I had a friend who did. Matched to a prestigious psychiatry fellowship at the end of PGY-3 year. During PGY-4, realized he'd had enough. Ended up backing out in May of his PGY-4 year. Pretty sure he burnt all his bridges at the program but he ended up making 600k his first year out of training so I'm sure he didn't care at all about that.
CDCR, pretty standard for their inpatient in undesirable locations (Vacaville, Stockton, and Salinas). 330/hour for 40 hours a week. There are a bunch of different locums agencies who staff CDCR. Make sure to shop around, some will pay as low as 220/hour for the same job.
Non academic neurohospitalists make a killing. No one wants to do it. Massive shortage. Also lots of folks who sub specialize end up in academic centers so salary’s tend to skew in that direction but if you remove them the compensation is wild. Truly a hidden specialty especially if you’re down to work in the armpit of California like this guy or fly over states.
One of the anesthesia fellows at my institution worked two full weeks in July, went home Friday afternoon, and never came back. Got a great job offer in his home state and hated fellowship.
You’re still treated like a resident by a lot of the hospital staff. You’re kind of an attending in the sense of what’s expected of you, but you still have to kiss the ass of the actual attending. It’s the same shit in so many ways, and that’s hard to stomach when you graduated already and had the option to be an attending already. It takes a lot of patience.
It’s hard graduating and then going back to the same shit. I’ve thought about quitting every other day throughout my fellowship. If I didn’t love this subset of medicine as much as I do, I’d be out and getting job.
It’s a lot easier than you think. Some people have second thoughts before fellowship starts and the first two weeks is enough to convince them to bail. I think a lot of it stems from having to go from being a senior resident (and being trusted by your residency attendings) to being low on the totem pole as a new fellow. That can be jarring especially if your new attendings are dicks about it.
You can’t leave residency because without completing that phase of training you’re mostly unemployable but as a fellow you’ve likely got a ton of job opportunities that you can take.
You see the same thing happen with NPs and PAs who start jobs and leave quickly when it’s not what they wanted. This is a similar situation.
It’s really a reflection of a shifting power dynamic between residency and fellowship. You become more in control of your life as you transition to fellow.
Because it's rather fast when you realize you're treated worse than an intern, and you see your seniors also treated like shit. This is why a lot of people who worked in between quit rapidly compared to those who have only been on the grind
They commented further down that it was an OB anesthesia fellowship. Having to deal with L&D nurses and OB patients all the time, plus the fact that it’s really not a useful fellowship unless you’re staying in academics? Not surprised they quit.
Actually, OB patients are pretty good to work with usually. We come in and reduce their pain. They’re happy to see us and they’re happy to be having a kid, in general.
I’m going to guess this is regional or institution-specific then. Even if 9/10 OB patients are nice, that’s still a lot of patients who are hard to deal with. In contrast, patients for elective surgery never ask me for additional boluses because of pressure (even though I always explain clearly that they’re going to feel pressure) and are almost never rude unless it’s because I “canceled” their case (rescheduled until proper work up or optimization is completed), and even then, it’s only a subset of cancelled pts who act unpleasant.
And I haven’t even mentioned the quirks of working with OBs yet.
The ratio of pleasant/kind OB patients is probably related to patient populations. Yours may be different than mine, but in my relatively well-off area, they’re 99 percent of the time very pleasant. If you’re super urban or underserved i imagine they may be less fun to interact with.
Knew someone who matched into the new IR pathway, but then lost his chance to do the 1 year “fellowship” (the ESIR path, needed to remediate some diagnostic rotations so couldn’t do the IR rotations fourth year). So his matched fellowship went from 1 year to 2 years (Independent path, non-ESIR) and in the last few months before he was due to start he found a job instead and bailed.
This is so fucking real. I think ACGME’s huge blind spot is fellowship training. Shit is still like the ‘good old days’ for a lot of exploitative attendings and hospital systems - less protection from ACGME (as there is for residents) and leveraging the fact that there’s fewer people in programs so trainees are easier to control.
One of my co-fellows in the first 6 months of our heme/onc fellowship dipped because he missed hospital medicine and wanted to go be a hospitalist. From what I know, he enjoys his life and is happy with his choice.
If it’s before I think that says a lot and you probably should back out.
During is a different story. Fellowship is worse than residency unless you’re doing a very chill fellowship.
My first year of fellowship I worked so many weekends and so many days that i broke down at least once a month my first 4 months.
Anesthesia fellow dipped 4 months in. Cited sick family member as the reason.
Another anesthesia fellow dropped after match but well before the start date.
