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Would a program let you do this? Let's say it's a competitive residency. Can you offer to complete it for free?
Can you pay for your own residency?
- Thread starter chickflick
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You can but that probably won't make you competative enough. Most people offer to pay the program director an additional amount.
Its hard to determine how much to offer but lets say you really suck... I'd maybe offer 1000 a month just for the difficulty of dealing with things you'll mess up and the embarassment of having you at his/her program.
Things are getting more competative
and you and your parents need to step up your offer if you're going to get that residency. Good luck!
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Yes...if you're John Carter trying to switch from surgery to the ER back in 1997. Probably not in real life.
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Probably not.
You're not the first person to ask this on SDN. In that thread, aProgDirector chimed in with helpful (as always) advice:
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This question tends to come up every year around this time. In the vast majority of cases, the answer is no.
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ftw!!!!
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You can but that probably won't make you competative enough. Most people offer to pay the program director an additional amount.
Its hard to determine how much to offer but lets say you really suck... I'd maybe offer 1000 a month just for the difficulty of dealing with things you'll mess up and the embarassment of having you at his/her program.
Things are getting more competative
Whoa there tiger...me and my parents? Getting a little ahead of yourself buddy. Just because a guy has money doesn't mean its mommy's and daddy's. Don't hate on me buddy, I was given this world, I didn't make it.
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I agree with what has been said here and in threads past... including the experience and knowledge shared by AProgDirector. Just to add some thoughts to the topic:
1. my understanding of programs being required to pay residents goes also to "same level" residents, to my knowledge must be paid the same too. So, you could not have an unpaaid or lesser paid PGY1 withe the rest of the PGY1 class paid a standardized/different compensation.
2. A theme often permiates many healthcare/physician thoughts that it is improper for physicians to expect high compensation. That, we somehow, must do it purely for the warm feeling within our hearts and a greater sense of service. Well, going to the OP question, we are talking about "competitive" specialty. By the proposed idea, someone is not getting in because they are competitive but rather because they are ~wealthy... Effectively, someone is buying their way into the field. The appearance of injustice would be too much. There are too many sad stories of impoverished trying oh, so hard to get into college, then into medical school, then residency... now comes along the great wealthy non-competitive applicant that circumvents any semblance of "hard work" or "merit" and simply buys into the specialty.
I appreciate the ER/John Carter memories, etc... But, I do find this resurrection of theme fairly distasteful when you actually think about the implications, i.e. ~can I buy my way into residency if I can't compete.
No offence intended. Just saying it sometimes takes a little extra and you (and you alone champ) may have to step it up beyond just working for free. I matched in a tough specialty some years ago by working for free but some of these guys from india etc. are coming in these days and topping my offer. I don't think I could keep up this application cycle if I had to do it again and I had my own trust fund. If I had to outbid these guys I'd need my parents help...thats all I meant. Anyway, best of luck to you squirming into a spot...don't think everyone is out to get you.
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Hey I'm from India!
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You can but that probably won't make you competative enough. Most people offer to pay the program director an additional amount.
Its hard to determine how much to offer but lets say you really suck... I'd maybe offer 1000 a month just for the difficulty of dealing with things you'll mess up and the embarassment of having you at his/her program.
Things are getting more competative
What...?!
I have never heard of this before. People pay the the program director to accept them? Is this a widespread practice??? I would think it would be illegal for a prospective resident to bribe a program director to accept you into his/her residency program, as well as illegal for a program director to accept a bribe. This sounds like something I could imagine happening in a foreign country struggling with corruption issues, but not here in the US. Please tell me that I am confused and not understanding this correctly...
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What...?!
The above poster was being sarcastic...
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What...?!
