Switching from IM to ER

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rs2006

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Hi everyone,

I hope everything is going well for everyone in the forum. I am currently a 2nd yr IM resident at a "good, well ranked" IM program and am frustrated w/ my current specialty. The way things are looking right now, it looks like I am stuck doing this for another year (ie, I will complete my current residency) and then I was thinking about switching to something else--- possibly EM. I was wondering whether since IM and EM have somewhat of an overlap, if I were to switch, would I get any time off (ie credit for years) the residency? Anyone else have any experience like this or do this themselves? Thanks in advance for all the advice.
 
I was wondering whether since IM and EM have somewhat of an overlap, if I were to switch, would I get any time off (ie credit for years) the residency? Anyone else have any experience like this or do this themselves? Thanks in advance for all the advice.

If you switch prior to finishing residency you may get minimal credit for things such as MICU, Medicine wards, etc. These are usually replaced with extra EM months. You would still have to do 3 years. The problem you may run into is the whole funding issue.

If you finish IM residency, you are eligible for 6 months credit (max allowed switching specialties). So you would only be doing 2 1/2 years of EM residency. Not sure how the funding issue works if you complete one residency and enter a different one.

While I've not done either myself, my program has someone in both positions. Hence why I'm versed on the topic. 😉
 
Since you are doing categorical IM, you get 3 years at 1.0 FTEs. Any time after that is directly paid at 0.5 FTEs, but the indirect payments make up for it (in other words, no residency is going broke to educate you a second time).
 
If you do make the switch after finishing IM, keep on top of your new EM program to get all the paperwork done with the RRC/ACGME to get your 6months credit. We had a resident in my class who did the same thing (finish IM then start EM) and the program didn't get his paperwork done on time. So he still had to 'be a resident' for the entire three years. Basically he did 6 extra months of 'elective' during the third year.
 
One of my classmates did this. She got 6 months credit (you can't get it 'off') and used it to do cool rotations like Tsunami relief, etc.

She also took wise advice and double boarded.

the financing wasn't an issue.
 
You shouldn't have too hard of a time trying to get into an EM program, however, it may be too late for you to join up in July. I am unsure of how the scramble went this year.

However, make sure you get boarded in IM, because, if you do decide to do EM, and you are double-boarded, this will make you a much more competitive applicant for a job, i.e., extra money.

Q
 
Do you like critical care? You'll be very well set up to do EM/IM/CC if you finish your IM residency, then do an EM residency and a CC fellowship. That's a lot of training though
 
Hi everyone,

I hope everything is going well for everyone in the forum. I am currently a 2nd yr IM resident at a "good, well ranked" IM program and am frustrated w/ my current specialty. The way things are looking right now, it looks like I am stuck doing this for another year (ie, I will complete my current residency) and then I was thinking about switching to something else--- possibly EM. I was wondering whether since IM and EM have somewhat of an overlap, if I were to switch, would I get any time off (ie credit for years) the residency? Anyone else have any experience like this or do this themselves? Thanks in advance for all the advice.

Sounds like you're not sure what you want to do. Are you certain you'd be a good fit for EM? It's not an "easy" specialty, in that it's very physically and emotionally demanding. People who go into EM just because they are unhappy with their primary residency are often not a good fit.
 
At the University of Chicago, we take about 1-2 applicants who have trained in other specialties every year. Right now we have the following:

2 residents completed FP residencies
1 resident did 3 years of Gen Surgery
1 resident did 1 year of Gen Surgery
1 resident did 3 years of Ortho

We have also had a number of residents who have gone through our program who have previously completed IM residencies. The advanced Gen Surg resident, FP residents who completed, and IM residents who completed all received 6 months of credit (only had to do 2.5 years of EM training), and graduated in Dec instead of June. The advanced ortho resident and Gen Surg resident that only completed 1 year received no credit.

I would complete IM, then apply go to an EM program that gives you 6 months of credit.... curious why you wouldn't rather just subspecialize in IM? It pays better. Do you really like EM? Are you sure you like it for the right reason? If you do, great! Welcome aboard.
 
If your home program has an EM program as well I would talk to the residency director. They may be able to work out something with your IM program and double board you in 5 years of training if both agree.

Otherwise, most residencies will make you do 2.5 to 3 full years. Look at 1-4s as well b/c they'll wave a year.
 
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