leviathan Posted August 17, 2011 Report Share Posted August 17, 2011 So has the change officially happened or is it happening for sure? I really want to do internal medicine, but the thought of another 5 years in training before I can finally be done is making me have second thoughts. Although I wonder if things are a bit more enjoyable when you're a resident making your own decisions without someone cosigning all your work, making an income (albeit small), etc. Link to comment Share on other sites More sharing options...
cheech10 Posted August 17, 2011 Report Share Posted August 17, 2011 There has been a change, but it's not as simple as being 5 years. Basically you have 2 choices now to practice internal medicine: 3 years core IM + 1 year IM = Royal College certification in Internal Medicine or 3 years core IM + 2 years general IM = Royal College certification in General Internal Medicine Both pathways will be available, the first lets you do Internal Medicine (unchanged from current practice), the second lets you call yourself a "subspecialist in General Internal Medicine." Why this designation is necessary is a mystery to me. Link to comment Share on other sites More sharing options...
leviathan Posted August 17, 2011 Author Report Share Posted August 17, 2011 Thanks for the info. Is it going to be harder to get a job if you only have certification in Internal Medicine vs. GIM? Also if I do a critical care fellowship (3+2), am I still able to work as an internist as a base specialty? Link to comment Share on other sites More sharing options...
cheech10 Posted August 17, 2011 Report Share Posted August 17, 2011 You can still do IM as your base specialty with Critical Care as your main practice. Getting a job for IM shouldn't be too much of an issue, at least for locums and then settling into a long term position. Critical Care on the other hand has an extremely tight job market right now. Link to comment Share on other sites More sharing options...
leviathan Posted August 17, 2011 Author Report Share Posted August 17, 2011 You can still do IM as your base specialty with Critical Care as your main practice. Getting a job for IM shouldn't be too much of an issue, at least for locums and then settling into a long term position. Critical Care on the other hand has an extremely tight job market right now. Sorry I should have been more clear, can you do IM if you only do the 3 base years and then go straight into the CCM fellowship, or would you have to go back and do the 4th GIM year? As you said, the reason I want to know is I'm guessing I might have trouble finding ICU jobs at the start. Link to comment Share on other sites More sharing options...
cheech10 Posted August 17, 2011 Report Share Posted August 17, 2011 You can always do IM if you've finished the first 3 years, no matter what subspecialty your further training is in. Link to comment Share on other sites More sharing options...
Maxime Posted August 17, 2011 Report Share Posted August 17, 2011 You can't bill as an internist if you subspecialize in Quebec. You can't even moonlight in internal if you're doing your subspecialization residency, even though you did your 3 years of core internal medicine. Heard it was more lax elsewhere though.... Link to comment Share on other sites More sharing options...
cheech10 Posted August 17, 2011 Report Share Posted August 17, 2011 To moonlight, you need to have finished your 3 core years, + the first year of your subspecialty, + have passed the IM Royal College exam. Then you can apply for an independent practice licence. If you finish another subspecialty, you can still work as an internist, but the codes you bill are those of your subspecialty. Usually they are very similar (eg., a respirologist and an internist can bill the same consults, assessments, etc, and pay roughly the same, but the codes themselves are different). I don't see why you couldn't work as an internist in Quebec after getting your independent licence, and just bill the corresponding subspecialty codes. Maybe I'm missing something about it (I practice in Ontario). Link to comment Share on other sites More sharing options...
Maxime Posted August 17, 2011 Report Share Posted August 17, 2011 You can work as an internist, but you can't bill as an internist (an internist consult is worth more than a cardiology consult, at least in Québec: It's comprehensible, the internist consult is generally much longer than the cardiology one). In Quebec, even if you passed your Royal College exam in R4, and are doing say cardiology, you can moonlight in cardiology (during R5), but not internal (which is quite a bummer, internist moonlighting positions being more available than the contrary). The only way to moonlight in GIM is if you're a GIM resident. Residents do go to New Brunswick to moonlight though, maybe different there. A law passed with the Collège des Médecins a few years back, which was definitely not appreciated by residents in Quebec, for the reason stated above. Link to comment Share on other sites More sharing options...
e_is_hv Posted August 18, 2011 Report Share Posted August 18, 2011 Does anyone know, if you do the 3 + 2 for GIM, or the 3 + 1 for IM, do you have to match again? (like you would do if you wanted to do 3 + 2 for endocrinology say). Link to comment Share on other sites More sharing options...
rmorelan Posted August 18, 2011 Report Share Posted August 18, 2011 Two-year family medicine residency part deux. Credentialism run amok. A terrible move for the Royal College. I am still confused on what the heck the difference is between these two things? Link to comment Share on other sites More sharing options...
cheech10 Posted August 18, 2011 Report Share Posted August 18, 2011 Does anyone know, if you do the 3 + 2 for GIM, or the 3 + 1 for IM, do you have to match again? (like you would do if you wanted to do 3 + 2 for endocrinology say). All IM residents have to match after the 3 core years, regardless of how long the program you want to finish is (1, 2, or 3 years). Link to comment Share on other sites More sharing options...
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