While I do think the poster was being sarcastic, I do not doubt at all the reality of something like this happening. When BIG $$$$ starts being thrown around, our country and countrymen are not at all immune to being bribed. If you truly believe our country does not have corruption, then you are being quite naive. Case in point, when St. George bought New York rotation spots:
http://www.fiercehealthcare.com/sto...igns-caribbean-med-school-training/2008-08-06
I have started seriously wondering about the possibility of Caribbean schools paying residency programs (who are looking to make some cash) a nice "bonus" for taking their graduates. Think about it from a business perspective. It is important for Carib programs to market that their grads are getting into residencies or else the value of their programs (and the $$$ generating) will drop. No pre-med, no matter how desperate, wants to go to a program that cant get them into a residency. So from a marketing perspective it absolutely benefits the Carib schools to do things like - a). buy rotations spots or more b). secretively, buy residency spots. No, I do not have proof in this claim. But I thought it rather eye-opening in a hospital I rotated at when the program directors, and all the big wigs of the residency programs and hospital take an annual all-expense trip to Dominica for "educational purposes". And of course the hospital is teeming with St George students, and each of the residencies in the hospital have a large percentage of St George grads...well you can make your own inference.
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I have worked with many SGU students, many who are my friends, this is not an attack on the students of SGU, but instead is bringing to light the business practices of SGU which I feel is downright wrong!!
I hope NY med schools reverse the bribery/corruption/nepotism exhibited by the NYC Health and Hospitals Corp. together with your school and SHUT OFF the highly padded($$$) rotation spots bought by your school. At the same time because of this obvious example of SGUs willingness to pay money for rotation spots, than paying for residency spots is not in the least a far fetched idea.
"....Maybe the school does offer the "annual all-expense trip", but that is to discuss clinical rotations and how they can be improved. " Yeah...right! The same way Pharmaceutical companies used to offer free things (eg. trips, dinners, etc) just so they could discuss how much better their drugs work! Continue to think whatever, to make you feel better at night. SGU is a corporation, with profit sharers. The only thing that matters at the top of the food chain in corporations is PROFITABILITY! Medical school grads getting residencies is a marketing tool (and ALL Carib schools use this tool to death - meaning they advertise incessantly about where their grads get residencies). Corporations spend lots of money on marketing tools. Again, is this a far fetched idea? Nope.
Bitter, with a complex???? Not in the least. I received a great education. I am very happy with how the interview season went, and I look forward and confidently to hearing where I matched next week, and starting residency in a good program come July 1st.
On the other hand, personally attacking me like this makes you look more like the bitter one.
Geeze, the sense of entitlement in this field is ridiculous. Why do physicians/ physicians in training draw such rigid lines against each other? Part of the appeal of this field to me was the concept that doctors rise above divisors like creed, race, age, sex, nationality...school of attendance to do their jobs
pull out your genitals fellas and fellies, the contest is just beginning
pull out your genitals fellas and fellies, the contest is just beginning
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Geeze, the sense of entitlement in this field is ridiculous. Why do physicians/ physicians in training draw such rigid lines against each other? Part of the appeal of this field to me was the concept that doctors rise above divisors like creed, race, age, sex, nationality...school of attendance to do their jobs
pull out your genitals fellas and fellies, the contest is just beginning
We rise above most of those things but not douchebaggery of which the OP is clearly guilty.
Point of clarification, I'm referring to the AMG/IMG debate raging on in the two posts above my initial one. Continue the barrage of rotten tomatoes at OP lol
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They're intertwined in this thread though.
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Op? Wait that's me. Why am I a bad guy again? Oh yes because I wanted to do something evil. Ok go on.
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Question has been asked and answered numerous times. Well thought and reasonable responses given. Links to previous discussions also incleded. At this point, it seems clear this thread is more a humor/political or troll-esque debate.
Wow, the responses to OP are way harsher than I would have expected.
Anyway, as the others have suggested, practically speaking the answer to your question is pretty much no.
In actuality, spots can be (and are) paid for in certain cases. The rub is that the payment needs to be made by a third party.
A common example I have heard of several times is that a program is approved by the ACGME for more residency/fellowship spots than they have funding for, so they are accredited to train more residents than they can pay. Often these spots just sit unfilled, but sometimes these spots are given to the following types of people:
1. Resident comes from a residency program that shuts down, but program still agrees to fund resident's education if they can secure a spot elsewhere. This type of funding is thought to be kosher because the resident did match and another institution (not the resident himself) is paying for it. Often residents aren't this lucky, because many times when a program folds, the funding goes with it.
2. Resident from a foriegn country has some sort of funding from their home country for training in a specialty that they can't receive at home. In this case the government pays the program enough to fund the spot, the program takes the resident, and the resident goes back to said country after training is complete.
