Differences in IM residencies

[arc5005]

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Can anyone please explain differences in IM residencies, please. I've seen comments on these forums that post-merger, IM is going to be more difficult for DO students to match into, but that "community IM" will still be okay to match into for those without red flags/decent stats. What exactly does this mean -- what is the difference between non-community IM and community IM? Is non-community IM, like IM programs at larger universities/larger hospitals?

I see so many DO grads matching into IM from difference DO programs, so I assumed it wasn't a difficult match, but now I'm wondering if most of those programs were community IM programs and not "whatever non-community IM programs are." What are the differences in the actual residencies? Do community IM programs teach differently? do they prepare their residents similarly? is it a subpar residency for IM? Is it more difficult to get into a fellowship from a community IM program? Does community IM just prepare you to be a internist or hospitalist?

 

[NITRAS]

Community IM programs usually work at a smaller hospital where your consultants are not in training.

If you want to become a specialists, you should try to avoid a community program and go to an academic center.

I went to a busy community program. I now work in a tertiary center. I came out with a lot of experience. I could manage a vent pretty darn good. I didn't have as much experience with specific specialists or dealing with fellows. The patients are, on average, less complicated. I also now see quite a few more zebra diseases. The third week of my PGY2 year, I was alone at night in the ICU with only the ED attending or my attending by phone to bail me out. At the current institution, only PGY3s do nights, and they are suppose to wake the PCCM fellow for admits.

I think my training was very good. Probably not as broad as an academic center, and often times many of the specialists were a bit behind on guidelines.

Again, if you have any interest in a competitive fellowship, go to an academic institution. The opportunity for more diverse pathology, research opportunities, and connections with fellowship directors is invaluable. If you want to be a hospitalist or a PCP, in some ways you get better experience as you don't have to compete with fellows for everything.

 

[AlbinoHawk DO]

You basically got it down. It's smaller hospitals vs academic centers.

Not all community programs are created equally. Some of them will have insane pathology and hard work. I've seen better doctors come out of Arrowhead than UCI. Other community programs are weaker.

As you can probably imagine, university programs will always have the upper hand if your goal is fellowship. I don't think DOs will necessarily be displaced entirely from universities, but I think you'll have to work a bit harder to get there (e.g., audition rotations).