this is not for me

[thatflava]

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hey folks
i'm a categorical IM intern. By late fourth year I was sure if I really wanted to go into IM...for a number of reasons. I stayed on the course, though, and here I am. I like the program just fine...It's just that I don't see myself doing this.... or any of the subspecialties....for 30+ years.

does anyone have any advice for navigating out of a categorical program after the year is up? is it too risky? i've heard if i don't match i may be out of a second year spot. also, will programs i apply for next year (in another specialty) view me as indecisive....or as someone who has a little experience i(I want to get into and EM program)

thanks for any advice....sorry if this question has been posted before...i didn't see any other threads after some perusing

 

[DR]

I know a couple of people who did just what you're thinking about. They went from IM to EM after their intern year in IM. They had no problems. They are both actually at the same hospital. It wasn't looked upon negatively.

 

[theD.O.C.]

In terms of changing residencies=indecision. Well it's all in how you spin it. Why not say that your time as a resident allowed you to work really closely with <fill in the blank> and see the positives in this field which include: blank blank and blank. You're never indecisive when you can spout out reasons, or are you?

 

[Bobblehead]

Playing devil's advocate, how certain are you that you want to practice emergency medicine for 30+ years? Intern year can be a pretty miserable experience, you may want to reassess your choices later on this year (i.e. after January) when there's a light at the end of the tunnel..

 

[thatflava]

thanks for playing devil's advocate, bobblehead. i like the pace of the ED, i like the breadth of cases, and i like the amount of procedures. conversely, in IM....the word "chronic" flashes in my mind. i realize an IM doc can be oriented towards doing as many procedures as he/she would like...but it's not quite the same. i remember during my fourth year elective watching my attending put an IJ line in a man who presented with what clinically (and turned out to be) a rupturing AAA. he was lightning fast. efficient and almost seemed detached from the commotion around him as he set out to do what needed to be accomplished. he had the patient up to the OR as fast as it could have possibly been done. i was the person who placed the large bore IV's and just doing that alone had me flying high for about a week. i loved the adrenaline...in fact, it's pumping right now just recounting this experience.

my IM program watches the 80 hour work-week like hawks. we do everything electronically and there is no pressure at all to fudge hours. what i'm trying to say is that my 30 days as an intern haven't been so bad and i'm doing the 2nd toughest rotation (supposedly CCU isn't quite as bad as MICU).

 

[gwen]

don't be afraid to switch out if you're unhappy. i realized i LIKED int. medicine as a transitional year going into PMR. my PMR program gave me a tough time, but come on, would they rather see me at their PMR prog. extremely unhappy or find a new resident who wants to be there? i know it must have been tough on the program, but i didn't change my mind at the last minute and give them no time. i told them way ahead of match this year so that they could look for new candidates. i thought long and hard before making this huge career move.

and this year (new rule as of 04), our beloved NRMP has decided to screw over each and every resident who (how DARE we) chooses to change specialty. i am 'barred' from the match for one year...not that i'm matching for anything, but the whole thing makes me mad. how unfair is it that the NRMP basically meddles in the business of us trying to pick a career path?! i was just lucky that the program where i did my trans. year liked me and kept me...where i wanted to be anyway. it was some stupid ass loophole that let me stay.

so my warning to you is that NRMP may ban you from the match if you choose to switch out of IM (or any field for that matter). so you may have to find a place that will take you in outside of the match. just a little heads up from someone who didn't know the crazy a** things that NRMP does to screw us over. another troy madsen-like story. ok, maybe not that extreme.