leaving Internal Medicine residency for Occupational/Preventive Medicine.

[asdfg123]

Hello all,

I searched for similar forums but did not find any and I am in search of advice/experiences. I am currently a PGY-I in a middle tier Internal medicine Program. I have found that I am extremely unhappy in Internal medicine and I realize that it is not the specialty for me. I have been researching other specialties/careers (particularly occupational/preventive medicine) and have decided that I would like to try and make a switch, but I don't even know where to begin. Its late in interview season at this point, I am dreading having this conversation with my program director, and I have no clue as to if and how I would go about this. I know that most occupational/preventive medicine programs allow you to apply after completing an intern year, which I plan on doing, but is it plausible or likely that I would be able to land a spot after leaving an Internal Medicine program behind? Hind site is 20/20, and if I could do it all over again, I would have applied for a prelim or transitional year spot. I made a mistake picking internal medicine just because I thought it was broad and that I would be able to find my niche somewhere. Unfortunately I no longer feel like this is the case. I have been doing ok on my rotations and have received good reviews. My performance has been good, but I just do not enjoy internal medicine enough to continue on this tract. It has caused me a significant amount of stress which is now affecting my home life and my relationship with my wife. Any advice that anyone could offer me in this situation would be greatly appreciated.

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[AdmiralChz]

Why in particular do you think occupational/preventative medicine would be a good fit for you? Have you had exposure to it, how would it fit your skill set?

These are the first questions you need to ask before jumping ship on a residency.

 

[ThoracicGuy]

Paging @fantasty.

 

[fantasty]

Quoting from thread #2

Too tired to retype this but if it helps OP - post 7:

HELP, want to change residency

But, this is the same OP that I responded to in that thread. I am thinking of re-writing this as a blog / article though. Also, OP... if you are the same person I had a detailed phone conversation with a couple of days ago, please feel free to reply directly. I understand this is a big decision so it's understandable to want to get as much feedback as possible - I spoke with someone in a similar situation though, so I just wanted to clarify you might be hearing the same person's opinion.

 

[futuredo32]

Can you do an elective?
If you are sure you want to do it and have had exposure, do it ASAP. I don't know if its too late for ERAS to pick up something post scramble. Nor do I know how competitive PM&R is. But I do know this. My first year of psych residency I told my PD I wanted to do primary care, I didn't hate psych but I missed medicine. She said it was normal and wasn't surprised because I had done a TRI but I was doing awesome in psych. She had me do a bit of inpatient and C/L I liked that less than outpatient. But it was past ERAS, passed the deadline for the year to try and do much. BUT I rotated with a FP Dr the following year who was to be the PD of a new FP program and he LOVED me his comments on my eval included "born to be a physician" "God's gift to medicine" He PROMISED me a spot either then or when I finished psych. I should have said now, but I thought it would be awesome to do a little of each, I do like a little therapy. I switched programs because there were big bad changes to the program, our PD quit and it was awful. The FP PD kept in touch with me, we met twice for coffee and he emailed me twice making sure I would apply to his program. It wasn't the greatest, but it was , I thought a guarantee. So 4th year of psych residency comes, I apply to his program and like 30 others in my home state. I got a whopping 2 interviews and neither at his program. Turns out he had the credentials for being a PD and the rest of the leadership didn't like him. He had no say at all. I emailed and called him and he tried to get me an interview at least. I blew it. I should have left while I had the chance.
If you don't like IM because of the hours or the program, suck it up, it gets better after residency. But if it's IM you don't like and you have had actual exposure to PM&R or get some, use a vacation week to shadow PM&R if an elective isn't possible talk to the PM&R PD at your institution AFTER you talk to your PD. Your funding clock is running out. Hospitals make oodles of money on residents but they only get half of that money for a second residency. See if your current PD can pull any strings for you during the scramble. I am going to apply for FP in 2020, a few important things to take care of first. It isn't likely I will match but I am going to volunteer in a FP clinic and see if I can get a locums job doing workmans comp physicals or something more "medicine like" than psych.

 

[fantasty]

Prev med is different than PM&R. Just sayin'

 

[fantasty]

Why in particular do you think occupational/preventative medicine would be a good fit for you? Have you had exposure to it, how would it fit your skill set?

These are the first questions you need to ask before jumping ship on a residency.

And some of us are particular that it's "preventive" not "preventative".

 

[calitechmed]

Hello all,

I searched for similar forums but did not find any and I am in search of advice/experiences. I am currently a PGY-I in a middle tier Internal medicine Program. I have found that I am extremely unhappy in Internal medicine and I realize that it is not the specialty for me. I have been researching other specialties/careers (particularly occupational/preventive medicine) and have decided that I would like to try and make a switch, but I don't even know where to begin. Its late in interview season at this point, I am dreading having this conversation with my program director, and I have no clue as to if and how I would go about this. I know that most occupational/preventive medicine programs allow you to apply after completing an intern year, which I plan on doing, but is it plausible or likely that I would be able to land a spot after leaving an Internal Medicine program behind? Hind site is 20/20, and if I could do it all over again, I would have applied for a prelim or transitional year spot. I made a mistake picking internal medicine just because I thought it was broad and that I would be able to find my niche somewhere. Unfortunately I no longer feel like this is the case. I have been doing ok on my rotations and have received good reviews. My performance has been good, but I just do not enjoy internal medicine enough to continue on this tract. It has caused me a significant amount of stress which is now affecting my home life and my relationship with my wife. Any advice that anyone could offer me in this situation would be greatly appreciated.

Have you had any success? I am sure that you are aware but the ACPM recently began their own match process and currently have many positions still available for Preventive Medicine residency programs. I would post a URL link but I just got a SDN account and can't. Go to Google and type "prevmedsap" then to Database (for Applicants) to find those schools. Hope this helps!
Best,
calitechmed