Neuro vs IM vs Subspecialty

[Chibucks15]

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Sup ya crazy people,

Time for me to get some feedback. Went into 3rd year thinking I'm all in on neuro. I liked the coursework, liked my previous experience, salary was where I want it, and the flexibility to switch between inpatient and outpatient lifestyles was a big plus. Of course, my school didn't let me switch a rotation into neuro so I'm clueless besides what I hear from other students on neuro. Instead I did a cards rotation which I really enjoyed. Big plus is my home site has a IM and cards in house. I'm a non-trad so not 100% sure I have the stamina to get through a fellowship, especially with 3 years lost salary it would take about 5 to make up. I liked my IM rotation too, would probably enjoy hospitalist work, but would ideally like a longer term patient relationship. The other thing I noticed in cards is idk if I want to be so specialized. There were plenty of things that patients had that we just ignored. Basically just because VSAS is coming out soon I gotta figure this nonsense out of what I wanna be when I grow up. I'm planning on doing a neuro rotation first thing next year but it doesn't give me a lot of time to build a neuro app if I do like it.

Step 1 230
COMLEX 1 550
Almost exactly 50th percentile class rank
1 cards poster, currently working on another cards project that may or may not get off the ground
1 peds case report in progress, no idea where it'll get published but its a good case

So lay it on me. I know I'm not super competitive for 'top' places and that's cool. Just wanna match in the midwest and not do academics. Basically trying to get a halfway decent schedule, as close to 300k as possible, with longer term patient relationships. I'm not as naive as some premeds thinking I'll make 300k for 3.5 days of work and no call but you guys know the deal. Hate the OR and hate OB. Any tips on how to figure all this out?

 

[InternistDO]

As someone who switched last minute into IM, you really don't need to do anything crazy to tailor your application to it, unlike say EM where you're expected to do a bunch of aways. I have no real aways or subis and I have some big city academic IM invites (on the East Coast) and my friends have some in the Midwest.
I'd try and set up a neuro rotation in July and your medicine subi in August or September and see which you like better. Neuro isn't crazy competitive anyway so I don't think a lack of research is going to hurt you. Just make sure you have letters of recommendation for both specialties when September rolls around so you aren't running around like crazy if you change your mind.

Don't forget there are plenty of other IM subspecialties besides cards--rheum and endo, for example, can have decent followup (and way better schedules) and even primary care can make good money in the Midwest with a pretty laid back schedule.

 

[DennisReynolds]

Was in the same shoes.

Liked neuro a month before ERAS was submitted so couldn't get new LORs and tailor my app to neuro and went for IM.

Got 15+ interviews with step 1 score <220, and a 50+ point drop between comlex 1 and comlex 2 CE with most of those on the west coast at community programs with in house fellowships.

Only thing that made me switch is that neurohospitalist is a 1 year fellowship after 4 years neuro residency. vs. 3 years for IM and doing hospitalist or outpatient work with much better schedule making 350K in the area I plan on settling down.

Even if you do a 2 year fellowship (rheum, allergy, neph), making 350+K isn't unusual in my neck of the woods.

Wasn't worth the stress to change my entire application for me, personally.

Good luck homie!

 

[DennisReynolds]

Did you get academic IM interviews or any with in house fellowships? I have a pathetic step 1 score myself and I’m just curious. You can PM me if you want.

I think you can get neurohospitalist jobs without a fellowship. I do understand your point of view though. Still figuring everything out.

Yes. I mentioned in my original reply that a majority of my interviews were at community programs with in-house fellowships. So far about 6 outta 7 places I've been to have in-house fellowships like cardio, pulm-crit, GI, etc.

No academic programs.

No need to PM. I'm a fairly open book and wanna see others get some motivation/guidance from my posts!

Hopefully that helps.

***Edit: I also honored both of my IM rotations and had solid remarks on my clinical eval which have been mentioned at every interview... which is super surprising lol. I'm sure that helps offset the step 1 I had.

 

[Giovanotto]

Was in the same shoes.

Liked neuro a month before ERAS was submitted so couldn't get new LORs and tailor my app to neuro and went for IM.

Got 15+ interviews with step 1 score <220, and a 50+ point drop between comlex 1 and comlex 2 CE with most of those on the west coast at community programs with in house fellowships.

Only thing that made me switch is that neurohospitalist is a 1 year fellowship after 4 years neuro residency. vs. 3 years for IM and doing hospitalist or outpatient work with much better schedule making 350K in the area I plan on settling down.

