Switching primary speciality

[Intensivist]

Hi guys and gals,

I am currently CA1 planing on switchin to IM as primary speciality followed by CCM, but bare in mind l come from european background, and here vast majority of intesivists are anaesthetists. My reasons are more diagnostic medicine and clinics. I still love anaesthesia but l reckon this one is more suitable route for me. Now, any comments on IM background for CCM? I have a app 1 year experience with anaesthesia based ICU, have learned a lot from those guys, both in manual skills and medicine in general.

Am l making a mistake here or not? Is there a right choice at all?

Help please

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[Hernandez]

6 of one half dozen of another. gas CCM fellowships are per sdn easier to get into, and overall the length of training would be 1 year loner for pulm-cc.

if you want to learn more medicine and also have a separate specialtyt that expands your job options go for it, but if you just want CCM, then you can still be a well trained CC doc via the gas route.

 

[MTGas2B]

Agree with previous. If you are looking for pure CCM work in the future it doesn't really matter what your training background, you can find work. What may matter more is the practice models in the community you want to live in. Some places may be ran by Pulm/CCM groups who only want to hire Pulm/CCM guys. I think there will be less and less of that if demand for intensivists increases, supply of non-pulm/ccm intensivists increases.

I had a faculty member in fellowship who orginally trained in IM plus CCM (without pulm). He worked some great private practice CCM jobs. Week on week off kind of schedule good money. He decided he wanted to go into academics, but most academic medicine departments don't want CCM folks without pulm training. So, he went back and did an anesthesiology residency. Then took a faculty position in the anesthesiology deparment, where he still gets to do the ICU.

I think some of the stereotypes are probably true of residents, surg/anes more procedurally savy, IM a bit more on top of IMish stuff, but that should all go away in good fellowship training. I wouldn't sweat that part too much.

I would say train in the environment where you think you'll be happiest. I wouldn't drag myself through medicine residency because I think its better when I can still do what I want to do in the end with anesthesiology training.

My $0.02