Michigan

[SeekerOfTheTree]

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Greetings! How are you? Going through my third year I have come to a fork in the road. I like IM and I like ER. I am not sure I can commit to one or the other. I have commitment issues. I can't decide betweek soup or salad at olive garden because if I get the salad I want the soup...its a problem. At the drive thru I am always split too. So my problem is I am geographically limited to the Michigan area. I think I could get IM here pretty easily since I got a 240+ on step 1 but I am not sure on the competitiveness of ER in this region. Any advice if it would be worth applying if I am so limited and is there anything I could do to increase my chances? Also what are your thoughts on the IM/EM program at the Henry Ford? Thanks for your help.

 

[monkeybutt]

You don't mention if you've done your EM or your IM rotations in med school yet. I think you'll find that many EM physicians (this is especially true for me) have a certain personality type that is compatible with emergency medicine and is definitively incompatible with internal medicine. Before you consider a joint program, I would make sure you do rotations in each.

240 is a competitive score for EM, but it's not all about scores.

 

[SeekerOfTheTree]

I had a chance to rotate through ER and felt like those were my people. The only thing is I have not rotated through IM but the program at my school has very uptight IM guys and I am the opposite of uptight. I was hoping they were just this way because they are FOBs and they just dont warm up to you till they know you. I dont ever want to specialize if I did IM.

 

[EM_Rebuilder]

I had a chance to rotate through ER and felt like those were my people. The only thing is I have not rotated through IM but the program at my school has very uptight IM guys and I am the opposite of uptight. I was hoping they were just this way because they are FOBs and they just dont warm up to you till they know you. I dont ever want to specialize if I did IM.

I dont want to stereotype IM guys as 'uptight'; I dont think that is the best word to use.... but I think the difference you already observed in your few experiences contrasting EM vs IM may hold more true overall than you realize.....

 

[SeekerOfTheTree]

I dont want to stereotype IM guys as 'uptight'; I dont think that is the best word to use.... but I think the difference you already observed in your few experiences contrasting EM vs IM may hold more true overall than you realize.....

Sorry bad choice of words on my part. Do you think it is realistic for me to apply to a field as competitive as EM with the location restrictions I have? IM I know I could get into here just because of the number of programs and good amount of research and stats behind me.

This is like wanting to be that hot girl that never wants to settle down and will give you the wildest ride of your life (EM) but maybe having to settle down with that average girl thats stable, wants to have kids, and you know she's the type of girl you can bring home to mama(IM). Thats why i was thinking about settling down with the homely girl but having an affair with the hot chick so I end up at an EM/IM program.

 

[Arcan57]

I had a chance to rotate through ER and felt like those were my people. The only thing is I have not rotated through IM but the program at my school has very uptight IM guys and I am the opposite of uptight. I was hoping they were just this way because they are FOBs and they just dont warm up to you till they know you. I dont ever want to specialize if I did IM.

Choose your specialty based on the work (at the attending level), not the people. Those fun, laid back EM docs? I spend <10 minutes a shift interacting with them because we're all too busy managing our own crises. Those stuffy, uptight IM docs? I spend 30 minutes to 1 hour talking on the phone or in person per shift. I imagine other than the fact that some of them have time to eat lunch together in the doctor's lounge they'd tell a similar story regarding how much they interact with the peers (not specialists).

 

[Arcan57]

Sorry bad choice of words on my part. Do you think it is realistic for me to apply to a field as competitive as EM with the location restrictions I have? IM I know I could get into here just because of the number of programs and good amount of research and stats behind me.

This is like wanting to be that hot girl that never wants to settle down and will give you the wildest ride of your life (EM) but maybe having to settle down with that average girl thats stable, wants to have kids, and you know she's the type of girl you can bring home to mama(IM). Thats why i was thinking about settling down with the homely girl but having an affair with the hot chick so I end up at an EM/IM program.

What are you going to do with an EM/IM certificate when you're an attending? You've stated your desire to not specialize, so that's going to significantly limit your options if you really do want to practice both. An academic hospitalist/EP gig is the most likely scenario for practicing both on a continuing basis. There will be significant barriers to practicing both in a community setting, with most EM/IM people I know only practicing EM (of course there's selection bias there).

EM and IM reward fairly different cognitive skill sets and, with the exception of hospitalists, have very different lifestyles. Figure out what your strengths and weakness are and compare them to what the attendings in each specialty do on a day-to-day basis (well chronicled on SDN).

 

[Emergency!]

Do you think it is realistic for me to apply to a field as competitive as EM with the location restrictions I have?.

There are a ton of EM programs in Michigan (and Ohio, for that matter). Just by virtue of location, they tend not to be as competitive as the programs in the big cities and on the coasts. There are programs in Grand Rapids, Kalamazoo, Lansing, Ann Arbor, Saginaw, Grand Blanc, Detroit (multiple). There are two programs in Toledo, OH, as well, which. would be just as close to the Detroit area as some of the programs on the other side of the state.

As for your competitiveness, you have a good board score, but that's not all that matters. I highly recommend researching the various programs and trying to do an away or two at the ones that most interest you.

 

[SeekerOfTheTree]

Thanks guys. I think I'm going to try to do an away rotation and see if I can woo them with my skills and good looks. Appreciate the input.

If I went internal med I would have done hospitalist. I had no idea what I was going to do with EM/IM, just wanted to see if it would be easier to match into.

 

[hothause]

Seriously dude or dudette, you're going to be spending the next 30-40 years in the practice you pick. Decide on what fits you best by doing full rotations in each and self reflecting and talking to people in both fields. The application process for each shouldn't be the crux of your decision.

And, avoid calling people FOBs.

 

[SeekerOfTheTree]

Seriously dude or dudette, you're going to be spending the next 30-40 years in the practice you pick. Decide on what fits you best by doing full rotations in each and self reflecting and talking to people in both fields. The application process for each shouldn't be the crux of your decision.

And, avoid calling people FOBs.

Sure sure....will do.

Thanks for your help.

 

[logos]

Thanks guys. I think I'm going to try to do an away rotation and see if I can woo them with my skills and good looks. Appreciate the input.

If I went internal med I would have done hospitalist. I had no idea what I was going to do with EM/IM, just wanted to see if it would be easier to match into.

In general IM will be easier to get into than EM. Surprisingly, you will likely also find EM/IM easier to get into than straight EM. This is why you will see more foreign grads in EM/IM programs.

 

[SeekerOfTheTree]

In general IM will be easier to get into than EM. Surprisingly, you will likely also find EM/IM easier to get into than straight EM. This is why you will see more foreign grads in EM/IM programs.

How does it look if you apply to an EM program at an institution and then also their EM/IM program?