quitting fellowship

[Raha44]

Hi everyone,

I have just started fellowship and I am realizing that my personality doesn't match the field. I really blame myself for not figuring this out before applying. I liked the subspecialty and obviously had rotated and work in that field. But I wasn't the actual person in charge and now that I am, I realize that it isn't for me.
I don't know how to go about this. My PD and some of the attendings in my fellowship know all the people that I previously worked with. My mentors really helped me with the match and I bugged them a lot during the match so it would look really bad.
Despite all of this, I think it is the right decision for me. I would appreciate any help or advice on how i can go about this. Thanks!

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[gulmohr]

Difficult to say without knowing the subspecialty in question, and what alternative you see yourself doing.

 

[wysdoc]

"But I wasn't the actual person in charge and now that I am,"

Are you feeling insecure about making the decisions?
That's pretty normal for the first week of a new job.
Give it a few months and if you have not adjusted then re-think.
You still have attending physicians and supervisors to ask questions of.

 

[Raha44]

Difficult to say without knowing the subspecialty in question, and what alternative you see yourself doing.

cards and I will do hospitalist

 

[Raha44]

"But I wasn't the actual person in charge and now that I am,"

Are you feeling insecure about making the decisions?
That's pretty normal for the first week of a new job.
Give it a few months and if you have not adjusted then re-think.
You still have attending physicians and supervisors to ask questions of.

I hear you. I don't want to rush into quitting but I think it is likely that I will so wanted to know how bad it can affect my career.

 

[CptNemo]

Seems like this decision should not be taken lightly. While I can't tell YOU what is the right decision for YOU, in general I tell people to try to power through in these situations unless there are some really huge factors in your life where that wouldn't work.

Financially and career-wise, cardiology opens many more doors and increases earning potential quite a lot over being a hospitalist (think about the difference in the barrier for entry for hospitalist vs. cardiology). And cardiology is such a broad field that I'd bet you can find something in it that matches your personality.

I'm pretty sure that if you quit cardiology, it will be nearly impossible for you to match again into cardiology in the future. But, I don't think that quitting a cardiology fellowship would negatively impact your ability to get a hospitalist job. Caveats being:
1.) Your current institution may think twice (as this would potentially burn some bridges in the medicine department - though I'm guessing that this early in the year the cardiology dept could likely find someone to take your spot - but still a headache for them).
2.) For the current academic year, a lot of the better hospitalist jobs have likely been already filled (but seems like openings are frequent in the field).

 

[DrMetal]

cards and I will do hospitalist

So then quit. What's the problem? (If you're sure that's the right decision for you, then do it). If your current institution gives you grief for it (which I doubt they will, it's more in your head than their), then find a different place to work.

 

[chessknt]

Well hospitalist always comes out financially ahead so... /s

In all seriousness in one month you havent experienced the full gambit. Cards has the most variation of any field in practice environments--sure maybe clinic sucks but if you love procedures you can focus on IC; maybe procedures arent your thing--great you can do general cards without interventional. Hell you could subspec in to ICU if you wanted to or possibly just read studies all day if you absolutely hate all patient interaction.

Stick with it for a few more months to get exposure. You arent in charge of anything and you worked your ass off to get there--give yourself a chance.

 

[rokshana]

Hi everyone,

I have just started fellowship and I am realizing that my personality doesn't match the field. I really blame myself for not figuring this out before applying. I liked the subspecialty and obviously had rotated and work in that field. But I wasn't the actual person in charge and now that I am, I realize that it isn't for me.
I don't know how to go about this. My PD and some of the attendings in my fellowship know all the people that I previously worked with. My mentors really helped me with the match and I bugged them a lot during the match so it would look really bad.
Despite all of this, I think it is the right decision for me. I would appreciate any help or advice on how i can go about this. Thanks!

You are 6 days into your fellowship… and I doubt that you are the person in charge as a spanking brand new fellow.

You really haven’t had any time or experience with the field to say that this isn’t for you…and I bet it took a lot of work and exposure to the field to successfully match cards…and once you quit…you will be done for this specialty…done.

