Some thoughts regarding common GI questions...

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nycscope

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Hi everyone. A fellow SDN member sent me a message with some questions regarding the journey to GI. I typed up some quick thoughts for him/her and thought the answers may be helpful for someone else pondering the same things. I will sit down and flesh these out a little more later (please feel free to add to them) but here are some quick "stream of consciousness" answers to common questions (please excuse misspellings and grammatical errors):

1. What made you want to go into IM--> GI ?
I initially wanted to be a surgeon. I love working with my hands, and even took up instrument building/repair to develop fine motor skills that would be applicable to surgery. I then did my SubI as a 4th year and found that I really could "take or leave" the OR...in other words, it wasn't my favorite place in the world and there were many times I would have rather been somewhere else. This, to me, meant that I would be a terrible surgical resident in terms of drive, as I wouldn't want to deal with the hierarchy and rigor of surgical life to moderately enjoy a portion of the job. I had never really considered anything else to that point, and Medicine became VERY attractive because it afforded me time to decide what I REALLY wanted to do as well as offer a vast amount of clinically imperative knowledge in managing patients. I love that IM covers just about everything in terms of knowledge (it's not that surgery or IM is better or worse than the other...simply 2 different specialties...it's like debating whether Bill Russell or Michael Jordan was the greatest basketball player. Both were excellent, both won multiple titles, one did it with stellar defense and the other with aggressive offense. Anyway, getting back to the question...IM gave me functional capability, clinical knowledge, time and OPTIONS! Did I like Critical Care? Did I want to tinker with electrolytes in Nephro? I had no idea really until I started taking care of patients. I always enjoyed Gastroenterology as a subject...I just understood it so much more than other subjects. If you consider every specialty in medicine, putting it simple, there is a spectrum of physiology<-------------->pathology. Of course, both are involved in every field, but what I mean is that some fields lean more to one than the other. Example: cardiology and pulmonology don't have a *vast* majority of derangement, but the positionality of the derangement determines its upstream and downstream effects...it is VERY physiology heavy. The GI tract, on the other hand, is a self-propogating tube that takes nutrients in on one end and turns out waste product on the other...not that difficult. However, WITHIN GI, you have different pathological occurrences in the esophagus, the pancreas, the liver, the colon, etc...a huge # of different possibilities. Is it cancer? infectious? psychological? GI affords you the ability to utilize your IM skills of differential diagnosis and then take it a step further and intervene! Now you CAN clip that bleed. You CAN find that adenoma. You CAN prove your suspicion of Crohn's. The combination of complexity of pathology and "thinking and doing" made GI the choice for me.

2. You talked about case reports. Is this simply typing up stuff from some other physicians data or what?
Case reports are exactly what they sound like...a formal presentation of an interesting case and its management. Example: Patient X presents with vertigo. Labs and physical exam were done, tests X, Y, Z were ordered, turns out patient had a stroke. This is an unusual presentation of stroke, but can happen, here is a short discussion of other times this occurred and how we might look for warning signs in future cases. Done, that's it...basically it's like a "History and Physical" write-up, featuring a discussion and a few implications at the end of the discussion. These are easy to come by. Ask your residents and attendings for INTERESTING cases that you can write up and present. Tell them of course their name will be on it. They will happily give you cases to write up and research. You can present these as posters at conferences, and submit them to peer review journals to get them published. These are "stat stuffers"...demonstration that you are willing and capable to perform academic inquiry and obtain information relevant to the practice of medicine.

3. I want to do "clinical research" but I've never done lab research. How would I go about doing clinical research?
I was in the same boat. You know what the secret of research is? THERE IS NO MAGIC TO IT! What I mean is, it does not matter if you know exactly what to do from the get go...you only learn by doing. The easiest thing to do is ask residents and attendings how you can help on current projects. Are you good at stats? Great, tell them you do their data number crunching. Are you a good writer? Excellent, then you'll go to the research office and find out what you need to do to write up the IRB and you'll do it. Are you good at teasing out research articles? Awesome, you'll do the literature review. Find a way to be a functional cog in a bigger machine, and learn from that machine as you go along! Eventually, you'll have an idea...hey, if eosinophilic esophagitis is in someone's throat, why do we give them their treatment (steroids) in their veins? What if we made it into a spray and sprayed it directly into their throat? Would that improve symptoms? Help their disease resolve faster? Do nothing at all? You figure out this question, fill out the paperwork, review the literature to see if it's been done already and, if so, how you can improve on what's been done or put a different twist to it, talk to an attending to have access to patients for your study, and then go do it!