Even if you do a 2 year fellowship (rheum, allergy, neph), making 350+K isn't unusual in my neck of the woods.

Wasn't worth the stress to change my entire application for me, personally.

Good luck homie!

Source? I was told differently.

 

[Postictal Raiden]

I know countless of people doing neurohospitalist without fellowship. Ofc having a year of fellowship in stroke or epilepsy would increase your marketability but definitely isn’t a prerequisite even in big cities.

OP, do neuro and you’ll thank me.

 

[Epilepsy365]

Sup ya crazy people,

Time for me to get some feedback. Went into 3rd year thinking I'm all in on neuro. I liked the coursework, liked my previous experience, salary was where I want it, and the flexibility to switch between inpatient and outpatient lifestyles was a big plus. Of course, my school didn't let me switch a rotation into neuro so I'm clueless besides what I hear from other students on neuro. Instead I did a cards rotation which I really enjoyed. Big plus is my home site has a IM and cards in house. I'm a non-trad so not 100% sure I have the stamina to get through a fellowship, especially with 3 years lost salary it would take about 5 to make up. I liked my IM rotation too, would probably enjoy hospitalist work, but would ideally like a longer term patient relationship. The other thing I noticed in cards is idk if I want to be so specialized. There were plenty of things that patients had that we just ignored. Basically just because VSAS is coming out soon I gotta figure this nonsense out of what I wanna be when I grow up. I'm planning on doing a neuro rotation first thing next year but it doesn't give me a lot of time to build a neuro app if I do like it.

Step 1 230
COMLEX 1 550
Almost exactly 50th percentile class rank
1 cards poster, currently working on another cards project that may or may not get off the ground
1 peds case report in progress, no idea where it'll get published but its a good case

So lay it on me. I know I'm not super competitive for 'top' places and that's cool. Just wanna match in the midwest and not do academics. Basically trying to get a halfway decent schedule, as close to 300k as possible, with longer term patient relationships. I'm not as naive as some premeds thinking I'll make 300k for 3.5 days of work and no call but you guys know the deal. Hate the OR and hate OB. Any tips on how to figure all this out?

Be prepared to grind through first two years of IM if you want that Cardiology fellowship. Not worth it IMO.

Based on your stats and research check box, you will do very well in the Neurology cycle as long as you have min 1 Neuro letter (better if two). Apply to only community/university and university programs.

Do your first away KUMC or Mayo in July and get those letters. Also, there are plenty of Neurohospital gigs w/o the need for a fellowship. If you can master the reading of EEG and bang out >200 EMG studies during residency, the sky is the limit in term of salary after residency. Make sure to look for programs that will give you a diverse exposure when you’re applying for residency.

Cardiology is fun but is overrated after residency if you care about lifestyle.

 

[Postictal Raiden]

Reading EEG is an invaluable skills for inpatient neurology. EMG not so much. I doubt there are many residency programs that can provide you with 200+ EMG exposure without having to do few neuromuscular electives.

Now regarding cardiology, unless you are dead set on it, I honestly wouldn’t pursue IM for it. Like mentioned above, you’ll need to continue this rat race for another two years during your IM residency, then endure 3 plus potentially another 2 years of further subspecialization (nowadays no one stops at General cards, almost everyone does structural or IC or EP), and continue to work 70+ hours for nearly a decade after medical school. After all that, in today’s job market, you’ll be lucky to get a job paying 400k+ in a major city. The financial loss you endure during these extra years of training is not something you can shrug off. However, if you love cardiology then it’s all justified.

 

[EmilKraepelin55]

I know countless of people doing neurohospitalist without fellowship. Ofc having a year of fellowship in stroke or epilepsy would increase your marketability but definitely isn’t a prerequisite even in big cities.

OP, do neuro and you’ll thank me.

Disregarding interest, do you think it would be financially or professionally beneficial to do a fellowship in movement disorders?

 

[Postictal Raiden]

Disregarding interest, do you think it would be financially or professionally beneficial to do a fellowship in movement disorders?

Financially? Maybe not since you’ll be doing mainly outpatient and due to the nature of the field, your encounters maybe more time consuming.
Marketability and niche? For sure. It’s in big demand. Many general neurologists feel inadequate when it comes to movement disorders.

