Post "Transitional Year" Options

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I have whats maybe an 'interesting' situation and need some advice. I tried to match into a competitive surgical specialty and went unmatched. I backed up my list with a transitional PGY1 spot locally. Does anyone know how the transitional year impacts future reimbursement to programs? Say for instance, I decide that General Surgery is great this year, will a program have problems taking me due to the medicare reimbursement issue? So in anticipation of the question, I chose transitional year, because I liked Emergency Medicine more than GS, but not as much as my Ortho attempt. Now, the last question, does the transitional year ding the ER reimbursement and lessen my chances of matching next year? If I had the option to switch to a PRELIM status instead of Transitional Year, would this be beneficial?? I.E. would a PRELIM surgery designation preserve 5 years of reimbursement and make ER reimbursement a non-issue? OR would the PRELIM surgery designation force a future surgical residency spot to avoid getting no spot in anything? I'm looking for help in untangling this issue. Thanks.

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[MSKrads]

I don't know much about the Transitional Year and its effect on funding, but I do know you can't go wrong with the Prelim-Surgery option.

Same situation here. I tried - unsuccessfully - to match Ortho last year, decided to go Prelim Surg. Note, that the Prelim Surg year will not suffice for a 3-year EM residency, but is okay for a 1+3 EM program.

Bottom line: prelim surg is the safest option from a funding standpoint. but obviously not the easiest of pathways.

 

[IndyXRT]

I'm no expert on the issue, but it was my impression that a transitional year basically did not lock you in to a certain number of years of funding. Unlike prelim medicine and prelim surgery, a transitional year really isn't considered declaring your intended specialty. So, you should be able to do anything you want after a TY.

 

[joshmir]

amcas puts out FAQ PDF on this issue. unfortunately, you may have a problem.

medicare has determined that the numbers of years to train an ED doctor is 3...they don't even pay for the 4th year at 4 year em programs.

any residency you step foot in, mediacre will say "we will pay for the minimum number of years necessary and no more" so if you went into derm or gas, that's fine, medicare will say "the minimum number of years is 3 + 1 intern year" but with medicine, or er an intern year is not required , so you will lose a year of funding. that will make you less marketable. my er chairman (who's big nationally) told me if they *really* want you it won't make a difference. but who wants to have that caveat? it sucks. so you will have problems in er and surgery, unless you go for a 4 year er program. then you are in the same boat as all the other applicants.

i looked into all this before. on the amcas website is a number for a lady yuou can call with questions. (there is a typo for the anesthesia allotment.)

I'm no expert on the issue, but it was my impression that a transitional year basically did not lock you in to a certain number of years of funding. Unlike prelim medicine and prelim surgery, a transitional year really isn't considered declaring your intended specialty. So, you should be able to do anything you want after a TY.