I am an IM intern at a top 5 IM program. I chose IM over a surgical sub because I felt I could still pursue a procedural specialty (Cards or GI) but still be THE doctor, with the knowledge base and and ability to manage sick patients better than anyone else that well trained Medicine docs possess. OK, so I mind tells me the above, but for the last month or so I'm feeling pretty bummed about IM in general. Maybe it's the mid-intern year blues, I don't know, but whatever it is, it's hitting hard. Maybe it's all the nursing home placement admits or the patients with social issues that keep them from leaving the hospital -- not only do they take up time, but they come to the hospital gomed out and healthy, and then become sick while here. Maybe it's the intimidation of having to become proficient at so broad a field as Medicine as a resident next year. I guess I just want to feel like I've accomplished something, and sometimes I feel like I do, but most of the time I feel like I've really done nothing for the patient for a bunch of paperwork. I've thought about switching to something else. I like procedures, so I've thought about going to Rads (IR) or Ophtho, where a year of IM would count. I've even thought about OB or Ortho or GU, which would of course mean starting over again. While these fields seem fairly disparate, they have in common the idea that you are responsible for a particular region or area of expertise, and that's your thing (except Rads of course, but IR allows you to narrow your scope if you wish). I guess what I'm asking is 1)Am I being too rash and is this just mid-intern year blues, 2)What is the feasibility of switching both from a political standpoint (my PD, another program's PD) and from a funding standpoint now that things have become tighter for funding GME, 3)What is the reality/process of applying/interviewing as a resident in another field already? Help!