government funding issue,is it true? Thanks.

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edwardamytan

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If you begin a three year residency regardless of the specialty, you are only allowed funding for 3 years total. If you have completed 2 years of a 3 year residency, you would only be eligible for 1 more year of government funding. Is it true? Thanks for advice.
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Yes it is true.

As has been discussed in multiple threads:

Each year of funding "counts". If you do two prelim IM years back to back, that counts as using 2 years of funding but not frm the "clock".

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. Thus if you do 2 years of a 3 year residency, you have used up 2 years of your 3 years of full funding.

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".
 
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I just wrote a detailed reply but the wonders of cyberspace and my loaned (stolen) wi-fi internet connection are such that it didnt make it through. (joking of course, but not on the wi-fi hehe)

Seriously though - our gr8 friend WS is spot on. And you are too. I'll add that you can do as many fellowships as you like - there's no limit to the 50% medicare pay plan.

PM me your 'real' email and I'll send you the exact Medicare documents that outlines this whole process....
 
turquoiseblue said:
i heard that prelim years don't count toward funding...and i found this post that also according to aPD it does not count.
http://forums.studentdoctor.net/showthread.php?t=575357
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That's not what I said (that they don't count at all).

They don't count toward the "clock" or the limit.

I meant that they count overall (this is applicable to someone who starts a terminal residency, is given a "clock" of X years and then drops out, and does a prelim year. That prelim year is going to count against the funding clock because that clock was already set. Prelim years don't count in terms of using up funding except in that situation.)

My quote in the earlier post is *also* from aPD.
 
Winged Scapula said:
That's not what I said (that they don't count at all).

They don't count toward the "clock" or the limit.

I meant that they count overall (this is applicable to someone who starts a terminal residency, is given a "clock" of X years and then drops out, and does a prelim year. That prelim year is going to count against the funding clock because that clock was already set. Prelim years don't count in terms of using up funding except in that situation.)

My quote in the earlier post is *also* from aPD.
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i see...so nondesignated pgy1 (or pgy2) prelim years don't count toward the clock unless they become attached to another pgy2 terminal residency.
 
turquoiseblue said:
i see...so nondesignated pgy1 (or pgy2) prelim years don't count toward the clock unless they become attached to another pgy2 terminal residency.
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If you do 6 surgery prelim years and then, out of pity, somebody stupidly gives you a categorical spot, you will have used up all of your "fully funded" time because you've already done 6 years of surgery which is only a 5-year (funded) residency.
 
gutonc said:
If you do 6 surgery prelim years and then, out of pity, somebody stupidly gives you a categorical spot, you will have used up all of your "fully funded" time because you've already done 6 years of surgery which is only a 5-year (funded) residency.
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I don't believe that to be true. aPD has commented several times that Prelim years do not count toward the funding clock since the clock isn't set until you start a terminal (categorical) residency.

(and there is also the issue that ABS does not allow more than 3 Prelim years, but I know your example wasn't really serious)
 
I have talked to my GME office multiple times about this. And the honest truth is, they don't really know and it always gets confusing. But, as far as I can tell, what's posted above is not correct. I think the post that turqoiseblue is accurate, but his (and WS's) interpretation of what I said is not correct.

Here we go:

1. Every year that you do of training "counts" towards your maximum funding, regardless of prelim / chaging fields / etc. Hence each year you train counts as a year of training.

2. If you start with a categorical program, then your clock is "set" to expire when you use the minimum number of years required to train in that field. This sets the maximum number of years you can get funded.

3. If you start with a prelim / TY year, then your clock is not set. That happens when you start some other, "terminal" program that will result in board certification. However, when that happens all of your prior prelim training "counts" against that clock.

4. If you match into a field but never start it, then nothing happens. You actually have to train in that field to have your clock set.

So, examples:

1. A student matches into and starts a Categorical IM program. Therefore, his clock is set at 3 years. He completes three years of training and decides to continue in an Endocrine fellowship. That fellowship will be funded at 50%. DME.

2. A student does a prelim medicine year (1 year), followed by a radiology residency (4 years). During the first year, one year of funding is used but the clock is not set. During the second year, clock is set at 5 years (since that's how long it takes to train in rads including the manditory prelim year).

