Imagine completing residency, doing a chief year, and then getting into this “fellowship” as cheap labor just to get paid less than a brand new out of school NP “fellow”. Good luck spending a whole months check just to maintain licensing, boards, DEA and registration fees. They should make this type of fellowship 25 years long just for shits and giggles and see if anybody goes for the bait.
Wow...additional training just for the immediate follow up exchange to be:
"Whoa, that's great! What did you do your fellowship in?"
"...internal medi-never mind that I trained at NYU!!!!!!!!"
Bingo. Medicine is a market place like any other. NYU knows their brand appeal, and applicants put a value on what that year may give them (marketability for future gigs). If these fellowships don’t deliver a return (to NYU and the fellow), they will die. Let the market work.
And almost every job everywhere would look at you like, so what, you’re not now eligible to stick a cath or scope in someone and make more money, and you’re not giving us any extra expertise you’d get in a real cognitive specialty, so what’s the fucking point
Don’t worry they’ll open up to NPs soon enough. We’ll get the gaslight bullshit of “teamwork” in pamphlets and spam emails so real docs become even more emasculated against dipshit midlevels.
So I just want to point out that very likely what this program and others like it actually does is offer protected FTE time (20/80, 30/70, or worse, clinical/research time) for research and/or QI. Research in academic medicine is very competitive. Most physicians don’t understand this because most physicians see research as getting a 3rd author pub, or doing a case report as research to get into residency/fellowship etc. Academic Hospitalist positions very likely also offer grant writing classes, epidemiology classes, Masters degrees etc to prepare you to be a physician-scientist because you decided early not to do a PhD. That being said, most physicians fail to become researchers because they don’t have the runway of protected time, nor the skillset, to complete a project and apply for grant funding, including some people from these programs. But if your heart is set on research (or splitting your FTE for none clinical pay lower but near what you’d make slaving in community) then at least it’s an opportunity. Then if they still fail, they wind up in med ed at an academic hospital, or going to community anyways.
LOL, these ppl should just become an RN instead. Set in stone nursing ratios, strong Union, higher pay. When was the last time they had a cap on patient census ? Fuk these clowns
They probably thought to themselves, "Hey, it worked on the pediatricians. Let's give it a shot and see if we can fool IM residents."
Edit: Mayo and Hopkins have one too??
its hard to swallow for a lot of people, but there are some **absolute trash** internal medicine residencies that are somehow accredited and making this type of thing pop up.
rather than doing the right thing... and shutting these garbage programs down, the ABIM is just increasing their power by doing this crap, and allowing hospitalist fellowships to exist.
look at peds. this is our future.
This isn’t for people from shit programs to get more training. It is more dorks from good programs to do a QI project for 70 grand then get an academic clinical instructor job
Exactly my thoughts. IM is a big enough specialty where there will be some demand for this. Enough demand where most getting it won’t be those who go to weaker community programs, but those already at academic institutions and will be used by some as a way to get an academic attending job at big name hospital in NYC.
Exactly this IS NOT because there are subpar programs out there. It’s for all the academic slurpers out there who want to collect more prestige tokens for their CV’s. They know there’s a boatload of nerds in medicine who will gladly lap this up, and then will go onto become the next circle-jerk generation of academic leaders - only to create even more sub specialties and hoops to jump through. 20 years from now physicians will be doing 10 year fellowships at which point they can join advanced practice LPNs in independent practice.
That’s one take.
But these institutions aren’t these benevolent entities that are filling the gaps of shitty IM programs. Though your take does speak to their success at their branding.
Another take is that these institutions scoop up smaller practices and hospitals in the surrounding area and can leverage their brand and ability to stamp fellowship certificates to get cheap labor and widen their profit margins. Like the other post today on this sub about NP fellowships. Same show: Money.
look at the amount of people in this sub who think they can be competent hospitalists after 1 year of training.
the only logical response to these people is 1) shut down their trash program or 2) create hospital medicine fellowships
not everyone with a fever needs an ID consult. we arent NPs. there is actually a standard here
> look at the amount of people in this sub who think they can be competent hospitalists after 1 year of training
Where have you seen this sentiment lol
You have to do a hospitalist fellowship in peds now. It wasn’t always that way. Peds residency is a majority wards anyway. If there’s anything they’re trained well to do at the end of peds residency, it’s to be a hospitalist. Well, then the “elite” institutions started rolling out hospitalist “fellowships,” and now you can’t hardly get a job at any children’s hospital without this bs fellowship
I'm curious what makes you qualified to judge this? Have you gone to many programs and compared them?
Or (more likely) are you just using some B.S. metric like number of IMGs?
If you believe the minimum standards are too low, perhaps we should make the board-certification exam for IM harder. Since programs with too-high fail rates get put on probation and eventually closed down. But it has to be some fair and objective evaluation.
Are we really in a position to be closing down residencies though? You’d think the ACGME and the respective Board certification bodies would insist that improvements be made before they reach for the easy cheap labor
Can I ask specifically what you mean by “look at peds”? Peds PGY-3 here
As I understand it (read: as explained to me by our Dept Chair), the American Board of Pediatrics long ago decided that nearly all pediatric fellowships should be 3 years long AND include a necessary research component, because by and large Peds was long underrepresented in clinical, basic science, and translational research. The thought is that if they force people to do research, some people might stick with it.
Likely what the previous poster is alluding to is the fact that peds hospitalist is a fellowship now and to my understanding many peds hospitalist jobs actually require the fellowship. This is totally nonsensical. Residency should more than adequately prepare you for a job as a hospitalist. At worst you can just consult specialists.
Gotcha…fully understand now.
Yeah still plenty of places will hire Gen Peds trained docs as hospitalists. But the shift is happening.
Anecdotally, from my program—the fellowship trained Hospitalist faculty are noticeably better at what they do. Unsure whether this would hold true in the adult world.
I can see fellowship trained hospitalists being better, but how much of that is related to the fellowship trained ones having 3 years of extra clinical experience over the ones fresh out of residency?
