Thank you for the additional information. There appear to be several problems. We DO want to help but there are some significant issues at work here.
First, as an FMG without stellar USMLE scores and more than 6 years from medical school graduation, you are not a competitive candidate. The farther you, or anyone, even a US grad, gets away from graduation, the less competitive they generally are. Only stellar candidates can purposely take 3.5 years off to do research and expect to have anywhere near good chances of getting into training in the US.
But perhaps you weren't aware of this, perhaps you didn't prepare in advance to come to the US and find out what you needed to do to match. All of that is in the past. You cannot change when you graduated nor can you change your USMLE scores. So you're starting off "behind the 8 ball".
I did research for 3 1/2 years, my boss helped me to get into IM residency with his influence against the will of program director.
During my interview, the PD was asking me how can my boss can force him to take me in, and i said i honestly don't know anything. I got in.
I can understand being desparate for a position but it sounds as if this was destined to fail. I too would wonder how the PD could be "forced" to hire you, unless your boss was the Department Chair, some other hospital bigwig or had some dirt on the PD that he threatened to tell if he didn't hire you.
At any rate, forcing yourself into a position and having the PD tell you that he doesn't want you there, seems to me to be a set-up for failure. In no way am I now suprised that you were fired. He gave you a chance he didn't want to, and documented that you could not succeed, so was well within his rights to fire you.
The very first month in July 2007 my attending a best friend of PD, gave evaluation of 5 and wrote a letter to PD, that I can't handle CCU. Next month Aug i did CCU and i got evaluation of 6 and i passed.
Again, you got shafted. You are, at that point, 5 years out of medical school, having spent 3.5 years doing research. Almost everyone's clinical skills would be creaky, if not downright rusty at that point. To put you in the CCU for your first month, where the level of knowledge, the skill set and the acuity is pretty high, is again, a plan for you to fail.
BTW, the numbers "5", "6", etc. mean nothing to us. Every hospital uses a different system of evaluation - I shall assume, however, that you mean on a scale of 10 - with 10 being the best they've ever seen and 5 is somewhat substandard (that would mirror the system we used).
All the attendings and residents like me except chief residents, i don't know why. In the month of Nov i had a resident who was going to be a cheif resident and i faced lot of trouble with her. She mentioned that i neglected breast cancer pt and i was kept on probation from Dec to FEB.
Whether they like you or not is almost irrelevant (although being liked can get you through a program even if you are substandard). They clearly had some concerns about your level of knowledge and perhaps more importantly, your judgement. Did you neglect a cancer? When you were told you did, what was your response? Did you learn from the experience or argue with the Chiefs?
All my eval from Dec to Feb are 6, 7, and 8. Then i went to MICU in March 2008. My attending in MICU is a X chief resident. On the 2nd day when i worked in MICU the program director came to my attending and spoke to her inlength. i worked in MICU for 10 days. During this period, my MICU attending wrote a letter to PD that I was supposed to call the MICU fellow to his house for any new admissions on the days i am on overnight call.
My overnight call is handled by CCU , 3 rd resident, and she admits the new patients. i told her that i need to call the fellow for new admissions. She said pt is stable no need to call, call him tomorrow at 6:00 AM and i followed her instructions and i called at 6:00 AM. The fellow was pissed off. I explained the entire story, but him and the attending were not convinced. They told me even the pt is stable i need to call, and i should not follow resident instructions. I said i am sorry, i wont' repeat the same mistake.
Sounds like they weren't clear about the instructions from the beginning. I also learned the hard way that calling the Chief or the fellow, at all times, even if patients were stable, was the best way. THEY (the fellow, the Chief, the attending) will tell you if you don't need to call. But either your 3rd year also wanted you to fail, didn't realize herself that the fellow wanted to be called about all admissions or was going to call him herself. It would have been nice if your 3rd year had stood up for you and told them that she instructed you not to call; but physicians aren't known for such chivalrous behavior.
Every single day during rounds they ask me billions of questions but they don't ask other resident or intern. 10 days working in MICU i was terminated.
Sometimes there is a resident who is made a scapegoat; some like to call it tough love (ie, if they didn't care about you, they wouldn't be asking and trying to improve your knowledge base) but often it is just picking on the resident. I'm sorry it was you - sounds like they had serious concerns about your knowledge and readiness to be in the MICU.
My program director gave me Letter of recommendation. He mentioned i am hardworking, good work ethic.
As you mentioned in your first post, this is a pretty bland recommendation. What is more glaring is what he doesn't say - ie, you have good insight and judgement, your clinical skills, your level of knowledge. Obviously, its important for a resident to be hardworking and have a good work ethic (suprising few residents do), but the other attributes are important as well.
