IM to EM

[bellatrix]

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Hi Folks!

I am a PGY3 IM resident in a mid-tier Northeastern University program. I had a difficult time choosing between general surgery and IM prior to residency application time but ultimately chose IM for the option of doing a critical care fellowship.

Throughout my intern year, I had doubts about IM, but decided that was a symptom of "intern blues". This feeling didn't pass and I realized that I missed caring for surgical & ob-gyn patients...and was sad to learn that pulm/cc docs no longer do airway management. I also enjoyed urgent primary care visits -- and would miss treating these problems in critical care. I contemplated switching to anesthesiology, but held back as I knew I would miss talking to patients & families and treating acute IM problems.

I didn't realize that EM was the field for me until July of this year, when I had a required rotation in the ED. I loved it. I loved the team atmosphere of the ED, the crazy random things that people do to end up in the ED, quick decision making, the chaos, and the fact that I when I went home -- I was home. Plus -- ED residents and attendings are generally laid back, fun people!

I have heard that it is difficult for IM residents to apply for EM residencies due to lack of Medicare funding. How difficult is this? Will I be able to find a spot? I would love to return to the Midwest and as I'm interested in academic EM, I would love to find a residency spot in a University program. Has anyone else made this switch? Do you have any advice? I plan to complete my PGY 3 year (I've come this far...) and hope to be double-boarded in IM/EM.
Many thanks in advance.

 

[Static Line]

Hi Folks!

I am a PGY3 IM resident in a mid-tier Northeastern University program. I had a difficult time choosing between general surgery and IM prior to residency application time but ultimately chose IM for the option of doing a critical care fellowship.

Throughout my intern year, I had doubts about IM, but decided that was a symptom of "intern blues". This feeling didn't pass and I realized that I missed caring for surgical & ob-gyn patients...and was sad to learn that pulm/cc docs no longer do airway management. I also enjoyed urgent primary care visits -- and would miss treating these problems in critical care. I contemplated switching to anesthesiology, but held back as I knew I would miss talking to patients & families and treating acute IM problems.

I didn't realize that EM was the field for me until July of this year, when I had a required rotation in the ED. I loved it. I loved the team atmosphere of the ED, the crazy random things that people do to end up in the ED, quick decision making, the chaos, and the fact that I when I went home -- I was home. Plus -- ED residents and attendings are generally laid back, fun people!

I have heard that it is difficult for IM residents to apply for EM residencies due to lack of Medicare funding. How difficult is this? Will I be able to find a spot? I would love to return to the Midwest and as I'm interested in academic EM, I would love to find a residency spot in a University program. Has anyone else made this switch? Do you have any advice? I plan to complete my PGY 3 year (I've come this far...) and hope to be double-boarded in IM/EM.
Many thanks in advance.

I went EP. I have a good friend who went IM at decent mid-tier program and wanted to switch to EP. She met lots of roadblocks though. The main one is the medicare funding. Once your medical education clock starts ticking it doesn't stop. Your clock is coming to an end. I would talk to individual PD to find out what they are willing to overlook. You'll hear lots of opinions on here that aren't gospel(unless they are a PD or GME). Whoever you find you need to know that they are willing to overlook that small thing. So start looking in places willing to turn a blind eye or an eye where they see you may benefit them. A good place to look may be new start-up EM programs that could use some upper level mentoring, etc.... Good luck.

 

[Saladin MD]

This is a sort of related question...what about Emergency Medicine fellowships like this one:

http://www.emfellowship.com/

Is this a backdoor to EM for someone who did IM? Or is there a huge catch?

Thanks!

 

[deleted77919]

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[SoCuteMD]

This is a sort of related question...what about Emergency Medicine fellowships like this one:

http://www.emfellowship.com/

Is this a backdoor to EM for someone who did IM? Or is there a huge catch?

Thanks!

a) not board-certified
b) 10 months x 12-14 shifts a month? That's a few more shifts than I'll do in intern year (and we work 10s and 12s)
c) doesn't involve any ICU months (at my program we do peds ICU and surgical ICU in addition to various other ICU months)
d) No ob/gyn, ortho, ultrasound, or anesthesia training