Internships & Residency for Internal Medicine

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PellsBells93

OSU College of Veterinary Medicine Class of 2020!
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I am a third year vet student looking for advice on internships and residencies in internal medicine in academia vs private practice. What are the pros and cons? Thank you!

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First and most important is there are good programs in academics and private practice. So you really have to consider the specific program. But in general...

Academic program
Pros:
Tend to have structured seminars and oversight. They are already set up to teach students.
More research opportunities
Most are 501(c)(3) institutions and qualify for PSLF
Academic residencies may prefer applicants with academic internships because of teaching experience
Many don't require state license
Cons:
Potential competition between students and house officers for cases
Many are in smaller towns

Private practice programs
Pros:
Often busier with faster pace (lots of exceptions though)
Often in larger metropolitan areas
More programs to choose from (internships)
Salaries tend to be higher (but still suck)
Cons:
Lack of effective oversight for internships is important for smaller, less well known programs

Realize these are all generalities and there are plenty of exceptions.

William Thomas
 
After considering Dr. Thomas' general points above, you really need to dig deep into each program's description and contact the current interns/residents (depending on what positions you're applying to). There are amazing training programs in both academia and private practice. Unfortunately, there are also some sub-par ones. In addition, you want to find a program that is a great fit for you and vice-versa. Applying someplace just because of reputation is not always a great idea. For example, if well known and reputable rotating internship program lists 65% time spent in ER throughout the year; you don't like ER/critical care medicine and want to pursue an internal medicine residency. One can conclude that this program would not be a great fit for you and programs that have less ER time and allow for additional time on other specialty services would be more appropriate.
 
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Potential competition between students and house officers for cases
Curious, what schools put their interns on the same level as students to the point where they have to compete for cases?

Illinois interns are the lead clinicians on their case. Students report to the intern on the case, then the intern pitches the plan to the attending. Students and interns don't have any sort of competition at all. I've never heard of it being different elsewhere.
 
From the perspective of someone in a primarily academic residency (that has a private practice component) who did rotating and specialty internships in private practice - there are pros and cons to having students working with us for sure. I'm not quite sure that from my perspective I'd phrase it as competing for cases necessarily so much as competing for learning opportunities in general with respect to case management.
 
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