switching from IM to radiology. what to do?

[1Life]

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I did not see a current thread on this specific topic.

Hi. Here is my profile.
-US citizen, graduated from a mid-tier US medical school(big university program with many in-house fellowships). Steps 220/low 200s/Pass/ not taken step 3 yet.
-Initially applied to general surgery (with doubts, to few competitive places) and did not match
-repeated first year of medical school and postponed my graduation after not matching to do more IM rotations and reapply only to IM.
- Currently, I'm a categorical IM intern in a low-tier community program with no inhouse fellowships. I like the field but my chances for subspecialty fellowships are very low.

Here is the kicker, it hit me that I have always been fascinated with imaging, am technology saavy, love physics, pay great attention to detail, can visualize in 3D with ease and I have a background in art and near photographic memory. I like direct patient care and intern year is going great, but I believe I can serve patients more using my attributes which may make me best suited for radiology.

I know this is a few months into intern year and I won't make big decisions or considerations at this point. But, I want to know more about the process. Specifically,

1) what are my chances of transferring into a PGY-2 spot in radiology at the end of my intern year?
2) what can I do to facilitate the process? (who to contact, what to do to secure LORs, how to network)
3) where can I find more resources?
4) what is all the talk about radiology hitting a rough patch?

Thanks,

 

[MDtoUSMLE]

Hi

It is a tough task indeed, taking into consideration that programs directors prefer fresh graduates with double 99 (on the old scale). You might have some chances in programs that have IMGs since they are less competitive but you will need contacts to get interviews with your scores in radiology. Try to see your friends who matched in radiology or in low tier programs if they can push your application to get interviews.

 

[Law2Doc]

I did not see a current thread on this specific topic.

Hi. Here is my profile.
-US citizen, graduated from a mid-tier US medical school(big university program with many in-house fellowships). Steps 220/low 200s/Pass/ not taken step 3 yet.
-Initially applied to general surgery (with doubts, to few competitive places) and did not match
-repeated first year of medical school and postponed my graduation after not matching to do more IM rotations and reapply only to IM.
- Currently, I'm a categorical IM intern in a low-tier community program with no inhouse fellowships. I like the field but my chances for subspecialty fellowships are very low.

Here is the kicker, it hit me that I have always been fascinated with imaging, am technology saavy, love physics, pay great attention to detail, can visualize in 3D with ease and I have a background in art and near photographic memory. I like direct patient care and intern year is going great, but I believe I can serve patients more using my attributes which may make me best suited for radiology.

I know this is a few months into intern year and I won't make big decisions or considerations at this point. But, I want to know more about the process. Specifically,

1) what are my chances of transferring into a PGY-2 spot in radiology at the end of my intern year?
2) what can I do to facilitate the process? (who to contact, what to do to secure LORs, how to network)
3) where can I find more resources?
4) what is all the talk about radiology hitting a rough patch?

Thanks,

The hurdles that prevented you from matching and why you think you couldn't get into a subspecialty fellowship, which you were a bit vague on, might make it difficult to transition into a more competitive specialty. Also people with near photographic memories usually have an easier time with pre-clinical years of med school and the steps, so that part isn't ringing so true.
Your best bet is to talk to local PDs in radiology in your region. Some networking is going to be necessary because your stats and history aren't screaming that you are a shoo in for a more competitive path than you are in.

 

[QofQuimica]

I'd suggest finishing the residency you're already in and giving up on this idea of continually looking for greener grass elsewhere. The reason why you're not seeing many threads on IM-to-rads transfers is because it's a transfer to a much more competitive specialty. You are not a very competitive residency applicant in general, let alone for rads, and right now you do at least have a residency position that will result in you being a BE physician three years from now. The odds that you can improve on your current position by reapplying for residency a third time are pretty low. Best to focus on making the most of the opportunity you already have, especially since you say things are going well in your current program.

 

[1Life]

I truly appreciate the advices. I enjoy hospital medicine and I am just exploring my options. Once I get boarded in IM, what radiology fellowships do I have a reasonable chance in matching into, given that I network well, do research and do away electives in residency?

 

[DermViser]

I truly appreciate the advices. I enjoy hospital medicine and I am just exploring my options. Once I get boarded in IM, what radiology fellowships do I have a reasonable chance in matching into, given that I network well, do research and do away electives in residency?

