cbrons

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I want to do all three in 6 years. However, I notice there are only 4 programs in the country that are officially offering the 6-year route.

Is it possible to add another year of CCM to a traditional IM/EM 5-year program? If yes, can you tell me which IM/EM programs offer the option for such a pathway?
 
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What's the end goal here? These combined programs are puzzling to me. I can't imagine you'd get adequate training in any of the three fields and will probably have a very tough schedule to try and cram all that in 6 years. There's a reason only 4 programs do this.
 

TimesNewRoman

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I don't believe so. The reason being is that CCM fellowships are 2 years after either EM or IM.
 

mochief2000

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What's the end goal here? These combined programs are puzzling to me. I can't imagine you'd get adequate training in any of the three fields and will probably have a very tough schedule to try and cram all that in 6 years. There's a reason only 4 programs do this.
i have to disagree with you on this. All with the exception 1 weird guy I meet have been great IM/CC/EM. I don't think the IM added much to the process though and EM/CC would probably have the same "knowledge ". The ones I have meet where more or less ED attending per se trying to add more certifications, so their procedure skills where pretty good ( i know procedure are not critical care, but it helps). The bigger question would be how do these people end up in the long run i.e. CC only, ER only or a mixture.
 

inspirationmd

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I want to do all three in 6 years. However, I notice there are only 4 programs in the country that are officially offering the 6-year route.

Is it possible to add another year of CCM to a traditional IM/EM 5-year program? If yes, can you tell me which IM/EM programs offer the option for such a pathway?
If you are not at one of the 4 programs it is not currently possible. In order to be eligible in all three in 6 years the institution has to formally apply to ABIM and ABEM to become a designated combined program. This requires paperwork to be submitted through GME and ultimately approved by both boards. It's not possible to add 1 more year to one of the EM/IM programs that has not done this because the guidelines state that you have to do 2 years after either EM or IM to be board eligible otherwise. There are many EM/IM graduates who have had to do 2 years elsewhere because the option is not available at their institution. Hennepin has 1 right now that I am aware of. Many frequently go on to other places to obtain the training including at institutions like Pittsburgh, Maryland, Dartmouth and Stanford to name a few.

If you want EM/IM/CCM in 6 years your only option at this point is to match into one of the 4 programs. Otherwise its 7 years for all 3 specialties or you can get 2 (either EM/CCM or IM/CCM) in 5 years.
 
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inspirationmd

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What's the end goal here? These combined programs are puzzling to me. I can't imagine you'd get adequate training in any of the three fields and will probably have a very tough schedule to try and cram all that in 6 years. There's a reason only 4 programs do this.
Yeah I am doing it right now and I can tell you that you most certainly get more than adequate training in all 3. There is substantial overlap in the 3 fields and my cohort and I are among some of the strongest residents in our institution. The same can be said at the other programs as well. The schedule is tough early on but like most other programs it gets easier as you become more senior. Anyone that completes this training can get it done from outpatient management to a cardiogenic shock patient in extremis in the Cardiac ICU when its done.

At the risk of speaking for a very diverse group: The end goal for a lot of us is to find a career as Emergency Physicians and Intensivists though I have seen many other things. I have seen primarily ED docs with significant critical care research going on. I have seen one doing EM, MICU and running an aeromedical EMS service. I have seen ICU primarily with per diem EM shifts. Lots of options.

The Internal Medicine training provides additional breadth as well as extensive exposure to the chronic conditions that are frequently managed in the ICU. This allows for anticipation of the clinical course on the floor and in the outpatient setting which can help guide management as we "captain the ship through the storm" in the ICU to quote JDH or send someone out of the ED with the hope they eventually follow-up. Six years for all of the options that the 3 certifications provides is not bad at all. The biggest sacrifice is the financial hit and continuing to be a trainee for an extended period of time.
 

