Radiology residency contract not renewed after PGY-4. What now?

[RadDoc001]

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i was a radiology resident who was let go of my program at the end of my PGY-4 (R3) year. my PD has given me the certification letter mentioning I successfully completed my PGY-4 year ( crediting me with 36 months of training) I have certificate of completion of my prelim internal medicine year as well. My question is: what my options are?

1. can i obtain a license and try to see if i can get a job in an urgent care/occupational medicine?
2. How about applying for non-clinical roles in the biopharma like pharmacovigilance/patient safety or MSL roles?
3. what are my chances of getting back to radiology and somehow graduate from residency?
4. or my only option is to go get a job at UPS or somewhere like that?

i was put on multiple remediation plans during my residency and was finally non-renewed.

 

[comp1]

Omph, this sucks hard and the specific situation is extremely uncommon. I guess you could get a license. I mean don't you already have a license as a PGY4? You have more than 3 years of postgraduate training. I don't know about urgent care. I don't think you're qualified? I can't imagine a malpractice carrier insuring you. Same with occupational medicine. I mean that's an actual specialty. Did anyone moonlight at your residency outside the main program? (I know not you since you were on remediation.) If they did, maybe you could do one of those jobs...forever. Maybe a clinical role in research, but those are weird jobs that often involve internal networking connections more than combing the web for postings. It's very hard to figure out if you could rematch. It's always unlikely, but it's hard to say it's impossible without more details. Like...why did you need remediation? You just didn't know stuff? Interpersonal arguments? Didn't show up? In terms of non-clinical jobs, maybe teaching at a community college. You have the doctoral degree and vaguely relevant experience.

 

[RadDoc001]

Omph, this sucks hard and the specific situation is extremely uncommon. I guess you could get a license. I mean don't you already have a license as a PGY4? You have more than 3 years of postgraduate training. I don't know about urgent care. I don't think you're qualified? I can't imagine a malpractice carrier insuring you. Same with occupational medicine. I mean that's an actual specialty. Did anyone moonlight at your residency outside the main program? (I know not you since you were on remediation.) If they did, maybe you could do one of those jobs...forever. Maybe a clinical role in research, but those are weird jobs that often involve internal networking connections more than combing the web for postings. It's very hard to figure out if you could rematch. It's always unlikely, but it's hard to say it's impossible without more details. Like...why did you need remediation? You just didn't know stuff? Interpersonal arguments? Didn't show up? In terms of non-clinical jobs, maybe teaching at a community college. You have the doctoral degree and vaguely relevant experience.

i did not know alot of stuff. and had performance issues tho my program was always putting me on rotations without holding back. so, then that full unrestricted license I possess is good for nothing i guess

 

[NotAProgDirector]

There's no easy path forward. You definitely can get a medical license, essentially in any state, with three PGY years completed. But what to do with it is complicated.

Options:

• Continue residency training
  • Radiology - this is highly unlikely. Your past program terminated you because you were unable to progress. Sounds like they gave you multiple remediation attempts. To get another rads spot, you'd need to convince a program that somehow you've fixed this issue (whatever it was) and will do well now. You mentioned that you "did not know stuff". Why was that? Were you studying / trying to improve? Or depressed and unable to learn? Or other life problems got in the way? The answer might help us mentor you, although getting another rads spot regardless of the answer seems a big uphill climb.
  • Some other field - is possible. You'd apply and spin your story that you were not a good fit for rads, but you'll do better in some other field. Again, depends upon how you got into trouble in rads as to how this will play out. All competitive fields will be out. You might be able to get a spot in IM/FM, or Occ Med, or pathology. It's too late to apply now. You'd spend this year getting some clinical experience in the field you're interested in, generate an LOR, and plan to apply next year.
• Work clinically with your current training in a standard clinical job
  • You should be able to get a license. But job opportunities will be very hard to come by. A prelim PGY-1 years ago with no / minimal IM experience since will make urgent care a hard sell - do you really know enough to work in an urgent care? It's often said that prisons and the Indian Health Service will hire almost anyone, so they may be options.
• Think creatively, consider a non-standard clinical position or a non-clinical position. There's no defined pathway, you need to hunt and find something. Options that others have done:
  • "Consulting" or "Research" or "Teaching" - honestly these are very unlikely. Big consulting firms are looking for pedigree, so unless you're coming from a top school it's unlikely. Research is only an option if you already have experience there. Almost no one pays for teaching any more.
  • Non standard clinical work - there's a poster here who did not complete a residency, and then learned how to manage chronic wound therapy. They set up a business to supply such to their local nursing homes, and turned that into a successful business. Lots of online sites are offering compounded meds (GLP-1's etc) and need physicians to prescribe them. Etc.
  • Non-clinical work: There's another poster here who ended up working for their state's insurance program doing prior auth / case review / fraud investigations. Doesn't pay as well as being a clinician, but it's 9-5 with no weekends or call and all holidays off. How much of this work will soon be owned by AI is unclear.
• Something else entirely - ignore your medical degree, and pursue something else.

None of those pathways are easy. Much depends upon how you got yourself into this hole in the first place.