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Ask an IM intern anything
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As someone who is currently interested in IM, I am very glad to see this thread! Thank you in advance for your time and comments.
1) Why IM?
2) How did you narrow down various specialities of interest? Were you interested in IM since the beginning?
3) What would you say to students who don't enjoy IM at all because they don't feel they are not fixing or changing anything, compared to, say, surgeries?
4) What are your thoughts on doing research in medical school, even though someone is interested in relatively non-competitive areas like IM?
5) What would you wish you knew, from where you were as a pre-med to where you are now?
6) In what areas of IM are you interested in, if there is any particular? Why?
1) Why IM?
2) How did you narrow down various specialities of interest? Were you interested in IM since the beginning?
3) What would you say to students who don't enjoy IM at all because they don't feel they are not fixing or changing anything, compared to, say, surgeries?
4) What are your thoughts on doing research in medical school, even though someone is interested in relatively non-competitive areas like IM?
5) What would you wish you knew, from where you were as a pre-med to where you are now?
6) In what areas of IM are you interested in, if there is any particular? Why?
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How much research did you do before and/or during med school? Clinical or basic science? How important was that during your residency apps?
1) Why IM?
I actually came very close to doing surgery. I liked the procedural aspect and the physical act of "doing" something to help my patients. In the end, the lifestyle seemed a little too rough, and I truly do believe in the sentiment that if you can be happy doing something else, you should strongly consider it. For me, that something is GI, which offers some similarities to surgery. So I, in essence, chose IM with the intention of pursuing GI. With that said, IM offers SO MUCH variety. I think that every type of person can find a field within IM that would satisfy whatever intellectual/career goals they had
2) How did you narrow down various specialities of interest? Were you interested in IM since the beginning?
I sort of addressed this in the previous question. To expand, I also briefly considered OB/Gyn, which is a great mix of medicine and surgery.
With that said, at this junction, it's really not necessary for you guys to start narrowing down specialties. It really wouldn't and shouldn't occur until after your 3rd and maybe even after part of 4th year.
3) What would you say to students who don't enjoy IM at all because they don't feel they are not fixing or changing anything, compared to, say, surgeries?
Again, IM is so varied. I felt this way about IM for a while, but there are fields in IM where you can certainly "do" something if by doing you mean procedures; consider Cards, GI, Pulm/CC in particular. And that's certainly not to say that other IM fields don't "do" anything for their patients, quite the opposite really.
4) What are your thoughts on doing research in medical school, even though someone is interested in relatively non-competitive areas like IM?
If you want to attend a competitive residency, doing research is important. Unlike some of the surgical subspecialties and other really competitive residencies, it matters less the subject matter of your research. But the top academic programs will see that you have engaged in research to some degree, even if it's something small like a case report or a lit review.
5) What would you wish you knew, from where you were as a pre-med to where you are now?
Mostly I wish I would have known how best to study and not to alter my studying style just because other people around me were doing it a certain way. I didn't do as well as I would have liked on the MCAT because I hadn't learned this lesson yet.
Also, I wish I would have known not to worry about little things. That one C won't kill you. This volunteer position vs. that volunteer position won't make or break you. Etc.
6) In what areas of IM are you interested in, if there is any particular? Why?
Haha, I guess I'm pretty good at anticipating your questions. See above about why GI is awesome!
I actually came very close to doing surgery. I liked the procedural aspect and the physical act of "doing" something to help my patients. In the end, the lifestyle seemed a little too rough, and I truly do believe in the sentiment that if you can be happy doing something else, you should strongly consider it. For me, that something is GI, which offers some similarities to surgery. So I, in essence, chose IM with the intention of pursuing GI. With that said, IM offers SO MUCH variety. I think that every type of person can find a field within IM that would satisfy whatever intellectual/career goals they had
2) How did you narrow down various specialities of interest? Were you interested in IM since the beginning?
I sort of addressed this in the previous question. To expand, I also briefly considered OB/Gyn, which is a great mix of medicine and surgery.
