Blitz2006

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So here's my dilemma.

I'm on J1 visa here in NYC, IMG PGY2 Psychiatry. I'm on restricted/provisional license in NY, as I am a IMG and can't get my full license until after PGY-3 (so PGY4).

I'm interested in doing en elective in Boston (Neuropsychiatry). The PD at one of the hospitals stated that the application is due end of PGY3, so it would be advisable to do elective early PGY3. But he said that in order to do an elective as a PGY3, I need a MA License.

So here's the issue, according to fsmb:

http://www.fsmb.org/policy/public-resources/state_specific

Prior to January 2014, 2 years for domestic graduates and 2 years for IMGs.
After January 2014, 2 years for domestic graduates and 3 years for IMGs.

So looks like I can only get a full MA license in PGY4.

Does this mean there is no chance in doing an elective in PGY3 in Boston? I find this hard to believe, because IMGs match all the time into MA residencies, so how are they able to work as a resident from PGY1-PGY3? Its the same as here in NY, I can only get full license after PGY3.

Replies appreciated, thanks.
 

gutonc

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So looks like I can only get a full MA license in PGY4.

Does this mean there is no chance in doing an elective in PGY3 in Boston? I find this hard to believe, because IMGs match all the time into MA residencies, so how are they able to work as a resident from PGY1-PGY3? Its the same as here in NY, I can only get full license after PGY3.

Replies appreciated, thanks.
Why do you need a full, unrestricted license for a 1 month rotation? If the program where you want to do the elective is willing to sponsor you (or whatever the Mass board requires), you should be able to get a training license which should be just fine.
 
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Blitz2006

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I agree, but the PD said I would need a license. Thats why I was wondering.

But I'm sure IMGs do electives in other states all the time....
 

gutonc

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I agree, but the PD said I would need a license. Thats why I was wondering.

But I'm sure IMGs do electives in other states all the time....
Yes...you need a license. It can be a training license. Figure out how to get one. Here's a link to get you started.
 

Winged Scapula

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I agree, but the PD said I would need a license. Thats why I was wondering.

But I'm sure IMGs do electives in other states all the time....
Is this really a thing; doing electives during residency outside of one's home program/affiliated programs?

Seems pretty rare in surgery with the exception of someone wanting to rotate with some superstar in the field (but since electives aren't common most don't bother).
 

Raryn

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Is this really a thing; doing electives during residency outside of one's home program/affiliated programs?

Seems pretty rare in surgery with the exception of someone wanting to rotate with some superstar in the field (but since electives aren't common most don't bother).
It's relatively uncommon in medicine, though I know a few that have done it to get letters for fellowship when they don't have a home program in the same. I looked into it, but it was more trouble than it was worth.
 
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typhoonegator

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Yeah, people do it. Sort of like how med students do away rotations to get into competitive residencies, residents do these visiting rotations to try-out for fellowships and get letters. Particularly useful when you want to do a fellowship that is not universal. For instance, I'm a neurointensivist, and not every hospital has a neurocritical care program or even a NeuroICU. So people who don't have local opportunities come from all over to do rotations so they can get experience and letters from people in the sub-field.

And just like that, I've made this thread all about me! To the OP, they can't possibly expect you to get a full MA license just to do an away rotation. That would take months and a lot of money and would be completely unnecessary with regard to the scope of your practice during the rotation. You want to do a supervised elective rotation -- not moonlight as a nocturnist or something.
 

gutonc

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Is this really a thing; doing electives during residency outside of one's home program/affiliated programs?
Agree with the others. This is rare, but happens, especially when looking to do a sub-specialized rotation that's not available everywhere as the OP wants to do. The HPB and MIS surgical services at my hospital have 2 or 3 outside residents each year, usually from community or smaller academic surgery programs.

But the thing I don't quite understand is that the OP is in NY and there are 2 neuropsych programs in NY. Why not take the easier route and do an elective at one of those places without having to go through the trouble of getting another limited/training license in a different state. Also, if the GME office at Man's Greatest Hospital isn't willing to help you with this, or the PD of the program isn't willing to even point you in that direction, that should tell you something about how much they want you there.
 

Winged Scapula

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Agree with the others. This is rare, but happens, especially when looking to do a sub-specialized rotation that's not available everywhere as the OP wants to do. The HPB and MIS surgical services at my hospital have 2 or 3 outside residents each year, usually from community or smaller academic surgery programs.

