Can first 3 general surgery years of an integrated plastic surgery program transfer later toward GS?

[Pothos]

Too short of a 'title' section for this thread unless I abbreviated too much (I would worry no one would even know what the topic was)

I previously asked in PRS forum but got no answers (not even uninformed ones). Might be more germane to this section/readership.

Suppose candidate completes 6yr integrated PRS program (3GS 'prerequisite' + 3PRS 'requisite' for PRS board certification). Then for their own edification and because they'd like to be able to safely do international relief missions on more general surgical patients, they'd like to get GS training/certification.

There are a lot of answers about the pathway where you take 5yrs GS then 3yrs PRS for dual certification; I think usually the above hypothetical (0r my own interest which I'll keep to myself) is just rare (people like to ditch GS for PRS and people look at you funny if you suggest going PRS then going back to complete some years of grad med ed to get GS). But anyway I'm interested in how the system is structured in terms of allowing one to do just that.

I'm looking at https://www.abplsurg.org/documents/2014-2015_Booklet_of_Information.pdf for plastic surgery and https://www.absurgery.org/xfer/BookletofInfo-Surgery.pdf for general surgery and particularly interested from the GS one on "Experience obtained in accredited programs in other recognized specialties, although containing some exposure to surgery, is not acceptable." That quote seems obvious for going from pediatric residency and counting those years towards GS; but, from the first booklet I can't see if the terms line up in such a way that the first 3 'prerequisite' GS years would be considered categorical GS years or not.

If they could be understood as such then in theory 3yrs GS then 3yrs PRS for PRS board certification then returning for PGY-IV and PGY-V year of GS and presto, same overall 8 years as the people who do it in droves in the other direction (GS then PRS through fellowship route).

On the other hand, there might be a perception of stigma against the 3GS years from a PRS program ('didn't they just do dermatology for half that time' sort of thing maybe for all I know?) There might be some truth to that at some programs making uniformity a messy call. There might be some programs who might consider 2 of the 3 years but make you do 3 years based on individual circumstances. The system may balk entirely and you'd have to start over at year 1 (i.e. 6yrs PRS then 5yrs GS if you could do it, basically ensuring even the rare candidates with a desire to go that route wouldn't do it unless they were a little nuts). Maybe if you can sweet talk the right person from the right board/committee they can push the paperwork anywhich way and it's more anything goes where one candidate might be able to do whatever they'd like easy and another gets screwed.

That's why I'm asking in hopes of an answer from someone who has experience either as a candidate trying to actually transfer years and familiar with the specific terms for PGY-x in y specialty... or program attendings/directors/administrators who would be able off hand to tell me something insightful like for example, 'in theory you could but the paperwork will never go through at the x level so in practice don't plan on it' or alternatively 'sure. You just can't find info on it because as you said, practically no one does. But the 3GS years at the beginning of an integrated PRS program would be considered equivalent on paper at least and all you'd need to do is wait around for a vacancy to pop up somewhere and be willing to move and you could do it'.

Hoping SDN can connect me to some people in the know. I appreciate any insider aid I can get, thank you for your time reading along and consideration answering.

---

Members don't see this ad.

 

[vhawk]

I am not particularly knowledgeable about this but my guess is it would be one of those things that it makes some sense for you to be able to do but that the ABS would basically never allow because its such a rare situation and they get nothing out of it. You arent likely special enough for the headache that figuring this out would be

 

[ACSurgeon]

N=1

I know a foreign grad who completed his general surgery training outside the U.S. and then came to the U.S. and did 2-3 years worth of surgical fellowships. He was later (after working as a surgical attending for a few years) given the option to complete 2-3 more years of general surgery residency to be eligible to sit for the ABS board exam and become BC. He's taking the written exam this year.

Purpose of long story: talk to the ABS and see what they will accept as "years of training." Perhaps the more challenging part will be finding a program to take you as a PGY 3 or 4. However, as long as you have the green light from the ABS, I imagine some program somewhere would be willing to take you.

For this one person that I know- he was offered a residency spot at the rural program at which he was an attending for a few years. Interesting dynamic but you can't make this stuff up.

 

[doc05]

you'll probably only get 1 (maybe 2) years of credit. more importantly, you'll run out of gme funding, and no general surgery program would take you.

plus there's no point in following this path. if you want to do both (which doesn't make any sense) then do GS + independent plastics residency.

 

[PL198]

N=1

I know a foreign grad who completed his general surgery training outside the U.S. and then came to the U.S. and did 2-3 years worth of fellowships. He was later (after working as an attending for a few years) given the option to complete 2-3 more years of general surgery residency to be eligible to sit for the ABS board exam and become BC. He's taking the written exam this year.

Purpose of long story: talk to the ABS and see what they will accept as "years of training." Perhaps the more challenging part will be finding a program to take you as a PGY 3 or 4. However, as long as you have the green light from the ABS, I imagine some program somewhere would be willing to take you.

For this one person that I know- he was offered a residency spot at the rural program at which he was an attending for a few years. Interesting dynamic but you can't make this stuff up.

I lost you when you said he was working as an attending but then wasn't BC? was he working as like an FM doc or something?

 

[ACSurgeon]

I lost you when you said he was working as an attending but then wasn't BC? was he working as like an FM doc or something?

Foreign trained doctors can and do work at American hospitals without any U.S. Training. The hospital has to get special permission and say that this individual has a unique skill set that the hospital isn't able to find in American trained doctors. I think this is meant to be used in underserved areas where obtaining an American trained specialst is difficult, but I had surgical attendings at my medical school and residency who were not US trained and certainly not BE or BC. Neither city is under served. Not sure how they can get these exceptions approved. However, those doctors are almost stuck only working at the institution that obtained special permission for them. For my example above, his motivation to go back to residency after being a surgical attending was to become BC and have the flexibility to go elsewhere if and when he desires.

 

[tartesos]

Foreign trained doctors can and do work at American hospitals without any U.S. Training. The hospital has to get special permission and say that this individual has a unique skill set that the hospital isn't able to find in American trained doctors. I think this is meant to be used in underserved areas where obtaining an American trained specialst is difficult, but I had surgical attendings at my medical school and residency who were not US trained and certainly not BE or BC. Neither city is under served. Not sure how they can get these exceptions approved. However, those doctors are almost stuck only working at the institution that obtained special permission for them. For my example above, his motivation to go back to residency after being a surgical attending was to become BC and have the flexibility to go elsewhere if and when he desires.

That's interesting.
They can get special fellow license and some limited scope of practice( I knew 2 at my training institution, the one that was working in that way in surgery
they used him like a pa for rounds and stitches, consults etc, not as an attending in any way) and that was in NYC.
Most of the time they have 1 or 2 years of American training( like he had).

I've never had an urge to find out more about this, but it's interesting