With that said, at this junction, it's really not necessary for you guys to start narrowing down specialties. It really wouldn't and shouldn't occur until after your 3rd and maybe even after part of 4th year.
3) What would you say to students who don't enjoy IM at all because they don't feel they are not fixing or changing anything, compared to, say, surgeries?
Again, IM is so varied. I felt this way about IM for a while, but there are fields in IM where you can certainly "do" something if by doing you mean procedures; consider Cards, GI, Pulm/CC in particular. And that's certainly not to say that other IM fields don't "do" anything for their patients, quite the opposite really.
4) What are your thoughts on doing research in medical school, even though someone is interested in relatively non-competitive areas like IM?
If you want to attend a competitive residency, doing research is important. Unlike some of the surgical subspecialties and other really competitive residencies, it matters less the subject matter of your research. But the top academic programs will see that you have engaged in research to some degree, even if it's something small like a case report or a lit review.
5) What would you wish you knew, from where you were as a pre-med to where you are now?
Mostly I wish I would have known how best to study and not to alter my studying style just because other people around me were doing it a certain way. I didn't do as well as I would have liked on the MCAT because I hadn't learned this lesson yet.
Also, I wish I would have known not to worry about little things. That one C won't kill you. This volunteer position vs. that volunteer position won't make or break you. Etc.
6) In what areas of IM are you interested in, if there is any particular? Why?
Haha, I guess I'm pretty good at anticipating your questions. See above about why GI is awesome!
How much research did you do before and/or during med school? Clinical or basic science? How important was that during your residency apps?
I did some basic science in undergrad, spent one summer and kind of did it part time during the school year. Hated every minute of it, but my PI was gracious enough to slap my name as 3rd-4th author on 2 papers. I think this was critically important to my med school app.
In med school, I did only clinical research. I spent the summer between M1 and M2 year doing clinical research and managed to get my name on 2 papers (one was a lit review). Again, I think this was critically important to landing a spot in a top academic IM residency program.
As much as I generally dislike research, it's one of those important boxes to check. Pick a topic you find interesting, bearing in mind that it's usually easier to publish in clinical research. Find a supportive mentor who knows you want a pub out of it.
I did some basic science in undergrad, spent one summer and kind of did it part time during the school year. Hated every minute of it, but my PI was gracious enough to slap my name as 3rd-4th author on 2 papers. I think this was critically important to my med school app.
In med school, I did only clinical research. I spent the summer between M1 and M2 year doing clinical research and managed to get my name on 2 papers (one was a lit review). Again, I think this was critically important to landing a spot in a top academic IM residency program.
As much as I generally dislike research, it's one of those important boxes to check. Pick a topic you find interesting, bearing in mind that it's usually easier to publish in clinical research. Find a supportive mentor who knows you want a pub out of it.
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how similar is your life to jd's and do you have a dr cox
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Since you were on the admissions committee, what advice do you have on both filling out secondaries and the interview process?
how similar is your life to jd's and do you have a dr cox
Considering I'm a bit of a loud-mouthed clown myself, my life is probably closer than most IM interns'. And that's how I like it.
As far as attendings, we have some curmudgeons and some serious hotshots who know it, but everyone for the most part is ridiculously nice and supportive. Not too many blends of the two types to make the perfect Cox though
Considering I'm a bit of a loud-mouthed clown myself, my life is probably closer than most IM interns'. And that's how I like it.
As far as attendings, we have some curmudgeons and some serious hotshots who know it, but everyone for the most part is ridiculously nice and supportive. Not too many blends of the two types to make the perfect Cox though
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Thank you for your comments there.
1) How do you find out your most efficient way to study? Is it as simple as a series of trials and errors? Any advice on this?
2) Instead of little things, what should we then worry about? Anything else besides step 1, LORs, and clinical rotation grades?
3) What are your thoughts on oncology? Any particular things that a student interested in oncology should be aware of?
4) You talked about lifestyle factors. I understand that it varies tremendously by regions, types of the practice, and so on. But, in general, what type of lifestyle should students expect when pursuing GI/cards/Pulm that might have more procedural factors vs. onco/peds/others that have less procedural aspects? Are they both very similar lifestyles by and large, but different "activities" in the hospital?