But the thing I don't quite understand is that the OP is in NY and there are 2 neuropsych programs in NY. Why not take the easier route and do an elective at one of those places without having to go through the trouble of getting another limited/training license in a different state. Also, if the GME office at Man's Greatest Hospital isn't willing to help you with this, or the PD of the program isn't willing to even point you in that direction, that should tell you something about how much they want you there.
Well that's why I was confused. I understand that for niche sub specialty that may not be available, if you had elective time, you might choose to go elsewhere. I just didn't understand that neuropsychiatry was such a speciality and why the OP would have to leave the state of New York to find a rotation.

Like you, I suspect are simply trying to make it hard for her to do a rotation there.
 
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typhoonegator

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Well that's why I was confused. I understand that for niche sub specialty that may not be available, if you had elective time, you might choose to go elsewhere. I just didn't understand that neuropsychiatry was such a speciality and why the boat we would have to leave the state of New York to find a rotation.
Eh, maybe the OP has family in Boston or something and thinks that a rotation at MGH/BWH/BIDMC/Tufts/BU/CHB will give them a leg up for fellowship applications. As Gutonc noted, the Harvard affiliate centers must have to deal with this so often, I'm sure the GME office has a streamlined procedure for licensure sponsorship. I'm puzzled that it was just left up to the resident to figure it out.

That said, I'm sure that there are good neuropsychiatry divisions in NY, and the OP could do a rotation there with the goal of getting some famous people to write them good letters. I think people tend to put a bit too much stock in the "try out" component to these away rotations, as if face time will give them a major advantage in fellowship matching. Most people don't look their best when they show up in a new hospital with a new electronic health record system and they don't know anybody. Certainly some people are rock stars, but if attendings don't give you the benefit of the doubt, you could come out of the situation worse than if you'd just stayed local and gotten a nice letter from a reputable source. At the very least, you can spare yourself the headaches and energy around getting a new limited license for a 2 or 4 week rotation.
 
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gutonc

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That said, I'm sure that there are good neuropsychiatry divisions in NY, and the OP could do a rotation there with the goal of getting some famous people to write them good letters.
Just a couple of mediocre no-name places. Columbia and Mt. Sinai.
 
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aProgDirector

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The problem with training licenses in MA is that you need to be sponsored by a MA training hospital / program. Many of them aren't interested in the extra paperwork involved. So they only accept you if you have your own license.

Another option is to get a full license in your home state, and then get a temporary license in MA. But in the OP's case, they can't do that until their PGY-4.
 

typhoonegator

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Just a couple of mediocre no-name places. Columbia and Mt. Sinai.
Well there you go, no wonder they have to turn to Boston to find a credible institution!

And aProg, the relative willingness to sponsor temporary licenses probably varies by department, no? Or is it a characteristic of the GME office?
 
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Blitz2006

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hey, thanks for all the responses!

So yeah, basically I want to do an elective at one of the Big 3 in Harvard. I figure it will strengthen my fellowship application. Yes, Columbia and Mt. Sinai is available in NY, but:

1) Columbia historically prefers neurologists (I'm a psych resident)
2) Mt. Sinai's Dept. is good, but not in the same league as UCSF/Hopkins/MGH

I figured doing 1 month in a Harvard hospital will open my doors to any big name fellowship in the U.S.

I have been doing some research, looks like I can get a limited MA license for $100, and takes 6-8 weeks to process. Not too bad...

http://www.bidmc.org/Medical-Educat...ial Limited License Application Kit 2011.ashx

But I'm gonna call the hospital admin this week and get more info.

Appreciate all the help. I'm hoping they will let me do this, as I think it would be beneficial for my career.
 

Winged Scapula

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I think you are drastically overestimating the impact of a one month elective
Blitz listen to these 13 little words.

It's very difficult to shine during an away elective. You are putting yourself in a position of being totally unfamiliar with their facilities, electronic medical record, and their culture. In addition, presumably their current residents are the cream of the crop. It is the rarest superstar resident who can put themselves in a totally unfamiliar environment and compare favorably especially during such a short period of time.
 
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Blitz2006

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Points well taken.

But here's the situation:

1) The Harvard faculty member is impressed with my CV and has specifically "highly reccomended" I do an elective with them. So I turn it down?
2) I mean, what do I have to lose? Worst case scenario, I tank the elective yet I get a month of experience at Harvard. Even if I bomb it, I doubt it will ruin my career.

But you guys have given me some food for thought, thanks.
 

Winged Scapula

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Points well taken.

But here's the situation:

1) The Harvard faculty member is impressed with my CV and has specifically "highly reccomended" I do an elective with them. So I turn it down?
2) I mean, what do I have to lose? Worst case scenario, I tank the elective yet I get a month of experience at Harvard. Even if I bomb it, I doubt it will ruin my career.

