How did you decide between Cards and GI?

[Eyeaboutthat]

I realize these are two very different fields, however given most interns starting residency seem to be considering one vs the other, I'm curious what elements ended up being the deciding factors for those of you who faced a similar decision.

Unfortunately I don't get to do these rotations until the later half of this year and I've been told to contact faculty members now to set up mentorship/research, so also wondering how you navigated the process while being uncertain given lack of more in-depth experience in these fields (than just 3rd-4th yr rotations as a med student). How early should we be setting up contacts/research? Any pearls of wisdom are much appreciated!


Thanks in advance!

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[Anicetus]

I realize these are two very different fields, however given most interns starting residency seem to be considering one vs the other, I'm curious what elements ended up being the deciding factors for those of you who faced a similar decision.

Unfortunately I don't get to do these rotations until the later half of this year and I've been told to contact faculty members now to set up mentorship/research, so also wondering how you navigated the process while being uncertain given lack of more in-depth experience in these fields (than just 3rd-4th yr rotations as a med student). How early should we be setting up contacts/research? Any pearls of wisdom are much appreciated!


Thanks in advance!

Some people in my program already emailed faculty to set up research. Have you talked with your fellow cointerns yet? I would do it as early as they are if the faculty are willing to get you started as long as you can learn to be an efficient resident as well. People on here say to wait and just learn to be a good intern but IM is full of GI/cards gunners now so it probably has evolved to “research on day 1”.

 

[Eyeaboutthat]

Some people in my program already emailed faculty to set up research. Have you talked with your fellow cointerns yet? I would do it as early as they are if the faculty are willing to get you started as long as you can learn to be an efficient resident as well. People on here say to wait and just learn to be a good intern but IM is full of GI/cards gunners now so it probably has evolved to “research on day 1”.

Some of them probably have though I haven't heard anything concrete, but my main dilemma is how people chose between the two and timing of contacting faculty when you're not sure which field you want to pursue yet. Otherwise, if I knew definitively, I would contact sooner rather than later too

 

[CatFactorial]

Some people in my program already emailed faculty to set up research. Have you talked with your fellow cointerns yet? I would do it as early as they are if the faculty are willing to get you started as long as you can learn to be an efficient resident as well. People on here say to wait and just learn to be a good intern but IM is full of GI/cards gunners now so it probably has evolved to “research on day 1”.

You really need to relax.

 

[CatFactorial]

I realize these are two very different fields, however given most interns starting residency seem to be considering one vs the other, I'm curious what elements ended up being the deciding factors for those of you who faced a similar decision.

Unfortunately I don't get to do these rotations until the later half of this year and I've been told to contact faculty members now to set up mentorship/research, so also wondering how you navigated the process while being uncertain given lack of more in-depth experience in these fields (than just 3rd-4th yr rotations as a med student). How early should we be setting up contacts/research? Any pearls of wisdom are much appreciated!


Thanks in advance!

It’s too early to be looking for research mentors. If you do that now and focus on abstracts, posters, and the like, you will more than likely sacrifice clinical competence, and people do note that. The oft repeated (and seemingly ignored) advice to be a good intern isn’t just vapid feel-goodery. Developing a reputation for poor quality work early in residency is hard to shake. Focus on efficiency, thoroughness, and expanding knowledge base now. As you rotate through various services you will figure out what you like. It may not be cardiology or GI, fascinating though they are.

 

[IMreshopeful]

Some people in my program already emailed faculty to set up research. Have you talked with your fellow cointerns yet? I would do it as early as they are if the faculty are willing to get you started as long as you can learn to be an efficient resident as well. People on here say to wait and just learn to be a good intern but IM is full of GI/cards gunners now so it probably has evolved to “research on day 1”.

I decided on cards about halfway through my intern year and it took me a few months to find a research mentor. More important for me was doing well in my clinical rotations in cardiology and trying to get letters of recommendation. Being a good resident and intern is way more important at this stage.

Yes - there are these crazy gunners who try to hook up with research mentors even before starting. Let them. I didn’t and still matched well.

 

[Animalcules]

Jesus, why don’t you start with ordering your first bowel regimen and take a deep breath.

 

[Rocher]

As others have said, you’ll figure out what you’re attracted to as time goes along. They’re totally different fields, they both do procedures but totally different types. They’re also different mindsets.

I was dead set on heme/onc coming in, but it became obvious in the first 6 months that I loved cardiology because I couldn’t stop reading about it (and didn’t care that much about most other things)

 

[NewYorkDoctors]

To the OP, find out what the residents in the class above you are most likely to do, especially the ones who are likely to become Chief resident. Then choose the opposite subspecialty!

Come on, I know you were all thinking it...

 

[Trisphorin]

To the OP, find out what the residents in the class above you are most likely to do, especially the ones who are likely to become Chief resident. Then choose the opposite subspecialty!