Radiology fellowships are only after Radiology residency only.

 

[BlondeDocteur]

Actually you can do a non-ACGME interventional radiology fellowship, but you will never be boarded in IR or obtain hospital privileges.

 

[Shikima]

Once you complete your residency, you have the option to apply through the match into radiology. I think there is a nuclear medicine option too for IM candidates.... check up on that.

 

[Dral]

Also people with near photographic memories usually have an easier time with pre-clinical years of med school and the steps, so that part isn't ringing so true.

My guess is that they are meaning to say they are a visual person and have good visual memory (never forget a face, type thing), not photographic memory (like as you alluded to, the ppl in med school who got 270 step I scores had that).

 

[1Life]

Once you complete your residency, you have the option to apply through the match into radiology. I think there is a nuclear medicine option too for IM candidates.... check up on that.

I will consider that. thanks.

My guess is that they are meaning to say they are a visual person and have good visual memory (never forget a face, type thing), not photographic memory (like as you alluded to, the ppl in med school who got 270 step I scores had that).

May be I stretched it a bit. But, I am a visual person and have a decent memory. I just did not put the effort needed in studying for the steps. I spent 4 weeks of full-time study for Step 1 and 1 week for Step 2. I'm not trying to make excuses but went through some personal stuff. At the end of the day, it is my responsibility. I'm looking to do what I can from here on out. I like IM but would like to look into my other options

 

[colbgw02]

Actually you can do a non-ACGME interventional radiology fellowship, but you will never be boarded in IR or obtain hospital privileges.

I mean, he could do any of the many non-ACGME, yet highly prestigious and competitive, radiology fellowships - not just IR. He'd also be wasting his time even submitting an application. The other poster is right. With the exception of nuclear medicine, radiology fellowships are for those who have done a radiology residency.

Speaking of which, the OP should be aware that nucs-trained non-radiologists have even worse (much worse) job prospects than radiologists. These people are typically not useful to PP groups, meaning the only jobs are in academia, where there is enough high-level nucs being done to justify an FTE who can't read purely anatomic imaging.

Cardiologists can do imaging fellowships, but that's a long road to haul unless you already like cardiology. Besides, it's not like one can simply walk into a cardiology fellowship.

 

[BlondeDocteur]

Columbia took regular, board-eligible, finished-radiology-residency IR fellows and they took completely ineligible ones too. I worked closely alongside their current fellow as a med student, and she was a cardiologist from Japan who had not done a single day of radiology and was applying for IM residency in the States. Her job title was "IR fellow" and she took call and everything, but definitely operated with much more supervision than the regular fellow. The attendings told me this was reasonably common since all sorts of physicians had vascular access and procedural skills despite the lack of image interpretation training. But maybe it was a total anomaly, I don't know. I also know a guy who was fired from a neurosurgery residency who did the same.

 

[gutonc]

Quite a few places have spots for non-rads trained "IR fellows" but they typically go to people coming from specialties like Cards, Neuro, Neurosurg where it makes sense to have vascular interventional skills.

I'm not sure how many places would take a chance on an IM trained person who only wanted to look at black and white pictures all day as an interventional fellow. Which is what this thread is about.

 

[colbgw02]

Columbia took regular, board-eligible, finished-radiology-residency IR fellows and they took completely ineligible ones too. I worked closely alongside their current fellow as a med student, and she was a cardiologist from Japan who had not done a single day of radiology and was applying for IM residency in the States. Her job title was "IR fellow" and she took call and everything, but definitely operated with much more supervision than the regular fellow. The attendings told me this was reasonably common since all sorts of physicians had vascular access and procedural skills despite the lack of image interpretation training. But maybe it was a total anomaly, I don't know. I also know a guy who was fired from a neurosurgery residency who did the same.

Yes, but those people are acquiring skills, usually endovascular procedures, that have significant overlap with their primary specialty, which they will subsequently return to. They're not training to be interventional radiologists, their badge titles notwithstanding. That's not analogous to the OP's situation. So, unless he wants a relatively crappy paycheck for a year for no good reason, then he'd be wasting his time applying.

 

[Zenfudge]

Did not want to start another thread. Haven't posted on here in a long time. SDN has been helpful to me in the past.

Same question as the OP, somewhat different circumstances.

