Primary track fellowship possibility?

[blessfulmd]

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Can I pursue fellowship from primary track IM? Prefer someone who did primary track give me their guidance . Thank you all for your input.

 

[chessknt]

I dont think there are any ACGME rules against it and if you are planning to pursue an outpatient specialty (except maybe heme/onc or rheum) they arent terribly competitive and you can upsell all the clinic experience you get during residency.

 

[blessfulmd]

I dont think there are any ACGME rules against it and if you are planning to pursue an outpatient specialty (except maybe heme/onc or rheum) they arent terribly competitive and you can upsell all the clinic experience you get during residency.

Thank you for the kind words. I see you are fellow right now . did you do primary track as well? Do you know anybody who did?

 

[chessknt]

Thank you for the kind words. I see you are fellow right now . did you do primary track as well? Do you know anybody who did?

No my residency didnt have a dedicated primary care track though it had global health which was kind of primary care focused.

 

[Rocher]

I did and matched a competitive subspecialty

 

[gutonc]

Can I pursue fellowship from primary track IM? Prefer someone who did primary track give me their guidance . Thank you all for your input.

Yes. About the only things that might be harder to do from a PC track are PCCM because of less ICU experience, and maybe cards. But you can do anything really.

 

[DrMetal]

Can I pursue fellowship from primary track IM? Prefer someone who did primary track give me their guidance . Thank you all for your input.

Why do people do this? Just do a regular IM residency. You need the non-primary care experiences as well, you'll keep your options more open, and you can certainly do primary care afterwards.

 

[blessfulmd]

Thank you all for kind words!

 

[blessfulmd]

Why do people do this? Just do a regular IM residency. You need the non-primary care experiences as well, you'll keep your options more open, and you can certainly do primary care afterwards.

Dear Doctor. Wise suggestion and truly baffling situation. I be honest. Some ppl might not have luxury of matching categorical due to low scores and studying abroad as of my case. you take every invite as an opportunity.

 

[DrMetal]

Dear Doctor. Wise suggestion and truly baffling situation. I be honest. Some ppl might not have luxury of matching categorical due to low scores and studying abroad as of my case. you take every invite as an opportunity.

Ok, if you that's all you matched into, then go for it.

 

[rokshana]

Why do people do this? Just do a regular IM residency. You need the non-primary care experiences as well, you'll keep your options more open, and you can certainly do primary care afterwards.

Because they think they may have a better chance to match at a more prestigious place if they feign interest in a PC tract...

Frankly, they should make it that if you take a PC track spot, then you shouldn’t be able to apply for fellowship, but understandable that people may really have the intention of going in to PC and then develop an interest in a sub specialty...maybe they could make it so you have to do PC work for a few years before you can then apply for a fellowship.

 

[DrMetal]

Because they think they may have a better chance to match at a more prestigious place if they feign interest in a PC tract...

Ahh, so if I gun for the PC tract, maybe I could train at Harvard or Mayo, that kind of deal?

Silly. A general residency (general internal medicine, general surgery, general pediatrics) should not be any further sub-specialized. The point is to keep it general, so you get a wide breadth of experiences and training. 'Tracks' already exist, they're called fellowships.

 

[rokshana]

Ahh, so if I gun for the PC tract, maybe I could train at Harvard or Mayo, that kind of deal?

Silly. A general residency (general internal medicine, general surgery, general pediatrics) should not be any further sub-specialized. The point is to keep it general, so you get a wide breadth of experiences and training. 'Tracts' already exist, they're called fellowships.

Well I don’t necessarily disagree with a PC track...inpt and outpt medicine differs a lot now and if one wants to do outpt from the get, it kinda makes sense to focus on that. But how many people really know that coming out of Med school?

 

[the argus]

Everyone should remember that there is no distinction from the ACGME between a "primary care" IM program/track compared to a traditional IM program/track. People coming out of primary care programs/tracks still have to complete the same requirements for internal medicine training according to the ACGME (and ABIM when you are discussing subsequent board certification). This includes at least 4 months of ICU (maximum of 6), certain amount of inpatient and outpatient IM, 1 month of EM, etc. When all the requirements are finally fulfilled, It turns out that the differences between primary care and traditional IM programs often turn out to be pretty minimal.

I was in the primary care IM program/track at my residency, and those of us who decided to pursue fellowship all matched comparatively to people coming out of the traditional program/track, all subspecialties included. I only remember being asked about it once on the fellowship interview trail, and it seemed more out of curiosity rather than questioning whether I would be able to handle fellowship coming from a primary care track. I think I was definitely considered "applicant from university of xxx" and not "applicant from primary care track at university of xxx."

**EDITED to correct vocabulary

 

[gutonc]

Track dammit...the word is track.

 

[mszzeta]

Can I pursue fellowship from primary track IM? Prefer someone who did primary track give me their guidance . Thank you all for your input.

I have even heard people in primary care track applying for cardiology fellowship. I know people may question whether they really liked primary care at the first place and no one really would know.......

