Applying for fellowship without residency

[NewUser124]

Is it possible to do this? I saw YouTube video where he advises students who couldn’t get residency to try for fellowship instead.

Also, I know not everyone does fellowship, but I heard lots of people are doing it these days for resume to look more competitive.

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[VincentAdultman]

I’m pretty sure this is for foreign medical grads who completed residency outside the US but are trying to practice in the US.

 

[sella.turcica]

Hard to listen to this guy and I don't really understand what he is talking about. What I do know is that (typically) there so much at stake, why risk it by trying to bypass USMLE's and U.S. residency. You want to practice here, go through the normal process like everybody else.

 

[W19]

It's possible... I worked with 2 neuro-oncologists at U. Miami who only did only a fellowship in the US (MSK Cancer Center in NY)... These 2 docs are not board certified though.

 

[sella.turcica]

not board certified though.

Why would that be preferable?

 

[W19]

Why would that be preferable?

I don't think it's preferable... But it is shorter with the ability to start earning an income in 2 years, but not being able to be boarded is a major problem.

 

[Donald Juan]

I've known at couple of physicians who did this as well, and they couldn't get board certification and it severely limited them on where they could work. But yes, it is possible.

 

[Giovanotto]

I've known at couple of physicians who did this as well, and they couldn't get board certification and it severely limited them on where they could work. But yes, it is possible.

I know a couple of doctors who work in fairly profitable practices in large cities and they are not board-certified. Doesn't seem to affect them at all, what am I missing?

 

[Donald Juan]

I know a couple of doctors who work in fairly profitable practices in large cities and they are not board-certified. Doesn't seem to affect them at all, what am I missing?

Again, it limits you on where you work, which hospital will credential you, which insurers will pay you, which practices will hire you.

 

[NotAProgDirector]

Of note, you can no longer do this in the IM fellowships. To be accepted to an IM fellowship, you must have completed an IM residency first. This rule was changed / added a few years ago.

 

[nimbus]

Again, it limits you on where you work, which hospital will credential you, which insurers will pay you, which practices will hire you.

It does limit mobility, job prospects (most practices will not hire you if you are not board eligible) and hospital credentialing. However, it generally does not affect insurance reimbursements. Insurance companies are blind to the credentials of who’s sending them the bill.

That said, there are still quite a few doctors out there with successful practices who are not board certified.

 

[michaelrack]

It does limit mobility, job prospects (most practices will not hire you if you are not board eligible) and hospital credentialing. However, it generally does not affect insurance reimbursements. Insurance companies are blind to the credentials of who’s sending them the bill.

That said, there are still quite a few doctors out there with successful practices who are not board certified.

Many insurers will not credential you if you are not board certified

 

[nimbus]

Many insurers will not credential you if you are not board certified

Huh??

Most doctors are not board certified for their first 1-5 years of practice depending on specialty. They still get paid. Payment is not dependent on board certification. There’s no “credentialing” by insurance companies. I have many young partners who are new to practice and not yet board certified and they get paid. I got paid before I was board certified. I work with a surgeon late in his career who is not board certified. He gets paid.

 

[CherryRedDracul]

Huh??

Most doctors are not board certified for their first 1-5 years of practice depending on specialty. They still get paid. Payment is not dependent on board certification. There’s no “credentialing” by insurance companies. I have many young partners who are new to practice and not yet board certified and they get paid. I got paid before I was board certified. I work with a surgeon late in his career who is not board certified. He gets paid.

Well, if you're "board eligible" then it's assumed that you will pass your certification exam and become "board certified". And you can't claim to be "board eligible" indefinitely as there is a time limit unti you are stripped of that designation.

After that, rest assured that you will be harrassed by any insurance companies, hospitals, practices, etc., that you're associated with until you become board certified and continue your Maintenance of Certification. Otherwise, the racket wouldn't hold water, would it?

 

[nimbus]

Well, if you're "board eligible" then it's assumed that you will pass your certification exam and become "board certified". And you can't claim to be "board eligible" indefinitely as there is a time limit unti you are stripped of that designation.

After that, rest assured that you will be harrassed by any insurance companies, hospitals, practices, etc., that you're associated with until you become board certified and continue your Maintenance of Certification. Otherwise, the racket wouldn't hold water, would it?

