Finish residency early?

[Psychobabbling]

I've posted along this topic previously (came off the child track, don't have a PGY4 spot). I applied to some PGY 3 spots while I could, but they didn't seem to really be interested in applicants and more so just putting out feelers.

My PD is aware of my issue and fairly supportive, but has pretty much said "pgy4 spots aren't really a priority for programs, why don't you just go back on the child track or do child elsewhere"

Since I don't want to do child (and don't want to prolong my training), is it at all possible to finish a residency early? For acgme purposes, after this outpatient year, I need to complete 2 rotations in child. Are 10 months of "electives" required, seriously, to graduate? I'd stay here, for free, to finish out 2 months (can't fund my fourth year, expected me to be in child)

Thanks for any tips/info/responses in advance

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[MacDonaldTriad]

You will need 48 months of documented training no matter what rotations have and have not been finished. This is an "and", not an "or". It is very difficult to find programs interested in filling a PGY-IV spot. You might be interested to know that the ABPN doesn't care what PGY year you call yourself. All that matters are the completed requirements.

 

[2014legacy]

@Psychobabbling you have started a very interesting post here. So what are requirements by ABPN to be eligible for boards and finally become a psychiatrist. I have been looking at curriculums of different psychiatry programs and they differ quite a bit and ultimately each one of those residents ( from different programs ) take boards to be in the field. So basically from my observation , fourth year is very flexible in most of the residency program and is tailored individually ( my understanding) , III year mostly out patient psychiatry, II year: Addiction ( 2 months), inpatient ( 4-6 months) , CL ( 2-4 months), Emergency Psychiatry ( 2-3 months) and approximately half to one day of outpatient experience in a week . What I find interesting and very much want to know what is a requirement for I year ( as there is a great variation I year curriculum in different programs) but in general, Internal Med ( 2-4 month), Family Med/Pediatrics/ ER ( 1-2 months), Neurology ( 2 months) and Inpatient psychiatry ( 3-6 months). So I feel that it is the first and second year curriculum which is important as far how many credits a psych resident need for IM, Neurology, Emergency Psych, CL, Inpatient Psy, Addiction and any other thing I missed , I think I have not included Child and Adolescent experience. We would like to know what exactly is the standard requirement to be eligible for boards.

 

[OldPsychDoc]

The ABPN requires that you fulfill the ACGME requirements:

What Are the Board's Requirements for Certification in Psychiatry, Neurology, or Neurology with Special Qualification in Child Neurology?To be Board-certified in psychiatry, neurology or neurology with special qualification in child neurology, a candidate must:

1. Be a graduate of an accredited medical school in the United States or Canada or of an international medical school listed by the World Health Organization.
2. Hold an unrestricted license to practice medicine in at least one state, commonwealth, territory, or possession of the United States or province of Canada. If licenses are held in more than one jurisdiction, all licenses held by the physician must meet this requirement. For more information on license restrictions, see the appropriate Information for Applicants publication that can be downloaded from the ABPN web site, www.abpn.com.
3. Have satisfactorily completed specialized training requirements in psychiatry, neurology or child neurology in programs that are accredited by the Accreditation Council for Graduate Medical Education (ACGME) or certified by the Royal College of Physicians and Surgeons of Canada. This training must adhere to all Board requirements.
4. Submit a completed official application form including all required attachments and the appropriate application and examination fees by the specified deadlines. Only applications submitted on the current application form are accepted. Faxed copies of applications are not accepted.
5. Pass the appropriate specialty certification examination(s).

Does Certification Expire?
As of October 1, 1994, all individuals achieving Board certification by the ABPN are issued ten-year, time-limited certificates. Certificates issued in the subspecialties of addiction psychiatry, clinical neurophysiology, epilepsy, forensic psychiatry, geriatric psychiatry, hospice and palliative medicine, neurodevelopmental disabilities, neuromuscular medicine, pain medicine, psychosomatic medicine, sleep medicine, and vascular neurology, including those issued prior to October 1, 1994, are ten-year, time-limited certificates. Ten-year, time-limited certificates for child and adolescent psychiatry began in 1995. All ABPN time-limited certificates, regardless of their exact dates of issuance, are considered to expire ten years later on December 31.
What Are the ABPN's Rules Regarding Transferring Between Programs?
To ensure continuity of training, the Board requires that two of the three years of residency training, excluding the PGY-1, be spent in a single program. The 36 months of full-time specialized residency training must be completed in no more than two blocks. If completed in two blocks, the blocks must not be more than ten years apart. In addition, credit is not given for less than one-year blocks of training (including the PGY-1). The ABPN Credentials Committee considers exceptions to these rules only under extraordinary circumstances. In such cases, respective program directors should contact the Board office, in writing, prior to the transfer. The letters must outline the resident’s training content, duties, and responsibilities, including exact dates (from month/day/year to month/day/year) of training, and indicate clearly that the resident will satisfy all ACGME program requirements. Each case is considered on an individual basis.

