I'm wondering if I would fit in with the IM culture.

[itsabigworld24]

I was always thinking FM. I think I fit in well with the FM culture. However I don't like peds, OBGYN, and the pathology seemed too simple for me. I like solving difficult cases and doing big workups. I'm a big picture type of guy and not super detail oriented. I'm worried this could cause me problems in IM. I don't want to be seen as the dumb resident because I often struggle remembering small details. I also have 3 small kids and I'm trying to leave a very strict religion (cult). My wife still believes in said religion so family life has been very stressful. Do you think an IM residency would be too stressful and tear my family apart? Maybe a FM residency would be less stressful?

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[IMGASMD]

I was always thinking FM. I think I fit in well with the FM culture. However I don't like peds, OBGYN, and the pathology seemed too simple for me. I like solving difficult cases and doing big workups. I'm a big picture type of guy and not super detail oriented. I'm worried this could cause me problems in IM. I don't want to be seen as the dumb resident because I often struggle remembering small details. I also have 3 small kids and I'm trying to leave a very strict religion (cult). My wife still believes in said religion so family life has been very stressful. Do you think an IM residency would be too stressful and tear my family apart? Maybe a FM residency would be less stressful?

Regardless whatever residency you do, it will take a toll on you and the family. We do sacrifice a lot for the profession. As to what speciality? Only you can really answer. But if you already ruled out peds and OB/Gyn. Maybe IM isn’t bad. If you have the scores, some of the surgical sub-specialities are nice. Anesthesia can be fulfilling for certain personality.
About your concerns regarding details in IM? Everything becomes easier with practice. Especially when you’re responsible for 10 patients as intern. 30-50 as a senior resident. I’ve cross cover ~100 patients as a hospitalist. You will learn to remember the important things. The pace of outpatient vs inpatient is also something you won’t appreciate until you’re “in it.”

Good luck with everything.

 

[Redpancreas]

IM doesn't have a "culture" unlike your typical Ortho bro, Derm/Ophth lifestyle person, or good natured EM resident. IM Residents are diverse in terms of ethnicity, country of origin, personality, gender, etc. In terms of the details, I agree with the above post. When it comes to fellowships, people have said that Cardiologists share some surgeon characteristics, Pulm/Crit shares some EM characteristics, etc. but that's down the road. I've always thought of myself as a big picture person, and do notice IM contains a lot of detail, but it's about learning to remember the important details, not remembering all of them.

 

[GastriqueGraffin]

I agree with others that there is no stereotype culture for all IM. It has more to do with the type of IM program (community vs university, IMG vs AMG, fellowship oriented vs primary care). Maybe consider a community IM program if you like the FM personalities or subspecialize in something like allergy or rheum.

 

[Eyeronic]

Elite academic IM has a bit of a "culture", one that I personally did not like at the end of the day. But what others are saying is true: IM has a very wide personality spectrum otherwise, especially when you get out there into the everyday world outside the ivory towers.

P.S. LOL at the "good natured EM resident".

 

[IMreshopeful]

I was always thinking FM. I think I fit in well with the FM culture. However I don't like peds, OBGYN, and the pathology seemed too simple for me. I like solving difficult cases and doing big workups. I'm a big picture type of guy and not super detail oriented. I'm worried this could cause me problems in IM. I don't want to be seen as the dumb resident because I often struggle remembering small details. I also have 3 small kids and I'm trying to leave a very strict religion (cult). My wife still believes in said religion so family life has been very stressful. Do you think an IM residency would be too stressful and tear my family apart? Maybe a FM residency would be less stressful?

I’m sorry about the cult situation... that’s truly a unique issue I’ve heard of so far on this forum. I don’t know what advice I can offer on that front.

As an IM doc yes being detail oriented is important. You’re a generalist as a hospitalist and a primary care doc - meaning that you need to pay attention to stuff. That low K and Mg? Matters. The slowly downtrending platelets? Matters, especially if concerned about HIT. etc etc. In inpatient IM training this is definitely emphasized from an educational perspective. It is possible to be detail oriented and not get bogged down in the minute details however - the big offender in medicine IMO for getting overly antsy about details to me is nephrology, which doesn’t personally appeal to me. So it’s a balance.

That being said... it’s a big field and there’s no single personality fit. The guy or gal doing cardiology is very different from the person doing rheum. If you enjoy the field you will probably do just fine. Also remember that “fit” is a big part of where you choose your residency - you may thrive somewhere your colleagues may not.