I'll try to find a link to one of the threads where I've discussed this more thoroughly, but in order to give you some quick thoughts....
It is, in my opinion, worth changing residencies if you know it's not going to be a good fit. I, too, started in internal medicine, and I still value my experiences in it. IM offers a lot of diverse opportunities and is amenable to a wide variety of personalty types and skill sets. So, as far as job opportunities go, it does make life a lot easier in the long run to be boarded in a primary care specialty like IM if you want to have a clinical medicine be a big part of your career. And, being dual-boarded in primary care PLUS preventive medicine can open up a lot of opportunities, including those that have little-to-no direct patient care. So... if you aren't certain that you don't want to finish IM *residency* (regardless of whether or not that would be your life-long practice), you might want to tough it out at least another year. You might also find that your feelings change about IM as you get closer to PGY-2. I'm sure SOMEONE can pull up the graphs that show a clear spike in depressive symptoms in PGY-1 between Oct and Feb. (And, for a good portion of my residency class, I can confirm that clinical depression is a real entity at this stage). You may or may not feel the same way as you get more confidence toward the end of the year, and hopefully get more balance between electives and hard-core call months.
HOWEVER... you may have reached the point of certainty that this (IM) isn't what you want to do. So, this time of year is still a perfectly reasonable time to start looking at Prev Med residencies. You are correct --- not only is it possible to complete a PM residency after your intern year... it's in fact mandatory. Having a PGY-1 year is a pre-req for applying to Prev Med, Occ Med, or Aerospace Med programs. You need to have enough clinical experience and training to be able to take Step III and obtain a medical license for the state you intend to practice in (EDIT: Not that you have to have your license to start in PM residency). And, in your preventive medicine rotations.... or more appropriately in some cases, practicums... you'll often be relying on your clinical experience from IM while learning and practicing public health and preventive medicine.
I'm a few years out of the loop, and things have been in flux since I did my PM residency. The best source of information is going to be ACPM.... and this is the link to the Resident information page:
Residency Programs - American College of Preventive Medicine
They have been working on a more standardized application process (which the page alludes to)... but, historically, it was still possible to submit applications, get interviews, and get acceptances well into the Spring (for July 1 start dates). Even though the standardized process has pushing the schedule up, I would not automatically assume that it would be impossible to get a spot for July 1 at many programs (included some of the most respected in the field). (EDIT: There is usually a residency fair at the annual conference at ACPM, which used to be in Feb but now is in May.... so even if you can only come for a day or two, the conference is always a great opportunity to learn about programs, and historically at least, some programs conduct interviews at the conference).
Then there's the question of "what can you do with Prev med?" (particularly if you are not dual-board certified but opt to complete and pass just PM). That's where this page is helpful (
Medical Student Section - American College of Preventive Medicine). More specifically, check out the recruiting slideshow (link halfway down the page) for specific examples of the kind of work we do (in residency and then as career options).
Like IM, one of the great things about PM is that there are a lot of different avenues you can go with this training. (for me, that's a blessing and a curse.... because I kind of like several areas and still am not 100% sure which way I want to commit long term to). I won't pretend that PM doesn't have issues of it's own. Lack of visibility is one - people don't even realize we're a real field, partially because you don't apply directly out of medical school. Many people know about PM and plan to do PM after their intern year (or after a full residency with the plan to be dual-boarded). But, the relative number of jobs is smaller, as we're a small and diverse specialty. We're even smaller than Occ Med (but this is a "sister specialty" and their are routes to becoming an Occ Med specialist after a PM residency). I don't have the data to support this, but during the job hunt, it certainly seems like - for every 1 PM job listing, there are probably 10 OM job listing. And, there's probably 100 IM job listings. (You'll find out how frequently recruiters start bugging you in PGY2 IM just how many IM jobs are out there)... but... there is data to support this: Prev Med and Occ Med both have some of the highest job satisfaction ratings for physicians.
Ha... that was my attempt at a quick response. I'm sure the other threads I bump will have similar information but may have some specific details I forgot to mention today. But, I'll be glad to answer questions (in this thread or via private message if you prefer). But, I probably should stop procrastinating
