rs2006

student
10+ Year Member
7+ Year Member
Jul 17, 2005
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Southeast
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Hi everyone,
I hope all is well for everyone in the forum. I finished my IM residency back in 2009 and since then have been working and am currently applying for a NON GI/Cards IM subspecialty fellowship program. I am a US citizen/US grad from a major US medical school and passed all my steps on the first attempt with no problems during my medical school/residency training. I got ~220 on step 1, step 2cs pass, step 2ck ~230s and step 3 240.
I have been working in urgent care/ ER at a large medical center and find the work rather frustrating-- many difficult patients and families, systems issues, etc-- much the same frustrations that I felt when I was an IM resident.
I am relatively young, but to a certain extent fed up with medicine and feel that I am currently at a fork in the road--- leave medicine vs return to training in a IM subspecialty that realistically is NOT going to be more financially rewarding than just plain IM vs repeat a residency in a different specialty. I know that repeating a residency comes with the funding issue which would require me to find a program that can privately fund my residency training which would likely be very difficult. I have been on many interviews for fellowship and somehow feel that it may not be worth it to persue fellowship as I have seen few competitive US grads and mostly foreign grads on the interview trail. I have also heard that this year there is 1 US grad applicant for ~3 fellowship spots in this specialty.
To be completely honest, the subspecialty that I am applying for is not one that “love,” but one I can think that I may be able to tolerate. I was one of those people that went through medical school and even residency and cannot really say that I “loved” anything and chose IM because it was broad-based and I felt that it would give me the most post-residency career options. Three years later, I find myself with limited options with just plain IM—primary care vs hospitalist vs academics vs return to fellowship/do another residency. On the other hand, I feel that NOT finishing a fellowship would leave my training “unfinished” and may leave me feeling guilty when I am older and do not have the option to return to training due to other personal obligations . Has anyone else in this forum found themselves in the same situation and have any advise ? Thanks .
 

jdh71

epiphany at nine thousand six hundred feet
10+ Year Member
Dec 14, 2006
67,340
45,085
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FEMA Camp, USA
Status
Attending Physician
Hi everyone,
I hope all is well for everyone in the forum. I finished my IM residency back in 2009 and since then have been working and am currently applying for a NON GI/Cards IM subspecialty fellowship program. I am a US citizen/US grad from a major US medical school and passed all my steps on the first attempt with no problems during my medical school/residency training. I got ~220 on step 1, step 2cs pass, step 2ck ~230s and step 3 240.
I have been working in urgent care/ ER at a large medical center and find the work rather frustrating-- many difficult patients and families, systems issues, etc-- much the same frustrations that I felt when I was an IM resident.
I am relatively young, but to a certain extent fed up with medicine and feel that I am currently at a fork in the road--- leave medicine vs return to training in a IM subspecialty that realistically is NOT going to be more financially rewarding than just plain IM vs repeat a residency in a different specialty. I know that repeating a residency comes with the funding issue which would require me to find a program that can privately fund my residency training which would likely be very difficult. I have been on many interviews for fellowship and somehow feel that it may not be worth it to persue fellowship as I have seen few competitive US grads and mostly foreign grads on the interview trail. I have also heard that this year there is 1 US grad applicant for ~3 fellowship spots in this specialty.
To be completely honest, the subspecialty that I am applying for is not one that “love,” but one I can think that I may be able to tolerate. I was one of those people that went through medical school and even residency and cannot really say that I “loved” anything and chose IM because it was broad-based and I felt that it would give me the most post-residency career options. Three years later, I find myself with limited options with just plain IM—primary care vs hospitalist vs academics vs return to fellowship/do another residency. On the other hand, I feel that NOT finishing a fellowship would leave my training “unfinished” and may leave me feeling guilty when I am older and do not have the option to return to training due to other personal obligations . Has anyone else in this forum found themselves in the same situation and have any advise ? Thanks .
You seem to indicate that the number of non-americans also applying to your fellowship is bothering you, why?

I think you need to find something you like to do, not merely tolerate. Maybe this isn't possible?
 

Scaredshizzles

10+ Year Member
5+ Year Member
Jul 11, 2007
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You seem to indicate that the number of non-americans also applying to your fellowship is bothering you, why?

I think you need to find something you like to do, not merely tolerate. Maybe this isn't possible?
There are some people who just aren't going to enjoy work. I don't think any service sector job would sit well with the OP. I would recommend anesthesia though, because I see people getting anesthesia residencies after completing IM.
 

staup

10+ Year Member
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Feb 16, 2007
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I wouldn't recommend any fellowship or specialty change unless you think you will like it, but i also understand that can be hard to know before you actually practice it. I also feel that the "unfinished" feeling to not doing a fellowship is a bias, not true, and something you will get over.

Rads and Gas are two specialties that do not deal with psychosocial issues that you might like, Gas probably easier to get into than Rads, especially after already doing an IM residency. Who knows what their salary will be in the future. Rads has adecent lifestyle and Gas is OK, but they really do work hard despite what some people think. They are at the hospital at 6-7 and many don't leave until 5 or so plus weekend work depending on their group. Not really a lifestyle specialty.

One option might being going to the hospitalist direction and doing Administrative work. It reduces your clinical load and even though you will deal with some psychosocial issues as a hospitalist, it will not travel with you after you leave the hospital. Your lifestyle would be good and it definitely pays well even in academics these days (although not nearly as high as Gas and Rads). As an AMG with a decent backrgound it would not be too difficult to transition into the admin role after a few years and do less actual clinical work.