You will have to give it 45 days to make sure you don’t have a match violations. Frankly would say you should at least give it this year and see if your prospective changes… this could all be cold feet and you will find that you still like cards… if not then you will have given yourself a chance to find a hospitalist job to go into next year and give your program a chance to replace you… though that prolly won’t be to hard…there are plenty of people unmatched in cards that will jump to come in and take your spot.

And remember if you are on a visa, and quit, you may have to leave the US and go back to your home country in the interim between jobs.

 

[rokshana]

I hear you. I don't want to rush into quitting but I think it is likely that I will so wanted to know how bad it can affect my career.

Hospitalist jobs are a dime a dozen… they won’t care if you once trying to be a cardiologist.
You will most likely never get a fellowship in cardiology again if you change your mind again…and those cards mentors are prolly people you won’t get good letters from anymore.

 

[dgdg]

I remember in internship the best and most common advise from those above us was to not make any career, marital, large financial, or other major life decisions during your first training year. Just get through it and then decide.
It's just too hard to see perspective and think straight. I would imagine first year cardiology might be similar in this regard.
I wish you the best going forward whatever you decide.

 

[cards67]

Care to go into more detail? Attending life isn't like fellowship.

 

[Gastrapathy]

Cards can be similar to hospital medicine if you want it to be, only you’re paid more. Give it 6 mo.

 

[Raha44]

You are 6 days into your fellowship… and I doubt that you are the person in charge as a spanking brand new fellow.

You really haven’t had any time or experience with the field to say that this isn’t for you…and I bet it took a lot of work and exposure to the field to successfully match cards…and once you quit…you will be done for this specialty…done.

You will have to give it 45 days to make sure you don’t have a match violations. Frankly would say you should at least give it this year and see if your prospective changes… this could all be cold feet and you will find that you still like cards… if not then you will have given yourself a chance to find a hospitalist job to go into next year and give your program a chance to replace you… though that prolly won’t be to hard…there are plenty of people unmatched in cards that will jump to come in and take your spot.

And remember if you are on a visa, and quit, you may have to leave the US and go back to your home country in the interim between jobs.

Thank you for your advice.
I am concerned about the workload and stress which feels like torture. I feel overwhelmed already by the expectations.
I agree that I should wait a bit before making the decision so will give a few weeks unless something bad happens or I make a bad mistake.
I am not on a visa which is a big relief. I am credentialed in another hospital in a different city for moonlighting. I am thinking of going back there and see if they will take me.

 

[thecalccobra]

Thank you for your advice.
I am concerned about the workload and stress which feels like torture. I feel overwhelmed already by the expectations.
I agree that I should wait a bit before making the decision so will give a few weeks unless something bad happens or I make a bad mistake.
I am not on a visa which is a big relief. I am credentialed in another hospital in a different city for moonlighting. I am thinking of going back there and see if they will take me

First year can be very tough with long hours and it’s okay to feel overwhelmed. I would wait a little longer before deciding to quit. There are a ton of people out there who would do anything to be in your shoes.

 

[gulmohr]

cards and I will do hospitalist

First year of fellowship is brutal. The transition from being an internal medicine resident to a subspecialty fellow where you are expected to provide solutions for your system of choice rather than ask questions is really tough. Depending on what the culture of your institution is, you may not be getting the supervision and support you need.

I would echo what has been said by those before; give it more time. Minimum 6 months, ideally a year. It will be tough going but the three years of cardiology fellowship will be worth it down the line in terms of the flexibility you'll have when choosing what kind of employment you want as well as the financial rewards. Most likely, your work burden as well as your comfort will improve significantly after your first year of fellowship.

Give it time.

 

[90sportsfan]

You are 6 days into your fellowship… and I doubt that you are the person in charge as a spanking brand new fellow.

You really haven’t had any time or experience with the field to say that this isn’t for you…and I bet it took a lot of work and exposure to the field to successfully match cards…and once you quit…you will be done for this specialty…done.

You will have to give it 45 days to make sure you don’t have a match violations. Frankly would say you should at least give it this year and see if your prospective changes… this could all be cold feet and you will find that you still like cards… if not then you will have given yourself a chance to find a hospitalist job to go into next year and give your program a chance to replace you… though that prolly won’t be to hard…there are plenty of people unmatched in cards that will jump to come in and take your spot.

And remember if you are on a visa, and quit, you may have to leave the US and go back to your home country in the interim between jobs.

