Specialty Decision

[TankTuck]

Hey guys, I am a 3rd year med student trying to figure out what the hell I want to do for the rest of my life and was wondering if any more experienced people could give me some advice. I have always been an active guy and into sports, drawing me to the sports med major in undergrad. Anyway, I am a DO student, scored close to a 240 on Step 1, have very little research experience, but my extracurricular's and grades are good/great.

Looking in on the future, I can definitely picture myself doing SM and it sweetens the deal that I could use and benefit off of the OTM that I spent so many hours developing. Where the cross roads comes is the pressure I have had from my friends, classmates and adviser to pursue something more competitive than family medicine residency followed by a SM fellowship and they see me as "wasting" my board scores. These would be the "lifestyle" specialties, two that have always popped out to me are EM and Rads. I love south west/west and it would be a total bummer for me to have to move back to the midwest just to pursue a "lifestyle" residency.

Finally, a field I know less about, PM&R sparks my interest. From my limited research, it sounds like PM&R may receive more MSK training right off the bat and is proficient in the use of EMG's, which is important to me. The issue I see with this field and my app is that I have minimal research and the 2016 stats on PM&R showed 8.4 research projects on average per matched applicant. Also there are far less PM&R residencies, especially with a SM fellowship than family med.

Any advice would be highly appreciated!

TLDR: considering residency, what is the best route to a successful Sports Medicine practice?

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[Mizzou_EM]

EM would be a good route to take. Easy to work in both the ER and sports med when you're done since EM is shift work. Most fellowships are open to EM docs now. Good compensation, competitive specialty.

 

[teacherman84]

First of all, who cares what people think? Do what you want and be happy. I got a lot of "oh, you're just doing FM?" in med school from my friends going to ortho, neuro surg, etc...who cares. Go the route you'll be most happy. Ultimately i'd pick FM, PMR, EM, IM or peds based on the primary specialty you'd be most happy doing.
I think FM is a very clear route to sports, pick a place with a good fellowship that tends to keep its own and you can integrate the sports into all 4 years.
PMR seems like an easier residency (in terms of lifestyle) and they are no doubt MSK experts, I'm in fellowship with PMR folks and they know MSK anatomy really well. But they don't do the primary care thing.
EM seems like a good fit too, but to me it seems like fitting a set sports clinic schedule and EM shifts would be tough and more like 2 part time jobs, but I'm admittedly ignorant here.

 

[TableMD]

Hi

I will be working 2 days a week as a family doc and 2.5 weeks as a sports doc in an integrated PT/Gym/Doctor's office with a good relationship with ortho for referrals. My "life" will be that job, my family, and my 5 - 6 friends, one of whom I went to med school with. All that surrounding, "what will you specialize in" hoopla goes away with finishing med school. As a resident you will be way too busy taking care of patients and learning to care. If you don't have them on your Facebook feed then they cease to exist after graduation.

PM&R is a great speciality and I spent a decent amount of time with them as an MSI after a pretty neat gait lecture. The decision of PM&R vs FM to sports is very personal, and I think is best decided by exposing yourself to how the primary specialty practices. Which one would you be happy in WITHOUT doing Sports is probably the best way to know. Dont feel bad for being unsure, just increase exposure to both.

 

[hippopolice]

I was in a very similar situation. I had great board scores, good grades, and was gearing up to apply for ortho when I decided it did not fit for me. I also got a lot of flack from my advisers, friends, and family for deciding between less competitive specialties, FM and PM&R, with a plan to pursue SM afterwards (which I'm interviewing for now). Ultimately I decided Family Medicine and I have loved it. That being said, PM&R seems amazing too and I'm sure it would have been a good fit for me too. Like the poster above me mentioned, the question that really helped me decide which field to choose was: What would I be most happy practicing if I didn't get a sports medicine fellowship? It was still a tough decision, but I really enjoy primary care and being a generalist, so I think I made the right choice. If you have questions about my decision making process or about family medicine, I'd be happy to talk.

 

[Gauss]

TLDR: considering residency, what is the best route to a successful Sports Medicine practice?

Far more PCSM jobs exist than in any of the other specialties, I'd say peds is #2
Jobs | AMSSM Career Center

 

[septoplasty]

Far more PCSM jobs exist than in any of the other specialties, I'd say peds is #2
Jobs | AMSSM Career Center

I think he meant *FM PCSM.

I agree as to why though, but i'm biased towards the FM cause.

 

[KeikoTanaka]

Hi

I will be working 2 days a week as a family doc and 2.5 weeks as a sports doc in an integrated PT/Gym/Doctor's office with a good relationship with ortho for referrals. My "life" will be that job, my family, and my 5 - 6 friends, one of whom I went to med school with. All that surrounding, "what will you specialize in" hoopla goes away with finishing med school. As a resident you will be way too busy taking care of patients and learning to care. If you don't have them on your Facebook feed then they cease to exist after graduation.

