EM/IM- Dispell the Rumors!

Shkelzen,
I agree completely with your statements. I've stated this before in other posts over the past 6 months. I completed the EM/IM program at Ford in Detroit 2 years ago and am the current chief fellow at the University of Pittsburgh Critical Care program. I have accepted a wonderful academic job which will pay me private practice $ to work 11 days/month between the ICU and ED and the other 7 days or so to work on my research.

Several of my previous classmates have gone on to academic careers, research and critical care fellowships. Several are in a group practice together splitting time between the ED and inpatient service at the Univ. of Michigan.

As a group we have excelled, consistently winning local and state research awards as well as resident of the year awards. Whether or not this is because we were the 'cream of the crop' or rather the 5 years gave us tremendous insight and experience into many aspects of medicine is debatable.

A word of caution, DO NOT, and I repeat, DO NOT do this as a 'back door' into an EM residency. If you don't like IM, you will be in tremendous pain!!! All those cushy elective rotations are usually postponed until your 4th or 5th years. If you aren't interested in IM at all, don't do this. You don't need 5 years to do an EM based fellowship.

As always, any questions, please drop me a line.

Shkelzen, what are you doing July 1?

Originally posted by SHOX
I have heard a few rumors from Med. Studs. around the country about some Deans, Chairs or PDs trashing EM/IM programs all together or advising students not to apply to both the combined and categorical programs at the same institution. This is most unfortunate and not true!!!

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The only real opinion I heard personally on the matter was active encouragement to pursue the combined program from my Chair of Medicine. In the end, I didn't feel interested in medicine enough. I didn't know so many people were trashing them.

mike

For what it's worth - and right now, most of what I say isn't worth a lot, being a soon-to-be M1.

Anyways, although I'm early in my medical career, I am considering the possibility of doing IM/EM. For a long time before I applied to medical school, I thought that a combined program in Medicine and Psychiatry would be perfect, but for some reason, the more I learned about medical psychiatry, the more I realized it didn't quite have everythhing in order for me to be happy. That being said, I happened upon a the IM/EM combined specialty while surfing around, and the more I read and learn about the field - I think it's more suited to my interests. With IM/EM - you get both the training and skills needed to do a little bit of everything from managing critical patients and patients experiencing traumatic injuries to managing patients with psychiatric illness. That's what draws me to the field.

I'm a nontraditional student and have worked in research for a while. Having done research in medicine, emergency medicine, and psychiatry, I can see the value of training in IM/EM. I know there is a great possibility that I may change my career choice in the future, but given my past, it is likely that I will want to continue pursuing IM/EM. My biggest fear is that these programs will be much more difficult to enter than just a categorical program.

Anyways - I always learn a lot from these kinds of threads and enjoy learning personal accounts of participating in an IM/EM program.

-Tomi

I agree with everything said so far. I am coming to the end of my first year of 5 at UIC in the EM/IM program and I am so happy that I chose to do both. I still have no clue what I would like to do after my 5 years is up butI know that I will be very well trained to do either IM or EM and would be well qualified to enter any fellowship I choose. Being double boarded has its perks.
I do admit that EM/IM is not for everyone.
The drawback: when both your IM and EM categorical classmates have left the program and you have 2 more years to go. Honestly I don't see any others. Any of the other residents might help me find another.
From what I've seen for the most part the 4th and 5th year em/IM residents command a lot of respect from the attendings: on the floors and in the ED.
You become more adept at procedures than your IM counterparts: lines, LPs, intubations, etc...
and more knowledgeable about medicine than the EM residents: ekgs, critical care etc...
Overall the combined training strengthens both an IM and/or EM career.
Plus the ability to carry that training into a fellowship such as critical care is golden. How many intensivists in MICU are qualified to place a chest tube if needed, or perform RSI when needed? very few.
I wish that both advisors and program directors for both IM and EM would do their MSIII and MSIV's a favor and attempt to learn more about the combined programs before dismissing them so quickly.
EM/IM is no harder to enter than a categorical residency and I find that on the interview trail the same group of people are in the running for all the same positions. The key to successfully matching at an EM/IM program is prove to them that you belong and truly want to endure the training. Each program is proud of its success rates with its residents and are very disappointed when a resident fails to make the commitment and drops from the program because they took the spot of a resident who might have truly done well in the program from start to finish. Any questions about EM/IM or specifically UIC please feel free to PM me.

Does anyone have any info on Em/IM/CC residencies? I know that Pitt has one, anybody else? I'm starting at Pitt for school and am really interested in EM/IM but was wondering about the triple combination residencies. cheers

So is there a specific EM/IM board certification or do you take both as individual tests?

Both as individual tests. EM has written (1 day) and if you pass those, you take orals 6 months later. IM is a 2 day written test.

I think Ford in Detroit is the only EM/IM/CCM program that has an actual resident in it. Pitt has been approved for a combined EM/IM/CCM, but we have not yet received funding so we can't start it yet officially.

Kyle

India,
If you are really interested in the IM/EM/CCM program at Pitt, talk with Scott Gunn. He is the PD and a very good friend of mine. He is as willing to talk about options for EM residents interested in CCM as anybody. He is also listed as a mentor on the ACEP Critical Care section.

His email is
[email protected]

Good luck,
Kyle

Originally posted by motmas
With IM/EM - you get both the training and skills needed to do a little bit of everything from managing critical patients and patients experiencing traumatic injuries to managing patients with psychiatric illness. That's what draws me to the field.

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I am not so sure if the IM/EM training in psychiatric illness. At least in the ED I rotated through, there is a separate psych room with psych resident on-call who handles all the psych patients going through the ED. Then, on the medicine floor, psych issues are often ignored. The most important thing on the medicine floor is to clean up the lab values (an exaggeration, of course) and D/C the patients home ASAP to primary care docs.

Psych is still a pretty well ignored field. Not much exposure to it unless you actually go through psych residency.