About the ads

  1. This site uses cookies. By continuing to use this site, you are agreeing to our use of cookies. Learn More.

Tox fellowship to ER residency

Discussion in 'Medical Toxicology (MD, DO, PharmD)' started by drmg456, Dec 21, 2005.

  1. This forum made possible through the generous support of SDN members, donors and sponsors. Thank you.
  1. drmg456

    drmg456 Member

    Joined:
    Dec 21, 2005
    Messages:
    31
    Status:
    Attending Physician
    SDN 5+ Year Member

    SDN Members don't see this ad. (About Ads)
    I am a Pediatrician who has been selected for a tox fellowship, my ultimate aim is a EM residency after the Tox fellowship, is it possible
  2. EctopicFetus

    EctopicFetus Keeping it funky enough

    Joined:
    May 3, 2004
    Messages:
    9,884
    Location:
    Arizona
    Status:
    Attending Physician
    SDN 7+ Year Member
    I think this would depend on you having federal funding left for your training. Are you referring to a Peds-Em fellowship or are you referring to doing straight up EM?
  3. southerndoc

    southerndoc life is good Moderator Emeritus Lifetime Donor

    Joined:
    Jun 6, 2002
    Messages:
    11,106
    Location:
    Atlanta
    Status:
    Attending Physician
    Physician SDN 10+ Year Member
    Can you combine the two?

    One of our peds EM attendings combined both tox and peds EM at Boston Children's. I think he was there for 4 years total.
  4. drmg456

    drmg456 Member

    Joined:
    Dec 21, 2005
    Messages:
    31
    Status:
    Attending Physician
    SDN 5+ Year Member
    I want to do straight up EM rather than Peds EM, what is the story about federal funding, I heard that the federal govt will fund only for seven years total of your residency. Is that true
  5. southerndoc

    southerndoc life is good Moderator Emeritus Lifetime Donor

    Joined:
    Jun 6, 2002
    Messages:
    11,106
    Location:
    Atlanta
    Status:
    Attending Physician
    Physician SDN 10+ Year Member
    No, the federal government will only fund your first residency. So if you completed a pediatrics residency, the program will get no federal funds for your emergency medicine residency. The government won't pay for more training than is mandated by their standards (i.e., 4-year EM programs do not get funding for the fourth year).

    Most places will still consider you. The smaller programs or community-based programs might be hesitant to train somebody like you IF (and only if) they are already stretched for funds.

    I know we take people with previous training. I can think of a couple people now who have completed a residency before EM. Two in internal medicine, another in surgery, and one other that switched to EM from surgery (so many of her years will not be funded). We also have two people who switched from IM to EM mid-residency.
  6. EctopicFetus

    EctopicFetus Keeping it funky enough

    Joined:
    May 3, 2004
    Messages:
    9,884
    Location:
    Arizona
    Status:
    Attending Physician
    SDN 7+ Year Member
    There you have it.
  7. drmg456

    drmg456 Member

    Joined:
    Dec 21, 2005
    Messages:
    31
    Status:
    Attending Physician
    SDN 5+ Year Member
    the federal government funding is limited to residency or does it include the training years in fellowship also,

    I KNOW IN cOOKCOUNTY they have lots of EM after they get trained in another specialty, they might be getting the county funding also

    so you mean to say that it's not impossible, but improbable

    thanks for your valuable insights
  8. southerndoc

    southerndoc life is good Moderator Emeritus Lifetime Donor

    Joined:
    Jun 6, 2002
    Messages:
    11,106
    Location:
    Atlanta
    Status:
    Attending Physician
    Physician SDN 10+ Year Member
    Fellowship isn't funded by the federal government, except for a few programs. (Some tox programs are funded by the federal government.)

    It's neither impossible or improbable to do another residency. People do it all the time. It's improbable to do it at a location that doesn't have enough money to support you. Smaller programs may need the government funding for its residents. Larger programs (i.e., academic medical centers, large tertiary care facilities, etc.) can afford to pay the residents without the funds.

    As I mentioned earlier, we have several residents who have completed other residencies, started other residencies and transferred in, etc. that are not funded by the government. They still receive the standard resident salary. I am in a 4-year EM residency, which means that 100% of our residents in their 4th year are not funded.
  9. MM9

    MM9 Member

    Joined:
    Aug 6, 2004
    Messages:
    47
    SDN 7+ Year Member
    It is a HUGE misconception the programs will recieve "No federal funding" for residents past their intial residency.

    Check out: http://www.aamc.org/advocacy/library/gme/gme0001.htm which as some links on this issue including this nice brochure: http://www.aamc.org/advocacy/library/gme/dgmebroc.pdf. Like most PDF files, it will only take about 5 or 6 tries to download. Keep trying though, it is worth it.

    In summary, there are 2 types of funding, Direct and Indirect. These amounts vary based on several factors such as the number of Medicare patients, the average stay of these patients, a "hospital specific amount", the position of the sun, and the temperature in Toledo, Ohio (ok, I made the last 2 up). When you match into a field, you are 'locked' into how many years of full Direct funding the government will give your program. For example, if you match into IM you have 3 years of full Direct funding (they count you 1.0 when they do the math). Once you use up those 3 years, since you are obviously completely useless, you count as half a resident. I'm not kidding, when they do the math you are counted as 0.5.

    This is only true for the Direct funding; for the Indirect funding you count as a whole person for as many years as it takes. Fellowship is spared from this maddness as well.

    The brochure above shows some nice examples of the math. It also mentions that for most hospitals, the Indirect funding "far exceeds" the Direct. It goes on to say, “So as a percentage of the hospital’s total Medicare medical education payment, the financial impact of a resident beyond the initial residency period may be small.”

    If anyone has any other information, or can find fault with the above, please let me/us know.
  10. southerndoc

    southerndoc life is good Moderator Emeritus Lifetime Donor

    Joined:
    Jun 6, 2002
    Messages:
    11,106
    Location:
    Atlanta
    Status:
    Attending Physician
    Physician SDN 10+ Year Member
    I learn something new everyday.

Share This Page


About the ads