Switching Specialties/"Going Back" to Fellowship

[rs2006]

Hi everyone,

Good afternoon. I hope all is well. I am a US Medical Grad/US trained IM (University Program "Top 15") physician and completed by residency in IM in 2009. I have been working in general IM since the time I completed my residency. The work has now become routine, and I am considering either going back to residency to switch specialties or "going back" to felllowship. If I were to switch specialties, I would likely switch to EM and if I were to "go back" to fellowship, I would likely be interested in GI (although realistically, I probably have a better chance of switching to EM given how competetive GI is currently).

I had solid performance throughout medical school and residency with solid board scores Step 1 ~220, Step 2ck 230s, step 2 cs pass, and step 3 ~240 (all passed on first attempt). Unfortunately, I do not have any research.

I see a few obstacles to my application-- I have been out of residency for a while and feel that this may be used against me by PDs. I am aware that there is a "funding issue" if I do a second residency as medicare would not fund it. I am also worried that I would not be able to get letters from physicians in the specialty to which I would be applying as I have been out of residency for a while and have not had much contact w/ any physicians in those specialties. I also know that GI is incredibly competetive right now.

I would be grateful if anyone who has been in my position could provide any advice regarding the steps I would need to take to get "back in the game." I apologize for this rambling post. Thanks in advance for any advice.

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[NotAProgDirector]

The funding issue is usually not a deal breaker. It's not that you get no funding, you just get less funding.

Being out of residency can be both a strength and a weakness. You now have some real world experience, and that's worth something. The question PD's will consider is whether you can really shift back into "resident" mode -- i.e. being supervisied and "taking orders" from others.

You should get LOR's from your "boss" (if you have one). If not, then from a colleague with whom you work closely. If you're looking for ED, consider trying to get letters from ED colleagues. Or, see if you can do some moonlighting time in an ED.

 

[Gastrapathy]

GI is not as competitive as it initially appears because FMGs are a huge part of the IM applicant pool. An average US allopathic grad from a top 15 program should get a fellowship if you apply broadly enough. If IM has lost its luster in 2 years, I'd bet EM wouldn't take much longer

 

[dragonfly99]

You should think hard about which if the 2 specialties you really want to do. I think you are correct that GI would be harder to get. You probably cannot get GI at one of the top/academic type programs with no research and being out of residency for a couple of years. You may get a GI fellowship somewhere. You've only been "out" for 1.5 years, right? You could apply and see what happens. You could quit your job and do GI research for a year or two, which would probably guarantee that you could get a GI fellowship somewhere if you publish something. If you can find an "in" somewhere and get a LOR from somebody who has pull, you could probably get in to GI without any research.

 

[Buzz Me]

Are you just looking for something other than what you're currently doing? I remember a while back you were interested in applying to Radiology vs. Cardiology. What exactly are you looking for? Better lifestyle? Procedures? Less primary care?