IM but don't feel like I belong

[cookiegrub]

What do you guys say when someone who has some interest in IM decides they don't have any good mentors at their institution to make them feel welcomed in IM? I don't want to slash out IM from my list of specialties just because of the lack of faculty interested in mentoring me but I also feel as if I am just too stupid for this specialty by the way I am reprimanded sometimes. I have already ruled out FM and am now contemplating my future in medicine as I thought IM always had something to offer to me.
Primarily, I wanted to do a surgical subspecialty for the longest time but IM was always a fall-back because of its versatile fellowships. At times, I would always make myself feel better knowing that it wasn't as cutthroat as surgery but lately I have had encounters where I have felt less welcomed in this specialty. Now, I am stuck not having anything to be happy with. As residents, do you ever experience this feeling in IM or is it just me and my way of odd experiences? Should I jump the boat on IM and consider surgery to be a better calling for my personality type?

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[NITRAS]

What about surgical specialties makes you think you will fair better? In my experience they, on average, less tolerant of low functioning residents.

I’d suggest you try really hard to figure out your deficiencies and to work very hard at correcting those deficiencies, because they will follow you whatever you do.

You are a pgy 1?

EDIT: I read your post wrong.

 

[cookiegrub]

No, I am a medical student seeking advice on whether any current PGYs feel this way about the field of IM.
You are right that Sx specialties are less tolerant but I have had a different experience in that I generally stay very vigilant and concerned about the body language (knowing the low tolerance level) and am thus able to adjust to the environment in that sense. However, in IM, I simply have a much harder time impressing. I will attempt to work harder and find my weaknesses as you are right that this will follow me. But you know how one knows that they are in the company of like-minded people? I have never had that feeling with IM; infact, I have always felt a social anxiety around the crowd that which I don't feel around any other specialty. This is why I am asking if it is right to just abandon the idea of going into IM if I just don't get the vibe that I belong there.

 

[scootad.]

I'd worry less about whether you "belong" in a particular field based on the personalities of the docs in that field, and more about whether you can see yourself actually doing and enjoying the work. There is a common misconception amongst medical students to place too much importance of their opinion of a field on the way they "click" with residents in those specialties during clinical rotations. In every field, you will see people of all different personality types, and also the people you encounter in academic centers are often very different than those who end up in private practice.

 

[Raryn]

What do you guys say when someone who has some interest in IM decides they don't have any good mentors at their institution to make them feel welcomed in IM? I don't want to slash out IM from my list of specialties just because of the lack of faculty interested in mentoring me but I also feel as if I am just too stupid for this specialty by the way I am reprimanded sometimes. I have already ruled out FM and am now contemplating my future in medicine as I thought IM always had something to offer to me.
Primarily, I wanted to do a surgical subspecialty for the longest time but IM was always a fall-back because of its versatile fellowships. At times, I would always make myself feel better knowing that it wasn't as cutthroat as surgery but lately I have had encounters where I have felt less welcomed in this specialty. Now, I am stuck not having anything to be happy with. As residents, do you ever experience this feeling in IM or is it just me and my way of odd experiences? Should I jump the boat on IM and consider surgery to be a better calling for my personality type?

So *in general*, there's some truth to the tropes that specific personality types tend to end up in different subspecialties.

For example, if I described a medical student triathlete who loves mountain climbing in between checking out the local microbreweries, no one would be surprised if said student went into Emergency Medicine - and there might be a few more eyebrows raised if he went into Pathology.

And yet... I'm sure if you looked at the couple thousand Path residents, you'd find a few triathlete microbrewery enthusiasts. Why? Because they thought Pathology was *interesting*.

People do self-sort, but Internal Medicine is the largest field in the US. A full quarter of all doctors in the US are internists of one stripe or another (counting all the subspecialists). There's no one personality that dominates - not with >20,000 residents split among >500 programs.

As long as you are interested in learning (which is probably as close as I'd get to an IM stereotype - we're nerds), you'll be welcomed in an IM program somewhere. If you end up deciding to go for it, apply broadly and get a feel for the personality of programs in different places.

 

[TraumaLlamaMD]

I’m confused - are you still interested in surgical subs? Are you competitive for them? If not, what about general surgery over IM? If you really like IM, that’s one thing, but I didn’t get much from your post other than it’s a backup for you.

 

[cookiegrub]

I’m confused - are you still interested in surgical subs? Are you competitive for them? If not, what about general surgery over IM? If you really like IM, that’s one thing, but I didn’t get much from your post other than it’s a backup for you.