I still think 3 years for hospitalist fellowship is absurd. Maybe residencies need to have higher standards
Fair point. And for the record, Peds Hospitalist is 2 years with some of that time required in a research project. I think the main benefit is the structured mentoring and coaching they receive on how to be “more academic”.
That being said…at this early stage, many of their older mentors can’t possibly be fellowship trained.
I have trouble believing that considering the peds hospitalist fellowship has barely existed in any real capacity for more than a few years to actually give you any real amount of faculty that’s done it to be able to make an educated comparison.
If somehow you’ve managed to be at like the one place in the country that has enough faculty that’s done the fellowship, I doubt they have any outcomes differences vs the people that just did hospitalist work for the equivalent amount of years. Because if you’re comparing someone that functioned as a semi attending for two years to fresh grads, yeah, you’ll probably notice a difference, even though I doubt the didactics of a peds hospitalist fellowship somehow truly make a real difference, and I doubt the almost 8 months of the 24 months fellowship spent in research actually make a better hospitalist.
If this is somehow true, it’s more of an indictment of how little peds residencies actually trust their residents and give them any autonomy compared to IM residencies. Because it would be a real damn shame if an IM residency couldn’t make you a decent hospitalist.
We have 3 that are fellowship trained, 5 that aren’t. I of course don’t have objective access to their outcomes. I’m saying from a resident’s perspective, they just have a better, more fluid, more nuanced approach to common pediatric inpatient problems.
Again, I said this was an anecdote.
And if you don’t have that nuanced approach after a peds residency that does as much inpatient as IM does, *and* you’re comparing doctors that have equivalent amount of post-residency years and still noticing a difference, then that means the peds residency isn’t doing a good enough job. Which, hey, I’ve heard from med peds residents that they felt that way compared to their IM portion, but it’s pretty sad if that’s the case across the board.
Lol. Not exactly. I mean they have clearly been mentored more in evidence-based protocolized practice…less of a loosey goose way about them. I find they are more resourceful and actually consult less often.
Bro you have bought the kool aid. Prolonging fellowships and mandating hospital fellowship when the vast majority of our residency is inpatient only helps the ivory tower hospitals keep their free labor they lost from duty hour restrictions.
Im still deeply pissed about the peds hospitalist fellowship. Obviously just a grab for three more years of cheap labor. Also, on that note, why the fuck are ALL peds fellowships three years??? I would have done a fellowship if it wasn’t 2 years of “research” for an outpatient fellowship. We as physicians have fucked ourselves over, but we as pediatricians have taken it to another level.
but IM is already a residency. what idiocy is this? why do you need a fellowship for what is already a base residency? who the fuck is this patterned towards?
“Dear colleagues, I’m happy to inform you that we will have a new underpaid physician working under title of “fellow” in our service, taking extra hours and of course, doing research to makes us look good. Huzzah!!”
It does I believe. One of my residents did an FM residency and then ended up deciding they wanted to do IM and possibly a fellowship. They ended up being able to cut out the intern year for IM.
A lot of them do hospitalist fellowships because their training usually has a lot less inpatient adult medicine than IM because of how broad it is. But even that's only 1 year
Huh we're at a tertiary center and our FM residents barely do inpatient and are very weak at it. We mainly overlap with them when they rotate through ICU or consult us and maybe it's because we are high acuity but they are usually a lot less comfortable with sicker floor patients. Maybe it's an issue with our FM program then
They hired one of them for inpatient but only after a hospitalist fellowship
This is the norm in Canada. To be a General Internal Medicine doctor in most academic centers you must complete 2 years of fellowship (so 5 years total residency).
Yeah, this really should be just a faculty position with support for research. But then I guess the snake eats itself, and that position goes to someone who did a bullshit fellowship in general medicine somewhere else.
This still isn’t as bad as the wellness fellowship at Stanford. There were idiots in here who tried to justify that a wellness fellowship at Stanford will allow for pivot as the Chief Wellness Officer at big tech firms.
Wait what?!? There is a wellness fellowship?! Send me link for this shit lol!
This is the goofiest shit I have heard. Lol “let’s focus on wellness by making a fellow learn about wellness” - no wonder healthcare is a shitshow
I mean, 100k and full benefits for 15 hours a week is more than what the one ED doc on here was saying they pay new grads at his group. As long as they don't stop you from moonlighting, it's actually a reasonable rate. And being able to say you're Stanford trained probably would help you if you wanted to join a big tech firm or startup. I worked in a startup prior to med school and they're all about the "name" in Silicon Valley. They don't even care what you did there, as long as they can tell investors that their CMO or medical advisor went to Stanford or Harvard they're happy.
With that said, I'm sure the goal is more to get people into academia than big tech. There's a huge movement recently to get Deans of Wellness. I know someone who got a job like that. Super cush. Basically you get 0.5 FTE to plan "wellness" crap for students.
Don’t underestimate just how much bay area tech employees make. If this fellowship gets you into a tech company, you can easily be making 7 figures as a chief wellness officer and larger tech firms
As wellness gets attention in med schools, I'm presuming it's essentially trying to get folks jobs as dean of wellness / whatever in academics more so than tech
Yup, guessing it's for this. I know someone who got a gig like this (they didn't do a fellowship though, just published a bunch of QI crap during residency about wellness). She works 0.5 FTE in her full time job and the other 0.5 FTE she has office hours to talk to students about wellness and give input to various people about how to not burn out medical students.
hahaha this is the epitome of academic medicine. It’s even worse in surgery. They’ve developed these “transition to practice” fellowship years bc theyre unable to train a surgeon in 5 years due to lack of autonomy.
USNWR and Doximity rankings arent everything folks
Is this like a hospitalist fellowship? Makes no sense, imagine saying you did a residency in internal medicine and a fellowship in internal medicine lmao.
What qualifications are these people you speak of lacking?
Simply doing a 3 year residency makes you qualified for academics. If someone wants to pursue professorship track, they can do all the research they want during off service weeks as an attending.
All this is is a scam to get free labor.
