which is the least competitive field

[elep]

would that be pathology / psych ?

I need a program in a particular location. has PGY1 medicine completed.

I want to apply for some least competitive fields, please don't mistake me.

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[deleted87716]

I need a program in a particular location. has PGY1 medicine completed.

Seems like the path of least resistance would be internal medicine. There are more IM programs around than pretty much anything else, and IM isn't particularly competitive.

That being said, every program has standards. Nothing is guaranteed.

 

[NotAProgDirector]

Path, Neuro and FP seem to be at a low point.

'Course, I'm an IM PD, so I'd like to think that IM isn't at the bottom of the barrel, interest wise.

 

[jjbmsiv]

Psychiatry is on its way back up the ladder. Salaries, number of applicants, etc, are all on the rise these past few years.

 

[TRAMD]

Family, IM and occupational medicine are the least competitive. Slightly more competitive are the 'P's: path, PM&R, psych and peds. Every specialty will be competitive at certain programs.

Path is the most underappreciated specialty by medical students in my opinion.

 

[sikegeek]

Family, IM and occupational medicine are the least competitive. Slightly more competitive are the 'P's: path, PM&R, psych and peds. Every specialty will be competitive at certain programs.

Path is the most underappreciated specialty by medical students in my opinion.

No way psych is more competitive than IM.

 

[elep]

could someone tell me what this residency is like and where people work afterwards.

thanks.

 

[Winged Scapula]

could someone tell me what this residency is like and where people work afterwards.

thanks.

I am confused...in another thread here you are asking about switching to FM from IM. I take it you have not made up your mind what you want to switch into?

It also sounds as if you are contemplating switching at the end of this year...if that is the case and you don't have your NRMP application in already, you are behind the 8 ball. While it is true that many advanced positions are available outside of the match, others are offered in the match and/or since you are switching specialties you may not find a program which will give you credit for your years done in IM and may have to accept repeating your intern year.

Is it your PROGRAM that is making you miserable or IM?

To learn more about Occupational Medicine: http://www.acoem.org/

 

[TRAMD]

No way psych is more competitive than IM.

Way.

 

[TRAMD]

could someone tell me what this residency is like and where people work afterwards.

thanks.

The website Kimberli put up is a great resource.

Occupational medicine is a field in demand and unknown by many medical students. As more and more companies learn about the advantages of having an occ med doc the demand is increasing. The residency is 3 years. You usually do a prelim year in just about any specialty but most common would be family, transitional and IM. You apply directly to your second year in occ med during your prelim year. Residency is 1 year of classroom work getting your MPH (masters in public health) and 1 year of working in clinics and at companies (usually industrial). Occ med docs do anything from work physicals all day long to managing the health, safety and prevention for a large corporation. Lifestyle is EXCELLENT with 40 hours being typical with no nights, weekends or call. Salary is often around $200,000.

 

[arrhythmia7]

That's great that they have the specialized training pathway for OM, but I don't think it is necessary if you want to work in this field. I've been doing per-diem OM physicals and other work for a goverment agency and I'm a resident in IM. I'm not sure about salaries nationwide, but I'm paid the same as full-time attendings, and it is only $80/hr, so I think it would be hard to clear $200,000 unless you really grind.

 

[mlw03]

would that be pathology / psych ?

I need a program in a particular location. has PGY1 medicine completed.

I want to apply for some least competitive fields, please don't mistake me.

you're making a huge decision about what you want to do for your career based on what's easiest to get into? that's a dicey move - a lot of people end up miserable when they make decisions using that rationale. that said, FP and IM, by sheer numbers and the number of community-based programs that simply need bodies to take care of their patients, would presumably be the easiest to get into. note that these are the same programs american allopaths are doing their best to avoid because they have reputations for poor teaching and basically treating residents like highly trained slaves.

solid academic-based (and solid community-based) programs are going to be tougher to get into, no matter what specialty you're talking about.

 

[Jack Daniel]

would that be pathology / psych ?

I need a program in a particular location. has PGY1 medicine completed.

I want to apply for some least competitive fields, please don't mistake me.

