4 years off before residency impossible??

[nonny2]

Hello! I hope someone here can give me some advice. So, my brain has been exploding trying to think of a way to make the timing of my training work. Here's my deal. I am a medical student married to an intern... an intern in the army. I will be done with school in 3 years and he will be done with residency in 4. After that, he will be sent who knows where to pay back his 4 year commitment. So, I can either live apart from him (a bad idea since we have one baby and one on the way) or wait to do my residency. I wouldn't mind waiting at all, it is so impossible trying to do this with babies. Plus, I am still in my early 20s so its not like I am running out of time.

Here's my question. If I completed my intern year and took step 3, would I have a chance of being accepted to a residency if I quit for 4 years after that? I did really well on step one if that would even matter at that point and I don't want to do anything crazy competitive- probably peds or medicine. What do you guys think? I hope this idea is possible... its the only way I can see to make my life work! Thanks for the input.

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[MrBurns10]

I think it depends on what you go into. It is harder to get into competitive specialties after taking time off, especially if it's as much as 4 years...this is because your clinical skills will deteriorate significantly the more time you're away from medicine. What you could do is take a research year in between 3rd and 4th year so that you and your husband finish at the same time. Then, you can try to get a residency near where your husband gets stationed, especially if he gets any sort of choice in the matter. Best of luck! You'll make it work.

 

[Winged Scapula]

It depends on what you do for those 4 years.

Frankly, it will almost assuredly be a detriment to your career. Most programs will not take someone, regardless of their Step 1 score, more than 5 years away from medical school graduation, and many balk at less time than that.

If you were working in some medical capacity, getting an advanced degree, you might be able to swing it, but I think this is one of those situations in where I have to be honest and say that you're going to have to choose between your family and a VERY tough road to match 4 years from medical school graduation. This is true even for non-competitive specialties as it will be assumed that your meager clinical and scientific skills will have withered by that time. Programs would prefer someone with fresh training.

The idea that Burns has above is an excellent one - time your medical school graduation to your husband's residency graduation and hope that he is transferred somewhere with a lot of programs in your desired specialty.

 

[nonny2]

Thanks, keep the advice coming please! The thing is, once you get "stationed" somewhere, it is pretty unlikely that you will stay there more than a year or two. Plus, there are all the deployments. It would be pretty hard to attempt residency then. If I did finish my intern year though, I could work for the military as a general medical officer for those 4 years which would keep me a little more up to speed. The only other option would be for him to do a fellowship here- which would tack on another 3 years of payback. Ick.

Or, how possible would it be to transfer after a year of residency and enter as a second year?

 

[Dr^2]

It's not infrequent for people to switch specialties or hospitals after their intern year. The catch is that depending on the switch, they may be required to repeat intern year (e.g. Panda Bear)

There are also people who don't match in to a full length residency after 4th year, so they go in to free-floating intern or transitional years and apply to other programs from there.

I suppose you could apply to do your intern year in whatever city your husband is doing his residency, then apply for residency in his new location. Even if he's forced to move after two years, you'd only a have a year apart (unless you have your heart set on sth like neurosurgery).

You won't be on the fast track to being an attending, and you may have to go through the application process an extra time, but you can make it work!

Good luck!

 

[SoCuteMD]

If I recall correctly, doesn't the Army have some policy with respect to married couples and the distance they can be stationed apart? Wouldn't it make sense for you to join the Army for the tuition benefits and do an Army residency (if possible) so that you two could be stationed together? Sure, it'd mean another four years in the army since you'd have to pay it back as well, but at least you'd be together!

 

[edmadison]

If I recall correctly, doesn't the Army have some policy with respect to married couples and the distance they can be stationed apart? Wouldn't it make sense for you to join the Army for the tuition benefits and do an Army residency (if possible) so that you two could be stationed together? Sure, it'd mean another four years in the army since you'd have to pay it back as well, but at least you'd be together!

A couple of things (I'm an Army doc).

First, if the OP is not in the military, then it will be very difficult to get special consideration made for choice of post-residency billet. Sometimes consideration is given, but very rarely (usually to take care of a very sick parent). In my experience there is no consideration given to co-locate a non-Active Duty spouse. Second, depending on the OP's husband's specialty, duty stations can be pretty lousy. Many of them are pretty far away from a training program (Fairbanks, Alaska). Very few of them are close to multiple programs. The consultant for his specialty will try to help him out, but seniority rules when it comes to assignments and there will be plenty ahead in line. Third, you can generally stay in one location for more than 1-2 years, especially if you are in a relatively unpopular location. If he wanted to stay at Ft. Bragg or Ft. Campbell for 4 years, he probably could.

Although I am loathe to suggest this, one option to consider is for the OP to do a two-year HPSP scholarship and do residency in the Army. It's much more likely you'd get a joint domicile and get to be together. One of my fellow residents did this and she and her husband were able to end up together. Of course, she was in Iraq for 15 months of her 24 month payback....

Ed

 

[Law2Doc]

Most programs will not take someone, regardless of their Step 1 score, more than 5 years away from medical school graduation, and many balk at less time than that.

