lawj

10+ Year Member
Jul 28, 2005
71
0
241
The vast Midwest
Status
Resident [Any Field]
Hi all,

Seriously considering pursuing a critical care fellowship after EM residency, preferably an Internal Medicine CCM fellowship so that I can become board certified. My question is, will place of residency matter when it comes time to applying for fellowships? Will a four year program be looked on more favorably than a three year program? Will the amount of exposure to critical care rotations during residency be important?

Thanks.

ps -- Don't know if this is better asked here or in the Critical Care forum. Figured I would start out here first.
 

southerndoc

life is good
Moderator Emeritus
Lifetime Donor
15+ Year Member
Jun 6, 2002
11,908
867
381
Atlanta
Status
Attending Physician
A 4-year program will probably give you a slight advantage. Considering that the vast majority of programs are 3-year programs, I don't see it as being a huge advantage to attend a 4-year program.

Names also mean a lot, and since you're applying outside the standard EM field, big name hospitals might mean more than big name EM programs. Most IM CC fellowship directors wouldn't know that Cincinnati is a top EM program.
 

J ROD

Watch my TAN walk!!
Lifetime Donor
10+ Year Member
Aug 1, 2005
58,227
1,968
281
working on my tan......
Status
Resident [Any Field]
How does that work?

I really like EM and want to do it for some time but also would like to move into CC eventually after 10-15yrs....

Is EM a viable route to CC yet? Also, can you jump from EM into an IM CC fellowship?

Just trying to learn.....thanks.
 

RxnMan

Who, me? A doctor?
Moderator Emeritus
10+ Year Member
7+ Year Member
Jan 13, 2006
4,112
15
141
Somewhere in time and relative dimensions in space
Status
Medical Student
ABIM and ABEM Reach Agreement on ABEM Co-Sponsorship of IM CCM

We are pleased to announce that we have achieved an agreement with the American Board of Internal Medicine to become a co-sponsor in IM Critical Care Medicine. This means that our residents will have access to training in two-year critical care Internal Medicine sponsored fellowship programs upon completion of their Emergency Medicine residencies. Following successful completion of the fellowship, they will be able to become certified in Internal Medicine Critical Care Medicine.

At this time, the only route to Critical Care Medicine certification for Emergency Medicine physicians is through Internal Medicine based fellowships. Both the American Board of Anesthesiology and the American Board of Surgery have indicated that they are not interested in pursuing a similar agreement. We continue to hope that in the future this may change and will continue to work with both boards as opportunities arise.
From here.

sourthern makes sense: if a completely new crop of applicants with unknown quality of credentials suddenly applied to fellowships, the CC PDs would likely rely on what they knew to be good institutions (for IM).

I would guess that LORs from known CC faculty would also have an impact.
 

gutonc

No Meat, No Treat
Staff member
Administrator
10+ Year Member
Mar 6, 2005
17,930
10,704
481
Status
Attending Physician
sourthern makes sense: if a completely new crop of applicants with unknown quality of credentials suddenly applied to fellowships, the CC PDs would likely rely on what they knew to be good institutions (for IM).

I would guess that LORs from known CC faculty would also have an impact.
I think the LORs are going to take an EM trained physician a long way in this setting. Getting a solid LOR or 3 from IM/CCM docs is the way to go until this pathway gets better established.
 

southerndoc

life is good
Moderator Emeritus
Lifetime Donor
15+ Year Member
Jun 6, 2002
11,908
867
381
Atlanta
Status
Attending Physician
European ICU boards are open to U.S. trained ED docs and allow work in a U.S. SICU (at least at academic institutions) according to a couple of examples that i am aware of, including one at my med school. This pathway may be closing, however, in light of the ABEM/ABIM deal reached within the past year.
Sorry, I meant by an American board. You're correct that you can get certified through the European boards.
 

dmitrinyr

Senior Member
10+ Year Member
15+ Year Member
May 25, 2003
835
3
0
Visit site
Status
Attending Physician
Can someone do an EM residency and work for 10yr and then go back and get the IM CC fellowship?

Just wondering about having a gap like that between residency and fellowship....
Why would you want to do that? I'd think that after that many years of being an attending you wouldn't want to be a resident/fellowship again. Still, I'm curious as to the answer myself?
 

J ROD

Watch my TAN walk!!
Lifetime Donor
10+ Year Member
Aug 1, 2005
58,227
1,968
281
working on my tan......
Status
Resident [Any Field]
Why would you want to do that? I'd think that after that many years of being an attending you wouldn't want to be a resident/fellowship again. Still, I'm curious as to the answer myself?
Might get tired of all the nights....etc....want something new...

Plus, I have a few other personal reasons....

I am more curious than anything to see how this works....options that are available....
 

dmitrinyr

Senior Member
10+ Year Member
15+ Year Member
May 25, 2003
835
3
0
Visit site
Status
Attending Physician
Might get tired of all the nights....etc....want something new...

Plus, I have a few other personal reasons....

I am more curious than anything to see how this works....options that are available....
Are you referring to working as an EM attending for 10 years and then possibly doing a CC fellowship in order to be a full-time CC attending or CC part-time while being an EM doc? I understand that a person might get tired of doing nights/weekends in the ED, wants to try something new, or maybe for another reason my want to try CC.

I doubt that there is a strict period after which you cannot do a fellowship or another residency. As long as you can find a fellowship program that's willing to take you and you are willing to do fellow/resident hours, then you'll be OK.

