Split between Body vs. Mammography fellowship

[PlasmodiumVivax]

Hey everyone,


I am a current 2nd year DR resident and split between abdominal imaging vs. mammography fellowships. I really like both but there are some things that I can't shake off. I enjoyed the patient-care side of Mammography I had some bad experiences in my 2nd year rotation that made me rethink my choice. My residency program is amazing with great attendings that let us get involved with almost all mammo procedures, but the second rotation I had unusual experiences with tech passive aggressive situations and I personally don't know if I can handle that all day.

On the other hand, body/abdominal imaging I've always been interested in, I enjoy getting good at a diversity of modalities and the attendings here I believe are the most laid-back or similar to my personality so I get along with everyone great. I enjoy CT-guided procedures and can see myself doing a mix between procedures and reads. I also really like that body fellowships are outside of the match, as I want to go somewhere that is region specific and my residency is not close. Our mammo attendings have great connections but not so much in the places I had in mind.

Every time I think about body fellowships I worry that I will lose my mammo interest and get concerned that I am going into the field for the wrong reasons. If I choose mammography then I get worried about where I match and my future career goals. In an ideal world, I would be doing a mix between body/mammo where I can read screeners + body CT/MRs. I heard of body/mammo combined fellowships but the general consensus is to stay away as you're not a true specialist in either field. If there's anyone who has personal insight or went through similar feelings, what did you end up deciding on or what would you recommend?

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[clutch21]

Body fellowship with a decent amount of elective time to use on breast.

 

[vm26]

Hey everyone,


I am a current 2nd year DR resident and split between abdominal imaging vs. mammography fellowships. I really like both but there are some things that I can't shake off. I enjoyed the patient-care side of Mammography I had some bad experiences in my 2nd year rotation that made me rethink my choice. My residency program is amazing with great attendings that let us get involved with almost all mammo procedures, but the second rotation I had unusual experiences with tech passive aggressive situations and I personally don't know if I can handle that all day.

On the other hand, body/abdominal imaging I've always been interested in, I enjoy getting good at a diversity of modalities and the attendings here I believe are the most laid-back or similar to my personality so I get along with everyone great. I enjoy CT-guided procedures and can see myself doing a mix between procedures and reads. I also really like that body fellowships are outside of the match, as I want to go somewhere that is region specific and my residency is not close. Our mammo attendings have great connections but not so much in the places I had in mind.

Every time I think about body fellowships I worry that I will lose my mammo interest and get concerned that I am going into the field for the wrong reasons. If I choose mammography then I get worried about where I match and my future career goals. In an ideal world, I would be doing a mix between body/mammo where I can read screeners + body CT/MRs. I heard of body/mammo combined fellowships but the general consensus is to stay away as you're not a true specialist in either field. If there's anyone who has personal insight or went through similar feelings, what did you end up deciding on or what would you recommend?

Bad experiences during your 2nd year rotation is like me saying I should never have tried sprinting since I fell so many times as a toddler.

Also where do you see yourself practicing as an attending? Academics vs private practice, Large metro versus rural etc..

If you are thinking private practice, my recommendation would be a hybrid fellowship (body/body MR ideally with light IR) with a few months of breast fellowship. Unless you want to do academic breast imaging, I personally think a year long fellowship is overkill. I idid a hybrid fellowship with 2 months of breast imaging which was sufficient for private practice. If you just want to read screeners you probably don't need fellowship training in breast.

 

[guytakingboards]

Every time I think about body fellowships I worry that I will lose my mammo interest and get concerned that I am going into the field for the wrong reasons. If I choose mammography then I get worried about where I match and my future career goals. In an ideal world, I would be doing a mix between body/mammo where I can read screeners + body CT/MRs. I heard of body/mammo combined fellowships but the general consensus is to stay away as you're not a true specialist in either field. If there's anyone who has personal insight or went through similar feelings, what did you end up deciding on or what would you recommend?

I don't have personal experience with your particular scenario but just have a few points of consideration.

Doing a fellowship makes you a specialist. In groups of a certain size it might make you *the* specialist. That person is the one everyone else goes to for specialty specific questions. The person everyone else expects to take the tough case, manage the protocols, cover the specialty tumor boards and/or run the mammo clinic. Do you want to be "the body person" or "the mammo person"?

Side point for mammo: a lot of groups are short mammo coverage and you may end up doing 80+% mammo with only token general call. Do you see yourself doing full mammo all day every day? Doing MR-biopsies and reading breast MRI on top of screeners/diags/regular stereo and US biopsies?

Based on your description, it sounds like you want to do a body fellowship with R4/ fellowship year electives in mammo. It sounds like you want to be a hospital person who dabbles in screeners, not the mammo person who occasionally covers the hospital.

 

[PlasmodiumVivax]

Bad experiences during your 2nd year rotation is like me saying I should never have tried sprinting since I fell so many times as a toddler.

Also where do you see yourself practicing as an attending? Academics vs private practice, Large metro versus rural etc..

If you are thinking private practice, my recommendation would be a hybrid fellowship (body/body MR ideally with light IR) with a few months of breast fellowship. Unless you want to do academic breast imaging, I personally think a year long fellowship is overkill. I idid a hybrid fellowship with 2 months of breast imaging which was sufficient for private practice. If you just want to read screeners you probably don't need fellowship training in breast.

Thank you very much for the responses everyone they were very helpful, I apologize as I just got back home from a trip! I think my first year rotation was making me lean 80% mammo but the 2nd one was so awful that it really ruined the experience. I felt like I was 'good' in mammo, like it was something Im naturally feeling like I got it.

If I could do a fellowship like that, that would be perfect. I enjoy body MR + mammo screeners/diags. I don't really care for academics but I dont like to lose opportunities. Ideally see myself in a certain competitive region (thinking Northeast vs. Socal) and I don't want to box myself out. If I could even do a couple of months after body fellowship in more mammo work I'd be perfect for that but I know that would be non-feasible.

I don't have personal experience with your particular scenario but just have a few points of consideration.

Doing a fellowship makes you a specialist. In groups of a certain size it might make you *the* specialist. That person is the one everyone else goes to for specialty specific questions. The person everyone else expects to take the tough case, manage the protocols, cover the specialty tumor boards and/or run the mammo clinic. Do you want to be "the body person" or "the mammo person"?

Side point for mammo: a lot of groups are short mammo coverage and you may end up doing 80+% mammo with only token general call. Do you see yourself doing full mammo all day every day? Doing MR-biopsies and reading breast MRI on top of screeners/diags/regular stereo and US biopsies?

Based on your description, it sounds like you want to do a body fellowship with R4/ fellowship year electives in mammo. It sounds like you want to be a hospital person who dabbles in screeners, not the mammo person who occasionally covers the hospital.

I go back and forth on this, and honestly this is an excellent question that really made me think on what I wanted to be. I honestly go back and forth, I personally have an interest in oncology work and I think thats why mammo really satisfies that area of interest, but I don't want to solely do diag's and screeners all day. Procedure time is nice but I can see myself doing CT-guided light IR procedures or US para's as well, pretty impartial. I get dissuaded from full body fellowships as I hear the notion "if you like mammo just do mammo" so often as job market and lifestyle is great, but I don't want to end up somewhere where I don't want to live in fulltime. Thank you again for all of the advice I know I have a lot of soul-searching to do.

 

[Lifeman]

There are a couple of body+breast 1 year fellowships.