Completely agree. I think the OP owes it to him/herself to give it some more time to be sure Cards isn’t the right fit. Like most things, it often takes time to get used to new things.

 

[Señor S]

If nothing else, you would be leaving a lot of money on the table. Have you ever worked as a hospitalist before?

 

[Miles Gloriosus]

I might be best to talk to a senior fellow or chief fellow at your program about your feelings of stress and feeling overwhelmed.
This kind of sounds a little but like imposter syndrome. Like everyone else seems to look like they have it together except you. In reality, I bet your cofellows are thinking the same thing. Everyone feels like an idiot first week of med school, intern year, fellowship and even starting off as attending.
If you decide to keep trucking, please write an update in 6 months. You’ll look back at your original post and laugh.

 

[BicepsTriceps]

I'm a hospitalist and you can't pay me enough to do a cardiology fellowship.

I'm serious I won't do it for $300,000 yearly in Cleveland clinic.

So I have no interest in cardiology and I know that the fellowship itself sucks so much and harder than residency.

You were interested in cardiology and begging people for letters and help and you didn't realize how tough it's gonna be?

You basically took the seat from someone who's actually gonna finish it and actually wanted to become a cardiologist which is a ****ty move honestly.

Just resign early and don't drag it on maybe they can replace you quickly.

I can't believe people reach this far in life and still indecisive and lost.

Good luck nonetheless

 

[DrSnips]

I would echo

Seems like standard cards advice.

I'm serious I won't do it for $300,000 yearly in Cleveland clinic.

Well yeah, you'd be living in Cleveland...

 

[Raha44]

"But I wasn't the actual person in charge and now that I am,"

Are you feeling insecure about making the decisions?
That's pretty normal for the first week of a new job.
Give it a few months and if you have not adjusted then re-think.
You still have attending physicians and supervisors to ask questions of.

I feel very insecure about myself. My co-fellows are doing fine and they all want to help me which makes me feel even worse that I am the only one who needs help.
Yeah I will not quit now and will wait but I think the odds are high. I am not comfortable being the bad one and I already feel that way.

 

[Raha44]

Seems like this decision should not be taken lightly. While I can't tell YOU what is the right decision for YOU, in general I tell people to try to power through in these situations unless there are some really huge factors in your life where that wouldn't work.

Financially and career-wise, cardiology opens many more doors and increases earning potential quite a lot over being a hospitalist (think about the difference in the barrier for entry for hospitalist vs. cardiology). And cardiology is such a broad field that I'd bet you can find something in it that matches your personality.

I'm pretty sure that if you quit cardiology, it will be nearly impossible for you to match again into cardiology in the future. But, I don't think that quitting a cardiology fellowship would negatively impact your ability to get a hospitalist job. Caveats being:
1.) Your current institution may think twice (as this would potentially burn some bridges in the medicine department - though I'm guessing that this early in the year the cardiology dept could likely find someone to take your spot - but still a headache for them).
2.) For the current academic year, a lot of the better hospitalist jobs have likely been already filled (but seems like openings are frequent in the field).

Just thinking it is a bad sign that I haven’t even started and I feel so incompetent. I notice the other fellows and they are more knowledgeable and smart and also have it together.
I have a moonlighting gig available so can survive.
If I quit cardiology, I wouldn’t wanna go back to it anywhere else. I think I am the issue not the program.
I totally agree with you about all the perks of cards. The issue is that I am not fit and it is worse that I am realizing it now. I understand that I messed things up and that this is serious and that’s why I came to SDN.

 

[Raha44]

Well hospitalist always comes out financially ahead so... /s

In all seriousness in one month you havent experienced the full gambit. Cards has the most variation of any field in practice environments--sure maybe clinic sucks but if you love procedures you can focus on IC; maybe procedures arent your thing--great you can do general cards without interventional. Hell you could subspec in to ICU if you wanted to or possibly just read studies all day if you absolutely hate all patient interaction.

Stick with it for a few more months to get exposure. You arent in charge of anything and you worked your ass off to get there--give yourself a chance.

Do you think it is a pretty bad sign that I already feel this way? My co fellows are all smart and good and have it together which makes me question my decision more. If I am the lousy one that means I am not that qualified. Just feels wrong.