In general, fellowships don’t help you make more money in neurology (unless it’s in pain or interventional), but they can influence your lifestyle immensely. A good analogy is rheumatology. It doesn’t necessarily boost your income but it significantly reduces your inpatient bitch work, shields you from babysitting patients, and provide you with a great lifestyle without having to sacrifice $.

 

[DennisReynolds]

Source? I was told differently.

This was what I was told by my neuro preceptor. But I would have definitely listened to @Ibn Alnafis MD .

I was flirting with the idea of going into neuro and he helped me tremendously and was very encouraging but I just couldn't make it happen on my part due to personal issues and family situations.

He's the man to PM and he'll help you.

Also, I'm personally not planning on going for fellowship at this point since my loans are minimal and the hospitalists where I live are raking in 350-400K. This may change but we shall see in the next 3-4 years.

Just know that salaries in fellowships range in terms of different locations.

I live in an area that isn't that attractive to the big city folks but it has everything I and my family need.

The less people that move here... the better lol

good luck with ur decision!

 

[BorntobeDO?]

Sup ya crazy people,

Time for me to get some feedback. Went into 3rd year thinking I'm all in on neuro. I liked the coursework, liked my previous experience, salary was where I want it, and the flexibility to switch between inpatient and outpatient lifestyles was a big plus. Of course, my school didn't let me switch a rotation into neuro so I'm clueless besides what I hear from other students on neuro. Instead I did a cards rotation which I really enjoyed. Big plus is my home site has a IM and cards in house. I'm a non-trad so not 100% sure I have the stamina to get through a fellowship, especially with 3 years lost salary it would take about 5 to make up. I liked my IM rotation too, would probably enjoy hospitalist work, but would ideally like a longer term patient relationship. The other thing I noticed in cards is idk if I want to be so specialized. There were plenty of things that patients had that we just ignored. Basically just because VSAS is coming out soon I gotta figure this nonsense out of what I wanna be when I grow up. I'm planning on doing a neuro rotation first thing next year but it doesn't give me a lot of time to build a neuro app if I do like it.

Step 1 230
COMLEX 1 550
Almost exactly 50th percentile class rank
1 cards poster, currently working on another cards project that may or may not get off the ground
1 peds case report in progress, no idea where it'll get published but its a good case

So lay it on me. I know I'm not super competitive for 'top' places and that's cool. Just wanna match in the midwest and not do academics. Basically trying to get a halfway decent schedule, as close to 300k as possible, with longer term patient relationships. I'm not as naive as some premeds thinking I'll make 300k for 3.5 days of work and no call but you guys know the deal. Hate the OR and hate OB. Any tips on how to figure all this out?

You can prob get into cards if you match a program that has it (which your scores suggest you can). But if you hate the OR and don't want to do interventional I would suggest nuero for shorter length of training and immediate subspecialization.

 

[BorntobeDO?]

Its nice to see nuero getting some of the love it deserves. A great specialty IMO, even tho I am not going for it.

I think Cards is overrated. Yeah you can make a milli if your interventional, work 90 hours a week and have no life, but why would you want to live that way? Then if you don't do all the call and intervention it drops to 350-400k range. I guess the heart is simple tho, and people have high regard for it, so there is that.

 

[scoopdaboop]

I think Cards is overrated. Yeah you can make a milli if your interventional work 90 hours a week and have no life, but why would you want to live that way? Then if you don't do all the call and intervention it drops to 350-400k range. I guess the heart is simple tho, and people have high regard for it, so there is that.

nobody lives that way forever. you do it to pay off loans quickly, invest in other places, then you take it easy.

 

[BorntobeDO?]

nobody lives that way forever. you do it to pay off loans quickly, invest in other places, then you take it easy.

Some people do, I know them. Great docs, but its not for me.

 

[Espressso]

This is a great thread. But bruh OP you can definitely get in neuro with your stats. From your description, it seems like neuro would suit what you want better. Plus like others have mentioned, the chase for the cards fellowship and subspeciality is long and enduring.

 

[Spectreman]

Yes. I mentioned in my original reply that a majority of my interviews were at community programs with in-house fellowships. So far about 6 outta 7 places I've been to have in-house fellowships like cardio, pulm-crit, GI, etc.

No academic programs.

No need to PM. I'm a fairly open book and wanna see others get some motivation/guidance from my posts!

Hopefully that helps.

***Edit: I also honored both of my IM rotations and had solid remarks on my clinical eval which have been mentioned at every interview... which is super surprising lol. I'm sure that helps offset the step 1 I had.