So I have research background for the surgical field I am interested in but I also have a corresponding subspecialty in IM that is in the same topic as the surgical subspecialty. I do really like IM but there are many times where I have been distraught because no one currently is interested in being my mentor (atleast not the ones I have met). This sparked my conversation on this forum on whether or not I should even consider IM as a second option if surgery doesn't pan out the way I imagine it to. I don't necessarily consider IM my second option though even if I refer to it as such. To be frank it started out as the first thing to pursue but after some unfortunate experiences, I have been drawn away from it. For example, I have met several IM physicians that constantly tell me to pursue something else.

I realize this is a diverse field but sometimes it doesn't seem like many personalities exist. Sometimes it seems like I am meeting the same types of people over and over again.

 

[Gastrapathy]

IM is not IM sub.

 

[rokshana]

Have you thought that maybe you are finding it difficult to find an IM mentor is because you project that IM is back up for you?

 

[cookiegrub]

Have you thought that maybe you are finding it difficult to find an IM mentor is because you project that IM is back up for you?

Perhaps but to serve as a second option, I have to have met people that I like and can see myself working along with. I don't consider IM being my backup as a negative because it is still shoulder to shoulder with my first choice so I have never treated any opportunities I've had for granted. Most part of IM residency will be with generalists and having interacted with many of them I have never felt part of the team. I think I might need to branch outside of my area and see if different institutions would be more open to me.

 

[Dave1980]

Sounds like the IM folk are victimizing you with microaggressions!

 

[IMreshopeful]

So I have research background for the surgical field I am interested in but I also have a corresponding subspecialty in IM that is in the same topic as the surgical subspecialty. I do really like IM but there are many times where I have been distraught because no one currently is interested in being my mentor (atleast not the ones I have met). This sparked my conversation on this forum on whether or not I should even consider IM as a second option if surgery doesn't pan out the way I imagine it to. I don't necessarily consider IM my second option though even if I refer to it as such. To be frank it started out as the first thing to pursue but after some unfortunate experiences, I have been drawn away from it. For example, I have met several IM physicians that constantly tell me to pursue something else.

I realize this is a diverse field but sometimes it doesn't seem like many personalities exist. Sometimes it seems like I am meeting the same types of people over and over again.

There’s disgruntled physicians in every field. I’ve met not one but two orthopedic spine surgeons who told me to stay away from medicine because it’s not worth it anymore. Said surgeons were making over a million dollars and had excellent lifestyles - but for whatever reason they didn’t feel like their job was worth it anymore (idk why - no more drive, burnout, no more enjoyment in the work, not enough money for their alimonies, who knows). So even in the rosiest of fields you find some bad apples. You may see it more frequently in IM simply because it’s such a huge field, and is the largest field of medicine. That alone shouldn’t be a deterrent IMO.

I would think hard about which fields you want to apply for. I know some folks who switched from surgical subs to IM because they really liked a subspecialty of some sort and they liked it. However there’s no guarantee of this.

 

[R2R_MD]

I'd like to give you some feedback as a recently matched MS4 waiting to start residency in July. Your clinical years have a major influence on what specialty you choose going forward and the randomness of hospital/group assignments for certain rotations — core or elective — breeds disdain for some specialties and a passion for others. My internal medicine clerkship was 3 months long and while the clinical exposure was satisfactory, my colleagues were less than appealing. They were clique, vindictive, and absolutely hated being outshined. There were times where I wanted to leave the hospital earlier because I simply dreaded being around them. But otherwise, I found the clerkship itself to be productive for the sake of my medical education. Nevertheless, it made me think about being other specialities because the prospect of being stuck with a similar group of people for 3 years was agonizing.

Something else to consider is that IM, much like surgery, requires extensive group interaction more than other specialties and is therefore more prone to personal conflict. On that note, I will tell you that I seriously considered surgery during my surgery clerkship because I loved the authority of holding the scalpel, the extensive knowledge of human anatomy and hands-on nature of the specialty that it offered. Alas, after a month of a surgical ICU elective, I've come to see the surgery "clan" as indescribably malignant and overworked. If you're seeking a sense of self-worth (which is totally fine) in your specialty, I think surgery will leave you cripplingly depressed by virtue of the narcissistic masochists the specialty attracts.

To leave you with a rosy picture, just remember that you can always switch specialties if you encounter a change of heart throughout your journey. Intern year is a good time for people to learn the ropes and get a good grasp of what internal medicine or surgery is really like.

 

[Coupd'Cat]

Vibes can vary widely, even within the same field. IM residents are as varied as people generally are.
I'd try to get a sense of what IM residency is like in different hospital systems and cities before you jump ship based on personality alone. If your school offers various rotation (e.g. academic v. community), give that a shot. Away rotations in MS4 can be a good chance to send out feelers as well, if you can spare the time, effort, and cost.