Help finding a hidden gem specialty

[FormerNFLQB]

You would have to make ~600k/yr to have a take home of 350-400k.

Yea. Unrealistic and I’m okay with making less than that.

---

Members don't see this ad.

 

[FormerNFLQB]

This is true. If you have a fail you’re dead in the water to any competitive specialty. As advised earlier your best chance to would be to apply to formed DO programs with only a comlex. You’re at a big disadvantage but retaking step won’t significantly help you. Programs that use step will to still screen you out with a prior fail.

Yea and that’s the plan as of now. I am just worried that doing a COMLEX only will cause me to not be able to attain any specialty after IM? So that’s really the question now would be how many fellowships will screen me for not having the step series

 

[Ho0v-man]

Without a Step there are only a handful of former AOA programs that are available. GS is notoriously unfriendly to COMLEX only applicants, 98% of programs filter for Step scores. Even most of the former AOA programs will expect a Step score

Ah. Didn’t realize it was that quite that bad.

 

[Drrrrrr. Celty]

Without a Step there are only a handful of former AOA programs that are available. GS is notoriously unfriendly to COMLEX only applicants, 98% of programs filter for Step scores. Even most of the former AOA programs will expect a Step score

IM is a lot more friendly to COMLEX ONLY applicants. You're going to struggle to get University programs. East and West coast university is basically no.
But you can get a solid 800 bed community hospital or communiversity program. Which is brand name enough.

 

[FormerNFLQB]

IM is a lot more friendly to COMLEX ONLY applicants. You're going to struggle to get University programs. East and West coast university is basically no.
But you can get a solid 800 bed community hospital or communiversity program. Which is brand name enough.

Enough for being able to match a fellowship if I bust my ass and publish etc?

 

[Drrrrrr. Celty]

Enough for being able to match a fellowship if I bust my ass and publish etc?

Sure. Why not.

Here's the problem with what you're heading into.

1) You're going into Internal Medicine aiming for competitive specialty medicine. What happens if you don't get it? Are you going to be miserable doing hospital work - i.e spending a lot of your time consulting others, pain management, electrolyte replacement, managing run of the middle AKI, CHF, COPD AE, A Fib w/RvR? Will you be happy if all ends badly potentially switching gears into a different fellowship?

Like critical care you probably can match. You just might have to do Nephro or ID first as a lot of programs borderline advertise themselves as combined programs for those willing.

But what if you decide by your 3rd year you're too tired for more training?

2) You're switching from Cut Cut Chop Chop Land to Medicine. You're going to spend 2 hours a day literally rounding and trying to elaborate on the intricacy of hyponatremia, volume status, and fluid rates to run to prevent overcorrection. You're going to be on the ground to manage blood sugars for surgery after they're done doing the "important" part. And now just want you to get their patient medically optimized to go to SNF/SAR for recovery.
And honestly, it's not for a lot of people. I will actually say that I enjoy hyponatremia management. But I also enjoy physiology and manipulating bodily chemistry. Will you get extremely exhausted doing this?

Fundamentally this a 3 year residency. It is not a bridge to fellowship. It's a bridge towards being a generalist. You're expected to be good at it. Not good at your one thing you like and screw all the rest.

I'm not doubtful you can pull it off. I just want you to be realistic about what you're going into and not look at this as some sort of COMLEX 3.5 or 4 hoop.

 

[FormerNFLQB]

Sure. Why not.

Here's the problem with what you're heading into.

1) You're going into Internal Medicine aiming for competitive specialty medicine. What happens if you don't get it? Are you going to be miserable doing hospital work - i.e spending a lot of your time consulting others, pain management, electrolyte replacement, managing run of the middle AKI, CHF, COPD AE, A Fib w/RvR? Will you be happy if all ends badly potentially switching gears into a different fellowship?

Like critical care you probably can match. You just might have to do Nephro or ID first as a lot of programs borderline advertise themselves as combined programs for those willing.

But what if you decide by your 3rd year you're too tired for more training?

2) You're switching from Cut Cut Chop Chop Land to Medicine. You're going to spend 2 hours a day literally rounding and trying to elaborate on the intricacy of hyponatremia, volume status, and fluid rates to run to prevent overcorrection. You're going to be on the ground to manage blood sugars for surgery after they're done doing the "important" part. And now just want you to get their patient medically optimized to go to SNF/SAR for recovery.
And honestly, it's not for a lot of people. I will actually say that I enjoy hyponatremia management. But I also enjoy physiology and manipulating bodily chemistry. Will you get extremely exhausted doing this?

Fundamentally this a 3 year residency. It is not a bridge to fellowship. It's a bridge towards being a generalist. You're expected to be good at it. Not good at your one thing you like and screw all the rest.

I'm not doubtful you can pull it off. I just want you to be realistic about what you're going into and not look at this as some sort of COMLEX 3.5 or 4 hoop.

This makes a lot of sense. Thank you for such a detailed post.

I am only 1 week into my IM rotation and I’ve liked it this far but I’m unsure if I would like it forever if I was unable to do fellowship. I guess I will have to see how my rotations go moving forward.

I just wanted to make sure that I could attain these specialties.

 

[DOVinciRobot]

Right but in another post I believe I was advised not to retake because it wouldn’t help me for surgery matches since I have the fail

That is correct.

Be a good IM resident at a place with in house fellowships and make a name for yourself. I’ve personally seen very average students back door themselves into cards and GI that way.

If all else fails there is always EM lol. I’d personally rather do FM than EM, but that’s just me.

 

[FormerNFLQB]

So I think I may dual apply to GS that were former AOA as well as IM or neurology (whichever I like more) and let the chips fall as they may.

I’ll be placed wherever I am supposed to be.

 

[DOVinciRobot]

So I think I may dual apply to GS that were former AOA as well as IM or neurology (whichever I like more) and let the chips fall as they may.

I’ll be placed wherever I am supposed to be.

If you apply GS at all you need to audition. I would do 6. The DO programs that don’t give a rip about Step basically only take auditioners…

If you want to consider GS it’s your only shot

 

[FormerNFLQB]

If you apply GS at all you need to audition. I would do 6. The DO programs that don’t give a rip about Step basically only take auditioners…

If you want to consider GS it’s your only shot

Thank you for that info. Do you know which ones exactly you’d suggest to audition at?

 

[Arabia Magna]

Thank you for that info. Do you know which ones exactly you’d suggest to audition at?

I think this is a good starting point to look: https://osteopathic.org/index.php?a...e-gme-transitioned-programs-opportunities.pdf

 

[DOVinciRobot]

I think this is a good starting point to look: https://osteopathic.org/index.php?a...e-gme-transitioned-programs-opportunities.pdf

The problem is a lot of those programs will expect a Step score and will filter someone out without it.

OP is going to have to talk to people who are current interns who did a lot of auditions on the DO trail and know which programs are very “DO” and only care about COMLEX and auditions. There are programs that exist like that, but most aren’t. Places like Doctors, Genesys, PCOM, etc are competitive and not having a Step score will be a red flag at those places.

The HCA programs basically filter and rank based on Step scores alone.

 

[FormerNFLQB]

I am going to try and find some people who did what Robot says. I am going to continue to publish papers and try and make connection in the field while also exploring other specialties that have a heavy procedural practice.

If I can find something that I enjoy as much as surgery, I will go that route but I dont see that happening.