3. Same as above, but resident comes from some underserved area within the US and has funding from a local hospital. Hospital pays program, program takes resident, and then resident returns to area to practice.
I know personally of people who have obtained spots in situations 1 and 2. I have only heard of people in #3 second hand.
One thing to note that in these situations (for sure in #1, not 100% sure about #2 and #3) is that the program is not really being paid anything extra, they are just being given what it would take to pay for the residents salary and benefits.
Now the question you are probably asking is if the above scenarios are considered OK, then what's wrong with an individual just offering to pay the program that sum of money themselves? It seems the main difference is really just the source of the money (of course, there are others). Is there anything ethically wrong with this? Maybe. However, I think it is a much more complicated ethical question than some of the posters in this thread would have you believe. To explore it fully would require more effort than I want to expend (and it looks like everyone else pretty much feels the same way). I think the "douchebag", etc. comments are out of line as you could easily construct scenarios in which an individual paying for a spot would be considered ethically acceptable by most reasonable people.
On the other hand, you could probably more easily construct scenarios in which most reasonable people would find an individual "funding" their own spot very unethical. And when most people ask this question, these are the types of scenarios that they tend to have in mind -- which is why the responses can be so negative.
Anyway, as the others have suggested, practically speaking the answer to your question is pretty much no.
In actuality, spots can be (and are) paid for in certain cases. The rub is that the payment needs to be made by a third party.
A common example I have heard of several times is that a program is approved by the ACGME for more residency/fellowship spots than they have funding for, so they are accredited to train more residents than they can pay. Often these spots just sit unfilled, but sometimes these spots are given to the following types of people:
1. Resident comes from a residency program that shuts down, but program still agrees to fund resident's education if they can secure a spot elsewhere. This type of funding is thought to be kosher because the resident did match and another institution (not the resident himself) is paying for it. Often residents aren't this lucky, because many times when a program folds, the funding goes with it.
2. Resident from a foriegn country has some sort of funding from their home country for training in a specialty that they can't receive at home. In this case the government pays the program enough to fund the spot, the program takes the resident, and the resident goes back to said country after training is complete.
3. Same as above, but resident comes from some underserved area within the US and has funding from a local hospital. Hospital pays program, program takes resident, and then resident returns to area to practice.
I know personally of people who have obtained spots in situations 1 and 2. I have only heard of people in #3 second hand.
One thing to note that in these situations (for sure in #1, not 100% sure about #2 and #3) is that the program is not really being paid anything extra, they are just being given what it would take to pay for the residents salary and benefits.
Now the question you are probably asking is if the above scenarios are considered OK, then what's wrong with an individual just offering to pay the program that sum of money themselves? It seems the main difference is really just the source of the money (of course, there are others). Is there anything ethically wrong with this? Maybe. However, I think it is a much more complicated ethical question than some of the posters in this thread would have you believe. To explore it fully would require more effort than I want to expend (and it looks like everyone else pretty much feels the same way). I think the "douchebag", etc. comments are out of line as you could easily construct scenarios in which an individual paying for a spot would be considered ethically acceptable by most reasonable people.
On the other hand, you could probably more easily construct scenarios in which most reasonable people would find an individual "funding" their own spot very unethical. And when most people ask this question, these are the types of scenarios that they tend to have in mind -- which is why the responses can be so negative.
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I also know of people - FMGs - from a rich country that shall remain unnamed - who are in the above described situation (number 2). What is not obvious to me though, as was given as a reasoning for such a paid placement, is about the specialties/training not being provided in their home country. The people I know have gone into e.g. internal medicine and of course it is offered in said country. I think the idea of a superior US training is more dominant. Said country has a HUGE program dedicated to placing residents in this manner. Lucky for the recipients. (I am not from said country)
Thanks for clarifying the ACGME background of how it works.
As to the posed question of the "ethical" aspect - let me pose another paid scenario. There are some highly competitive programs who charge around $5000 (five thousand) for 1 (one) month's observership. What do you think of the ethics of that?
And totally aside from the ethical aspect, what I would really like to know from you guys is - if someone coughed up the $s and paid for such an observership or extership, would the experience and LOR obtained as a result be as good as the same would have been obtained from a non-paid one? Again, keep in mind this is a highly respected competetive institution.