The ACGME requires that you complete 48 months of training, and specifies how many months of what counts for that.
http://acgme.org/acgmeweb/Portals/0/PFAssets/ProgramRequirements/400_psychiatry_07012014.pdf

IV.A.6. Curriculum Organization and Resident Experiences
IV.A.6.a) Residency education in psychiatry requires 48 months, of which 12 months may be completed in an ACGME-accredited child and adolescent psychiatry program. Although residency is best completed on a full-time basis; part-time training at no less than half time is permissible to accommodate residents with personal commitments (e.g., child care) and the equivalent experience of 48 months is met.

 

[2014legacy]

Thanks OldPsych doc and splik for valuable information. I have a question that I would like to know:
As per ABPN requirement that credits of any postgraduate year will not be considered unless they are offered in a block of one year: ( to ensure continuity of training, the Board requires that two of the three years of residency training, excluding the PGy-1, be spent in a single program. in addition, credit will not be given for less than one-year blocks of training, including the PGy-1)- these are exact words from the ABPN website for transferring residents. If the transferring resident has 10 credits instead of 12 in a block of one year, so that person would not get any credits counted for that year ??? Will that resident repeat that PG year and get the 12 credits in lieu of completion of previous postgraduate year in the next program ??? ( if the resident gets a spot in the other position and gets 2 more credit for the previous postgraduate year, will that work ??? )

 

[psychattending]

Thanks OldPsych doc and splik for valuable information. I have a question that I would like to know:
As per ABPN requirement that credits of any postgraduate year will not be considered unless they are offered in a block of one year: ( to ensure continuity of training, the Board requires that two of the three years of residency training, excluding the PGy-1, be spent in a single program. in addition, credit will not be given for less than one-year blocks of training, including the PGy-1)- these are exact words from the ABPN website for transferring residents. If the transferring resident has 10 credits instead of 12 in a block of one year, so that person would not get any credits counted for that year ??? Will that resident repeat that PG year and get the 12 credits in lieu of completion of previous postgraduate year in the next program ??? ( if the resident gets a spot in the other position and gets 2 more credit for the previous postgraduate year, will that work ??? )

In theory all the months for the specific year have to be in same program in order to count. However, on rare occasions when the two programs present a coherent training program for the 12 month period the Board might approve a split year, but you need to get the approval up front. If you do not get it approved then you will have to do an entire new year at some program in order to complete training.

Residents are allowed to do up to 6 months of away electives and still count that time in their home program; so you could check to see if your program would allow you to do 2 months of elective at the other place.

 

[2014legacy]

Thanks psychattending

 

[2014legacy]

Can anybody with less than 12 months of experience wants to start a fresh as PGY I psychiatry do the ACGME allow it. If yes, then do they do all the rotations or just those for which they lack the credit. Seniors please advise!

 

[Shikima]

No. You've done the crime, now do the time.....

 

[2014legacy]

@ Shikima, thanks for your great note. I think Shikima, this forum is there to guide people in best possible way in a respectful manner. It is really sad that people can pass personal ruthless comments. Anyways it is big remark without knowing if person is talking in general or has personally gone through it, but no problems. In psychiatry we see lot of patients who do not turn out to be the way we want them to behave.

But anyways with all due respect , Shikima, what was NO for ??? please let me know, because your answer does not explain anything about your answer.

But anybody out here who has some other answer for the questions being asked? Thanks in advance.

 

[MacDonaldTriad]

Can anybody with less than 12 months of experience wants to start a fresh as PGY I psychiatry do the ACGME allow it. If yes, then do they do all the rotations or just those for which they lack the credit. Seniors please advise!

I have read this a couple of times and I'm still not clear on the question.