Sounds like you've already found it: Intern-trained generalist.

Back in the day, folks stopped at PGY1 and hung out a shingle. You're livin' the dream, man. Livin' the dream.

Of course, you'll probably never be able to get hospital privileges or insurance reimbursements.....which probably explains why it's not competitive.

 

[Blade28]

You need to first figure out what about your current situation is making you miserable.

Is it FP?
Is it Medicine?
Is it your colleagues? Fellow residents? Attendings?
Is it the hospital?
Is it the program?
Is it the city?

 

[iqureshi7]

Please go to this link: http://www.nrmp.org/data/advancedatatables.pdf

Go to page 6 to view the No. of Ranks/Positions. This will give you a more objective view of relative competiveness of each speciality.

Accordingly, least competitve fields (ordered least to "more" competitive) for US grads are: FP, PSY/PATH, IM, NEURO/PMR(most positions in PGY2)

Overall (including independent apps) least competitive are: FP, PATH, PSY, PEDS, NEURO, PM&R, IM

Of course getting into top tier programs of any speciality will be pretty darn competitive.

 

[TRAMD]

That's great that they have the specialized training pathway for OM, but I don't think it is necessary if you want to work in this field. I've been doing per-diem OM physicals and other work for a goverment agency and I'm a resident in IM. I'm not sure about salaries nationwide, but I'm paid the same as full-time attendings, and it is only $80/hr, so I think it would be hard to clear $200,000 unless you really grind.

You certainly don't have to be specifically trained in OM to do OM but it will help in many situations. Median salary is around $180k and average salary is around $190k; close enough to $200K [shrugs]. $80/hr is a lot for an OM moonlighting job, nice work. It is, however, on the low-normal end for a board certified OM doc. Plus, 45 hrs per week at that pay would put you in the $180k per year range.

 

[elwademd]

You certainly don't have to be specifically trained in OM to do OM but it will help in many situations. Median salary is around $180k and average salary is around $190k; close enough to $200K [shrugs]. $80/hr is a lot for an OM moonlighting job, nice work. It is, however, on the low-normal end for a board certified OM doc. Plus, 45 hrs per week at that pay would put you in the $180k per year range.

another nice part of occupational medicine is that you are typically reimbursed 95-97% of what you bill... compared to the outpatient internist who may collect 50-65% of what he/she bills from medicare, and at most 70-75% from other hmo's/insurance.

with that being said, elep, try to figure out what you want to do 1st. with the rate you're going with some of these threads, you might be back in a year asking the same questions!

 

[elep]

I have been through some tough time lately affecting my performance at work. I am a PGY3 now, resigned a week ago. I know I don't want to continue with IM, may be it is the bad experience I have gone through.

I want to start fresh next July , FM if possible or something else, where I could put all my effort in and get started. I am applying now, hoping it is not too late.

 

[OldPsychDoc]

No way psych is more competitive than IM.

Fewer slots, better lifestyle.

 

[TRAMD]

another nice part of occupational medicine is that you are typically reimbursed 95-97% of what you bill... compared to the outpatient internist who may collect 50-65% of what he/she bills from medicare, and at most 70-75% from other hmo's/insurance.

with that being said, elep, try to figure out what you want to do 1st. with the rate you're going with some of these threads, you might be back in a year asking the same questions!

My father, an occ med doc, collects 99% of what he bills.

elep, if you don't have a specific location in mind where you want to live when you are out in practice you should really look into occupational medicine.

 

[Blade28]

I have been through some tough time lately affecting my performance at work. I am a PGY3 now, resigned a week ago. I know I don't want to continue with IM, may be it is the bad experience I have gone through.

I want to start fresh next July , FM if possible or something else, where I could put all my effort in and get started. I am applying now, hoping it is not too late.

Let me ask again:

You were having a tough time because of your coresidents/attendings? Because of the hospital? The program? The choice of Internal Medicine?

Or something external, like personal/family issues?

I ask because if it's due to your program, then yes, a change would do you good. If it's external, though, switching may not help (unless you're talking about geography).

