Do you call it medical informatics, biomedical informatics, or health informatics? What did you medical school call it? Maybe your medical school didn't even cover the topic of medical informatics. That seems to be the story for many medical school graduates (otherwise known as physicians). The topic of medical informatics isn't even available as an elective. As a result, students graduate from medical school and they may know that computers are important for the future of health care, but they don't really know much about the specifics of health informatics.
How many people finish residency to pursue a fellowship in biomedical informatics? I'd say it's only a small percentage at this point. What about others? Do they sign up for a graduate degree in health informatics? Maybe they should take formal courses or attend major national conferences. There are many ways to get involved with informatics, but you need to have a strong interest in technology and you have to be motivated to teach yourself if you're not going to invest time and energy into formal training.
There are many exciting opportunities in the world of medical informatics. To find them, you need to be connected to the right individuals so that they can open up opportunities for you. I know that there are many startup companies that are looking for medical consultants to help them as they develop specific services and products that revolve around health information technology (health IT).