I am at a top IM program and am interested in switching into radiology. My program has a ridiculous fellowship match and 80% of residents go into fellowship. Something like 40% into cards. Those that don't go into fellowship do so because they choose not to.

The problem is...I don't want to match into a competitive IM fellowship. Everything I thought I loved about internal medicine has been beaten out of me over the course of intern year. I was interested in radiology from way before med school, but given that my medical school had a high focus on primary care, and IM was lauded, I stifled my desire to go into a field wherein you "hung up your stethoscope" and "sat in a dark room". I don't want to bash IM or play this like I have some special gift for rads, or that rads would solve all of my problems. I thought I had a case of the intern blues initially and did not want to discuss it with any of my colleagues. I've since got some relief by talking things out with a few trusted friends and colleagues. I've met with some of seniors and they are actually supportive of me making a switch if I choose to. How much of their support would actually concretize when I need it is to be seen. I'm a realist.

I was a competitive candidate for rads, but obviously if I switched after intern year of categorical IM, I'd have some taint on me lol. If it matters, my scores are above average when compared to the average rads applicant. I have research, but none in rads. Connections are slim, but I do have some people I could reach out to.

How do I even start to make a switch like this?

 

[mercaptovizadeh]

Did not want to start another thread. Haven't posted on here in a long time. SDN has been helpful to me in the past.

Same question as the OP, somewhat different circumstances.

I am at a top IM program and am interested in switching into radiology. My program has a ridiculous fellowship match and 80% of residents go into fellowship. Something like 40% into cards. Those that don't go into fellowship do so because they choose not to.

The problem is...I don't want to match into a competitive IM fellowship. Everything I thought I loved about internal medicine has been beaten out of me over the course of intern year. I was interested in radiology from way before med school, but given that my medical school had a high focus on primary care, and IM was lauded, I stifled my desire to go into a field wherein you "hung up your stethoscope" and "sat in a dark room". I don't want to bash IM or play this like I have some special gift for rads, or that rads would solve all of my problems. I thought I had a case of the intern blues initially and did not want to discuss it with any of my colleagues. I've since got some relief by talking things out with a few trusted friends and colleagues. I've met with some of seniors and they are actually supportive of me making a switch if I choose to. How much of their support would actually concretize when I need it is to be seen. I'm a realist.

I was a competitive candidate for rads, but obviously if I switched after intern year of categorical IM, I'd have some taint on me lol. If it matters, my scores are above average when compared to the average rads applicant. I have research, but none in rads. Connections are slim, but I do have some people I could reach out to.

How do I even start to make a switch like this?

I think you should just finish IM and then take it from there. You are midway in intern year or now a PGY2? I think lots of people feel stressed and disillusioned by the discharge/dispo/social work/coordination aspect of hospital medicine and the patient-mill that is primary care. But in the midst of that, there are bright spots, patients I feel I was able to make a big impact on, patients who got a lot better, patients who were grateful for their care and told me as much.

You can try to switch into radiology now, but since you are posting right now I take it you have not re-applied, so that means you would have to apply next September, so that means starting radiology in PG3. It just seems easier and less risky (what happens if you don't match - will all your bridges be burnt to continuing IM?) to finish up IM. It's a 3 year residency. It's not switching from something way longer like neurosurgery.

 

[NotAProgDirector]

Well, as pointed out above, you're late to the game for this year. That said, you could look for "R" positions in the match -- PGY-2 rads positions to start this coming July. You should talk to your PD first. Next, I'd talk to your local rads program. After that, if you're in a city with several programs (or are close enough to interview at nearby programs) you could contact them. Rather than set up a whole ERAS application now (since it's so late), you could ask your IM program for a copy of your application from last year (not your letters, just the basics). See what happens. You'll need an LOR from your current PD. You should also do a radiology elective ASAP, if you haven;t done one recently -- would be a real bummer to start training in rads only to find that you dislike it more than IM.

If you don't get any nibbles, then you're probably going to finish your IM residency, as you won't be able to really apply until next year. Then you could apply for R positions to start immediately, or A positions with a 1 year gap (where you could work, since you'll be fully trained in IM).

Alternatively you could resign from your current program and do "research". Unlikely you'll get paid very well for this, and then there is some risk that you don't get a rads spot and are stuck (although almost certainly someone will take you back in IM).