3. Same student in #2 decides to resign her rads spot prior to starting, had a change of heart and wants to go into IM. Crazy, I know. She starts as a PGY-2 in IM. Clock gets set to 3 years when she starts the IM residency, and the prelim year counts as 1 year against that maximum. Matching into rads does not set the clock.

4. Same student in #2 decides to resign her rads spot after 1 year of rads training. Switches to IM, again as a PGY-2. This time, the clock was set to 5 years once the rads training begins. 1 year used as prelim, 1 as rads. She can finish her IM residency in another 2 years, and then has one full funded year left if she decides to do a fellowship.

How CMS keeps any of this straight is beyond me.

And, just to make things even crazier, Medicare uses the Oct 1 - Sept 30 accounting cycle.
 
aProgDirector said:
I have talked to my GME office multiple times about this. And the honest truth is, they don't really know and it always gets confusing. But, as far as I can tell, what's posted above is not correct. I think the post that turqoiseblue is accurate, but his (and WS's) interpretation of what I said is not correct.

Here we go:

1. Every year that you do of training "counts" towards your maximum funding, regardless of prelim / chaging fields / etc. Hence each year you train counts as a year of training.

2. If you start with a categorical program, then your clock is "set" to expire when you use the minimum number of years required to train in that field. This sets the maximum number of years you can get funded.

3. If you start with a prelim / TY year, then your clock is not set. That happens when you start some other, "terminal" program that will result in board certification. However, when that happens all of your prior prelim training "counts" against that clock.

4. If you match into a field but never start it, then nothing happens. You actually have to train in that field to have your clock set.

So, examples:

1. A student matches into and starts a Categorical IM program. Therefore, his clock is set at 3 years. He completes three years of training and decides to continue in an Endocrine fellowship. That fellowship will be funded at 50%. DME.

2. A student does a prelim medicine year (1 year), followed by a radiology residency (4 years). During the first year, one year of funding is used but the clock is not set. During the second year, clock is set at 5 years (since that's how long it takes to train in rads including the manditory prelim year).

3. Same student in #2 decides to resign her rads spot prior to starting, had a change of heart and wants to go into IM. Crazy, I know. She starts as a PGY-2 in IM. Clock gets set to 3 years when she starts the IM residency, and the prelim year counts as 1 year against that maximum. Matching into rads does not set the clock.

4. Same student in #2 decides to resign her rads spot after 1 year of rads training. Switches to IM, again as a PGY-2. This time, the clock was set to 5 years once the rads training begins. 1 year used as prelim, 1 as rads. She can finish her IM residency in another 2 years, and then has one full funded year left if she decides to do a fellowship.

How CMS keeps any of this straight is beyond me.

And, just to make things even crazier, Medicare uses the Oct 1 - Sept 30 accounting cycle.
Click to expand...

:confused:

Now I'm more confused because I thought that's what I said - that Prelim years and TYs don't count against clock (unless you go into a specialty that uses that year as a base year??)?

Ok, well how about this scenario:

student resigns mid-year PGY-2 position in rads to go into general surgery (even crazier, right?); clock had been set at 5 years for rads but is only 1 year (from Prelim Med) used or does that not "count" since the Prelim year in IM can't be used for Surgery.

Last question: why do we worry endlessly about this? Either its a problem for programs or it isn't. You'll never know unless you apply/ask.
 
Winged Scapula said:
:confused:

Now I'm more confused because I thought that's what I said - that Prelim years and TYs don't count against clock (unless you go into a specialty that uses that year as a base year??)?

Ok, well how about this scenario:

student resigns mid-year PGY-2 position in rads to go into general surgery (even crazier, right?); clock had been set at 5 years for rads but is only 1 year (from Prelim Med) used or does that not "count" since the Prelim year in IM can't be used for Surgery.

Last question: why do we worry endlessly about this? Either its a problem for programs or it isn't. You'll never know unless you apply/ask.
Click to expand...
Well, perhaps I just misunderstood your comment, which is not uncommon given the insanity of the way this system works.

In your example, if a student does a prelim year, and then a rads year, and then goes into ssurgery, the rads year sets their clock at 5 years, of which they used 2 (Prelim and Rads). Thus, they have three years of full funding left and will "run out" before finishing surgery (less of a problem if they start as a PGY-2 in surgery).

