IM or Endocrinology?

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Misaki27

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Hi! What would you choose between IM (with no fellowship afterwards or maybe Rheumatology) and Endocrinology? I feel like Endo might become a bit boring over time and there's always more variety in IM.

What would you do if time and debt weren't an issue?

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Hi! What would you choose between IM (with no fellowship afterwards or maybe Rheumatology) and Endocrinology? I feel like Endo might become a bit boring over time and there's always more variety in IM.

What would you do if time and debt weren't an issue?
You realize Endocrinology is a fellowship after IM, right?
 
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You realize Endocrinology is a fellowship after IM, right?
I know that. I meant choosing between just doing IM with no fellowship or doing Rheum/Endo afterwards.
 
I know that. I meant choosing between just doing IM with no fellowship or doing Rheum/Endo afterwards.
people do endo or rheum because they like the subject matter not because of money...lifestyle is a draw though.

have you done a rotation in either? get some exposure (esp outpt clinic...inpt is not reflective of either of these specialties).
 
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

EDIT: only added parenthesis for grammar
 
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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.
 
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I am sorry if my post sounded stupid. I am an IMG, so in my country the system is a bit different. You get to choose your specialty right off the bat, right after graduation, through an entrance exam. Also, I chose Endocrinology, but I find it to be a tiny bit boring and laid back.

I am having second thoughts about it and I have actually considered transferring to IM and then following up with a second specialty (as it is called here) in rheum.

Thanks for all your replied and sorry if my post sounded weird.
 
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Haha I love how gutonc and Raryn both gave kind of troll-ish responses and people reading this (crayola227, me) felt like they had misinterpreted the OP on purpose. But then it turns out they were right, and the OP actually had posted a somewhat nonsensical question. But then it turns out that the forum basically answered the question that the OP hadn't asked but actually required (namely, how to choose a specialty). So much intrigue.


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I'm not sure where rheum stands on the "how competitive is this specialty" index right now. On the rheum forum they were posting NRMP R3 data showing that rheum had the lowest match rate (66%) of any specialty this year, including endo (81.4%) and the more competitive specialties like cards (74.9%) and GI (66.9%). There's probably more to that story than the numbers (how strong the applicants are themselves, for instance), but worth thinking about.
 
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I am sorry if my post sounded stupid. I am an IMG, so in my country the system is a bit different. You get to choose your specialty right off the bat, right after graduation, through an entrance exam. Also, I chose Endocrinology, but I find it to be a tiny bit boring and laid back.

I am having second thoughts about it and I have actually considered transferring to IM and then following up with a second specialty (as it is called here) in rheum.

Thanks for all your replied and sorry if my post sounded weird.

Ah. We can speak a little bit as to the actual practice of these specialties in the states, but I honestly couldn't tell you too much relevant to your dilemma on how to pursue training in your country. Endocrine is a fairly laid back specialty, but most people who do it here in the states certainly don't seem to find it boring... It's one of those specialties people choose because it is interesting to them (it "helps" that it doesn't pay extremely well, so we don't get people doing it just for the money).

I'm not sure where rheum stands on the "how competitive is this specialty" index right now. On the rheum forum they were posting NRMP R3 data showing that rheum had the lowest match rate (66%) of any specialty this year, including endo (81.4%) and the more competitive specialties like cards (74.9%) and GI (66.9%). That's 44% of applicants not matching, which is a pretty high bar.

That being said, I don't necessarily think that means rheum is the most competitive specialty. The quality of the applicants also plays into competitiveness, and there are a variety of indications that the rheum pool is overall less competitive. It's still something to think about when labeling rheum as a middle competitiveness specialty - I could see it being considered highly competitive by the time the OP is actually applying.

It's tough to say, but I'd still put Rheum in the middling category. The self-selection and competitiveness for GI/Cards at the very least is significantly higher, and I'd probably put Pulm-Crit and Heme-Onc in that top category as well. On the other hand, all you need is a pulse to match ID, Nephrology, Geriatrics, so they're my low group. At this point, probably Rheum above Endo, but they're both still somewhere in between (in my opinion based on the available data).

What would help would be a new charting outcomes in the specialty match, but the last one published was in 2013, for the 2011 appointment year, which had a match that took place in 2010.
 
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