Can I just tell you how beautiful it is to see your invite numbers? I love seeing success stories like this. Congrats to you! Can’t wait to hear where you matched when that day comes.

 

[Drrrrrr. Celty]

I don't think you'll go wrong with either specialty. Many know I ended up in IM by a less than ideal route, and while at first I never imagined myself doing it, I've really found it to be a great field. I offers a lot opportunity to sub-specialize into a variety of fields and carve out a niche. The generalist to specialist route gives solid training and it offers a lot of time to decide what you really want to do.

I'm at a program that I like with a good amount of in house fellowships. And rotating through them really showed me that there's a lot I could branch out to happily and above all maintain a solid lifestyle after training completes.

So if Neuro is a bust, then IM is a pretty good field to fall back onto.

 

[BudQuarter]

Be prepared to grind through first two years of IM if you want that Cardiology fellowship. Not worth it IMO.

Now regarding cardiology, unless you are dead set on it, I honestly wouldn’t pursue IM for it. Like mentioned above, you’ll need to continue this rat race for another two years during your IM residency, then endure 3 plus potentially another 2 years of further subspecialization (nowadays no one stops at General cards, almost everyone does structural or IC or EP), and continue to work 70+ hours for nearly a decade after medical school. After all that, in today’s job market, you’ll be lucky to get a job paying 400k+ in a major city. The financial loss you endure during these extra years of training is not something you can shrug off. However, if you love cardiology then it’s all justified.

Can you guys elaborate what you mean by grinding through the first two years of IM? Apologies if this a dense question, but why do you grind just the first two years specifically?

 

[Epilepsy365]

Can you guys elaborate what you mean by grinding through the first two years of IM? Apologies if this a dense question, but why do you grind just the first two years specifically?

Just bc you’re doing IM with in house Cards fellowship doesn’t mean you’re guaranteed to get that spot. You better be preferably in the top 20-30% of your residency class to be in consideration, meaning you volunteer to work hard shifts and take crappy calls in order to build the reputation of that wonderful reliable resident among your colleagues and your attendings. You also need to score in the top 20-30% in the in-house exams, aka the USMLEs of IM residency. On top of that, you also need to do some research. All of these need to be done by end of Year 2 to get your application ready for Cards application during Year 3. For this reason, it’s not uncommon for some IM residents to take a research year of 20K a year in income in order to pump out some quality research for Cards.

My source comes from the PD of my program Cards fellowship.

 

[Postictal Raiden]

Can you guys elaborate what you mean by grinding through the first two years of IM? Apologies if this a dense question, but why do you grind just the first two years specifically?

If you are planning on matching a fellowship after IM, you need to know that early on so you plan accordingly. You need to start attending specialty conferences, engage in research, have presentations/publications, etc... You will need to spend a significant portion of your precious little free time doing things that reflect your interest in the field you're pursuing.

This is not unique to IM. Every fellowship has this expectation.

 

[Drrrrrr. Celty]

Can you guys elaborate what you mean by grinding through the first two years of IM? Apologies if this a dense question, but why do you grind just the first two years specifically?

By 3rd year you've pretty much got like 2 hard rotations and a bunch of chill rotations. Some programs call is reduced or almost non-existent. The first two you're still trying to get things down, got wards, icu, and call.

 

[Drrrrrr. Celty]

Just bc you’re doing IM with in house Cards fellowship doesn’t mean you’re guaranteed to get that spot. You better be preferably in the top 20-30% of your residency class to be in consideration, meaning you volunteer to work hard shifts and take crappy calls in order to build the reputation of that wonderful reliable resident among your colleagues and your attendings. You also need to score in the top 20-30% in the in-house exams, aka the USMLEs of IM residency. On top of that, you also need to do some research. All of these need to be done by end of Year 2 to get your application ready for Cards application during Year 3. For this reason, it’s not uncommon for some IM residents to take a research year of 20K a year in income in order to pump out some quality research for Cards.

My source comes from the PD of my program Cards fellowship.

No one says don't work hard. But I don't think everyone in an IM program class is going to want to do Cards. I personally don't. And most of my class doesn't either.

 

[Epilepsy365]

There is a difference between IM working hard and Cards working hard.

Lastly, it doesn't matter if you're at a community IM program with in house Cards fellowship. If you're a mediocre IM resident, you will not be guaranteed to get that in house Cards fellowship. In that scenario, the program will look for the best candidates.

