Residency Question

[MtbMike]

I was looking around the SGU website stats for residencies and didn't notice anything for Pathology or Infectious Disease. These are the areas that I would like to specialize in, so I'm curious if SGU would be an appropriate starting point. Just a little worried that I didn't notice any residencies for this. Thanks for your help.

[geoff]

Two thingies here.... one Infectious disease is a fellowship completed after internal medicine. So essentially anyone getting IM in the last few years could apply for that....so that's encouraging. Pathology...well, I haven't gone thru the process myself..as in applying specifically for Path...but I think it's not rated as one of the more competitive specialties...though there aren't an enormous amount of residency training spots. So both are attainable.
Geoff

[helpfulgrad]

To answer your question...YES. SGU is a very reasonable option if you would like to pursue training in either of these fields.
I know for a fact that SGU students have attained pathology residencies. There is a 3rd yr and a 2nd yr resident in path from SGU at my training program.
Regarding infectious disease, it is also attainable. You would have to do a 3 year residency in Internal Medicine and then pursue fellowship training in I.D. Note that fellowships in IM are getting much more competitive across the board. Cardio and GI remain the two most competitive fellowships followed by the others. I.D., Rheum and Allergy/Immunology are competitive due to the smaller number of spots.

HG
Attending, Internal Medicine
Fellow, Infectious Diseases
SGU grad :)

[MtbMike]

Great! Thanks for the info.

[geoff]

I have a question for you Helpfulgrad... how would you classify or comment on the life/field of IM fellows.... I have interest in Critical Care, but also Hem/Onc allergy..... do you have any pluses or minus for these few... and maybe even a few on ID..he he... cause it sounds like you're a fan already.
Geoff

[jaywalk81]

yea i have a question for you too helpfulgrad...
i am interested in ID. how long is the fellowship program and is it hard to obtain one after IM residency? and also which ID program is more well known. thanks

[helpfulgrad]

Hey great questions guys...
Let me start by saying this. Make sure to do electives during med school or even residency in the field that you're interested in to make sure it's really what you want.
I'll start with I.D. since I'm obviously biased. It's a great field if you're intellectual and like to think about problems. It's not a procedural field (like cardio, GI, hem/onc, critical). Life as a fellow is busy. It can be extremely busy in some programs that get upwards of 60 consults per month or can be relatively reasonable if the consults are not that many. Programs are obviously set up differently and in one program you may find yourself extremely busy in the first year (10 or 11 consult months) and easy in second year (mostly research) whereas in another program the work is spaced out over the two years.
This brings me to the length of the I.D. fellowship. Again, there are various programs out there. Most programs offer a 2 year (clinical) fellowship while some other offer both a 2yr program and/or a 3 year (research) fellowship. There is not much difference except the extra year and more research oriented with the research fellowship. Some programs that I interviewed at (like Univ. Hospitals of Cleveland/Case Western Reserve U) have 3 yr programs where you can get an MS or MPH degree with the fellowship.
Regarding other pros/cons, some programs don't have the fellows take antibiotic approval calls and allow a pharmacist to give the first dose of antibiotic or approve the drug. This is GREAT since you're not paged at 2am to approve a dose of Rocephin. Other programs have the fellows take pages for everything (can get annoying). I.D., like the other fellowships is competitive. It is much easier to get than cardio and GI but tough in its own right (number of spots limited etc etc.)
In terms of well-known fellowship programs, there are many well known programs in the U.S. They are popular for various reasons. One program may be more known for HIV research while others may be known for antibiotic exposure or clinical experience. Needless to say, there are alot of good programs. A good bet is to stay away from the community programs (no offense to them) and stick with university programs or university affiliated programs.

Regarding the other fellowships, they are busy as well. The least busy of the fellowships is probably rheum and allergy/immunology since they are not heavily based on consults. Allergy/Imm is also tough to get since there are few programs in the country with a limited number of spots. Rheum is a bit easier.
The other fellowships like cardio, GI, nephro, Hem/onc can all be very busy since these fields actually require the fellows to come in for emergencies. For cardio, you may have to come in to see patients or come in to assist with caths etc. In GI you'll have to come in to do endoscopies etc. In Nephro, you'll have to come in to dialyse a patient and in Hem/Onc you may have to come in for oncologic emergencies or to see patients and start chemo (esp for AML's etc).
So life as a fellow, while being much easier than a resident in IM, can be busy as well. For the most part, most fellows (except for cardio) take beeper call from home and only go in if necessary.

Okay guys, hope this helps a bit, I gotta jet for a few.....may post more later... any other questions... feel free. Geoff I'll post on critical care later..

HG

[tiredintern]

Good thing about ID is that its mostly a 9-5 job.. if there really is an emergency I can always open the pharmacopenia myself ;)

[helpfulgrad]

Regarding critical care geoff....
It's not a bad fellowship as a stand alone. You can do it in one year (after internal med) and you pretty much spend the entire year doing the ICU. Most people do pulmonary/critical care together as a 3 year fellowship as there is some overlap...lots of respiratory physiology in ventilator management etc. More recently, some ID and Nephro fellows have decided to spend an extra year doing critical care and being board certified in both fellowships. The market is good for intensivists as there are many hospitals and groups looking for people solely to cover their ICU patients.
Pros: ONE year, decent money. Lifestyle (you can do 5-6 24 hr calls for a month)
Cons: ?Burn out unless you really like taking care of really sick patients with multiple problems all the time.

[jaywalk81]

is there a need for ID physicians?

[geoff]

Hey...you really are helpful. Ya...that's just what I was looking for. I'm trying to suss out fellowships a bit as I enter IM so I can figure out how to work toward some goals. I have a research project to do....and most people as I understand end up do their research on a topic that kinda follows their fellowship dreams. So Critical Care is only one year?! wow...I thought it was a two year. And I don't understand what you meant by the 5-6 24 hour calls a month.... do you mean that often CC docs only work a total of 6 shifts per month....or are you saying that they do 8-5 M-F plus 5-6 24hr calls?
Thanks a lot too,
Geoff