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Transitioning into a Speciality


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I've been in hospitalist medicine for a little over 2 years now and feel like I've finally hit that critical threshhold where I feel like I know what I'm doing (for the most part at least). With the new ACGME regulations, we're being crushed with more and sicker patients. Because of all this, I'm working even harder without that rapid gain in knowledge ie. giving so much to the job and getting little in return.

 

I feel ready for a change... have been interested in nephrology since PA school but wanted broad medicine exposure first. It would be focused care on HD and pre-HD patients with 2ish month of inpatient nephrology per year with the rest of the time spent in inpatient/outpatient HD and interventional radiology if I wanted. The job sounds amazing as far as regular hours, interaction with the supervising physician, and room for professional growth.

 

I've been completely excited without second-guessing until today when I was managing a peri-septic patient with no clear source, developed RVR with rates to 160s, and flash pulmonary edema several hours later. Though it was stressful, it felt amazing to know and see that I could handle it. I worry that I'm going to miss general medicine.

 

Does anyone have any thoughts/experience with transitioning to a specialty after doing medicine? Anyone with nephrology experience and job satisfaction?

I've been in hospitalist medicine for a little over 2 years now and feel like I've finally hit that critical threshhold where I feel like I know what I'm doing (for the most part at least). With the new ACGME regulations, we're being crushed with more and sicker patients. Because of all this, I'm working even harder without that rapid gain in knowledge ie. giving so much to the job and getting little in return.

 

I feel ready for a change... have been interested in nephrology since PA school but wanted broad medicine exposure first. It would be focused care on HD and pre-HD patients with 2ish month of inpatient nephrology per year with the rest of the time spent in inpatient/outpatient HD and interventional radiology if I wanted. The job sounds amazing as far as regular hours, interaction with the supervising physician, and room for professional growth.

 

I've been completely excited without second-guessing until today when I was managing a peri-septic patient with no clear source, developed RVR with rates to 160s, and flash pulmonary edema several hours later. Though it was stressful, it felt amazing to know and see that I could handle it. I worry that I'm going to miss general medicine.

 

Does anyone have any thoughts/experience with transitioning to a specialty after doing medicine? Anyone with nephrology experience and job satisfaction?

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