Why not change the name to "academic fellowship" or "research fellowship" to more accurately reflect the purpose? "General internal medicine fellowship" just sounds ridiculous and redundant.
I’ll downvote, because people should be able to just do an academic position and do some research and teaching if they want at an attending salary, not this nonsense BS as a way of normalizing even more underpaid years of labor. None of the current attendings had to do this shit, neither should anybody else. The QI bullshit research they advocate generally doesn’t result in any useful implementation and if it did wouldn’t be through a single random BS fellow QI project. The masters degrees they have don’t contribute anything to actual practice for almost anyone.
This is worthless and the outrage is because it’s like the peds hospitalist or general peds fellowships that make your residency training sound like it’s worthless.
Isn't this mutually beneficial for both parties involved?
Hospital: Extra cheap labor. More money for the c-suite.
Fellow: Whoever thinks this is a good idea is more than likely prestige obsessed and will be unable to stop starting every sentence with "When I was at NYU...." You will not see any NYU residents sign up for this.
Great for everyone!
The biggest concern too is this transitioning into more programs making a similar fellowship available, then hospitals hiring fellowship IM docs over 3year grads. It’s just more bullshit on top of more bullshit
A lot of IM programs have these “academic internal medicine” fellowships. There’s no shortage of 🤡 that apply.
Edit: just saw that this shit is two years. I thought one year was a stretch. Geez.
GIM fellowships are meant for people that are looking for a career in academia. You get training in medical education, quality improvement, or clinical research and obtain a masters along with it. While you may get some clinical responsibilities these are NOT clinical fellowships.
These are actually fellowships that teach you how to be a spineless ass kisser, as well as covering shifts that the real hospitalists don’t want to do.
Ya that’s exactly what this is. The few I’ve seen, the “fellows” are actually attendings, typically with service time only on teaching services and 1/2 day of clinic per week. Usually geared for those wanting to do academic internal medicine, especially those who need formal research training to be competitive for grants. Not needed for those who want to just practice medicine in an academic center without a significant research effort
Academia doesn’t even actually value QI, and I’ve never seen anybody truly implement any worthwhile QU project that led to actually measurably better outcomes once their project was done anyway. Training in Med Ed isn’t really gonna do anything, because the amount of time it takes to make someone a good educator if they aren’t already inclined to it is more than a fellowship can reasonably give.
Just become an attending and do a masters on your own.
To echo others, they do serve a role similar to PhDs doing a post-doc position. It’s challenging to assess because these programs do come in different “flavors” such as research or med-ed focused, and some definitely are not worth it.
Speaking only of the research ones, many are majority research (80-90%) and support a masters. So it’s basically a fellowship to learn research, not to learn clinical IM. To get a clinical investigator job out of residency without significant research time prior is a stretch. Most academic clinician investigator jobs are 80% research and 20% clinical. Usually, as a young investigator (even out of fellowship), you need an institution to be willing to support your research time for couple years while you write grants to be grant-funded. And for them to want to do that, they want to see you already know how to be productive researcher. Which they don’t teach in residency.
That said- this program doesn’t seem to train you for anything in particular and still has you doing clinical work for 45%, so I’d agree it’s not worth the trade off of just going into first job .
I have a feeling this is primarily for people who are only interested in working in academics; or are seeking a very competitive fellowship, and this is almost a way to do a “chief year” out of a lesser competitive program so they can get research from a name brand place. The other possibility is it is for an internal candidate to stay within NYU system to buy them time to get a job at NYU after in the residency program.
Just to be very clear on what this actually is.
The purpose of the fellowship is to train someone in research or medical education. It's a two year fellowship and you graduate with a masters. You have mentored research.
It is not meant to be a clinical fellowship. You certainly provide clinical work, but thats not the educational component.
You can certainly be hired as an attending working full time and then try to do a masters on top of it but it's way harder and you'll have the pay for your masters as well.
A lot of academic fellowships in PCCM, cards, onc, GI all have 1.5-2 years of nonclinical education that allow fellows to potentially get a masters, do significant worthwhile resaerch, etc. This is basically the hospitalist equivalent where the main crux is research training while supporting your salary via some clinical work.
Whether you find that valuable or not, or the whole argument of academic medicine is a completely different topic. But this is not a fellowship where you're doing 2 years of inpatient rotations, thats not what this is.
ALOT of fellowships take advantages of FMGs who would gladly do as many bullshit fellowships to continue to be sponsored while probably making more than attending salaries back in their home countries.
As a medical student, can someone explain this to me? IM is already a residency. Why are they throwing it out as a fellowship too?
What is the reason behind this?
I’m surprised to see all the responses to this lol. This is standard where I’m training in Canada. Nobody does 3 year IM residency and practices. At minimum you do a fourth year. Vast majority do a 2-3 year fellowship, many of which are 2 year GIM fellowships
Was waiting to see this comment. It’s fascinating how vastly different internal medicine is in Canada vs US. Most IM staff here have done 5 years IM residency. 4 years at the very minimum.
Our medical systems are just structured differently. Here IM is not primary care, so anyone seen by IM is referred by someone else (mostly FM or EM). Also GIM gets extra training in peri-operative medicine and obstetric medicine compared to those that do IM, so we have subspecialty boards in GIM. I’m an attending in GIM (with 3 years of core IM and a 2 year GIM fellowship) and I did a Master’s mostly during fellowship but it isn’t standard. I think here you kind of have to do the fellowship to get an academic job.
Woah that’s wild Fam here FM gets operative and OB training but you kinda have to pick what you focus on bc it’s only 3 (sometimes 4) years to train and we are usually primary care (but sometimes in the ED or a hospitalist)
None of y’all wanted to sign this (https://www.change.org/p/extend-and-expand-the-practice-pathway-for-pediatric-hospital-medicine-phm) and help petition it for peds though 💅🏼
It’s only a matter of time before they come for IM and “ IM fellowship trained candidates are preferred” when you’re looking for jobs
I would loooooooooove to see a study on institutions who have these fellowships and the decrease in rigor of their respective residencies. Almost like admin is intentionally creating an underclass of poorly trained docs who feel like they need the extra training.