5) Can you elaborate more on this: "And that's certainly not to say that other IM fields don't "do" anything for their patients, quite the opposite really." I am interested in oncology, so you can use that as an example if that's easier.
6) What were your typical activities/priorities/obligations outside studying for exams/steps/doing rotations?
7) Anything else about GI that intrigued you, besides relatively more procedures within IM?
Since you were on the admissions committee, what advice do you have on both filling out secondaries and the interview process?
Yikes, those are kind of broad questions.
Fill the secondaries out early, since interview spots go quickly. ...Without more specific Qs, it's hard to say more than that.
As far as interviews, it's probably been reiterated a million times. But when I was interviewing candidates, I was primarily looking for applicants who were well-spoken (you'd be shocked how many pre-meds are not!) and who seemed like they would be fun to work with. I could already see from the applications that they were accomplished, and I think it already goes without saying that you should be professional. But if they could eloquently answer my serious questions, but then also engage in enjoyable casual conversation, it was a win for them. Nerves are certainly forgivable; we all remember how nerve-wracking interviews could be. But if you wound up being just a plain cool person, I could forgive any mis-steps in the interview.
Yikes, those are kind of broad questions.
Fill the secondaries out early, since interview spots go quickly. ...Without more specific Qs, it's hard to say more than that.
As far as interviews, it's probably been reiterated a million times. But when I was interviewing candidates, I was primarily looking for applicants who were well-spoken (you'd be shocked how many pre-meds are not!) and who seemed like they would be fun to work with. I could already see from the applications that they were accomplished, and I think it already goes without saying that you should be professional. But if they could eloquently answer my serious questions, but then also engage in enjoyable casual conversation, it was a win for them. Nerves are certainly forgivable; we all remember how nerve-wracking interviews could be. But if you wound up being just a plain cool person, I could forgive any mis-steps in the interview.
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It might be a very strange question, but what is the typical number of legitimate publications (probably excluding abstracts/posters/etc) that students interested in IM can say, "That's probably enough for top residency programs I want to get into?"
Did you feel entitled/necessary to do research before/after the summer between M1 and M2?
1) How do you find out your most efficient way to study? Is it as simple as a series of trials and errors? Any advice on this?
Definitely a matter of trial and error. Some people learn by reading, some people learn by re-writing everything. I personally learn by speed-reading the same material multiple times, then doing ****-tons of practice qs. College is the time to figure this out. I know premed classes seem difficult, but they're easy compared to med school, so use this time to try a couple styles.
2) Instead of little things, what should we then worry about? Anything else besides step 1, LORs, and clinical rotation grades?
Well, those are the top things to worry about as a medical student, for sure (plus research if you want to go somewhere competitive). For premeds, it's MCAT, GPA, research/clinical experience. Those are the main boxes you absolutely have to have checked.
3) What are your thoughts on oncology? Any particular things that a student interested in oncology should be aware of?
Personally, I'm not a huge fan. I thought liquid onc was really interesting to learn about, but once I spent time treating heme/onc patients, I was less of a fan. Bear in mind, however, outpatient and inpatient onc are VERY different practices. Inpatients are significantly sicker and have a tendency to tank and/or wind up on hospice, while outpatients can be very well-compensated and/or in remission. Two very different patient populations.
4) You talked about lifestyle factors. I understand that it varies tremendously by regions, types of the practice, and so on. But, in general, what type of lifestyle should students expect when pursuing GI/cards/Pulm that might have more procedural factors vs. onco/peds/others that have less procedural aspects? Are they both very similar lifestyles by and large, but different "activities" in the hospital?
Oh gosh, even within each field, once you're an attending, the lifestyle can be so highly variable. I.e. are you mostly inpatient/outpatient? How much of your time is spent doing procedures? For pulm/CC, are you primarily doing ICU time? Even beyond that, how much of your time is spent doing clinical vs. research vs. academic vs. admin?
