Are those leaving categorical IM or Peds screwed?

[Fiend]

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If you leave a categorical IM or Peds residency program after internship, are you still damaged goods to Anesthesia residencies with respect to Medicare funding and FTEs? I think Medicare says that initial residency training will be funded at 1.0 FTE/year for up to 5 years or the length of the initial residency chosen. IM and Peds are 3-year categorical programs, but anesthesia is four. So will anes programs that accept IM or Peds categorical dropouts (even if these dropouts only completed intern year and not a day of PGY-2) have to settle for 0.5 FTE from Medicare for the last year of those individuals' training? Is that a disincentive for them not to select such individuals? It would seem that prelim IM or prelim Peds folks would be off the hook.

 

[UTSouthwestern]

A single year of residency followed by a transfer to anesthesiology will not result in a loss of Medicare reimbursement to a program. You are only damaged goods if you are leaving your internship with a bootprint where the good lord split you.

 

[Fiend]

Thanks.
I figured as much but then looked at a website about Medicare funding for GME and got worried as I couldn't figure out if resigning from a categorical program as opposed to just doing a one-year designated prelim year would hurt me in the Match.
Refer to the following website, page 158, under the section "Programs with Prerequisites", from sentence 3 on:
http://www.medpac.gov/publications/congressional_reports/Mar01 Ch10.pdf
Thanks again if you go through the trouble of accessing this website and telling me what you think (i.e. if that changes what you've already written).

 

[Swaydaa]

A single year of residency followed by a transfer to anesthesiology will not result in a loss of Medicare reimbursement to a program. You are only damaged goods if you are leaving your internship with a bootprint where the good lord split you.

That was pretty darn funny!

 

[bubalus]

Total training for anesthesia is 4 years, but a prelim year is required. If you do a medicine year (either prelim or a switch from categorical) you will be eligible for 3 full years of subsidy because you can be board certified in IM in 3 years. Any time spent in residency after those 3 years, e.g., your last year of anesthesia, will be at one-half subsidy. If you did a transitional year, you would be eligible for 4 years because you can't be board certified in transitional medicine. This doesn't apply if you started out in a categorical anesthesia residency because they are categorical. See page 6 of the link.

"A number of specialty programs
require one or two years of prior
general training in another specialty
before receiving training in the specific
specialty; these include anesthesiology,
dermatology, pathology, radiology,
child neurology, and ophthalmology.
Prerequisite years of training can be
taken in a preliminary program in
another specialty (such as internal
medicine or general surgery), in a oneyear
transitional program, or in the
actual specialty if a first-year position is
offered. If the preliminary year or years
of training are taken in another
specialty, the initial residency period is
determined based on the training
required to become board eligible in the
preliminary specialty."

Will the program get less money if you leave a categorical IM instead of doing an IM prelim? No. But they will get less money than if you had done a prelim year in surgery, a transitional year, or started a categorical anesthesia program. Is this going to hurt you in the end. Probably not.