3 year vs 4 Year Program

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Arshavin

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Hi ,I was wondering how come you only qualify for EM programs with 4 years training instead of 3 after doing year of Preliminary year.Any help will be appreciated.
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has to do w/ funding... EM gets max funding of 4 yrs including any prelim, so you'd have to find a place that would take you willing to eat the 5th year.

given that most of the 4 yr programs are generally considered more competitive... tough to do, if not impossible.
 
Wait, so you don't qualify for a 3 yr program if you do a prelim? I'm confused.
 
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Wait, so you don't qualify for a 3 yr program if you do a prelim? I'm confused.

Not true. Prelims don't count toward your GME cap. 3 year programs have no problem taking you after a prelim. They do if you instead do a year of something categorical.
 
has to do w/ funding... EM gets max funding of 4 yrs including any prelim, so you'd have to find a place that would take you willing to eat the 5th year.

given that most of the 4 yr programs are generally considered more competitive... tough to do, if not impossible.

Think this is way off base.
Most applicants I know avoid these places if at all possible.
 
Think this is way off base.
Most applicants I know avoid these places if at all possible.

I guess the conclusion is even after doing a prelim year you can either go for a 3 year or 4 year program.Interestingly one of the EM pd who has a PGY-2 opening told me ,I can`t take you ,we need at least 2 year training as we are 3 year program .Oh ,well.:)
 
jacobi, penn, cook county, northwestern, NYU, LAC/USC, kings county, denver, BMC, MGH... not "more competitive"??? on what planet??
 
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Think this is way off base.
Most applicants I know avoid these places if at all possible.

then your friends are not so wise... see my above post. i trained at one of those places and the "name" has carried me quite far in my career (2.5 yrs in community practice, just switched jobs)
 
jacobi, penn, cook county, northwestern, NYU, LAC/USC, kings county, denver, BMC, MGH... not "more competitive"??? on what planet??

then your friends are not so wise... see my above post. i trained at one of those places and the "name" has carried me quite far in my career (2.5 yrs in community practice, just switched jobs)

And what about places such as Emory, UCIrvine, UCDavis, UCLA, Stanford, OHSU, Hennepin, Mayo, Vanderbilt, Duke, BIDMC...

There are competitive programs in both 3 and 4 years...just because it's a 4 year program doesn't mean it's competitive..
 
that isn't what i said. i said one would be especially unlikely to be able to get an EXTRA YEAR at most 4 yr programs, b/c MOST of them are more competitive.

i didn't say anything against any others...
 
then your friends are not so wise... see my above post. i trained at one of those places and the "name" has carried me quite far in my career (2.5 yrs in community practice, just switched jobs)

Good job. I think we all knew that as it is pretty obvious from your posts that you trained at a four year program. However, as others have said, 4 year programs are not more competitive than 3 year programs.
 
Since this post has been brought up, my question is " is there a difference between a three or a four year EM residency?" Is it program specific? How does one go about " picking out the ideal EM residency?" I know I will find out more as I get through school and get started in rotations but I was just interested on how you choose. For instance, why would I choose a four year program and not a three year? I am assuming that I probably would want to be a a busy established hospital to gain the best experience but what constitutes this and how would you know if you are choosing one out of state?
 
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Just throwin' this out there as well: It has been said (and may be true) that a fourth year of residency training equates to a 200,000 dollar mistake. That's one less year of attending salary that you're voluntarily forfeiting.

... and seeing as how most PGY2-3s function rather well independently when they moonlight....
 
Just throwin' this out there as well: It has been said (and may be true) that a fourth year of residency training equates to a 200,000 dollar mistake. That's one less year of attending salary that you're voluntarily forfeiting.

... and seeing as how most PGY2-3s function rather well independently when they moonlight....

I went to a 4 year residency program and made approx $350K during my last two years of residency plus got the benefits of an extra year of training. (That included my resident pay; approx 250K from the actual moonlighting).

I am a fan of going to a 4 year program with great moonlighting opportunities. An extra year of training is priceless... I learned things during my fourth year and still learn things as an attending...

Its been said on here by many to 'live like a resident for one year and pay off your loans'... thats what I was essentially forced to do and left residency school loan free plus made a down payment on our house. Most of my colleagues had a six figure bank account at graduation.

As to the other debated above, typically 4 year programs are less competitive because it is an extra year of training and people want out of residency as quick as possible. Board pass rates are the same; I would argue those same people could pass the boards after a two year residency. The boards is about test taking skills and studying/cramming the prep books...

Its an endless debate and at the end of the day, either fulfill the RRC requirements and end up at the same goal. I think the most important aspect is to go where you think you will be happy..
 
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While its true that many (like EM rebuilder) make oodles of money moonlighting (one of my co-residents is also making absurd amounts of cash)... the catch is;

...you're still a resident.

