Let me clear up the facts for all the radiology residents that are thinking about fellowships in this market: Just like any other job market, the number of radiology attending positions available is subject to market forces. Moreover, this prolific job market will not last forever. To support these claims, in my medical career, I have seen two job cycles, trough to peak. And we are sure to see others. It’s just a matter of time.
So, how does the changing job market impact the topic for today’s blog, the necessity of fellowships? Well, I have a bit of explaining to do.
Back in the early 2000s, when I completed my residency at the last market peak, great jobs were everywhere. California, New York, and Florida were no exceptions. The theme of the job market was: “Name your price!” And, I can distinctly remember the heated discussions in the reading room about whether fellowships are necessary.
Well, it’s happening again. All you need to do, go to the recent forums on Aunt Minnie on the topic. Or, you can stop by my residency program. You will hear a few passionate debates on the matter. (We had this discussion during noon conference a week or two ago!) Regardless, I think this is a prescient indicator of a market peak. Not that it means we will experience a sudden downturn. But, we are riding somewhere along the top of the curve.
So, what happened the last time around the market went from peak to trough? Well, if you took a poll of radiologists without a fellowship, I believe a higher percentage of these folks would have had more issues with their career than those with one. Therefore, I am going to throw a bit of proverbial cold water on those of you who are thinking about going down this non-fellowship path by telling you why.
More Likely To Have Work You Don’t Like
For better or for worse, those radiologists without a specialty tend to have less control over their domain of practice. Don’t like mammo and plain films? Well, you can’t say you are an expert in another area that you enjoy more when you are starting your career. So, guess where the practice will want to place you!
Severely Limited Job Market On The Coasts
If you want to have a better chance of securing a job in the more populated portions of the country, you will have a much better shot if you have a fellowship. I can certainly speak for my part of the country, New Jersey. It’s possible, but good luck finding a quality position without one!
Not Considered An Expert In Any Area
Now, this may or may not bother you. But, many radiologists like their colleagues and referrers to perceive them as experts in a particular area. Clinicians know individual radiologists and ask for them by name because of their fellowships. That will be less likely to be you!
Much Harder To Start A New Fellowship Once Established
Once you have already been working as a full-fledged radiologist for a while, it becomes much more traumatic to start anew as a fellow. You may have a family. Or, perhaps you have become accustomed to the lifestyle of a radiologist. It’s hard to go back and do a fellowship once you’ve started your career!
Yes, You Will Have Increased Chance Of Losing Your Job
And finally, you may not want to hear this, but as an employee of a practice, when the reimbursements turn down and the market becomes sour, who is the first to go? Well, it’s not likely to be that expert in neuroradiology who the neurosurgeons love. And, it’s not going to be the nuclear radiologist who performs complicated radiopharmaceutical treatments on the referring physician’s patients that the practice cannot replace so easily. Hmmm. Who can be ousted the most quickly without a significant impact on the business? That person is much more likely to be you!
Booming Job Market: Still Need Fellowships!
I get it. You’ve been out working for so many years. And, you’ve become impatient. Maybe, you have a family and want to earn a real living. But, in the long run, it’s not worth the additional risks that you will take by not completing the additional training. So, think again before you choose to enter the job market without a fellowship now. You may regret your big decision later in life!