guys, the fact that IM is on the path to endo doesn't really answer this OP's question
but way to just assume that they meant their question in the stupidest way possible rather than trying to give the benefit of the doubt and try to interpret the question in the only way that makes sense - just what I expect from y'all
OP - I advise that anyone going into medicine (I mean medicine like MD, not IM to have a distinct comfort with being a PCP
I can only endorse that you do IM with an understanding that you might be "stuck" as an outpt PCP or a hospitalist. If you can swallow that, go young man/woman
seriously, make peace with IM and not the fantasy of excape if you do it
once you're there you'll get the sense if you should "esacpe" to one of the many subspecialties technically available
benefit of leaving gen IM: Christ I won't go into it
downside of endo: possible boredom, but on all other scales, increased QOL
So, IMHO do IM cuz you like doin the IMs
if you only want to do IMs on a path to elsewhere, be sure you like **that* destination for sures and that it won't be too competitive to get into
The OPs post was quite confusing, because it groups IM with Rheum and then puts Endo separately. Our reactions were perfectly reasonable, even if a bit sarcastic.
Anyway, my answer would depend on what point in the process the OP is in. If he's a medical student or earlier, I think it's great to have an interest in Endocrine, and that all he needs to do at this point is set himself up to get into a decent IM program. Endocrine (and Rheum for that matter) are middlingly competitive fellowships where you don't have to start laying groundwork forever in advance. It would help if wherever he does IM has an internal Endo/Rheum program, but it isn't 100% necessary.
If he's a resident, then again, to leave options open he should do an early Endocrine/Rheum rotation or two, just to see how he likes it. Then he should decide which of the two subject matters he likes more. They both have similar pay and lifestyle, so it's really a question of enjoying the material. After making that decision, late intern year or early PGY2 year is a great time to talk with one of your Endo/Rheum faculty and get on board for a short clinical research project.
Then, at the end of PGY2/beginning of PGY3, it would be time to evaluate long-term goals. Your options at that point are to apply to fellowship now or decide to be a PCP, hospitalist, or traditional IM mix-of-both (rarer and rarer these days) for now, with the option to apply to fellowship after a year or two (knowing every year out of residency your chances go down). Everyone has their own priorities, and after two years of residency you should have a clearer idea of them as well as what each job path entails. If the OP is at *this* point and still not sure, wants specific clarification of some pros and cons, they can post again... but most people get there and know what they want to do.
"I feel like Endo might become a bit boring over time and there's always more variety in IM." is a bit of a red flag as well, in that any material you enjoy shouldn't become truly boring over time. The routine day-to-day insulin titration? That may become boring. But actually counseling the patients, or learning more about new treatments, or encountering some of the rare things and being able to teach someone about them? Shouldn't be boring if you went into the job for the right reasons.