43]

I did my first rheum rotation (outpatient) and it was not near as exciting as I hoped.. the inpatient side is definitely exiting, but I prefer outpatient medicine.

For what its worth, if you want to do endo, you can probably match at your #1 with no research.

Real life rheumatology outside of consults at an academic center is mostly joint disease, and lab abnormalities. Rheum applicants need to prepare themselves for that.

 

[FohBay]

Real life rheumatology outside of consults at an academic center is mostly joint disease, and lab abnormalities. Rheum applicants need to prepare themselves for that.

I think that applies to almost all medical fields.

 

[bronx43]

I think that applies to almost all medical fields.

I realize that... I was responding to the poster who said inpatient rheum was exciting while outpatient was not.

 

[rokshana]

I realize that... I was responding to the poster who said inpatient rheum was exciting while outpatient was not.

the opposite is kinda true for endo...inpt generally is sugar control with the rest mostly hypercalcemia with the occasional hyper/hypothyroid...the more interesting endo conditions show up in the clinic.