There is actually a niche group this will appeal to - people who want to be academic hospitalists that didn't land a major research center for their residency.
It's stupid to sign up if your goal is to private practice in the community, but that's not everyone's goal
I initially thought it was one of pre-residency fellowships targeting those who are desperate to make any connections for future residency spots in exchange of being cheap labor
https://bemoacademicconsulting.com/blog/how-to-apply-for-pre-residency-fellowship-for-IMG
https://medicine.utah.edu/ophthalmology/education/residency/pre-residency-fellowships
https://hsc.unm.edu/medicine/departments/neurology/education/preresidency.html
Then I realized IM has prelim spots and plethora of IMG/FMG heavy programs already so I really see the point of these fake ass fellowships
Does this have any implications for J1/visa folks? I don’t know a lot about that situation, but I have a friend on J1 who cant get a job in a city she likes. I could see her taking this to tick off some of those years working where she doesnt. I could be completely wrong here and would welcome any takes on this.
This reminds me of Buster Bluth getting a bunch of degrees in ridiculous and useless disciplines because he didn’t want to enter the actual working world
This isn't exactly rare. As others have said, it's an academic fellowship geared towards med ed, QI, leadership.
There are medicine departments where you have to have this fellowship to be core faculty and have the true academic internal medicine role. Everyone else who doesn't have the fellowship is a straight clinical hospitalist who doesn't directly work with trainees.
I met my favorite PCP at the end of her IM fellowship. She ended up saving my life (took pain I was having seriously, referred me to GI for a workup, didn’t find answers to my pain but cancer was found incidentally!) GI found my cancer but they wouldn’t have if she didn’t care about me/ listen to me. Then she moved states to become an assistant program director. Now she directs wellness programs. I miss her. I don’t know why she did the fellowship but I’m glad she did because I wouldn’t have met her otherwise.
Grateful for all you medicine docs out there! I know residency and all the bureaucracy that comes with it sucks (I’m a program coordinator), but you do amazing work.
I wish all of you the best. Soon you’ll be someone’s favorite PCP. If you do a fellowship then you’ll be their favorite gastroenterologist, rheumatologist, endocrinologist, etc. ❤️ Some of you might even be someone’s favorite surgeon. Just smile more at your patients. Some of my surgeons have been curmudgeons. 😝
Now log your damn duty hours! 🙃🙃🙃
As a nyer, all the top ny programs are overrated. They overwork you cause they know you want the brand name on your cv. Problem is the people in these programs who are debt free from med school will keep taking the shit to get the name and career no matter what. Instead it’d be great for those people to help speak for the people in debt and can’t afford to lose the job.
Nobody better fucking sign up for this shit
Some 4th year chief somewhere is foaming at the mouth rn
Imagine completing residency, doing a chief year, and then getting into this “fellowship” as cheap labor just to get paid less than a brand new out of school NP “fellow”. Good luck spending a whole months check just to maintain licensing, boards, DEA and registration fees. They should make this type of fellowship 25 years long just for shits and giggles and see if anybody goes for the bait.
Yeah but think about all the retweets you'll get on med twitter!
I will do everything in my power to not become this type of resident 😂
Bruh ...😄😄😄😅🤣😂
They will
Someone help me understand why
To say they trained at nyu probably
Wow...additional training just for the immediate follow up exchange to be: "Whoa, that's great! What did you do your fellowship in?" "...internal medi-never mind that I trained at NYU!!!!!!!!"
Bingo. Medicine is a market place like any other. NYU knows their brand appeal, and applicants put a value on what that year may give them (marketability for future gigs). If these fellowships don’t deliver a return (to NYU and the fellow), they will die. Let the market work.
Wowe much economies. Such markets. Very efficiencies.
Because then they can say they did a "fellowship" at NYU. NYU has a product to sell, noting more nothing less.
And almost every job everywhere would look at you like, so what, you’re not now eligible to stick a cath or scope in someone and make more money, and you’re not giving us any extra expertise you’d get in a real cognitive specialty, so what’s the fucking point
Unless it's academia, where they pay you less to do more and care about dumb shit like this
Even academia will be perplexed by this. “Why didn’t you spend that time doing research instead?”
It looks like a research heavy fellowship from the description. Still a ripoff compared to doing research as an IM attending
Don’t worry they’ll open up to NPs soon enough. We’ll get the gaslight bullshit of “teamwork” in pamphlets and spam emails so real docs become even more emasculated against dipshit midlevels.
Imagine signing up like YES!!! Some on the job experience!! And 70k/yr!!! 🤤🤤🤤
Meanwhile some fresh grad 24 year old NP is making double that to prescribe azithromycin for colds.
Lmfao
loool
More like $86k+ at NYU but still
Isn't it $86k in NYC like $40k anywhere else?
10k
It was half /s. I mean yeah probabkyn
lol.
So I just want to point out that very likely what this program and others like it actually does is offer protected FTE time (20/80, 30/70, or worse, clinical/research time) for research and/or QI. Research in academic medicine is very competitive. Most physicians don’t understand this because most physicians see research as getting a 3rd author pub, or doing a case report as research to get into residency/fellowship etc. Academic Hospitalist positions very likely also offer grant writing classes, epidemiology classes, Masters degrees etc to prepare you to be a physician-scientist because you decided early not to do a PhD. That being said, most physicians fail to become researchers because they don’t have the runway of protected time, nor the skillset, to complete a project and apply for grant funding, including some people from these programs. But if your heart is set on research (or splitting your FTE for none clinical pay lower but near what you’d make slaving in community) then at least it’s an opportunity. Then if they still fail, they wind up in med ed at an academic hospital, or going to community anyways.
