Question for those who DON'T want to do a fellowship

[drivesmecraazee]

Why? Why wouldn't you want to do an IM fellowship?
I've some pretty hard IM bashing coming from surgeons, radiologists, pathologists, OB-GYN's, etc. They don't like the idea of working as an IM with or without fellowship, but they all say that working as an IM with no fellowship is even worse, like it's something they would never, ever do!!
I would like to hear some opinions coming from the flip side, tell me your reasons for working as IM physicians with no need to have a fellowship.
I also would like to know what do you think about those fields that bash IM so much. Why wouldn't you do that for a living? What's wrong with it?
Come on guys, lets get agressive!!! LOL LOL
Thanks...

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[Is It Lupus?]

I'm doing IM but not planning to subspecialize because there is no one field that really appeals to me - I have a great deal of interest in so many subspecialties. If I had to pick one, I would pick Cardio, but I don't think that's good enough reason to commit the rest of my career to it, especially since I mostly just enjoy the preventative aspect of Cardio.

Anywho, I tenatively plan to stay in the field of primary care and do hospitalist medicine after residency, then possibly join a group practice when I figure out where my husband and I will settle down. Now if I end up really liking hospitalist medicine and want to work in an academic setting and teach residents, a General Medicine fellowship might be helpful. But I don't feel the pressure to just reach out blindly and pick an IM fellowship because it would be the most lucrative thing to do. I fully understand that in the future, I may not make as much money as an interventional cardiologist would, but primary care is what I enjoy doing, so that's what I'm gonna do.

It's always easier to bash another field, especially one that you loathe and wouldn't pick for yourself. That bashing you speak of is probably due to the common stereotypes about primary care IM - you work long hours, have to see many patients a day to make money, and then you still may need to refer patients to specialists when all is said and done. It's too early for me to know how true this all is, but what I do know is that there are positives and negatives to any field in medicine and that you just need to sift through it all and see where you would be happiest.

 

[Geri_Gal]

I've some pretty hard IM bashing coming from surgeons, radiologists, pathologists, OB-GYN's, etc.
Come on guys, lets get agressive!!! LOL LOL
Thanks...

I can see why one wouldn't go after a fellowship. Primary care medicine offers predictable office hours, with no need to admit your patients to the hospital if there is a hospitalist service. Some of the greatest gains in medicine stem from good primary care. You can help your patient prevent illness with smoking cessation counseling, yearly pap testing, lifestyle modification counseling, etc. I really like my continuity clinic and find it gratifying when a patient tells me that he's quit smoking b/c of my or another health care professional's advice. Also gratifying when a patient's HgA1C is <7, or their BP is finally controlled.

Helping patients realize that their health is in their control is NOT as much of an ego "rush" as performing a procedure on your own to effect change. In the broader perspective, however, primary care can help our patient population more profoundly than many well-compensated procedures (e.g. CABG, oncologic surgeries and chemotherapies).

Also: no butt pus (rectal abscess I&D), no staring at vaginas @ 3a.m. waiting for a baby's head to crown, no post-operative complications, no sitting in dark rooms with hundreds of films to read (w/ threat of law suit at missing that early CA on a mammogram)

 

[drivesmecraazee]

So I guess that's all, there aren't any other future IM docs who don't want to go for a fellowship...
Thanks to Lupus and Geri for posting...

 

[pseudoknot]

So I guess that's all, there aren't any other future IM docs who don't want to go for a fellowship...
Thanks to Lupus and Geri for posting...

Don't you usually post in the surgery forum? It seems like you came here to try to start a specialty bashing thread. Not cool, if you ask me.

 

[drivesmecraazee]

Don't you usually post in the surgery forum? It seems like you came here to try to start a specialty bashing thread. Not cool, if you ask me.

You might be confused
I am a MSII and I post on many forums, ENT, Urology, Rads, Path and Clinical Rotations...
I usually post casual threads cuz Im very curious, not those "what are my chances" since Im not in that phase yet.

