Any cons to starting at PGY 2 and getting credit in lieu for PGY 1 when applying to fellowship?

[Nutella-addict]

I wonder if anyone would be able to cast any light on starting PGY 2 for IMG. I have done residency abroad and been offered few PGY 2 start from outset and to get credit in lie for PgY 1. I wonder if that will cause trouble when applying for fellowship/ state license?

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[Raryn]

I wonder if anyone would be able to cast any light on starting PGY 2 for IMG. I have done residency abroad and been offered few PGY 2 start from outset and to get credit in lie for PgY 1. I wonder if that will cause trouble when applying for fellowship/ state license?

For state license, almost certainly no problem. The requirement is to have a minimum of X years of residency training, where X for an FMG is a number typically in the 2-3 year range. Assuming you finish at least those 2-3 years of residency and become board eligible, you'll be eligible for a license in all 50 states.

For fellowship, it gets a little more complicated. In general, if you're board eligible at the end of your residency in your primary field, you'll be eligible to do a fellowship. That is, you'll meet the minimum requirements to do a fellowship. Whether fellowship programs look down on this and make it less likely for them to take you? I have no idea. I would hazard a guess that it would likely be fellowship dependent, with more competitive fellowships probably being pickier from that standpoint. But that's a guess, because I don't even know what your primary field is. IM doesn't allow credit for foreign training, and I'm not personally familiar with the fellowship process in other fields.

 

[Nutella-addict]

For state license, almost certainly no problem. The requirement is to have a minimum of X years of residency training, where X for an FMG is a number typically in the 2-3 year range. Assuming you finish at least those 2-3 years of residency and become board eligible, you'll be eligible for a license in all 50 states.

For fellowship, it gets a little more complicated. In general, if you're board eligible at the end of your residency in your primary field, you'll be eligible to do a fellowship. That is, you'll meet the minimum requirements to do a fellowship. Whether fellowship programs look down on this and make it less likely for them to take you? I have no idea. I would hazard a guess that it would likely be fellowship dependent, with more competitive fellowships probably being pickier from that standpoint. But that's a guess, because I don't even know what your primary field is. IM doesn't allow credit for foreign training, and I'm not personally familiar with the fellowship process in other fields.

Thank you, that is really helpful. My primary field is IM and have been offered PGY 2 and to get credit in lie for intern year, so my residency will be 2 years only. ABIM allows that interestingly.

 

[Raryn]

Thank you, that is really helpful. My primary field is IM and have been offered PGY 2 and to get credit in lie for intern year, so my residency will be 2 years only. ABIM allows that interestingly.

Huh. You're right.

I've never heard of this path in IM before. For people that are curious, this is their requirement:

ABIM may grant credit for some or all of the 12-month requirement at the R-1 level for training taken prior to entering training in internal medicine. The program director of an accredited internal medicine residency program must petition ABIM to grant credit in lieu of standard R-1 internal medicine training. Candidates who have already completed 12 months of accredited U.S. or Canadian R-1 internal medicine training are not eligible to be petitioned for credit. Before being proposed, the candidate should have been observed by the proposer for a minimum of three months. No credit will be granted to substitute for 24 months of accredited R-2 and R-3 internal medicine training.

...
4. Up to 12 months may be granted for three or more years of training completed abroad prior to entering accredited training in the United States or Canada.

1. Must demonstrate satisfactory overall clinical competence as an internist.
2. Must complete a minimum of 18 months of direct patient responsibility.
3. Must have either a standard certificate from the Educational Commission for Foreign Medical Graduates (ECFMG) without expired examination dates or comparable credentials from the Medical Council of Canada at the time of application for admission to the Certification Examination in Internal Medicine.
4. Include a non-refundable Special Candidate fee of $300.

Proposals for credit in lieu of standard training may be emailed to AcademicAffairs@abim.org and must:

• Document the reasons the proposer feels the candidate merits special consideration.
• Include letters from the program directors where prior training was completed documenting the training.
• Exact from-to dates of training.
• A brief description of the training.
• Confirmation of the candidate's satisfactory clinical competence in the program. Please note that ABIM does not accept certificates of completion of training or certification by other certifying boards as fulfilling this requirement.
• Include a copy of the candidate's curriculum vitae and bibliography.
• If applicable, include documentation of certification by an ABMS member board in another clinical specialty.
• Include the candidate's date of birth and Social Security/social insurance number.

It must not be commonly utilized. I know plenty of FMGs that trained for a residency abroad and had to restart from zero here. Regardless, you'll still be eligible for fellowship training here (having completed the ABIM requirements), but the fellowships may look down on it. It will vary from field to field. Nephrology for example won't give a damn, because they're desperate for warm bodies. GI probably would.

As for licensure, that does put a little bit of a hiccup into matters in that I assumed you were in a 4 year or longer field. If you're only doing 2 years of US residency (and if you don't get a fellowship), there's a number of states that require 3 full years of training for IMGs. Now, some or all of them might have exemptions if you're board certified or if you're licensed in another state, but I don't know the specifics for every single state. Federation of State Medical Boards has a table of state specific guidelines and links to the licensing boards. Picking the first one (Alaska), for FMGs they require either 3 years of training, board certification, OR licensure in another state AND three years of practice there, so you'll be fine. Other states will probably vary.