I’m not disputing that hospital medical staffs and practices will require it. Most hospital medical staffs require board certification after a number of years. Many practices require it too, mine does.

But no insurance company that I’ve ever dealt with requires it. I currently work with a cardiac surgeon who trained overseas and is not board certified. He’s been at my current hospital for 25 years, grandfathered in before our medical staff required board certification. He’s on every major insurance panel. Indeed even independently practicing midlevels get paid by insurance companies. The clerks at the insurance companies are completely clueless and unqualified to judge our qualifications. Do you think insurance companies have the ability to track board eligibility by every single specialty board and all their different rules?

I’m a board certified anesthesiologist. I could do a skin biopsy, or reduce a fracture and bill for it and get paid even though those procedures are clearly outside the scope of my specialty board.

The bottom line is that insurance reimbursement is not tied to board certification status. Thousands of non-board certified doctors get paid millions of dollars every day by insurance companies.

And MOC is just a joke. Many of the most prominent and highly regarded doctors in my community have declined to participate and they remain on every insurance panel and get referrals up the wazoo.

 

[michaelrack]

In Ms and Tn, it's difficult to get on some insurance panels. BCBS plans tend to require board certification, at least for psychiatrists (probably true board eligibility is ok).

 

[michaelrack]

There can be differences in applying for an insurance panel as a solo doc vs as part of an existing group, but some (Not all) require certification in either case.

 

[libertyyne]

I’m not disputing that hospital medical staffs and practices will require it. Most hospital medical staffs require board certification after a number of years. Many practices require it too, mine does.

But no insurance company that I’ve ever dealt with requires it. I currently work with a cardiac surgeon who trained overseas and is not board certified. He’s been at my current hospital for 25 years, grandfathered in before our medical staff required board certification. He’s on every major insurance panel. Indeed even independently practicing midlevels get paid by insurance companies. The clerks at the insurance companies are completely clueless and unqualified to judge our qualifications. Do you think insurance companies have the ability to track board eligibility by every single specialty board and all their different rules?

I’m a board certified anesthesiologist. I could do a skin biopsy, or reduce a fracture and bill for it and get paid even though those procedures are clearly outside the scope of my specialty board.

The bottom line is that insurance reimbursement is not tied to board certification status. Thousands of non-board certified doctors get paid millions of dollars every day by insurance companies.

And MOC is just a joke. Many of the most prominent and highly regarded doctors in my community have declined to participate and they remain on every insurance panel and get referrals up the wazoo.

Just because someone was grandfathered into credentialing at a hospital and bills currently without board eligibility or certification does not mean that doors will remain open for others. Malpractice Insurance, and some insurance plans will not cover you or provide full reimbursement if you are neither eligible or certified. Medicare iirc adds a bonus for cert, or subtracts an percentage for lack of board certification. That being said, im sure people can carve out cash only practices or maybe even more in undeserved areas where hospitals are desperate for docs. Doesn't mean it is an optimal strategy.

 

[GoSpursGo]

I've seen this work for a couple of foreign grads who have done residency in their home country, and then they often will go back and complete a residency AFTER fellowship to become board-eligible. This is advantageous for them because it gives them a chance to gain USCE that they otherwise would not be able to obtain, and particularly they are able to make connections at the residency at the same institution. You still wind up needing to eventually do all the USMLEs, often prior to applying for the fellowship.

This doesn't make any sense for a current US citizen grad. Even if there are some cases out there of people having no trouble getting credentialed/reimbursed without board certification, this is not broadly applicable across specialties/states/hospitals. Furthermore, for the cases where people are able to get away with it right now, I would not bank on that remaining so indefinitely--these things change over time, and it's much better to have the certification just in case even if you could potentially get by without it right now.

 

[mvenus929]

The bottom line is that insurance reimbursement is not tied to board certification status. Thousands of non-board certified doctors get paid millions of dollars every day by insurance companies.

And MOC is just a joke. Many of the most prominent and highly regarded doctors in my community have declined to participate and they remain on every insurance panel and get referrals up the wazoo.

I worked with one person who ran out of board eligibility and had to do a remediation thing to become eligible again, and one of the major payers in our area would not reimburse for his services. Made it super annoying for the rest of us because we had to see those patients on that plan post call. When he finally passed the boards, the insurance company started paying for his services.

So while you may not have experienced it, it is a thing.