Please advise. Planning switching from Family (FM) to Internal Medicine (IM)

[Fococoroco22]

Hi all.
I'm currently a PGY1 at an unopposed, university affiliated FM residency. Thing is, I've come to realize that my happiest and best days are on the medicine service. We run every service in the hospital, and have 4 months of Medicine just in Intern year. It's the toughest service, according to the upper levels, but I love it, am getting great reviews and am excited at least 80% of the time to go to work (while on IM)-- despite the 430am call time.
Peds and OBGYN just don't interest me like I thought they would. Pretty bummed actually-- wanted to love the whole "full spectrum doc" thing but it turns out that really ain't me. I want to focus on adults. I can connect with adults, whereas peds is similar to vet medicine and OBGYN is just, to put it nicely....not my thing. I'm likely planning a switch to IM.

Someone on here said that FM needs to be 7 years in order to properly prepare to be an OB, PED and IM doc because that's the standard you are held to-- IMO that's completely true. To be a great FM doc you have to be an excellent Pediatrician, OB and IM doc. I don't love sick kids, pregnant women or babies. I love working with adults. Wish I would have figured this out before residency but, heck.

I know I'm likely out of luck if I want to start July 2017. Perhaps I can find something in the SOAP/Scramble. But I'm definitely able to start the application/interview process during PGY2. We have a PGY2 switching to Anesthesiology actually.

My questions:
1. Do you know of anyone who has made the switch? Any timing/logistic/application advice would be much appreciated. I have a feeling finding a spot after PGY 1 or PGY2 is going to be rough.

2. I don't know if I'll find a place for July 2017, I have no new LORs and no time as an intern to interview, but if I want to try, should I start calling programs in December to see if there will be spots? Any other advice?

3. After finishing an FM PGY1 year how much credit would I likely be able to get in an IM program? I know it's tough to determine but, ~6 months?

4. If I wait and apply during my PGY2 year (so I'll be starting IM after my FM PGY2) would I be able to get a year of credit? Or is the maximum 6 months? I read on AAP that likely 6 months is the max. Correct?

5. The reason I want to switch is simple: I don't care enough for treating kids and OB pts. I also am concerned with the available jobs for FM trained docs out there. I chose FM for the variety but it seems that FM is being relegated more and more to the clinic only. I want to be a hospitalist at this point with the option to sub specialize later if I choose.

6. I would ultimately like to be in NC or SC, ideally 1-2 hours away from Asheville/Hendersonville or even L.A.- CA as I have family in all those places. I've been solo my whole life and residency is the first time I've truly realized just how nice it would be to have family near by.

7. Simply, is it worth it? I've searched for Hospitalist jobs in CA, NC and SC and, like most of you know, very few locations appear to hire FM trained docs. Is this really true? If I had to make a final decision right now I'd say I want to be a hospitalist in NC, near Asheville/Hendersonville. I think being IM trained would assist in making that a reality. But please tell me your opinion. If I'm wrong I'd actually be relieved.

Thank you very much!

STATS:
DO
COMLEX I 550
COMLEX II 600
Great extracurriculars pre-medicine life and during med school, albeit without research under my belt.

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[witzelsucht]

hospitalist fellowship for FM grads

https://www.spartanburgregional.com...cal-education/hospitalist-fellowship-program/

 

[NotAProgDirector]

I can answer question #3 for you. If your current institution has no IM program, the maximum you will get is 6 months, and only credit for IM rotations. You can look at it here: http://www.abim.org/certification/p...-subspecialty-policies/internal-medicine.aspx Scroll down to "Credit in Lieu of standard training".

Since you'll only get 6 months, you'll still need a PGY-1 position. Therefore, you should basically start looking now. And your IM PD needs to observe you for 3 months before you get any credit, so you might need to repeat the entire internship.

If you complete the entire FM residency, then you can get 12 months of credit.

Ultimately, you'll need to decide whether it's better to change to IM or just finish FM and then focus your practice on adult patients.

 

[tatsuchi]

7. Simply, is it worth it? I've searched for Hospitalist jobs in CA, NC and SC and, like most of you know, very few locations appear to hire FM trained docs. Is this really true?

Are you saying this after factual research, or from what you've "heard?"

Quick perusal shows many positions still open to both IM/FM in North Carolina.

If you want to be a hospitalist, then FM is reasonable. Focus on doing more inpatient rotations on your elective months, pick up inpatient moonlighting jobs, etc.

 

[gutonc]

My questions:
1. Do you know of anyone who has made the switch? Any timing/logistic/application advice would be much appreciated. I have a feeling finding a spot after PGY 1 or PGY2 is going to be rough.

Not personally, but I'm sure they're out there.

2. I don't know if I'll find a place for July 2017, I have no new LORs and no time as an intern to interview, but if I want to try, should I start calling programs in December to see if there will be spots? Any other advice?

Lack of LORs and time off are going to be a huge issue. It's a little late in the season to go for it this year. Might be worth registering though just so you can SOAP if you want.

3. After finishing an FM PGY1 year how much credit would I likely be able to get in an IM program? I know it's tough to determine but, ~6 months?

4. If I wait and apply during my PGY2 year (so I'll be starting IM after my FM PGY2) would I be able to get a year of credit? Or is the maximum 6 months? I read on AAP that likely 6 months is the max. Correct?

aPD has already answered these for you. The caveat I want to make sure you understand is that, any credit you do get, is completely up to the PD that takes you on. So assume you'll get nothing, and be happy with whatever you do get.

5. The reason I want to switch is simple: I don't care enough for treating kids and OB pts. I also am concerned with the available jobs for FM trained docs out there. I chose FM for the variety but it seems that FM is being relegated more and more to the clinic only. I want to be a hospitalist at this point with the option to sub specialize later if I choose.

6. I would ultimately like to be in NC or SC, ideally 1-2 hours away from Asheville/Hendersonville or even L.A.- CA as I have family in all those places. I've been solo my whole life and residency is the first time I've truly realized just how nice it would be to have family near by.

Neither of these are questions.

7. Simply, is it worth it? I've searched for Hospitalist jobs in CA, NC and SC and, like most of you know, very few locations appear to hire FM trained docs. Is this really true? If I had to make a final decision right now I'd say I want to be a hospitalist in NC, near Asheville/Hendersonville. I think being IM trained would assist in making that a reality. But please tell me your opinion. If I'm wrong I'd actually be relieved.

It's probably not worth it. You'd probably be better off just maximizing the amount of inpatient floor/ICU time you can get over the next year and just applying for jobs after you finish up your FM residency.

 

[rokshana]

finish out FM and then do a hospitalist fellowship if being a hospitalist is your goal.

 

[GadRads]

My friend did a FM residency, and is practicing as a hospitalist without any fellowship.

 

[swlabr1980]

The FM graduate requirements for a hospitalist position vary by employer. I have seen "FM board certified candidates accepted" and "FM board certified candidates with at least two years of inpatient experience accepted" listed in job postings.

 

[tartesos]

One of the interns a few years back had 1 year of family medicine residency under her belt, she got a lot of experience from it, and 3 years later an Internal Medicine certificate.
Because you are so geographically limited, I would be careful not to spoil your current situation looking for greener pastures.
Best of luck!.