From Residency to Practice: Getting Started Without a Fellowship With the practice of neurology becoming more complex by the minute, there’s a lot of pressure on physicians to follow up their neurology residency with even more specialized instruction in the form of a fellowship. Reasons to advance to this next level of training range from the desire (or need) to become an expert in a specified area of practice, to the fear of not being hired for key positions without one. But not everyone follows the same path, and not every good job requires candidates to have fellowship training. Heather Schweizer, DO, is an example of a successful neurologist whose formal education did not include a fellowship. That’s partly by design—she did review the option but decided against it—but also by lack of design. That is, unlike some of her colleagues and friends who entered medical school with a plan for each stage of their career, Schweizer took a more laconic approach. “I’m not really ‘Type A,’” she said, “So I’m okay with plans changing and trying things out.” That’s a life approach Schweizer applied to her training path as well. Although she is happily positioned now as the stroke medical director for The Villages Regional Hospital in Florida, she wasn’t even aware of neurology as an area of practice when she first entered her residency at Larkin Community Hospital in Miami. Despite having enjoyed the subject during medical school, neurology as a professional track wasn’t on her radar. “I thought I
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was going to do family medicine when I went to Larkin,” she said. “I didn’t even know they had neurology in my residency program, and then a spot opened up in my second year, so I decided to apply.” As luck would have it, Schweizer was entering a newly-evolving program at Larkin, getting in on the ground floor as the hospital was developing its neurology rotations. This gave her and fellow residents the opportunity to provide feedback and help shape the program as rotations were added. Even so, she still didn’t have specific plans for the direction her career would take—she just wanted to continue learning about the subject that had held her attention so well during medical school. Nevertheless, Schweizer began to explore the question of fellowships. Over the next couple of years, she inquired with different attending physicians about the fellowships they’d taken and how they thought their careers had benefited. The answers were mixed, which was enough to give her pause. Some of the attendings told her they don’t use their fellowship training in their work—an answer she found most frequently among the outpatient and general neurohospitalists. The prospect of having a fellowship “not pay off” was especially daunting to Schweizer. “It was a difficult decision financially because I don’t come from a lot of money,” she said. “I had $400,000 in loans, so to take another year digging into that hole, it had to be worth it for me. But the other problem was that I didn’t