 

[Raha44]

You are 6 days into your fellowship… and I doubt that you are the person in charge as a spanking brand new fellow.

You really haven’t had any time or experience with the field to say that this isn’t for you…and I bet it took a lot of work and exposure to the field to successfully match cards…and once you quit…you will be done for this specialty…done.

You will have to give it 45 days to make sure you don’t have a match violations. Frankly would say you should at least give it this year and see if your prospective changes… this could all be cold feet and you will find that you still like cards… if not then you will have given yourself a chance to find a hospitalist job to go into next year and give your program a chance to replace you… though that prolly won’t be to hard…there are plenty of people unmatched in cards that will jump to come in and take your spot.

And remember if you are on a visa, and quit, you may have to leave the US and go back to your home country in the interim between jobs.

I have noticed that everyone in the program including attendings and fellows are constantly looking to see how you are performing, even in our first week. As an example, I felt pressured and uncomfortable because people were telling me what to do in the simulation lab and it felt like a competition. My cofellows were talking about who is the best etc. I am on the sensitive side and I think this is going to stress me even more and make my performance worse.

 

[Raha44]

I remember in internship the best and most common advise from those above us was to not make any career, marital, large financial, or other major life decisions during your first training year. Just get through it and then decide.
It's just too hard to see perspective and think straight. I would imagine first year cardiology might be similar in this regard.
I wish you the best going forward whatever you decide.

Thanks! I can be the black sheep and go on. It will kill me but I can just don’t know if it eventually be helpful.

 

[Raha44]

First year of fellowship is brutal. The transition from being an internal medicine resident to a subspecialty fellow where you are expected to provide solutions for your system of choice rather than ask questions is really tough. Depending on what the culture of your institution is, you may not be getting the supervision and support you need.

I would echo what has been said by those before; give it more time. Minimum 6 months, ideally a year. It will be tough going but the three years of cardiology fellowship will be worth it down the line in terms of the flexibility you'll have when choosing what kind of employment you want as well as the financial rewards. Most likely, your work burden as well as your comfort will improve significantly after your first year of fellowship.

Give it time.

Really? Give it one year?

 

[Raha44]

If nothing else, you would be leaving a lot of money on the table. Have you ever worked as a hospitalist before?

No

 

[Raha44]

I might be best to talk to a senior fellow or chief fellow at your program about your feelings of stress and feeling overwhelmed.
This kind of sounds a little but like imposter syndrome. Like everyone else seems to look like they have it together except you. In reality, I bet your cofellows are thinking the same thing. Everyone feels like an idiot first week of med school, intern year, fellowship and even starting off as attending.
If you decide to keep trucking, please write an update in 6 months. You’ll look back at your original post and laugh.

Thanks! I don’t feel comfortable with the chief (seemed really intense). I don’t know the other fellows that well. They seem kinda intense overall. I was comfortable with one who I met once in the simulation lab but don’t feel like opening up to anyone yet.
We have had some trainings and stuff and I have been the dumbest and last to catch up. Wouldn’t say it is all imposter.

 

[rokshana]

I feel very insecure about myself. My co-fellows are doing fine and they all want to help me which makes me feel even worse that I am the only one who needs help.
Yeah I will not quit now and will wait but I think the odds are high. I am not comfortable being the bad one and I already feel that way.

The ones that squak the loudest are usually the most insecure and are trying to prove something… ignore them.
Find a mentor to help… they don’t have to be at your program and can be someone that has helped you get to where you are…have questions for them and have request meetings( phone, email, zoom, lunch…) to have a plan. Women, especially, don’t do this and it’s what gets you supported.
There is, I’m sure a women in cardiology fb page… find it and join it.

 

[Raha44]

The ones that squak the loudest are usually the most insecure and are trying to prove something… ignore them.
Find a mentor to help… they don’t have to be at your program and can be someone that has helped you get to where you are…have questions for them and have request meetings( phone, email, zoom, lunch…) to have a plan. Women, especially, don’t do this and it’s what gets you supported.
There is, I’m sure a women in cardiology fb page… find it and join it.

