One last thing is that combined programs are slightly easier to get into. Apollyon
I certainly do not agree with this statement and I am wondering by what path you came to this conclusion?
Are you applying to the programs? Do you have first hand experience?
I am certainly not saying that these programs are more difficult than straight EM. They are equally difficult in their own right.
The EM/IM programs have similar ratios of applicants to spots as the EM programs, and some such as LIJ have in the past have had up to 200+ applicants for 2 spots. That ratio is much higher than the normal EM application:spot ratio.
On average,I would say that EM/IM programs receive between 50 -100 applications depending on the program and location. Most interview 15-25 prospective residents.
Being a part of the present recruiting process, I know that those who received interviews are excellent candidates (LORS, high boards, top evals, and excellent personal statements) and would have no trouble getting interviews and spots at top tier straight EM or IM programs. Atleast at our program, the personal statement was used to help identify those who really showed a specific interest in IM/EM. At my program, the residents have a strong say in the future of the program, because we are a tight knit group and are dedicated to continually strengthening the program.
At present, there are 9 allopathic programs in the US, with news of a potential 10th (not confirmed). The programs are University of Maryland, Univ of Illinois at Chicago, Long Island Jewish Medical Center/Albert Einstein University, UCLA Olive View, Christiana Care--Delaware, Louisiana State Univ/Charity program, Henry Ford Hospital--Detroit, Allegeny Hospital--Pittsburgh, and SUNY Brooklyn.
All programs take 2 new residents per year, with the exception of Christiana which has 3 residents per year, and SUNY Brooklyn which has 6 new residents per year. This is a total of 23 spots in the US for EM/IM. There are also Osteopathic EM/IM programs but I know very little about these programs so I will defer questions to those involved with those programs.
As for career choices for the graduates, the sky is the limit. The training allows graduates to enter academic careers in both EM and IM. Fellowships and combined EM/IM positions are also a possibility. It varies from program to program the ratios of EM, IM and EM/IM positions. My program, UIC, originally had most residents entering into EM positions, but as of late we have begun to send residents into critical care positions, EM/IM combined positions and atleast one of the present residents wants to do an IM fellowship (cards).
there aren't a lot of fellowships for (like critical care medicine, especially, where you can become board-certified - EM CCM fellowships are not yet accredited). Apollyon
I disagree with this statement.
IM/EM grads are able to enter both EM and IM fellowships without difficulty and with the potential for full board certification. We are not limited in our choices.
For example within EM (Tox/EMS/International EM) and IM (cards, pulm/Crit care, GI, nephro, endo, rheum, heme/onc, geri, ID, etc...) are all available to the grads. Second of all, a straight critical care fellowship is available with full board certification based on the IM trainind and ceritification. Yes, EM is not at present able to become board certified in Crit care but the EM/IM grads can without difficulty with the dual board certification. Furthermore, some programs, specifically mine is able to have their residents enter into a 6th year Critical care fellowship and forgo the 2nd year of training. EM/IM grads get very extensive critical care training between 10-12 units in 5 years (micu/ccu/sicu/picu/nsicu/nicu/ctcu) are all possible training sites and each program varies which units there residents rotate through and the number total for 5 years.