separate IM and EM residencies to be IM/EM

[dmaes]

I'm curious about people's thoughts on doing separate residencies in IM and EM in order to achieve dual boarding and practice in both areas (as opposed to not liking one type work). The dual residency programs would seem to be the preferred route especially from a time perspective. I do believe that I read on the ABEM website that if you were medicine boarded/board eligible you could petition the program and shave 6 months off your training. I don't know if the ABIM has something similar. So, with separate residencies, I guess in a best case scenario you are looking at an extra 6 months to as much as 2 years extra training (with a 4 yr em program). Doing two residencies is clearly not ideal but given the limited number of dual residency spots this could be the only path if one really wants to do both. So some specific questions are:

1) What are your general thoughts.

2) Has anybody done this or know reliably of someone who has done this?

3) What are opinions on the best order to do the residencies? (I would think EM then IM because of the general competiveness of EM over IM as well as the decreased medicare funding).

Thanks in advance!

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[NinerNiner999]

Quinn has someone in his program in the same situation - ask him...

 

[DrQuinn]

Quinn has someone in his program in the same situation - ask him...

Thanks for the nod, Niner!

One thing you need to be aware of is the FUNDING issue. If you are an IM resident, you are alloted 3 years for your GME training. For you to come back to an EM resident after completing your post graduate training is an issue for the EM program. You would have to find a program that is willing to forgo the Medicare funding for your education. Some programs will do that, i.e. mine. We have a med/peds attending who is back to be EM BC.


Q

 

[Sessamoid]

Quinn is exactly right about the funding issue. I think the important thing to do if you're contemplating doing both residencies is to do the one you think you'd be happiest in FIRST. That way if you find it impossible to get into the second residency you maximize your chances at being in a field you enjoy over the long term.

 

[dmaes]

Quinn is exactly right about the funding issue. I think the important thing to do if you're contemplating doing both residencies is to do the one you think you'd be happiest in FIRST. That way if you find it impossible to get into the second residency you maximize your chances at being in a field you enjoy over the long term.

Thanks for the responses. The funding issue was what I was trying to get at with my question on the order of residencies. I seem to remember reading that medicare will fund a PGY 4-whatever training position at 1/2 the level it does for PGY 1-3. This applies for longer residencies (such as surgery) or fellowships. I may just be making this up. My thinking is that it would be best to do EM as a first residency because there seem to be a relative abundance of medicine residencies and therefore a greaster need for residents so it would be more likely that one would be able obtain a position despite the funding issue.

Thanks again for the replies!

 

[ERMudPhud]

If you are dead set on doing it this way you might find a 2,3,4 EM program and do your prelim year as IM. That way you get 4 years payed for, have a year of accredited IM training, and can then look for PGY2 IM spots. It works out to 6 years of which only 2 are underfunded. I've thought about doing this a few times and then my wife hits me upside the head and I realize I'd have to be nuts

 

[dmaes]

If you are dead set on doing it this way you might find a 2,3,4 EM program and do your prelim year as IM. That way you get 4 years payed for, have a year of accredited IM training, and can then look for PGY2 IM spots. It works out to 6 years of which only 2 are underfunded. I've thought about doing this a few times and then my wife hits me upside the head and I realize I'd have to be nuts

Thanks again for the suggestions! Does doing a prelim IM and a 2,3,4 program get all four years paid for? I can't seem to get the medicare residency funding rules straight.

I'm not dead set on anything but simply trying to understand all options. My wife is a research scientist and is done with her post doc so where ever she can get the best position will determine where we will be for a while. Whatever the location may be may not be proximate to a combined program.

 

[ERMudPhud]

Thanks again for the suggestions! Does doing a prelim IM and a 2,3,4 program get all four years paid for? I can't seem to get the medicare residency funding rules straight.

It used to and I think it still does but that route will probably be drying up shortly, leaving all the four year programs with their last year unfunded. I know of some 2,3,4 that have gone to 1,2,3,4's at least in part because the thought was it was better to have 3 out of 4 years funded than 2 out of 3. If you really want to be double boarded then applying to the combined EM/IM programs is probably a shorter and more reliable route.