Thank you! This is helpful, Appreciate it

 

[Señor S]

No

Well, allowing for the usual variation in job quality, I can tell you anecdotally that many people find it unsatisfying and the burn-out rate is high. It would be helpful if you could seek out some hospitalists-turned-cardiologists and get their input; I believe poster @timpview is one. I'm not trying to belittle what you're experiencing but I will say that training is its own thing and practice is often very different (sometimes better, sometimes worse). I also think that you're probably not doing nearly as badly as you think you are. Also, the fact that you feel insecure is a good sign; people who are willing to accept feedback/criticism are almost never deemed a "problem."

 

[timpview]

First year of fellowship is brutal. The transition from being an internal medicine resident to a subspecialty fellow where you are expected to provide solutions for your system of choice rather than ask questions is really tough. Depending on what the culture of your institution is, you may not be getting the supervision and support you need.

I would echo what has been said by those before; give it more time. Minimum 6 months, ideally a year. It will be tough going but the three years of cardiology fellowship will be worth it down the line in terms of the flexibility you'll have when choosing what kind of employment you want as well as the financial rewards. Most likely, your work burden as well as your comfort will improve significantly after your first year of fellowship.

Give it time.

Ha. Good chance those fellowship years will be the lightest work load you’ll ever experience…

1. I would give it another couple months
2. No shame in quitting. No one will care. It won’t impact any future jobs imo. Can always blame health reasons or family.
3. Cross IC off the board. You’ll likely work harder with a 1000x more stress/responsibility as an attending as a fellow
4. General cardiology in the biggest group you can find can actually provide some decent lifestyle jobs..

Cards has a lot of bad stuff going for it (nights, horrible non shift based call, hospital dependency/loss of autonomy, complications, critical pts/deaths, etc). So if there is any doubt, get out.

 

[AlbinoHawk DO]

Hi everyone,

I have just started fellowship and I am realizing that my personality doesn't match the field. I really blame myself for not figuring this out before applying. I liked the subspecialty and obviously had rotated and work in that field. But I wasn't the actual person in charge and now that I am, I realize that it isn't for me.
I don't know how to go about this. My PD and some of the attendings in my fellowship know all the people that I previously worked with. My mentors really helped me with the match and I bugged them a lot during the match so it would look really bad.
Despite all of this, I think it is the right decision for me. I would appreciate any help or advice on how i can go about this. Thanks!

You don't owe anyone ****. If you feel you made a mistake, you should just quit. Be sincere as to why you don't find the field aligns with what you are trying to get out of your education. I far more respect someone that is forthcoming than someone that will hang there just because they feel forced to

 

[aafisahar]

Ha. Good chance those fellowship years will be the lightest work load you’ll ever experience…

This is so true. Fellows don't realize how much bull**** they get shielded from by attendings. Now that I'm out in the real world, I wish I could go back to the fellow workload even though at the time we all thought we were the hardest working group in the hospital and the attendings just sat around doing nothing.

 

[deleted980918]

1. First year is hard, everyone knows.
2. Second year is easy if you planning on going IC/EP
3. Third year is a complete joke. There are third years in my program who’s on elective I.e home for 8 months of the year

In any class of people, there is always going to be someone who’s more talented than others. The truth is, hard work always prevails. If you do it enough times, you will be really good at it at the end. Can’t read an ekg, do it 1000 times on ekg source u will be pretty good after that.

 

[Miles Gloriosus]

Thanks! I don’t feel comfortable with the chief (seemed really intense). I don’t know the other fellows that well. They seem kinda intense overall. I was comfortable with one who I met once in the simulation lab but don’t feel like opening up to anyone yet.
We have had some trainings and stuff and I have been the dumbest and last to catch up. Wouldn’t say it is all imposter.

This sounds like a self confidence issue and a little bit of “whoa is me” type of mentality.

No one expects you to be attending level right away. It’s a 3 yr fellowship for a reason.

I get the sense that maybe your program one of those east coast intense programs. Again, just b/c others seem to have it together, they don’t. They just don’t show their insecurities or try to make others insecure to make themselves feel better.

It only matters what kind of doctor you are at the end of the fellowship, not the beginning.

Anyway, you have two options: 1. Persevere, grow and learn/become a better doctor and overcome.; 2. Give up and quit.

What kind of person you want to be?

 

[anonperson]

This is so true. Fellows don't realize how much bull**** they get shielded from by attendings. Now that I'm out in the real world, I wish I could go back to the fellow workload even though at the time we all thought we were the hardest working group in the hospital and the attendings just sat around doing nothing.