4. I'm assuming the first step in getting into GI would just get into a great IM residency, yes?
The first step into getting a GI fellowship is to be the BEST INTERNAL MEDICINE RESIDENT YOU CAN BE! Does pedigree help? Yes. Will programs be more likely to pick you up from UPenn than a community hospital in Alaska? Probably, yes. Will they know if you are lazy and simply feel entitled because you come from a good program? YES!
Of course, do your best to find the program that best suits your needs. In this case, it is a program with:
- its own GI fellowship
- available research with willing attendings/professors that will guide and help you
- a place that you are happy to work at day in and day out, even when things are rough

Of course, there are much minutia that one can tease apart later on...letters, recs, phone calls, etc. First and foremost though, if you are a lazy resident, then you will be a lazy doctor, and that will not fly for fellowship. Smile, work hard, STUDY, go the extra mile for your patients, show that you are interested and demonstrate that interest by following through on some projects...a couple of case reports, a few presentations, contribute to a good study that is happening at your institution...maybe go to a national meeting with that attending, and you will be fine :)
Simply put, start by being the best damn IM doctor that ever was, and you will make a heck of a Gastroenterologist!

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I will add to this later, please feel free to correct/chime in!

EDIT: ADDING MORE! :D
Basically a collection of answers I've supplied in some other threads compiled into 1 for those who are search-function challenged or just want it all in 1 go!


GI vs Hospitalist
Before you get into the minutia of each field, just consider broad strokes:

1. What do you ENJOY learning? You will be studying a particular field for the rest of your life...choose something you love, not something that looks attractive in the moment. GI and Cards are self-explanatory. As a hospitalist, you can treat everything from gout to cellulitis to pneumonia...which is pretty cool if you like that kind of clinical variety.
2. What do you see yourself doing? Do you mostly want to do procedures? Teaching rounds? A mixture of things? You can do anything in any field, yes, but if you end in, say, outpatient medicine, you can't help but do fewer procedures, and student exposure may be one at a time as opposed to a posse.
3. This bit is less important than the other two, but still matters...what kind of personality are you, or rather, what kind of WORKER are you? I.e. Laid back + Pulm/Crit for example is doable, but LAZY + Pulm/Crit is not. Let's face it, those going into Cards, GI, etc. tend to be more...type A...than others and the work environment can be a "go go go" type of energy. If you prefer to work at a slower pace, your own pace, or would like to answer to yourself from the get-go, then doing an intensive 3 year fellowship may not be a good choice.

It's very important to be HONEST with yourself in these decisions. Don't say "well, I COULD work hard" or "I COULD like this field." They are questions only you can answer, but answer them with brutal truth. Once you do, feel free to post and we can help a bit more
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Is it worth doing a chief year?


1. When is it worth it to do a chief year, as opposed to just taking your chances with the regular fellowship match?
Depends on the program. Some places require commitment before fellowship applications, others after. If you are in the before camp, then you need to be very, very realistic about your chances...do you *think* you are a competitive applicant or *hope* you are one? If you hope, hedge your bets, do the chief year. If you really, really think you can do it, go for it.

2. Is chief year something you can decide to do if you failed to match, or do you have to commit early?
Depends on the program. My program asked me early, I said no thanks, and by the grace of the Almighty and the skin of the skin of my teeth, I matched and didn't have to regret the decision. My friend was applying for cards, was asked after me, and he took it with a wink and a nod that he'd be very competitive to match at the program for next year.

