Is NICU fellowship going to be worth it?

[Just Trying Dog Mom]

I am currently a first year NICU fellow, and I'm struggling to decide if it is worth it to finish fellowship. I have always liked NICU the best since my rotations in medical school medical school, and my career goal has always been to go back to my small population home state to be an attending at one of the level III NICUs. I have been told by several attendings in my home state that I should do a few years as an attending at bigger institutions to build confidence as a staff before coming home.

Fellowship is going fine. I'm getting procedures done and seeing the bread and butter of neonatology. I am meeting expectations and there is nothing chasing me out of fellowship. I enjoy the content of neonatology and reading/thinking about the physiology. I am not a big fan of academic research, but I feel satisfied with my fellowship research project. During residency NICU was always my favorite place. I didn't love gen peds clinic, but I know I did a good job and would be a fine pediatrician. It seems like a doable job. I passed my peds boards first time, so that will not be a barrier.

I'm just wondering if this is all worth it time-wise with 2.5 years of fellowship left and likely 2-3 years elsewhere before I could really come home to be an effective neonatologist. I want to go home so badly and be able to spend quality time with my partner, family, dogs, and play in the snowy mountains (currently in a place with non-snowy hills only). I feel so sad thinking going home is still so long from now.

I'm just really struggling with how to prioritize the quality of life I want vs sticking it out 5-6 more years before living where I want to be. I think I have optimized things the best that I can here to spend as much time with my partner, pets, and hobbies as possible, but I can't shake the sense that I'm still waiting for my life to start when I get to move home.

I know no one can tell me what to do, but I'm just wondering what anyone else's experience has been like when weighing quality vs career. It's just so hard.

Thanks in advance.

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[SurfingDoctor]

I am currently a first year NICU fellow, and I'm struggling to decide if it is worth it to finish fellowship. I have always liked NICU the best since my rotations in medical school medical school, and my career goal has always been to go back to my small population home state to be an attending at one of the level III NICUs. I have been told by several attendings in my home state that I should do a few years as an attending at bigger institutions to build confidence as a staff before coming home.

Fellowship is going fine. I'm getting procedures done and seeing the bread and butter of neonatology. I am meeting expectations and there is nothing chasing me out of fellowship. I enjoy the content of neonatology and reading/thinking about the physiology. I am not a big fan of academic research, but I feel satisfied with my fellowship research project. During residency NICU was always my favorite place. I didn't love gen peds clinic, but I know I did a good job and would be a fine pediatrician. It seems like a doable job. I passed my peds boards first time, so that will not be a barrier.

I'm just wondering if this is all worth it time-wise with 2.5 years of fellowship left and likely 2-3 years elsewhere before I could really come home to be an effective neonatologist. I want to go home so badly and be able to spend quality time with my partner, family, dogs, and play in the snowy mountains (currently in a place with non-snowy hills only). I feel so sad thinking going home is still so long from now.

I'm just really struggling with how to prioritize the quality of life I want vs sticking it out 5-6 more years before living where I want to be. I think I have optimized things the best that I can here to spend as much time with my partner, pets, and hobbies as possible, but I can't shake the sense that I'm still waiting for my life to start when I get to move home.

I know no one can tell me what to do, but I'm just wondering what anyone else's experience has been like when weighing quality vs career. It's just so hard.

Thanks in advance.

Or, when you graduate fellowship, you just go to that NICU near your home.

Their advice is nonsense. No matter where you go as a junior attending, you’ll make mistakes. And if you chose to, you’ll learn from those mistakes. That is person dependent, not place dependent.

Might as well go home and decompress at a place you like.

 

[HemeOncHopeful19]

Take the job you want out of fellowship, a level 3 NICU isn’t some boring do-nothing shop as far as I understand it and IMO would set you up fine for a career covering… a level 3 NICU.

Whether it is “worth it” to do a 3 year fellowship that comes along with that lifestyle change compared to Gen Peds is a different question you kinda have to answer on your own.

One final thought - jobs near snowy mountains aren’t exactly a guarantee

 

[oldbearprofessor]

Agree - finish fellowship and then do and go where you want and get the job you like.

 

[Oso]

Agree with the above, pursue the job you actually want after fellowship, if at all possible. Fellowship should prepare you to work in a level 3 NICU.

The work-life balance/is it worth it question is totally different… no one can really answer that for you. I wonder about it all the time. Do I wish I had been interested in allergy or some other relatively chill, more lifestyle friendly specialty? Absolutely. Hoping my life balance gets a little bit better as an attending in academics

 

[pedsIDguy]

Fellowship is going fine. I'm getting procedures done and seeing the bread and butter of neonatology. I am meeting expectations and there is nothing chasing me out of fellowship. I enjoy the content of neonatology and reading/thinking about the physiology. I am not a big fan of academic research, but I feel satisfied with my fellowship research project. During residency NICU was always my favorite place. I didn't love gen peds clinic, but I know I did a good job and would be a fine pediatrician. It seems like a doable job. I passed my peds boards first time, so that will not be a barrier.

Yeah, this. Most first year fellows would kill to say this. If you’re still feeling reasonably good about where you stand in the midst of your first year, you’re in the right place. Don’t leave fellowship and go to the level III NICU near your home afterwards. Anyone who gives you advice about needing to stay at a big academic center in a clinical heavy specialty like NICU is just wrong, especially if academics is not what you see yourself doing long term- you’re not going to a nursery, you’re going to a level III NICU. You’ll keep your skills sharp.

 

[BigRedBeta]

I don't disagree with the sentiment that 2-3 years in a high acuity place with all the bells and whistles is beneficial. The steep part of the learning curve doesn't end when you have fellowship certificates in hand. Getting yourself into and then out of trouble is a necessary stage of growth to be the absolute most badass neonatologist you can be. I'd focus more on a first job with all the acuity, not based on academic affiliation, as there are places that have the acuity without the academic riff raff. If all the NICU's in your home state ships the top 20% highest acuity cases somewhere else, then yes, you would likely be stunting your skills to a degree. Maybe that doesn't matter to you, maybe it does.

But by all means, continue fellowship.