5) Can you elaborate more on this: "And that's certainly not to say that other IM fields don't "do" anything for their patients, quite the opposite really." I am interested in oncology, so you can use that as an example if that's easier.
Well... I would argue that coordinating treatment plans for a cancer patient, monitoring their responses, managing any complications that could arise, and having to frequently address goals of care and hospice is certainly doing a lot for a patient. Even if you don't have a scalpel or scope in your hand.
6) What were your typical activities/priorities/obligations outside studying for exams/steps/doing rotations?
Having a life outside of medical school, I'd say! In all seriousness, I concentrated my research time during M1 summer. And the nice thing about residency is that if you have the board scores and the strong clinical rotation grades, they really don't give a care if you spent every weekend at a soup kitchen or day-drinking with friends. Killing yourself doing extracurriculars just for an application just wasn't part of my reality in medical school; they play a much smaller role in residency applications
7) Anything else about GI that intrigued you, besides relatively more procedures within IM?
I think the diseases are interesting, quite frankly. The bread and butter (GI bleeds, inflammatory bowel) is fundamentally interesting to me - I should mention, I'm more gut than liver.
I like that the GI system covers a lot of real estate in the body. I also like that there are a variety of pathologies that occur in the GI system (malignancy, autoimmune, infectious, etc.)
Definitely a matter of trial and error. Some people learn by reading, some people learn by re-writing everything. I personally learn by speed-reading the same material multiple times, then doing ****-tons of practice qs. College is the time to figure this out. I know premed classes seem difficult, but they're easy compared to med school, so use this time to try a couple styles.
2) Instead of little things, what should we then worry about? Anything else besides step 1, LORs, and clinical rotation grades?
Well, those are the top things to worry about as a medical student, for sure (plus research if you want to go somewhere competitive). For premeds, it's MCAT, GPA, research/clinical experience. Those are the main boxes you absolutely have to have checked.
3) What are your thoughts on oncology? Any particular things that a student interested in oncology should be aware of?
Personally, I'm not a huge fan. I thought liquid onc was really interesting to learn about, but once I spent time treating heme/onc patients, I was less of a fan. Bear in mind, however, outpatient and inpatient onc are VERY different practices. Inpatients are significantly sicker and have a tendency to tank and/or wind up on hospice, while outpatients can be very well-compensated and/or in remission. Two very different patient populations.
4) You talked about lifestyle factors. I understand that it varies tremendously by regions, types of the practice, and so on. But, in general, what type of lifestyle should students expect when pursuing GI/cards/Pulm that might have more procedural factors vs. onco/peds/others that have less procedural aspects? Are they both very similar lifestyles by and large, but different "activities" in the hospital?
Oh gosh, even within each field, once you're an attending, the lifestyle can be so highly variable. I.e. are you mostly inpatient/outpatient? How much of your time is spent doing procedures? For pulm/CC, are you primarily doing ICU time? Even beyond that, how much of your time is spent doing clinical vs. research vs. academic vs. admin?
5) Can you elaborate more on this: "And that's certainly not to say that other IM fields don't "do" anything for their patients, quite the opposite really." I am interested in oncology, so you can use that as an example if that's easier.
Well... I would argue that coordinating treatment plans for a cancer patient, monitoring their responses, managing any complications that could arise, and having to frequently address goals of care and hospice is certainly doing a lot for a patient. Even if you don't have a scalpel or scope in your hand.
6) What were your typical activities/priorities/obligations outside studying for exams/steps/doing rotations?
Having a life outside of medical school, I'd say! In all seriousness, I concentrated my research time during M1 summer. And the nice thing about residency is that if you have the board scores and the strong clinical rotation grades, they really don't give a care if you spent every weekend at a soup kitchen or day-drinking with friends. Killing yourself doing extracurriculars just for an application just wasn't part of my reality in medical school; they play a much smaller role in residency applications
7) Anything else about GI that intrigued you, besides relatively more procedures within IM?
I think the diseases are interesting, quite frankly. The bread and butter (GI bleeds, inflammatory bowel) is fundamentally interesting to me - I should mention, I'm more gut than liver.