Really?

I was a fellow in a different surgical specialty and hated it.

Irritating patients who abused the call system since they knew fellows were first call.

Annoying patients who only wanted to talk with the attending etc.

Having weak attendings nit pick meaningless things for no reason.

Some attendings were very good and I learned a lot. Others were terrible and it was terrible having to staff cases with them.

Hospital staff could be hit or miss. Some would be annoyed at your presence and you'd end up doing a lot of crap work.

-------------------------------

I've been out about 6 years. Did 4 years of residency and 3 years of fellowship. By year 7, I was dragging. Would never go back to being a trainee.

I love being the final say on a lot of things.

Patients come specifically to see me and get my take on things.

I continue to study and improve my technique and it is gratifying when it works.

Staff goes out of their way to make my life easier ( operate out of a hospital with no trainees).

------------------

Attendings didn't shield me from anything.

 

[anonperson]

Thanks! I don’t feel comfortable with the chief (seemed really intense). I don’t know the other fellows that well. They seem kinda intense overall. I was comfortable with one who I met once in the simulation lab but don’t feel like opening up to anyone yet.
We have had some trainings and stuff and I have been the dumbest and last to catch up. Wouldn’t say it is all imposter.

You're not comfortable because you don't know much cardiology currently.

That's what fellowship is for.

But fellowship is a different beast because the learning is much more self directed.

I've posted this in other threads to residents who are stressed etc. Usually this is tied into their level of comfort/perceived competence.

Jobs/specialties become much less stressful when you actually know what you are doing. It becomes routine which is good.

Hospitalist work seems easy to you because your residency has essentially prepared you for this over three years.

If you enjoy the specialty, you have to commit to learning it. Memorizing the guidelines, reading your basic textbooks, etc. With knowledge comes comfort and fellowship will get better. There are still the same social issues to deal with etc ( annoying co fellows, irritating attendings etc) but that is the same with any job.

If you hate the actual subject matter, that's a different story. Then just quit.

 

[anonperson]

I have noticed that everyone in the program including attendings and fellows are constantly looking to see how you are performing, even in our first week. As an example, I felt pressured and uncomfortable because people were telling me what to do in the simulation lab and it felt like a competition. My cofellows were talking about who is the best etc. I am on the sensitive side and I think this is going to stress me even more and make my performance worse.

My first year of fellowship was supposed to be a full research year but I still did half a day in the OR ( fellowship wasn't supposed to do this but they didn't care). I came from a different residency and was basically the outsider while the other fellows were homegrown. They knew the attendings preferences etc. I also am guessing I wasn't high on their rank list because they never seemed too thrilled with me.

First week, I get into the OR with little guidance and a fourth year resident who was running circles around me. I had no clue how the attending liked things set up while the resident did. I looked fairly clueless. I did some things differently because of where I trained on the east coast and got criticized in the OR often.

Developed a nervous tremor. It was a small fellowship so only a few attendings. The worst was the PD who was passive aggressive. He would hound me to go see someone to get on a beta blocker etc. I did. Mistake on my end because it messed with my getting disability insurance coverage.

It was a bad first year for sure.

Tremor went away when I learned to ignore the BS. Focused on getting better/studying etc.

Got through fellowship after 3 long years. Became board certified in my specialty and sub specialty ( written and oral boards X2). Learned a lot of what to do and not to do in fellowship but glad to be away from their.

I'm respected for my skill at my hospital.

I even because chair of the department for the year ( it's not impressive, at a smaller community hospital, no one else wanted the job, Lol).

 

[Raha44]

My first year of fellowship was supposed to be a full research year but I still did half a day in the OR ( fellowship wasn't supposed to do this but they didn't care). I came from a different residency and was basically the outsider while the other fellows were homegrown. They knew the attendings preferences etc. I also am guessing I wasn't high on their rank list because they never seemed too thrilled with me.

First week, I get into the OR with little guidance and a fourth year resident who was running circles around me. I had no clue how the attending liked things set up while the resident did. I looked fairly clueless. I did some things differently because of where I trained on the east coast and got criticized in the OR often.