TimesNewRoman

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Yeah I am doing it right now and I can tell you that you most certainly get more than adequate training in all 3. There is substantial overlap in the 3 fields and my cohort and I are among some of the strongest residents in our institution. The same can be said at the other programs as well. The schedule is tough early on but like most other programs it gets easier as you become more senior. Anyone that completes this training can get it done from outpatient management to a cardiogenic shock patient in extremis in the Cardiac ICU when its done.

At the risk of speaking for a very diverse group: The end goal for a lot of us is to find a career as Emergency Physicians and Intensivists though I have seen many other things. I have seen primarily ED docs with significant critical care research going on. I have seen one doing EM, MICU and running an aeromedical EMS service. I have seen ICU primarily with per diem EM shifts. Lots of options.

The Internal Medicine training provides additional breadth as well as extensive exposure to the chronic conditions that are frequently managed in the ICU. This allows for anticipation of the clinical course on the floor and in the outpatient setting which can help guide management as we "captain the ship through the storm" in the ICU to quote JDH or send someone out of the ED with the hope they eventually follow-up. Six years for all of the options that the 3 certifications provides is not bad at all. The biggest sacrifice is the financial hit and continuing to be a trainee for an extended period of time.
Yea. I'm EM applying for IM-based CCM fellowship right now. If I had to do it all over again, I'd probably have done EM/IM/CCM for the extra year. I think the extra knowledge base would probably be worth the extra year. I just hate clinic so, so much. And none of the locations particularly appeal to me.
 
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cbrons

cbrons

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Yea. I'm EM applying for IM-based CCM fellowship right now. If I had to do it all over again, I'd probably have done EM/IM/CCM for the extra year. I think the extra knowledge base would probably be worth the extra year. I just hate clinic so, so much. And none of the locations particularly appeal to me.
My big worry is that there are so few programs, it will be really hard to match. I also have a wife and kid so I don't want to get stuck in a major city if I can help it. Still I don't think I would be 100% happy doing something other than one of these programs.
 

TimesNewRoman

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Although, I am looking forward to having a good bit more research time in fellowship than the EM/IM/CCM folks get. Plus, I could do fellowship and get a masters in 3, thus getting double boarded and a masters in the same period of time - arguable more valuable if you go into research (which I plan on doing).
 

TimesNewRoman

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My big worry is that there are so few programs, it will be really hard to match. I also have a wife and kid so I don't want to get stuck in a major city if I can help it. Still I don't think I would be 100% happy doing something other than one of these programs.
Happiness shouldn't depend on your job.
 

inspirationmd

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Yea. I'm EM applying for IM-based CCM fellowship right now. If I had to do it all over again, I'd probably have done EM/IM/CCM for the extra year. I think the extra knowledge base would probably be worth the extra year. I just hate clinic so, so much. And none of the locations particularly appeal to me.
We all hate clinic. I don't know a single EM/IM that likes it in any of the programs.
 
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cbrons

cbrons

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If you are not at one of the 4 programs it is not currently possible.
Ideally I would match at one of the four which does offer the 6-year track (you already know where) but just trying to see what other options I might have in case that falls through. I also imagine these programs are getting extremely competitive.
 

gutonc

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Ideally I would match at one of the four which does offer the 6-year track (you already know where) but just trying to see what other options I might have in case that falls through. I also imagine these programs are getting extremely competitive.
Your options are IM/EM (5) + CCM (2) or some other combination of IM, EM, CCM (or PCCM) ranging from 5y on the low end to 9 years on the high end. But you already knew that.
 

quickfeet

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Any residents/fellows on here from IM/EM/CCM at U Maryland, Henry Ford, or ECU/Vidant? Trying to make some connections, start a dialogue. Please PM me or let me know if I can PM you.
 
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TimesNewRoman

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Any residents/fellows on here from IM/EM/CCM at U Maryland, Henry Ford, or ECU/Vidant? Trying to make some connections, start a dialogue. Please PM me or let me know if I can PM you.
Haven't seen him on here in a while but @sylvanthus could probably be helpful.