Leave fellowship?
Hey everyone,
I am a surgical fellow in a combination subspecialty fellowship. It is akin to a combination ENT/Plastics fellowship in microsurgery/aesthetics so I’ll just use that as the example for my issue. The goal of the fellowship is to spend some time with my home field (plastics) and some time with attendings from another field in which I did not train (ENT). My training was very aesthteics heavy, and very independent, and my program is a leader in aesthetics. So I feel fairly comfortable doing it, in practice, without needing to pursue fellowship. But my micro training was spotty, so while i can get through those cases, there is a lot of fundamentals that i am missing that i want to learn formally from senior faculty. The reason for doing this specific fellowship was to gain this perspective from another specialty, as well as see an active dual-practice from someone in my field. I was told that my fellowship would be 50% time spent with each service. 6 total months with each service. The fellowship director is known well for his practice mix of both specialties, and there was no reason to suspect that this would have changed since i was accepted.
Fast forward to moving to this city, leaving my wife at home (putting kids on hold for now), and fellowship. I come to find out that my director does not actually do much if any microsurgery, and only does aesthetics. His reasoning is that microsurgery doesnt pay the bills, and thus it is now a small part of his practice. He has been squeezed by his department (it seems) and the "realities of life" have pushed him this way. Additionally, my block time in microsurgery (with ENT) has been severely reduced in favor of me covering more aesthetics cases. So now ive gone from 6 months total to about 1 month of micro in total over the year. I am very very pissed, as i was already on the fence about doing fellowship to begin with. Additionally, the micro surgeons were not even aware that i was coming. They have taken me under their wings, and are incredible teachers, and mentors already in the few days i get to spend with them. But it is clear that what was sold was not something that had formally been set up on their end, and they arent aware of the arrangement. My reasoning was ultimately it was worth it to be able to practice standard of care and safe up to date care. I have a job lined up already at my home institution. The caveat is that the few days i have been able to spend with the micro team, have been incredible and i have gotten to do a lot of learning. Unfortunately, in a few months time that will be reduced to almost nothing, maybe 1 day a week in favor of aesthetics, for the rest of the year.
My question to everyone here is, do i quit this fellowship? I hestitate to press the nuclear button but i am frustrated. How do i even have this conversation with my director? I have a very good report with the micro team, and i wouldnt need to worry about future connections/reputation with them. But the aesthetics team may try to burn me in the future, and im worried about burning the bridge by leaving. Theres a universe where i just leave the fellowship and switch over to the micro fellowship entirely but i would be leaving my home specialty department, in favor of a specialty i am not a part of. I'd like to think that i am a reasonable person, but this has really deeply pissed me off in a way that I did not expect. I admit that my ability to think reasonably about being forced to do something that I am not interested in is severely impaired. Any thoughts would be helpful here. Thanks so much.