IM Subspeciality in the Military

[IMDoc123]

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Does anyone have experience or advice with matching into military IM subspecialties? I was interested in Cardiology and my brother Gastroenterology. How competitive is it to get into one of these programs in the military after finishing an IM residency? Thanks!

 

[SupraDOc]

Would also like to know, thanks!

 

[DrMetal]

Does anyone have experience or advice with matching into military IM subspecialties? I was interested in Cardiology and my brother Gastroenterology. How competitive is it to get into one of these programs in the military after finishing an IM residency? Thanks!

you'll probably have to do a utilization tour as an internist after your IM residency, before going to a fellowship. At least, this was the case for the GIs I met this past summer.

Cant speak of cards . . . but I had the opportunity to shadow the GI staff at NNMC (Bethesda) this past summer. Is a very cool specialty, diverse, lots of clinical and procedural stuff, research too. If you're interested in setting up a rotation there or something, PM me your "real" name and info, I can pass it along.

 

[Droopy Snoopy]

A more favorable applicant/spot ratio and a GMO/staff internist/chief resident tour both give you a much better shot at getting a competitive IM subspecialty spot (cards, GI, allergy, heme/onc) in the milmed vs. as a civilian. That's the word on Army/AF at least.

 

[Gastrapathy]

A more favorable applicant/spot ratio and a GMO/staff internist/chief resident tour both give you a much better shot at getting a competitive IM subspecialty spot (cards, GI, allergy, heme/onc) in the milmed vs. as a civilian. That's the word on Army/AF at least.

The ratio is highly variable (and, in fact, can be unfavorable for current residents). Although we talk about how hard GI and cards are to get on the outside, in reality, US allopathic MD grads have a fairly high selection rate. The numbers look worse because IM is a common place for IMGs to land and so many apply for fellowship.

That said, for the marginal performer or DO (there is a major bias here still), you are more likely to get fellowship inside the .mil but you will probably have to wait your turn.

I've answered these sorts of questions before on multiple occasions. Try a search.

 

[glamqueen]

you'll probably have to do a utilization tour as an internist after your IM residency, before going to a fellowship. At least, this was the case for the GIs I met this past summer.

Cant speak of cards . . . but I had the opportunity to shadow the GI staff at NNMC (Bethesda) this past summer. Is a very cool specialty, diverse, lots of clinical and procedural stuff, research too. If you're interested in setting up a rotation there or something, PM me your "real" name and info, I can pass it along.

One of my friends is a first-year fellow who went straight from IM residency to her fellowship. You don't have to always do a utilization tour. This is in the AF, fwiw. She was non-prior service.

 

[former military]

from my knowledge of how things work in the AF there are advantages to doing your residency in the same place as the fellowship. in this case you were a known commodity. They knew you were intelligent, hard worker, and not an A hole. Most importantly you had built up contacts and had an inside track.
I wasn't IM... but did six years of residency at WHMC and BAMC so I saw a lot of IM residents come and go through the program and saw how they matched in fellowship.

 

[DrMetal]

One of my friends is a first-year fellow who went straight from IM residency to her fellowship. You don't have to always do a utilization tour. This is in the AF, fwiw. She was non-prior service.

Understood, but that's not a likely path, given that the military needs internists right now (aka PCPs, people they can deploy).

In any case, I don't think a utilization tour as an internist is such a bad thing. It probably pays to sharpen your skills in a medicine service before going into a subspec, especially one as vast as GI.

 

[Gastrapathy]

Understood, but that's not a likely path, given that the military needs internists right now (aka PCPs, people they can deploy).

In any case, I don't think a utilization tour as an internist is such a bad thing. It probably pays to sharpen your skills in a medicine service before going into a subspec, especially one as vast as GI.

The main advantage of doing a utilization tour prior to fellowship is for people on a 3 year HPSP, who can then sign an MSP prior to fellowship. Professionally, it doesn't buy much and its better to get through fellowship as quickly as possible from a promotion/professional development standpoint. If you get the chance, go straight through and, if not, find as short a utilization tour as possible.

Remember, its 6 years through IM and GI (plus 1 for hepatology or advanced endo), so if you add in a 3 year utilization tour, you won't finish training until you are almost 10 years out from med school. Can you really see yourself still being treated as a trainee in a decade?

Also, at least in the Navy, there isn't any bias to local residents. Portsmouth residents are well represented in all the fellowship programs.

 

[JACO22]

I'm not sure what branch of service you're in. I would say that to get into an Army Cardiology fellowship at either BAMC or WRAMC, it is competitive enough to where the majority of fellows will have done several years as staff prior to entering fellowship. In the Air Force, cardiology is slightly easier to enter fellowship direct from residency if you're a strong candidate. Of course, all this depends on how popular the subspecialty is in a given year and how many people in the field remain interested. Additionally, it is unclear what the future SAMMC integration of BAMC and WHMC will bring in terms of volume and how many cardiology fellows can be trained there.