IM/EM combined program

Can someone tell me a little bit more information about IM/EM programs? I'm one of those torn between EM and IM, and it seems the combined program would be an ideal choice. But knowing there're only 9 of those programs, and avg taking in only 2 spots, the chances are slimmer than those doing neurosurgery. What kind of numbers do you need to even have a chance? I didn't rock USMLE, was involved in a couple EM reserach, and I am pretty sure I'll get good letters. I've my EM rotation in June, and will work damn hard to get that honors. I'm also planning on doing rotation in August as well.

I have a couple friends that are trying to match for IM/EM. I had thought about myself, but decided just to do EM. IM/EM is great if you want to do academics, the biggest con that you will here is that you will ultimately pick one or the other and that it is 5 yrs. I don't think that is necessarily bad, you just have to decide what you want to do. I felt it would be beneficial if you were interested in critical care medicine given that you can't sit for the boards if you are EM, but you can if you are IM. The main reason I looked into it was my interest in international medicine. Good IM and EM knowledge allows you to do some longterm work in foreign countries, but I ultimately decided that if I was going to do any long term work, it was going to be in improving emergency medical services, starting or teaching at and EM residency, or through public health/advocacy. All these things did not require strong IM knowledge, I too liked IM a lot, but I found that internal medicine was not what I wanted to do after doing my sub-I after having done an EM rotation.

The biggest advice I can give you is to apply to EM and/or IM programs in addition to the combined program, b/c I've met some great residents that had to scramble into less than ideal IM programs b/c they only ranked IM/EM programs.

Good luck, you'll have time to figure out what you want to do

Sorry, to attempt to answer your question about board scores, I don't know exactly what you need, but I figure if you beat the mean, and you have good clerkship evals and LOR's you shouldn't have a problem getting interviews. By that point it would be up to you to find out how good of a match you are during the interviews. I'm no expert, but I think they would choose a matching personality over board scores any day.

There's a guy at Columbia who is boarded in IM, EM, IM-Critical Care, and Pulmonary. He works in the unit and in the ED alternating months. He admits them at the end of the month, and is service attending at the beginning of the next.

Break the paradigm, and think of it this way: get out of the "it's 5 years!" mindset...IM/EM, you're a BC/BE doc...you do a pulmonary/critical care fellowship. You, as a fellow, are attending-level. Besides getting all the cool procedures in the Western world, you can work one to two shifts a week in the ED (you are not moonlighting, because you are BC/BE), and get all of the other coolest procedures in the world, and add $60 or $70K on top of your $65K/year you get for being a fellow (unless you are at a program that gives a PGY-6 $50 grand per year).

If you are 26, that means that, at 34, you are (hopefully) board certified X 2, board eligible X 2 more, bulletproof for academics, as rock hard a clinician you can be, and the envy of people all over. YOU say how much you want, and you get the pref over someone who 'just wanted to be a resident for 3 years'. And, lest some people not agree, 8 years is par for CT or transplant surgeons, or interventional cardiology - some of the heaviest hitters on the circuit.

It's not for everyone, but a little foresight can have you happy as all get out, and cruising way cool for your whole career.

Apollyon

I don't think I could have said it better myself. If you want to be a critical care god, then IM/EM c Critical care training is what you have to do. There's also a guy at UNM that is just incredible, does the same stuff as they guy from columbia I assume.

Though, I did not decide to do IM/EM, I feel strong critical care training is essential to being a good EM doc. It's where we can make a real difference in patient care. When I interviewed at UNM, I stayed c a resident that new his stuff cold. He would actually follow up on his patients that went up to the unit. He recommended getting a critical care text and knowing that cold. That's my plan for the next 3-4 years on top of reading Tintanelli or Rosens.

Hi all,
If anyone is interested in discussing this further, I spent 5 years at Henry Ford in Detroit (EM/IM) and am now finishing 2 years of critical care at Pittsburgh. Drop me an email and I'll be glad to answer any questions.

You can also check out my earlier post on critical care fellowships. Here is a link for some FAQ.

http://www.ccm.upmc.edu/education/adult/fellowship_emc.html

I trained with Alan Tuttle, I assume this is the doc you are talking about who is practicing in New Mexico. Who is the doc you mention practicing at Columbia? I'm trying to keep track of all of us who wear several hats.

Good luck with the match. You are all probably better candidates than you think.