 

[blessfulmd]

Thank you guys for your input . Much appreciated

 

[yakattack16]

Because they think they may have a better chance to match at a more prestigious place if they feign interest in a PC tract...

Frankly, they should make it that if you take a PC track spot, then you shouldn’t be able to apply for fellowship, but understandable that people may really have the intention of going in to PC and then develop an interest in a sub specialty...maybe they could make it so you have to do PC work for a few years before you can then apply for a fellowship.

Except for the fact that you're dictating how someone can make a living despite their meeting of the national boards' qualifications for being eligible for subspecialization. If my residency program told me outright that I couldn't apply for a specialization that I SHOULD be qualified for, then I'd tell them to sit back down and stay out of my way. That would never hold up in court.

 

[rokshana]

Except for the fact that you're dictating how someone can make a living despite their meeting of the national boards' qualifications for being eligible for subspecialization. If my residency program told me outright that I couldn't apply for a specialization that I SHOULD be qualified for, then I'd tell them to sit back down and stay out of my way. That would never hold up in court.

yes but if they told you outright during the interview phase that the position is for those interested in primary care and there is a stipulation that you must practice as a PCP for say 3-5 years and you still rank it knowing you want to specialize, then that would be on you...that could hold up since it would be a part of your employment contract and if you decided to go into fellowship in less that the acceptable time, they could argue you breeched the contract...

it would probably also require fellowship programs to say that PC track residents are not qualified for application right out of residency.

though gotta feeling if you said something like that to your PD, it would probably put you under a the microscope pretty quick...

 

[deleted898021]

Everyone should remember that there is no distinction from the ACGME between a "primary care" IM program/track compared to a traditional IM program/track. People coming out of primary care programs/tracks still have to complete the same requirements for internal medicine training according to the ACGME (and ABIM when you are discussing subsequent board certification). This includes at least 4 months of ICU (maximum of 6), certain amount of inpatient and outpatient IM, 1 month of EM, etc. When all the requirements are finally fulfilled, It turns out that the differences between primary care and traditional IM programs often turn out to be pretty minimal.

I was in the primary care IM program/track at my residency, and those of us who decided to pursue fellowship all matched comparatively to people coming out of the traditional program/track, all subspecialties included. I only remember being asked about it once on the fellowship interview trail, and it seemed more out of curiosity rather than questioning whether I would be able to handle fellowship coming from a primary care track. I think I was definitely considered "applicant from university of xxx" and not "applicant from primary care track at university of xxx."

**EDITED to correct vocabulary

Sorry I am bumping, so in that case, it’s actually beneficial to matching at a better university program in PC track, how competitive are the tracks? I would think it’s competitive?

 

[mcat_taker]

Can someone please explain to me why these primary care IM tracks exist ? Wouldn't someone interested in primary care just do an FM residency instead ?

 

[chessknt]

Can someone please explain to me why these primary care IM tracks exist ? Wouldn't someone interested in primary care just do an FM residency instead ?

IM will prepare a PCP better for the care of a complicated adult patient better because of the interaction with medical subspecialties during training as well as the inpatient exposure that lets you see what happens when things go wrong. Im sure both can handle relatively healthy 18-65 year olds the same but if someone has CAD/CHF/DM/CKD/HTN/OSA and wants a one stop shop an IM grad is better equipped to handle that straight out of training because they have treated all of these conditions on the inpatient side and have seen how subspecialties manage them as outpatients.

The trade off is you have no idea what to do with ob or pediatrics.

 

[InternistDO]

IM will prepare a PCP better for the care of a complicated adult patient better because of the interaction with medical subspecialties during training as well as the inpatient exposure that lets you see what happens when things go wrong. Im sure both can handle relatively healthy 18-65 year olds the same but if someone has CAD/CHF/DM/CKD/HTN/OSA and wants a one stop shop an IM grad is better equipped to handle that straight out of training because they have treated all of these conditions on the inpatient side and have seen how subspecialties manage them as outpatients.

The trade off is you have no idea what to do with ob or pediatrics.

I know this is the party line (I’m an IM primary care resident), but I’m not really convinced it’s true. All the FM attendings I had in med school would treat those things the same way my IM ones would. It’s not like any of these are rare conditions, and the inpatient management of them is not always the same as outpatient.

 

[chessknt]

I know this is the party line (I’m an IM primary care resident), but I’m not really convinced it’s true. All the FM attendings I had in med school would treat those things the same way my IM ones would. It’s not like any of these are rare conditions, and the inpatient management of them is not always the same as outpatient.

Of course with time and exposure in academia that is going to happen. A brand new fm grad is not going to be on the same level with these issues as a brand new IM grad. Now put them out in the community away from rare conditions where exposure to these issues is less common and that expertise is even more valuable especially in a resource limited area where there is a single cardiologist who practices outdated medicine, no rheumatologist, no endocrinologist etc etc

 

[Prehealth1011]

Sorry I am bumping, so in that case, it’s actually beneficial to matching at a better university program in PC track, how competitive are the tracks? I would think it’s competitive?