 

[elep]

Okay, I was going through a divorce, it affected my social interactions. I did not want to disclose it to others, or did not feel comfortable with it, became more isolated, less interactive and less sociable all these led to bad evaluations and the program has given me borderline pass to board of internal medicine 2 years in a row. I am taking time off now until next July, having counseling sessions with my psychologist. I have almost recovered now, I know I will be completely ready next July. But not IM again, so initially chose FM, hoping it will be somewhat close to IM, still a different board which has no bad record of me what so ever, and this will give me the opportunity to start fresh again.

Do I make sense now ??? I still have my MD degree and good USMLE scores which I thought will help me get a new life altogether.

Now any advice you have for me.... I listen to all.

 

[Winged Scapula]

How does having a "borderline pass" affect your Board Eligibility for IM? Frankly, I wasn't even aware that there was a scale other than Advance/Non Advance to the next year. Is this an IM thing or program specific?

At any rate, I just wasn't sure if it made any difference because in general as long as you complete the requirements you are BE and its not like in 20 years someone is going to deny you hospital privileges because you had a "borderline pass" during residency.

You certainly have reason to perform poorly as a divorce, especially without social support, is extremely difficult. In hindsight perhaps you should have taken some time off. But if you have good USMLE and ITE scores as well as LORs from your faculty, I shouldn't imagine you would have trouble finding a program somewhere.

 

[elwademd]

My father, an occ med doc, collects 99% of what he bills.

must be the location and payor mix i suppose.. i just finished a 2 week occupational medicine rotation, and i was told 95-97%. i'm in so cal, and most of the contracts were with lapd, lafd, la county, and ups.


elep, you don't think you could just finish out another year of internal medicine at another institution and be done?!

 

[NotAProgDirector]

How does having a "borderline pass" affect your Board Eligibility for IM? Frankly, I wasn't even aware that there was a scale other than Advance/Non Advance to the next year. Is this an IM thing or program specific?

At any rate, I just wasn't sure if it made any difference because in general as long as you complete the requirements you are BE and its not like in 20 years someone is going to deny you hospital privileges because you had a "borderline pass" during residency.

You certainly have reason to perform poorly as a divorce, especially without social support, is extremely difficult. In hindsight perhaps you should have taken some time off. But if you have good USMLE and ITE scores as well as LORs from your faculty, I shouldn't imagine you would have trouble finding a program somewhere.

Actually, the ABIM requires that PD's evaluate their residents each year, and assign them into one of four overall categories: Superior, Satisfactory, Marginal, or Unsatisfactory.

If you get Superior ratings, nothing exciting happens. No extra gold leaf on your diploma. No secret society membership. No magical powers. (unless you become a PD, of course!)

If you get an Unsatisfactory, you must repeat the year.

If you get a Marginal in year 1 or 2, nothing happens. However, if you get two marginals, you must repeat a year. You are not allowed to get a Marginal eval in your PGY-3 -- it's either Superior, Satisfactory, or Unsatisfactory (all marginals are supposed to be classifed as unsatisfactory).

So, if the OP's program classified him as Marginal to the ABIM for two years, he would need to repeat his PGY-2.

 

[Winged Scapula]

Ahh...thank you very much, aPD. Perhaps this is the reason for the OP's desire to switch residency...if it means repeating a year in IM.

Guess I"m pretty lucky they didn't do that in surgery (that I know of).

 

[TRAMD]

must be the location and payor mix i suppose.. i just finished a 2 week occupational medicine rotation, and i was told 95-97%. i'm in so cal, and most of the contracts were with lapd, lafd, la county, and ups.

Oh, I wasn't arguing with you, just trying to back up your point.

 

[elep]

Does this affect my future residency certifications in any other field in any way ??

More important question I have is can I apply for something like Neuro ? with this record. I know my knowledge base in IM is not as bad, honestly.

It came as a shock to me as well, when the PD showed me this evaluation, I never knew that such thing existed..

 

[elep]

does this bad record affect any other board certifications if and when I switch.

thanks in advance..

