Myth busters: Dispelling 4 common misconceptions about fellowship

If you've come this far in your medical training, you're likely aware of the ways in which fellowship might serve you. Fellowship paves a direct path to become a specialist and will likely boost your odds in the job market. It's a badge of honor, increasing your credibility among patients and bringing respect from your peers and medical institutions.

According to medical experts, these are some of the most common myths and misconceptions about fellowship—along with some information and perspective that may help you separate fact from fiction.

Myth #1: Fellowship guarantees a higher salary

Maybe you decided to do a fellowship because you thought it would earn you the big bucks right away.

But this often isn’t the case, as you may already be finding out. 

In fact, in the short term, you'll likely be earning considerably less than you would as a physician.

"It takes years to realize your earning potential," wrote Brandon Murphy for the AMA.^[] "As a physician, you will not maximize your earnings until the completion of your graduate medical education."

According to an article published on the job site Indeed.com^[], the average 1st year resident physician makes about $60,000. "While fellows still do not earn the same salary as physicians in their specialty, they often make more than they did during their residencies,” the authors wrote, noting that fellows are typically fully licensed and have more experience than residents.

The bottom line is that lucrative specialties require more training and education.

“Extra training takes more time and, unfortunately, means less money right away,” wrote the authors of an article from Inspira Advantage.^[] "Depending on the program, fellows can expect to earn between $60,000 to $70,000 a year. Some fellows have reported a 20% increase in their salary post-residency," they wrote.

Salary structures can also vary depending on factors such as location, institution, and demand for the subspecialty.

So while you may not get rich during fellowship, you will have gained a wealth of knowledge, research experience, and clinical skills. In the meantime, the best thing you can do is learn to manage your finances while you are still in training.  

Myth #2: Life will be easier when fellowship ends

Brent Lacey, MD, founder of The Scope of Practice, goes on to describe what he calls the “medical training myth.”

This is the belief that a doctor’s life gets easier once they complete training. Writing for KevinMD.com, Dr. Lacey explains that there’s much that goes on in clinical practice that residents and fellows might not be aware of beforehand.^[]

“As an attending physician now, I can tell you I definitely keep longer hours than I did as a resident or fellow, and most of my colleagues do the same,” Dr. Lacey wrote.

This is why Dr. Lacey wants to dispel the notion that attending physicians somehow have it easier than trainees.

“Your life is hard, and it’s going to get harder. You’ll be busier and have tougher jobs at each stage of your career,” Dr. Lacey wrote.

Although this may be a hard pill to swallow, Dr. Lacey believes in the benefits of continued training.

“Once you come out of training,” he wrote, “you’ll be battle-tested and ready to tackle the challenges of clinical practice.”

Myth #3: I can’t change my specialty during fellowship

You’re in the middle of fellowship when it hits you: You’re unhappy in your subspecialty. This may frighten you—especially considering the amount of time, energy, and money you’ve spent to get here.

According to a recent poll published by Doximity, 20% of nearly 4,200 physicians reportedly changed their specialty at least once over the course of their careers.^[] An additional 6% reported they had considered the idea.

Doctors may want to switch to a different specialty for any number of reasons. Increased pay, better quality of life, and moderate training periods are just a few factors that influence some physicians to make the jump, according to the authors of the Doximity article.

For doctors with more established careers, however, switching to a new specialty may “require a degree of sacrifice,” as noted by the authors of a BoardVitals blog post^[]

That sacrifice may mean repeating residency and taking a pay cut. “However, if you are willing to plan for those extenuating circumstances, you can change specialties to pursue a more satisfying career,” the authors wrote.

One physician who followed this path, Dr. Karen Tran-Harding, switched from OB/GYN to radiology. Because of her former experience, Dr. Tran-Harding was able to provide unique care to a pregnant patient who was undergoing tests to determine if she had breast cancer.

“When I went to tell [the patient] the biopsies showed the lymph nodes were cancer free, she burst into tears because she had lots of questions—not questions about her cancer, but questions about her pregnancy,” Dr. Tran-Harding said in the blog post. “Thanks to my background, I was able to answer each of her questions. That gave me another reason to be eternally grateful to the practice of OB/GYN.”

And, in the words of Dr. Tran-Harding, “It truly never is too late to try something different because time and experience is never really wasted.”

Myth #4: Burnout is inevitable

Physicians in fellowship have a lot on their plates, to say the least.

The responsibilities and pressures of being a doctor-in-training give you all the more reason to be mindful of your health, and take action to prevent burnout before it begins.

According to an article published by the AMA,^[] fellows can maintain their well-being by committing to:

• Nutrition and fitness: Physicians in training have notoriously busy schedules, but that shouldn't keep you from carving out time to refuel. Be sure to schedule your meal times in advance.

On top of that, keep your body moving! Your physical health is a top priority. If you have access to your medical center’s gym, take advantage of it.

• Emotional health: Take responsibility for your mental and emotional well-being by seeking help as needed.

With guidance, you may learn to identify and navigate both personal and professional conflicts, as well as how to nurture your relationships. You may also learn to implement mindfulness strategies to help reduce stress.

• Preventive care: Just because you’re a doctor doesn’t mean you should stop seeing yours!

According to the authors of the AMA article, physicians in training can prevent burnout by staying on top of preventive care practices.

“As a medical professional, you know the importance of preventive care for keeping patients healthy,” they wrote.

Some fellowship programs may allow you to take an occasional weekday afternoon off for these purposes. Check to see if yours is one of them.

There are additional strategies you can employ to prevent burnout, such as taking care of your financial health and practicing behavioral adaptability.

All in all, fellowship does not have to wreak havoc on your well-being. 

As long as you remain an active participant in your own health, fellowship can be a chapter of your training that you find stimulating, challenging, and rewarding.