Rather nice to make that much money working 30 hours/week as an attending, rather than 60+ as a resident, and then try to burn the candle at both ends to chase that almighty dollar.

I'm starting moonlighting here soon; probably end of February. I'm not killing myself by working more than I reasonably can. There's life out there to live, beers to drink, sports to watch, golf to play, etc.
 
Whaaaaaaaaaaat?!?!?!?

I'll go out on a limb here and say that 350K in last two years like EM-rebuilder said is not the norm. More than likely, this money is earned at a rural place as it does pay well for most cases.

To be realistic, I think if you can earn an extra 20K per year as a resident moonlighting, you're in pretty good shape. you still have time for family, movies, and catch your home team here and there.

on this note, some programs will let you moonlight as early as 6 months into your first year, and some will not allow you to moonlight late into your second year with approval from director.
 
To be realistic, I think if you can earn an extra 20K per year as a resident moonlighting, you're in pretty good shape. you still have time for family, movies, and catch your home team here and there.
I think I paid that in taxes, and didn't moonlight that much. We were underpaid at our moonlighting gig (~$130/hr), and I still brought home $5K month moonlighting. All I did was moonlight about 3 shifts/month. Not too awful. I had a "vacation" month that I moonlight something like 6 shifts, and brought home $10K. You just have to realize that you pay taxes on it at the end as they aren't taken out as you earn it. But if you aren't getting at least as much as we got, it isn't worth doing. You'll be taking on malpractice risk without getting paid, and also, if you're not working in an ED, then you're not learning job applicable skills. ED moonlighting makes you more marketable when it comes to jobs right out of residency.
on this note, some programs will let you moonlight as early as 6 months into your first year, and some will not allow you to moonlight late into your second year with approval from director.
If you're moonlighting 6 months in, you're not really moonlighting. You can't get licensed in any state without at least a year of post grad training. In house moonlighting is usually something ridiculous that feels like scut.
Also, many programs forbid you from moonlighting until 3rd year. It is hard for ABEM to argue that you need EM residency trained people to work EDs, while allowing not quite fully trained residents to do the same.
 
I guess the conclusion is even after doing a prelim year you can either go for a 3 year or 4 year program.Interestingly one of the EM pd who has a PGY-2 opening told me ,I can`t take you ,we need at least 2 year training as we are 3 year program .Oh ,well.:)


You can do residency at either a 3 or 4 year program after a prelim year. However, I doubt that many, if any, program(s) in EM will give you much in the way of credit towards graduation. I am in a 4 year program and we currently have a PGY3 that had a prelim year under her belt; she started as a PGY 1, however.

Hope this helps.

As to the great 3 year vs 4 year, who is more competitive debate...It is fundementally a silly discussion. There are great 3 and 4 year programs. A program's competitiveness is not determined by this feature nor on any other singular point.

I would encourage every applicant to check out both 3 and 4 year programs as you may be surprised what you like. I was...

iride
 
has to do w/ funding... EM gets max funding of 4 yrs including any prelim, so you'd have to find a place that would take you willing to eat the 5th year.

given that most of the 4 yr programs are generally considered more competitive... tough to do, if not impossible.

lo, this is what i originally said... my intent was not to get into the old 3 vs 4 year discussion. maybe i should have said that the majority of programs IN GENERAL are 3 yr and that therefore even just #'s wise a 3 yr would be potentially more likely to match someone who had done a prelim year.

but the funding thing IS an issue, and a place needing to fill a slot would be more likely to take someone "underfunded".
 
I went to a 3 year program and now am an attg / fellow at a very academic 4 yr. program. I think my 3 year program was sufficient to get the training I needed re: procedures, sick patients, being able to handle large patient volume and efficient/fast patient flow. What I could have used more of personally that the 4 year programs have is 1) more elective time (I only had 2 weeks vs. 4 yr programs that have months) and 2) more research time.

The research thing doesn't matter to many people. Despite whether or not you want to be in academic center in the future or not, research can be a great way to "network" whether within or outside your hospital.

If I had 2 cents, I would advocate for a blanket 3.5 year residency all over. Then you could combine the best of both worlds.
 
I enjoy my being at a 4 year program and it has helped me land the job I wanted. I'm glad I picked it and would do the same if given the chance to do over.

I think 4 leads to great training. I'm learning so much this year.

Given that, I think I'd still be prepared coming out of one of the 3 year programs I had high on my ROL.
 
I was ready to be done and gone after three years.

A fourth year at the same institution, with the same educational opportunities, and the same attendings, would have relatively zero to offer. There are things I didn't see or do in residency, but a fourth year at the same institution wouldn't necessarily have given me that exposure.

Other residencies may differ.
 
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