IM, GIM, and CCM?

[Coldery]

Hey guys. Just a few questions about IM, GIM, and CCM. I'm also still a first-year medical student so mind my ignorance if I ask any dumb questions here:

1. With 4 year IM programs still being a thing and with many internists writing the Royal College exam in their 3rd year, what prevents other subspecialists from also qualifying as a (non-General) Internal Medicine doctor and working in community settings? 
2. From what I've heard, the job market for CCM is one of the worst out of all of the MSM specialties. Is this true? If #1 is possible, could someone going into CCM hedge it with the possibility of practicing IM while waiting for a job in the ICU?
3. I believe that GIMs can practise in ICU settings too so could you technically work in community ICUs as a quasi-intensivist?

Thanks!

[ACHQ]

19 hours ago, Coldery said:

Hey guys. Just a few questions about IM, GIM, and CCM. I'm also still a first-year medical student so mind my ignorance if I ask any dumb questions here:

1. With 4 year IM programs still being a thing and with many internists writing the Royal College exam in their 3rd year, what prevents other subspecialists from also qualifying as a (non-General) Internal Medicine doctor and working in community settings? 
2. From what I've heard, the job market for CCM is one of the worst out of all of the MSM specialties. Is this true? If #1 is possible, could someone going into CCM hedge it with the possibility of practicing IM while waiting for a job in the ICU?
3. I believe that GIMs can practise in ICU settings too so could you technically work in community ICUs as a quasi-intensivist?

Thanks!

 

1. Yes depending on where you end up practicing, other subspecialists can definitely do this. Most don't because most would rather just focus on their own sub-specialty.

2. Most people who do CCM via IM do exactly this. They either locum here and there in ICU and the rest of the time do GIM to make an income.

3. Again depending on where you practice this is possible. Usually smaller community/rural ICU's (about 6-10 beds). I can only comment on this within the Ontario context, but basically anywhere in the GTA this is NOT a thing, you would have to go at least 1.5-2 hours away from the GTA before GIM's are covering ICUs (again smaller ICUs)

[futureGP]

I honestly think with the way most young intensivists I know are working, everyone with an interest in GIM+slight ICU should just do the CCM fellowship.

The days of GIM doing ICU is mostly gone unless you are in rural hospitals with 8-10 monitored beds. 
 

As IM trained-Intensivists, you can do everything GIM does within the hospital plus work in the ICU. 
 

I had thought long and hard about this 5year GIM thing that academic centres are pushing and I think it really only makes sense if you want to be an academic GIM running an academic CTU, doing research on some QI stuff, preop, ob med etc. 
 

If anyone is wondering about working in the community as an internist which in most big cities will be mostly hospital-based, but don’t want to do 4-year GIM for whatever reason (self-worth, academic pride etc), just do IM-CCM. And you can work as both internist and intensivist doing purely inpt work without overhead in a large hospital, still with option of working in academia.