Anyone Know?

[clement]

I have two questions, if you could answer either.

1. Next year, there will be no more "out of the match" offers for IMGs etc. What about PGY2 openings? Can those still be outside of the match?

2. Does anyone know of someone switching from a 4-year residency (after their second year) to another 4 year specialty to start again as a pgy1? I understanding there will be medicare GME funding issues and no one can say how much that would or would not matter.

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[Winged Scapula]

I have two questions, if you could answer either.

1. Next year, there will be no more "out of the match" offers for IMGs etc. What about PGY2 openings? Can those still be outside of the match?

Not according to the NRMP: http://www.nrmp.org/all-in.pdf

2. Does anyone know of someone switching from a 4-year residency (after their second year) to another 4 year specialty to start again as a pgy1? I understanding there will be medicare GME funding issues and no one can say how much that would or would not matter.

It depends.

For example, if you are switching to a specialty which would give you an entire year's credit for your first specialty intern year, then you might be able to start as PGY-2.

It will also depend on whether a position is available.

You should expect to redo your intern year, but be pleasantly surprised if you are given some credit for your current intern year.

 

[clement]

Not according to the NRMP: http://www.nrmp.org/all-in.pdf



It depends.

For example, if you are switching to a specialty which would give you an entire year's credit for your first specialty intern year, then you might be able to start as PGY-2.

It will also depend on whether a position is available.

You should expect to redo your intern year, but be pleasantly surprised if you are given some credit for your current intern year.

Regarding the out-of-the-match question, what about pgy2 positions that become available AFTER the match? In other words, say a resident informs program they are leaving in April, I think their program can recruit people outside the Match for that same year.

 

[clement]

Regarding the out-of-the-match question, what about pgy2 positions that become available AFTER the match? In other words, say a resident informs program they are leaving in April, I think their program can recruit people outside the Match for that same year.

Bump...Someone's gotta know the answer to this. Can people apply for open pgy2 positions outside of the match next year if you're switching specialties? i ask because pgy1 prematches will no longer be allowed.

Also, if you're switching specialties and apply for both pgy2 and pgy1 spots...and you don't get a spot... is there a rule saying you have to leave your current residency if the pd is still cool with you staying? I think not.

 

[NotAProgDirector]

The answer to the first question is "its all in flux, and definite maybe is the right answer".

If the PGY-2 position opens in a field that participates in the match at the PGY-1 level, then the answer is yes. So, if in my IM program an intern informs me that he/she will not be continuing, I can find and sign a PGY-2 outside of the match. There is no IM PGY-2 match.

But, let's say a PGY-1 intern resigns in the middle of the year. Can I sign a new PGY-1 intern outside the match to start mid year? Interestingly, the NRMP just created a policy around this. The answer is yes, if training begins prior to Feb 1. If you'll start after Feb 1, then we must use the match. I find the Feb 1 cutoff very early.

PGY-2 positions are also interesting. Let's say someone drops out of a radiology program to which they have matched. It's early december of their prelim year, and they;ve had a change of heart. NRMP waivers of advanced matches are automatic if you ask by Jan 15, as long as you're not going to train in that field. The rads program must use the NRMP to fill the spot. They will simply go into the next match looking for both their PGY-2 advanced positions, but also a "Reserved position" which would be a spot starting that immediate July. Amazingly, I haven't heard a huge outcry about this, I think that programs haven't really "figured it out" yet.

Regarding continuing if looking for other spots, it also depends. If a resident in my program is interested in another field, I help them look for a spot. I also start looking for a replacement. If I find one, then they have to make a choice. I can;t risk losing someone good to fill a spot. So, sometimes you have to choose to keep your spot, or let it go and hope for something else.

 

[clement]

The answer to the first question is "its all in flux, and definite maybe is the right answer".

If the PGY-2 position opens in a field that participates in the match at the PGY-1 level, then the answer is yes. So, if in my IM program an intern informs me that he/she will not be continuing, I can find and sign a PGY-2 outside of the match. There is no IM PGY-2 match.

But, let's say a PGY-1 intern resigns in the middle of the year. Can I sign a new PGY-1 intern outside the match to start mid year? Interestingly, the NRMP just created a policy around this. The answer is yes, if training begins prior to Feb 1. If you'll start after Feb 1, then we must use the match. I find the Feb 1 cutoff very early.

PGY-2 positions are also interesting. Let's say someone drops out of a radiology program to which they have matched. It's early december of their prelim year, and they;ve had a change of heart. NRMP waivers of advanced matches are automatic if you ask by Jan 15, as long as you're not going to train in that field. The rads program must use the NRMP to fill the spot. They will simply go into the next match looking for both their PGY-2 advanced positions, but also a "Reserved position" which would be a spot starting that immediate July. Amazingly, I haven't heard a huge outcry about this, I think that programs haven't really "figured it out" yet.

Regarding continuing if looking for other spots, it also depends. If a resident in my program is interested in another field, I help them look for a spot. I also start looking for a replacement. If I find one, then they have to make a choice. I can;t risk losing someone good to fill a spot. So, sometimes you have to choose to keep your spot, or let it go and hope for something else.

This is interesting info. So it seems what you're saying is, if a CATEGORICAL program happens to have a pgy2 opening, they don't have to use the match...but an advanced program (i.e. start at pgy2) DOES have to use the match... maybe it's good that candidates can "soap" into those spots if they don't fill, but it will put the pressure of two matches on the program.

as for the "clock" on each resident: switching after a year, even two years, there isn't a consensus on how much the program one switches into in order to start all over as a pgy1 will care about reduced medicare funding for 1-2 years..., but so far I don't get the vibe that it is a HUGE deal for some, i just dont' know what percent would care about 50% less funds...esp if they are tied into funds flowing in from VA, .fellowship spots, research, etc. maybe rougher on community programs?

 

[NataliaGB]

So no more prematches for DO's and FMG's and also PGY2 spots for advanced programs must go through the match.
What if someone is ALREADY in residency and wants to switch to another specialty as PGY1. I know someone who switch in last year outside of the match after doing two years of another residency. Is this also no longer the case? Meaning DO's and FMGs can't prematch, but can people already in residency get PGY1 and 2 positions outside of the match?

 

[Smurfette]

Merging with similar thread from a few days ago.