Hey guys.
I'm a PGY-1 IM guy and just got interested in some Wilderness Medicine and/or Toxicology. I realize these are currently boarded through EM. I wonder if anyone's had any experience with doing these through medicine (and maybe taking extra courses/rotations for learning the peds and ob stuff)? Also are fellowships possibly flexible on this? I just got into extreme weather medicine and would like to get into it. Any help would be amazing.
Thanks.
Wilderness medicine is not an ACGME accredited fellowship, so the program can technically take whomever they want. As transmogrifier said, most have you working in the ER to help fund your fellowship. It would depend on the individual fellowship director to figure out how flexible he wants to be/can be in trying out alternatives. I think it's possible but it will require a lot of leg work. Start early. Email all the fellowship directors and ask if they would ever consider taking an IM residency graduate. I bet you can find someone to do that. The list of fellows of the academy of wilderness medicine (
http://wms.org/fawm/fellows.aspx) has people boarded in IM and orthopedics, so some people succeeded. Maybe try reaching out to those people too.
Toxicology is ACGME accredited, so things are a little stricter. However, technically the base specialty requirement just says who can be board certified after completion of the fellowship, not who they can take (same way ER docs have been doing critical care fellowships for years, but only recently have they had the option to be board certified at the end of the fellowship). Potentially you could do a fellowship, but then not be board certified. Unfortunately, this would mean you would have trouble getting work at a poison center. EM residencies would not hire you as faculty given that you are IM. IM residencies would not be particularly interested in your tox training. Over all, it would seem like doing a tox fellowship, even if you could get into one, would simply be not worth it.
Even if you don't succeed getting into a fellowship, you can continue to explore and develop your interest in these niches. Read the journals, become a member of their professional societies, collaborate on research with people at/near your institution who are already in these fields, attend conferences/research meetings. You don't necessarily need to do a fellowship to develop and enjoy these niches.
