Backing out of cardiac anesthesia fellowship

[David2017]

I am currently a CA3 and matched into CT fellowship. Due to unforeseen circumstances, this additional year of training is now seeming more like a burden. Having gone through the match process I am aware that I essentially signed a contract. Does any one have any experience in backing out of fellowship before starting?

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[GravelRider]

Do the fellowship. If you really can't for personal reasons then tell them sooner, rather than later, so they can fill the spot. You wouldn't be the first person to back out of a fellowship.

 

[David2017]

GravelRider, thanks for the response. Would backing out of CT fellowship hurt my chances of getting a private practice job? Will I still be able to get a good recommendation from my program?

 

[AdmiralChz]

I am currently a CA3 and matched into CT fellowship. Due to unforeseen circumstances, this additional year of training is now seeming more like a burden. Having gone through the match process I am aware that I essentially signed a contract. Does any one have any experience in backing out of fellowship before starting?

I know of a few people who backed out of doing a fellowship, for several different reasons (family illnesses, unexpected job, change in interests...). This is a really tough decision that you need to think carefully about, and I would speak with some of the faculty you trust at your home program for more specific and direct advice. Your program will (in all likelihood) support you through this (especially since there is still a few months before the start of fellowship allowing them to fill quickly - there are plenty of qualified applicants available), especially if you detail your reasoning. If you are staying at your home program you need to meet with all involved about this - your current residency PD as well as your fellowship PD assuming they are not the same. If it is at another institution, you are obligated to speak with the PD there as well out of professional courtesy. Fellowship programs know the opportunity cost to you of foregoing a year of attending wages is significant, so unlike residency they are more apt to be understanding.

That being said, if you go through with this you will, in effect, close off this subspecialty as an option for you completely. No one will be willing to take a shot on a guy who already backed out once - again, there are many qualified applicants and all spots (except the odd one or two) have filled the last few years.

Will it hurt getting a private practice job? Probably not (unless a group you are interested in has a need for hearts-trained graduates), since you don't really need to tell them about this in the application process. It is getting towards the later side for jobs starting in July/August so I would recommend contacting groups immediately if you want to go through with this.

There are many pros and cons (honestly, in my opinion as someone starting a cardiac fellowship in a few months there are more cons not knowing your specific situation) that I am sure others can touch on. Whatever you decide, be sure you seek the advice of others (online is a reasonable start, but this is a conversation that must be had face-to-face with faculty) and do not make and rash decisions - once you withdraw it will be a final move on your part.

 

[Man o War]

I would stick with it unless you absolutely can't. If you're on the fence, do the fellowship. I'm so glad I did despite the sacrifice. It was worth it and then some, especially for PP.

 

[Robotic Wis-Hipple]

This sounds like it just hit you you're going to make 60k next year instead of 300k. Obviously, if it's for a real reason you do what you need to do for what's best for your life. But if this is more of a cold feet thing I think you'll regret backing out introspectively as well as opportunity-wise.

Plus, unless you already have connections or have a job lined up, starting 5-6mo before you graduate to look for one is way late, so consider that.

 

[nimbus]

Agree with above posters. Need to know why you want to back out. One of the few good reasons to back out would be if you have a great job fall in your lap. Otherwise it's better to do the fellowship.

 

[aneftp]

This sounds like it just hit you you're going to make 60k next year instead of 300k. Obviously, if it's for a real reason you do what you need to do for what's best for your life. But if this is more of a cold feet thing I think you'll regret backing out introspectively as well as opportunity-wise.

Plus, unless you already have connections or have a job lined up, starting 5-6mo before you graduate to look for one is way late, so consider that.

Nah. Plenty of jobs available for new grads if u are shooting for $300k-350k at AMC. No need to sweat job search now. Most places only willing to wait 3 months for new person coming on board anyways.

 

[pgg]

Wasn't the match rate something like 77%? Plenty of latent demand out there; the program isn't screwed out of a body if you give up your spot.

If you do decide not to go, I'd decide soon.

It's only January. Someone will take the spot and the program will be OK. (I know a couple people who are looking.)

 

[Robotic Wis-Hipple]

Nah. Plenty of jobs available for new grads if u are shooting for $300k-350k at AMC. No need to sweat job search now. Most places only willing to wait 3 months for new person coming on board anyways.

Well, that's likely true. But AMC headhunter gigs will always be around. For a reason.

 

[David2017]

Thank you all for your thoughts.