Come on, I know you were all thinking it...

Hahaha good one. you know its a good year when all of your chiefs want to do academic hospitalist

On a side note, I have observed that most gunner intern want to do either GI or card then slowly the card people migrate to GI or hospital medicine

 

[aafisahar]

Cares and GI have almost nothing in common except the high salary. GI almost functions as a technician in the inpatient side. Which is fine because that needs to be done. GI rarely follows patients as primary. Procedures are often dirty (eg food in stomach, poop in the butt). You are the expert in endoscopy of the gut. Not sure about reading other imaging studies such as US, MRI, CT.

Cards gets a lot more "what is this EKG" type curbsides. Moreover, cards patients are the typical IM patient taken to its logical end. Uncontrolled HTN/DMII presenting with hehea disease. You get a lot more consults for borderline/unstable patients and often manage your own patients in the CICU during fellowship. Procedures are relatively sterile and by flouroscopy. You can become well versed in multiple forms of imaging such as CT, MRI, ultrasound.

The person interested in both fellowships are drawn by salary. Find out what pathology you want to deal with.

 

[Elixir6]

Cares and GI have almost nothing in common except the high salary. GI almost functions as a technician in the inpatient side. Which is fine because that needs to be done. GI rarely follows patients as primary. Procedures are often dirty (eg food in stomach, poop in the butt). You are the expert in endoscopy of the gut. Not sure about reading other imaging studies such as US, MRI, CT.

Cards gets a lot more "what is this EKG" type curbsides. Moreover, cards patients are the typical IM patient taken to its logical end. Uncontrolled HTN/DMII presenting with hehea disease. You get a lot more consults for borderline/unstable patients and often manage your own patients in the CICU during fellowship. Procedures are relatively sterile and by flouroscopy. You can become well versed in multiple forms of imaging such as CT, MRI, ultrasound.

The person interested in both fellowships are drawn by salary. Find out what pathology you want to deal with.

Wow - what a one sided review.

 

[Southplains]

Cares and GI have almost nothing in common except the high salary. GI almost functions as a technician in the inpatient side. Which is fine because that needs to be done. GI rarely follows patients as primary. Procedures are often dirty (eg food in stomach, poop in the butt). You are the expert in endoscopy of the gut. Not sure about reading other imaging studies such as US, MRI, CT.

Cards gets a lot more "what is this EKG" type curbsides. Moreover, cards patients are the typical IM patient taken to its logical end. Uncontrolled HTN/DMII presenting with hehea disease. You get a lot more consults for borderline/unstable patients and often manage your own patients in the CICU during fellowship. Procedures are relatively sterile and by flouroscopy. You can become well versed in multiple forms of imaging such as CT, MRI, ultrasound.

The person interested in both fellowships are drawn by salary. Find out what pathology you want to deal with.

Tell me where the Gastroenterologist touched you. This is a safe place.

 

[MyTachyBradyHeart]

Cares and GI have almost nothing in common except the high salary. GI almost functions as a technician in the inpatient side. Which is fine because that needs to be done. GI rarely follows patients as primary. Procedures are often dirty (eg food in stomach, poop in the butt). You are the expert in endoscopy of the gut. Not sure about reading other imaging studies such as US, MRI, CT.

Cards gets a lot more "what is this EKG" type curbsides. Moreover, cards patients are the typical IM patient taken to its logical end. Uncontrolled HTN/DMII presenting with hehea disease. You get a lot more consults for borderline/unstable patients and often manage your own patients in the CICU during fellowship. Procedures are relatively sterile and by flouroscopy. You can become well versed in multiple forms of imaging such as CT, MRI, ultrasound.

The person interested in both fellowships are drawn by salary. Find out what pathology you want to deal with.

A gastroenterologist must have left a colonoscope up your butt.

To OP. In all seriousness, deciding on a fellowship usually comes down to (in no specific order):
1) Pathology you are interested in
2) What types of patients you want to deal with
3) The culture of a specialty
4) The mentors you were exposed to said specialty
5) Inpt procedural vs. inpt clinical vs. outpt

 

[Trogghunter]

It depends on the type of fluid you prefer....

Synovial? Rheum
Urine? Urology
CSF? Neuro
Mucus? Pulm
Pus? Derm
Blood? Cards
Yes please? GI
Bonus...none? hospitalist/psych

 

[CatFactorial]

It depends on the type of fluid you prefer....

Synovial? Rheum
Urine? Urology
CSF? Neuro
Mucus? Pulm
Pus? Derm
Blood? Cards
Yes please? GI
Bonus...none? hospitalist/psych

Blood? H/O* (MAYBE?)

 

[IMreshopeful]

Blood? H/O* (MAYBE?)