I have no idea if you get "partial credit" if you drop out before the year is complete.
 
i have a few subsequent questions: what happens when the clock runs out and you want to do more residency (e.g. the example above where the clock doesn't provide enough years to fully fund you)? does the hospital pay out of pocket? where do they get the funds? can a resident fund their own if they ever wanted to (e.g. work free or pay to work?).
is this why it is hard to get a second residency?
 
Thanks for the comments everyone. I actually have the actual Medicare guidelines on this issue, I found them on AAMC I think, but cant remember now exactly where. If there is a way to post attachments on SDN, please let me know as I am unaware of it. At least it'd help everyone.
TO my understanding - what aPD said is exactly what's written in the doc.

F/up from turq's question - I guess its part of the reason why switching and finding a second residency is so hard. I've also wondered - legalities aside - if one likes a specialty so much so as to work unpaid - can that work?

Now from other posts on SDN, I also gather that this is not enough reason to exclude an otherwise stellar applicant the program likes, but on the other hand if a prog doesn't want to take a candidate, this may be an 'excuse'. Obviously I guess it also depends on the hospital's funding status too.

Would appreciate anyone's inputs to turq's questions...
 
snowbank said:
Thanks for the comments everyone. I actually have the actual Medicare guidelines on this issue, I found them on AAMC I think, but cant remember now exactly where. If there is a way to post attachments on SDN, please let me know as I am unaware of it. At least it'd help everyone.
TO my understanding - what aPD said is exactly what's written in the doc.
Click to expand...

Here you go:

http://www.aamc.org/advocacy/library/gme/dgmebroc.pdf

As to turq’s question: Remember that, after completion of the set number of years determined by one’s terminal residency, hospitals still receive some Medicare funding for additional years: 50% DME funding and 100% IME funding. IME funding varies from hospital to hospital. The method by which the govt calculates how much IME funding an institution receives is complicated and based on things like total number of Medicare admission days and such, but in some instances the amount of IME funding received far outweighs the DME funding. So the loss of DME funding is relatively minor for these places and can be made up in other ways. There may also be non-Medicare/philanthropic sources of funding available. This is how some places are able to sustain fellowships or "second specialty" residents. But other individual hospitals/programs may certainly have funding issues. Varies.

Can someone offer to do a second residency for free? I believe not paying a resident is against ACGME/RRC guidelines. I don't know about AOA guidelines. If the residency/fellowship spot is unaccredited – perhaps one could work for free. But doing this would essentially serve no purpose other than experience. You couldn't use the non-accredited year toward licensure or board certification. And I imagine working for free gets real old real quick.
 
I don't want to beat scenarios into the ground, but I have been rejected from continuing training and reason given is "you burned up too much GME funding" (excuse or truth? who knows). Given this:

1. I match into a combined program, 5 years training to be BE/BC...no prelim/transitional years. (I think the clock is set at 5 years here and not 3?) Each specialty, if done by itself, is 3 years...combined it requires 5.

2. I train for 3 months; then I take 3 months of family/med leave due to a family tragedy (does this FMLA time count toward the clock?)

3. I resign to deal with family issues after 6 months because the program says I've used up my FMLA and they want me back. I get NO credit for the 3 months I trained (does 3 months of training count toward the clock if no credit is given for those 3 months?)

4. Now I decide to switch specialties into a 3 year program, no prelim no transitional and I'm restarting as a PGY-1 (Is the clock still initially set at 5 years or is it now "reset" to 3 years?).

No program so far, even after consulting with GME, has been able to figure this one out (or so they say). I've used http://www.aamc.org/advocacy/library/gme/dgmebroc.pdf to try and figure it out on my own and I am even more confused.

Can anyone (APROGDIR for ex.) help me figure this one out?
 
Ludicolo said:
Can someone offer to do a second residency for free? I believe not paying a resident is against ACGME/RRC guidelines. I don't know about AOA guidelines. If the residency/fellowship spot is unaccredited – perhaps one could work for free. But doing this would essentially serve no purpose other than experience. You couldn't use the non-accredited year toward licensure or board certification. And I imagine working for free gets real old real quick.
Click to expand...

I believe this to be true as well.

TB - remember that in addition to the salary, there are benes which can add substantially to the cost of training: malpractice, health insurance, educational fund, disability, etc. Who is going to pay for that if you work for free?
 
