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nnz3

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Hello,

I am a PGY-1 in a IM/Peds program and am strongly considering switching to PM&R. I did two PM&R rotations as a med student, and actually applied to and interviewed in IM/Peds, IM and PM&R, with my rank list looking like 1 IM/Peds program (the one I matched in), then 4 PM&R programs (I've been struggling with my decision a long time). I'm anxious to make the switch. I enjoy inpatient medicine (the pace and the team aspect) but a life with higher acuity patients causes me stress. I am most interested in connecting with my patients and making a difference in their day-to-day lives, which leads me to believe that if I continue on my current path, I would end up in primary care. That wouldn't be the worst.
I am an osteopath as well and am in an allopathic program with no DO faculty, so no OMT practice, which also bums me out. My interests lie in integrative medicine, and I plan to do a fellowship in that regardless of my residency. All in all I'm seeking advice about making the choice to switch. I want a family and fulfilling career that requires me to be intellectually stimulated and able to meaningfully connect with others.

Sorry this is long winded! I'm new to these forums but desperate to get some feedback about this choice without causing alarm at my current program. thank you!
 

DMBandFan86

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Can you list some reasons why you would want to go into PM&R and what your interests are in? How do you expect a specialty change to bring about more job satisfaction in the future verses what you are currently in?

Why do you mention the lack of OMT exposure in your current program? Yes, there are PM&R physicians that do OMT, but it's not standard practice to learn this during a typical PM&R residency. You can do rotations/electives in OMT just as you can probably do in IM/Peds. So I wasn't sure why this was a topic to bring up. There are PM&R programs like Michigan State that are more osteopathic focused and have more exposure than others, but nothing to warrant changing from Peds/IM to PM&R.

It's common for residents to second guess their specialty of choice at least a few times throughout residency. Especially during their PGY-1 year when things are harder and you are lowest on the totem pole. What it really comes down to is would a change of specialty actually make you happier and more interested in your career for years to come. From what I gather, I don't think picking up an EMG needle and poking people is going to do that for you. So you have to tell us what interests you in PM&R to best help you. You also have to consider the time and monetary deferments a specialty change would do.

But if you decide that PM&R is where you want to be, then making a switch in your position shouldn't be all that hard. You'd obviously loose a year of training (assuming you move on to PGY-2 next year) if you apply next year and get accepted, but you should be able to come in as a PGY-2 level as long as what you have done counts as an internship year.
 

nnz3

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Can you list some reasons why you would want to go into PM&R and what your interests are in? How do you expect a specialty change to bring about more job satisfaction in the future verses what you are currently in?

Why do you mention the lack of OMT exposure in your current program? Yes, there are PM&R physicians that do OMT, but it's not standard practice to learn this during a typical PM&R residency. You can do rotations/electives in OMT just as you can probably do in IM/Peds. So I wasn't sure why this was a topic to bring up. There are PM&R programs like Michigan State that are more osteopathic focused and have more exposure than others, but nothing to warrant changing from Peds/IM to PM&R.

It's common for residents to second guess their specialty of choice at least a few times throughout residency. Especially during their PGY-1 year when things are harder and you are lowest on the totem pole. What it really comes down to is would a change of specialty actually make you happier and more interested in your career for years to come. From what I gather, I don't think picking up an EMG needle and poking people is going to do that for you. So you have to tell us what interests you in PM&R to best help you. You also have to consider the time and monetary deferments a specialty change would do.

But if you decide that PM&R is where you want to be, then making a switch in your position shouldn't be all that hard. You'd obviously loose a year of training (assuming you move on to PGY-2 next year) if you apply next year and get accepted, but you should be able to come in as a PGY-2 level as long as what you have done counts as an internship year.

Thank you for your response!
I really enjoy PM&R pathology- particularly SCI, MSK conditions, amputations. I have a background teaching yoga and have always been interested in improving function and utilizing mindfulness to improve outcomes. I really like procedures/working with my hands- I've enjoyed what I've done in IM/peds so far in the inpatient setting but don't think the stress of higher acuity that comes with inpatient procedures in IM is for me. Considering the future is my main reason for switch. If I switch to PM&R, I would probably want to do combined in/outpatient in general rehab, or outpatient practice utilizing injections/botox/baclofen pumps etc, with OMT and other integrative medicine modalities to assist patients with disabilities or chronic pain with mobility and function. I have a picture in my mind of being able to combine my interests with a residency in pm&r and that sounds very fulfilling, especially if it gives me enough work-life balance to have a family, pursue research in these areas, and work with patients over time. These were my thoughts essentially since I tinkered with my match list moments before it was finalized (did the thing you're not supposed to do) and sent it in for submission panicking.
My current program has no precedent for OMT rotations so it would be more difficult, but possibly doable. Would depend on my PD. I guess it was just another thing on my mind.
On my current track, I feel that primary care is the closest fit. I'm not as interested in IM subspecialties as I am in PM&R pathology. I could still do some small office procedures from time to time, and pursue integrative medicine and osteopathy with an NMM +1 year after residency.
My question is- does it seem possible to have the career I envision from pm&r? Or would my best bet be to pursue primary care? My intern year would qualify as an intern year with ACGME programs. Michigan State is definitely high on my list of programs I would reach out to.
Thanks again.
 
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