Internal Medicine Fast-Tracking

[task]

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This whole concept of fast-tracking into IM fellowship needs to be clarified.

There are no "combined" IM/Cardiology, IM/GI or IM/(insert fellowship) tracks at all. I remember seeing something in my med school library a few years ago about some community program in Pittsburgh that let you do that, but I don't know if it exists any more or what the specifics of the program were. You do not officially match into combined programs in this day and time as a general rule. Programs may promise you stuff or work out things under the table to attract you to a given place, but nothing formal. The closest thing to combined IM/fellowship tracks that I know exist are fast-track setups where an individual with significant research experience prior to residency (like substantial research experience in a field or a PhD or something) works it out with the IM program director, subspecialty division chief, chair of the dept., etc. that he/she would be able to accelerate their IM training to be BC/BE in 2 years or so and start their first year of fellowship a year or so early. Two caveats: 1. the opportunity will depend on the fellowship, and 2. significant research means siginifcant research, and the likely intention of going on into a career in academic medicine.

For example, I have worked with two residents this year who have fast tracked. One will finish his second year of IM residency and go onto ID fellowship somewhere else starting 7/2002. He has SIGNIFICANT #s of publications and has been working on a PhD in Epidemiology while in med school and residency. Also, given that ID is not the most competitive fellowship to get, this arrangement was not hard to work out -- they get a top notch researcher and clinician 1 year early who will come to their fellowship and be productive. Another resident I worked with was an MD/PhD and started his Endocrine fellowship in 1/2002 here as well after 2.5 years of residency. His PhD work was in molecular biology and he worked out his fast-track during his intern year -- a lab to plug into during his Endocrine fellowship, etc. He only has 1 clinical year in fellowship anyway, and he wants to teach/do research for a living.

I was trolling departmental websites and saw Duke's GI division stating something to the effect that certain candidates would be eligible to fast-track into GI there, but the implicit assumption was that it would only be people who were IM training at Duke and who were already knee-deep in research interests.

So fast tracking is possible, but it seems possible only for those who have the research credentials to validate their reasons for fast-tracking and it seems to work for those fellowships which are not known for having an onslaught of applicants. There are always exceptions, but these are few and far between.

This post is based on what I've seen and heard, so if others have heard othwerwise, please post to that effect 🙂

 

[navs]

Great info.!!

Thanks.

 

[leof]

There?s a combined program at Mayo called CI - Clinician Investigator. You match with both: IM residency and fellowship, but there are 2 years of research between residency and fellowship. In heme/onc and cardio this means 7 years.

leo

 

[AJM]

Good info. And to add onto that, for the most part fast-tracking isn't really fast-tracking at all. While you do one less year of IM residency, typically the requirement is that you have to do an extra research year during your fellowship, so you end up not saving time at all. I've never heard of anyone cutting a year from residency yet keeping the total length of their fellowship the same. While that option may very well be out there, it's my understanding that it's pretty rare.

 

[task]

AJM --

Good point about the sum total # of years. Not doing a third year of IM means an additional research year in fellowship. I don't understand (from a $$ standpoint) how the IM fellowships (like Cards) get away with essentially increasing the # of years of training while other fields (like some Gen Surg subs) have had to curtail years. I would think the only answer is that because the IM fellowships have research years, they are funded thru grants and other sources, not just the Feds.

But I still think it matters. Many colleagues in my intern class are narrowing down fellowship choices now and many are taking the # of years to train into account. While I don't think it will have an immediate effect on #s of applicants, etc., just wait a few years.