I like that the GI system covers a lot of real estate in the body. I also like that there are a variety of pathologies that occur in the GI system (malignancy, autoimmune, infectious, etc.)
It might be a very strange question, but what is the typical number of legitimate publications (probably excluding abstracts/posters/etc) that students interested in IM can say, "That's probably enough for top residency programs I want to get into?"
There really is no magical number. I had 2 in basic science and 2 in clinical that were peer-reviewed publications. I'm sure I have classmates who have none and classmates who have in the double digits. I would say to be safe, have at least 1 just to check the box. Any more than that is gravy.
Did you feel entitled/necessary to do research before/after the summer between M1 and M2?
Nope, but I also knew I was going to get a pub out of the research I did that summer. And I also have a particular dislike of research so I didn't bother trying to do more.
There really is no magical number. I had 2 in basic science and 2 in clinical that were peer-reviewed publications. I'm sure I have classmates who have none and classmates who have in the double digits. I would say to be safe, have at least 1 just to check the box. Any more than that is gravy.
Did you feel entitled/necessary to do research before/after the summer between M1 and M2?
Nope, but I also knew I was going to get a pub out of the research I did that summer. And I also have a particular dislike of research so I didn't bother trying to do more.
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Which is worse, IM or Gen Surg?
Which IM subspecialties will have the largest cuts to reimbursement in the next 5-10 years?
Which IM subspecialties will have the largest cuts to reimbursement in the next 5-10 years?
I imagine the procedural specialties have the most to lose. Regardless, there are certain specialties in IM that you couldn't pay me enough to do.
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I didn't know that. Thank you for sharing it.
1) Were you not a fan of heme/onc, because patients seemed "too sick" or going to hospice too frequently? Can you elaborate on what your thoughts/feelings were, say, compared to GI patients you loved to treat?
2) About the variables like inpatient/outpatient and etc., can you choose what you want to do as an attending, or are they simply "assigned/given to you?" In other words, can someone say, "I want to have 2 full weekdays a week to do research/academic, while having other days in ICU treating inpatients and preferring procedures?" I want to know how much flexibility it is there.
These are probably my last questions for tonight. Thank you so much again for your time and comments. Many things have been clarified.
EDIT: Okay, I lied. Here's the last one.
Any advice for getting good clinical rotation grades? I've read an article in KevinMD about doing rounds more often to show care and trying the best to gain trust and responsibility from the team, instead of recalling lab values rapidly to "show off" among peers.
D
deleted393595
Uhm...... Do you even lift?
1) Were you not a fan of heme/onc, because patients seemed "too sick" or going to hospice too frequently? Can you elaborate on what your thoughts/feelings were, say, compared to GI patients you loved to treat?
Eh, I guess that was part of it. I don't have a great love for goals of care discussions. And while these are important in every field, they seem to occur more frequently in Onc. Furthermore, onc is a very research-heavy field; there are always clinical trials that you will be enrolling your patients in. And quite frankly, the things that you find interesting in med school will evolve as you progress to clinical practice; I just found other fields more interesting.
2) About the variables like inpatient/outpatient and etc., can you choose what you want to do as an attending, or are they simply "assigned/given to you?" In other words, can someone say, "I want to have 2 full weekdays a week to do research/academic, while having other days in ICU treating inpatients and preferring procedures?" I want to know how much flexibility it is there.
As a brand new attending, you will likely not have the ability to dictate your schedule exactly how you like it. This will also depend on where you wind up working, i.e. academic vs. private. As you become more senior, you will certainly gain more ability to determine your schedule.
These are probably my last questions for tonight. Thank you so much again for your time and comments. Many things have been clarified.
EDIT: Okay, I lied. Here's the last one.
Any advice for getting good clinical rotation grades? I've read an article in KevinMD about doing rounds more often to show care and trying the best to gain trust and responsibility from the team, instead of recalling lab values rapidly to "show off" among peers.
Memorizing lab values, in my mind, is a relatively useless skill, period.