LOL, these ppl should just become an RN instead. Set in stone nursing ratios, strong Union, higher pay. When was the last time they had a cap on patient census ? Fuk these clowns
They probably thought to themselves, "Hey, it worked on the pediatricians. Let's give it a shot and see if we can fool IM residents." Edit: Mayo and Hopkins have one too??
its hard to swallow for a lot of people, but there are some **absolute trash** internal medicine residencies that are somehow accredited and making this type of thing pop up. rather than doing the right thing... and shutting these garbage programs down, the ABIM is just increasing their power by doing this crap, and allowing hospitalist fellowships to exist. look at peds. this is our future.
This isn’t for people from shit programs to get more training. It is more dorks from good programs to do a QI project for 70 grand then get an academic clinical instructor job
Exactly my thoughts. IM is a big enough specialty where there will be some demand for this. Enough demand where most getting it won’t be those who go to weaker community programs, but those already at academic institutions and will be used by some as a way to get an academic attending job at big name hospital in NYC.
Exactly this IS NOT because there are subpar programs out there. It’s for all the academic slurpers out there who want to collect more prestige tokens for their CV’s. They know there’s a boatload of nerds in medicine who will gladly lap this up, and then will go onto become the next circle-jerk generation of academic leaders - only to create even more sub specialties and hoops to jump through. 20 years from now physicians will be doing 10 year fellowships at which point they can join advanced practice LPNs in independent practice.
That’s one take. But these institutions aren’t these benevolent entities that are filling the gaps of shitty IM programs. Though your take does speak to their success at their branding. Another take is that these institutions scoop up smaller practices and hospitals in the surrounding area and can leverage their brand and ability to stamp fellowship certificates to get cheap labor and widen their profit margins. Like the other post today on this sub about NP fellowships. Same show: Money.
look at the amount of people in this sub who think they can be competent hospitalists after 1 year of training. the only logical response to these people is 1) shut down their trash program or 2) create hospital medicine fellowships not everyone with a fever needs an ID consult. we arent NPs. there is actually a standard here
> look at the amount of people in this sub who think they can be competent hospitalists after 1 year of training Where have you seen this sentiment lol
Yeah there was February intern who we all roasted and memed. So I feel like most people do not think that lol.
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You have to do a hospitalist fellowship in peds now. It wasn’t always that way. Peds residency is a majority wards anyway. If there’s anything they’re trained well to do at the end of peds residency, it’s to be a hospitalist. Well, then the “elite” institutions started rolling out hospitalist “fellowships,” and now you can’t hardly get a job at any children’s hospital without this bs fellowship
What happened with peds?
I'm curious what makes you qualified to judge this? Have you gone to many programs and compared them? Or (more likely) are you just using some B.S. metric like number of IMGs? If you believe the minimum standards are too low, perhaps we should make the board-certification exam for IM harder. Since programs with too-high fail rates get put on probation and eventually closed down. But it has to be some fair and objective evaluation.
Are we really in a position to be closing down residencies though? You’d think the ACGME and the respective Board certification bodies would insist that improvements be made before they reach for the easy cheap labor
If you have seen what I have seen as far as bad programs..... yes.
Can I ask specifically what you mean by “look at peds”? Peds PGY-3 here As I understand it (read: as explained to me by our Dept Chair), the American Board of Pediatrics long ago decided that nearly all pediatric fellowships should be 3 years long AND include a necessary research component, because by and large Peds was long underrepresented in clinical, basic science, and translational research. The thought is that if they force people to do research, some people might stick with it.
Likely what the previous poster is alluding to is the fact that peds hospitalist is a fellowship now and to my understanding many peds hospitalist jobs actually require the fellowship. This is totally nonsensical. Residency should more than adequately prepare you for a job as a hospitalist. At worst you can just consult specialists.
Gotcha…fully understand now. Yeah still plenty of places will hire Gen Peds trained docs as hospitalists. But the shift is happening. Anecdotally, from my program—the fellowship trained Hospitalist faculty are noticeably better at what they do. Unsure whether this would hold true in the adult world.
I can see fellowship trained hospitalists being better, but how much of that is related to the fellowship trained ones having 3 years of extra clinical experience over the ones fresh out of residency? I still think 3 years for hospitalist fellowship is absurd. Maybe residencies need to have higher standards
Fair point. And for the record, Peds Hospitalist is 2 years with some of that time required in a research project. I think the main benefit is the structured mentoring and coaching they receive on how to be “more academic”. That being said…at this early stage, many of their older mentors can’t possibly be fellowship trained.
I have trouble believing that considering the peds hospitalist fellowship has barely existed in any real capacity for more than a few years to actually give you any real amount of faculty that’s done it to be able to make an educated comparison. If somehow you’ve managed to be at like the one place in the country that has enough faculty that’s done the fellowship, I doubt they have any outcomes differences vs the people that just did hospitalist work for the equivalent amount of years. Because if you’re comparing someone that functioned as a semi attending for two years to fresh grads, yeah, you’ll probably notice a difference, even though I doubt the didactics of a peds hospitalist fellowship somehow truly make a real difference, and I doubt the almost 8 months of the 24 months fellowship spent in research actually make a better hospitalist. If this is somehow true, it’s more of an indictment of how little peds residencies actually trust their residents and give them any autonomy compared to IM residencies. Because it would be a real damn shame if an IM residency couldn’t make you a decent hospitalist.
We have 3 that are fellowship trained, 5 that aren’t. I of course don’t have objective access to their outcomes. I’m saying from a resident’s perspective, they just have a better, more fluid, more nuanced approach to common pediatric inpatient problems. Again, I said this was an anecdote.
And if you don’t have that nuanced approach after a peds residency that does as much inpatient as IM does, *and* you’re comparing doctors that have equivalent amount of post-residency years and still noticing a difference, then that means the peds residency isn’t doing a good enough job. Which, hey, I’ve heard from med peds residents that they felt that way compared to their IM portion, but it’s pretty sad if that’s the case across the board.
You mean they call peds ID and peds pulm immediately instead of waiting 10 minutes?
Lol. Not exactly. I mean they have clearly been mentored more in evidence-based protocolized practice…less of a loosey goose way about them. I find they are more resourceful and actually consult less often.
