Medical Resident

Choosing a residency is not easy, and shortly after starting residency you already have another choice to make. First, you have to decide whether subspecialization is for you. If you think you want have subspecialty training, there are several factors to consider.

I will briefly outline the main fellowships in Internal Medicine.

Some specialties are using the NRMP "Match", but most are not. Check the NRMP website.

Cardiology - probably the most competitive subspecialty fellowship. Very fast-paced, intense. Lots of specific areas and different practice options. For example, you may want to do a mostly echocardiography- and office-based practice, or you may want to be an interventionist, doings caths, stents all day. Very evidence-based. Length of training 3-4 years. Uses the Match.

Gastroenterology - also extremely competitive. There are few spots per program. Some programs emphasize procedures more than others. Length of traning 3 years. Does not use the Match.

Hematology-Oncology - getting more competitive over the last few years. Currently would rank about 3 in terms of competitiveness. Most programs are research-intensive. Length of training 3 years for the combined program, some programs allow training in Hematology or Oncology separately, with training time being 1 less year. Does not use the Match.

Critical Care / Pulmonary - moderately competitive. Obviously inpatient-oriented. Length of training 3 years. Uses the Match.

Rheumatology - not competitive. Lots of office-based practice and chronic diseases. Some procedures. Length of training 2-3 years.

Endocrinology - mostly not competitive. Length of training 3 years. Does not use the Match.

Nephrology - mostly not competitive. Length of training 3 years. Does not use the Match.

Infectious Diseases - not competitive. Length of training 3 years. Uses the Match.

Allergic Diseases - becoming more competitive. Excellent lifestyle attracting lots of applicants. Length of training 3 years. Does not use the Match.