itimebomb2 Posted June 3, 2011 Report Share Posted June 3, 2011 Is it terrible to apply to two specialties in the first round of carms? I'm thinking emerg and IM - they've got a lot in common, and I think I can split my electives evenly between both to show interest in both. Anyone see anything bad with this strategy? Link to comment Share on other sites More sharing options...
psychoswim Posted June 3, 2011 Report Share Posted June 3, 2011 I don't think so. Curious, if you wanted, could you do all your electives in the same domain? And how many do you have? We have a total of 4, and no more than 2 can be in related fields so no choice but to split. Link to comment Share on other sites More sharing options...
NLengr Posted June 4, 2011 Report Share Posted June 4, 2011 I would weight the electives toward emerg. It's a competitive speciaty and you will need as much exposure to the various programs as you can. That's what the people you will compete with will do. IM isn't competitive. You can scale back the electives a bit on that side of things. I would do two electives at your top two locations. With those under your belt you would still have a very solid base if you go unmatched and try for one of the second round IM spots that are always left over. Link to comment Share on other sites More sharing options...
A-Stark Posted June 4, 2011 Report Share Posted June 4, 2011 I'm thinking of doing the same - albeit between gen surg and IM, with pre-CaRMS electives divided accordingly (along with 3 weeks of anesthesia). I don't know if it's the ideal way of going about it, but it will have to do - at least unless I make a firmer decision some time later in the summer. Link to comment Share on other sites More sharing options...
NLengr Posted June 4, 2011 Report Share Posted June 4, 2011 I'm thinking of doing the same - albeit between gen surg and IM, with pre-CaRMS electives divided accordingly (along with 3 weeks of anesthesia). I don't know if it's the ideal way of going about it, but it will have to do - at least unless I make a firmer decision some time later in the summer. Gen Surg and IM are probably do-able with an even split. Gen Surg isn't as competitive as ER. Link to comment Share on other sites More sharing options...
Lactic Folly Posted June 5, 2011 Report Share Posted June 5, 2011 Nice combo (GS and IM) - I wonder if you'll enjoy the advantage of these specialties being less likely to see you as backing up for the other! Link to comment Share on other sites More sharing options...
A-Stark Posted June 5, 2011 Report Share Posted June 5, 2011 I can only hope! It may require some good spinning at the interview stage but such is life. The main disadvantage at the pre-CaRMS stage is not being able to experience as many programs in either specialty, but I don't think that will present a major problem. (At least not insofar as the split represents genuine indecision rather than "backing up" ) Link to comment Share on other sites More sharing options...
cardiomegaly Posted June 5, 2011 Report Share Posted June 5, 2011 Is it terrible to apply to two specialties in the first round of carms? I'm thinking emerg and IM - they've got a lot in common, and I think I can split my electives evenly between both to show interest in both. Anyone see anything bad with this strategy? Would you do your IM electives in general CTU? I bet you could spin some strategic electives well for emerg, like CCU/Cardiology. Either way, should be too bad. Could also back up with family 2+1 at your top location Link to comment Share on other sites More sharing options...
MrKhiladi Posted June 7, 2011 Report Share Posted June 7, 2011 hey Nlegr, check ur mailbox,i sent you a message but havent heard back from u? mrk Link to comment Share on other sites More sharing options...
itimebomb2 Posted August 14, 2011 Author Report Share Posted August 14, 2011 I'm gathering that the opinions here are that GS and IM make good "co-backups".... I.e doing an even split of electives bt the two wouldn't hurt you for either when you apply? Or rather might it be better to do most of the electives in GS and apparently backup with IM? Do IM programs dislike being a backup? Link to comment Share on other sites More sharing options...
Lactic Folly Posted August 14, 2011 Report Share Posted August 14, 2011 I don't know of any program that "likes" being a backup. Link to comment Share on other sites More sharing options...
NLengr Posted August 15, 2011 Report Share Posted August 15, 2011 Tolerates or understands is a better description. Link to comment Share on other sites More sharing options...
ploughboy Posted August 15, 2011 Report Share Posted August 15, 2011 I'm gathering that the opinions here are that GS and IM make good "co-backups".... I.e doing an even split of electives bt the two wouldn't hurt you for either when you apply? Just keep in mind that GS and IM are very different specialities that attract different personalities and have quite different professional cultures (with the possible exceptions of GI and interventional cards, but even then...). If you are applying to both be sure that you would be happy in either. Link to comment Share on other sites More sharing options...
