Choosing a Post-Fellowship Path

While the gastroenterology career path is by no means short, for many of us it was relatively straightforward. If, like me, you knew you wanted to pursue gastroenterology, you moved from medical school to residency to fellowship relatively seamlessly, without need for significant pause or reflection. Yet during fellowship, there is a looming fork in the road. Mentors ask about your career goals. Family and friends probe to see if you'll be moving to a job near them. Emails arrive from recruiters around the country. The good news is that there are options. The challenge is sorting through them to find a job that fits your needs, both personally and professionally. Key considerations for both academic and private careers include career goals, financial planning, expectations for work-life balance, family needs, and more. How you weigh these considerations will depend on your personal priorities and preferences. Career Goals and Passions Career ambitions typically fall into two categories—academic and private. The question of which to choose surfaces almost immediately during fellowship. If, after years of training in the academic setting, you envision a career that involves conducting clinical research, performing procedures not typically done in the community setting, or teaching future generations of gastroenterologists, then a faculty position at an academic institution may be a great fit for you. You're already well-poised to understand the role—most fellowships provide consistent opportunities for fellows to hone their academic credentials and conduct research. By contrast, if you know that you want to spend a sizable majority of your time providing hands-on patient care, you may consider private practice. And there's certainly no shortage of private options—these jobs make up the bulk of recruiting mail that floods our inboxes during fellowship. But the functions of academic and private jobs aren't always so neatly divided. Many academic positions offer the opportunity to work primarily as a clinician–educator. Similarly, research and teaching opportunities are available at some practices and healthcare organizations associated with academic centers. Financial Considerations Let's face it, for the vast majority of us, financial considerations will play a role in our decision. The burden of educational debt and corresponding lack of savings is a concern for many. On the whole, gastroenterologists have a strong return on investment and are well-positioned to tackle debt, regardless of whether they choose academic or private medicine. According to the 2015 Medscape Gastroenterologist Compensation Report, gastroenterologists are among the most …