r/InternalMedicine

Where is the best place/ country to do Endocrine fellowship as a Post graduate IM resident- ACGME accredited outside of US.

For those who started, how much did you realistically need to get started and how many employees did you have initially.. Also, what EMR do you recommend for a small practice? Is it worth getting one from the start or maybe manage it in manual system initially?

Appreciate your time. Thanks

Hello all. M4 looking to apply IM this cycle. Wanted to gain some insight as far as careers in oncology goes or if anyone had insight. Originally came into medical school planning to pursue oncology, and am really excited about it. If at a big enough practice, would love to find a niche in breast cancers. Would love to hear any career advice from residents pursuing this fellowship, fellows, and any heme oncs. If you had to do it again, would you? Are you satisfied with your career? Is the work overwhelming? Do you feel fairly compensated?
The only hesitation I have is admin work (charting, peer to peers/insurance denials, disability paperwork) — really did not enjoy this aspect of the clinic but no specialty is perfect. Welcoming all advice and insights for a med student applying to residency soon! TIA!! :)

After almost 15 years working as a hospitalist, I am transitioning into the world of primary care. I am doing the longitudinal knowledge assessments (LKA) with ABIM which is great for keeping up with some of the topics of outpatient medicine, but I'd love to know if there are any books or important resources that I can start looking through before starting in Primary Care in December (have a few more months as a hospitalist). I am excited but very anxious and want to brush up on vaccination recommendations, cancer screenings, etc.

Im a M20 college student, This condition found me 4 years ago When I was 16 years old, I felt like there was urine stuck in my urethra near frenulum at that time. I have never had a girlfriend or any sexual intercourse before. I'm hoping to get some advice or hear from others who might have experienced something similar.

Symptoms:

• I've noticed that the "stuck pee feeling in the tip of the penis" (weak urine stream) is often there. Just a minute or so after coming from the toilet, especially after pooping.

• I have had issues with the need to go to the toilet very often (Usually within the 40-60minute mark after taking a pee)

• I pee normally without any issues, but towards the end, I get this sensation that some urine is still stuck.

• After finishing, if I stand and apply a bit of pressure, a few drops and sometimes even a small stream of urine come out.

• The feeling is generally always there but varies in intensity. It takes up a lot of my focus, making it difficult to concentrate on anything or enjoy stuff and relax. It's ruining many aspects of my daily and social life

• The feeling has also developed a bit over this long time, but the "stuck pee feeling in the tip of the penis" has always been there.

I have no pain at all.

What I've tried:

• Cystoscopy: Showed nothing

• Prostate size: Normal

• Ct scan report & ultrasound: No findings

• Different medications: No effect

The doctor told me to seek psychiatrist and that it's just a mental issue, but I'm not entirely convinced. Please tell me EXACTLY what you did. Types and number and length of stretches, medications and usage and dosage or any advice or similar experiences would be greatly appreciated.

I feel like UTD has a little bit more nuances but sometimes I have to read like 3-4 articles to learn a disease from UTD that I’m not familiar with.

Is amboss considered a good resource for learning as a resident?

Or should I just read utd as much as I can?

This analysis highlights just how dependent U.S. internal medicine is on physicians born outside the country.

Nearly **half of the U.S. internal medicine workforce is non–U.S.-born**.

Some numbers that stood out:

* Non–U.S.-born IMGs make up **36.1%** of U.S. internists.
* **India alone contributes 10.8% of the entire internal medicine workforce**, the largest share from any foreign country.
* Non–U.S.-born IMGs constitute **more than half of geriatricians, nephrologists, and sleep medicine physicians**.
* In 2024, non–U.S.-born physicians cared for **22.5 million traditional Medicare beneficiaries**.
* Their patients were disproportionately **low-income, disabled, Black, Latino, and Medicare-Medicaid dual eligible**.
* They were also more likely to care for people living in **high-poverty, medically underserved, and physician-shortage areas**.

So this isn't simply a story about immigrant doctors filling vacancies.

**They are a fundamental part of the U.S. healthcare infrastructure—particularly for patients and communities that already struggle to access care.**

And India's contribution is remarkable: roughly **1 in every 9 U.S. internal medicine physicians is a non–U.S.-born IMG from India**.

Hey everyone! I’ll be taking the Internal Medicine ITE soon and wanted to get some advice from people who’ve taken it before.

I’ve only got about a week to seriously prepare, so I’m trying to figure out how to use my time as effectively as possible rather than trying to cover absolutely everything.

For those who’ve taken it:

• What topics would you focus on the most?
• What resources or question banks helped you the most?
• Is doing mostly practice questions the best approach with only a week left?
• How difficult did you find the actual exam compared with MKSAP/UWorld?
• Any particular topics or types of questions you wish you had prepared better for?
• Any exam-day/time-management tips?

Not expecting to master internal medicine in a week haha, just hoping to make the most of the time I have.