With that said, things that seemed to contribute to my success as a clinical student included:
1) Knowing my patients. As an intern, I appreciate this even more now. When I'm carrying 8-10 sick as **** patients and you as my med student have 1-2, you will most certainly know them better than I do.
2) Putting myself out there. Offer up a plan for every problem you identify for your patient. I want you to show good clinical judgement, but I also want to see that you're just plain thinking and not relying on your residents to decide everything while you sit passively.
3) Kick ass on the shelf. Quite frankly, all your clinical evals will probably be a wash anyway. You'll get some wildly unfairly ****ty ones and some really strong ones that you don't think you deserve. At least in my med school, the people who did the best on the shelves were usually the ones who got honors. Plain and simple.
It really doesn't take being a crazy gunner to do well. You don't need to bring papers every day. You don't need to answer every question correctly. Use common sense, try to help out your interns so that the whole team has a good time, and don't be excessively douchey 🙂
Eh, I guess that was part of it. I don't have a great love for goals of care discussions. And while these are important in every field, they seem to occur more frequently in Onc. Furthermore, onc is a very research-heavy field; there are always clinical trials that you will be enrolling your patients in. And quite frankly, the things that you find interesting in med school will evolve as you progress to clinical practice; I just found other fields more interesting.
2) About the variables like inpatient/outpatient and etc., can you choose what you want to do as an attending, or are they simply "assigned/given to you?" In other words, can someone say, "I want to have 2 full weekdays a week to do research/academic, while having other days in ICU treating inpatients and preferring procedures?" I want to know how much flexibility it is there.
As a brand new attending, you will likely not have the ability to dictate your schedule exactly how you like it. This will also depend on where you wind up working, i.e. academic vs. private. As you become more senior, you will certainly gain more ability to determine your schedule.
These are probably my last questions for tonight. Thank you so much again for your time and comments. Many things have been clarified.
EDIT: Okay, I lied. Here's the last one.
Any advice for getting good clinical rotation grades? I've read an article in KevinMD about doing rounds more often to show care and trying the best to gain trust and responsibility from the team, instead of recalling lab values rapidly to "show off" among peers.
Memorizing lab values, in my mind, is a relatively useless skill, period.
With that said, things that seemed to contribute to my success as a clinical student included:
1) Knowing my patients. As an intern, I appreciate this even more now. When I'm carrying 8-10 sick as **** patients and you as my med student have 1-2, you will most certainly know them better than I do.
2) Putting myself out there. Offer up a plan for every problem you identify for your patient. I want you to show good clinical judgement, but I also want to see that you're just plain thinking and not relying on your residents to decide everything while you sit passively.
3) Kick ass on the shelf. Quite frankly, all your clinical evals will probably be a wash anyway. You'll get some wildly unfairly ****ty ones and some really strong ones that you don't think you deserve. At least in my med school, the people who did the best on the shelves were usually the ones who got honors. Plain and simple.
It really doesn't take being a crazy gunner to do well. You don't need to bring papers every day. You don't need to answer every question correctly. Use common sense, try to help out your interns so that the whole team has a good time, and don't be excessively douchey 🙂
**** yeah I do. Although I'm a chick... so probably not as much as would actually impress you. I probably drink more like a guy than I lift like a guy.
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Does name of the medical school one attends matter as much as Step 1 score concerning getting into a good IM program? Any other insights into that?
They're both pretty important, unfortunately. It's probably unjustified, but it's true.
Applicants from a top medical school with a slightly lower step score can still get interviews at top programs. Applicants from a medium tier medical school will need top scores to get the same interviews. And even if they have top scores, they could still get screwed.
That, at least, has been my experience. I had a lot of comments about the caliber of my medical school during interviews, so I think it worked to my advantage for sure.
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Thanks for the quick reply!! This is definitely food for thought.
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you are perfect
Ha! Thank you?
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Is it true that top schools tend to have more good looking students than non-top schools? I was told that this was the case for Mayo and Hopkins.
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How is dating/relationship in medical school and beyond?