Sorry to paint a solemn tone but that's the reality. Every person here thinks that you can just waltz into a Cards fellowship by being at a community IM program with in house Cards fellowship by just working hard whatever that means. No, you need to be a competitive candidate who's well liked by everyone with strong LORs and competitive in house exam scores.

The Cards program at my training program in the most recent year took all fellows who aren't in-house. That's the main reason why the grinding doesn't stop here. Be prepared to grind like you're gunning for Ortho during your IM residency especially if you're shooting for Cards.

 

[DennisReynolds]

Can I just tell you how beautiful it is to see your invite numbers? I love seeing success stories like this. Congrats to you! Can’t wait to hear where you matched when that day comes.

I really appreciate it. It means more than you'll ever know.

I pray and hope I will have good news to share with you and everybody else here on SDN come match time in March.

Also, as it has been brought up, yes getting into cards is going to be competitive. It's actually funny to me how many starting IM residents start off wanting cards and by year 2, they end up changing their minds.

So yes... for the uber competitive fellowships like GI and Cardio, you gotta be on top of your game and know what you want and get your CV to reflect that.

 

[MrTaco92]

Neuro has plenty of different 1 year fellowships which will offer you plenty of different kinds of lifestyles

 

[Doctor_Strange]

Damn, kinda glad I am interested in EM. The hustle to get an IM fellowship seems a lot more competitive than I expected.

 

[Splenda88]

Damn, kinda glad I am interested in EM. The hustle to get an IM fellowship seems a lot more competitive than I expected.

Yes it it...

People in my program who want the competitive fellowships are working hard while trying to pump out research papers. Not an easy thing when you are working ~70 hours/week even as a PGY2.

 

[Doctor_Strange]

Yes it it...

People in my program who want the competitive fellowships are working hard while trying to pump out research papers. Not an easy thing when you are working ~70 hours/week even as a PGY2.

Curious to know how much harder one has to hustle if at a community program with very little to no fellowship programs? I would imagine a good chunk of DOs who are in IM would fall in that category of residency.

 

[Splenda88]

Curious to know how much harder one has to hustle if at a community program with very little to no fellowship programs? I would imagine a good chunk of DOs who are in IM would fall in that category of residency.

I am at a low tier academic program and I see a lot of hustling for GI, card, Hem onc, PulmCrit and even Rheum these days. I guess coming from a community program make things even harder.

 

[Doctor_Strange]

I am at a low tier academic program and I see a lot of hustling for GI, card, Hem onc, PulmCrit and even Rheum these days. I guess coming from a community program make things even harder.

If I don't pursue EM, the I have some interest in Pulm/CC so I appreciate the insight!

 

[Splenda88]

If I don't pursue EM, the I have some interest in Pulm/CC so I appreciate the insight!

If you can tolerate (emphasis on tolerate) EM, do it. You will get the best bang for your buck. Short training with extremely high salary.

The lifestyle of EM can be erratic at the beginning, but once you become financially independent, you can only work 2 days/week and still make 200k+/year. Assuming the job market won't change that much.

 

[BorntobeDO?]

If you can tolerate (emphasis on tolerate) EM, do it. You will get the best bang for your buck. Short training with extremely high salary.

The lifestyle of EM can be erratic at the beginning, but once you become financially independent, you can only work 2 days/week and still make 200k+/year. Assuming the job market won't change that much.

Agree as long as you are willing to go rural I think the EM job market will be good for a while. It is in danger in the medium term due to residency expansion and the high levels of mid levels entering, but they will never force out the physician in the ER IMO. Nobody wants doctor nurse in a trauma.

 

[Doctor_Strange]

If you can tolerate (emphasis on tolerate) EM, do it. You will get the best bang for your buck. Short training with extremely high salary.

The lifestyle of EM can be erratic at the beginning, but once you become financially independent, you can only work 2 days/week and still make 200k+/year. Assuming the job market won't change that much.

Yeah, I think for some reason lots of med students view EM as a lifestyle specialty, but having been a scribe + done 20 something ER shifts through M3, it is most certainly not.

Agree as long as you are willing to go rural I think the EM job market will be good for a while. It is in danger in the medium term due to residency expansion and the high levels of mid levels entering, but they will never force out the physician in the ER IMO. Nobody wants doctor nurse in a trauma.

This is a fair concern, one I share. I think the more metro locations will simple continue to be saturated. So, being aware of that ahead of time is important. I think I want to do community academics, so that may lessen the expected pay cut!