I passed all the evaluations. She will be credited for the following 8 months and listed all the rotations in letter. He wrote this letter in the month of March. In MAY he submitted an ABIM evaluation and gave me unsatisfactory for 8 months and I got "0 " credits.
From March to June he gave me reading electives. He never mentioned any where about the reading electives.
I'm not sure what reading electives are except they sound like an attempt to improve your knowledge base and are not considered for credit - at your program or with ABIM. So what was said to you in March? Were you told that you woud not be offered a contract for this year and instead would be doing non-credit electives? I am confused about what you were told about the reading electives and what the PD says about the discrepancy between the LOR and the ABIM evaluation. Did he have a change of heart?
I called few IM programs and explained them that in recommendation letter i have credits and in ABIM report i don't have credits. The IM program coordinators mentioned they will go by the ABIM.
Yes, I expect they would (go by the ABIM report).
I called the FP PGY2 programs and they mentioned that they just need a letter from the PD, that i was given credits and they will see which ones match and they can give me credits.
Sounds good - so they will take the letter as proof and not a report from ABIM?
I am not sure how many of these will be credited. I have faxed my information for few PGY2 programs in FP and i didn't get any call.
I did the following rotations 3months of INPATIENT medicine wards, 1 mon CCU, 1 mon ER, 1 month Nightfloat, 1 month Hematology consult and 1 month research elective.
Programs have to use whatever requirements the ABFM says they can in order to allow you credit. You may or may not get FM credit for those months.
I want to apply for PGY1 FM, and a program director in AAFP mentioned there will be medicare funding issues...
Did you do a Prelim Medicine year or were you hired as a Categorical IM resident? If it is the latter, then you have 3 years of Medicare Funding. 8 months is currently used. If it is the former (you were a Prelim IM resident), then the clock has not started on your Medicare Funding. It starts when you enter training for the terminal BE/BC in your field.
about 60k has been given to my IM program for 8 months i worked and the new program i join will not get this 60k .medicare.
Nor should they. If your program spent 8 months attempting to train you, there is no reason another program should get money for it as well.
However few programs don't care about funding.
Which are these programs?? i don't know, i am assuming probably Univ programs in FP? with my background i don't even know whether i will be qualified for univesity programs.
No one knows where these programs are, because a central list does not exist.
If you were a Prelim, your funding clock has not started, so there is no problem.
If you were a Categorical resident, then you have 3 years total, of which you have used 8-12 months (it is unclear to me why you said you got funding for 8 months or 60K, as CMS funding is for 12 months and usually around $100K per resident. From my calculations it sounds as if you were a resident from July 2007 to July 2008. That is unless, you were essentially fired in March and the program did not accept or receive funding for you for the last 4 months.)
Do not make the mistake of thinking that University programs have more money or are more competitive than community programs, it doesn't always work that way. In addition, even if you have used up 8 - 12 months of your funding, programs will still get some money from CMS after your clock runs out.
It is only true that you will have problems based on funding as a function of other probems with your application. That is, a great resident, typically doesn't have funding issues because programs are willing to do with less money for training that resident.
I suspect that the funding issue is an easy way for programs to get around discussions about your application. Its much easier for them to tell you that than to tell you that your poor evaluations, distance from medical school, low USMLE scores, etc. are the reason they aren't interested.
But all is not lost; people in similar positions have found spots. You essentially have to call, and write, and FAX everyone and everything about a position.
None of us here has a crystal ball as to where the programs are that would be ok with your application.
Will some one pllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllease help me .
i am graduate of 2002 from india, did 3 1/2 yrs of research, 2 years of observership, 8 months PGY1 in IM, and 3 months of acting internship.
scores step 1 85, step 2 second attempt 75, step 2 cs passed . now preparing for step 3.
Have you ever attempted to go through the match? Why did you spent 3.5 years doing research and 2 years of an observership? Did someone tell you that these would be good things to do to get into a US residency? I am stymied that you have spent that amount of time away from medicine and appear not to have tried to apply anywhere but rather finagled your way into a program that didn't really want you and are now suprised when they fired you for what appears to be some knowledge and judgement deficits.
I suppose the answer to my questions above won't really make a difference except to underscore the importance to others that you have to keep trying to get in, and cannot settle back doing other things and wishing yourself into a residency. Have you been applying for the match for 6 years now and never got in anywhere?
Openings will crop up this year as people leave programs, but they aren't well advertised. If you still have some connections at your former program, if any of the attendings are willing to help you, you need letters from them, and assistance in getting a position. You need to resolve this issue with the PD about whether you are getting credit or not.
Finally, the match for 2009 is starting in a couple of weeks. Do you have your application ready to go? Do you have letters, etc.? I would suggest you consider starting over with PGY-1 rather than looking for a PGY-2 program that will take you mid year.
i remain confused...