I would just say not to stress about it now. You will have 2 years of preclinical years and then 1.5 years of actual clinical experience to help you make this decision. You could certainly do a little shadowing now in those fields, particularly if you're considering applying to a competitive surgical subspecialty where knowing early in medical school would be beneficial in the application process. But if you're considering gen surf vs. IM vs. ob/gyn, I don't see any great rush to make a decision before you actually experience these fields as a 3rd year.
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This is fantastic to hear. I have been kind of leaning this way (new M1) but it is good to hear the same sort of thought process from someone far ahead in the game. I just got really tired of trying to jump through hoops to get one of the 8 spots a week at the local free clinic when they would be filled ~3 minutes after the email went out.
I am most interested in IM, and would like to match into a top academic program as you have. Out of curiosity, could you give a short list of what the current top programs are in your opinion? And what factors did you like about your current residency that elevated it above the rest (eg call schedule, research focus, mentors)?
Finally, I am also interested in subspecializing (GI was coincidentally where I got most of my shadowing hours as an undergrad), so I am wondering how you feel about doing your IM residency? Is it 3 years that you are just going to suffer through until you get to the field you are really interested in or are you looking forward to it? How will your IM training make you a better gastroenterologist (if at all)?
Ha, not to sound jaded, but the 2 times you work in the local free clinic will make zero impact on your application. I did the exact same thing exactly twice and was never asked about it.
As far as the top IM programs, there are myriad lists in the Internal Medicine forum, and you will hear a lot of back and forth arguments over who's right and who's wrong. I would say that the top tier includes places (in no particular order) like Hopkins, MGH, Brigham, Penn, UCSF, Columbia, Duke, Michigan. That is hardly an all-inclusive list and generated off the top of my head in all of 30 seconds.
As far as residency choices, I heavily considered 3 of the places in that list. Geography played a large role, and I think it does for many applicants. Research focus did not, as they all have research opportunities. Call schedule didn't really play a large role, simply because they're all fairly similar with duty hour rules and because any small differences are probably not enough to sway you towards or away from a program.
The thing that has made my residency so positive thus far has been the quality of my colleagues. It's hard to get a feel for the residents at the program during a single interview day, but if you have any insider info (i.e. you know residents from your medical school), it would be very useful to ask their personal opinion on each program. You will get a very sunshine-y view of each program during the interview day, so it's invaluable to hear honest info from any source you can.
As far as my perspective towards IM as a means to get to GI, there are certainly rotations that I'm less excited about and that I'd be perfectly happy to skip as they will have little bearing on my ability to be a good gastroenterologist. But I do like the idea of being a strong general internist and being able to manage complex patients of all types. Sure, GI is specialized, but it does interact with all of the other systems of the body, and having a strong general medicine background will only make you a stronger clinician and give you the skillset to become a strong gastroenterologist.
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Hey thanks a lot for doing this, it's really helpful. I'm glad to hear about the lack of emphasis on extracurriculars outside of school. It makes complete sense, as residency directors are looking for employees who are good at their jobs and good co-workers to fit in with their team of physicians, which has little to do with how much you volunteer at a soup kitchen or whether or not you ran an interest group or started a nonprofit. I always thought this was the case, mainly from reading on SDN, but it is tough to keep that mindset of "do well in school, but have fun outside of it" when everyone is competing to get into the free clinics/trying to get elected to head student orgs etc, etc (not to mention complaining about how they do nothing but study/volunteer all day and never have any free time). Makes me feel a lot better about focusing on nothing but school and research as far as "productive activities" while making sure I enjoy my free time outside of that (keeping up with my hobbies/starting new ones, seeing my SO every weekend, volunteering at places I really want to, drinking after every quiz...).
Just a few more questions: do you have any recommendations as far important factors to look for in a residency? I know you said try to get a feel for the residents you will be working with, and that call schedules/research focus didn't really matter. Do you have any other suggestions? Anything you realize is important to you now that you didn't think of before you started your internship? I do know geography will play a big role for me, as my SO will match a year before me (likely into IM as well).