3. Is a chief year worth doing for someone with a reasonable shot at matching?
Well, now it becomes a personal question. A chief year is not by any means fun. At some places, you are a bobblehead... yes sir, thank you sir for the PD and you carry out their edicts. At others, you are given more free reign as to how you will engineer the residents' schedules, conferences, etc. You also play mother, father, pastor, referee, and any other role you can think of to residents who will often complain, seldom thank you. You do, however, get to see how the sausage is made, and it does get you bumped up some lists.

Chief year is the Ribavirin of fellowship applications...it won't guarantee sustained response on its own, but it can sure help!

What do I look for in a fellowship program?

Well, here was my thought process:

I REALLY want to do GI. Well, more like I HAVE to do GI.
Send applications far and wide...seriously, send 100 and maybe, if you are competitive, you get something like 15-20 invites. Go to your interviews, decide which places you like. Of course, before that research the programs that offer you an interview:

- who is a faculty member? what are they good at? what do they spend their time investigating?
- what do YOU want to do? advanced? ibd? hep? some places are better equipped to deal with your interests than others. I wouldn't prefer a program without it's own transplant program if I wanted to be a transplant hepatologist for example.

It's pretty much about who's going to give you a shot to begin with.

nobody can answer this but you. This is like asking us what kind of car you want assuming you can have any car. What if I say Ferrari? It's fast, flashy and fun. It won't matter a lick though if you live in the Northeast come winter time. If you say "well, there is heavy snow where I live and I need cargo space to shop at Costco but I want something sporty too" then we can discuss the details of a Jeep vs Range Rover vs Whatever.

Some of the more "prestigious" places I went to quoted fellow procedure numbers from 800-1000 by the end of fellowship. Some of the lesser recognized places had higher numbers than that...one quoted 2000. Although this wasn't my only criterion, it was a very big one as I want to be an excellent endoscopist and feel I need the hands on training to be one. This lead me to rank the lesser known program higher whereas I would have had no clue to do so earlier.

The way I'm reading this question is "which program will open doors for me and let me do whatever I want later on?" Prestige does not equal clinical acumen. It DOES give you brand recognition. The general public doesn't know what the heck a Fazioli is but they sure know what Steinway is (but given the choice, I'd take Fazioli 10/10 times). I think what you are asking is: which programs are the most prestigious. US News will give you that info.
http://health.usnews.com/best-hospitals/rankings/gastroenterology-and-gi-surgery

Again though, that doesn't make them the best for you, just the most easily recognized. If you are great at what you do, you will open your own doors.
Finally, I know I said this before, but I'll say it again: If this is what you want to do, apply far and wide. There are roughly 170 programs out there for almost 450 seats. That's not all that many. Consider applying to all of them if money isn't a factor. If it is, then use whatever criteria you want to filter (you haven't told us what career goals are...if you want to do academics or something super sub specialized, maybe don't apply to Nowhere, USA Community Hospital X).
After you get your limited number of interviews, you can compile a list of pros and cons based on what you want out of the program specifically and make your rank list.

What does compeititve mean?

It's a loaded word for sure:
- board scores - not THE most important, but it D O E S matter for filters. Scored a 211 on your Step 1 but a 250 on Step 2? Well, if the filter is set on minimum 225 for example, sorry, you are out of luck. If it's an AVG 225, then hey, guess what, your app gets a look
- networking - single most important factor. who do you know? who will vouch for you with a telephone call? how much does your home program like you?
- residency performance - if you do the bare minimum, who will want to hire you? if you show up every day and are consistent in fulfilling your responsibilities and are pleasant while you do it, this will go a long way
- research - the more you contribute, the more you are "interested" and likely to produce for your program. They are thinking: "we will train you to be a gi. what will you do for us?"
- pedigree - where do you come from? university trained by and large = more consistent product in the eyes of the PD. Same thing with US vs Caribbean grads.

Very generally, in my experience, it's something like:
networking > residency performance > pedigree > research > board scores.

