BellKicker

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Hi all.

Like many of you, I'll start my IM residency this summer. I'm not sure whether I want to do a fellowship but I would like to keep the door open until I make that decision. Basically, I look at the subspecialties and I find them less interesting/challenging than hospitalist IM.

When I look at the list of fellowships, there a few that I could see myself pursuing, especially, ID. I like how it spans several other specialties, both surgical and medical. Then there's the exotic imported infections, which I (and everyone else, I guess) find interesting. It's certainly a changing field and with rising resistance everywhere, it could become a very important specialty in a few years.

So how come it's so uncompetitive? Does everyone else but me find it boring or is it just about the money?

Any input is appreciated.
 

cadoc

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I think it's a combination of the money and the fact that many ID docs in large urban areas have become primary care for HIV/AIDS patients.

If you like it and find it interesting....do it. Only you know what will make you happy for the next 30+ years.
 

Furrball

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I think also there aren't a lot of jobs. I've been told that most ID docs work at large tertiary care centers. Some people do not want to work at that type of institute.
 

irlandesa

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I'm under the impression that ID is generating a lot more interest these days b/c of the integration of research and clinical practice.. The thing is, it is hard for MD students and house staff to really get much in the way of this integrative training before fellowship, and therefore, it's hard to recruit people that have a good idea of what they are getting into going into ID. Nonetheless, ID is often regarded as one of the most intellectually challenging fields out there; I know a # of residency applicants who got some good interviews by playing up their interest in ID. One applicant's CV consisted almost entirely of "pending case reports," many which will probably never be published b/c it is not easy for a student to get anything published in clinical ID journals, but the very idea got some ridiculously competitive programs interested in someone who was not even close to being AOA.
 

Albondiga

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I'm a resident recently gone through the ID interview circuit, and I can tell you, it definitely has gotten more competitive than in the past, although, the same can be said for all fellowships in general. A couple of things make ID less attractive. First, income is a factor. There are no billable procedures like there are in other specialties. You can make more in the NY/NJ metro area by being starting out as a hospitalist, than by going into ID. Many ID guys in private practice supplement their income by doing general IM practice.
Second, the emphasis today, in the good programs at least, is academics. You must be well-published to be even considered for an ID position, and during fellowship you are expected to continue to publish in abundance. Research is an important component, and in fellowship you will be expected to begin a project / study immediately and see it thru to completion before fellowship is over.
Finally, affiliation with a major academic center is important. If you want to pursue solely private practice, don't like teaching/research, don't like the environment of a big university-style hospital, or all of the above, then ID is not the best choice for you.

That being said, what's most important is to follow your heart's desire, and if you're set on ID, then go for it!!!
 

retroviridae

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Hey, I have always wanted to do ID. I am just finishig an ID research fellowship right now in HIV ... but I have decided not to do fellowship in it. Why? Well, besides the fact that my main interest is HIV and not the rest of the ID field, it's because of the money. It is hard to reconcile doing a fellowship and not getting paid any more than if you just did primary care. That's 3 more years getting paid a resident's salary. Kind of sad, but economics do enter the picture eventually.