I know people that did one residency and then applied and got into another residency and finished that up. Same reasoning... as long as you can find a place to give you a spot, you'll be OK.

Still, if you think you might want to do CC someday, just do a CC fellowship right after finishing EM residency. Then, if you want to work as a CC doc parti-time or wait a few years to work in the ICU, you can do that. I'm curious though if the will let you be a CC attending if you have not done CC for 10 years after fellowship (I'm sure you can find a place that would let you work as long as you show that you've been keeping up with the up-to-date knowledge). Just my 2 cents.
 

pinipig523

I like my job!
10+ Year Member
15+ Year Member
Jan 7, 2004
1,320
22
251
Missing Chicago
Status
Attending Physician
2 questions:

1. So when does this CC fellowship officially a part of EM accepted subspecialties? I looked on ABEM and it is not listed on their fellowship link.

2. Are we able to apply to any and all CC IM fellowships?
 

MSmentor018

Hooah!
10+ Year Member
Jul 9, 2007
1,199
239
281
it's always hot!
Status
Attending Physician
2 questions:

1. So when does this CC fellowship officially a part of EM accepted subspecialties? I looked on ABEM and it is not listed on their fellowship link.

2. Are we able to apply to any and all CC IM fellowships?
have you looked into EM ran CC fellowships? I interviewed at st lukes-PA for EM residency and that was a selling point for the program. also I believe beth israel has one??
 

pinipig523

I like my job!
10+ Year Member
15+ Year Member
Jan 7, 2004
1,320
22
251
Missing Chicago
Status
Attending Physician
have you looked into EM ran CC fellowships? I interviewed at st lukes-PA for EM residency and that was a selling point for the program. also I believe beth israel has one??
That's the thing, I cant or don't know where to find this information...
 

MSmentor018

Hooah!
10+ Year Member
Jul 9, 2007
1,199
239
281
it's always hot!
Status
Attending Physician

pinipig523

I like my job!
10+ Year Member
15+ Year Member
Jan 7, 2004
1,320
22
251
Missing Chicago
Status
Attending Physician

gutonc

No Meat, No Treat
Staff member
Administrator
10+ Year Member
Mar 6, 2005
17,930
10,704
481
Status
Attending Physician
That fellowship page for St. Lukes looks to be old. It is for european certification, I want the newest info with american certification.
It was only approved like 2 months ago. Relax...the info will come.
 

7starmantis

10+ Year Member
Jul 10, 2008
8,453
4,533
281
Three Sheets to the Wind
Still, if you think you might want to do CC someday, just do a CC fellowship right after finishing EM residency. Then, if you want to work as a CC doc parti-time or wait a few years to work in the ICU, you can do that. I'm curious though if the will let you be a CC attending if you have not done CC for 10 years after fellowship (I'm sure you can find a place that would let you work as long as you show that you've been keeping up with the up-to-date knowledge). Just my 2 cents.
This interests me. What do you think is the "normal" job outlook for someone after this CC fellowship? Are people really working both at the same time? I mean working the ER and rounding ICU or something? Just curious. Or are most looking at transitioning at some point to only CC ?
 

dmitrinyr

Senior Member
10+ Year Member
15+ Year Member
May 25, 2003
835
3
0
Visit site
Status
Attending Physician
This interests me. What do you think is the "normal" job outlook for someone after this CC fellowship? Are people really working both at the same time? I mean working the ER and rounding ICU or something? Just curious. Or are most looking at transitioning at some point to only CC ?
There are attendings that work both CC and ED shifts. Some do 2 weeks in ED and then 2 weeks rounding in ICU and being on-call. Some do one more often than the other. It matters on the person, their preference and the type of hospital they work at. Both can be done at the same time.

I also know attendings that are both EM and IM certified that work part time as an EM attending and part-time as an IM hospitalist.

I know surgical attendings that work at a very busy ED as an attending on the "surgical/trauma" division of the ED and then works 2-3 days/week as a full-time practicing surgeon with OR time and clinic time.

This is just from my personal experience.
 

Pure Anergy

10+ Year Member
7+ Year Member
Jun 25, 2008
169
10
151
Status
Attending Physician
Hi all,

Seriously considering pursuing a critical care fellowship after EM residency, preferably an Internal Medicine CCM fellowship so that I can become board certified. My question is, will place of residency matter when it comes time to applying for fellowships? Will a four year program be looked on more favorably than a three year program? Will the amount of exposure to critical care rotations during residency be important?
Hi lawj,

I'm interested in doing CC also. It's still such a new path for EM that I don't think anyone can really say at this point how much all those things will matter. To me it makes sense to apply to where you think you might want to do your residency and rank the programs the way you like them. Doing well in residency and getting good LORS might end up mattering more than any of the other things you asked about.
 

MSmentor018

Hooah!
10+ Year Member
Jul 9, 2007
1,199
239
281
it's always hot!
Status
Attending Physician
Hi lawj,

I'm interested in doing CC also. It's still such a new path for EM that I don't think anyone can really say at this point how much all those things will matter. To me it makes sense to apply to where you think you might want to do your residency and rank the programs the way you like them. Doing well in residency and getting good LORS might end up mattering more than any of the other things you asked about.
name of residency is the determining factor but getting your face in and working hard would be much better so yeah, going to a residency that has a fellowship is always in your best interest. getting LOR's, someone picking up the phone...etc. at least that's what they sold me during interview season