But you guys have given me some food for thought, thanks.
My question is: when you say they "highly recommended "an elective with them was this in response to your query about matching into a fellowship there?

If so I would suggest that this may be a boilerplate response from them.
 

rokshana

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you may very well be able to do the elective...but please don't think think that makes you a slam dunk in getting a fellowship at any of the Harvard programs...sure they take some FMGs...but they tend to be rock stars in their own right...but a LoR from a well known attending may help you get a fellowship elsewhere.
 
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235009

I mean, what do I have to lose?
If they don't sponsor you for a limited training license then you'll be out $1500 for a full license and ~$1500 in rent plus travel costs.

If the goal is to get a letter from a big name then go to Columbia or Sinai. If the goal is to end up at the program you should look to see if they take IMGs to begin with. I'm assuming these spots are limited and competitive.
 
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Blitz2006

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Points well taken.

Well, I'm going to call up MA Licensing this week/Harvard, regarding the limited license. I am hoping limited should be enough ($100). I still am only a resident, and MA residents only have limited licenses, so I think it should be alright.

I agree living cost will suck. $1200ish for rent + transport. But I figure it will be a invaluable experience, and like rokshana's said, even if I don't match into Harvard, my thinking is that a Harvard letter will help possibly plug me into another well reputable program. But yes this could also just be a waste of $2k/1 month of my life.

I'm also banking on the fact that Neuropsychiatry isn't exactly a SUPER competitive fellowship (unlike Gastro in IM or surg onc in Gen Surg). Even within the world of psych, neuropsychiatry is down below, in already a relatively non-competitive field of applicants for psych fellowships in general (I believe in 2015 Child Psych, most competitive psych fellowship, only filled 85% and CL Psych filled 57%). With neuropsych not even ACGME accredited...

But lets see what admin says this week.

Really appreciate everyone's input, definitely helping me decide if I should head up the I-95 or not.
 
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235009

Points well taken.

Well, I'm going to call up MA Licensing this week/Harvard, regarding the limited license. I am hoping limited should be enough ($100). I still am only a resident, and MA residents only have limited licenses, so I think it should be alright.

I agree living cost will suck. $1200ish for rent + transport. But I figure it will be a invaluable experience, and like rokshana's said, even if I don't match into Harvard, my thinking is that a Harvard letter will help possibly plug me into another well reputable program. But yes this could also just be a waste of $2k/1 month of my life.

I'm also banking on the fact that Neuropsychiatry isn't exactly a SUPER competitive fellowship (unlike Gastro in IM or surg onc in Gen Surg). Even within the world of psych, neuropsychiatry is down below, in already a relatively non-competitive field of applicants for psych fellowships in general (I believe in 2015 Child Psych, most competitive psych fellowship, only filled 85% and CL Psych filled 57%). With neuropsych not even ACGME accredited...

But lets see what admin says this week.

Really appreciate everyone's input, definitely helping me decide if I should head up the I-95 or not.
Well good luck. Definitely don't take the I-95 from nyc to boston.
 
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rokshana

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If they don't sponsor you for a limited training license then you'll be out $1500 for a full license and ~$1500 in rent plus travel costs.

If the goal is to get a letter from a big name then go to Columbia or Sinai. If the goal is to end up at the program you should look to see if they take IMGs to begin with. I'm assuming these spots are limited and competitive.
Mass full license isn't that expensive...700? i think? + the CSR too...150 i think..
 
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Blitz2006

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So I called MA License board today. They said I shouldn't have any issues getting it.

It looks like a limited license costs $100, and doesn't seem too intensive of an application, few pages to fill out:

http://www.mass.gov/eohhs/docs/borim/kits/initial-limited-kit.pdf

Takes about 6-8 weeks to process.

So basically now I just need to make sure I can come to Dept. of Psych Harvard on J1 visa. I'm fairly certain Harvard will accept me on J1, usually its the visa hospitals like, but need to get in touch with them this week.

Yeah NY License is around $780 (Full License), so I doubt full MA license is $1500?

Isn't I-95 the only way from NYC to Boston?!?
 
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235009

Yeah NY License is around $780 (Full License), so I doubt full MA license is $1500?

Isn't I-95 the only way from NYC to Boston?!?
I think $1500 includes getting a DEA number and other things. That's just the number I've heard people mention/complain about.

Use Google maps. I95 is the longest and least direct route.
 
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Blitz2006

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Yeah you are correct then. Cause DEA here is another 700ish

I think $1500 includes getting a DEA number and other things. That's just the number I've heard people mention/complain about.

Use Google maps. I95 is the longest and least direct route.