JerryMeister said:
I don't want to beat scenarios into the ground, but I have been rejected from continuing training and reason given is "you burned up too much GME funding" (excuse or truth? who knows). Given this:

1. I match into a combined program, 5 years training to be BE/BC...no prelim/transitional years. (I think the clock is set at 5 years here and not 3?) Each specialty, if done by itself, is 3 years...combined it requires 5.

2. I train for 3 months; then I take 3 months of family/med leave due to a family tragedy (does this FMLA time count toward the clock?)

3. I resign to deal with family issues after 6 months because the program says I've used up my FMLA and they want me back. I get NO credit for the 3 months I trained (does 3 months of training count toward the clock if no credit is given for those 3 months?)

4. Now I decide to switch specialties into a 3 year program, no prelim no transitional and I'm restarting as a PGY-1 (Is the clock still initially set at 5 years or is it now "reset" to 3 years?).

No program so far, even after consulting with GME, has been able to figure this one out (or so they say). I've used http://www.aamc.org/advocacy/library/gme/dgmebroc.pdf to try and figure it out on my own and I am even more confused.

Can anyone (APROGDIR for ex.) help me figure this one out?
Click to expand...


I will try to address your questions as much as possible, but I don't know the answers to everything.

So, you matched into a 5-year combined program that covers two residencies that would each be three years in length. The two that come to mind are EM/IM or EM/peds. Funding clock gets set at the number of years it takes to complete the shortest residency program PLUS one year = 4 years for you.

I don't know the rules on whether you get three months' worth of credit. However, you should have, at minimum, three years of full DGME funding time remaining.
 
Let me tell you that there is NO WAY to get a clear answer on this. Here's why: There is no such thing as "Medicare" to call and ask. Instead, all Medicare billing is processed through private companies called "Medicare Intermediaries". There are several of them, each assigned to a specific area of the country. They each make their own decisions, and hence what might be "OK" in one part of the country might be "Rejected" in another. Sounds crazy?

Second, if you call one of these intermediaries and try to get an answer, invariably the answer is "submit it and we'll let you know", which means that the hospital has to hire you and spend the money without knowing whether it will get paid or not.

JerryMeister said:
1. I match into a combined program, 5 years training to be BE/BC...no prelim/transitional years. (I think the clock is set at 5 years here and not 3?) Each specialty, if done by itself, is 3 years...combined it requires 5.
Click to expand...

As mentioned, the clock is set to the length of whichever program is longer. If both programs are primary care, then you get to add one more year. So, likely your clock is set to 3 or 4 years.

2. I train for 3 months; then I take 3 months of family/med leave due to a family tragedy (does this FMLA time count toward the clock?)
Click to expand...

FMLA time does not count towards anything.

3. I resign to deal with family issues after 6 months because the program says I've used up my FMLA and they want me back. I get NO credit for the 3 months I trained (does 3 months of training count toward the clock if no credit is given for those 3 months?)
Click to expand...

Whether you get credit or not is not important to medicare. If they paid you, it counts. Residents who have their training extended due to underperformance do not get extensions in their funding -- the hospital has to eat any shortfall. So, yes, your three months all counts.

I should point out that FMLA guarantees your job for 12 months. They cannot force you to come back or resign. In your case, you don't actually qualify for FMLA since you need to work for 12 months first, so I guess they can do anything they want.
4. Now I decide to switch specialties into a 3 year program, no prelim no transitional and I'm restarting as a PGY-1 (Is the clock still initially set at 5 years or is it now "reset" to 3 years?).
Click to expand...

Your clock is not "reset". It is what it was -- either 3 or 4 years. You've used 3 months. The rest is yours to use.
 
Just when I think I've learned what I can about this important issue, I seem to pick up more information from WS and APD. I appreciate the responses.

This is an issues that affects me as well. As I am finding out this is kind of an abstract issue because many times there is no clear way to get a determination on the matter, as APD makes clear.

It makes it more difficult to present yourself as a potential resident (when your doing 2nd residency) to a program if you are only going to have 50% DME funding. Seems like an area of residency funding that needs some reform, IMHO. However, I can't see Medicare setting aside more funds in this area in this era when they are cutting payments. In fact, state medicaid programs are cutting funding to residency programs too. See here

And honestly I can't blame a PD for choosing the applicant that has full funding. If they have a choice between a new, freshly graduated 4th year with full funding and another applicant that has already done a residency (and already has a career) with only 50% DME, then its a no brainer right? As a 2nd residency applicant, you would have to have something compelling about the strength of your application or have connections in order to get a spot in your chosen field.