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Maybe not the answer you were looking for, but short of something like a Radiology or Pathology observership, I wouldn't find a LOR from an observership to be helpful at all.
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Do you consider it unethical for medical students to pay tuition, or for Medicare to subsidize hospitals for employing residents? Yeah sure in a way everything is pay-for-play, but you're trying to compare apples and oranges here.
Do you mean that where there is less patient interaction the clinicians will have more time to interact with you (or because you will have opportunity to work hands-on) and therefore they will get to know you better and hence more meaningful LORs? And the opposite for clinics?
Just want to make sure I understand what you mean.
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I would not pay $5k for an observership. You would get more mileage out of a high USMLE score, doing research, and rotating somewhere as a med student (hopefully NOT in an observer-only role).
As far as paying for residencies, you can't pay for an ACGME residency. there are some fake derm residencies that won't lead to board certification that someones fp or IM docs will do. This works mainly if you want to do derm stuff in some small town...you kind of apprentice yourself to some private practice derm place or clinic that doesn't have a "real" residency. I can't say how good the training would be, but might be adequate to expand your scope of practice somewhat.
There are cases where I've seen foreign countries pay for a trainee to do a fellowship in the US. In some cases, the people are taking a spot that a US resident could have had.
As far as paying for residencies, you can't pay for an ACGME residency. there are some fake derm residencies that won't lead to board certification that someones fp or IM docs will do. This works mainly if you want to do derm stuff in some small town...you kind of apprentice yourself to some private practice derm place or clinic that doesn't have a "real" residency. I can't say how good the training would be, but might be adequate to expand your scope of practice somewhat.
There are cases where I've seen foreign countries pay for a trainee to do a fellowship in the US. In some cases, the people are taking a spot that a US resident could have had.
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He means that an observership does not give the letter writer the ability to see you in a clinical capacity and therefore, the letter is LESS meaningful. An observership does NOT offer "hands on" work.
Fake residency??
It's either a residency or it's not as far as I know. Could you please elaborate on "fake residencies"? How do they pass off as a residency?
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While the term "fake" may imply that it is not a "real" residency, DF's point that since these are not accredited residencies, they do not lead to BE/BC in that specialty and are therefore, not worth the paper your certificate is written on. In this day and age of increasing requirements for credentialing, training in an unaccredited or "fake" residency is foolhardy, IMHO.
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No, what I meant was on most services simply being an "observer" won't allow you to do anything. I'm not sure if you'd be able to participate in discussions during rounds in fields like Medicine/Peds (perhaps, perhaps not) but certainly you wouldn't be doing anything in a procedure-based field and hence wouldn't obtain a LOR.
Exactly.
What ostensible country could this be??
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There really should be no reason for being offended by the residents in such programs. Ethics and integrity should prevail and if they are in a program... there really should be day light on what the arangement is. It makes no sense to say, "Oh, I am offended cause you know my native nation has paid/sponsored my residency in the USA"...It's not ostensible, it "is".
I don't want to name the country in case any of the residents/potential residents are reading and they get offended somehow. There are very many of them.
I have never seen the checks to GME or agreements. But a few points based on limited conversations and "FMG Placement Prelim Year/s Program" advertising....
1. I believe Washington has a substantial FMG recruit and brag of placement program.... Folks can look for and/or investigate any truth to it
2. I have been told by program directors/admins and residents alike that Saudi Arabia & Kuwait pay for resident training. Further, I have been told the "standard" is for these countries to pay double what the fed pays for USA trainees. Generally, can't speak for every program, this money goes to the sponsor institution/university and not the specific residency. Rather, the foreign residents employment package looks identical to all other residents and the program sees identical funding from the sponsor/parent institution/GME/etc.... The arguments have been multitude on why there is this "double charge" to the home country..... The foreign residents see same salary/healthcare/etc... and have a return and work obligation with sponsor native country.... sort of like military residents....
Either way, I have not arrange any such deals and therefor not been privy to all facts/details/etc... rather, just had admins & residents tell me this. Maybe all hyperbole and false info.