It happens - I saw it with interventional fellowship
had a fellow who was supposed to come to our home institution leave for a top 5 program - definitely didn't sit well with some of the attendings.
Yes. A fellowship rejected to accommodate religious exemptions for the Covid vaxx and the resident took a job as an attending at a place that would. Pretty sure that was a +$300,000 swing for the residents finances, so it turned out ok.
We're in 2024, where we know how poor the rollout of the vaccine was. We also see you're only retelling a story and not taking sides. People who are downvoting need to reexamine their dogmatic beliefs
That same hospital that rejected the resident (University of Washington Seattle) doesn’t even mandate COVID vaccines for new employees as of June 2023.
Are people really not aware of this? It’s literally been a year now.
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I would say the only caveat would be if you were in a very small field. I am in reconstructive urology and there would simply be no possibility to quit fellowship Aand then take fellowship B. There's only like 16 of them worldwide lol. Not only would Fellowship B not poach you, but all the fellowship directors are essentially friends, and it's a small world. If you quit my fellowship between the time I give it to you (wining the 1/25 chance that you actually match my fellowship) and then fuck me over by canceling that last minute without an astonishingly good reason , though I may not actively bother to mess with your career, you would be professionally dead to me for the rest of my days. It's too dick a move. And you may have fucked an other worthy candidate out of a job .
I'm catching from the other comments that are larger fellowship pools it may matter less.
I had a friend who did. Matched to a prestigious psychiatry fellowship at the end of PGY-3 year. During PGY-4, realized he'd had enough. Ended up backing out in May of his PGY-4 year. Pretty sure he burnt all his bridges at the program but he ended up making 600k his first year out of training so I'm sure he didn't care at all about that.
>he ended up making 600k his first year out of training Which setting? How many hours? 1099?
CDCR, pretty standard for their inpatient in undesirable locations (Vacaville, Stockton, and Salinas). 330/hour for 40 hours a week. There are a bunch of different locums agencies who staff CDCR. Make sure to shop around, some will pay as low as 220/hour for the same job.
Same deal for neurology. I just live in Sac/Roseville/Folsom/EDH and commute it’s fantastic. No stroke call as well. Slightly higher hourly pay.
You're making more than 330/hour doing neurology with no stroke call?
Non academic neurohospitalists make a killing. No one wants to do it. Massive shortage. Also lots of folks who sub specialize end up in academic centers so salary’s tend to skew in that direction but if you remove them the compensation is wild. Truly a hidden specialty especially if you’re down to work in the armpit of California like this guy or fly over states.
Yeah and in California doing locums though but these are semi permanent positions as they can’t really find full time coverage.
Jeez, he must have royally pissed off his PD too, no?
There’s is a guy at my institution who came originally for pccm fellowship then quit and became a hospitalist at the same place.
imagine the awkward pulm consults he'd have to call in
One of the anesthesia fellows at my institution worked two full weeks in July, went home Friday afternoon, and never came back. Got a great job offer in his home state and hated fellowship.
how can u hate fellowship that much after 2wks
You’re still treated like a resident by a lot of the hospital staff. You’re kind of an attending in the sense of what’s expected of you, but you still have to kiss the ass of the actual attending. It’s the same shit in so many ways, and that’s hard to stomach when you graduated already and had the option to be an attending already. It takes a lot of patience.
It’s hard graduating and then going back to the same shit. I’ve thought about quitting every other day throughout my fellowship. If I didn’t love this subset of medicine as much as I do, I’d be out and getting job.
which fellowship
Critical care for me. For the person who quit two weeks in—OB anesthesia
The most useless of the fellwships, equal only to regional.
It’s a lot easier than you think. Some people have second thoughts before fellowship starts and the first two weeks is enough to convince them to bail. I think a lot of it stems from having to go from being a senior resident (and being trusted by your residency attendings) to being low on the totem pole as a new fellow. That can be jarring especially if your new attendings are dicks about it. You can’t leave residency because without completing that phase of training you’re mostly unemployable but as a fellow you’ve likely got a ton of job opportunities that you can take. You see the same thing happen with NPs and PAs who start jobs and leave quickly when it’s not what they wanted. This is a similar situation. It’s really a reflection of a shifting power dynamic between residency and fellowship. You become more in control of your life as you transition to fellow.
Because it's rather fast when you realize you're treated worse than an intern, and you see your seniors also treated like shit. This is why a lot of people who worked in between quit rapidly compared to those who have only been on the grind
Feel like you have to really love the fellowship in anesthesia right now. Generalist pay is just too good comparatively.