A little more background: I chose to apply for cardiac fellowship because it has been the rotation I have enjoyed the most and because it seemed like nearly everyone in my program does a fellowship. I see the fellowship as an additional year to prepare for the real world and be better equipped to manage sicker patients. That being said, I don't want to only do hearts or manage sick patients exclusively. The concern now is that we have a baby and my partner has struggled to find a suitable job. We live in a very expensive city, which makes matters worse. I am not looking to make more money as much as to stabilize my family's finances. Doing a fellowship seems to push off that to a distant future. For those of you who have replied that a fellowship is worth it, could you please share how has it helped you professionally?

 

[Robotic Wis-Hipple]

With this my first thought is that you don't want to be typecast as "the cardiac guy", which in your early career you absolutely will. If you would take a job that was non-cardiac out of fellowship to avoid this I'd say you should just not do the fellowship.

 

[GravelRider]

Thank you all for your thoughts.

A little more background: I chose to apply for cardiac fellowship because it has been the rotation I have enjoyed the most and because it seemed like nearly everyone in my program does a fellowship. I see the fellowship as an additional year to prepare for the real world and be better equipped to manage sicker patients. That being said, I don't want to only do hearts or manage sick patients exclusively. The concern now is that we have a baby and my partner has struggled to find a suitable job. We live in a very expensive city, which makes matters worse. I am not looking to make more money as much as to stabilize my family's finances. Doing a fellowship seems to push off that to a distant future. For those of you who have replied that a fellowship is worth it, could you please share how has it helped you professionally?

Do the fellowship. I live in a very expensive metro area and the best jobs are for people who have fellowship training...particularly cardiac and pain. I did not do a fellowship for a similar reason...I live in an expensive area and it would be financially very difficult to support a family on a fellow salary if my spouse couldn't work. I regret the decision. Can you moonlight?

 

[anes121508]

I'm a CT fellow in a really expensive city.

My wife had a great job. However she lost her job while being pregnant. We have a 1 month old at home. I totally understand your concerns about finances. It can cause a whole lot of stress and worry.

That being said I highly encourage you to do the following:

1. examine your initial motivation for fellowship. I believe you do a fellowship and make the year long financial sacrifice because you truly love the specialty. Others believe that it's an investment that pays off in the future. Either is fine.

2. Examine your expenses and determine where you can cut back. Many people live off of way less than 60k and have multiple kids. Not easy, but just look at what is truly necessary to spend. Amazing the waste you will find on your credit card statement.

3. Setup moonlighting if possible. Maybe even talk to the PD about moonlighting across town if they don't offer it at your home institution. This has made an enormous difference for me.

4. I understand that childcare in a major city is super expensive without family help and it basically negates your wife having "any old job", but look into anything she can do on the side...free lance work for a couple hundred here and there really adds up.

5. Be honest with yourself and with your PD about your circumstances and what your motivations are. Then it will work out. Your PD is probably a mother or father too.

Best of luck.

PM me for any personal details.

One last thing...N of 1 , but the fellowship year helped me find a better job.

 

[Man o War]

Thank you all for your thoughts.

A little more background: I chose to apply for cardiac fellowship because it has been the rotation I have enjoyed the most and because it seemed like nearly everyone in my program does a fellowship. I see the fellowship as an additional year to prepare for the real world and be better equipped to manage sicker patients. That being said, I don't want to only do hearts or manage sick patients exclusively. The concern now is that we have a baby and my partner has struggled to find a suitable job. We live in a very expensive city, which makes matters worse. I am not looking to make more money as much as to stabilize my family's finances. Doing a fellowship seems to push off that to a distant future. For those of you who have replied that a fellowship is worth it, could you please share how has it helped you professionally?

I'm a bit different because I wanted to do hearts all day every day and I didn't want to supervise CRNAs anymore. The jobs I interviewed for fit that description. However, I know cardiac fellows who went on to work at PP jobs and only do hearts 1-2 days a week.
There is a bit of a trend occurring that hospitals want the docs doing cardiac to have the TEE advanced board cert. One very good PP group I interviewed with was told they had to phase out all their non boarded cardiac docs within 3 years. Some of those guys had been doing hearts there for decades. Complete BS, but they didn't have a choice.
You will have access to groups and markets you otherwise may not. I would encourage you to make sure you're doing hearts regularly though or you're going to get really rusty and possibly struggle to maintain the numbers necessary to keep your board cert in TEE.

 

[urge]

I am currently a CA3 and matched into CT fellowship. Due to unforeseen circumstances, this additional year of training is now seeming more like a burden. Having gone through the match process I am aware that I essentially signed a contract. Does any one have any experience in backing out of fellowship before starting?

Call the program and tell them your reasons. You are not the first.

 

[Wiscoblue]

Do the fellowship. There are plenty of private practices where you will be able to do General and OB in addition to hearts and you will make more money than the non fellowship guy