I'll use my profile. Let's break it down using the criteria we stated above:

1. networking - you better believe I did everything just short of washing the PD's car at my home program (and would've if he/she asked). Late nights on elective? no problem. Type up that IRB for you? You bet! I attended whatever meetings I could...grand rounds/local/national and shook hands with lots of people that way. Long story short, I did my very very very best here, and I believe firmly that it had a huge hand in matching. Me 1/ Odds against 0.
2. residency performance - I like to think I did my best. Did I know everything? Absolutely not. Did I do what I thought was the BEST I could for my patients? Yes. Day in, day out, don't leave work for others. Smile, be polite and helpful...I wasn't always successful at all of this, but again, I did my utmost. Me 2/Odds against, 0.
3. pedigree - mid-tier university program, towards the end of the list on "US News Top 50" Gastro programs. I didn't come from an MGH/Hopkins/UCSF etc etc, so I've got to give this to the "odds against" category...applicants from many prestigious places are your direct competition. Me 2/Odds against 1.
4. research - again, did my best. 2 pub (1st author), 5 case reports (4 1st author), 9 poster all-together (national and local). enough to show I care, not enough to blow anyone's socks off. You'd better believe there are some "W O W" applicants out there in this category...I was certainly not one. Me 2/Odds against 2.
5. Board scores - we never escape the sins of our past, do we? My less-than-even-mediocre scores caught up with me here, and I had a number of programs let me know that I was filtered out based on this (I called, "Hey did you guys get my app?" kind of thing). I even had a doc on one of my interviews say that they were not good compared to other candidates and that this was a serious red flag against me...I think that's an extreme but hey, it happened.
So, Me 2/odds against 3.

All in all, I think I had a DECENT profile. My residency performance and networking were certainly my best attributes, and the fact that they are weighted heavily in the process ultimately tipped the balance in my favor ever for slightly. Why did I type all that? So that when I mention that I applied to 100 programs and got 10 invites, it should mean something. I filtered out the programs based on family location. They are in NY/NJ/PA area, so I applied to pretty much every program from Maine to Florida and as far west as Ohio,maybe a bit beyond that. Frankly, I didn't care so much if I ended up at Community Hosp X or University Hosp Y...I just wanted a chance to be a GI doc. I ended up liking community places more actually, since fewer fellows meant more procedures per fellow...that changes wildly depending on where you go though.

What do YOU want to do? Where do YOU see yourself? What matters to YOU? Location? Weather? Family-friendly? None of us can answer these questions, so it's up to (you guessed it) YOU to decide where you want to apply and why. Perhaps by sharing my thought process I gave you an example of how I ended up where I did.
 
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For me it was "GI this year or ...next year after some soul searching and brainstorming regarding CV improvement" :D
 
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Lots of views, no questions...nothing I can help you guys with?
 
Lots of views, no questions...nothing I can help you guys with?
1. How much time do you spend doing paperwork? Are most IM subspecialties similar in that regard?
2. How's the job market outside of NYC/LA/SF?
 
Lots of views, no questions...nothing I can help you guys with?

1. How much is your average private practice GI spending in the hospital? I find myself really enjoying clinic, procedures, and dealing with sick patients in the hospital. I feel like GI allows for a pretty good split between these areas, is this accurate?

2. What role does GI play in some of the less common GI cancers (liver, biliary, pancreas)? I'm interested in working with these patients due to a family link. Is your average GI in the community involved with these cases?

Thank you so much for doing this!
 
1. What made you want to go into IM--> GI ?
I initially wanted to be a surgeon. I love working with my hands, and even took up instrument building/repair to develop fine motor skills that would be applicable to surgery. I then did my SubI as a 4th year and found that I really could "take or leave" the OR...in other words, it wasn't my favorite place in the world and there were many times I would have rather been somewhere else. This, to me, meant that I would be a terrible surgical resident in terms of drive, as I wouldn't want to deal with the hierarchy and rigor of surgical life to moderately enjoy a portion of the job. I had never really considered anything else to that point, and Medicine became VERY attractive because it afforded me time to decide what I REALLY wanted to do as well as offer a vast amount of clinically imperative knowledge in managing patien

I'm and MS3 and I am still very much in between IM->GI and Surgery, and at this point I would much prefer to go into GI than surgery. However, getting a fellowship in GI is no guarantee and I'm not sure I would be happy working as a hospitalist while continuing to pursue a GI fellowship. I guess what I'm getting to say is that as of right now, it appears like surgery is more of a guarantee/less of risk than pursuing IM->GI. How much of a role did that come into play when you were deciding between GI and surgery?
 