Also could you explain what you mean by having some rotations you aren't looking forward to? What rotations does the average IM resident have to cycle through, and about how much time do you spend on each one? The whole "being a resident" concept is still pretty nebulous to me.
Thanks again!
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Just watched a video on HuffPost about doctor burnout. There was an older doctor talking about working 126 hours/week (before restrictions). I know now it's not allowed for you to work that much but you're still working at least 80 hr/week right? Could you explain what that's like and if you work on weekends?
When you're looking at which residencies to apply to, most people initially break it down by:
academic vs. community (most top programs are academic)
geography (visit the city and see if you would actually be able to live there for 3 years)
and then everything else is sort of a soft factor and personal. For example, some people really care about international medicine and having the ability to do rotations abroad. My residency, quite frankly, is not that strong in this area. Other people look for hotshots in the subspecialty they're looking to match into; personally, I did not. And then as I said, the feel you get from the residents, either from the interview day itself or, ideally, from an insider source.
Things that people seem to emphasize but in the end, I don't personally think make much of a difference are:
call schedule
caps (i.e. max # patients you carry)
Things that I'm now recognizing do have a role in my day-to-day happiness are how the block schedule is arranged; i.e. does the program have a 4 and 2 or 6 and 2 schedule. This means every 4-6 blocks of inpatient is followed by 2 weeks of inpatient. Helps to break up the q4 call months with a couple weeks of 9-5 with weekends.
As far as rotations you'll go through, some places (i.e. my residency) are very subspecialty heavy. Others are less so. Everyone will do MICU time and gen med time. We seem to spend a lot of time on subspecialty services (Cards, GI, Renal, Onc) over just plain gen med time. You learn a lot and get really good at managing rarer things and really sick patients. But there are certain services that I just find less interesting than GI.
80 hours per week is supposed to be the max, and you're supposed to get on average 1 day off in 7. Personally, I've never broken duty hours. I anticipate it may happen once or twice over the course of intern year. But it hasn't happened yet.
Some weeks are more tiresome than others, but for the most part, intern year really hasn't been bad at all. Working 80 hours/week when you're doing real work is significantly less annoying than just languishing in the hospital as a med student just to show face.
And yes. We work weekends. One day off on average in 7 but with the occasional golden weekend (i.e. real weekend with both Sat and Sun off). You get used to it.
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Do you really really like GI or is it that nice income? I have been to that type of doc a couple of times, they mostly see elderly people (colonoscopies). Maybe I'm just scarred for life after getting an upper endoscopy done and I dislike that specialty. 🙄
Wow. That's quite an accusatory tone to take with someone who you don't know about a topic that it seems you've had fairly limited, albeit personal, exposure to. I've already explained my affinity for GI in the above posts. I'm happy to answer more specific questions or offer more details if that is what you're looking for. Otherwise I'm not sure what else I can offer you.
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Ha! We could have a matching set of loans. That's almost as cute as matching Volvos, right?
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When did getting drunk define fun? lol ok I'll take you out to dinner and show you a good time.
Graduated some time in May. Started mid to late June. That's pretty typical timing.
Forgot to mention one other actually INCREDIBLY important thing, and that's being AOA.
If you go to a middle tier school and you want to go to a top tier IM program, you better bust your ass to be AOA (usually a combo of Step 1 scores and clinical rotations).
****, even coming from a top tier med school, being AOA opened a lot of doors for me.
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I see some people saying that same thing about AOA, but I also see others saying that AOA is redundant. If you have the grades, the step 1, the research, etc to be eligible for AOA, then having it or not is pointless. Everything that AOA is based on is already in your ERAS, so a lot of residencies don't even really care because they can already judge a person based off the same achievements.
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uh...what is AOA?
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Alpha Omega Alpha. It's this med school frat that's really hard to join. To pledge, you need to go through a lot of hazing and poop related activities. You need to sit outside their frat house for a few days etc. But man, once you're in, you get to spend all of med school totally loaded. The head of the frat's dad is like in with a lot of residency directors, so if you're a brother, you can pretty much get in anywhere.