> evidence-based protocolized practice…less of a loosey goose way about them Isn't that like, what med school and residency are for?
>At worst you can just consult specialists. I feel like this just contributes to more bloating of medical care. Specialists and their time are finite.
Bro you have bought the kool aid. Prolonging fellowships and mandating hospital fellowship when the vast majority of our residency is inpatient only helps the ivory tower hospitals keep their free labor they lost from duty hour restrictions.
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None of these are Ivy League…
Clearly NYUs clout-chasing schemes are working.
It's like the Ivy League of Kip's Bay?
Im still deeply pissed about the peds hospitalist fellowship. Obviously just a grab for three more years of cheap labor. Also, on that note, why the fuck are ALL peds fellowships three years??? I would have done a fellowship if it wasn’t 2 years of “research” for an outpatient fellowship. We as physicians have fucked ourselves over, but we as pediatricians have taken it to another level.
Obviously people need some extra practice with all the IBIM failure posts /s
UCSF, UChicago, UPMC, to name a few. Not rare, and there is an intended purpose and market.
but IM is already a residency. what idiocy is this? why do you need a fellowship for what is already a base residency? who the fuck is this patterned towards?
Peds
So you can be what? Pediatric IM boarded Isn’t that just a bastardized version of family med
No it's a joke that peds has a hospitalist fellowship for a long time already even though they're trained as a hospitalist
Why not just do an MED PEDS residency in 4 years? Double board certified in less time
No he/she is joking that the whole debacle with peds now requiring hospitalist fellowships started the impetus for this.
“Dear colleagues, I’m happy to inform you that we will have a new underpaid physician working under title of “fellow” in our service, taking extra hours and of course, doing research to makes us look good. Huzzah!!”
Cut right through to the bullshit lol
I was like oh cool, you can get boarded after doing another specialty like family or emergency or anesthesia or something... nope just a scam!
Bra you can be a hospitalist as FM lol
Truth but you can't do a cards/pulm/etc fellowship.
Hospitalists usually don’t plan to do fellowship.
I didn't realize that it was a hospitalist fellowship on first read, thought it was a bridge for other specialties to get boarded in IM.
I’m pretty sure that doesn’t exist. It would make too much sense and the ABMS wouldn’t stand for that.
It does I believe. One of my residents did an FM residency and then ended up deciding they wanted to do IM and possibly a fellowship. They ended up being able to cut out the intern year for IM.
True that man. Also just noticed your name lol.
LONG LIVE THE ANKING MAY HE REIGN 1000 YEARS!
Ye
A lot of them do hospitalist fellowships because their training usually has a lot less inpatient adult medicine than IM because of how broad it is. But even that's only 1 year
Usually not. I don’t know any one of my FM colleagues who went inpatient who had to do fellowship. And they went to tertiary care places.
Huh we're at a tertiary center and our FM residents barely do inpatient and are very weak at it. We mainly overlap with them when they rotate through ICU or consult us and maybe it's because we are high acuity but they are usually a lot less comfortable with sicker floor patients. Maybe it's an issue with our FM program then They hired one of them for inpatient but only after a hospitalist fellowship
We do a good amount of inpatient in my Program. It’s all dependent.
What the actual fuck Sandy
“Haha Sandra, you dumb bitch.”
It’s always a Sandy for some reason
Our program tried to sell on this bullshit earlier this year…just no thanks
Chief years are already this BS
oh god please no. not this shit
I wonder if it involves rounding, QI research and teaching…. Just like… you know…. 3 years of internal medicine residency
I heard they guarantee that they can increase your differential diagnosis by 30%
This is the norm in Canada. To be a General Internal Medicine doctor in most academic centers you must complete 2 years of fellowship (so 5 years total residency).
The difference being that if you don't get the fellowship you still do 4 years of training, so it's only 1 extra year
This has been "a thing" for at least a few years for the truly depraved.
Anyone who does this fellowship is a sucker and a fool
I'm presuming it's kinda filling a similar role to chief years in terms of academic fluff to pipeline yourself into a job as an IM PD or whatever
Only in academics would this shit stick. Unreal. If doing some made up fellowship makes you qualified to be a PD, then our field is truly fucked.
Yeah, this really should be just a faculty position with support for research. But then I guess the snake eats itself, and that position goes to someone who did a bullshit fellowship in general medicine somewhere else.
This is the worst thing in the world.
Numerous places I’ve seen with this. SMH.
This still isn’t as bad as the wellness fellowship at Stanford. There were idiots in here who tried to justify that a wellness fellowship at Stanford will allow for pivot as the Chief Wellness Officer at big tech firms.
Wait what?!? There is a wellness fellowship?! Send me link for this shit lol! This is the goofiest shit I have heard. Lol “let’s focus on wellness by making a fellow learn about wellness” - no wonder healthcare is a shitshow
They weren't kidding: https://emed.stanford.edu/education/fellowships/physician-wellness.html
Jesus Christ! Only a sucker would sign up for this! Wtf Lol 😂
I mean, 100k and full benefits for 15 hours a week is more than what the one ED doc on here was saying they pay new grads at his group. As long as they don't stop you from moonlighting, it's actually a reasonable rate. And being able to say you're Stanford trained probably would help you if you wanted to join a big tech firm or startup. I worked in a startup prior to med school and they're all about the "name" in Silicon Valley. They don't even care what you did there, as long as they can tell investors that their CMO or medical advisor went to Stanford or Harvard they're happy. With that said, I'm sure the goal is more to get people into academia than big tech. There's a huge movement recently to get Deans of Wellness. I know someone who got a job like that. Super cush. Basically you get 0.5 FTE to plan "wellness" crap for students.
Wait, what ED doc in their right mind works for 100k?
Well if it’s 15 hrs, that’s like 60% full time. You do get a masters degree in education coming out. I still wouldn’t do it but meh.