Updated with more info up top as promised
 
1. How much time do you spend doing paperwork? Are most IM subspecialties similar in that regard?
2. How's the job market outside of NYC/LA/SF?

1. Enough...definitely much less than IM. Clinic still has notes, consults are still like H+P's, and patients you see still need daily notes. Whatever time you save in comparison re: clinic note or daily note brevity you make up in prior auth's for super-fantastic-brand-new-must-have ppi's and general internist notifications (I saw pt blah blah who has findings of blah blah on egd...). Still, I stick by less paperwork than a general internist. Most specialties are similar.

2. Much, much better in terms of pay, heavier often times in terms of responsibility. If you go to Bumbleyouknowwhat Kansas, sure you might get that $550K, but you better believe it's you and the other 1 GI doctor in a 100 mile radius on call every other night, God help you if you are a therapeutic endoscopist...
If pay is what you are alluding to, then you need to consider employed vs self-employed. You work for a hospital, chances are you will make a lot less. If you slave for and then buy into an ASC, you will possibly make more in the long run...a lot more.
 
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Where did you end up matching @nycscope (State and not program if you prefer for anonymity)
 
GI is the best specialty EVEN if they cut salaries very low. It is the best lifestyle (other than therpaeutic advanced endo) and best variety of physiology and patient satisfaction. even IBS patients, with some wisdom, are way easier to deal with than complex 10000 problem internal med patients.
 
I'm and MS3 and I am still very much in between IM->GI and Surgery, and at this point I would much prefer to go into GI than surgery. However, getting a fellowship in GI is no guarantee and I'm not sure I would be happy working as a hospitalist while continuing to pursue a GI fellowship. I guess what I'm getting to say is that as of right now, it appears like surgery is more of a guarantee/less of risk than pursuing IM->GI. How much of a role did that come into play when you were deciding between GI and surgery?

Lol, the fact that you're even considering NOT doing surgery means you shouldn't do surgery. Surgery is meant for people who can't see themselves "happy" doing anything else. Note that happy is in quotations because such an emotion does not actually exist in that specialty. And if you like gut that much then... I don't know what to tell you. I guess people have had stranger fetishes.
 
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Agree hundred percent with Bronx43. Furthermore, even if you like surgery, if you can be happy doing something else, then do that something else.
 
GI is the best specialty EVEN if they cut salaries very low. It is the best lifestyle (other than therpaeutic advanced endo) and best variety of physiology and patient satisfaction. even IBS patients, with some wisdom, are way easier to deal with than complex 10000 problem internal med patients.
Pretty sure GI would quickly drop down to average competitiveness within a few years once reimbursement gets destroyed for endoscopy. 2016 Medicare fee scheduling anyone? I'm glad you like the field, but I'm pretty sure 75% of the applicants are hoping to scope for dollars.
 
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Forget about dollars for a moment, the field gives you "fun" procedures to do (rather than clip toe nails or stick people's groin while they are going into a VT storm on your table). It makes you think about systemic physiology when on inpatient, offer challenging imaging techniques and multidisciplinary approaches. Patient satisfaction even in functional areas is pretty good. IBD alone makes it a noble calling. I think all specialties have their points but GI, even with average money reimbursement, is so satisfying.
I love medicine subspecialties, and think cardiology is so elegant, but GI will give you a good life (relatively less stress) and good results.
 
