Already did residency... planning on doing it again.

[Terra Cotta]

I know it sounds strange, but hear me out.

I've already done my internal medicine residency (2006-2009) in a small little-known community hospital, and also did critical care medicine (2009-2011) in a university-affiliated program... though still a small little-known program as well. I was under a J1 visa then... and after training, circumstances dictated that I had to go back to my country of origin, where I am working now as an attending.

Now that life situations have improved for me a bit, I'm wanting to go back to the US again. But I felt that my internal medicine residency training was rather inadequate... and I never really liked critical care medicine as a fellowship to begin with (back then, I hoped to use it as a "bridge" to make my CV look good, which would increase my chances of getting accepted in the fellowship training of my liking, but unfortunately those plans didn't come to realization). The thing is, I've already done 5 years worth of training under the J1 visa program. Is it possible to do the whole thing again (like "start from zero" and join the residency match) under the J1 visa as well? I'm hoping that with prior residency training and 4 years of clinical experience post-training, I could be matched in a much bigger university-based program (not like the one I was matched in before), then eventually be accepted in a fellowship of my liking.

What do you all think? Is this technically possible?

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[IMPD]

Short answer: No.

Slightly longer answer: No. You've burned your Medicare training dollars and no PD in their right mind would take someone who is fellowship trained (in the US) and put them back as a PGY1. This isn't even getting into the 7-year total time limit for J1 visas.

 

[Terra Cotta]

How about the final 2 years left in my J1-visa program? Given the time elapsed (from 2011 to now), can I still qualify for applying for a 2-year fellowship?

 

[deleted480308]

What did you think a critcare fellowship would get you into?

 

[Terra Cotta]

Either a pulmonary fellowship or a heme-onc fellowship.

 

[deleted480308]

Either a pulmonary fellowship or a heme-onc fellowship.

Forgive me if I'm mistaken here....but hemeonc is pretty competitive. If you couldn't get in during the normal process, I doubt it will happen after a delay without full funding.

I know how silly this sounds, but you may just have to "settle" with being an american fellowship trained physician....it's a good gig

 

[22031 Alum]

It sucks to not be in your first choice specialty, but I don't think entering training again is in the cards for you. Luckily you are US-trained and will be able to get licensed - it may be time to try and figure out practice options you can tolerate within your current field.

Good luck!!

 

[inspirationmd]

Either a pulmonary fellowship or a heme-onc fellowship.

The pulmonary only fellowships aren't that competitive so it's conceivable that you could match into that. It would suck because you'd have to do 2 years for the Pulm eligibility which effectively has you do 4 years for what other folks get in 3 with Pulm - CCM fellowship. Intensivist work is pretty good. Not sure why you want to go back into training after all these years. How do you think you'll do with presenting and taking orders again?


Hem-onc isn't going to happen. Honestly, jut working is probably your best bet but if you're motivated the few Pulm fellowships might look at you

 

[dozitgetchahi]

This is just about the craziest thing I've ever read on this board (which is really saying something).

Pull yourself together and work as either a hospitalist or an intensivist.

As stated above, no PD in their right mind is going to start you over as a PGY-1 IM trainee, and I'd have to wonder about the sanity of any trainee who actually wanted to do that to themselves.

The pulm-only fellowships sound like your best bet at this point.

 

[Terra Cotta]

This is just about the craziest thing I've ever read on this board (which is really saying something).

Pull yourself together and work as either a hospitalist or an intensivist.

As stated above, no PD in their right mind is going to start you over as a PGY-1 IM trainee, and I'd have to wonder about the sanity of any trainee who actually wanted to do that to themselves.

The pulm-only fellowships sound like your best bet at this point.

My residency (and fellowship) program basically sucked... the breadth of learning wasn't robust, and the teaching curriculum was laughable (as a FMG, I'm betting these are the types of programs they typically match us in), and having been out of the US scene for roughly 5 years, I thought it to be the best strategy. Yes, it sounds insane to you, but it's a personal choice that I am willing to go through again (and perhaps having no student load debt to pay back gives me a financial advantage if I were to subsist on a resident's/fellow's salary.

 

[Crayola227]

For ****'s sake, there are programs that can get you experience to get you back to clinical practice, or you can do an oberservorship, or you can see if a doc will take you under the wing to get you started. You could maybe negotiate with a hospital to be paid less and share a census with a doc already there with some agreement to continue working there for some period of time for dealing with the hassle/malpractice of that arrangement, if it's a place really looking for manpower.

Don't make this about "I don't feel ready or got a good education to just work in my field, that's my excuse to want to start all the way over or do even more training." You got your training, get a job, leave it for others.

Be a hospitalist. Work in the ICU. Hell, you might be able to work in rural ED with your credentials, urgent care, or outpt office in a group if you offer them a deal for some supervision and training. I say this because being boarded in IM can open up those things if you're willing to go to the middle of nowhere, be paid less, and proactive about getting help to work up your competency.
You could look into clinical research too, or the pharm industry.

 

[dozitgetchahi]

My residency (and fellowship) program basically sucked... the breadth of learning wasn't robust, and the teaching curriculum was laughable (as a FMG, I'm betting these are the types of programs they typically match us in), and having been out of the US scene for roughly 5 years, I thought it to be the best strategy. Yes, it sounds insane to you, but it's a personal choice that I am willing to go through again (and perhaps having no student load debt to pay back gives me a financial advantage if I were to subsist on a resident's/fellow's salary.

How were you able to get through critical care training if your general IM knowledge/skills are so bad? CCM fellowships generally aren't a joke.

You say you're an attending in some other country now. What are you doing there? Isn't that giving you worthwhile skills/experience to improve?

Is this more about poor self esteem than any actual lack of skills?

As with so many of these SDN weird-ass scenarios, I'm just trying to wrap my head around this. I know crap training programs exist in this country, but usually those residents put in a boatload of effort to read up and get to the point where they feel confident about things - and usually those programs work the daylights out of the residents to boot, which (while miserable) has the side effect of producing practitioners who usually know what the hell they're doing for at least bread and butter issues.

 

[Raryn]

Just out of curiosity... Are you IM boarded? What about CC boarded? Or was the training so bad that you failed the boards?

 

[visari]

My sincere advice: find a good paying PCP or hospitalist job and call it a day.
What you're trying to do is wrong on so many levels (not to mention what you've already done: going into CC to get a hemonc fellowship??!!)