Categorical vs Primary IM

[abu barney]

Hey peoples,

I want IM, and I want a fellowship afterwards (Onco or ID), but I was thinking of doing a primary care IM residency for the benefit of being the more well-rounded physician. I also hope to work a year or two or three after the basic IM residency. How does all of this (primary care and working for a couple of years) fare with getting a nice fellowship spot.

Also, what are the key factors for obtaining a good fellowship position? Reputation of IM program, research, contacts, etc???

Thanks.

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[rtk]

abu barney;

All medicine fellowships have gotten more competitive in the past 2-3 years. Cardiology and GI have always been competitive, but recently, those subspecialties that were a 'sure-thing' such as heme/onc and ID are becoming quite competitive. Much of this competition can be traced back to a change in percieved (and actual) demand for primary care. The pendulum has swung back to suspecialization and 75-80% of IM grads are gunning to subspecialize.

Don't know what'll happen in 3-4 years when you've finished residency, but it'd be a good idea to be as competitive as possible. With that in mind, my advice would be to do your residency at a University program, preferably a program that offers a fellowship in the area you're interested and do medical research in your area of intererst (with the goal of publication). You can get a fellowship after doing an IM primary care track residency, but it may be percieved that you're not sure of your interests and may not be committed to (insert subspecialty). One cavieate to this would be if you planned to subspecialize in an field that was primarily outpt based such as rheumatology...

Good luck with your plans.