Hospitalist vs Procedural Subspecialty vs Nonprocedural Subspecialty

[FlirtDoc]

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Some observations I have noticed at my university program last three years. More IM residents are doing Hospitalist medicine. The ones applying to fellowships have migrated away from procedural subspeciaties to nonprocedural subspecialties such as Rheumatology and Heme/Onc.

With that said, GI appears to be stable in terms of applicants but Cardiology applications seem to be going down. Perhaps this trend at my program is due to the forthcoming obamacare that will cut reimbursements for procedures.

Have you guys noticed any trends at your programs to IM residents career path due to Obamacare ?

 

[Gpan]

most definitely. Only 2 applied to fellowship last year. It seems to be the trend this year.

 

[C5toC9]

Many doing hospitalist or nocturnist gigs, some for year off while applying to fellowship and some for longer

 

[bronx43]

Some observations I have noticed at my university program last three years. More IM residents are doing Hospitalist medicine. The ones applying to fellowships have migrated away from procedural subspeciaties to nonprocedural subspecialties such as Rheumatology and Heme/Onc.

With that said, GI appears to be stable in terms of applicants but Cardiology applications seem to be going down. Perhaps this trend at my program is due to the forthcoming obamacare that will cut reimbursements for procedures.

Have you guys noticed any trends at your programs to IM residents career path due to Obamacare ?

Heme onc is getting more competitive than before from what I understand. GI is still the most competitive IM subspecialty. Cardio is in a free fall. Hospital medicine is on the rise, but I think most people don't see it as the longterm solution.

 

[jdh71]

I see the "taking a few years off" as a hospitalist mentality a lot. Hospitalists are doing well and I can't think of many other specialties with that kind of income potential in three years - maybe EM.

The problem is you just don't really make it back for one reason or another.

 

[bronx43]

I see the "taking a few years off" as a hospitalist mentality a lot. Hospitalists are doing well and I can't think of many other specialties with that kind of income potential in three years - maybe EM.

The problem is you just don't really make it back for one reason or another.

The only people I see making it back to fellowship are the ones that start applying during their first year out. If you're 2-3 years out, the chance of going back to training is nil.

 

[Gpan]

The only people I see making it back to fellowship are the ones that start applying during their first year out. If you're 2-3 years out, the chance of going back to training is nil.

is it because it's too good, too comfortable, too settled, to safe to leave their current gig as hospitalists or is it because they have no chance against the younger , more eager, more energized freshed off residency docs? I know it's a combination, but which is more of a deciding factor?

 

[bronx43]

is it because it's too good, too comfortable, too settled, to safe to leave their current gig as hospitalists or is it because they have no chance against the younger , more eager, more energized freshed off residency docs? I know it's a combination, but which is more of a deciding factor?

Depends what they were trying to apply for. If they wanted cardio, GI, allergy, etc, then it's the latter. If for rheum, endo, neph, then it's the former.

 

[infarct]

Depends what they were trying to apply for. If they wanted cardio, GI, allergy, etc, then it's the latter. If for rheum, endo, neph, then it's the former.

....but also can be vice versa depending on the person.

 

[Silent Cool]

Depends what they were trying to apply for. If they wanted cardio, GI, allergy, etc, then it's the latter. If for rheum, endo, neph, then it's the former.

Yo Bronx,

Are you considering a fellowship in anything? I think that you're doing IM with hospitalist plans in the near future. Might you consider subspec. eventually?

 

[bronx43]

Yo Bronx,

Are you considering a fellowship in anything? I think that you're doing IM with hospitalist plans in the near future. Might you consider subspec. eventually?

I am still considering a cardio fellowship but it's looking less and less financially attractive. The job spam that are rolling in are advertising some really sweet deals.

 

[obiwan]

we have 15ish starting hospitalist gigs which is definitely on the higher side from what is typically expected. lets just say that we were alot more relaxed and contemplating on what we were gonna be buying with our first big paycheck compared to our departing fellow colleagues