The other option I would think is if the hospital has other sources of funding for this particular situation. I would think this would be the case because this is the same situation for someone doing a fellowship. The only difference being a fellow would have 50% DME for one or two years and sometimes maybe three years. So hospitals are finding the funding because fellowships do exist. In fact at my home institution they have seven fellowships. So, I think there is some hope.

For someone like myself applying to a four or five year program (depending upon how much credit given from my previous program) a hospital would have to find I believe $10K per year, so a total of $40-50K over the entire training period. I believe that the precise amount is specific to each hospital and depends upon a number of factors.

In short, its a seems a bit of a quagmire. I will know more in the next several months one way or the other.
 
It gets more complicated, as I expect you can guess.

Each institution has an "institutional cap" -- a maximum number of residents that it can be paid for at any one time. These caps were created in the BBA of 1997 which attempted (and succeeded) in curbing the exploding costs of GME. Each resident in their initial residency period counts 1.0 FTE, and each beyond their "clock" counts 0.5 towards the DME total (hence the 50% funding). Once an institution reaches the cap, they get no further funding. So, as you can see, if an institution is already above their cap, there is NO loss of funding in taking you, since they already were over their cap and your loss of 0.5 FTE simply comes out of the overage (which is not paid at all).

Before you ask, there is no way to know which institutions are above their caps. And, it also depends on how many other residents are funded only 0.5. And how many are doing research (which is currently not funded by medicare). So, as I warned, complicated.
 
Hi crew. My situation in brief... Started IM residency but didn't receive renewal contract at the end of the year nor granted full credit. Currently, reapplying for FM and IM.

I recently had a discussion with a dominant-type PD from my medical school. She called me in to explain how being offered an interview by her department was an error because the program doesn't interview PGY-1 candidates with partial “clocks.” She presented the funding/"clock" issue very differently from aprogdirector and she represented herself as 100% certain.

Here's what she said...

If you start in IM, your clock gets set for 3 years in IM only. So if you do 2 years in IM, and then start a new terminal residency, then your clock gets reset to 100%. If you stay in IM, then you have 1 more year of government funding. After your IM clock runs out, according to her, you get 0% of government funding for the IM residency.

Clearly, many have contradicted her in regards to the 0% funding at the conclusion of the clock. Perhaps this is what she chooses to believe as she is a PD of a university IM program that will easily fill with “virgin” clocks. Meanwhile, the university's sole payer base is the uninsured and Medicaid/medicare population. With this payer base, I guess you really need the $100,000 per resident. Interestingly, my medical school's residency has about 50 less IM spots than the IM residency program of the competing university that is located 2 miles away in a more payer-mixed part of town with similar #’s of beds/patients. This competing medical school did interview me and expressed much interest. They must have some “unpaid” spots…

Now examining her other claims…. So she said if I started residency in FM, I’d get a new clock and be funded at 100% for all 3 years of FM residency. This has not been the story that I have received during my FM interviews. From these encounters, there seems to be a lot of confusion about the funding issue. To sum it up, they believe that they won’t get complete funding, but no one seems to know for sure exactly how much they will get…

I will try to follow the advice, “Don’t worry about things you cannot control.” I have plenty of interviews and obviously wouldn’t have been awarded these interviews if I wasn’t going to be considered a candidate by these institutions. However, as a physician, I’m fixated on finding the “truth.”

Resultantly, I request additional data from you all. The utility of this endeavor is marginal at best. I’m relatively certain that no one really knows the true answer and if they did, funding policy will probably change in 6 months. Clearly, I have too much time on my hands and I should be doing more productive things…
 
freeagentmd said:
Hi crew. My situation in brief... Started IM residency but didn't receive renewal contract at the end of the year nor granted full credit. Currently, reapplying for FM and IM.
Click to expand...

That's a bummer

I recently had a discussion with a dominant-type PD from my medical school. She called me in to explain how being offered an interview by her department was an error because the program doesn't interview PGY-1 candidates with partial "clocks." She presented the funding/"clock" issue very differently from aprogdirector and she represented herself as 100% certain.
Click to expand...

100% certain in anything in medicine or GME is basically wrong, but I digress.

Here's what she said...

