Is fellowship as rough as residency?

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lost777

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As far as hours, workload, outside obligations, etc... or are the first 3 IM residency years worse?

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Substantially better, but I'm in rheumatology. It's very specialty and even program dependent. Also, depends on how cush your IM program was. There are GI and cards fellowships that are clearly way worse than your average IM residency.


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From my understanding, first year of fellowship is similar to/worse than busier years of residency. Subsequent years are then more relaxed with research, elective clinics, what have you.
 
I'm a first year cardiology fellow, and the workload is way worse than residency. In residency, I remember being capped at 14 and having interns and co-residents on the team helping with discharge, notes, and orders. Now as a fellow, on the busiest rotation, I have to supervise two inpatient services as junior attending, and see consults on the side by myself. It's a lot of work having to know all of the patients on the services, and writing notes and seeing consults on my own. And I also have to find time to do TEE's and other procedures during the day and prepare conferences and lectures. The main thing that keeps me going is that I love the specialty, but I'm so tired otherwise.
 
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hem/onc here. my first year of fellowship was definitely worse. No such thing as protection. You're often the only fellow covering services over the weekend or over night. Compared to residency, I had to stay at the hospital later, come from home at night frequently and get killed on a Saturday or Sunday with train wreck consults and +25 patients to follow. It got better in 2nd year and even much better in 3rd year.
 
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Agree with @visari. My first year of Onc fellowship was worse than anything I experienced during residency with the exception of my Q3 overnight call ICU block as an intern.

The rest of it was a total cakewalk though.
 
I'm a first year oncology fellow and have yet to hit the worst part of my schedule but the call alone makes this worse than residency (q5 home call, once a month full wknd call in the hospital). Each individual rotation varies in terms of hours as much or more than residency (i.e. Electives vs floor vs clinic). I've also noticed those who are efficient have a relatively easier time. I can also say that while there are caveats but if you prioritize being done on time so long as you're not with an attending that rounds until 8pm (which happens) your days aren't incredibly long. One thing I would say for oncology in particular is that it can be quite emotionally taxing which can play a huge role in burnout. It's been enjoyable thus far though.
 
Depends a lot on programs..
My IM residency program was resident-run. As a resident, I carried at least 10 consult patients (myself) and saw 3-5 new consults a day with fellow only supervising us. (Fellows don't do notes or see consults on their own in this program) . Residents take calls every day, every other night (home call) and every other weekend.

As a pulmonary/critical care fellow in a different program, we don't even have residents/students with us all the time. Even if there's a resident, he/she sees only 2 patients and maybe one pulmonary consult a day. By 4:30pm, resident is gone. Fellow takes all calls day/night/weekend. ICU is different but I am more than just supervisory role in this program. And with new administration changing our curriculum, my second and third year fellowship are not "more cushy" than first year. I think I'm just more comfortable with the workload/hours over the years.
 
Rheumatology fellow here...1st year fellowship half the year was as busy as the busiest part of residency, second half of the year was way easier than anything I've done. 2nd year fellowship is the best time I've had since I left college.

Overall, on average much better. As above, it's all heavily specialty dependent.
 
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As far as hours, workload, outside obligations, etc... or are the first 3 IM residency years worse?

They are different. Intern year is challenging because you don't really know how to be a doctor yet and **** rolls down hill. First year of cards fellowship is rough because you're getting rocked with call/consults/sick patients and nobody is going to hold your hand through it.
 
2nd year Pulm/CC fellow here. 1st year of fellowship was much more difficult in terms of work load and time spent in the hospital than any in residency. Surprisingly, I did not feel the level of burn out that I did during my floor months during residency. More surprisingly, my Pulmonary rotations are much busier on a daily basis than in the MICU. Overall, it's a better experience for me than residency was. I'd rather be busy doing something I love than slogging through something I don't.
 
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I can speak for CCM - definitely worse as a fellow.
Even that's variable. Where I did residency, the P/CC fellows were never in house at night, not even as first years. So they might have 3 or 4 months of every other night home call as PGY4s and certainly worked more daytime hours than the residents, but they worked fewer weekends and no in-home nights compared to even our PGY3s.

OTOH, I'm an Endocrine fellow right now. There's programs that are front loaded where the first year might be "as bad" as PGY3 with regards to hours (but certainly not as intense) that then let up second year. Other programs (like mine) split the work up evenly between PGY4 and PGY5, and it is significantly more cush than any time I spent in residency.
 
Even that's variable. Where I did residency, the P/CC fellows were never in house at night, not even as first years. So they might have 3 or 4 months of every other night home call as PGY4s and certainly worked more daytime hours than the residents, but they worked fewer weekends and no in-home nights compared to even our PGY3s.

Where is this heaven you speak of? Lol.
 
This is how it was where I did my residency. Was terrible critical care training but they churned out decent pulmonary docs. There were fellows graduating with 5 intubations and some never placed a chest tube.
WTF? As an IM resident, I got more than 5 tubes in my first two years and got 2 chest tubes.
 
This is how it was where I did my residency. Was terrible critical care training but they churned out decent pulmonary docs. There were fellows graduating with 5 intubations and some never placed a chest tube.
Oh, our fellows did plenty of procedures. Just in the daytime. They had a few hundred bronchs and something like 70 perc trachs by graduation, plus a fair # of the usual random stuff (lines, tubes, etc).
 
As far as hours, workload, outside obligations, etc... or are the first 3 IM residency years worse?
Depends on a) the residency b) the fellowship and c) what you are planning to do after fellowship (i.e. do another fellowship, do you need to still publish during fellowship, etc).

I'll say this, first year of cardiology fellowship was just as 'rough' if not 'rougher' than any year of residency. But after that it was downhill.
 
definitely worse as for all that was mentioned above, but depends on specialty.
 
Wut?????

I had over 9000 intubations when I left residency.

Where are all the rest if you mere mortals training. Lawl. Sucks to suck.
 
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