Is the Medicine Internship useful?

[Hard24Get]

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I am doing my Sub-I right now, and it is all paperwork, dispo, and coagulation adjustments, with a couple of diagnostic moments involving consults and complex radiology thrown in. Although it is a good experience, I don't see how a year of it could possibly help me be a better EM doc. Any insights? Cause if not I'm crossin' the 2-4 yr progs off my list. 👎

 

[nocallaochicas]

Cause if not I'm crossin' the 2-4 yr progs off my list. 👎

Before you cross of the 2-4 programs, remember transitional years have you see peds, ob/gyn, anesthesia, etc.

You will have to wait for someone more senior to post about the value of transitional years as an EM internship, but it seems pretty good to me and it seems fairly similar to an internship year that a 1-4 program might develop...of course, you loose all the benefits of being under the EM dept, but I dont' think that is a reason to cross off 2-4 programs.

ncc

 

[GeneralVeers]

I personally don't understand the 2-4 or 1-4 programs. I don't think a purely medicine year would add that much, as the EM approach is very different. As the other person mentioned, a transitional year is probably better, as you'd get wider exposure to many things relevent to EM.

I interviewed at Wash U, and I asked one of the 4th year residents what the advantages of a 4-year program were. He said in his 4th year he basically acted like an attending but got paid as a resident. That essentially clinched the decision for me. Some people claim that 4 year programs are better for those inclined towards academics. I've not seen good objective data to support or reject this.

 

[Hard24Get]

I personally don't understand the 2-4 or 1-4 programs. I don't think a purely medicine year would add that much, as the EM approach is very different. As the other person mentioned, a transitional year is probably better, as you'd get wider exposure to many things relevent to EM.

Sure, a transitional year would be better than a medicine internship year, since it involves several different depts, and I'd definitely scramble into one in a pinch, but I would argue that an EM internship year would be far better tailored to the type of training we need. We are not like Neurology or Derm, which have a firm basis in medicine alone. No offense, NCC, part of it is just me being cantankerous b/c of my exploding pager and q4 call.

I don't see a real advantage to 1-4s either (would rather a 3yr+fellowship for academics), but since a lot of great academic programs have 4yrs, I won't cross them off.

Incidentally, GeneralVeers, why are you still "homeless"? Thought you were fitting in well in Texas?

 

[nosugrefneb]

Do programs specify which (IM or transitional) is required, or is that left up to the applicant?

 

[StudentDoc327]

I had the same thoughts as you before I started the application process some months ago. I never thought I would have ranked the two pgy2-4 programs I interviewed at at the top of my rank list (#1 and #2), but I was really impressed with the training at both programs and thought the prelim/transitional year would be worth it as long as I didn't go somewhere that would be basically like 4rth year with a salary. I am hoping the prelim year (I will be doing prelim medicine but with a month of ER and 3-4 additional electives in any dept so im hoping to do more than just medicine during the year) will help me learn to be a good all around doc so I will have that down somewhat before I begin trying to be a good emergency physician. I know EM is different from IM, but i'm convinced there is a lot of general medicine in EM and knowledge from an intern year in IM wouldn't be completely useless and might actually make me more competent (I wonder what im gonna think a year from now though LOL). I'm hoping I will be a better physician at the end of 4 years of training as opposed to 3, but I by no means think that 3 years is not enough it was just my personal preference. I would have preferred a 1-4 but felt a little better after I looked at all the different rotation blocks of the programs I was applying to and noticed that the pgy2-4 programs were just about all EM or EM related (eg. tox, US, trauma, peds em) with the exception of 2 weeks of ob, anesthesia and 2 months of ICU as soon as you start the pgy-2 year so it was almost equal or equal to the # of EM months in 1-4 programs and more than the 1-3 programs.

 

[JackBauERfan]

yes, i think so, see my pm haha.