If you start in IM, your clock gets set for 3 years in IM only. So if you do 2 years in IM, and then start a new terminal residency, then your clock gets reset to 100%. If you stay in IM, then you have 1 more year of government funding. After your IM clock runs out, according to her, you get 0% of government funding for the IM residency.
Click to expand...

Nope.

The AAMC has updated their brochure. The old links (mentioned in this thread) no longer work. The new link is here. This answers most of your questions. Note that the "price" listed on the AAMC website is for a print version, the PDF is free to download.

Clearly, many have contradicted her in regards to the 0% funding at the conclusion of the clock. Perhaps this is what she chooses to believe as she is a PD of a university IM program that will easily fill with "virgin" clocks. Meanwhile, the university's sole payer base is the uninsured and Medicaid/medicare population. With this payer base, I guess you really need the $100,000 per resident. Interestingly, my medical school's residency has about 50 less IM spots than the IM residency program of the competing university that is located 2 miles away in a more payer-mixed part of town with similar #'s of beds/patients. This competing medical school did interview me and expressed much interest. They must have some "unpaid" spots…
Click to expand...

That's not exactly how it works, but yes some programs may be more financially constrained and hence may not be willing to consider residents without full funding.

Now examining her other claims…. So she said if I started residency in FM, I'd get a new clock and be funded at 100% for all 3 years of FM residency. This has not been the story that I have received during my FM interviews. From these encounters, there seems to be a lot of confusion about the funding issue. To sum it up, they believe that they won't get complete funding, but no one seems to know for sure exactly how much they will get…
Click to expand...

You do not get a new clock. Look at Question 8 on the link, and also question 15.

I will try to follow the advice, "Don't worry about things you cannot control." I have plenty of interviews and obviously wouldn't have been awarded these interviews if I wasn't going to be considered a candidate by these institutions. However, as a physician, I'm fixated on finding the "truth."

Resultantly, I request additional data from you all. The utility of this endeavor is marginal at best. I'm relatively certain that no one really knows the true answer and if they did, funding policy will probably change in 6 months. Clearly, I have too much time on my hands and I should be doing more productive things…
Click to expand...

"Yes"
 
Thanks aprogdirector. The link was very elucidating. It would appear that the loss to most programs would be about $12-15,000/year for the years of training after my clock runs out. It is a significant chunk of change, especially in this economy, but obviously not a deal-breaker for the programs that offered me interviews.

My greatest worry is that I think that there may be a huge misconception amongst program administrators regarding this funding issue. If all program directors really believe that they may receive 0% of funding for me, that could be a real issue. Afterall, the PD that told me this is a PD of a major university hospital and a boss of about 100 residents. Another PD told me that every program (except his because of a "special grant") was going to reject me due to this funding issue. That guy also hinted that since I'm not a senior allopathic medical student, I could potentially sign an out-of-Match contract. Before he went any further, I asked him if he had an immediate position for me and then the romanticizing came to an end.

But getting back to the real issue... Do you think it'd be tacky to send this link to my interviewing program directors? Maybe it'd be elucidating to them and this may help me get ranked higher. On the flip side, it may come off as aggressive and/or arrogant. What do think? Is this common information or as mystical as suggested by some of the "gem" interviewers out there?
 
I would not send it to places that interviewed you. If they have interviewed you, either they A) already know this and aren't worried, or B) haven't thought about it. If it's A, sending the link does you no good. If it's B, you potentially lose.

...and since you're not a senior medical student, you absolutely can sign a contract outside the match if offered.
 
I know this is a super old thread, but I have a new question -- is there a statute of limitations on one's "clock"? For example, I did an intern year in FM in 2011-2012 and will probably be applying the match this year to start over as a PGY-1 again as it's been so long since I was in training. Is my clock still down one year, or would it reset after so many years away from residency? Thanks for your help!
 
docmama said:
I know this is a super old thread, but I have a new question -- is there a statute of limitations on one's "clock"? For example, I did an intern year in FM in 2011-2012 and will probably be applying the match this year to start over as a PGY-1 again as it's been so long since I was in training. Is my clock still down one year, or would it reset after so many years away from residency? Thanks for your help!
Click to expand...
To the best of my knowledge, there's no "reset button" on your funding.

But if you've been out of training for 5 years, the funding limit is going to be least of your problems.
 
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Final LOR was uploaded on the 30th, how big of an issue is that?
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AlGamaty
AlGamaty
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