Quick question

[DrNightMoves]

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How difficult would it be to practice general IM for a few years and then get a fellowship into a subspecialty? I know some are way harder than others, but generally speaking, how much harder does it become as you are further and further out of residency?

 

[jdh71]

How difficult would it be to practice general IM for a few years and then get a fellowship into a subspecialty? I know some are way harder than others, but generally speaking, how much harder does it become as you are further and further out of residency?

"How much" is hard to quantify. Harder. And harder the further you get out.

 

[DrNightMoves]

But is it uncommon to practice for say 2-3 years prior to sub-specializing?

 

[jdh71]

But is it uncommon to practice for say 2-3 years prior to sub-specializing?

It's seems many folks are going out and trying the hospitalist route for awhile, with the plan of returning for sub-specialization. It remains to be seen if this will be a winning way to go. It's hard to read the trends.

But if I'm playing chess on this one correctly with more and more AMGs going into internal medicine, more and more will also be looking to sub-specialize and this will further more the applicant pool for an sub-specialty that much more competitive, which I think will ace out MOST people who decided to go work for a few years.

The next three to five years will let us all know if my assessment is correct.

 

[nephappl]

I think depends in part which specialty you are looking for.
I know Nephrology has become really non competitive according to NRMP data. Last year there were almost the same number of applicants compared to positions with more than 40 positions opened after the match with the number of applicants steadily decreasing.
But if you want HemOnc / GI / Pulmonary that is different.
It is doable, I did it.