- Joined
- Oct 21, 2009
- Messages
- 324
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- 15
Hello,
I am not exactly sure of where to post this. I asked for permission to get into the practicing physicians but have not been responded to. I am looking for a possible "reality" check and since many of you are learned individuals, I value the opinion of several posters on here. I am currently 33 yo, I graduated at an FM residency this past July. I did not choose the IM route prior because our experience was not that great and I was not exposed to CC at that time. Long story short, the residency that I graduated was an unopposed residency. I did over 13 months of inpatient medicine, we ran surgery and trauma's in the hospital, and I have 4-5 months of ICU time (I chose elective time in there). I graduated with an interest in CC and they elected to keep me on as a "fellow" in their ICU because of how competent I have been. I have over 30 excel pages of procedures that I have done just from residency. Central lines, arterial lines, intubation, ventilator mgmt, thoracentesis, paracentesis, chest tubes, lumbar punctures, thoracotomies (Yes, you read that right, I have 5 of these under my belt), transvenous pacers, swan-ganz catheters, and therapeutic bronchoscopies. I literally do most everything myself. Since I graduated I have worked in our ICU for 1 week/month as my "fellowship." COVID hit. I have been working in COVID ICU units from California to Texas, and to WV. There was a time in December I was a night doc to relieve the ICU physician in Texas because they only had one ICU physician on for 7 days/24 hours and I went into help for the COVID response. This hospital had converted not one but all 6 of its floors to ICU floors. Since there was only one CC doc on, this meant that we were regularly running anywhere between 40-70 ventilators at any one time. At least 3 Code Blues every night (interestingly all of the cardiac patients who came in same day is what it felt like). What I am trying to say there is that I didn't need the help of the CC physician or consultants. As I came to the east coast, there is much more malignancy against FM trainees for whatever reason, I get it. Everything is very specialized on the east coast to where it feels that the specialization works against itself. I digress, perhaps another time I will vent further. Anyways, I have found that I really enjoy CC and I have never really grasped onto outpatient medicine. Although, I do feel like it is the most important field, (Go ahead and argue with me on that) I am caught between this and the lack of opportunity for people that come from an unopposed FM residency and try to further themselves in a respected field. This was a long winded diatribe in order to hopefully reach out to see if there has been anyone in the same situation. I have contemplated going back and doing another residency (IM I would think), but the idea of redoing residency is very daunting and I hate the construct of residency. It would be nice to segway of having FM residents who meet certain criteria allowed to do fellowship in CC. However, it seems that the ABIM has been hesitant to do this. I am looking to see if there are any other options that people may have found out there (i.e. possibility of practicing underneath the "umbrella" of other CC physicians). The other caveat to this is that if I go back to do residency there is no guarantee I would make it into CC. I abhor research and my steps are not that great (208/222) step1/2 respectively. Perhaps this is just a venting thread. But, I am looking to see if anyone else has been in the same situation. Thank you all for taking the time to read this and I look forward to your response!
I am not exactly sure of where to post this. I asked for permission to get into the practicing physicians but have not been responded to. I am looking for a possible "reality" check and since many of you are learned individuals, I value the opinion of several posters on here. I am currently 33 yo, I graduated at an FM residency this past July. I did not choose the IM route prior because our experience was not that great and I was not exposed to CC at that time. Long story short, the residency that I graduated was an unopposed residency. I did over 13 months of inpatient medicine, we ran surgery and trauma's in the hospital, and I have 4-5 months of ICU time (I chose elective time in there). I graduated with an interest in CC and they elected to keep me on as a "fellow" in their ICU because of how competent I have been. I have over 30 excel pages of procedures that I have done just from residency. Central lines, arterial lines, intubation, ventilator mgmt, thoracentesis, paracentesis, chest tubes, lumbar punctures, thoracotomies (Yes, you read that right, I have 5 of these under my belt), transvenous pacers, swan-ganz catheters, and therapeutic bronchoscopies. I literally do most everything myself. Since I graduated I have worked in our ICU for 1 week/month as my "fellowship." COVID hit. I have been working in COVID ICU units from California to Texas, and to WV. There was a time in December I was a night doc to relieve the ICU physician in Texas because they only had one ICU physician on for 7 days/24 hours and I went into help for the COVID response. This hospital had converted not one but all 6 of its floors to ICU floors. Since there was only one CC doc on, this meant that we were regularly running anywhere between 40-70 ventilators at any one time. At least 3 Code Blues every night (interestingly all of the cardiac patients who came in same day is what it felt like). What I am trying to say there is that I didn't need the help of the CC physician or consultants. As I came to the east coast, there is much more malignancy against FM trainees for whatever reason, I get it. Everything is very specialized on the east coast to where it feels that the specialization works against itself. I digress, perhaps another time I will vent further. Anyways, I have found that I really enjoy CC and I have never really grasped onto outpatient medicine. Although, I do feel like it is the most important field, (Go ahead and argue with me on that) I am caught between this and the lack of opportunity for people that come from an unopposed FM residency and try to further themselves in a respected field. This was a long winded diatribe in order to hopefully reach out to see if there has been anyone in the same situation. I have contemplated going back and doing another residency (IM I would think), but the idea of redoing residency is very daunting and I hate the construct of residency. It would be nice to segway of having FM residents who meet certain criteria allowed to do fellowship in CC. However, it seems that the ABIM has been hesitant to do this. I am looking to see if there are any other options that people may have found out there (i.e. possibility of practicing underneath the "umbrella" of other CC physicians). The other caveat to this is that if I go back to do residency there is no guarantee I would make it into CC. I abhor research and my steps are not that great (208/222) step1/2 respectively. Perhaps this is just a venting thread. But, I am looking to see if anyone else has been in the same situation. Thank you all for taking the time to read this and I look forward to your response!