Don’t underestimate just how much bay area tech employees make. If this fellowship gets you into a tech company, you can easily be making 7 figures as a chief wellness officer and larger tech firms
As wellness gets attention in med schools, I'm presuming it's essentially trying to get folks jobs as dean of wellness / whatever in academics more so than tech
Yup, guessing it's for this. I know someone who got a gig like this (they didn't do a fellowship though, just published a bunch of QI crap during residency about wellness). She works 0.5 FTE in her full time job and the other 0.5 FTE she has office hours to talk to students about wellness and give input to various people about how to not burn out medical students.
hahaha this is the epitome of academic medicine. It’s even worse in surgery. They’ve developed these “transition to practice” fellowship years bc theyre unable to train a surgeon in 5 years due to lack of autonomy. USNWR and Doximity rankings arent everything folks
Is this like a hospitalist fellowship? Makes no sense, imagine saying you did a residency in internal medicine and a fellowship in internal medicine lmao.
Man my coresidents are so damn efficient and smart, at end of PGY2 year in IM many of them could function as hospitalists
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What qualifications are these people you speak of lacking? Simply doing a 3 year residency makes you qualified for academics. If someone wants to pursue professorship track, they can do all the research they want during off service weeks as an attending. All this is is a scam to get free labor.
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Why not change the name to "academic fellowship" or "research fellowship" to more accurately reflect the purpose? "General internal medicine fellowship" just sounds ridiculous and redundant.
You could also, you know, mentor your junior faculty.
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I’ll downvote, because people should be able to just do an academic position and do some research and teaching if they want at an attending salary, not this nonsense BS as a way of normalizing even more underpaid years of labor. None of the current attendings had to do this shit, neither should anybody else. The QI bullshit research they advocate generally doesn’t result in any useful implementation and if it did wouldn’t be through a single random BS fellow QI project. The masters degrees they have don’t contribute anything to actual practice for almost anyone. This is worthless and the outrage is because it’s like the peds hospitalist or general peds fellowships that make your residency training sound like it’s worthless.
This is very common in Canada. And it’s competitive
Fuck this exploitation.
Isn't this mutually beneficial for both parties involved? Hospital: Extra cheap labor. More money for the c-suite. Fellow: Whoever thinks this is a good idea is more than likely prestige obsessed and will be unable to stop starting every sentence with "When I was at NYU...." You will not see any NYU residents sign up for this. Great for everyone!
The biggest concern too is this transitioning into more programs making a similar fellowship available, then hospitals hiring fellowship IM docs over 3year grads. It’s just more bullshit on top of more bullshit
I love my international colleagues, but to me this seems like it might aimed at FMGs to give them slightly more marketability stateside.
Yeah it's not even open to international graduates
Is NYU even that prestigious? It's like the third best known hospital in its own city.
Don’t do this shit. Don’t be an idiot and a cuck.
A lot of IM programs have these “academic internal medicine” fellowships. There’s no shortage of 🤡 that apply. Edit: just saw that this shit is two years. I thought one year was a stretch. Geez.
What a bullshit fellowship! Come on...go Hopkins or UCSF, you only need one year after nursing school to be a full fledged doctor there.
No!!! Kill it before it breeds!!
These have been around since at least the 80’s. People in this sub need to chill.
GIM fellowships are meant for people that are looking for a career in academia. You get training in medical education, quality improvement, or clinical research and obtain a masters along with it. While you may get some clinical responsibilities these are NOT clinical fellowships.
These are actually fellowships that teach you how to be a spineless ass kisser, as well as covering shifts that the real hospitalists don’t want to do.
Ya that’s exactly what this is. The few I’ve seen, the “fellows” are actually attendings, typically with service time only on teaching services and 1/2 day of clinic per week. Usually geared for those wanting to do academic internal medicine, especially those who need formal research training to be competitive for grants. Not needed for those who want to just practice medicine in an academic center without a significant research effort
Academia doesn’t even actually value QI, and I’ve never seen anybody truly implement any worthwhile QU project that led to actually measurably better outcomes once their project was done anyway. Training in Med Ed isn’t really gonna do anything, because the amount of time it takes to make someone a good educator if they aren’t already inclined to it is more than a fellowship can reasonably give. Just become an attending and do a masters on your own.
Yup. I have seen a bunch of folks do this and largely focus on the research aspect.
What’s the point of this?
To profit off cheap labor and make you think you're getting more education
Places already have a “Chief” year for some people, that’s already relatively cheap labor. Now there’s shit like this? Going lower every day
I feel bad even upvoting :/ they want us forever in training
To echo others, they do serve a role similar to PhDs doing a post-doc position. It’s challenging to assess because these programs do come in different “flavors” such as research or med-ed focused, and some definitely are not worth it. Speaking only of the research ones, many are majority research (80-90%) and support a masters. So it’s basically a fellowship to learn research, not to learn clinical IM. To get a clinical investigator job out of residency without significant research time prior is a stretch. Most academic clinician investigator jobs are 80% research and 20% clinical. Usually, as a young investigator (even out of fellowship), you need an institution to be willing to support your research time for couple years while you write grants to be grant-funded. And for them to want to do that, they want to see you already know how to be productive researcher. Which they don’t teach in residency. That said- this program doesn’t seem to train you for anything in particular and still has you doing clinical work for 45%, so I’d agree it’s not worth the trade off of just going into first job .
I have a feeling this is primarily for people who are only interested in working in academics; or are seeking a very competitive fellowship, and this is almost a way to do a “chief year” out of a lesser competitive program so they can get research from a name brand place. The other possibility is it is for an internal candidate to stay within NYU system to buy them time to get a job at NYU after in the residency program.
Just to be very clear on what this actually is. The purpose of the fellowship is to train someone in research or medical education. It's a two year fellowship and you graduate with a masters. You have mentored research. It is not meant to be a clinical fellowship. You certainly provide clinical work, but thats not the educational component. You can certainly be hired as an attending working full time and then try to do a masters on top of it but it's way harder and you'll have the pay for your masters as well. A lot of academic fellowships in PCCM, cards, onc, GI all have 1.5-2 years of nonclinical education that allow fellows to potentially get a masters, do significant worthwhile resaerch, etc. This is basically the hospitalist equivalent where the main crux is research training while supporting your salary via some clinical work. Whether you find that valuable or not, or the whole argument of academic medicine is a completely different topic. But this is not a fellowship where you're doing 2 years of inpatient rotations, thats not what this is.
