FM vs IM residency cushiness.

[JiminyCricket]

I am debating between applying to IM or FM. From what I hear from FM residents, FM is cushier in terms of work hours, call schedules malignancy etc. However, I feel like since they need to know Ob-Gyn and Peds in addition to general IM, they graduate feeling less comfortable caring for the adult population than IM residents. I want to graduate and feel comfortable working with adults. I also want time to read in residency, and from what I hear, IM residency schedules give you little to no time to read especially in intern year.

So I ask you, which is the "cushier" residency....IM or FM? How do you balance "cushness" with being ready to take care of patients in the real world.

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[drfunktacular]

However, I feel like since they need to know Ob-Gyn and Peds in addition to general IM, they graduate feeling less comfortable caring for the adult population than IM residents. I want to graduate and feel comfortable working with adults. I also want time to read in residency, and from what I hear, IM residency schedules give you little to no time to read especially in intern year.

My impression thus far is that internists know more about less, whereas FP's know less about more.

Regarding reading, it has been pretty tough for me so far in my IM internship to sit down and read. Not that I don't try, but most nights I am so tired that I involuntarily fall asleep while trying. I dunno how it is for FM. Seems like they're on call less than us.

 

[smq123]

So I ask you, which is the "cushier" residency....IM or FM? How do you balance "cushness" with being ready to take care of patients in the real world.

Residency is just 3 years out of the rest of your career. You shouldn't base your decision on the potential "cushiness" of your residency.

Furthermore, this is not specialty specific, it is program specific. There are FM programs out there where it is common for their residents to hit 80 hours a week....and equally common for them to go over 80 hours.

If you want to be able take care of children and pregnant women, do FM. If not, do IM. If you want to take care of children, but NOT pregnant women, do med-peds.

If you think you might want to subspecialize in something like nephrology or rheumatology, go into IM. If not, FM might be an acceptable option.

 

[Doctor Grim]

I am debating between applying to IM or FM. From what I hear from FM residents, FM is cushier in terms of work hours, call schedules malignancy etc. However, I feel like since they need to know Ob-Gyn and Peds in addition to general IM, they graduate feeling less comfortable caring for the adult population than IM residents. I want to graduate and feel comfortable working with adults. I also want time to read in residency, and from what I hear, IM residency schedules give you little to no time to read especially in intern year.

So I ask you, which is the "cushier" residency....IM or FM? How do you balance "cushness" with being ready to take care of patients in the real world.

FM residencies do have a better lifestyle. And how much you invest in your education dictates how much you will gain from it. I was trained as a Family Physician and then went on to an IM based geriatrics fellowship and I felt comfortable with my medical knowledge.

A couple of my colleagues who were FM trained went on to become hospitalists in our university system and they feel the same.

Once you completed your internship year, you will probably work on the avg 50-60 hrs per week which isn't bad at all.

 

[ShyFly]

It really depends on the program. There are IM programs that are cushier than FM. Generally though, there are more cush FM programs than IM. If your concern is being prepared though, don't go for cush.

 

[lowbudget]

I don't think it's possible to generalize. Someone once said that FM goes for the practical while IM goes for the esoteric. Who knows. From talking with people, the FM board is difficult because of the range of possible questions while IM board exam is difficult because it appears to be written by sub-specialists who submit questions for the general IM exam.

One criticism I've heard is that training in FM programs can be intense because it's squeezing so much in a shorter period of time or not intense enough because people avoid the challenge to master the material. One criticism I've heard of IM programs is that people are not prepared for the real world when they graduate residency.

A friend of mine who did a community IM program did her first intubation as a 2nd month pulmonary fellow. At my FM program, interns learn intubations on day 1, are responsible for intubations in codes as a 2nd year resident, and will graduate on average with 50-70 tubes. In talking with another EM friend of mine, he said in 3 years of his EM residency he's done 50-70 tubes as well. But, ask that FM resident how do you treat renal crisis secondary to scleroderma and watch that resident fake a seizure.

You can argue that certain procedures or patient populations are irrelevant to you, but that's neither here nor there because that is a matter of opinion & personal preference.

My advise is if you want to judge a residency program, you should ask: What are the standards the faculty and fellow residents will hold me up to? What will people expect of me? That will tell you a lot about the quality vs. cushiness a program is.

I have never heard anyone who've graduated from either FM or IM residencies who've said they were "uncomfortable" treating adults. 3 years of training is 3 years of training. You will have seen a lot of things and there will be things you've never experienced. As above, every program is different, every setting is different... and every resident is different. Much of it is luck of the draw and depends on whether you're at the right place at the right time... or not.

 

[Doctor Bob]

But, ask that FM resident how do you treat renal crisis secondary to scleroderma and watch that resident fake a seizure.

Pssh... that's easy. You consult nephrology. Problem solved.