Would really appreciate any advice or experiences. Thanks!

I’m an IM intern. I’m very weak at interpreting ECGs and imaging, especially CT scans. What are the best methods or resources to learn them from the beginning and become proficient?

intern struggling with assessment and plan

IM residency programs that interview 239 step 2ck?
Want to match at an academic or university affiliated program.

Pls let me know if there are programs that I should definitely be considering based on my score.

Thanks!

I have been working at an outpatient facility for about a year. I currently see approximately 26–28 patients per day, especially when most of the visits are follow-ups, and I work five days a week.

I receive very limited support with inbox management, forms, and other administrative responsibilities. The MA will sometimes help when I specifically ask, but if I ask them to take on tasks beyond what they normally do, they are often reluctant.

There are also significant limitations with the clinic’s resources. We do not have a consistently functioning EKG machine—it works intermittently. Despite repeatedly requesting them, we still do not have basic point-of-care testing such as strep, influenza, or COVID testing in the office. Many of my requests for resources or workflow improvements have been rejected.

Another major issue is scheduling. Post-ER follow-up visits are supposed to be scheduled for 30 minutes, but they are frequently changed to 15-minute appointments without my permission. When I ask why the appointment was shortened, I am told that the patient did not inform the scheduling staff that they were coming for a post-ER follow-up visit.

The referral process is also very slow, and there are frequent mistakes with referrals, which creates additional work and frustration for both me and the patients.

A significant number of my patients also have requests related to controlled substances or disability documentation. When I do not agree with their requests, some patients repeatedly argue with me or contact administration to complain.

This is my first job after residency, so I am not sure how much of this is normal for outpatient primary care versus being specific to this particular practice. I have been feeling increasingly frustrated and overwhelmed by the workload, lack of support, inadequate resources, and administrative issues.

I am seriously considering leaving this position and potentially switching to hospital medicine. I would appreciate some perspective on whether these issues are typical of outpatient practice or whether this may simply be a poorly structured practice environment.

Hi everyone! I’m a non-US IMG applying for the upcoming Match cycle.
Profile:
Step 1: Pass
Step 2 CK: 255+
ECFMG Certified
YOG: 2026
I’m trying to build my program list and would really appreciate suggestions for programs that would be a realistic fit for my profile.
Which programs would you recommend I research/apply to? I’d love to hear about them.

Edit No USCE , publications still under review

Any good guide for keeping up my basic and core medicine knowledge fresh which book i should read side by side? Davidson/ Kumar and Clark`s, Harrison internal medicine or any other suggestion?
as i have done with mrcp 1&2 now will be aiming for training in cardiology....
#MRCP #NHS #IMT #Medicine

Hi! I’m a US DO with a step score of 248. Would I be able to apply for academic IM programs with this score? I would like to go into Cardio/GI. Hoping to apply to Florida and New York programs. Would this score impact fellowship applications? Thank you in advance for your time!

UWorld 1st pass: 57%, 18th percentile
Last ITE was < 30th percentile
Seems like chances of passing are low and with my exam one week out Im not sure what else to do.

I am an 2nd year DO student, and I am really interested in cardiology, and so I want to match at an academic center to best improve my chances of matching into a cardiology fellowship. Does anyone have any advice or ideas on where to start?

Thank you!

An intern working nightfloat and need advice on efficiency and surviving the night

I am a UK trained physician with dual CCT in Acute Internal Medicine (AIM) and General Internal Medicine planning a move to BC. I have been practising since 2012.

My current role as an Acute Physician involves working on the Acute Medical Unit, a 60+ bed medical admissions unit which admits internal medicine patients for the entire medical bed base, bar strokes. Acute internal medicine also runs the Same Day Emergency Care unit for complex internal medicine outpatient care. I would be very grateful for advice from general internists and hospitalists working in Canada.

I had a useful meeting with Health Match BC recently to discuss the recruitment process. Their opinion is that I am most suited to hospitalist roles.

Having reviewed the Canadian General Internal Medicine Competencies framework, my main limitation relates to ICU level care. My AIM training involved 6 months of ICU but I am not advanced airway trained. In the UK, ICU care is run by intensivists for the main part. I routinely manage patients on NIV, I am thoracic ultrasound trained; abdominal paracentesis, LPs and chest drains are routine on my unit but it has been several years since I inserted central lines.

I completed a one year Perioperative Medicine fellowship prior to CCT which also appears to be a significant part of the general internists role.

My main question is whether my lack of ICU level skills would preclude me from applying for general internists roles in BC? I am looking at jobs around the Vancouver area but we are flexible where we move to.

I would also be grateful for information regarding work life balance (my work is shift based with late evenings and non resident overnight on calls) and difference in pay between the two specialties.

Many thanks in advance.

I recently took Amboss Self Assessment 1. Does anyone know how performance on this compares to doing on the real ABIM?