IM or EM to pain?

[mednyc2012]

I am a 4th year med student and am interested in interventional pain. I realize that anes or PMR would be the wisest routes to get into a pain fellowship but honestly, I'm just not very fond of either. If pain didn't work out I could realistically see myself practicing either EM or IM. I understand there are pain fellowships that have accepted both IM and EM applicants, so I'm wondering which of these 2 paths I should apply for. Thanks for any advice you can give!

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[Ducttape]

as of right now, EM, with the most recent addition to EM pathway.


Addendum - see this thread. http://forums.studentdoctor.net/threads/welcome-emergency-medicine.1067927/

 

[emd123]

You already know that by not choosing anesthesia you reduce your chances of getting Pain a great deal. Realize that IM offers many fellowships that are excellent options also (GI, cards, etc) that expand your horizons outside of IM and can improve lifestyle and/or income, whereas EM fellowships are much more limited in what effect they'll have on income or lifestyle in that they focus you more tightly into EM (other than Pain, which is in it's infancy as an EM Subspecialty, or maybe Hospice/Palliative).

As of right now, EM would have the edge over IM due to the recent addition of pain as a Subspecialty. So far IM doesn't have that. As far as fall back if you didn't get Pain, EM vs IM would be up to you based on which you like better.

Bottom line: you need to decide what you want to do with your life, most: Pain, EM, IM, IM Subspecialty? Pick something, go for it, and never look back.

 

[mednyc2012]

Thanks for the quick replies! I know EM had an official pathway, but can't IM sit for the boards also? If not, then why have fellowships accepted IM individuals?
I do realize that I will be at a great disadvantage by not doing anesthesia. I am in a good US med school with competitive board scores and my advisers keep trying to steer me towards anesth. It just really isn't for me! I get too bored in the OR. I probably have a bit of ADD and just really enjoy procedures. This is why interventional pain seems so appealing. It will allow me the possibility to have an office, regular hours and still do plenty of hands on work. I thought about some of the IM fellowships but interventional cards is WAY too long of a training period with a terrible lifestyle. GI might be okay and would keep an open mind if I went the IM route.
So both of you suggested EM. Are IM grads just really an exception when they have been accepted in the past?

 

[oreosandsake]

have you considered IR?

 

[freddydpt]

Thanks for the quick replies! I know EM had an official pathway, but can't IM sit for the boards also? If not, then why have fellowships accepted IM individuals?
I do realize that I will be at a great disadvantage by not doing anesthesia. I am in a good US med school with competitive board scores and my advisers keep trying to steer me towards anesth. It just really isn't for me! I get too bored in the OR. I probably have a bit of ADD and just really enjoy procedures. This is why interventional pain seems so appealing. It will allow me the possibility to have an office, regular hours and still do plenty of hands on work. I thought about some of the IM fellowships but interventional cards is WAY too long of a training period with a terrible lifestyle. GI might be okay and would keep an open mind if I went the IM route.
So both of you suggested EM. Are IM grads just really an exception when they have been accepted in the past?

As of right now, an internist is not allowed to pursue the ABA pain medicine examination. That might change in the future if the ABIM applies to co-sponsor the pain medicine exam. I personally joined an ABR committee to make sure the application was submitted so pain would become an official subspecialty. Definitely be willing to do the same for the ABIM if you plan on choosing the IM route.

 

[freddydpt]

have you considered IR?

I second that. Radiology is a great base field for pain and is very procedural depending on where you attend residency. If you chose that route, make sure you go to an institution where residents DO procedures and not just WATCH procedures.

 

[emd123]

As of right now, an internist is not allowed to pursue the ABA pain medicine examination. That might change in the future if the ABIM applies to co-sponsor the pain medicine exam. I personally joined an ABR committee to make sure the application was submitted so pain would become an official subspecialty. Definitely be willing to do the same for the ABIM if you plan on choosing the IM route.

Yes. Any specialty could through PMR if you did an ACGME fellowship. Ended this year. Must apply for your specialty to be official, now. Heard Peds and FM are applying next.

 

[mednyc2012]

posted as a new thread.