Thick AML blood maybe

 

[go lakers]

Try having a conversation with the fellows (on both sides) and figure out why they chose the field. They are quite different, so I suspect you'll pick one over the other soon enough.

 

[mercaptovizadeh]

Apart from both being procedural, they are very different fields. The patient populations, the practice setup (consultative/procedural, mostly outpatient vs. heavily inpatient with mix of primary services and consults, imaging, procedures, electrodiagnostics) are so different. If you are obsessed with procedures per se, you should have done surgery. See in intern year what specialty actually interests you because of the patients, the pathology, and practice patterns, and then email mentors for research in that field.

 

[drfunktacular]

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[Milotic]

I realize these are two very different fields, however given most interns starting residency seem to be considering one vs the other, I'm curious what elements ended up being the deciding factors for those of you who faced a similar decision.

Unfortunately I don't get to do these rotations until the later half of this year and I've been told to contact faculty members now to set up mentorship/research, so also wondering how you navigated the process while being uncertain given lack of more in-depth experience in these fields (than just 3rd-4th yr rotations as a med student). How early should we be setting up contacts/research? Any pearls of wisdom are much appreciated!


Thanks in advance!

Everyone last year came in wanting Cards or GI. Most ditched it because

Cards: dealing with Chest Pain complaints, apparently Cards attendings are borderline "surgeon mean"

GI: Literally the smell of poop. Couple residents had poop splashed into their eyes/mouth the day they became complacent with draping/masks.

 

[IMreshopeful]

Everyone last year came in wanting Cards or GI. Most ditched it because

Cards: dealing with Chest Pain complaints, apparently Cards attendings are borderline "surgeon mean"

GI: Literally the smell of poop. Couple residents had poop splashed into their eyes/mouth the day they became complacent with draping/masks.

Surgeon mean? Must be an institutional thing. Most of our cardiology attendings are lovable nerds. Couple of the older cath attendings can be harsh but that’s about it.

 

[jhamaican]

why don't you just ask your real question and make a thread about how to make the most money possible out of IM.

That is honestly the only reason you would limit your choices to these 2 sub specialties and make this thread.

 

[Rocher]

why don't you just ask your real question and make a thread about how to make the most money possible out of IM.

That is honestly the only reason you would limit your choices to these 2 sub specialties and make this thread.

Most helpful post of this thread. /sarcasm

 

[Milotic]

Most helpful post of this thread. /sarcasm

I mean he does have a point. It isn't a good idea to choose IM with the main intention of making money. Other specialties can be chosen during medical school to fulfill this wish easier. Also, going into IM with the intent to ONLY do Cardiology and GI is like a med student going to medical school with the intent to ONLY do surgical specialties. Most that go into IM don't end up in those specialties. You can read the cringe on PD faces when someone states they want to do IM because they want to be a GI. I had to really make sure that I would be cool with plain internal medicine before making my choice and I remember hearing horror stories back when I was a med student and expressed my initial interest in doing IM for GI.

 

[Rocher]

I mean he does have a point. It isn't a good idea to choose IM with the main intention of making money. Other specialties can be chosen during medical school to fulfill this wish easier. Also, going into IM with the intent to ONLY do Cardiology and GI is like a med student going to medical school with the intent to ONLY do surgical specialties. Most that go into IM don't end up in those specialties. You can read the cringe on PD faces when someone states they want to do IM because they want to be a GI. I had to really make sure that I would be cool with plain internal medicine before making my choice and I remember hearing horror stories back when I was a med student and expressed my initial interest in doing IM for GI.

We don’t know why the OP is selecting between those specialties, and it’s just an inflammatory post typical of SDN

 

[rokshana]

Most helpful post of this thread. /sarcasm

Yet on point...those two subspecialties have little in common except money making potential.

 

[Eyeaboutthat]

Yet on point...those two subspecialties have little in common except money making potential.

They're both procedural with interesting pathology, unlike any of the other subspecialties offered through Internal Medicine (except for Critical Care). As admitted in the initial post, my exposure has not been extensive, which is why I am curious about people's experiences in the fields.

 

[IMreshopeful]

They're both procedural with interesting pathology, unlike any of the other subspecialties offered through Internal Medicine (except for Critical Care). As admitted in the initial post, my exposure has not been extensive, which is why I am curious about people's experiences in the fields.

Rheum has a lot of procedures, interesting pathology for some folks, much better lifestyle than either... pulm has interventional pulm which does pretty wild procedures (trachs, rigid bronch, etc) considering they’re medical trained... not just GI and cards. That’s why posters thought that the dolla dolla bills were a factor

 

[W19]

I dont get why it is so hard for some people to understand that people have different motivation in that line of work...

If OP wants to do something that will bring the $$$ while having a relatively good lifestyle, I think GI is the way to go...