Medicare funding issue

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corona 247

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Hello, I posted this in the ortho program, but wanted to post here to get a broader answer to my question to other specialties besides ortho.

A classmate of mine did not match DO ortho this year. He contacted a program to inquire about open Transitional intern spots and was told although they did have them, he would not be considered for an ortho spot because of Medicare funding issues, as the ortho program would not have enough funding for his 5th year of ortho residency since he had spent a year as an transitional intern.

It was my understanding that the traditional year would not "set the clock" of Medicare funding, and so one could again reapply and enter a residency without funding issues (vs taking say an EM residency and then trying to switch to ortho, and having funding issues)

Can anyone clarify for me?

Thanks!

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That's the way it's been explained to me and as I understood it - the clock isn't set until you match at something besides a one-year internship.
 
i think the clock is set if you do a ty/prelim year and it is not required for your specialty. for example, i thought about doing peds after completing an internal med prelim year. programs would not have funding for my final year b/c i would have already been set for a 3 year residency in internal med (and would need to do 4 years to complete peds since prelim med wouldn't count).

on the other hand, if ty/prelim year is required for a specialty (e.g. rads, optho, etc...) then you still have full funding if you want to switch specialties into one of those after completing a ty/prelim.

it is kinda screwy, but that's how i understand it. whether or not the funding thing is a problem depends on the particular program and whether or not they have their own funding for you.
 
i think the clock is set if you do a ty/prelim year and it is not required for your specialty. for example, i thought about doing peds after completing an internal med prelim year. programs would not have funding for my final year b/c i would have already been set for a 3 year residency in internal med (and would need to do 4 years to complete peds since prelim med wouldn't count).

Peds is 3 years.
 
yes, peds is 3 years, but i would have already received one year of funding so only 2 years of peds would be covered. at least that is my understanding and i looked into this pretty thoroughly at the time. on a side note, i did not encounter one program that seemed to care since peds is not that competitive.
 
Question for anyone who knows. Is a resident considered to have burned a full year of funding if he/she didn't finish the entire year? For example, what if a resident stayed at a program for 3 months, 6 months, or 9 months before leaving for another specialty instead of the entire year? Are all those equivalent to using a full year of Medicare funding? Thanks!
 
Hello, I posted this in the ortho program, but wanted to post here to get a broader answer to my question to other specialties besides ortho.

A classmate of mine did not match DO ortho this year. He contacted a program to inquire about open Transitional intern spots and was told although they did have them, he would not be considered for an ortho spot because of Medicare funding issues, as the ortho program would not have enough funding for his 5th year of ortho residency since he had spent a year as an transitional intern.

It was my understanding that the traditional year would not "set the clock" of Medicare funding, and so one could again reapply and enter a residency without funding issues (vs taking say an EM residency and then trying to switch to ortho, and having funding issues)

Can anyone clarify for me?

Thanks!

Here's how it works:

1. Each year of funding "counts". If you do two prelim IM years tandem, that counts as using 2 years of funding.

2. Your total available funding is "set" when you start a "terminal residency" -- i.e. one that results in board certification. All prior years count towards this maximum.

Therefore, in your example, you do a TRI -- this uses one year of funding, but does not set the clock. You then start ortho. This sets your clock at 5 years. However, you have already used one year, so you have 4 years left (and are one year short).

Once the "clock expires" funding does not go to zero -- programs get 50% of DME and 100% of IME. All fellowships are funded "post clock".

Question for anyone who knows. Is a resident considered to have burned a full year of funding if he/she didn't finish the entire year? For example, what if a resident stayed at a program for 3 months, 6 months, or 9 months before leaving for another specialty instead of the entire year? Are all those equivalent to using a full year of Medicare funding? Thanks!

I have no idea. Good question.
 
What happens to funding in this following scenario?:

1. Obtain a Prelim Medicine position but you (unfortunately) don't match into a specialty (categorical)
2. Complete the prelim year and apply in ERAS in 2010 for a categorical, say radiation oncology.
3. During 2011-2012, you do research for a year.

Will this affect the funding situation? Would the research year wind up being more valuable to a residency instead of doing another prelim year somewhere?

I guess the crux of the question is this: is it better to do research post-graduation or post-prelim year?
 
What happens to funding in this following scenario?:

1. Obtain a Prelim Medicine position but you (unfortunately) don't match into a specialty (categorical)
2. Complete the prelim year and apply in ERAS in 2010 for a categorical, say radiation oncology.
3. During 2011-2012, you do research for a year.

Will this affect the funding situation? Would the research year wind up being more valuable to a residency instead of doing another prelim year somewhere?

I guess the crux of the question is this: is it better to do research post-graduation or post-prelim year?

From a DME funding standpoint, doesn’t matter when you do a research year. Research years don’t count toward the funding clock. The rest of your post is a tad confusing since rad onc programs are usually advanced programs, starting in the PGY-2 year.


In your scenario, following an initial prelim (PGY-1) year:

If you match into an advanced year (PGY-2) program – regardless of specialty - following a prelim year (PGY-1): no funding issues.

If you match into a categorical (PGY-1) program, or another prelim/TY (PGY-1) following your initial prelim year (PGY-1): funding issues.
 
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