University rep or name > what track you’re in. For example, I would not rank SUNY downstate PC track lower than other academic programs just because it's a PC track. From talking to my GI PD at my program (I'm in IM), they literally stratify you university vs community right away and not so much oh I wonder what track they're in

Competitiveness I can't speak of. I know Yale PC track is competitive af

 

[rokshana]

University rep or name > what track you’re in. For example, I would not rank SUNY downstate PC track lower than other academic programs just because it's a PC track. From talking to my GI PD at my program (I'm in IM), they literally stratify you university vs community right away and not so much oh I wonder what track they're in

Competitiveness I can't speak of. I know Yale PC track is competitive af

Really? Not sure how many would rank
Downstate that higher to begin with…don’t get me wrong, you are well trained because you go through fire there…but not sure how highly ranked academically it is, especially when comparing to the academic programs in nyc.

 

[VA Hopeful Dr]

Of course with time and exposure in academia that is going to happen. A brand new fm grad is not going to be on the same level with these issues as a brand new IM grad. Now put them out in the community away from rare conditions where exposure to these issues is less common and that expertise is even more valuable especially in a resource limited area where there is a single cardiologist who practices outdated medicine, no rheumatologist, no endocrinologist etc etc

This has not been my experience (I'm FM with an IM PCP wife).

 

[deleted898021]

Everyone should remember that there is no distinction from the ACGME between a "primary care" IM program/track compared to a traditional IM program/track. People coming out of primary care programs/tracks still have to complete the same requirements for internal medicine training according to the ACGME (and ABIM when you are discussing subsequent board certification). This includes at least 4 months of ICU (maximum of 6), certain amount of inpatient and outpatient IM, 1 month of EM, etc. When all the requirements are finally fulfilled, It turns out that the differences between primary care and traditional IM programs often turn out to be pretty minimal.

I was in the primary care IM program/track at my residency, and those of us who decided to pursue fellowship all matched comparatively to people coming out of the traditional program/track, all subspecialties included. I only remember being asked about it once on the fellowship interview trail, and it seemed more out of curiosity rather than questioning whether I would be able to handle fellowship coming from a primary care track. I think I was definitely considered "applicant from university of xxx" and not "applicant from primary care track at university of xxx."

**EDITED to correct vocabulary

Another question if you can answer, is it ok to apply to the regular IM program as well as the Primary care track program at the same institution?

 

[the argus]

Sorry I am bumping, so in that case, it’s actually beneficial to matching at a better university program in PC track, how competitive are the tracks? I would think it’s competitive?

Overall I think PC tracks at any given institution are probably on the same level of competitiveness as the traditional IM tracks. In terms of applying to fellowships, as has been mentioned above, it is important to gauge whether the PC track leadership will be supportive in their residents pursuing subspecialty fellowships instead of actually going into primary care. My PD was extremely supportive in whatever the residents chose to do, but I would assume some PC track PDs would not be the same.

Another question if you can answer, is it ok to apply to the regular IM program as well as the Primary care track program at the same institution?

It probably depends on the specific institution and if you truly are considering primary care for your career. If you present yourself as genuinely interested in primary care, then sure apply to both and see what happens. If you present yourself as gunning for a GI fellowship, it might seem a little disingenuous to apply to the primary care track. Understand that the PDs from the 2 programs are likely to talk to each other.

I interviewed at both the traditional and primary care tracks where I ended up for residency. I was upfront throughout the whole process and was seriously considering primary care as my career path. I much preferred the primary care track after the interview days, and was extremely lucky to end up with a supportive PD when I decided to subspecialize. This very well might not be the case at some institutions. Look at the websites and see what their grads actually do. If 99% of the grads from the primary care track actually go into primary care, then I would assume the PC leadership cares about what their grads end up doing.

 

[deleted898021]

Overall I think PC tracks at any given institution are probably on the same level of competitiveness as the traditional IM tracks. In terms of applying to fellowships, as has been mentioned above, it is important to gauge whether the PC track leadership will be supportive in their residents pursuing subspecialty fellowships instead of actually going into primary care. My PD was extremely supportive in whatever the residents chose to do, but I would assume some PC track PDs would not be the same.


It probably depends on the specific institution and if you truly are considering primary care for your career. If you present yourself as genuinely interested in primary care, then sure apply to both and see what happens. If you present yourself as gunning for a GI fellowship, it might seem a little disingenuous to apply to the primary care track. Understand that the PDs from the 2 programs are likely to talk to each other.

I interviewed at both the traditional and primary care tracks where I ended up for residency. I was upfront throughout the whole process and was seriously considering primary care as my career path. I much preferred the primary care track after the interview days, and was extremely lucky to end up with a supportive PD when I decided to subspecialize. This very well might not be the case at some institutions. Look at the websites and see what their grads actually do. If 99% of the grads from the primary care track actually go into primary care, then I would assume the PC leadership cares about what their grads end up doing.

That makes sense! Thank you!