u/Coronxtra

Hospitalist here. Had a patient with suspected overdose/serotonin syndrome while in er. Apparently in our state/hospital these cases trigger an admin review/root cause analysis.

Issue is: patient later wanted her phone, which was inside her belongings bag, so I handed her the bag as she asked for it. It qas just next to her.

The bag was not sealed.

She took meds again while still in ER and overdosed.

I contacted posion control and evaluated her again as nursr informed shr is drowsy etc. And treated her for same.

At that point I was not thinking of it as sealed medication evidence/chain-of-custody because initially I did not know this would become an overdose-related investigation.

Now I have a meeting next week regarding the handling of the belongings bag. Leadership says it is non-punitive and more of a systems/process review, but obviously I’m anxious.

For people who’ve gone through similar RCA/admin meetings:

- How would you answer this professionally?

- How much detail is too much?

- I dont get it how am i wrong in handing a bag to a pt.

Would appreciate advice from other hospitalists/ED people/risk management folks.

I’m currently working as a nocturnist/hospitalist on a J1 waiver in a non-academic setting, with my waiver ending in 2027. Life has honestly been very difficult personally and professionally over the past few years, and I initially took this job mainly for stability and visa reasons. Over time, though, I’ve started feeling very stuck and worried that I’m limiting my future.

Interestingly, during the past several months, I’ve developed a real interest in rheumatology after taking care of patients here. I genuinely enjoy the complexity and diagnostic side of the field, and for the first time in a while, I feel motivated toward something academically again.

The difficult part is that I’m in a non-academic environment, so I don’t have much mentorship or guidance around me. I’ve recently started reaching out to professors and programs at other universities and have gotten a few responses and possible starting points, which gave me some hope.

I’m now trying to figure out the best path forward. I’m considering applying this cycle just to see where I stand, although I still need to take/pass ABIM boards. During residency and noctunist work (very heavy 12 hour eith xc snd 10 pts daily) went through a lot personally and honestly could not prepare properly for boards, but I do think it’s very doable now if I structure my time well over the next year.

Part of me wonders if it would be smarter to focus on boards first and apply in 2027 instead, but regardless, I want to start building my profile now so that by next year I’ve actually accomplished meaningful things.

I would really appreciate advice from anyone who transitioned from a non-academic hospitalist position into rheumatology fellowship.

Specifically:

How do I realistically strengthen my application from a non-academic setting?

Are there research groups, societies, foundations, virtual collaborations, etc. that are helpful to join?

What kinds of projects are realistic to start with (case reports, reviews, retrospective studies)?

How important are connections/networking versus publications?

Is it still realistically possible to match coming from my situation?

Edit.

Please don’t comment telling me to only focus on boards first and think about rheumatology later — because with a fixed J1 waiver timeline, I realistically have to prepare for boards while also planning my future and building toward what I want to do next, since I cannot stay indefinitely in my current job.

Can pay

Stay in worman mills area.

Havent used for 2 yrs. I tried to inflate tires in my own..couldnt do it.

I’m currently working as a nocturnist on a J-1 waiver position that will finish in 2027, and I’m interested in applying for Rheumatology fellowship. However, I currently have very limited rheumatology-related experience, research, or CV-building activities.

I’m trying to decide whether it’s realistic to strengthen my CV enough within the next 2–3 months to apply in the upcoming cycle, or whether it would be wiser to wait and apply next year with a stronger application.

Given my limited time outside of a busy hospitalist/night-shift schedule, where would you recommend I start? Are there specific research opportunities, case reports, conferences, mentorship pathways, or networking strategies that would give the highest yield in a short period of time?

I would really appreciate guidance from anyone who transitioned into Rheumatology later or applied while working full-time as a hospitalist.

Also At the same time, I had previously applied to Sleep Medicine in 2024 and received 23 interviews, but I ultimately decided to complete my J-1 waiver first instead of pursuing fellowship at that time. Because of that, I’m also considering Sleep Medicine seriously, especially since it seems to offer a lighter and more sustainable lifestyle long-term.

So what would be the best thing to do so far.

Im sure i do not want to continue being a hospitalist after ny waiver end. I can however 1 year additonal to make ny cv if i reaaaly have to.