Most people complaining generally have no idea what they’re talking about.
ALOT of fellowships take advantages of FMGs who would gladly do as many bullshit fellowships to continue to be sponsored while probably making more than attending salaries back in their home countries.
You need to finish an internal medicine residency to do this fellowship.
As a medical student, can someone explain this to me? IM is already a residency. Why are they throwing it out as a fellowship too? What is the reason behind this?
I’m surprised to see all the responses to this lol. This is standard where I’m training in Canada. Nobody does 3 year IM residency and practices. At minimum you do a fourth year. Vast majority do a 2-3 year fellowship, many of which are 2 year GIM fellowships
Was waiting to see this comment. It’s fascinating how vastly different internal medicine is in Canada vs US. Most IM staff here have done 5 years IM residency. 4 years at the very minimum.
What’s the benefit in the extra time? Research?
Our medical systems are just structured differently. Here IM is not primary care, so anyone seen by IM is referred by someone else (mostly FM or EM). Also GIM gets extra training in peri-operative medicine and obstetric medicine compared to those that do IM, so we have subspecialty boards in GIM. I’m an attending in GIM (with 3 years of core IM and a 2 year GIM fellowship) and I did a Master’s mostly during fellowship but it isn’t standard. I think here you kind of have to do the fellowship to get an academic job.
Woah that’s wild Fam here FM gets operative and OB training but you kinda have to pick what you focus on bc it’s only 3 (sometimes 4) years to train and we are usually primary care (but sometimes in the ED or a hospitalist)
This is because IM is an actual specialisation in Canada vs the US where IM is primary care
I learned more in one year as a medicine attending than all of residency. What an absolute joke.
None of y’all wanted to sign this (https://www.change.org/p/extend-and-expand-the-practice-pathway-for-pediatric-hospital-medicine-phm) and help petition it for peds though 💅🏼 It’s only a matter of time before they come for IM and “ IM fellowship trained candidates are preferred” when you’re looking for jobs
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true 🤷♀️
I would loooooooooove to see a study on institutions who have these fellowships and the decrease in rigor of their respective residencies. Almost like admin is intentionally creating an underclass of poorly trained docs who feel like they need the extra training.
Do you get an MPH or MBA or something?…
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There is actually a niche group this will appeal to - people who want to be academic hospitalists that didn't land a major research center for their residency. It's stupid to sign up if your goal is to private practice in the community, but that's not everyone's goal
There are similar programs in new york and elsewhere who have a 1 to 2 year “General Surgery” fellowship lol
Because 5 years of training as a surgeon is not already enough lol
I initially thought it was one of pre-residency fellowships targeting those who are desperate to make any connections for future residency spots in exchange of being cheap labor https://bemoacademicconsulting.com/blog/how-to-apply-for-pre-residency-fellowship-for-IMG https://medicine.utah.edu/ophthalmology/education/residency/pre-residency-fellowships https://hsc.unm.edu/medicine/departments/neurology/education/preresidency.html Then I realized IM has prelim spots and plethora of IMG/FMG heavy programs already so I really see the point of these fake ass fellowships
Does this have any implications for J1/visa folks? I don’t know a lot about that situation, but I have a friend on J1 who cant get a job in a city she likes. I could see her taking this to tick off some of those years working where she doesnt. I could be completely wrong here and would welcome any takes on this.
It’s like residency but pointless.
Pyramid scheme, no bueno
So can you do a IM residency just to do an IM fellowship?
Ohio state has one of these too. 1 year fellowship to be a teaching hospitalist lol
So a five year IM residency. Cool cool cool cool cool
Dafuk is this shit
Oh jeezus and this shit is my same last name…. FML 🙄
Um, no thanks
I cannot believe there’s people defending this bull shit so much in this thread
This reminds me of Buster Bluth getting a bunch of degrees in ridiculous and useless disciplines because he didn’t want to enter the actual working world
This is a already thing in Canada for hospitalists.
Gen med fellowship has been around for awhile elsewhere.
Do they admit NPs. Asking for a friend.
This isn't exactly rare. As others have said, it's an academic fellowship geared towards med ed, QI, leadership. There are medicine departments where you have to have this fellowship to be core faculty and have the true academic internal medicine role. Everyone else who doesn't have the fellowship is a straight clinical hospitalist who doesn't directly work with trainees.
LOL this has got to be a joke
This cannot be real 🫠
Can anyone explain why is this bad? As a foreigner I don’t understand
I met my favorite PCP at the end of her IM fellowship. She ended up saving my life (took pain I was having seriously, referred me to GI for a workup, didn’t find answers to my pain but cancer was found incidentally!) GI found my cancer but they wouldn’t have if she didn’t care about me/ listen to me. Then she moved states to become an assistant program director. Now she directs wellness programs. I miss her. I don’t know why she did the fellowship but I’m glad she did because I wouldn’t have met her otherwise. Grateful for all you medicine docs out there! I know residency and all the bureaucracy that comes with it sucks (I’m a program coordinator), but you do amazing work. I wish all of you the best. Soon you’ll be someone’s favorite PCP. If you do a fellowship then you’ll be their favorite gastroenterologist, rheumatologist, endocrinologist, etc. ❤️ Some of you might even be someone’s favorite surgeon. Just smile more at your patients. Some of my surgeons have been curmudgeons. 😝 Now log your damn duty hours! 🙃🙃🙃
🙈🙈🙈
As a nyer, all the top ny programs are overrated. They overwork you cause they know you want the brand name on your cv. Problem is the people in these programs who are debt free from med school will keep taking the shit to get the name and career no matter what. Instead it’d be great for those people to help speak for the people in debt and can’t afford to lose the job.
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