Developed a nervous tremor. It was a small fellowship so only a few attendings. The worst was the PD who was passive aggressive. He would hound me to go see someone to get on a beta blocker etc. I did. Mistake on my end because it messed with my getting disability insurance coverage.

It was a bad first year for sure.

Tremor went away when I learned to ignore the BS. Focused on getting better/studying etc.

Got through fellowship after 3 long years. Became board certified in my specialty and sub specialty ( written and oral boards X2). Learned a lot of what to do and not to do in fellowship but glad to be away from their.

I'm respected for my skill at my hospital.

I even because chair of the department for the year ( it's not impressive, at a smaller community hospital, no one else wanted the job, Lol).

Wow! This is pretty much the same situation that I am in now. I don’t think I was their preferred candidate and I sense that the PD is passive aggressive towards me.
They keep talking about how some of the attendings are crazy and have been hostile with fellows and that it is normal and we are not supposed to take it personally.
I did a year of research last year so I am rusty with procedures and my hands were shaking even in the simulation lab!!! My co fellows were commenting as they were closely in my face and the senior fellow started getting inpatient. Worse part is I am starting with cath and apparently the interventionists here are hostile so I am pretty sure my whole body will start shaking there.
The chief resident of the home program (now a fellow) acts like she is an attending and has been giving me unsolicited advice implying I don’t know things. While that is true to some degree, it isn’t helping me learn and I doubt she has good intentions.
It was helpful to read your story. I feel I am not the only one! Thank you!!

 

[gulmohr]

Really? Give it one year?

Ideally. Minimum 6 months. It's a very short time in the grand scheme of things.

Also, you have to realize you're not really competing with anybody. You're in training to be the best possible cardiologist YOU can be. Nobody will care how you were in the first few months after you're done with fellowship. Concentrate on learning as much as possible. Try to get extra time in the sim lab away from your co-fellows if possible so you can work on your technique away from judgemental eyes.. Everybody learns at a different pace. It's ok if you have a steeper learning curve. Put in more time and you'll get there. And again, you don't have to do procedure based cardiology once you're out if it's not for you.

Fellowship is intense but remember you do actually have a safety cushion which you won't once in practice. Embrace the challenge. It's supposed to be f**king hard.

From your mien, I am guessing you're a foreign grad. You may feel a little intimated by the confident familiarity (which may border on brashness) of your home-grown co-fellows.
But remember, you got through medical school, the USMLE journey, and then residency. As long as you want this, you got this.

 

[Nocturnist]

Do you think it is a pretty bad sign that I already feel this way? My co fellows are all smart and good and have it together which makes me question my decision more. If I am the lousy one that means I am not that qualified. Just feels wrong.

You're experiencing imposter syndrome.
This is normal and common.
You didnt get to the position you're in by accident. You are 'smart and good' as well, or you wouldn't be where you are today.
Cardiology has some of the broadest practice settings in medicine- from clinic, to ICU, procedures, even consulting/pharma/legal/entrepreneurship.
I agree it'd be ill advised to make any life changing decision the first year. Hospitalist will always be there for you as a backup.

 

[ROBINHO]

If you are 100 percent sure that this is not for you. Better to bow out now since it’s better and easier to find somebody now than in 6 months nov you quit in 6 months the program will distribute your calls to cO fellows and harder to find somebody off cycle.

I also agree about all the comments about imposter syndrome. You have to make sure that you are 100 percent sure. Don’t worry so much about mentors being disappointed or burning bridges. If you do it the right way you shouldn’t burn bridges.

 

[rokshana]

Ideally. Minimum 6 months. It's a very short time in the grand scheme of things.

Also, you have to realize you're not really competing with anybody. You're in training to be the best possible cardiologist YOU can be. Nobody will care how you were in the first few months after you're done with fellowship. Concentrate on learning as much as possible. Try to get extra time in the sim lab away from your co-fellows if possible so you can work on your technique away from judgemental eyes.. Everybody learns at a different pace. It's ok if you have a steeper learning curve. Put in more time and you'll get there. And again, you don't have to do procedure based cardiology once you're out if it's not for you.

Fellowship is intense but remember you do actually have a safety cushion which you won't once in practice. Embrace the challenge. It's supposed to be f**king hard.

