What happens if you don't get a job after one fellowship?

[alpinebrook]

My plan is to start interviewing for my first job during my fellowship year (2020-2021). Ideally, I'd like to get away with only doing one fellowship, as I have a mountain of debt and want to get on with my life. But given that you apply for fellowships two years in advance, what does one do if it becomes necessary to do a second fellowship? Look for programs that have an opening and apply last-minute? The reason why I've become worried about this is that my career plans/interests have changed a bit since I accepted my pedipath fellowship. I was originally dead-set on pedipath, but now I've realized I'd be happiest doing general surgical pathology, likely in a community practice setting, with more geographic flexibility (so I can be near family, which is very important to me). If I can find a clinical-track pediatric pathologist position at an academic center (service-oriented with teaching, etc., but no major research requirements), that'd be awesome, but I'm not banking on it. Research makes me miserable. I'm happy to collaborate and help other people with their projects, but otherwise it truly makes me miserable; I have no desire to write papers, grants, etc. At my program, I've seen expert academic pathologists have to wait decades before being finally promoted to full professorship. That's just not important to me. I have zero desire to be in that rat race. I want to be a kick-ass staff pathologist and work hard for my patients every day. I did an elective at a community hospital and realized I'd be much happier in that setting than in the cutthroat academic environment that I've been doing my residency in.

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[Unty]

Pediatric path requires you to do research. I don’t know if you will be able to get away with doing no research especially at an academic center. Most likely you can forget about it.

You plan on doing a gen surgpath fellowship? If so, you can always jump into a second fellowship last minute but that may require you to move anywhere the position becomes open. You could also apply for a second fellowship and drop the fellowship if need be if you find a job but that may piss off a fellowship director if you do it late in the game. I’m sure it happens all the time.

Start looking for a job 6 months to a year in advance and if you can’t find anything then at least you got a fellowship in hand.

Being from a good institution gives you leverage in an oversupplied job market.

My buddy applied to 20 plus jobs and only got 3 or 4 interviews and that’s with 3 fellowships. He ended up in a semirural place that most people may not be willing to move to.

I hope you can find a job close to your family.

The job market is not good (but not crap either) but there are jobs if you are willing to move. You may get lucky and a job gets posted where your family is. I’d contact all the groups in your area. You got to do what you got to do.

Another friend of mine lucked out and found a job close to where he currently lives. He couldn’t move for family reasons and he was stressed.

I have been looking at jobs near my hometown and literally have seen only a handful in the past 5-10 years of browsing pathoutlines.

 

[deleted314957]

You are in the wrong field for geographic flexibility, particularly if you intend to focus on p.p.hospital jobs and eschew academia and corporate path.

 

[Unty]

Mike what do you think about corporate jobs like Ameripath?

 

[path24]

Line up another fellowship. Dump it if you get a job.

The (crappy) job market and your debt will decide your future. Best of luck. Shouldn't have picked path, you are not in the driver's seat.

 

[deleted314957]

Mike what do you think about corporate jobs like Ameripath?

There are just too many variables and too many positions to make even a general, let alone blanket, statement. I personally know of some positions that are quite nice and others that are abysmal and everything in between.

 

[Med Director New England]

Line up another fellowship. Dump it if you get a job.

The (crappy) job market and your debt will decide your future. Best of luck. Shouldn't have picked path, you are not in the driver's seat.

Completely agree...
If you get even a decent job offer take it. If the fellowship you dump gives you grief ask if they’ll hire you post fellowship. Any reasonable Fellowship director would understand

 

[alpinebrook]

Thanks for the input. It certainly is stressful... My program director seems to think I could go either way -- apply for a second fellowship sooner rather than later, or make the most of my 4th year of training (which is largely elective time with opportunities to do "mini fellowships"), and hope for the best... I definitely plan on cold-calling a ton of places. I live in an area that is saturated with hospitals; hopefully one of them would like a friendly young pathologist

 

[twentyone]

Talk to some people that practice pedi path. Either in a "community" children's hospital or in a larger academic center. Not the ones who write grants, the ones who contribute to a few clinical case reports a year, participate in resident and possibly fellow teaching, and work hard to serve their patients every day. I think you have too narrow a vision of on-the-ground pediatric pathology.

 

[turtle1966]

One time, a Pathology department chief of a large hospital system, which included a large pediatric hospital, told me that their pediatric pathologist was a loss leader because she/he did not generate enough RVU.

My advice to you is : "It is much better to choose the right place to drill a well, than how deep you drill."

I have just retired and looking back at my 35+ year career, I will say to those considering it: "Pathology, as a specialty, leaving aside the emotional and "innate love" aspect, is like a city built on a mix of high ground and floodplain. When rain comes, SOME of those on the high ground worry, and those on the floodplain DO get soaked." You just do not know which part of the city you will land on.

I do not think that the prospect will change much in any foreseeable future, for many reasons.

 

[alpinebrook]

What about backing out of an already accepted fellowship to pursue a fellowship in a different area? I imagine less sympathy than backing out of a 2nd fellowship for a job offer...

 

[Guest8]

What about backing out of an already accepted fellowship to pursue a fellowship in a different area? I imagine less sympathy than backing out of a 2nd fellowship for a job offer...

I backed out of a surgpath fellowship at my residency site because a dermpath fellowship opened up elsewhere. Didn't hurt me at all, they knew dermpath is what I actually wanted.

 

[Med Director New England]

What about backing out of an already accepted fellowship to pursue a fellowship in a different area? I imagine less sympathy than backing out of a 2nd fellowship for a job offer...

You should back out of a fellowship if a good job offer comes or if you get into a fellowship more preferable to your long term goals (as professionally as possible of course). Backing out is (usually b/c of job offer) becoming more common now, PDs are more nimble these days and often have a backup candidate.

btw how is it going, was curious how your search would turn out..
You should reach out to yaah, maybe your skills and his/her groups needs match up.

 

[yaah]

We are finished hiring for now pretty much, except still looking for a dermpath. But as far as backing out of fellowships, this happens all the time. I know several people who did and some fellowships for whom the designated fellow quit a few months prior to starting.

 

[Pathbusiness]

Last minute replacement fellow is never a problem in any field(of Pathology). Takes one phone call. No one feels bad.

 

[Guest8]

I backed out of a surgpath fellowship because a dermpath fellowship opened up unexpectedly and I got it. I had planned on doing surgpath then dermpath, but really just doing dermpath was all I needed. The program was fine with it, didn't effect my career negatively.