What is IM residency really like

[DD214_DOC]

Just wondering what residency is really like. I did my general IM rotation at a FM residency program. It was a very, very good rotation as their IM service was strong (we admitted around 40% of all the hospital's inpatients) but rounds were really laid back and low key, which I liked.

What are "real" medicine rounds like? Much more formal and stressful? I ask because I don't think I really would like that type of atmosphere. I'm pretty laid back.

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[Krisss17]

Just wanted to bump it as I'm interested too!

 

[dragonfly99]

I don't think your question is answerable.
There are a lot of different IM programs, and the atmosphere varies.
If you are asking whether there will be more pressure at some major U. hospital IM program vs. an affiliated community hospital, the answer may be "yes".

There is a lot more to IM residency than just rounds. You have to think about your resident clinic, the ICU rotations, the outpatient rotations, your experience on ER rotations, etc. Also whether there is any significant research involvement by house staff...most all programs try to say there is, but it isn't true much of the time. It's not important if you don't want to do a fellowship, but if you want something like GI, cards or allergy/immuno, then being able to do research w/faculty can be an important distinguishing factor between you and other fellowship candidates.

 

[Krisss17]

Thanks, dragonfly99.

Is an IM residency 3 years or 4 years?

 

[iatrosB]

Thanks, dragonfly99.

Is an IM residency 3 years or 4 years?

3...and I concur that it varies greatly from program to program. I chose a more laid back program that suits me better.

 

[DaveinDallas]

I did one of my IM months at a program that took the overflow from Parkland in Dallas.

It turned out to be the best month of 3rd year, period. The interns were great, the 2nd year resident did more for my medical education than the next 3 combined and the attending was there to backstop it all, keep you on your toes and led by example. There was no wasted time and it was a good speed all the time - not too fast, not too slow. I'm going to be applying there with an eye on becoming a hospitalist. Significantly for me, the PD led morning report, could ask the right questions in a non-challenging manner and would correct you when you hosed up without making you feel like an idiot.....

Alternately, I did my first month of IM at a hospital in Ft. Worth --- the program would fill on scramble and with good reason. It was and still is very toxic. When the PD tells the med students to sit up front during morning report so "we'll know who to pick on", it doesn't bode well for good learning. The objective of morning report didn't seem to be to learn, it was more of a "let's shred the interns" type of deal. I think I'd rather sit out a year than scramble into that program.....Hours were long with lots and lots of standing around doing nothing......

 

[dragonfly99]

Yes,
For IM try to avoid malignant programs.

Really there is no reason for a medicine program to be malignant...it's not like general surg where sometimes there is just too much to do and too much crap hitting the fan....

You can choose an old-style university program that works you more/longer hours (like I did) which might be helpful if you are glutton for punishment, or want a competitive fellowship. Or if you know you want private practice or hospitalist, it might be better to pick a program with a more outpatient or private practice type orientation.

For most people, hopefully you'll have at least some choice about where you go.