competitive IM fellowships

[prominence]

id like to see how people would rank the various IM subspecialties in terms of the difficulty in obtaining fellowships.

(i.e. cardiology = #1 hardest IM fellowship to get, GI =#2, allergy =#3.... endocrine =#10, rheumatology = #11, etc, etc.)

hope to see the various opinions. thanks.

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[standoc]

Bump,

I'm very curious about this myself...I have an interest in interventional cardiology but i imagine this is very challenging to get admitted to.

Standoc

 

[DR]

Well, from what I have seen thus far, at this very moment I'd put GI in front of Cards as far as being tough to get into. This is from what I have seen, and from the fact that there seems to be less spots for GI in the US. But I think this is a snapshot because the situation is changing as time goes on. Plus I think it depends on where you train...I think at some programs, it isn't as hard to get a cards spot, let's say, than at other places.

 

[task]

The most competitive IM fellowship to get into is Allergy, based on numbers (60 spots nationally with more and more people applying each year). Of the "glamour" specialties, GI is the most competitive to get compared to Cards. Bottom line, there are only 200-250 spots in GI compared to (at least) 650+ spots in Cards.

BTW, for the poster interested in Interventional -- reimbursement for Interventional has taken a huge hit in the last two to three years. Be sure this is what you want to spend your time doing on a daily basis before committing to at least 8 years if not more of training. A lot of folks I know who had Interventional spots intitially have decided to opt out and do General Cards (diagnostic cath) once in practice because of the realities of the real world.

Food for thought.

 

[task]

Oh, so as a result, interventional spots are getting easier to get (still tough, but not as bad as a few years ago).

 

[Lara]

Where does endocrinology fit in? I rarely hear it mentioned and I presume it's less competitive than GI or cards, but aside from that I don't have much of an idea...

 

[Rigomortis]

I suspect it's just above Rheumatology, one of the few specialties where you actually take a hit in salary after specializing 🙁

 

[Behcet]

on the whole you're probably right about Rheum..BUT...some have found a niche doing infusion therapy and making a decent living at it

 

[Rigomortis]

Originally posted by Behcet
on the whole you're probably right about Rheum..BUT...some have found a niche doing infusion therapy and making a decent living at it

Hope so, cause it's at the top of my list these days!

 

[june015b]

1. GI

2. Cardiology

and the rest of them.....

Probably, the easisest one is geriatrics.

 

[MastaP]

This is not based on any real evidence

1. GI
2. Cardiology
3. Pulm/Critical Care
4. Allergy/Immunology
5. Nephrology
6. Heme/Onc
7. Rheum, Endocrine, ID, Geriatrics, etc (These are all grouped together because they all make less money than a regular general IM doc)

 

[Kalel]

I'd put allergy up there with GI, maybe even above cards, just because there are so few positions out there. It's definitely more competetive then pulm/CC. An allergist explained to me how fellowship spots are created, and he was telling me that the reason that there are so few allergy and derm spots is because in-patient hospitals and their execs (where most residency spots are) don't really need either specialty, and therefore don't provide the funding for them.

 

[Mav]

I'll throw a politically incorrect thing out there on this.

Even though Allergy, numbers-wise, looks the most competitive, it doesn't seem that the most competitive applicants are applying to allergy. It seems the rock stars in programs are shooting for GI and cards.. so in reality, a strong applicant in GI should compare better against the competition in allergy.

 

[johnd]

Originally posted by Mav
I'll throw a politically incorrect thing out there on this.

Even though Allergy, numbers-wise, looks the most competitive, it doesn't seem that the most competitive applicants are applying to allergy. It seems the rock stars in programs are shooting for GI and cards.. so in reality, a strong applicant in GI should compare better against the competition in allergy.

I agree. This is like the people who say that vet school is more competitive to get into than medical school because there are fewer spots. You have to take into account the strength of the applicants AND the number of spots to determine how competitive a field is. Some fields just attract a more competitive applicant.

 

[Kalel]

Well, I don't have too many statistics to back up my statements, but I still think that allergy is really competetive even after you figure in the selection bias that goes into GI and cards. Many top IM residents just don't want the lifestyle associated with GI and cards; allergy is a 9-5 job with no call and above avg salary (225K or so). I think that the reason that fewer residents talk about going into allergy is that most universities don't even have an allergy department or allergy faculty, so they never even consider it as a career. Those that have been able to secure positions from my school have been pretty competetive applicants.

 

[Hairy Man]

1. Cards = GI
3. Allergy
4. Pulm/CC
5. Hem/Onc
6. Nephrology
7. ID
8-10. Endocrine, Rheumatology, etc.

First, the number of nephrology applicants has increased at many programs, making it more competitive than before. Pulm and Hem/Onc are moderately competitive and deserve to be ranked just below the undisputable top 3.

 

[dochuffman]

when you guys say competitive do you mean like most people won't get into Cardiology or GI?

 

[governator]

anybody know what the ballpark figures are for subspecialty salaries in SoCal? GI? Cards? Allg? Hem/onc? endo? critical care?

 

[Kalel]

Originally posted by dochuffman
when you guys say competitive do you mean like most people won't get into Cardiology or GI?

The university programs that I interviewed claimed that some 80-100% of their applicants were accepted at GI or Cards programs somewhere in the country. When asked, residents and PD's denied discouraging non-competetive applicants from applying, but I'm sure that there is still some self-selection going on before people even apply (eg non-competetive applicants won't bother applying).

 

[DrIM]

Guys I got following stats from NRMP website from previous year match results ( I arranged them in tabular form)

Specialty----------------------US ------------Foreign
------------------------------------------------------------
Cardiovascular Disease--------64%----------22%
Infectious Disease------------ 53%--------- 33%
Pulmonary Disease--------------5%-----------74%
Pulmonary Disease/CC----------57%---------27%

Surprisingly only three sub specialities are participating in the match, other than these three none of them participating in match.

However, as far as I know competition as following order

1 Cards ( for each slot they are getting 400-600 applications)
2 GI
3 Hem/Onc
4 pulm/CC
5 Renal
6 ID

I don't know about Allergy where it falls between those, but for sure not on top two

 

[Kalel]

ckent/I have written those stats (including allergy and the rest of the fellowships) from JAMA 2003 in his/my FAQ on the top of this page.

 

[task]

I would still say Allergy is most competitive. There are only 60 spots nationally, and Peds and IM residents both apply to the same spots because you get double boarded to take care of kids and adults. Coming from Parkland, I can say with full certainty that many of our top residents apply to Allergy, folks who would be very competitive with those applying to GI or Cards.

Only Cards, Pulmonary and ID are in a match. The rest of the subspecialties never had or dropped out of the match.

GI is probably more competitive than Cards by a small margin. GI slots are fewer in # (250 or so) compared to the 600-700 in Cards, and there are just as many folks applying to GI as Cards -- this year at Parkland we had about 10 GI and 12 Cards, more than compensating for the difference in the # of spots between the two fields.

 

[june015b]

At my medical school's IM program, everyone who applied for cardiology matched to their top titer choices last year. But ~ 25% of people secured GI spot last year. GI is out of match and has fewer spots than Cardiology.