 

[Prehealth1011]

If you can tolerate (emphasis on tolerate) EM, do it. You will get the best bang for your buck. Short training with extremely high salary.

The lifestyle of EM can be erratic at the beginning, but once you become financially independent, you can only work 2 days/week and still make 200k+/year. Assuming the job market won't change that much.

Is there any data on when EM docs usually retire? vs IM/FM etc.

 

[Splenda88]

Is there any data on when EM docs usually retire? vs IM/FM etc.

I have not come across any such data. But with everything being equal, I think EM doc have the potential to retire earlier than IM/FM because earning an average for EM is a lot better than IM/FM (350k vs 250k)

Given the demanding nature of EM, I would hypothesize that EM docs (on average) probably retire at younger age than IM/FM docs.

 

[Doctor_Strange]

Is there any data on when EM docs usually retire? vs IM/FM etc.

I have not come across any such data. But with everything being equal, I think EM doc have the potential to retire earlier than IM/FM because earning an average for EM is a lot better than IM/FM (350k vs 250k)

Given the demanding nature of EM, I would hypothesize that EM docs (on average) probably retire at younger age than IM/FM docs.

One of the main reasons is due to burnout. Circadian rhythm disorder very much plays a factor. I don't know many EM docs who are in their late 60s practicing EM. I think they move onto urgent care clinics, administrative, part-time, or just leave the field altogether either by retirement or do a second-career. I see plenty of older hospitalists and sub-specialists more so than in EM. These are all factors I am trying to weigh as I progress through M3!

 

[BorntobeDO?]

One of the main reasons is due to burnout. Circadian rhythm disorder very much plays a factor. I don't know many EM docs who are in their late 60s practicing EM. I think they move onto urgent care clinics, administrative, part-time, or just leave the field altogether either by retirement or do a second-career. I see plenty of older hospitalists and sub-specialists more so than in EM. These are all factors I am trying to weigh as I progress through M3!

Its one of the reasons that if I did EM I would do FM-> EM Fellowship. I know that EM is not a specialty I would last beyond 10 years in, and being FM already makes it alot easier to transition out. I know the EM guys hate that fellowship and I get it, but honestly,the midlevels are flooding them far faster than FM fellows. I know I would much rather work with another physician.

 

[Doctor_Strange]

Its one of the reasons that if I did EM I would do FM-> EM Fellowship. I know that EM is not a specialty I would last beyond 10 years in, and being FM already makes it alot easier to transition out. I know the EM guys hate that fellowship and I get it, but honestly,the midlevels are flooding them far faster than FM fellows, I know I would much rather work with another physician.

I think something like only 60 or 40% of all EDs in the country are staffed by EM board-certified docs. The demand is there, moreso the more rural one goes. I have friend who is just going to do FM, go live rural (in an area he likes and his family likes), and pick up shifts at the local ED for years to come. Seems like a good idea. It does seem to me that an inordinate number of PAs/NPs pursue EM, but that is only anecdotal. Why that is, I am not sure.

 

[BorntobeDO?]

I think something like only 60 or 40% of all EDs in the country are staffed by EM board-certified docs. The demand is there, moreso the more rural one goes. I have friend who is just going to do FM, go live rural (in an area he likes and his family likes), and pick up shifts at the local ED for years to come. Seems like a good idea. It does seem to me that an inordinate number of PAs/NPs pursue EM, but that is only anecdotal. Why that is, I am not sure.

Its shiftwork and they see lots of other midlevels already there. Plus its higher paying than primary care. An easy target.

 

[alprazoslam]

You can get university programs w a 550/230. Just not anything near top and it’s harder in cali and East cost. This is for both IM and neuro.

 

[DrStephenStrange]

I was getting really fond of Cardiology, but at this point I'm ready to get stuck in IM or do any non-competitive fellowships that will better my lifestyle and schedule with less paperwork. This thread has opened my eyes a little bit to the reality of things out there. Thank you guys!!!

 

[Splenda88]

I was getting really fond of Cardiology, but at this point I'm ready to get stuck in IM or do any non-competitive fellowships that will better my lifestyle and schedule with less paperwork. This thread has opened my eyes a little bit to the reality of things out there. Thank you guys!!!

I don't think you should give up on cardio if this what you really want to do. But med students have to understand trying to get into cardio/GI/hemonc/pulmcrit is like doing med school all over again, but the only difference is that you're a resident trying to outdo other residents who also want these same competitive fellowships.

