nuc after internal medicine residency

[nukedoc]

hi all!
heard abt medicare paying for one residency -so is it possible for me to do a nuc med residency after i do a residency in internal medicine? wat r the issues regarding this? becos i want to have a good background in clinical medicine and then pursue nukes. is it possible?
thanks!

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[Imhotep]

In short, you can do NM after IM. Although many programs will have medicare funding issues, there are several that wont. You will need to contact them directly. Good luck.

 

[Strength&Speed]

yeah, it seems that nucs is a questionable road as well. Not sure where nucs is headed. Proceed cautiously is the advice I see given.

 

[Imhotep]

Interesting, Strength & speed.

Would you care to elaborate?

 

[nukedoc]

thank u very much imhotep!!
strength and speed, i did speak to a nuc med faculty in the university where i am doing int med residency. he said to complete residency in int med and then try the nuc residency. but he didnt know abt the medicare issues or anything. he doesnt have any doubt about the future of nukes at all. he says the scans are not going to go anywhere and PET is an integral part of all oncologic work up now. he seems very sure, i dont doubt him as he is a world renowned authority on PET scan. i did a rotation in nukes and absolutely loved it. thats why i want to pursue this field after im. and in the rare event nukes does vanish into thin air in future, i have sthing to fall back on

 

[Strength&Speed]

My point being that there are pros and cons to many fields, but nucs has more inherent risks. PET MRI becoming may be becoming more of a factor which nucs won't be able to read. a positive for nucs is that less rads programs are dedicating time to nucs, which is good for pure nucs. But they also have nuclear fellowships that rads can do. Agreed, there is more work in this country than can be handled by the nuclear trained rads alone, but then you also have some regular diagnostic rads out there reading. there is some encroachment from other fields as well. this would be fine and dandy if there was a back up plan, but there is none for nucs. you become expendable whenever a rads guy with nucs experience comes along. whether that will become the case, or i am being too chicken little, i don't know, but it seems risky.

Edit::::::OK, just read your recent post. I am admittedly not an expert in this field. Unfortunately, no one has a crystal ball. If you can assemble a large majority of people who can tell me nucs will be ok...I might be reassured. But the ease of getting into the residency is a troubling sign to me. I agree about the IM route, that will give you something to fall back on. Wish you the best.

 

[Imhotep]

Indeed. You are not an expert in this field. I am a practicing nuclear medicine physician who had multiple jobs offers at time of graduation. Even now I get offers from recruiters and colleagues who are looking to hire additional staff. At my current place of emplyoment, we have more work than we really want!PET/CT is the fastest growing imaging modality at the moment. Your point re: PET/MRI is taken. However, since 2007 NM has expanded to a 4 year residency (internship + 3), and cross sectional imaging including MRI is part of the curriculum.

Like you said, no one has a crystal ball. I can only share my experiences and those of people who trained with me, just before me, and right after me. The total number of individuals is approximately 25. Of these, only one (yes one) had difficulty finding a job, and thats because they were unable to pass the boards. Unlike IM, FM and other fields, being board certified is integral to getting "a" job in NM, and to a lesser extent radiology. It used to be a cakewalk to get into NM residency. And indeed, many FMGs would go into NM because they could not get anything else. It is changing, albeit slowly. At the time of my graduation, all applicants at my ex program were US grads, and two were MD-PhD.

To Nukedoc: feel free to ask any questions that you may have about this field.

 

[Strength&Speed]

Indeed. You are not an expert in this field. I am a practicing nuclear medicine physician who had multiple jobs offers at time of graduation. Even now I get offers from recruiters and colleagues who are looking to hire additional staff. At my current place of emplyoment, we have more work than we really want!PET/CT is the fastest growing imaging modality at the moment. Your point re: PET/MRI is taken. However, since 2007 NM has expanded to a 4 year residency (internship + 3), and cross sectional imaging including MRI is part of the curriculum.

Like you said, no one has a crystal ball. I can only share my experiences and those of people who trained with me, just before me, and right after me. The total number of individuals is approximately 25. Of these, only one (yes one) had difficulty finding a job, and thats because they were unable to pass the boards. Unlike IM, FM and other fields, being board certified is integral to getting "a" job in NM, and to a lesser extent radiology. It used to be a cakewalk to get into NM residency. And indeed, many FMGs would go into NM because they could not get anything else. It is changing, albeit slowly. At the time of my graduation, all applicants at my ex program were US grads, and two were MD-PhD.

To Nukedoc: feel free to ask any questions that you may have about this field.

thanks Imhotep. The PET/MRI piece is something I didn't know and is encouraging news. It is encouraging that nuc med is being aggressive about staying on top of things. The piece about residencies getting harder is also good news.

 

[nukedoc]

thanks imhotep and strength & speed for ur valuable advice.

its true wat u sed strength&speed-no one has a crystal ball, even i am skeptical, that is why the decision to do IM also. even i didnt know that they have added MRI in the new curriculum. the nuc med physician i was talking to also told me he didnt know anyone who didnt have a job at the end of training except one guy with visa issues (he was on a J1 and it was difficult to find a waiver job for nuclear medicine). about the workload- they say that the PET center the university where i study also has more cases than they can handle, so the physicians are busy while they r in office. i hope it doesnt get too hard to get into NM residency by the time i am done with IM residency!!only time will tell....

 

[keye]

How much does a nucmed doctor make in private practice??

 

[eddieberetta]

My biased opinion as a radiologist is that if you are a med student interested in nukes you are better off during a fellowship after rads (will likely be able to organize so you are double boarded ABR/CAQ/ABNM) in 6 yrs including one internship year and one fellowship year. Doing a pure nukes residency will limit your options and the added couple years to go the rad route gives you a lot of flexibility (simple example you can cover rads call which may help for PP groups).

If you already have IM certification, then the NM residency may be better for you because the extra time commitment becomes an issue and funding for a full rads residency may be hard to come by.

 

[Bubblehead-to-MD]

*Cues tumbleweed rolling across the screen*

 

[rick sambora]

Hi Imhotep,
I am very grateful for your insight on the discussions. I owuld further appreciate your advice in answering a few of my queries
I am a PGY3 pediatric resident and I applying for NM this year for a position starting July 2009. I have been invited to interview at Emory, Harvard, UoM, Johns Hopkins, William Beaumont and Rush. I feel that I have a reasonable chance of landing a position.
I have been advised against NM by a lot of people in practice. A NM graduate who is now an IM hospitalist actually called me up to advice against it as he could not find a job. In pursuant to this, do you have a resource that you used to get jobs?
I looked up a radiology jobs website and found only 2 jobs for nuclear med physician amongst the many 100 that are listed there. I spoke with my radiology residency chief and he actually discouraged saying that the future lies in general rads reading NM scans, of course he was biased but that did not boost any confidence knowing that most rads want to wipe out pure NM jobs.
Please comment
Rick

 

[radslooking]

I don't know about the recent gov't cuts as well. something to look into. They just cut reimbursement for many nuc med scans roughly 40%. I can't comment on the field as a whole. Just one more thing to consider.

 

[rick sambora]

I don't know about the recent gov't cuts as well. something to look into. They just cut reimbursement for many nuc med scans roughly 40%. I can't comment on the field as a whole. Just one more thing to consider

I thought the medicare payment cuts were put on hold by the congress. I do not think that they will be enforced. Though I know that Nuc Med scans are now part of the Designated Health Services(DHS) and are not exempt from the Stark self referral clause. But this will affect only large radiology groups and hospitals and not Nuc med physicians.