 

[Winged Scapula]

As someone who has completed at least a year of medicine, you are theoretically eligible for any specialty which would require that as intern training. The only sticking points would be:

a) CMS funding; as an IM resident you were funded for 3 years, 2 of which you have already used. Any program taking you on would only get a year of funding at 100%.

b) whether or not you will get good letters of support frm your former faculty which can state that you left and were not fired.

I am not aware that a poor evaluation in one specialty will transfer to another unless it is evident in your LORs. Essentially you are starting from scratch if you choose another specialty; perhaps others can weigh in but I'm not sure that a borderline pass in IM is of any concern to the boards in other specialties.

I agree with other posters here that it would be INFINITELY easier to find a PGY3 position in IM rather than starting all over in another specialty. While you may have to repeat a year (based on what aPD said) you are still closer to finishing than you would be if you switched.

A lot of residents have emotional issues during training...you made the mistake of trying to work through it rather than talk with someone or take time off. I did too until I realized after just a few weeks that I couldn't do it...other than having to mention taking time off, it didn't hurt me or my evaluations. You need to be honest about this because you will be asked about your performance, etc. from now on.

 

[elep]

Regarding funding I think, it is even worse, because when I resigned about a week ago I was a PGY-3. I heard when you sign the contract, the funds are allocated and then in the middle of the year if a resident leaves even the hospital does not get to use the money for a replacement. So, I guess all my money is gone..

Only good thing is now that I opened up and explained my personal issues, the faculty is being somewhat helpful, and they have given me good LOR for me to find a place.

It is hard for me to believe that all this has happened to me, but I guess I just have to keep trying and be positive.

 

[Blade28]

What other fields interest you? Are you wavering between different fields? I understand the relationship of FP to Internal Medicine, but Neuro, Psych, Path etc. all seem quite different.

 

[RockfordWF]

would that be pathology / psych ?

I need a program in a particular location. has PGY1 medicine completed.

I want to apply for some least competitive fields, please don't mistake me.

Family Medicine.

By FAR.

 

[jocg27]

Please go to this link: http://www.nrmp.org/data/advancedatatables.pdf



Overall (including independent apps) least competitive are: FP, PATH, PSY, PEDS, NEURO, PM&R, IM

.

My understanding of these specialties is that some, like path and neuro are not particularly competitive in terms of sheer numbers, applied/matched, but it's more because of the self-selecting nature of the applicants than the fields being noncompetitive or too low on the totem pole or whatever. People who want to do them can do them, simply because there aren't too many people interested. It doesn't mean they're 'easier' to match in if your scores are lousy or you are an idiot. (I am not calling anyone an idiot.) Are there really people who go into pathology because they're looking for a noncompetitive specialty, any noncompetitive specialty, and pathology is the path of least resistance?

 

[Rocket1]

For TRAMD, elwademd, or others who may know,

I looked into occupatinal residencies when I was a 4th year, and most of the programs I contacted emphasized that they prefer applicants who have completed a primary residency first. I finished my transitional year and am currently a PGY2 in another field, but I still have a great interest in occupational medicine and wanted to know if most occupational docs have completed another residency first. Thanks for any info.

 

[TRAMD]

For TRAMD, elwademd, or others who may know,

I looked into occupatinal residencies when I was a 4th year, and most of the programs I contacted emphasized that they prefer applicants who have completed a primary residency first. I finished my transitional year and am currently a PGY2 in another field, but I still have a great interest in occupational medicine and wanted to know if most occupational docs have completed another residency first. Thanks for any info.

I guess I don't know how strong that preference is. I know that almost all occ med residencies will accept someone after only completing an intern year and my perception is that this is the norm. I have a friend that went straight from a transitional year to PGY-2 in occ med. I am considering completing an occ med residency practicum year after completing my PM&R residency and getting my MPH on the side. My dad was grandfathered in after doing occupational medicine for many years as an FP--not an option anymore. Maybe you should just go for it and see if you get accepted or talk to more residencies.

You could try going on FREIDA and searching for occ med residencies and then checking how many years of GME are required or checking out different programs' websites.