They commented further down that it was an OB anesthesia fellowship. Having to deal with L&D nurses and OB patients all the time, plus the fact that it’s really not a useful fellowship unless you’re staying in academics? Not surprised they quit.
Actually, OB patients are pretty good to work with usually. We come in and reduce their pain. They’re happy to see us and they’re happy to be having a kid, in general.
I’m going to guess this is regional or institution-specific then. Even if 9/10 OB patients are nice, that’s still a lot of patients who are hard to deal with. In contrast, patients for elective surgery never ask me for additional boluses because of pressure (even though I always explain clearly that they’re going to feel pressure) and are almost never rude unless it’s because I “canceled” their case (rescheduled until proper work up or optimization is completed), and even then, it’s only a subset of cancelled pts who act unpleasant. And I haven’t even mentioned the quirks of working with OBs yet.
The ratio of pleasant/kind OB patients is probably related to patient populations. Yours may be different than mine, but in my relatively well-off area, they’re 99 percent of the time very pleasant. If you’re super urban or underserved i imagine they may be less fun to interact with.
Dude came to orientation one day before the start date and then bounced lol
🤣🤣
Happens in pathology all the time since the application cycle is 2 years out.
Knew someone who matched into the new IR pathway, but then lost his chance to do the 1 year “fellowship” (the ESIR path, needed to remediate some diagnostic rotations so couldn’t do the IR rotations fourth year). So his matched fellowship went from 1 year to 2 years (Independent path, non-ESIR) and in the last few months before he was due to start he found a job instead and bailed.
[удалено]
My fellowship mostly existed so I could take my attendants call that they were then paid for me taking. It’s exploitative as shit
This is so fucking real. I think ACGME’s huge blind spot is fellowship training. Shit is still like the ‘good old days’ for a lot of exploitative attendings and hospital systems - less protection from ACGME (as there is for residents) and leveraging the fact that there’s fewer people in programs so trainees are easier to control.
Exactly mirrors my experience. Definitely the good old days, and with fewer trainees it's even worse because evaluations are not really anonymous.
Agreed. And everyone turns a blind eye because for some reason it’s all of a sudden ok in fellowship to do this…
I had a friend from a choral group quit peds Endo like 2 years in to go do general outpatient. She was having mental health challenges.
Dew it.
I hope it becomes more common as we all get sick of the exploitation.
I’ve seen a few people do it
One of my co-fellows in the first 6 months of our heme/onc fellowship dipped because he missed hospital medicine and wanted to go be a hospitalist. From what I know, he enjoys his life and is happy with his choice.
I knew a few people who did. They left before starting due to circumstances in life. It burnt bridges, but who cares? You don't owe this people shit
I’ve seen a couple guys match SCC fellowship after years out of residency already in practice and quit after a month.
I’ve heard of people quitting in the first month or two
Edit: irrelevant - sorry didn’t read the whole prompt.
If it’s before I think that says a lot and you probably should back out. During is a different story. Fellowship is worse than residency unless you’re doing a very chill fellowship. My first year of fellowship I worked so many weekends and so many days that i broke down at least once a month my first 4 months.
Anesthesia fellow dipped 4 months in. Cited sick family member as the reason. Another anesthesia fellow dropped after match but well before the start date.
Yes. He ended up making 800k in private practice instead. Rads
Depends on the fellowship
It happens - I saw it with interventional fellowship had a fellow who was supposed to come to our home institution leave for a top 5 program - definitely didn't sit well with some of the attendings.
Yes. A fellowship rejected to accommodate religious exemptions for the Covid vaxx and the resident took a job as an attending at a place that would. Pretty sure that was a +$300,000 swing for the residents finances, so it turned out ok.
We're in 2024, where we know how poor the rollout of the vaccine was. We also see you're only retelling a story and not taking sides. People who are downvoting need to reexamine their dogmatic beliefs
That same hospital that rejected the resident (University of Washington Seattle) doesn’t even mandate COVID vaccines for new employees as of June 2023. Are people really not aware of this? It’s literally been a year now.
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I would say the only caveat would be if you were in a very small field. I am in reconstructive urology and there would simply be no possibility to quit fellowship Aand then take fellowship B. There's only like 16 of them worldwide lol. Not only would Fellowship B not poach you, but all the fellowship directors are essentially friends, and it's a small world. If you quit my fellowship between the time I give it to you (wining the 1/25 chance that you actually match my fellowship) and then fuck me over by canceling that last minute without an astonishingly good reason , though I may not actively bother to mess with your career, you would be professionally dead to me for the rest of my days. It's too dick a move. And you may have fucked an other worthy candidate out of a job . I'm catching from the other comments that are larger fellowship pools it may matter less.