Combined IM vs. IM programs - advise?

[pujllay]

Hello:

Newbie posting. I am a 3rd yr med student and I am in the process of learning about residency programs. I am interested in IM with subspecialization either in cardiology, emergency medicine or genetics. I've seen several programs that offer combined training and I wanted to ask people - resident, fellows - about the experiences or observations of these programs.

I am a little older, with a family and a big loan to repay. I would prefer to enter a program that is shorter and offers me a specific training of my interest.

These are some of my questions:
What are the major/not so obvious drawbacks/benefits of these combined programs? Is it easy to transfer if for whatever reason I don't like the program? What do I need to do different now to make myself better candidate for these programs?

I will greatly appreciate any responses and help. Thanks in advance.

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[NeedMyCoffee]

There are programs that combine Internal and Emergency Medicine. The combined training takes 5 years and rotates you every 3-6 months between the two specialties, so that at the end of it, you are eligible for board-certification in both specialties.

These programs are few in number, and relatively more competitive than either specialty on its own. The PDs usually look for a strong commitment to both specialties, and strong reasoning for wanting to pursue combined training. You would need strong letters of recommendation from faculty in both specialties. The upside of doing these has been discussed in several threads on the EM forum, but include being eligible for fellowships in available to both specialties, and a strong basis to pursue an academic career.

One of the downsides is that your colleagues in non-combined residencies will graduate in their respective field ahead of you, which some people dislike. Also, there's a longer time commitment.

Similarly other combined programs exist for example Med-Peds. I'm not too familiar with the others, but whichever one you choose, you'd need to provide a strong reasoning for pursuing that track and have done electives in both specialties so that you can get the letters.

I hope this helps. Good luck!