Procedure based medical specialties

[ms1234]

So I'm in my third year of medical school, doing core rotations. My first rotation was Surgery, and I completely loved it. I'm currently in Internal Medicine now, and it is not at all what I thought it would be. I had originally planned on going into IM, but my Surgery rotation changed my mind. I miss the OR, I miss doing procedures, I miss the adrenaline rush. I've only done these two rotations thus far, but I know that I definitely want to go into something procedure-based.

The catch? I'm an IMG and don't have the best Step 1 score, so any type of surgical residency is essentially impossible for me.

What types of subspecialties are very procedure-heavy, and will allow me to feel that same rush as in surgery? I've done research and have seen that GI, IR, and Interventional cardiology are subspecialties that do a lot of procedures, but any additional details about them (or other procedure-based specialties) would be appreciated.

Thanks!

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[.hematoma.]

Ophtho is pretty great, but if you said that your step score is on the lower end it may be a risk to apply to ophtho alone. Don't underestimate family practice though, at the clinic I shadow at the doctor does cyst removals (maybe not an adrenaline rush, but there is still the potential for some "procedures" if that's what you are passionate about!)

 

[mw18]

Ophtho is pretty great, but if you said that your step score is on the lower end it may be a risk to apply to ophtho alone. Don't underestimate family practice though, at the clinic I shadow at the doctor does cyst removals (maybe not an adrenaline rush, but there is still the potential for some "procedures" if that's what you are passionate about!)

Yeah if Gen Surg is out, then optho is definitely out. How low is your step score? What about OB/Gyn or anesthesia? Are you pretty much feeling you're limited to a post-IM fellowship? In the 2014 charting outcomes anesthesia and ob/gyn both had lower step averages than IM, but I have no idea how many lower-tier, less competitive IM programs there are that play into that average either.

 

[OnePunchBiopsy]

I know OB/GYNs who have a procedure-driven career: (robotic) hysterectomies, D&C's, endometrial biopsies, c-sections, IUD insertions (and sometimes removals that require the OR), hysterosalpingograms, ectopic pregnancies, ovarian torsions. Gyn Onc does a lot of uterine/ovarian cancer removals with lymphnode dissections. Maternal-Fetal medicine can even do procedures on the fetus in utero.

 

[lymphocyte]

So I'm in my third year of medical school, doing core rotations. My first rotation was Surgery, and I completely loved it. I'm currently in Internal Medicine now, and it is not at all what I thought it would be. I had originally planned on going into IM, but my Surgery rotation changed my mind. I miss the OR, I miss doing procedures, I miss the adrenaline rush. I've only done these two rotations thus far, but I know that I definitely want to go into something procedure-based.

The catch? I'm an IMG and don't have the best Step 1 score, so any type of surgical residency is essentially impossible for me.

What types of subspecialties are very procedure-heavy, and will allow me to feel that same rush as in surgery? I've done research and have seen that GI, IR, and Interventional cardiology are subspecialties that do a lot of procedures, but any additional details about them (or other procedure-based specialties) would be appreciated.

Thanks!

Without knowing the particulars of your application, there are probably lots of options open for you:

1. Intensive care after IM. Procedure-rich right at the edge of the physiological envelope. Pretty exciting!
2. Anesthesia is heavily procedural and becoming less popular now. It also offers a pathway into intensive care or pain. There's obviously time in the OR.
3. Neurology has always been receptive to IMGs and offers a pathway into neurointensive care and possibly neurointerventional (but that's a longer discussion with lots of complexity).
4. People heavily discount FM. But a sizable number of FM specialists do operate or attend obstetric surgeries, especially in a rural setting.

 

[ms1234]

Ophtho is pretty great, but if you said that your step score is on the lower end it may be a risk to apply to ophtho alone. Don't underestimate family practice though, at the clinic I shadow at the doctor does cyst removals (maybe not an adrenaline rush, but there is still the potential for some "procedures" if that's what you are passionate about!)

Thanks for the response! Is he able to to procedures every day, or does it just depend per patient?

 

[ms1234]

Yeah if Gen Surg is out, then optho is definitely out. How low is your step score? What about OB/Gyn or anesthesia? Are you pretty much feeling you're limited to a post-IM fellowship? In the 2014 charting outcomes anesthesia and ob/gyn both had lower step averages than IM, but I have no idea how many lower-tier, less competitive IM programs there are that play into that average either.

I haven't taken Step 2 yet, and I'm hoping to do a lot better, but my Step 1 was a 205. I thought Anesthesia required high step scores as well? I feel like I'm limited to IM and FM due to my score and was hoping to get a fellowship in order to still be doing procedures. Maybe GI?

 

[ms1234]

Without knowing the particulars of your application, there are probably lots of options open for you:

1. Intensive care after IM. Procedure-rich right at the edge of the physiological envelope. Pretty exciting!
2. Anesthesia is heavily procedural and becoming less popular now. It also offers a pathway into intensive care or pain. There's obviously time in the OR.
3. Neurology has always been receptive to IMGs and offers a pathway into neurointensive care and possibly neurointerventional (but that's a longer discussion with lots of complexity).
4. People heavily discount FM. But a sizable number of FM specialists do operate or attend obstetric surgeries, especially in a rural setting.

Thanks for the response!

Do you have any details on an Intensive Care fellowship and how competitive they usually are?

I have been hearing more about FM. When you say they can operate, do you mean only through OBGYN procedures, or is there a loophole into surgery?

 

[ms1234]

I know OB/GYNs who have a procedure-driven career: (robotic) hysterectomies, D&C's, endometrial biopsies, c-sections, IUD insertions (and sometimes removals that require the OR), hysterosalpingograms, ectopic pregnancies, ovarian torsions. Gyn Onc does a lot of uterine/ovarian cancer removals with lymphnode dissections. Maternal-Fetal medicine can even do procedures on the fetus in utero.

Do you know if Gyn Onc or Maternal Fetal Medicine are possible through FM, or are they ObGyn fellowships?

 

[OnePunchBiopsy]

Do you know if Gyn Onc or Maternal Fetal Medicine are possible through FM, or are they ObGyn fellowships?

Only through OB/GYN residency with a fellowship.

You can check out other subspecialties here:
http://www.abms.org/member-boards/specialty-subspecialty-certificates/

 

[meister]

IR would be a good fit for you. I suspect it will be above average to match into, but you could think about diagnostic rads with a two year fellowship. That's a long road indeed, though (1+4+2).