 

[Trifling Jester]

So I guess that's all, there aren't any other future IM docs who don't want to go for a fellowship...
Thanks to Lupus and Geri for posting...

You come on to the IM board posting this:

"I've some pretty hard IM bashing coming from surgeons, radiologists, pathologists, OB-GYN's, etc. They don't like the idea of working as an IM with or without fellowship, but they all say that working as an IM with no fellowship is even worse, like it's something they would never, ever do!!"

And now you try to goad us into responding?

Obviously, surgeons, radiologists, pathologists, and OBGyns do not like the idea of working in IM with or without fellowship, that's why they didn't go into IM.

Good luck with medical school,
The Trifling Jester

 

[drivesmecraazee]

You come on to the IM board posting this:

"I've some pretty hard IM bashing coming from surgeons, radiologists, pathologists, OB-GYN's, etc. They don't like the idea of working as an IM with or without fellowship, but they all say that working as an IM with no fellowship is even worse, like it's something they would never, ever do!!"

And now you try to goad us into responding?

Obviously, surgeons, radiologists, pathologists, and OBGyns do not like the idea of working in IM with or without fellowship, that's why they didn't go into IM.

Good luck with medical school,
The Trifling Jester

Ooohh so you feel offended ?!?
C´mon man Im not trying to indulge you into a defensive postion, I just want to hear the opinions of those who like to work in a certain field that is obviously pretty much disliked by sooo many people, Im sure IM has something good about it (like any other filed), and Im just tired of hearing the cons, you know, we all need some pros too in order to take the right decision, it's just that the people who actually can give me the pros don't talk much about it.
I don't want to know why others didn't choose IM (Im done with that s***), I wanto to know why did YOU chosed it, that's all.
Now if you're trying to make me feel bad for having a doubt then don't post.
Thanks to the ones who gave me their opinions, these are more than welcomed.

 

[pseudoknot]

What's wrong with [fields other than IM]?
Come on guys, lets get agressive!!! LOL LOL

C´mon man Im not trying to indulge you into a defensive postion, I just want to hear the opinions of those who like to work in a certain field that is obviously pretty much disliked by sooo many people, Im sure IM has something good about it

No, more like an offensive one.

 

[drivesmecraazee]

No, more like an offensive one.

The "lets get agressive" part was a joke, didn't you notice that I wrote "LOL LOL"??? I just wanted to hear some reasons for choosing IM instead other fields, people give this reason all the time!!
You just missed my point.
Just forget about it. You got too sensitive and it's just not worthed.

 

[Trifling Jester]

Ooohh so you feel offended ?!?

Sorry to disappoint you in your obvious troll attempt, but I do not feel offended. Next time you're interested in how I'm feeling just ask me without making any assumptions, and I'll be sure let you know

C´mon man Im not trying to indulge you into a defensive postion,

I didn't realize that I could be indulged into any sort of a position. [ed note: at least not with you, har har] Is english your second language?

I just want to hear the opinions of those who like to work in a certain field that is obviously pretty much disliked by sooo many people,

I am quite unaware that we are disliked by "sooo many people." In my limited experience as a physician I've had the opportunity to interact with other physicians both inside and outside the hospital setting to discuss patient care. I haven't had animosity directed towards me based on my chosen field.

With your vast experiences as an MSII perhaps you can fill us in on why "sooo many people" have such an obvious dislike for us.

Im sure IM has something good about it (like any other filed), and Im just tired of hearing the cons, you know, we all need some pros too in order to take the right decision, it's just that the people who actually can give me the pros don't talk much about it.

Do you find that people often don't wish to discuss things with you? Perhaps your approach puts people off. In other words, maybe those people who can give you the pros do talk about it, just not to you. "LOL LOL"

I don't want to know why others didn't choose IM (Im done with that s***), I wanto to know why did YOU chosed it, that's all. Now if you're trying to make me feel bad for having a doubt then don't post.
Thanks to the ones who gave me their opinions, these are more than welcomed.