Forget about dollars for a moment, the field gives you "fun" procedures to do (rather than clip toe nails or stick people's groin while they are going into a VT storm on your table). It makes you think about systemic physiology when on inpatient, offer challenging imaging techniques and multidisciplinary approaches. Patient satisfaction even in functional areas is pretty good. IBD alone makes it a noble calling. I think all specialties have their points but GI, even with average money reimbursement, is so satisfying.
I love medicine subspecialties, and think cardiology is so elegant, but GI will give you a good life (relatively less stress) and good results.
Ok, to each his own. Like I said, I'm glad you like the field, but the vast majority of the people going into it are looking at the money. You may find it fun, but I'm pretty sure most people wouldn't enjoy scoping asses all day if they didn't get paid a lot to do it.
 
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I guess same could be said about blowing balloons in 5 mm structures inside 500 lb individuals with 2495 medical problems.
 
I guess same could be said about blowing balloons in 5 mm structures inside 500 lb individuals with 2495 medical problems.
Yeah, probably. Your point being? Doesn't negate the fact that the main reason for GI's competitiveness is due to current reimbursement rates.
 
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Isnt that the major incentive for everything in life?! When one realize that money could be made in any specialty, then one focuses on "relatively" stress free life.
 
Isnt that the major incentive for everything in life?! When one realize that money could be made in any specialty, then one focuses on "relatively" stress free life.
Yes, that is the major incentive in life... never said it wasn't. In fact, that was kind of the implication of my original point - that the competitiveness of GI isn't driven by some profound interest in GI pathology but more by money. And there's nothing wrong with that. There are other interesting medical sub-specialties with better lifestyle than GI but aren't competitive. I suspect parity between most of the specialties when reimbursement rates largely equilibrate.
 
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I think we are on the same page: but lets say GI pays the same as endocrine or ID, i still think the lifestyle and fun of GI procedures beat endocrine or ID.
 
I think we are on the same page: but lets say GI pays the same as endocrine or ID, i still think the lifestyle and fun of GI procedures beat endocrine or ID.
To some. To others, no. For example, I think ID is FAR more intellectually stimulating than GI. In fact, GI is easily at the bottom of my list. There is simply nothing interesting to me about luminal GI. Hepatology is slightly better but not really better than ID or rheumatology. Lifestyle? There are negligible ID, rheum, or endo emergencies. There are not infrequent GI emergencies.
In my class at a top 30 institution, we only had 2 GIs but 4 IDs... out of interest and not of fear of competitiveness since no one fails to match at my shop. Obviously only anecdotal, but I think people's tastes are varied and you can't make wide claims like "GI is more interesting and fun than ID or endo."
 
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Where did you end up matching @nycscope (State and not program if you prefer for anonymity)

NYC. Most of my interviews were NY/NJ/PA.
I imagine you are in California adagio?
 
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1. How much is your average private practice GI spending in the hospital? I find myself really enjoying clinic, procedures, and dealing with sick patients in the hospital. I feel like GI allows for a pretty good split between these areas, is this accurate?

2. What role does GI play in some of the less common GI cancers (liver, biliary, pancreas)? I'm interested in working with these patients due to a family link. Is your average GI in the community involved with these cases?

Thank you so much for doing this!


1. Private GI spend as much time in the hospital as they want. They have blocked off time in the endo suite and must accommodate those times. They can visit their patients as often as they can justify. You can end up spending 1/2 your day in the hospital or (more likely) not. Most end up doing the split you allude to - clinic time, procedure time (hospital +/- asc +/- office), and less time dealing with acutely ill patients unless they are THEIR private patients...in which case fellows can be called to help set up the mobile cart if needed.


2. Your average GI is involved in the management, but not usually putting in stents, performing ERCPs, and the like. For the most part, it's therapeutic endoscopists and surgeons, with the general GI being intermediary and often team coordinator.
 
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Is pediatric gastroenterology a fellowship open only to those who have completed a pediatrics residency? Are there people who do IM --> adult GI and then some kind of peds super-fellowship on top of that?
 
Is pediatric gastroenterology a fellowship open only to those who have completed a pediatrics residency? Are there people who do IM --> adult GI and then some kind of peds super-fellowship on top of that?

why would you do IM if you wanted to do peds GI??
 
why would you do IM if you wanted to do peds GI??
I'm asking if that path even exists, like the way that surgeons do peds fellowships after a general surgery residency (for example).

