2nd Residency in Neurology (IM PGY2)

[El Nino]

Hello all,

My sincere apologies if this in the wrong section.

I'm a current PGY2 in IM considering doing a 2nd residency in Neurology. My interest developed after preparing a talk on neurology for noon conference (seriously, no joke).

Although I'm really want pursue neurology, I'm scared and intimidated given my neurology knowledge and skill set (as with many internist) is poor. I recognize this shouldn't be a barrier, but I won't be like a MS4s with fresh textbook knowledge.

Stats
Graduated from a top med school with a historically strong neurology program
Step 1 230s, Step 2 240s/CS Pass, Step 3 Pass (all first attempts)
Med school grades all passes except my SubI in Med
Residency: Community University Affiliated residency program, consistent top scorer on ITE exams and good rotation comment evals
-We have a busy neuro consult rotation which is composed entirely of senior and junior neurology residents from our university affiliated program. Unfortunately I have not had the opportunity to do this rotation, but I have a continuity clinic in neurology (few clinics thus far, not comfortable enough to ask attendings for letters).

Goals: (Neuro/IM) hospitalist & Medical Education

What's the best approach?
--Email my med school's PD asking about a spot?
--Email the residency's university affiliated PD (fortunately they did their intern year at my program, so there are no worries about clinical training)?
--Do the consult rotation at my hospital vs rotation at the university affiliated program?

I realize now that I can't go directly into a advanced position for 2021, and would have to take a gap year then apply.

Thank you,

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[GuillainMollaret]

First of all, your number one priority is to do a rotation in neurology to ensure that you want to go down this path. It probably doesn't matter where you do it. I 100% agree in my very biased opinion that neurology is more interesting than IM, but some of the IM subspecialties like rheum and heme/onc are pretty interesting in their own right.

If you want to do neuro, I don't really see the benefit of spending another year in IM. I would try to see if there are any open PGY2 (first year neuro) spots you can jump into outside the match. Unfortunately, it's pretty late in the year to spring this on your current PD and future chiefs, but it may be reasonable if you're at a large enough program where your loss wouldn't alter scheduling for the next academic year too much.

Neurology residency tends to be more grueling than IM (higher acuity, more call, etc.). I would quit if someone told me I had to do my neurology residency over again. Really make sure you want this before committing. I personally couldn't imagine doing 3 years of IM residency followed by 3 years of neurology. Woof.

 

[Thama]

Agree with the above - I got a close look at the difference between IM and neuro residencies as my wife and I went through at the same (very large urban) institution. Don't underestimate just how much more demanding neurology residency can be versus IM. My wife's reaction to my work hours and patient load was generally shock at what the ACGME allowed to happen. The hardest year of IM (internship) would have been a distant 3rd in difficulty after PGY2 and PGY3 years of neurology, and in particular was a bonafide vacation in comparison with PGY2 neuro.

I love being a neurologist and love what I do now, but going back through that residency would never happen.

 

[Postictal Raiden]

I’m a PGY2 neuro resident and echo the above. Neurology residency is no joke. When counting in my electives, I averaged 58 working hours per week during my internship “hardest year in IM”. Now I’m averaging 75. No regrets though. I love neurology and all this hard work and sleepless nights is justified.