You're "welcomed,"
The Trifling Jester

 

[drivesmecraazee]

Now you're trying to put words in my mouth...
I wasn't saying that IM physicians were disliked by others, I just said that I've noticed a lot of dislike for IM (as a field) here in these forum (MSII know how to use the forums, we will if you Sir New Physician let us), maybe I can't speak english that well, but you can't even understand it ...and english is actaually YOUR first language...Im pretty sure it's your only language too......so think about that before you make fun of me, at least Im capable of expressing my ideas in a foreign language.
My intentions were misunderstood, that's for sure, but my approach puts people off? Now you're turning it into a regular thing, you don't even know me man.
You're the one who started this stupid fight and I got tired of discussing this with you, so you either get the hell out of this thread or give me your point of view about what I asked. If you feel such a big necesity to fight with me buy yourself a plane ticket to Costa Rica or something.

P.D: You can consider me a troll if you want to, whatever makes you happy

 

[0382938]

Gracious, what an odd topic to try to sow animosity about. I've found most other specialists to be nothing but grateful that there are those of us who go into internal med (and sometimes even general IM) so that they don't have to. As for myself, I am starting IM residency next year and considering the option of no fellowship because I appreciate the breadth of general IM. On the other hand, I'm not so fond of the preventative medicine and behavioral medicine aspects of outpatient medicine (but God bless those of you who are!), so I may end up doing a fellowship in hospital medicine depending on where the field goes and what my life situation is at that point. (To state the obvious, another reason one might choose not to do a fellowship is the immediate income hike when training ends.)

 

[drivesmecraazee]

Thanks for your aswer.
I would consider doing IM (not fellowship) for the diversity that offers me, besides I am very scholarly person and it would make me happy to feel that Im aplying all or at least most of the things I learned in med school. What turns me off a little bit is that IM docs have to pass a lot of cases to specialists and being a transitory station makes the job bureaucratic in a certain way (a.k.a paper work). Preventive medicine doesn't seem too attractive to me either.
But of course I do respect the people who makes the choice to become an IM doc (even those who tought I was starting a flame war against them).

 

[Trifling Jester]

Now you're trying to put words in my mouth...
I wasn't saying that IM physicians were disliked by others, I just said that I've noticed a lot of dislike for IM (as a field) here in these forum (MSII know how to use the forums, we will if you Sir New Physician let us),

Very well, I will indulge (ha ha) in your game of semantics.

To rephrase my previous response (changes made in italics):

I am quite unaware that our field is disliked by "sooo many people." In my limited experience as a physician I've had the opportunity to interact with other physicians both inside and outside the hospital setting to discuss patient care. I haven't had animosity directed towards me based on my chosen field.

With your vast experiences as an MSII perhaps you can fill us in on why "sooo many people" have such an obvious dislike for our field.

I hope this clears things up for you.

maybe I can't speak english that well, but you can't even understand it ...and english is actaually YOUR first language...Im pretty sure it's your only language too......so think about that before you make fun of me, at least Im capable of expressing my ideas in a foreign language.

I understand english perfectly well, and you should start typing it properly. Perhaps if you indulge (ha ha) yourself into some ESL classes we might better converse. You're welcomed (oops, there it goes again) in advance.

My intentions were misunderstood, that's for sure, but my approach puts people off? Now you're turning it into a regular thing, you don't even know me man.

What is this "regular thing" that our discussion has turned into?

You're the one who started this stupid fight and I got tired of discussing this with you, so you either get the hell out of this thread or give me your point of view about what I asked. If you feel such a big necesity to fight with me buy yourself a plane ticket to Costa Rica or something.

I overheard some people from Venezuala talking about Costa Rica. They said y'all smell bad, and that they would never, ever want to be from Costa Rica. What do you think about that? Huh? C'mon, let's get aggressive!