If it exists, I suppose you might not take that path on purpose. Just if you went the IM --> GI route and then subsequently decided you would rather work with kids.
 
I'm asking if that path even exists, like the way that surgeons do peds fellowships after a general surgery residency (for example).

If it exists, I suppose you might not take that path on purpose. Just if you went the IM --> GI route and then subsequently decided you would rather work with kids.
No...that path does not exist.
 
It's a really silly discussion... It honestly depends on the interests of the individual. Of course someone who goes into radiology probably thinks it's more interesting than IM. Some people think some fields are more interesting than others
Not sure why this post needed to be made just to repeat what my point is...
 
Oh, and if you think managing picc lines for ortho is fun, go for it. GI has very few good trials for what we do. It's a whole lot more art than science. If you understand it at all, it's very complex. Even colonoscopy. I'm almost never bored.
 
GI is fascinating. I mean nature's mucosal immunology journal is huge now. Plenty of stuff to do in GI.

Is it worth going into IM, if GI is your only interest though? I wish it just wasn't so competitive.
 
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GI is fascinating. I mean nature's mucosal immunology journal is huge now. Plenty of stuff to do in GI.

Is it worth going into IM, if GI is your only interest though? I wish it just wasn't so competitive.

Yes. depending on where you go for residency it will require more/less work on your part to match. I know people from top programs that got GI spots with case reports and research in medical school, but also midtier programs with 1-2 retrospective studies. You have to be proactive in residency and find the balance to being good resident and having time for research / Life outside medicine. Its still not like Derm where you can put in the work/work your ass off and still have a good chance of not matching. For GI if you go to a midtier program, do research and be a decent resident you will match somewhere.
 
Yea, that's my worst fear. Applying GI, getting rejected and being stuck in limbo. The numbers don't look too favorable with only about 280 spots. I've been studying mucosal immuno since undergrad, years off, and in medical school.

Thanks for the reply HelpPleaseMD.
 
Yea, that's my worst fear. Applying GI, getting rejected and being stuck in limbo. The numbers don't look too favorable with only about 280 spots. I've been studying mucosal immuno since undergrad, years off, and in medical school.

Thanks for the reply HelpPleaseMD.
Med student here who's also always like GI... Granted that was in college. Looking forward to having it this year ( coming up soon :D )
 
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Did any of you do an away rotation? If so, did you get an interview there? Did you include that away rotation experience on your CV or only talk about it at the interview?
 
Did any of you do an away rotation? If so, did you get an interview there? Did you include that away rotation experience on your CV or only talk about it at the interview?

I did 2. One place offered interview, one didn't. I didn't mention it on CV, nor during the interview. They sure as heck remembered me though from my 2 weeks there...and I ended up with a fellowship at that spot actually :)
 
My home program loves me and asked me to draft my own LOR. I'm drawing a blank because it's not every day I write about myself in the third person. What do programs look for in a LOR?
 
My home program loves me and asked me to draft my own LOR. I'm drawing a blank because it's not every day I write about myself in the third person. What do programs look for in a LOR?

first-world problems. on a serious note, congrats, seems like that's a good problem to have
 
I feel like thats kinda of unethical...

My PD isn't letting me write it entirely and then just sign it. She/he wanted to see what I wanted to highlight and will use or leave out whatever she/he wants. I couldn't say "I walk on water" if I wanted to.
 
Hey so I know its been a while but wanted to ask some questions reading the form- I am interested in GI but wanted to understand-

ASC- Is this a surgical center for the outpatient scopes? If so, what is the average buy in? And is the buy in a membership style fee that must be renewed or??? Sorry I am learning and thanks.

Also was wondering if you have to pay "membership" for ASC, can't you do the procedures in a hospital? I understand you would need the priveleges for the hospital but do you have to pay a "membership" fee there too? If so which is better profit wise? Thanks again...
 
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