coastalslacker Posted August 16, 2011 Report Share Posted August 16, 2011 Just keep in mind that GS and IM are very different specialities that attract different personalities and have quite different professional cultures (with the possible exceptions of GI and interventional cards, but even then...). If you are applying to both be sure that you would be happy in either. Absolutely agree. Culturally medicine and surgery are incredibly different. While many people going into general surgery say they "like the medicine" aspect of it, this is a far cry from an internal medicine residency. Most (all? all the ones I know) surgical residents could not imagine themselves as medicine residents. Full stop. Unless your ultimate goal is ICU, I would figure out which of these two actually fits. Apply to both, by all means, but figure it out before your rank list needs to be submitted next year. Link to comment Share on other sites More sharing options...
thebouque Posted August 16, 2011 Report Share Posted August 16, 2011 A friend of mine backed up GS with IM and he's very happy in IM. Also keep in mind that usually (at least in Quebec), GS is 10X more competitive than IM. Link to comment Share on other sites More sharing options...
itimebomb2 Posted August 16, 2011 Author Report Share Posted August 16, 2011 Yeah I realize they are very different but they are the only two specialties I see myself in. I like them due to the general medicine aspects of both fields whih would allow me to do international work. I am leaning to GS but need some kind of backup... Link to comment Share on other sites More sharing options...
A-Stark Posted August 16, 2011 Report Share Posted August 16, 2011 Absolutely agree. Culturally medicine and surgery are incredibly different. While many people going into general surgery say they "like the medicine" aspect of it, this is a far cry from an internal medicine residency. Most (all? all the ones I know) surgical residents could not imagine themselves as medicine residents. Full stop. Unless your ultimate goal is ICU, I would figure out which of these two actually fits. Apply to both, by all means, but figure it out before your rank list needs to be submitted next year. I've been thinking ICU for a while (more so after a rotation there) and hopefully I can come to a decision on base specialty once I start my core CTU rotation next week... Yeah I realize they are very different but they are the only two specialties I see myself in. I like them due to the general medicine aspects of both fields whih would allow me to do international work. I am leaning to GS but need some kind of backup... You can do international work from just about any field - I don't know that the "general medicine" aspects of either are very similar. Gen surg involves the perioperative management of often very sick patients, while medicine is considerably more broad and - in residency - will extend to inpatient and ambulatory management of just about any conditions that aren't intrinsically surgical. I think you can certainly be a "medicine-minded" surgeon or an "intervention-minded" internist in a more procedure-based subspecialty. But you need to think about what kind of decision-making you like, the extent to which you enjoy technical challenges, and - of course - the type of practice and lifestyle you want. (Although, generally speaking interventional cardiologists do not lead especially relaxed careers.) Link to comment Share on other sites More sharing options...
Satsuma Posted August 16, 2011 Report Share Posted August 16, 2011 Is it terrible to apply to two specialties in the first round of carms? I'm thinking emerg and IM - they've got a lot in common, and I think I can split my electives evenly between both to show interest in both. Anyone see anything bad with this strategy? Many people apply to more than 1 specialty, there is nothing wrong with it. But as others have mentioned it limits the number of electives you can do in either. But because EM is broad you can argue almost any elective is relevant to it - just as long as you have some key EM electives. I am not sure how many electives you have done in IM vs EM, but I am not sure what the commonalities are that you perceive. Personally I don't think IM and EM have all that much in common. And typically you'll find very different personalities in these specialties. EM is acute care medicine, and episodic. A fair amount of procedures, no follow-up with your patients. You often have to make decisions quickly and with minimal information - your pt might not be able to give you any hx or you don't have the luxury of waiting for labs that take days to get back. So you do what you can. It also requires a broad knowledge base. You will work shift-work the rest of your life. IM can be acute, but is often chronic. You will work-up pts for EVERYTHING and order a plethora of tests. You will try an get to the bottom of things. Depending on the subspecialty - it may not have alot of procedures. Usually the environment is alot less chaotic, and you have time to mull over things. You will have a more focused knowledge base. You will need to like pt follow-up. You may have to put up with call for your career, but depending on the subspecialty you choose, you may end up with a 9-5 lifestyle with no to few emergencies. These are just some differences that come to the top of my head. I think maybe the more electives you do in each, the more you'll be able to see yourself leaning one way or the other. Link to comment Share on other sites More sharing options...
