internal medicine pgy2 vs. nuclear medicine

[radioactive]

quick question. i'm a prelim internal medicine who didn't match in radiology. i'm applying again and trying to make a gameplan for the next year or so. which would be more beneficial:

1. apply, continue internal medicine, in which case if i don't match i would be applying again the next year going into pgy3 of internal medicine rad in 2005, which would allow me to be double board certified.

2. go for nuclear medicine and research next year at a program with a good radiology program. that would put me in the loop of things, as the program i'm in now doesn't have rad.

thanks guys.

radioactive!

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[Voxel]

You have to realize that even if you finish a nuclear medicine residency it will be tough to land a radiology residency even with great letters of rec and inside connections. I have a friend who did this and was looking for work at the end of his nuclear medicine residency cause he didn't match into radiology even with his "in". *He failed to match radiology.* He was offered a nucs job after 8+ months of job searching during his final year of nucs, only to fill a pgy-2 position (Rad-Yr 1) because someone deferred that year do to personal issues .

1) It will be tough to do from nucs but not impossible.

2) Landing a straight nuclear medicine job these days is tough. In fact he was offered a job as an employee with no chance of ever becoming partner at this radiology practice. I'm sure the minute a double boarded rads/nucs guy came around looking for a job, he would have been told to hit the road.

 

[radioactive]

Hey voxel.
thanks. Well, at least it worked out for your friend. i see what you are saying. Any comment on my marketability as a board certified internist apply to radiology? i would imagine i should be pretty competetive by THEN??

thanks

 

[Jim Picotte]

I think the other problem with applying after you've already done a residency is that the radiology program doesn't get as much money from the government for your slot. I don't know how it works exactly, but I know that a program will get more money for a resident in his/her first residency. If you do categorical Internal Medicine, you'd get 3 years of funding (luckily you're prelim right now so it doesn't count), if you were in General Surgery you'd get 5 years of funding, so if you get a spot after this year you'd be golden. If you do a medicine residency, you'd have used up all your medicare funding (not exactly all but a certain percentage of it) for the residency and the program you'd be applying for would have the decision. A board certified internal medicine grad who we'd take a big hit in the funding department if we accepted or a 4th year med student who we'd get full funding for. You can see why it's so hard for people who've done other residencies to get into rads (easier for the gen surgeon who switches after 1 or two years because they have more years of funding, much harder for the IM person).

I've seen the same thing about the nucs supposed backdoor, I know several who weren't able to get into radiology after a nucs residency for whatever reason.

I'd try like hell this year as it's probably your best shot, but even if you don't get in this year, and you really want rads, keep trying and network like crazy. Spots do open up at times and you might get lucky. I think radiology needs all the dedicated people that they can get.

Good luck.

 

[radioactive]

thanks alot jim,

yeah, it's kind of dissappointing. b/c i know i if it work at internal medcine i'll be a good internist/subspecialist, but i feel like i'd be an amazing radiologist and i would LOVE my work. there is so much uncertainty to this situation that's it's annoying. thanks for the advice.

radioactive

 

[MacGyver]

So let me get this straight.

Radiology is very tough to match into, and every year many US trained MD/DOs are unable to match into it and become radiologists.

On the other hand, apparently there is a shortage of radiologists (if you believe the hospitals) so therefore some programs are starting to train PA/NPs to do some of the radiology work.

So on one hand we are blocking people from radiology while in the back door we are bringing in other people who didnt have to go thru the same hoops.

What the hell is that?

This reminds me of med school admissions vs foreign residents. On one hand we say that we cant accept many qualified american med students, but on the other hand we go behind their back and take in thousands of foreign grads. Hypocricy anyone?

 

[Jim Picotte]

Unless the government decides to pay for more radiology slots, it's just the way it's going to be. My program has been approved to train 10 residents a year, but we only have funding for 7. The hospital won't give us anymore funding and we're at our max for residents at our hospital so the only way we can get more funding from the government is to lose 3 residency slots from say...medicine (no chance in that happening) or getting some congressional funding for more radiology slots. I guess if you're willing to work for no pay or benefits and want a spot you could contact our PD, but 4 years without any income, don't know how anyone could survive.