Separate vs combined pulm/crit fellowship (particularly NIH)

[RememberWhen]

I was hoping to get perspectives on the pros/cons of completing a Pulm/Crit fellowship at a combined program vs doing each specialty separately. The program I have my eye on is the NIH critical care fellowship which is designed to have the fellow complete a year of clinical critical care training, then if interested in another specialty like pulmonology they can complete a year of that specialty at another institution, and then return to the NIH for research. Previous graduates have gone to programs nearby such as Hopkins, or even as far as University of Washington for their pulm year. Doing an NIH/Hopkins combined pulm/crit fellowship would be perfect for me geographically and certainly seems like a prestigious opportunity. But, I was wondering if I could get opinions on a few points, particularly from folks who have finished training

1. Would splitting my fellowship between two programs look odd to future employers? (FYI I want to stay in academics)
2. From my understanding, the NIH ICU has many patients on experimental therapies/with unique conditions. While there are certainly great learning opportunities with this, could it be detrimental that the population doesn't reflect the population I would see if I were to later work at a different institution?

I would greatly appreciate thoughts on these questions and general thoughts on this approach to fellowship. Thank you!

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[Nephro critical care]

Depends on what you want. If you primarily want to be in research this is the way to go. If you want to be primarily clinical then would do a pulm/cc fellowship because you won't get clinical exposure with this type of training.

 

[Soccer171983]

Agree 100% with this statement. NIH will be beneficial for research end but I doubt they can volume of bread and butter pulm/cc.


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[Nephro critical care]

We had a recent endocrinologist from NIH. A poorly controlled Type 1 diabetic presented to clinic . That endocrinologist managed to order for 52 genetic causes of type 1 DM on 1st clinic visit . The note was pretty amazing. Must have taken that endocrinologist 3 hours to see the patient and those tests probably cost about $ 50,000. I read the note and developed extremely low self esteem from my lack of knowledge about the genetic causes of diabetes. And on 2nd visit that endocrinologist managed to order for 12 more causes of genetic diabetes ! None of which came back positive. The patient died a few months later of complications of poorly controlled diabetes.

Thinking back now though despite my low self esteem at that time now I think the patient just needed good counseling about diet , compliance with insulin and perhaps an insulin pump.