Coming over from the dark side...

[switching teams]

Here's my story... I was a categorical general surgery resident until recently. I finished my PGY-2 year in June. I took Step 3 late, failed, and then lost my residency spot. (Warning to medical students: after you match, PLEASE make sure you know what the state requirements are for licensure in the state you matched. And yes, I was an idiot for not knowing this.) Anyway, after a lot of thought... and even rejecting a couple of opportunities that would have allowed me to continue my surgical career... I've decided to go into anesthesiology.

I've called up about half the programs in the nation and know that landing a spot for this year (2006-2007) is basically impossible. A decent number of programs have told me that they will better know the number of open CA-1 positions they'll have for July 2007 in September, and about 10 have told me that they actually will be accepting CA-1 applications for July 2007 starting next month. I have significant surgical research experience in the past and am hoping to do some significant anesthesiology research this year.

Any and all advice for my predicament would be appreciated. I know beggars can't be choosers, so fundamentally I'm just hoping to land a CA-1 spot for July '07. Can I actually hope to stay on the East Coast? Do I have a shot against FMGs who blew their USMLEs out of the water when applying for open CA-1 spots? Anything in particular I can do to make myself look attractive to anesthesiology programs except repenting for having chosen the wrong side of the drape from the get go? (And yes, I'm planning to take Step 3 again soon, and I'm hoping to do well on it.)

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[VolatileAgent]

there's a reason why the surgical drape is called the "blood-brain barrier".

good luck, my man. i'm sure there's a spot out there for you somewhere, if you're willing to be flexible.

 

[Laryngospasm]

Here's my story... I was a categorical general surgery resident until recently. I finished my PGY-2 year in June. I took Step 3 late, failed, and then lost my residency spot. (Warning to medical students: after you match, PLEASE make sure you know what the state requirements are for licensure in the state you matched. And yes, I was an idiot for not knowing this.) Anyway, after a lot of thought... and even rejecting a couple of opportunities that would have allowed me to continue my surgical career... I've decided to go into anesthesiology.

I've called up about half the programs in the nation and know that landing a spot for this year (2006-2007) is basically impossible. A decent number of programs have told me that they will better know the number of open CA-1 positions they'll have for July 2007 in September, and about 10 have told me that they actually will be accepting CA-1 applications for July 2007 starting next month. I have significant surgical research experience in the past and am hoping to do some significant anesthesiology research this year.

Any and all advice for my predicament would be appreciated. I know beggars can't be choosers, so fundamentally I'm just hoping to land a CA-1 spot for July '07. Can I actually hope to stay on the East Coast? Do I have a shot against FMGs who blew their USMLEs out of the water when applying for open CA-1 spots? Anything in particular I can do to make myself look attractive to anesthesiology programs except repenting for having chosen the wrong side of the drape from the get go? (And yes, I'm planning to take Step 3 again soon, and I'm hoping to do well on it.)

You were kicked out for failing step3? I thought that in most states you had 7 years after you passed step one to pass step 3? That would give you until your senior year of a gen surg program, was your program that malignant?

 

[switching teams]

You were kicked out for failing step3? I thought that in most states you had 7 years after you passed step one to pass step 3? That would give you until your senior year of a gen surg program, was your program that malignant?

You're right... in MOST states that's true, just not all. About my program, it had options on how to deal with me. It chose to turn its back on me.

 

[Laryngospasm]

You're right... in MOST states that's true, just not all. About my program, it had options on how to deal with me. It chose to turn its back on me.

Sorry to hear that, wish you luck with your apps.

 

[seattledoc]

If you haven't taken and passed step 3, you better before you interview somewhere. You're an albatross around their necks if they sign you and you can't pass the test.

 

[seattledoc]

retaken and passed I meant

 

[Laryngospasm]

retaken and passed I meant

Are you eligible to take it if you are not at an accredited program?

 

[switching teams]

Are you eligible to take it if you are not at an accredited program?

Yes. Just as each state has its own requirements on issuing training licenses (which is how I got burned), each of them have their own requirements for Step 3. I am registering with a neighboring state's board which has no traning requirements or limits on how many times a candidate sits for the exam. That being said, I don't really want to sit for this exam again. I am planning on taking it sometime in mid-September and have been studying for it everyday for a couple of weeks now.

So on the advice of a friend who had switched out of a surgical subspecialty into anesthesiology, I ended up calling probably a majority of the programs in the country and spoke to their respective program coordinator/secretary/assistant to the program director. Now I found out that a few of the programs whose coordinators told me they weren't accepting CA-1 applications for 2007 will, in fact, be interviewing people. Should I email individual program directors now as well to make sure that I'm not missing any opportunities, or do you think my phone calls to the coordinators/secretaries/assistants suffice?

 

[kittykat]

Not an expert, but here are my two cents which will hopefully give you some food for thought during this unexpected transition.

At www.fsmb.org/usmle_eliinitial.html you can find a list of state requirements regarding licensure. Most are 7 years as previous posts stated...but, before we start calling out programs as being malignant, WE have to first research whether WE were informed and WE failed to comply.

Cent #1:
For example, most residents receive a resident's handbook at orientation. If your institution failed to inform you of their rule requiring successful passing of USMLE 3 prior to being appointed as PGY-3, then they were derelict in their duty (whether or not you have recourse, you can consult with an attorney) ...but since I don't know your institution let's google a random school, try: w3.ouhsc.edu/surgery/reshbk2006.pdf
In summary:
*page 10 states- handbook organized for your benefit...your responsibility to read and comply with it...as agreed by your signature....blah, blah, blah.
*page 13 states- before a resident (new or old) can be appointed to PGY-3 they must have passed USMLE steps 1-3...even though state requirements summarized on page 20 talk about the 7 year deal.

Pretty standard stuff, whether it's medical programs, private businesses or city laws ...all can have stricter ordinances to make sure that they comply with and not supercede state/federal law; Bottom line "a little bit" of noncompliance is still noncompliance and can cause negative consequences.

Cent #2
As far as switching sides...you may want to read the AAMC pdf file on "medicare payments for GME that every med student, resident and advisor should know" on the AAMC website (recreated in the EM FAQ thread -June 2004). In summary:
It talks about how programs get paid when they accept people who have already used some of their GME funds that have been allotted to them. Granted, people switch all the time, but this may help explain how/why some programs may respond to you in the future.

I hope you will give us a follow-up on how things go for you. Thanks for sharing so that others may learn. Good luck in your endeavors.

 

[bubalus]

Here's what you need to do.

Send a CV and cover letter to every program. Get the addresses off FREIDA and use Word's mail merge to generate a personalized form letter. Couple hours worth of work and should cost <$50. If you don't know how to do it, use the help function or look on line.

Apply through ERAS for a 2008 CA-1 spot. Some programs you interview at may have 2007 spots and you may get one. Start the process ASAP.

Do well on Step 3. Failing a step is a big red flag. You need to prove it was an anomaly.