career options, locums, residency funding snafu

[PunaHI]

Major questions are bolded.

I have struggled to get into residency for a number of reasons and I need advice about my options. I’m not sure how many details to include. I have not been able to reach anyone at my med school and feel so alone.

I graduated from med school in 2015 in NV but did not get into a residency in NV (at the time there was only 1 DO program and I did not take the USMLE). I’ve never failed a board exam but am at average or just below. I had good LOR but only uploaded in ERAS and nothing in hand. My dean’s letter is the biggest hit to finding success.

I attended a 1 year TRI in Fl from 2016-2017. I was anxious to get back to NV upon completion because I had separated just before receiving the offer for the TRI and divorced during my time away. It was all very hard on my son, who had to remain in NV, and once I finished the TRI my plan was to be back with my son and travel to Utah or Cali to work locums (since NV requires 3 years of residency but UT and CA require only 1). However, the locums company that I had been corresponding with starting in FL then told me that I needed 6 mo of work experience outside of residency to work with them. I have applied for other locums jobs/companies but I either don’t hear back or they also need work experience outside of residency. Does anyone have a recommendation on a locums company that doesn’t require anything more than my internship year?

I corresponded with a new DO FM program but they explained that since I had one year of TRI, I only have 2 years of funding left. They don’t have any second year spots so I’d have to start as a first year but couldn’t due to that funding issue. They were about to take me when the PD learned this. I can’t find any information about this online however and it’s devastating. Is it true that I can only take a second year spot since I’ve spent a year in a TRI? I’ve been away from patients since last summer upon completing the program so I’m at a major disadvantage. I did not participate in this year’s DO match since both hospitals said they wouldn’t take me and I hadn’t been ready to move away from my son at the time.

I’ve been enrolled in an Executive Masters in Healthcare Administration since being back in NV as I didn’t see a way to get back into residency. However, I want to see patients and do what I was trained to do! Even if I can’t see patients I don’t know what else I can do with my degree and haven’t found any good resources with these answers. I’m well educated but not qualified to do anything it seems and it’s baffling. I even looked into teaching positions but am not qualified. What else can I do with my degree if I can’t get into residency or see patients?

Can I get the list of unfilled programs even though I did not participate in the match?

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[NotAProgDirector]

The details you've included are somewhat vague, which I understand. It's unclear to me if you've had trouble getting a spot because of problems in your MSPE, or because you decided to only apply to NV programs because of your personal situation and now are trying to return after only 1 year of training. If the former, we'll need more details about what the problems are to be of much help. If the latter, you've made a big mistake which will be difficult to fix, as getting 3 years of training might have separated you from your child for 3 years, but then you'd be able to work anywhere you wanted.

The best way forward is to get a PGY-2 position based on your TRI experience. If your PD would be willing to do that but can't because they have no open spots, they should help you find a spot somewhere else that has an opening. This is the best plan.

In any case, your bolded questions:

Does anyone have a recommendation on a locums company that doesn’t require anything more than my internship year?

I think you'll find this very difficult. Most employers will want you to be fully trained. With only 1 year of training, you really don't know what you don't know. Especially in locums, they will have difficulty finding spots where you only have 1 year of training

Is it true that I can only take a second year spot since I’ve spent a year in a TRI?

Somewhat. Your funding is capped at the number of years needed to train in a specialty. So, yes, if you were to restart as a PGY-1, the funding in your final year would be decreased, but not zero.

You can read all about this here: https://members.aamc.org/eweb/upload/Medicare Payments for Graduate Medical Education 2013.pdf

What else can I do with my degree if I can’t get into residency or see patients?

There are non-clinical career options, but none are easy to get and often require other skill sets. Often discussed are:

Consulting - Getting hired by a reputable consulting firm with minimal clinical experience is likely very difficult without connections or a business background.
Research - doesn't pay all that well, would likely need some research background
Insurance - one poster here on SDN has a job working for a state insurance company. See here: Considering leaving medicine, please help?
Hospital admin - again, without clear clinical or admin experience, unclear how you would make this happen

You can search "non clinical career" and find some discussions of these options.

Can I get the list of unfilled programs even though I did not participate in the match?

No, but you can still register for the match and participate in SOAP and post SOAP scramble. But you'd have to pull an application together quickly.