The above should be re-emphasized. More than a few programs list clearly on their websites that they don't consider people more than X years out of med school. I'd sure be cognizant of these before I took more than a year off. It may pay to take the time off AFTER doing a preliminary year (intern year) program, as you probably keep more doors open this way.

 

[SoCuteMD]

A couple of things (I'm an Army doc).

First, if the OP is not in the military, then it will be very difficult to get special consideration made for choice of post-residency billet. Sometimes consideration is given, but very rarely (usually to take care of a very sick parent). In my experience there is no consideration given to co-locate a non-Active Duty spouse. Second, depending on the OP's husband's specialty, duty stations can be pretty lousy. Many of them are pretty far away from a training program (Fairbanks, Alaska). Very few of them are close to multiple programs. The consultant for his specialty will try to help him out, but seniority rules when it comes to assignments and there will be plenty ahead in line. Third, you can generally stay in one location for more than 1-2 years, especially if you are in a relatively unpopular location. If he wanted to stay at Ft. Bragg or Ft. Campbell for 4 years, he probably could.

Although I am loathe to suggest this, one option to consider is for the OP to do a two-year HPSP scholarship and do residency in the Army. It's much more likely you'd get a joint domicile and get to be together. One of my fellow residents did this and she and her husband were able to end up together. Of course, she was in Iraq for 15 months of her 24 month payback....

Ed

I'm pretty sure that's what I suggested. I know the Army does not give special consideration to civilian spouses.

 

[group_theory]

Here's my question. If I completed my intern year and took step 3,

Make sure you take Step 3 as soon as you can. There are many states that have time limits on when you can complete your USMLE Steps (many have 7 year requirements from Step 1 to Step 3). The clock started ticking when you took step 1.

 

[nonny2]

This is helping a lot. As far as a 2 year hpsp, I thought you owed either the length of your medical school training or your residency, whichever is longer? Either way, I don't think I could be away from my babies and in Iraq, I would lose my mind. Plus, I am REALLY not a military person, I just happened to fall for a man who is. It certainly doesn't fit my value system...

Honestly, if I had a year of residency, passed step 3, and worked as a GMO for the military for 4 years, do you think I would have a shot at a peds residency *somewhere*?? Don't international grads have huge gaps in their training sometimes? There has to be a way for me to finish, keep my family together, and not join the military!! Maybe I would get stuck in the scramble, but surely somewhere in the US would take me? We could move anywhere at that point. Not looking for affirmation, though, looking for reality. Please be honest!

 

[MrBurns10]

Honestly, if I had a year of residency, passed step 3, and worked as a GMO for the military for 4 years, do you think I would have a shot at a peds residency *somewhere*?? Don't international grads have huge gaps in their training sometimes? There has to be a way for me to finish, keep my family together, and not join the military!!

I'm a little confused. You propose working as a GMO for the military for 4 years, but then you say you want to find a way where you don't join the military. Is a GMO not technically in the military or am I misunderstanding you?

If you did end up being a GMO, of course you could get a peds residency afterward. But I thought you didnt want to join the military. What if you take a research year between 3rd and 4th year, finish at the same time as your husband, then try to find a peds residency around where he is. Peds is 3 years and you could always be apart for a year or transfer to a different program in the middle of your residency (if space is available) if he has to move. And if you can't find a spot near him after 4th year, then just go the GMO route for a few years.

 

[nonny2]

That is confusing... it is my understanding that the military will contract out civilians as gmo, but I am not for sure! Surely you could do something with a license? I could try to transfer after a year, but the uncertainty freaks me out. And, I am already taking a year off because I had to transfer schools for his residency and that's just how it worked out. Two years would be bad news! I wish I could just transfer res. programs but what if he gets sent to BFE and there are no programs, or I don't get in?
It seems like maybe the best option would be him doing a fellowship here so I can go through uninterrupted. He is fine with that and pretty sure he'd get one, I just hate the idea of tacking on 6 more years of service!!! I am worried about what moving around a lot does to the mental health of kids/ teenagers!
I think I like to make things as difficult as possible.

 

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[edmadison]

It is my understanding that the the Army (and maybe the rest of the military) will no longer hire non-board certified docs to work in the clinics. I know that some at my hospital were terminated for this specific reason. We had one that had completed 2 years of peds training ten years earlier and was working as a contractor in our clinic. When they gave her notice of termination, she was able to join the military and complete residency at our program.

You also said in your last post you are pretty sure he'll get a fellowship. Why is this? Most Army physicians will be required to go out and serve a tour prior to getting a fellowship. It is quite unusual (although it does happen) for someone to go straight through to fellowship. Seniority, and service record (GMO tours, combat tours) are much more important that academic acheivement for selection for fellowship in the military.

Ed

 

[t33sg1rl]

As a med 4 applying to residencies-most programs have a rule that you can be no more than 3 years out of med school.

But if your husband is going to be stationed in the same place all 4 years, you can wait to find out where he is, then at least do a transitional year or something nearby.