PM&R is a great speciality and I spent a decent amount of time with them as an MSI after a pretty neat gait lecture. The decision of PM&R vs FM to sports is very personal, and I think is best decided by exposing yourself to how the primary specialty practices. Which one would you be happy in WITHOUT doing Sports is probably the best way to know. Dont feel bad for being unsure, just increase exposure to both.

Hey I know this was posted a long time ago, but can you enlighten me as to how you split the time between your two practices? Do you have benefits/insurance from a spouse who works full time? Working only 2 days a week in a FM clinic - does that create access issues for your patients? Do you share your patients with other docs in the office? Also I know this is kind of a personal question - but what is your income? I've been curious as to how working 2 PT jobs affects income vs just 1 FT job, especially from a FM lens. I've been having similar thoughts to the OP, but I'm torn between FM and EM as a main residency. I believe both would offer me the ability to work PT, but I think EM could almost be more flexible, but also has the potential to be worse if I have to work nights/weekends when a sports event would be going on, etc. Look forward to hearing your thoughts!

 

[TableMD]

Hey I know this was posted a long time ago, but can you enlighten me as to how you split the time between your two practices? Do you have benefits/insurance from a spouse who work?

Happy to answer all these questions.

I work for a small entity composed of several different physician practices/labs/anc services and a hospital.

I work in a single office. My primary care (no obstetrics) panel is approximately 400 and I see them 1 full day and a half day each week. The other three and a half days are for sports med referrals. It is a full time position therefore full benefits. I wanted to keep my hand in primary care, some choose to do 100% sports med, but I wanted a mix. I currently cover 1 school: football/lacrosse, other larger events, do help local docs with other games/teams.

Hours: 8 AM to 5 PM Mon - Thurs, with a half day Friday. May ditch the Friday half day to instead do a PM after hours clinic.

Call I in 8, over phone via a text triage.

Income: guaranted lower 200ish for two years, but can switch to production before that which I will likely do (will get a nice bump) which will be a combination of RVUs and collections. Also getting 100k in loan forgiveness and receive compensation for games covered.

I dont think any of this is as important as the difference between an EP and an FP, we think very differently. You will make more as an EP, but that is a practice environment that I am not suited for (although I enjoyed learning in the ED). I cant imagine the EPs I worked with enjoying primary care clinic. For example, the other day I saw a delightful elderly woman who came in for a URI, who was telling me she was petrified about going to the hospital, so we had a nice little chat about. POLST form vs advanced directives, and will have some info to mull over and follow up with. Stuff like that is ED Kryptonite.

Good luck

 

[teacherman84]

Happy to answer all these questions.

I work for a small entity composed of several different physician practices/labs/anc services and a hospital.

I work in a single office. My primary care (no obstetrics) panel is approximately 400 and I see them 1 full day and a half day each week. The other three and a half days are for sports med referrals. It is a full time position therefore full benefits. I wanted to keep my hand in primary care, some choose to do 100% sports med, but I wanted a mix. I currently cover 1 school: football/lacrosse, other larger events, do help local docs with other games/teams.

Hours: 8 AM to 5 PM Mon - Thurs, with a half day Friday. May ditch the Friday half day to instead do a PM after hours clinic.

Call I in 8, over phone via a text triage.

Income: guaranted lower 200ish for two years, but can switch to production before that which I will likely do (will get a nice bump) which will be a combination of RVUs and collections. Also getting 100k in loan forgiveness and receive compensation for games covered.

I dont think any of this is as important as the difference between an EP and an FP, we think very differently. You will make more as an EP, but that is a practice environment that I am not suited for (although I enjoyed learning in the ED). I cant imagine the EPs I worked with enjoying primary care clinic. For example, the other day I saw a delightful elderly woman who came in for a URI, who was telling me she was petrified about going to the hospital, so we had a nice little chat about. POLST form vs advanced directives, and will have some info to mull over and follow up with. Stuff like that is ED Kryptonite.

Good luck

Was this an advertised job or was it created for you?
Just curious how that works out... are practices/ systems seeing the benefit or did you have to sell it to a group who wanted another FM? Im still paying off a few more years in uniform (academic and full spectrum FM with a great sports clinic) but think this is a mix I'd be happy with going forward if i dont continue in academics.

 

[TableMD]

Was this an advertised job or was it created for you?
Just curious how that works out... are practices/ systems seeing the benefit or did you have to sell it to a group who wanted another FM? Im still paying off a few more years in uniform (academic and full spectrum FM with a great sports clinic) but think this is a mix I'd be happy with going forward if i dont continue in academics.

I had to explain that sports medicine was a specialty and the basics of what it was, and turned out that it was a good fit need wise.

 

[Moose A Moose]

So tell your friends and family to go do that if it’s what they want. You do what you want - if that’s family med, then so be it.

“Wasting board scores” ... smfh, they sound like a bunch of pretentious simpletons.