Multiple Specialties?

[OMSWeebHours]

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I know there are some dual residency programs that exist, but I am curious if anyone has actually successfully worked sustainably in multiple specialties.

 

[gutonc]

What specifically is your question? Can you be a GI/Neurosurgeon? No. Can you do primary care Med/Peds or FM/Sports or Anesthesia/CCM? Sure

 

[VA Hopeful Dr]

If something exists as a dual residency, it means there's a market for it.

That said, it can be difficult to find a job that lets you do both equally.

 

[Dral]

Subspecialty and specialty? yes. Separate specialties? There's always an exception, but generally no (unless dual residency).

So EM and toxicology; Sure. EM and Radiology; nah.

It seems this should be possible from a theoretical standpoint. However, when one enters the physician work force, one starts to understand how working in two unrelated specialties is not a tenable situation (for several reasons).

 

[LucidSplash]

I think people are going off topic. OP asked about the established dual/tri specialty training programs, not two random different training programs and if they could be practiced simultaneously.

Maybe we can give some more specific answers regarding the dual/tri residency pathways. There are more but off the top of my head I can think of:

EM/IM
IM/Peds
EM/IM/Peds
EM/Anesthesiology
EM/IM/CC
EM/Peds
IM/Neuro
IM/PM&R
IM/Derm
IM/Psych
IM/Rads
FM/Psych
Psych/Neuro
Pediatrics/Psychiatry/Child & Adolescent Psychiatry
Psych/Child Psych
Tox/Addiction Medicine

 

[TelemarketingEnigma]

speaking to med peds specifically: not everyone goes on to practice both, but according to NMPRA the majority of Med Peds grads do both in some capacity during their post-grad career. ratios and settings may vary a lot. my gut feeling is that this pans out, based on recent grads from my program. and even without seeing both, a lot of med peds grads find a niche where the combined mindset remains useful.

 

[dozitgetchahi]

I think people are going off topic. OP asked about the established dual/tri specialty training programs, not two random different training programs and if they could be practiced simultaneously.

Maybe we can give some more specific answers regarding the dual/tri residency pathways. There are more but off the top of my head I can think of:

EM/IM
IM/Peds
EM/IM/Peds
EM/Anesthesiology
EM/IM/CC
EM/Peds
IM/Neuro
IM/PM&R
IM/Derm
IM/Psych
IM/Rads
FM/Psych
Psych/Neuro
Pediatrics/Psychiatry/Child & Adolescent Psychiatry
Psych/Child Psych
Tox/Addiction Medicine

Bottom line is that some of these are more viable than others in terms of day to day practice.

Med/peds for instance is very viable, and probably somewhat similar to FM in terms of day to day practice. Med/peds + allergy is an especially good combo because allergy fellowship often focuses on both kids and adults.

In the case of combos like IM/psych and IM/derm, there can be issues with billing for patients who are both medical and psych/derm etc. You can’t always bill as a specialist if you are also the PCP etc etc. So it can be hard to practice both in an outpatient environment.

In the case of fellowship trained IM docs, there are certainly some folks that train and practice in both. Renal + general IM is common to see because it’s sometimes hard to make a viable income doing only renal.

In the case of inpatient situations, some of these combos can be viable. EM/CCM or Anes/CCM is probably a great example. You can do shifts as EM or anesthesia and then shifts in the ICU.

In general, however, many docs find it easier to focus on one specialty.

 

[djo208]

I briefly considered applying to a joint IM/psychiatry residency program to maintain a connection to medicine. I ultimately decided that that was not for me, but I did find a different route to the same goal: I am double-boarded in both general psychiatry and consultation-liaison (CL) psychiatry. This lets me practice both bread and butter psychiatry, but also gives me the skillset to work with more highly specialized, very medically-intense psychiatric cases. For example, I have a private practice where I see and treat everything from major depressive disorder to PTSD to schizophrenia. In my private practice, I provide psychotherapy and pharmacological treatments, but I ALSO work on medical floors providing advice to the medical teams and in this role, I often work with more specialized cases, like providing risk assessment and mediation around the psychosocial aspects of organ transplant or identifying delirium masquerading as depression, among other examples.

There are people who do CL psychiatry who are NOT board-certified in it, but the extra fellowship training after residency was helpful in developing my expertise in the field.

Now this is very different than doing two residencies, as CL psychiatry IS psychiatry--but it is a type of psychiatry that does benefit from expertise because you can run into circumstances very different than what you might see in other psychiatric contexts and I actively do both at different times: CL psychiatry twice a week and my private practice twice a week. What I do in my private practice differs a lot from what I do on the medical floors as a CL psychiatrist.

I thought my own experience might shed some light on your question.

 

[GritsNGuts]

This is somewhat interesting as literally none of the FM docs at my school see pediatric patients. Maybe like once per week in emergent situations. My school is not in a big city either. I wonder if it’s just that parents prefer to have their kids seen by a pediatrician or the clinics tell them not to

They also saw no OB patients but that’s more understandable I guess

No, TONS of FM physicians see kids as a large part of their practice. My spouse is one of them. FM is so flexible that is has the opportunity to see only adults, mainly children, some combination of both, some combination plus OB, mainly OB, etc. My spouse sees a really nice mix of adults, children, and OB patients. Your school is....well, your school. Not indicative of anything else but your school.

 

[VA Hopeful Dr]

No, TONS of FM physicians see kids as a large part of their practice. My spouse is one of them. FM is so flexible that is has the opportunity to see only adults, mainly children, some combination of both, some combination plus OB, mainly OB, etc. My spouse sees a really nice mix of adults, children, and OB patients. Your school is....well, your school. Not indicative of anything else but your school.

Many more prestigious hospitals look down on FM, so I wouldn't be surprised at something like this happening.