P.D: You can consider me a troll if you want to, whatever makes you happy

Did those urologists ever successfully answer your question? You know, the one where you asked, "what kind of drugs do you use to keep an erection under the effects of aenesthesia?"

http://forums.studentdoctor.net/showthread.php?t=495613

Sir Physician,
The Trifling Jester

 

[Sharn Penndroen]

Why do you care what anyone thinks about the field you choose to go into? Is this your career or a popularity contest? I'm going to assume for a moment that you didn't come over here to troll and start a flame war, and offer some honest advice.

1) Stop caring what other people think about you and your choice of specialty.
2) If you want to know about Ob/Gyn ask an Ob/Gyn doc. If you want to find out about ENT, ask an ENT doc. If you want to find out about IM, ask an IM doc. Etc. Point is other specialities don't know much about other specialties. Period. Why base your decisions on watered down and distorted opinions. Go straight to the source.
3) Stop caring what other people think about you and your choice of specialty.

And to address some of your concerns about general medicine, the vast majority of physicians do not work in a situation where they farm out all their patients to subspecialist. In fact, most general medicine doctors, be it in the clinic or hospital, take care of most of the patients without the need for a consult. I've done several rotations with hospitalists at private hospitals, and they had a wide variety of patient problems that they handled on their own. They rarely consult, and when they do it is well warranted.

 

[drivesmecraazee]

I REALLY would like to knock this whole thing off, Im sorry, I asked a question, some people felt attacked, I didn't bash IM, the opinions I was talking about come from people right on this forums. Here they are:

http://forums.studentdoctor.net/showthread.php?t=494415

Read a few if you want to, if you don't, then accept you didn't read it and stop attacking me and calling me a troll, just knock it off, I am giving you the probe, the source of those negative opinions. It's your choice wether you read em' or not. You can start attacking all the members who wrote IM bashing coments if you want to...but I am OUT.

 

[orientedtoself]

I am giving you the probe,

i'll give you the probe.

please let this thread die. i am dumber for having read it, and i will never get that three minutes of my life back.

 

[Trifling Jester]

I REALLY would like to knock this whole thing off, Im sorry, I asked a question, some people felt attacked, I didn't bash IM, the opinions I was talking about come from people right on this forums. Here they are:

http://forums.studentdoctor.net/showthread.php?t=494415

Wow! You found some non-IM docs who don't like IM! What other newsbreaking bulletins will you run past us next? Will you show us a statement from a surgeon who doesn't like anesthesia? Or a pediatricians' opinion on geriatrics?

Read a few if you want to, if you don't, then accept you didn't read it and stop attacking me and calling me a troll, just knock it off, I am giving you the probe, the source of those negative opinions. It's your choice wether you read em' or not. You can start attacking all the members who wrote IM bashing coments if you want to...but I am OUT.

I am glad that you're OUT.

-The Trifling Jester

 

[drivesmecraazee]

Wow! You found some non-IM docs who don't like IM! What other newsbreaking bulletins will you run past us next? Will you show us a statement from a surgeon who doesn't like anesthesia? Or a pediatricians' opinion on geriatrics?



I am glad that you're OUT.

-The Trifling Jester

Don't try your sarcasm here, you know the meaning of what you read in those posts, those users didn't say they didn't like IM, they were bashing it, im not, I never disrespected your profesion so I still don't understand your anger towards me.
Im very surprised you haven't read those posts before, oh wait...you were too busy stocking me (reading my posts in the uro forum...lame )
How about learning a new language my friend? Or do you feel less mediocre making fun of those who actually are able to comunicate in other languages, but with a few flaws.
Goodbye Jester the Molester.

 

[orientedtoself]

you mean like these kind of stockings?

oh wait...you were too busy stocking me (reading my posts in the uro forum...lame )

 

[Trifling Jester]

Don't try your sarcasm here, you know the meaning of what you read in those posts, those users didn't say they didn't like IM, they were bashing it, im not, I never disrespected your profesion so I still don't understand your anger towards me.

