switching to PM&R, should I tell my current program?

[ind12]

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Hi everyone. I am a 3rd year IM resident. A few months ago I discovered the field of PM&R (Our med school did not have PM&R department or staff) After that, I actually shadowed a PM&R physician in my community for about 10 days(vacation days). Now I am dead set on PM&R.
The problems is I haven't told my programm about it yet. I have a dilemma: Should I tell them now and start applying for PM&R or should I wait until I graduate and then apply for PM&R.
The reason I do not want to tell them now is that they might treat me as outcaste for the next 8 months (occasional jokes etc.)
On the other hand I think they might get upset in the beginning but then they might help me with obtaining a PM&R position (letting me do extra rotations in PM&R, letters of recommendation etc.)
Will the 3 years of IM work in my favor or against?
Should I try to get into just any program now or should I go through the match next year and get to a "better" program. This sounds self-explantory but I am asking this because of my unusuall situation (swith from IM).

 

[LTS6776]

I would tell them - I doubt they would treat you like an outcast if you plan on finishing out the year. Tell them you're planning to do primary care for the disabled or medically complex rehab, and I'm sure they'll be supportive.

 

[topwise]

Not so unusual, actually. We've got a few residents in our program who have completed an IM residency and also several attendings. I think you should tell your program and there's no reason they should hold it against you if you plan on finishing the year.

 

[Ludicolo]

People have done this before. Our field attracts all kinds of unusual.

I don’t see any major issue in telling your program now. As you said, having their assistance in LORs, arranging rotations, can only help your future application. Although it may be a little late in the season to start applying now, especially without the rehab rotations/LORs (shadowing don't count). If you can afford to wait, I would suggest taking the time to getting your act together and try to get into the best program you can. You'll be better off in the long run.

3 years of IM may be attractive to some. However funding issues for a second residency may come into play, and some programs will balk at this.

You’re going into PM&R - may as well start getting used to being treated as an outcast sooner rather than later…

 

[predodoc]

Except for the funding issure, I dont think you are disadvantaged at all and its probably an advantage for any program looking for a PGY2 spot to be filled next year. Ive met several other interviewers who are in their 1st or 2nd year of surgery who are switching. I think you wound be at an advangage over these people if you have 3 yrs of IM. You will come out with 2 specialties in 6 years. Duel IM/PMR programs would take 5 years. So you lost just 1 year.

 

[Llenroc]

Why would you want to do PM&R after already having done Internal Medicine? PM&R is sort of like an Internal Medicine subspecialty, or at least it could have easily been one if things had been organized differently. If you want to be a specialist, I would go for one of the IM fellowships. I don't know your position. Maybe you're at a community program that doesn't match much into fellowships. But if you go for PM&R you're looking at another three years of residency at least (perhaps another year of fellowship), during which you'll have 1-2 years of inpatient rehab. which is like Internal Medicine-lite. So if you really didn't like your residency, you're actually in for many more months (though not as intense), which are like it.

If it's a financial consideration, again I think given the time value of money and opportunity costs you'd probably still make out better by going into almost any kind of private practice next year then you would if you did another three years of residency and started out working in 2012.

Also, at this point it's not easy to get interviews.