From your mien, I am guessing you're a foreign grad. You may feel a little intimated by the confident familiarity (which may border on brashness) of your home-grown co-fellows.
But remember, you got through medical school, the USMLE journey, and then residency. As long as you want this, you got this.

Eh…I bet you anything it’s the FMGs that are the gunners here.

 

[Raha44]

This sounds like a self confidence issue and a little bit of “whoa is me” type of mentality.

No one expects you to be attending level right away. It’s a 3 yr fellowship for a reason.

I get the sense that maybe your program one of those east coast intense programs. Again, just b/c others seem to have it together, they don’t. They just don’t show their insecurities or try to make others insecure to make themselves feel better.

It only matters what kind of doctor you are at the end of the fellowship, not the beginning.

Anyway, you have two options: 1. Persevere, grow and learn/become a better doctor and overcome.; 2. Give up and quit.

What kind of person you want to be?

I would like to be the first option which is how most people want to be and what is everyone tells you to be.
I don’t know if I can pull it up. What scares me is that maybe I thought I have the qualifications but in reality I don’t.
I will suck it up for now. Tough part is not the actual work but being undermined by not only your superiors but also you peers.
Programs still claim to be supportive and friendly it is all BS.

 

[Raha44]

You're not comfortable because you don't know much cardiology currently.

That's what fellowship is for.

But fellowship is a different beast because the learning is much more self directed.

I've posted this in other threads to residents who are stressed etc. Usually this is tied into their level of comfort/perceived competence.

Jobs/specialties become much less stressful when you actually know what you are doing. It becomes routine which is good.

Hospitalist work seems easy to you because your residency has essentially prepared you for this over three years.

If you enjoy the specialty, you have to commit to learning it. Memorizing the guidelines, reading your basic textbooks, etc. With knowledge comes comfort and fellowship will get better. There are still the same social issues to deal with etc ( annoying co fellows, irritating attendings etc) but that is the same with any job.

If you hate the actual subject matter, that's a different story. Then just quit.

I don’t hate it. My fear is dealing with the stress and the people co fellows, attendings, leadership, PD etc. I don’t mind the patients really, not that they would never annoy me but the big issue is the people in the program.
I am going to try my best to learn. Not sure if I can do much about feeling incompetent when I am treated that way.

 

[BorntobeDO?]

I understand that I messed things up and that this is serious and that’s why I came to SDN.

Lol you came to SDN for the serious issue.

I agree with above, normal to feel incompetent, especially in first week of new position in mew institution. Especially if the EMR is new to you also. I know I feel incompetent in that scenario too.

 

[mszzeta]

Wow! This is pretty much the same situation that I am in now. I don’t think I was their preferred candidate and I sense that the PD is passive aggressive towards me.
They keep talking about how some of the attendings are crazy and have been hostile with fellows and that it is normal and we are not supposed to take it personally.
I did a year of research last year so I am rusty with procedures and my hands were shaking even in the simulation lab!!! My co fellows were commenting as they were closely in my face and the senior fellow started getting inpatient. Worse part is I am starting with cath and apparently the interventionists here are hostile so I am pretty sure my whole body will start shaking there.
The chief resident of the home program (now a fellow) acts like she is an attending and has been giving me unsolicited advice implying I don’t know things. While that is true to some degree, it isn’t helping me learn and I doubt she has good intentions.
It was helpful to read your story. I feel I am not the only one! Thank you!!

It is not uncommon to work in a place that you don't like, for whatever reason. Fellowship is 3 years and after that, you can say goodbye and never talk to any of the people again. Work is just work. Many people hate their job and they are still doing it. You are lucky that yours has an expiration date.

And you don't need to be a super star to graduate a fellowship program, nor do you need to make friends to all your colleagues. As long as you are not super irresponsible for patient care, you will graduate and make good gigs that you will probably be glad that you had not quit. Also, the actual cardiology practice can be different than fellowship. Many people do 100% outpatient which is much less stressful than inpatient or CCU...

 

[mszzeta]

I don’t hate it. My fear is dealing with the stress and the people co fellows, attendings, leadership, PD etc. I don’t mind the patients really, not that they would never annoy me but the big issue is the people in the program.
I am going to try my best to learn. Not sure if I can do much about feeling incompetent when I am treated that way.

Have you seen real super incompetent colleagues in your residency? They still graduate......