 

[DrStephenStrange]

I don't think you should give up on cardio if this what you really want to do. But med students have to understand trying to get into cardio/GI/hemonc/pulmcrit is like doing med school all over again, but the only difference is that you're a resident trying to outdo other residents who also want these same competitive fellowships.

Thank you! I mean I will try my best for sure, but at least I'll be ready for the worst outcome as well. I mean if someone want any of these sub-specialties, it makes sense that you gotta love IM first because there's a good chance you might not get what you want. The good thing about IM is that there are so many things you can do not necessarily increasing your pay, but at least better lifestyle/schedule and/or less paperwork.

One question though, is it possible/common that someone goes through IM residency, becomes an attending, gets some experience/research/recognition in the field under their belt for a couple years, and then go back to do a cardio fellowship? I mean I know it's not ideal to go from attending salary to fellow salary for 3 years, but is that unheard of? And would that lower or increase your chances to match?

Sent from my SM-G973U using SDN mobile

 

[Splenda88]

@DrStephenStrange

It's definitely possible. In fact, I was talking to a hospitalist at my job the other day who is doing that. He said he got a lot of invites and waiting for the fellowship match next month.

 

[Doctor_Strange]

I don't think you should give up on cardio if this what you really want to do. But med students have to understand trying to get into cardio/GI/hemonc/pulmcrit is like doing med school all over again, but the only difference is that you're a resident trying to outdo other residents who also want these same competitive fellowships.

I rotate at community sites w/o residents. I am so completely ignorant of what it entails to get a fellowship. So, in that regard thanks for shedding light on this topic. I think, conversely, since I don't have an strong desire to pursue any one field, that is probably another reason why I personally like EM -- a little bit of everything.

 

[Drrrrrr. Celty]

I don't think you should give up on cardio if this what you really want to do. But med students have to understand trying to get into cardio/GI/hemonc/pulmcrit is like doing med school all over again, but the only difference is that you're a resident trying to outdo other residents who also want these same competitive fellowships.

I think if you actually like those fields then you're really going to be motivated working towards and on those topics. Its one thing for someone who doesn't like Pulm/cc to do some extra central lines, get a stronger lor, publish an article on something and the guy who loves the field enough that they enjoy the very nature of that field and learning more about it.

 

[Drrrrrr. Celty]

Thank you! I mean I will try my best for sure, but at least I'll be ready for the worst outcome as well. I mean if someone want any of these sub-specialties, it makes sense that you gotta love IM first because there's a good chance you might not get what you want. The good thing about IM is that there are so many things you can do not necessarily increasing your pay, but at least better lifestyle/schedule and/or less paperwork.

One question though, is it possible/common that someone goes through IM residency, becomes an attending, gets some experience/research/recognition in the field under their belt for a couple years, and then go back to do a cardio fellowship? I mean I know it's not ideal to go from attending salary to fellow salary for 3 years, but is that unheard of? And would that lower or increase your chances to match?

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I think the key is that you don't go into the field exclusively wanting to be one thing and being disappointed that the general training is uninteresting for you.

 

[DrStephenStrange]

Was in the same shoes.

Liked neuro a month before ERAS was submitted so couldn't get new LORs and tailor my app to neuro and went for IM.

Got 15+ interviews with step 1 score <220, and a 50+ point drop between comlex 1 and comlex 2 CE with most of those on the west coast at community programs with in house fellowships.

Only thing that made me switch is that neurohospitalist is a 1 year fellowship after 4 years neuro residency. vs. 3 years for IM and doing hospitalist or outpatient work with much better schedule making 350K in the area I plan on settling down.

Even if you do a 2 year fellowship (rheum, allergy, neph), making 350+K isn't unusual in my neck of the woods.

Wasn't worth the stress to change my entire application for me, personally.

Good luck homie!

Just curious, could you please PM me the list of IM residencies you've applied to? I'm just trying to be proactive early, and have an idea how I'll be setting up away rotations next year. Thanks in advance.

 

[Deecee2DO]

Damn, kinda glad I am interested in EM. The hustle to get an IM fellowship seems a lot more competitive than I expected.

Its actually not haha this is SDN where everything is competitive. Yes GI is very competitive (cards and heme/onc sorta competitive and the rest not really competitive at all) as far as IM fellowships go. Heck i wouldnt be surprised if you found a thread on here where someone said community peds is getting competitive