Want to switch from pathology to IM

[zzz1991520]

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Hi~ I am new here. Right now I have this constant thought in my head. This keeps me from focusing on my pathology study. I really would like to hear some advice here.
I am an IMG with 245/250 cs first pass. I had 6 months USCE. Last year I applied both in PATH and IM. At that moment I was hesitating which specialty I should go. Because both fields attracts me in some point.
Finally I matched to a pathology program. It's a nice program. And people here are nice. But after 3 months of rotation. I missed direct patient care so much. I started thinking I may get the wrong place.
Then I am thinking apply IM again. But I am not sure what should I do to at this moment.
1. When should I tell my PD and Chair?
2. How can I get a chance to have a new LOR from IM attending?
3. What should I do to polish my package to get into IM?
4. Will my pathology experience be a disadvantage to IM program?

any advice will be appreciated. Thanks

 

[Successor12]

If this is truly what you want (burden is on you to find out)

Then
1) Tell them right away. People change their mind all the time and we are talking about a career committment for 30 years or more

2) Your scores are decent. I would apply with the LORs you have and just have your PD be honest about the reason why you switching in his letter. You miss taking care of people in a more interactive way that IM would be a better fit for you. That is fair. Aint anything wrong with you. You are brave. And this happens all the time.
3)Ask your PD to may be approach IM residency program in your instutions and make a few phone calls for you. Ask your IM residents friends if you have any to put in a good word for you and get you an intertview
4) I think any PD trying to choose a resident would be seeking and gauging their interest in that specialty. I might be biased by my own values but above all I appreciate honesty. And I think being honest about how you felt training in pathology should help build a strong case about your dedication for IM. You already had a spot! You just didnt think its where you want to be! And they will more likely than not will give you a shot.
If its what you want then Go for it.

The toughest question is: Are you sure this is what you want?

Rest is easy. And will sort itself out.

 

[zzz1991520]

If this is truly what you want (burden is on you to find out)

Then
1) Tell them right away. People change their mind all the time and we are talking about a career committment for 30 years or more

2) Your scores are decent. I would apply with the LORs you have and just have your PD be honest about the reason why you switching in his letter. You miss taking care of people in a more interactive way that IM would be a better fit for you. That is fair. Aint anything wrong with you. You are brave. And this happens all the time.
3)Ask your PD to may be approach IM residency program in your instutions and make a few phone calls for you. Ask your IM residents friends if you have any to put in a good word for you and get you an intertview
4) I think any PD trying to choose a resident would be seeking and gauging their interest in that specialty. I might be biased by my own values but above all I appreciate honesty. And I think being honest about how you felt training in pathology should help build a strong case about your dedication for IM. You already had a spot! You just didnt think its where you want to be! And they will more likely than not will give you a shot.
If its what you want then Go for it.

The toughest question is: Are you sure this is what you want?

Rest is easy. And will sort itself out.

Thanks for you advice. That's true. I am still not 100% sure about my decision. The reason why I don't want to apply this moment is that I think my LOR from IM is not strong (only got 3 IV last year for IM). So I don't want to waste money . But I didn't ask for my friends last year. Maybe I should try this. Or should I wait for next year? And do something to get a good IM letter?

 

[rokshana]

Thanks for you advice. That's true. I am still not 100% sure about my decision. The reason why I don't want to apply this moment is that I think my LOR from IM is not strong (only got 3 IV last year for IM). So I don't want to waste money . But I didn't ask for my friends last year. Maybe I should try this. Or should I wait for next year? And do something to get a good IM letter?

do you not like path? or are you just thinking the grass is greener?

if you like it, finish the residency...then if you feel that IM is really what you want to do, the apply for IM.

you could always do transfusion medicine fellowship after path and have some pt contact

 

[zzz1991520]

do you not like path? or are you just thinking the grass is greener?

if you like it, finish the residency...then if you feel that IM is really what you want to do, the apply for IM.

you could always do transfusion medicine fellowship after path and have some pt contact

I am still like diagnosing. But given the bad job market and visa issue this keeps bothering me all the time. And I really want to talk to people. Being a resident itself already lack a lot of interaction with people. I can't imagine being a community pathologist(my goal) in the future. And I know being an academic pathologist will be ok. But I not a research guy. I don't have any interest to do it. While being IM physician, I believe I can do that for the next 30 years. And I am willing to take 3 years hard training.

 

[Egghead34]

If you are unhappy, then switch. But I will share my story...

I switched from FM to IM after wanting to subspecialize. My PD was supportive but warned me of two issues.

First is funding. Part of our training cost (~20-30%, I forget) is paid for by the federal government. The day you matched into pathology they allocated you 4 years of funding (or however long path residency is). You've used up one of those this year, meaning that you only have 3 years of full funding left. If you match into a 3 year residency program now, it's no problem. But if you completed another year, whatever IM program took you would essentially have to eat the cost difference for 1 year (or more). That makes you a much less attractive candidate than when you were a medical student, since they can just take a fresh med student and have full funding. I had a strong CV and got 18 family medicine interviews. When I reapplied IM I only got 3, with many program rejections citing cost as an issue.

Secondly, a PD may not guarantee that your spot is available to you if you fail to match. My PD said to me that he had to start looking for a replacement if I really wanted to reenter the match. If I matched, then no problem. But if they found a replacement and I failed to match, I'd essentially have given up my spot for nothing and been stuck in limbo. Very scary place to be, especially as an IMG with (presumably) a lot of dept. I took the chance and matched...can't say I would risk it again if given the choice.

 

[zzz1991520]

If you are unhappy, then switch. But I will share my story...

I switched from FM to IM after wanting to subspecialize. My PD was supportive but warned me of two issues.

First is funding. Part of our training cost (~20-30%, I forget) is paid for by the federal government. The day you matched into pathology they allocated you 4 years of funding (or however long path residency is). You've used up one of those this year, meaning that you only have 3 years of full funding left. If you match into a 3 year residency program now, it's no problem. But if you completed another year, whatever IM program took you would essentially have to eat the cost difference for 1 year (or more). That makes you a much less attractive candidate than when you were a medical student, since they can just take a fresh med student and have full funding. I had a strong CV and got 18 family medicine interviews. When I reapplied IM I only got 3, with many program rejections citing cost as an issue.

Secondly, a PD may not guarantee that your spot is available to you if you fail to match. My PD said to me that he had to start looking for a replacement if I really wanted to reenter the match. If I matched, then no problem. But if they found a replacement and I failed to match, I'd essentially have given up my spot for nothing and been stuck in limbo. Very scary place to be, especially as an IMG with (presumably) a lot of dept. I took the chance and matched...can't say I would risk it again if given the choice.

Thanks, I am aware of that already. That's why I am a little bit nervous now. I have to make a decision now if I want to apply this year.Since I still have 3 years of founding now.

 

[RecumbentChair]

Thanks, I am aware of that already. That's why I am a little bit nervous now. I have to make a decision now if I want to apply this year.Since I still have 3 years of founding now.

Dont worry about the funding. Worry exactly why you dont want path, why didnt you choose im the first match. Those are good questions to know if you are making the right choice by switching.