Because you'd have to be extremely thick-headed not to see through your little charade.

BTW, I thought you were "OUT." What's keeping you?

Im very surprised you haven't read those posts before, oh wait...you were too busy stocking me (reading my posts in the uro forum...lame )

I'm glad you brought that up, I'd forgotten about that question. You asked, "what kind of drugs do you use to keep an erection under the effects of aenesthesia?"

http://forums.studentdoctor.net/showthread.php?t=495613

Exactly what kinds of activities does an MSII engage in which would necessitate an erect penis on an anesthetised patient?

How about learning a new language my friend? Or do you feel less mediocre making fun of those who actually are able to comunicate in other languages, but with a few flaws.

No, I don't feel "less mediocre," whatever that means.

Goodbye Jester the Molester.

Now you're saying goodbye for the second time?

"So, Lord craazee, at last we say goodbye again for the first time for the last time."

-The Trifling Jester

 

[drivesmecraazee]

Because you'd have to be extremely thick-headed not to see through your little charade.

BTW, I thought you were "OUT." What's keeping you?



I'm glad you brought that up, I'd forgotten about that question. You asked, "what kind of drugs do you use to keep an erection under the effects of aenesthesia?"

http://forums.studentdoctor.net/showthread.php?t=495613

Exactly what kinds of activities does an MSII engage in which would necessitate an erect penis on an anesthetised patient?



No, I don't feel "less mediocre," whatever that means.



Now you're saying goodbye for the second time?

"So, Lord craazee, at last we say goodbye again for the first time for the last time."

-The Trifling Jester

Sorry, "mediocre" is in spanish, it means that you're person who doesn't set more goals in your life life besides what you need, that you don't feel the necesity to gain new knowledge.
Are you starting an investigation based on what you read in the uro forum? . Go ahead Nancy Drew...

You seem like the kind of person who likes to have the last word, you know that shows you're pretty insecure, but hey, be my guest, have your last word, I really don't have any more time and patience for this discusion

 

[drivesmecraazee]

you mean like these kind of stockings?

it spelled "stalker" right? my bad...

 

[Trifling Jester]

Sorry, "mediocre" is in spanish, it means that you're person who doesn't set more goals in your life life besides what you need, that you don't feel the necesity to gain new knowledge.

Oh, well now I can see how that would be such a devastating insult...

Are you starting an investigation based on what you read in the uro forum? . Go ahead Nancy Drew...

Quit the dodging and answer my question: Exactly what kinds of activities does an MSII engage in which would necessitate an erect penis on an anesthetised patient?

You seem like the kind of person who likes to have the last word, you know that shows you're pretty insecure, but hey, be my guest, have your last word, I really don't have any more time and patience for this discusion

So now you are telling me goodbye for the third time?

Wondering when you'll finally be gone,
The Trifling Jester

 

[purplepants]

I don't know anything about the original poster but when I read his first post I didn't think too badly of it. maybe the 'aggressive' part was not necessary but there was an LOL next to it. (2 of them!) ; )
I think this is a misunderstanding due to the fact that the internet does not allow us to show emotions (emoticons just don't cut it) and I honestly don't feel that he/she meant anything. this is coming from someone interested in primary care internal medicine and is currently debating the idea.
also, nothing wrong with knowing a second language- more people should try.
lets just forget this and hope that the original question was answered.

but let me try:

outpatient primary care medicine is interesting to some because it allows one to work in the community, to hold a great breadth of knowledge, to learn/continue learning a lot about the entire body, to manage a patient, to build close bonds and long term relationships, and also to work on preventive care. Also, the work hours are stable, with no or few call and weekends off (although the encounters are often rushed 15 minutes or so and pay is less to a specialist).

p.s. I hope I never have a surgery but I especially dont want a surgery where the penis needs to be erect for any reason.

 

[JayneCobb]

alright guys, this has gone on long enough. lets try to let cooler heads prevail.