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[Kansas_Med]

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[collegestud2013]

All IM positions through the Match start at PGY-1, so you would need to repeat your entire intern year if you get a categorical position through the Match. You won't get any credit for any time since IM programs will be counting on your to staff their services for the entire year. Also, you probably won't have enough time to interview for both IM and EM positions during a busy intern year.

If would reapply to just EM through the Match this time. In case your don't match again and are unable to find a spot by around March or April next year, there are plenty of PGY-2 IM spots that open up usually around March-June every year outside the Match since this is time that Categorical PGY-1s decide not to renew their PGY-2 contract (eg they are transferring to another IM program or are switching specialties altogether). You may be able to stay at your current program for PGY-2 year if a spot opens, but if not you would need to transfer to another IM program with an open PGY-2 spot. The main difference between the Categorical and Prelim PGY-1 IM schedules at most programs is that the Prelims don't have any significant outpatient (ambulatory clinic) blocks, so that would be new for you. Remember you if you like EM, you can always do an EM type fellowship after IM residency to get more EM training and then work shifts in an ED (as an internist with ED experience) so it doesn't have to require doing a dedicated 3 or 4 year EM residency.

The bigger question is why you don't think you didn't Match EM this year. Making the necessary improvements in your application this time will be crucial; otherwise expect to yield the same results if applying with the same application. Are you USMD, DO, or IMG? How many programs did you apply to, how many interviews did you go to, and how many programs did you rank? What are your Step scores? Any red flags? Did you meet all the EM LOR requirements (eg SLOEs? EM has actually gotten slightly easier to get into lately (with USMD Match rate of 91.6% and mean Step 1 score of 233) since there are a lot of new community programs that aren't very competitive to get into.

 

[Dr Tapatio]

I don't understand why you're not applying to FM as a backup? Many FM people do the 1-year emergency fellowship which allows them to practice EM at smaller hospitals in rural or certain suburban areas. You will also have an easier time finding an urgent care job. At least it is closer to what you want than doing IM.

 

[GoSpursGo]

Yeah, underlying everything else is that you need to enter this with a concrete plan of what is going to be different this time around. If you simply applied to programs that were too competitive last time, then that's an easy mistake to fix; if you were already applying to less desirable programs without much love, then I'm not sure what could have changed in the last few months to make you think the outcome will be any different from last time.

 

[calvinhobbes]

I don't understand why you're not applying to FM as a backup? Many FM people do the 1-year emergency fellowship which allows them to practice EM at smaller hospitals in rural or certain suburban areas. You will also have an easier time finding an urgent care job. At least it is closer to what you want than doing IM.

Just to comment on this, a friend of mine did FM, then an EM fellowship from FM, and worked as an EM doc for a few years in a rural hospital...Then wanted to move back to his suburban hometown and not one ER would hire him as an EM physician, even with his training and experience. He is now re-starting residency in EM as part of their PGY-2 class (the program he found gave him some credit). So It’s possible for sure to do EM from FM but many places won’t hire you, thus why friend is kinda redoing residency.