Lactic Folly Posted August 17, 2011 Report Share Posted August 17, 2011 I am not sure how many electives you have done in IM vs EM, but I am not sure what the commonalities are that you perceive. Significant overlap in territory: A wing of the ED is usually devoted to IM inpatients waiting for a bed upstairs. At night, the consult room in the ED is occupied by the IM team. Link to comment Share on other sites More sharing options...
itimebomb2 Posted August 17, 2011 Author Report Share Posted August 17, 2011 You can do international work from just about any field - I don't know that the "general medicine" aspects of either are very similar. Gen surg involves the perioperative management of often very sick patients, while medicine is considerably more broad and - in residency - will extend to inpatient and ambulatory management of just about any conditions that aren't intrinsically surgical. I think you can certainly be a "medicine-minded" surgeon or an "intervention-minded" internist in a more procedure-based subspecialty. But you need to think about what kind of decision-making you like, the extent to which you enjoy technical challenges, and - of course - the type of practice and lifestyle you want. It depends... if you work in a major centre internationally than yes - most specialties can be helpful. However, I just got back from a rural gen surg elective in Africa and the opinion of all the docs there (surg and medical) is that surgeons are by far the more important docs. When your only diagnostic tool is an X-ray and a crappy ECG, and the supply of drugs is severely limited, medical doctors are rendered fairly handicapped. Plus, a general surgeon can pick up medicine much more easily than the other way around (at least in a 3rd world setting). Also, thanks for the below replies but my fickleness has led me to now be torn between GS and IM like Alastriss here, rather than EM + IM. Thanks though! I appreciate the input nevertheless. Link to comment Share on other sites More sharing options...
cardiomegaly Posted August 17, 2011 Report Share Posted August 17, 2011 GS and IM seem so different... the people who want to do surgery in my class tend to like to get things done, right then right now screw the details type of attitude where as the internal med keeners are great problem solves and love to think about the pathophys, differential diagnosis and weird/wonderful rare cases. Rounding on both services really shows the difference in approach.. Link to comment Share on other sites More sharing options...
coastalslacker Posted August 18, 2011 Report Share Posted August 18, 2011 I think it's a little BS to right off the bat assume that interests in specialties are mutually exclusive. Just because you enjoy general surgery that does not mean your interest in other specialties MUST be zero. When you ask yourself "What specialty do I want to do for the rest of my life", you should really be asking "What career choice do I want to make right now that will net me the most happiness and satisfaction overall". Of course the specialty you enjoy most is a key proponent but it isn't everything. It is entirely reasonable, nomatter how unlikely, to like two specialties that are vastly different. It's also entirely inappropriate to undermine someone's interest in specialty "y" just by the fact they have an interest in specialty "x". Disagree. You're right, interests in specialties are not mutually exclusive. To reiterate, internal medicine and general surgery, specifically, are culturally very different. One of those two hats will fit much better - I would submit again that someone considering both should carefully consider which of the two is the right fit for them, be it through introspection, more electives, whatever. Don't think anyone claimed that enjoying general surgery equates to an inability to have an interest in any other speciality. Lots of people who have no interest in being surgeons love their surgical rotations. If surgical residency/lifestyle were easier the number of applicants would go through the roof. From my experience, those who say "I would love to do surgery but I'm not sure I can work the hours" (and who aren't bull****ting you, which is also quite common and easy to see through) are seldom (ie almost never) those interested in internal medicine. They are typically thinking ER or Family (often with plans to work ER). Good luck in your clerkship. Link to comment Share on other sites More sharing options...
coastalslacker Posted August 18, 2011 Report Share Posted August 18, 2011 GS and IM seem so different... the people who want to do surgery in my class tend to like to get things done, right then right now screw the details type of attitude where as the internal med keeners are great problem solves and love to think about the pathophys, differential diagnosis and weird/wonderful rare cases. Rounding on both services really shows the difference in approach.. Dude, you realize surgeons are more detail oriented and OCD than internists, right? Don't equate massive differential diagnoses and chasing zebras to being detail oriented. Surgeons like to get things done, full stop. Link to comment Share on other sites More sharing options...
thebouque Posted August 18, 2011 Report Share Posted August 18, 2011 Also internal medicine really isn't about rare/weird diseases and chasing zebras. It's about perioperative medicine, hospitalization, techniques (unless you're a pure hospitalist in an academic environment, GIM and lots of IM subspecialties are extremely technique oriented). Link to comment Share on other sites More sharing options...
Nobodycirclesthewagons Posted August 18, 2011 Report Share Posted August 18, 2011 It depends... if you work in a major centre internationally than yes - most specialties can be helpful. However, I just got back from a rural gen surg elective in Africa and the opinion of all the docs there (surg and medical) is that surgeons are by far the more important docs. When your only diagnostic tool is an X-ray and a crappy ECG, and the supply of drugs is severely limited, medical doctors are rendered fairly handicapped. Plus, a general surgeon can pick up medicine much more easily than the other way around (at least in a 3rd world setting). Also, thanks for the below replies but my fickleness has led me to now be torn between GS and IM like Alastriss here, rather than EM + IM. Thanks though! I appreciate the input nevertheless. Interesting points. Where did you go? Link to comment Share on other sites More sharing options...
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