Previous training can fill in for requirements if three parties agree that they do: your program, the ACGME, and the ABPN. If you are going to be a PGY-I, don't make too many demands, the programs have a sea of applicants without needing to make accommodations. Having said that, the ABPN doesn't care what you call yourself, PGY-I, PGY-II, they just look at the training and bless it as complete or not.

 

[Shikima]

@ Shikima, thanks for your great note. I think Shikima, this forum is there to guide people in best possible way in a respectful manner. It is really sad that people can pass personal ruthless comments. Anyways it is big remark without knowing if person is talking in general or has personally gone through it, but no problems. In psychiatry we see lot of patients who do not turn out to be the way we want them to behave.

But anyways with all due respect , Shikima, what was NO for ??? please let me know, because your answer does not explain anything about your answer.

But anybody out here who has some other answer for the questions being asked? Thanks in advance.

My experience is that it's an all or none.... Either you get credit for the entire year or not.

P.S. Don't be so sensitive on a public forum.

 

[2014legacy]

@MacDonaldTriad and Shikima thanks for insightful answers.

@MacDonaldTriad what I can gathered from your answer is that in this particular situation finding PGY I year is difficult but PGY II is a possibility as long as PD, ACGME and ABPN agree .
(Having said that, the ABPN doesn't care what you call yourself, PGY-I, PGY-II, they just look at the training and bless it as complete or not)- This in parentheses means that as long as you have the all the required credits as per their guidelines, they are fine. Which makes sense, as different programs have different curriculum. But what is that they exactly consider to be trained a 48 months period or getting certain credits ( as per their requirement)?

@Shikima in your experience 10 months credit is not considered no-go and need to repeat the whole year again. So in that case even repeating the PGY I is only way to go.

 

[2014legacy]

@ Shikima I mean 10 month credit is considered no-go ( correction).

 

[MacDonaldTriad]

From the ACGME psychiatry requirements:
III.C.4.
If previous ACGME-accredited training was not in a psychiatry program, residents may receive up to but no more than 12 months credit for prior training as part of the expected 48 months of the educational program.

This infers that a partial year can be accepted. Not all rotations of non-psychiatry training count towards the psychiatry medicine requirements. There is also somewhere that requires at least two years of your training be from the place that graduates you, or something like that. I couldn’t find it. I do know that the 12 months of outpatient must be continuous and therefore not from two different places.

Your new program can work around not making you repeat things that your last director reports as completed, or they may just say you are a PGY-I like everyone else so take it or leave it. They may be able to take the next person on their list quite easily. I think it is fair to ask if they would entertain giving you “credit”, as this might shape your decision.

 

[Shikima]

@ Shikima I mean 10 month credit is considered no-go ( correction).

Right... that's the ugly reality.
You can get some credit for rotation and not having to repeat them, but the kicker is you're looking for a PGY-I spot to start fresh.

 

[Redkawolf]

some PGY 3 spots while I could, but they didn't seem to really be interested in applicants and more so just putting out feelers.

My PD is aware of my issue and fairly supportive, but has pretty much said "pgy4 spots aren't really a priority for programs, why don't you just go back on the child track or do child elsewhere"

ent has 10 credits instea

From the ACGME psychiatry requirements:
III.C.4.
If previous ACGME-accredited training was not in a psychiatry program, residents may receive up to but no more than 12 months credit for prior training as part of the expected 48 months of the educational program.

This infers that a partial year can be accepted. Not all rotations of non-psychiatry training count towards the psychiatry medicine requirements. There is also somewhere that requires at least two years of your training be from the place that graduates you, or something like that. I couldn’t find it. I do know that the 12 months of outpatient must be continuous and therefore not from two different places.

Your new program can work around not making you repeat things that your last director reports as completed, or they may just say you are a PGY-I like everyone else so take it or leave it. They may be able to take the next person on their list quite easily. I think it is fair to ask if they would entertain giving you “credit”, as this might shape your decision.

I know this is an old thread, but consider this: I did a TY year that counted towards my requirements and did more psych PGY"1" psych year. I am now a PGY"2" but in third year of residency. Could I graduate after third year? From what I have researched, I have completed all APBN and ACGME requirements. I'd be into doing a neuropsychiatry fellowship instead of a 5th year of PGY-4 psych inpatient rotations and electives limited at my community program.

 

[MacDonaldTriad]

I'm sorry, but you are grasping at straws and you already signed up for this deal. You can ask, but I'm not sure anyone will be motivated to say yes to what you want.