IM residency track

[kktt007]

Hello,
Congratulations to everyone who matched this year.
I am a recent graduate from Russia and will be applying for internal medicine residency this year. Many people have told me that connections are important to get residency spot in a good program in US. I have a connection in a primary care residency program in a decent university based hospital in North East. My goal is to pursue a career in academic medicine ( I want to do a fellowship, endo/nephro/cardio).
My question is that is primary care residency in a university based hospital better than categorical residency in community based hospitals?
Also I have heard that after primary care residency, it is very difficult to find fellowship, especially if you are an international graduate?
Thanks

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[the argus]

A large percentage (usually 30-50%) of people at primary care IM residencies go on to fellowship training. I think most would agree that a university primary care residency is preferred over a community categorical residency when applying for fellowships.

Since the ACGME mandated that all IM programs be 1/3 (i.e. 1 full year) of ambulatory, primary care vs categorical is no longer that different. Usually the difference comes down to a handful or less of months of rotations.

 

[kktt007]

A large percentage (usually 30-50%) of people at primary care IM residencies go on to fellowship training. I think most would agree that a university primary care residency is preferred over a community categorical residency when applying for fellowships.

Since the ACGME mandated that all IM programs be 1/3 (i.e. 1 full year) of ambulatory, primary care vs categorical is no longer that different. Usually the difference comes down to a handful or less of months of rotations.

thanks for the input

 

[rokshana]

A large percentage (usually 30-50%) of people at primary care IM residencies go on to fellowship training. I think most would agree that a university primary care residency is preferred over a community categorical residency when applying for fellowships.

Since the ACGME mandated that all IM programs be 1/3 (i.e. 1 full year) of ambulatory, primary care vs categorical is no longer that different. Usually the difference comes down to a handful or less of months of rotations.

i think this would be subspecialty dependent...pulm cc would probably prefer a community program with inpt experience vs a PC that is mostly outpt...but rheum and endo, the outpt experience would probably be a boost...

while its ACGME mandated 1/3 ambulatory , doubt that is realistic at most programs.

 

[tatsuchi]

My goal is to pursue a career in academic medicine ( I want to do a fellowship, endo/nephro/cardio).

Just for slight clarification, academic medicine generally refers to doing medicine in an academic setting, such as a University Hospital, where one may have additional duties aside from the practice of medicine such as research, lecturing, presenting at conferences, teaching and precepting fellows, residents and medical students.

Not to say you cannot practice academic medicine in the fields you mentioned, but just to clarify that going into a fellowship does not necessarily mean one will be practicing academic medicine once you finish and head out into the Real World. (Many subspecialists are in private practice where the money is).

My question is that is primary care residency in a university based hospital better than categorical residency in community based hospitals?
Also I have heard that after primary care residency, it is very difficult to find fellowship, especially if you are an international graduate?
Thanks

Twofolded question.

-"Is it better to place in a university based hospital primary care residency or a community hospital based categorical residency?"
It depends on your goals. On average one would expect your learning and resources would be better met at a University-based hospital, but there are plenty of very strong community based hospitals out there that will give you just as good if not sometimes better training.

Now if you are looking for fellowship, it depends on the hospital. It can be easier to land a fellowship at a University Hospital because of the resources and prestige certainly, but there are many community-based fellowship spots too. And if you happen to match at a community hospital with its own internal fellowship program, you may have an easier time matching internally. Not to mention the opposite sometimes holds true that some fellowship programs barely take applicants internally, even university ones (*cough*USC*cough*)

-"I have heard after primary care residency, it is very difficult to find fellowship, especially if you are an international graduate?"
It is more difficult to get into fellowship after a primary care residency regardless. Your international graduate status just makes it harder. The idea of the primary care residency track is to train physicians who are going to go out into the field after 3 years and work in an outpatient/light inpatient setting. And the programs are tailored to that, and some even discourage people who apply to them looking for fellowships post-residency.

 

[kktt007]

Just for slight clarification, academic medicine generally refers to doing medicine in an academic setting, such as a University Hospital, where one may have additional duties aside from the practice of medicine such as research, lecturing, presenting at conferences, teaching and precepting fellows, residents and medical students.

Not to say you cannot practice academic medicine in the fields you mentioned, but just to clarify that going into a fellowship does not necessarily mean one will be practicing academic medicine once you finish and head out into the Real World. (Many subspecialists are in private practice where the money is).


Twofolded question.

-"Is it better to place in a university based hospital primary care residency or a community hospital based categorical residency?"
It depends on your goals. On average one would expect your learning and resources would be better met at a University-based hospital, but there are plenty of very strong community based hospitals out there that will give you just as good if not sometimes better training.

Now if you are looking for fellowship, it depends on the hospital. It can be easier to land a fellowship at a University Hospital because of the resources and prestige certainly, but there are many community-based fellowship spots too. And if you happen to match at a community hospital with its own internal fellowship program, you may have an easier time matching internally. Not to mention the opposite sometimes holds true that some fellowship programs barely take applicants internally, even university ones (*cough*USC*cough*)

-"I have heard after primary care residency, it is very difficult to find fellowship, especially if you are an international graduate?"
It is more difficult to get into fellowship after a primary care residency regardless. Your international graduate status just makes it harder. The idea of the primary care residency track is to train physicians who are going to go out into the field after 3 years and work in an outpatient/light inpatient setting. And the programs are tailored to that, and some even discourage people who apply to them looking for fellowships post-residency.

thanks for the response.
So I guess it depends on a number of factors like which community program and fellowship opportunities the program has to offer.