JackaDeli, I agree with you in principle. However, the thing is, if the spot into which this resident was being taken was not the said "paid" spot, it would be highly likely that someone else would be taken based on better/prefered qualifications. The paid nature of these residencies oils these residents' way into these programs. So because of this, they don't want to talk about it, even though they don't deny it. If it were me, I guess I would feel a little uncomfortable too, to be "seen to be" taking the place of someone else who is better qualified than me, even thought strictly speaking this isn't true becuase the additional spot would probably not exist if it were not for the paid nature of the spot.
As for your explanation in point 2, I wasn't aware of those details but makes perfect sense. The question you pose as to why the resident would be paid as they are but institution gets double is, I think, answered in my above point.
Again, I don't have a problem with this. Just stating my observation. And kudos to the lucky recipients.
I didn't understand what your point 1 is about though. Perhaps you can elaborate.
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That sounds like they have a personal problem. "Their" insecurities resulting in non-discussion is just another example of political correctness. In truth, if someone is trying to be politically correct and not offend someone by just discussing some realities, then said individual shouldn't say it exists and then feign away from what countries are involved. It is silly, somewhat dumb, and frankly smacks of bating someone else to come and spell it out. Anybody trying to be politicaly correct and protect the ?dignity of these droves of anonymous forum readers should then say nothing at all.
Seriously? You don't want to mention a country name cause it might offend the natives... but you will entice the topic and then pretty much say, these individuals from countries that will remain un-identified, are for all intense purpose under qualified as compared to... But, let us not name a country cause we might offend.
Nothing to get other then there are supposedly "recipiant" programs on the USA side. If someone is interested in the topic, they can investigate.
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"Their" insecurities resulting in non-discussion is just another example of political correctness. In truth, if someone is trying to be politically correct and not offend someone by just discussing some realities, then said individual shouldn't say it exists and then feign away from what countries are involved. It is silly, somewhat dumb, and frankly smacks of bating someone else to come and spell it out. Anybody trying to be politicaly correct and protect the ?dignity of these droves of anonymous forum readers should then say nothing at all.Seriously? .
I suppose your said individual would be me. I'm amused by the accusation, but not offended. I wasn't trying to be politically correct, I never am. And yes, that would have required not saying anything at all. Mine was just a choice. You obviously knew much more about these programs than I did.
I'm sorry if it seemed like bating. It wasn't my intention and I didn't think US residents would even know these programs existed. Ok, I was wrong.
And you know, you could just have written you, rather than said individual.
I wouldn't have been more offended, just less amused.
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a while ago on SDN a position was offered where the program director would take you if you had funding from the army or navy. probably had to pay him something.
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Or... wait for it... you had to have military funding.
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I gotta say I know someone who is kinda desperate for a residency...they have the money to pay for it...how much depends on the residency but $50,000 for ANY PGY1 SPOT IS NOT OUT OF THE QUESTIONS (ONLY ACGME ACCREDITED). They might even offer a $5k finders fee.
The being said they absolutely do not want to do anything illegal or unethical, so the money has to be put do good use like improving the program, research, etc. Nothing that can be interpreted as an ethics violation or conflict of interest by any medical boards.
[email protected]
The being said they absolutely do not want to do anything illegal or unethical, so the money has to be put do good use like improving the program, research, etc. Nothing that can be interpreted as an ethics violation or conflict of interest by any medical boards.
[email protected]
If s/he has $55M at his/her disposal, why doesn't s/he do a year of unpaid but good research somewhere hence getting the experience and the LORs to get in a residency? I'm sure he'd find a good psoition as long as he doesn't want to be paid and the money would go toward supporting him/herself.
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Nothing says "you're my #1" more to a PD like some crisp Benjamins.
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Love it!
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is it considered bribery? and what did you post that email for? do they offer spots? if so, is there a payment plan..and what types of spots are offered? categorical?
(yes i am desperate...but doubt i could afford this)...
Under your name you're listed as "Resident". Why are you desperate?
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Wow.
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i was a resident..i had to leave due to illness..and they didn't accommodate for me to finish 2 months I missed..now that i've recovered, im trying to get residency again...i have to redo it...i didn't match or scramble this year...so therefore im desperate...i'd pay..if there was a payment plan...because i don't have $50k in hand...
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Double wow.
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