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Good afternoon everyone, my name is Josh. I am recent grad/US IMG of the Ross University School of Medicine ('17) and matched into categorical Internal Medicine at Texas Tech University this year. Thank you to all the contributors here for your insightful questions and comments, this has been a very useful discussion board!

Many of my colleagues also entering Internal Medicine residencies this year are dead-set on a fellowship that they want to pursue. Knowing this can obviously be useful to hit the ground running to build the CV (with scholarly work and conference attendance) and find supportive mentors from the beginning of residency, but what about not knowing immediately?

I know there are probably many incoming PGY-1's in my shoes who had academic interests in several subspecialty areas of Internal Medicine in medical school, but are still not entirely sure if they want to pursue fellowship or not. I realize that residency can help us figure this out, but I figured I would still pose the question to the experts to gain some specific insights:

- How soon should we make that decision of pursuing fellowship versus GIM? Some say 6 months in, some say by the end of first year.

Thank you for your time.