What if I don't get the IM fellowship I want???

[poormedstudent]

I want to go into IM because I am interested in a specific subspecialty...I do NOT like GIM

 

What if I don't get the subspecialty that I want though? Is it possible to apply again? Can I transfer from another subspecialty?

[Handsome88]

FFP, was a cardio fellow on these boards. He said that even for the most competitive specialties, if you want it, you will get it provided that you will move anywhere you want in the country and you do your due diligence to build your application up.

 

Are you sure it is still that way? I hope so. But I thought it changed and that it's getting more competitive now. For example, I've heard from good sources that it is now VERY difficult to do GI.

 

How is it for IMGs, specially ones who do IM in the states?

[cheech10]

GI and cardiology are competitive accross the country, but the majority of applicants will still find a spot somewhere. An alternative path would be to finish the 4th year of IM in Canada, then do a clinical fellowship in the US or elsewhere. By finishing the 4th year of IM, you can write the Royal College exam for IM and get an independent practice licence, and doing a fellowship abroad doesn't affect that status.

 

The far bigger problem is finding a job with these specialties. Very few groups in urban Canada are looking to hire for GI or cardio (or ICU, or...).

[aaronjw]

GI and cardiology are competitive accross the country, but the majority of applicants will still find a spot somewhere. An alternative path would be to finish the 4th year of IM in Canada, then do a clinical fellowship in the US or elsewhere. By finishing the 4th year of IM, you can write the Royal College exam for IM and get an independent practice licence, and doing a fellowship abroad doesn't affect that status.

 

The far bigger problem is finding a job with these specialties. Very few groups in urban Canada are looking to hire for GI or cardio (or ICU, or...).

 

What about endo?

[aKGDH]

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[Handsome88]

Thanks Cheech you are always helpful.

 

I didn't know about that route you mentioned (finishing residency in Canada then doing fellowship elsewhere).

 

I think the only hurdle is if you have an ROS contract which limits you in one province so that you cannot apply to a fellowship outside that province.

 

As to why Cards and GI are competitive, well this year cards wasn't competitive at all really (just from looking at numbers). But things will probably change (I hope) once the economy improves and docs retire.

[cheech10]

Actually, there are few jobs for either cardio or GI in academic or community settings. A significant limitation is access to endoscopy for the GI docs, and access to cath labs for the cardiologists. Anyone can open a private outpatient practice on their own, but you won't have access to these lucrative procedures unless you join an existing group, and in many cases, the established guys don't want to give up their time. That's part of the reason why non-surgical and non-procedural specialties are having an easier time finding jobs right now.

 

As for why people still go into these fields, remember that it takes a few years for job market realities to filter down to the trainee level. Many of the GI/cardio folks have been tailoring their activities to be attractive to these fields since med school or early residency, and it's too late to switch tracks. Also, the job market will get better eventually, so for those who really love it, sticking to it may be worthwhile.