Going into medical school, I wanted to be an interventional cardiologist. One of them saved my dad's life. However, once I got into medical school I fell in love with orthopedics as well so I started to pursue that. I am now at a crossroads where I have to apply IM or Ortho (I am finishing up my third year) and I am leaning towards IM. However, I really did not like IM. I am only doing it to become an interventional cardiologist. Some have said do not apply to IM unless you are totally content with IM because if not, they say I will be burnt out by the time I get to interventional cards 4-7 years from now. What do you guys think?
Want to be an interventional cardiologist - but I hate IM
- Thread starter almo0318
- Start date
- Joined
- Sep 14, 2006
- Messages
- 23,877
- Reaction score
- 46,292
I would worry more about what happens if you don't get that fellowship, or worse you get it and discover you don't really enjoy the field.
Isn't not liking your field a risk in any specialty?
- Joined
- Sep 14, 2006
- Messages
- 23,877
- Reaction score
- 46,292
Yeah but most people go into a field they liked initially. You already don't like the foundational field, so it is more likely that you may find similar dislike for the subspecialty that you seem to only want because of the connection to your family.
- Joined
- Apr 22, 2006
- Messages
- 2,806
- Reaction score
- 2,659
Except interventional cardiology is about as different from the "foundational field" of IM as you can possibly get. The day to day job of an IC is NOTHING like the day to day job of a general internist.
Do you like anything else in IM subspecialties? Pulm? GI? Allergy? Keep in mind that even if you don't want to pursue IC down the line, there are tons of other options. Once you're in ortho, there's no other choice but to saw bone.
- Joined
- Jul 30, 2014
- Messages
- 514
- Reaction score
- 253
try exploring transitional year to see really how IM feels for you. If you like IM, continue in that path. I am not sure if it will make you less competitive for Ortho(which usually is very competitive)
- Joined
- Jul 15, 2012
- Messages
- 1,279
- Reaction score
- 1,186
IC docs usually practice general cardiology as well, which has a clinic practice similar to GIM but more focused on risk reduction of ASCVD for the primary prevention visits and medical management of cardiac diseases. It’s not all wires and catheters
My advice to OP would be to decide why he’s doing this. If he wants to do be a primarily procedural and surgical guy then doing IM for three years, cardiology for three years, and IC for 1-2 years is not the way to go
- Joined
- Apr 22, 2006
- Messages
- 2,806
- Reaction score
- 2,659
But cardiology clinic is still vastly different from GIM clinic. Some orthopods do as much clinic as any procedural IM subspecialist. If one is trying to avoid clinic, then perhaps radiology and pathology would be the way to go.
- Joined
- Apr 6, 2007
- Messages
- 577
- Reaction score
- 555
or you could be a GI doctor and do a greater variety of procedures, better lifestyle and comparable money.
If you love procedures, Advanced endoscopy is about as close to a surgeon as you can get through IM.
Although you still have to make it through IM residency, the fellowship is not nearly as stressful.
If you love procedures, Advanced endoscopy is about as close to a surgeon as you can get through IM.
Although you still have to make it through IM residency, the fellowship is not nearly as stressful.
- Joined
- Apr 22, 2006
- Messages
- 2,806
- Reaction score
- 2,659
Totally depends where you do fellowship and residency. At my previous institution, the residents got it MUCH better than the GI fellows, who were severely overworked and took frequent call whereas the residents were somewhat protected and had a nightfloat system.
- Joined
- Jul 15, 2012
- Messages
- 1,279
- Reaction score
- 1,186
Not to be pedantic but the level of stress varies significantly with GI. My institutions GI fellows were worked to the bone. It is not an easy fellowship especially at large tertiary care centers where the training is typically better
Also, arguably both IC and advanced endo are quite “surgical” in their approach. The structural procedures that IC docs can now do were often previously the sole domain of cardiac surgery (ASD, PFO, TAVR, Mitraclip, TMVR, TPVR, etc etc). I’m not sure variety is necessarily more so in advanced endoscopy but likely similar. Also EP is even more versatile and advanced in some ways - ablation, Watchman, pacemakers, ICDs, ILRs, Micra, etc.
Most GI doctors I know do make comparable money, but they work long and hard hours for their work doing procedures and seeing patients in clinic. It’s not a joke. General cardiology often has comparable call responsibility, though yes IC is definitely tougher and busier. But it’s all relative.
I genuinely don’t think anyone should go into IM with the sole mindset of doing IC because it’s very competitive and you should have a backup plan if you can’t match. Something tells me OP would not love the idea of being a hospitalist.
- Joined
- Jul 15, 2012
- Messages
- 1,279
- Reaction score
- 1,186
It is different but in the community you see and manage a lot of the common stuff - HTN, lipids, CHF, prevention, etc. sometimes even DM. Either way this guy seems like he likes to be a proceduralist and if he doesn’t like the idea of regular GIM or hospitalist (I was fine truly with both if unable to match cardiology) then ortho or a surgical subspecialty is probably a better fit.
- Joined
- Jan 18, 2008
- Messages
- 194
- Reaction score
- 8
I was like OP 2 years ago applying for medicine residency, coming out of the idea of going into something surgical but ended deciding going through the IM-cardiology-probably IC vs heart failure route. In the begining, I hated the idea of general medicne as well but i have gradually learned to appreciate the breath of medicine especially now as a PGY2. I still would prefer and hopefully match cardiology next year but medicine isn't bad at all. i think it's important to emphasize that residency is such a dynamic experience and our ambition, interest and priority all change during that process. i still love cardiology, if anything residency so far further confirmed my interest, but that's just me and i know a lot of people have changed into PCCM or rheum or endo for that matter.
Sorry to dig this up, but could you expand on what about general medicine you began to appreciate? I'm a now-MS4 who has loved heart-lung stuff since forever but became disenchanted with the pace of IM in the clerkship. I've also become very appreciative of the "fixing" aspect of surgery. What made you stick with medicine?
- Joined
- Dec 7, 2017
- Messages
- 8
- Reaction score
- 6
I really really think this will vary based on your situation
If you are a US grad and go to a mid to high tier university program then you can probably run the gamble of doing IM knowing you only want to do cardiology. However, if you are like me (US born IMG) and ended up at a community program you will have to bust your ass to get a cardiology position and it definitely is not a guarantee. Personally you should do what you LOVE, and I really mean that - if you love orthopedics then go ortho. I was in a similar spot where I knew I wanted to do either radiology or cardiology and went for IM and have never regretted it, however, I would probably be in a very different boat had I not matched for fellowship.
Also specifically for interventional - You will want to put yourself at a university fellowship that has an inhouse program (regardless of if you stay there), it would be a shame to go to a community cards program and do six years of training and not be able to get an interventional program if that is what you want
