Does a non-ACGME accredited PGY-1 internship = externship?

[drdel]

Hi everyone,

I'm an IMG who took a little time after graduation to do research, and didn't successfully Match/Scramble last month. I heard about a prelim surgery position in a local hospital, interviewed and got it. Except I just realized it's not only a non-designated prelim position, it's also unaccredited. The contract calls it a "PGY-1," but designates it "Adjunct Teaching/Non-Accredited"... not "Preliminary" and certainly not "Categorical."

It just occurred to me -- is this what people refer to as an 'externship' whenever IMGs talk of clinical experience in the USA? Paid clinical work in the US with actual responsibility (vs. an observership)?

I have nothing against it, and as an IMG I figure the clinical experience would be good for me and my CV, and it pays a lot better than research, but I just want to know what the hell this position actually is. I don't want to call myself an 'intern' when I'm really nothing of the sort. And I want to know how to identify myself when I apply again for a real residency in the fall. Thanks!

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[myhandsarecold]

hmm, are they letting you practice medicine? do u have direct patient care responsibilities? can you prescribe and operate? is the medical board giving you a training permit?

 

[drdel]

I honestly wish I knew the answers to your specific questions. The contract, in terms of duties and responsibilities, seem to indicate that I will have direct patient care responsibilities. I will have malpractice insurance, an NPI number, etc. I have no idea about limited licenses/training permits.

I'm going through the same orientation as the accredited residents (both prelim and categorical), and the admin staff keep calling me a resident and PGY-1. I also seem to have the same schedule expectations as the other interns -- at least, I'm assuming so, working 6 days a week with occasional night float.

Basically, I have no idea what to make of it... the people I've mentioned it to have never heard of an unaccredited PGY-1 internship. Unaccredited fellowships, sure, but internship? Weird.

I'm on the brink of just asking the program coordinator what the heck it means, exactly. I just feel a little silly since I had to scramble for this thing, and basically jumped at the opportunity without (obviously) knowing enough information about it. That always seems like the kind of thing you hear about happening to others that you never think will happen to you... but it does.

 

[myhandsarecold]

yeah weird, hmm, sounds like a residency. wont hurt to ask to see if you will get any credit for it once you match to an accredited residency. call it "postdoctoral training/internship" in ur CV which is what it is. ask your state medical board if you will be able to apply for a full license after you complete the year

at least you have a job, right?

 

[drdel]

It is weird, right? I may ask the program coordinator (she seems nice), what exactly is the classification and function of this position -- meaning, what exactly do I call it on my CV when I reapply to the Match this year.

I should probably ask about limited licenses/training permits, too. I mean, if I'm somehow not responsible for patient care nor expected to, then it would be good to know. But, I also can't imagine they would offer to pay as much as they are paying me if I *wasn't* caring for patients!

I guess I go back to the original reason I even accepted this position: it's paid clinical experience, and a good paycheck. Accredited or non-accredited, it's still those two things. It's still something to put on the CV and money to throw at loans! Certainly pays a helluva lot better than research.

Oh, to address your other point; I don't think I can get a license after the year. I looked into New York requirements, and foreign medical school grads need 3 years of hospital training, not the 1 for AMGs (I looked into it because I've been interested in Preventive Medicine for a while and I thought at least I might try for it after this year is over, but I apparently not).

I don't mind doing internship over again if I have to, if I get a full, accredited residency, but I'd just like to know if this year counts against me in terms of CMS funding... Is doing this for a year going to bite me in the ass somehow...? Sigh.

Thanks for chiming in, tho; it's nice to have someone to bounce these questions off of!

 

[NotAProgDirector]

You're starting an unaccredited internship.

The good news:

You'll be a full fledged doctor. You'll be seeing patients, writing orders, signing prescriptions, etc. You'll be able to do exactly the same thing every other PGY-1 intern is doing. It will be a great way to gain US clinical experience.

The bad news:

Since it's unaccredited, it doesn't count for anything. It will not count towards board certification. It will not count towards licensure (probably, may be state dependent). When you apply again next year, you'll need to apply only for PGY-1 positions.

Also, since it's unaccredited, there are no rules. They can work you as hard as they want.

Some additional good news:

Since it's unaccredited, they probably don't bill Medicare for your training costs. This means that all of your funding remains intact for next year. Not 100% certain about this.

 

[drdel]

Thank you, aProgDirector -- that's pretty much exactly what I thought, on all counts, but it's still nice to hear it confirmed from someone who might actually know something definitive.

It's very unfortunate that they can work me as hard as they want, and I have no protection from it. May FSM give me strength.

Any idea as to how I should reference this position on my CV when I reapply to the Match this fall...?

Sincerely, thanks again!

 

[NotAProgDirector]

Any idea as to how I should reference this position on my CV when I reapply to the Match this fall...?

It's an unaccredited internship.

 

[aprusandrew]

Hi everyone,

I'm an IMG who took a little time after graduation to do research, and didn't successfully Match/Scramble last month. I heard about a prelim surgery position in a local hospital, interviewed and got it. Except I just realized it's not only a non-designated prelim position, it's also unaccredited. The contract calls it a "PGY-1," but designates it "Adjunct Teaching/Non-Accredited"... not "Preliminary" and certainly not "Categorical."

It just occurred to me -- is this what people refer to as an 'externship' whenever IMGs talk of clinical experience in the USA? Paid clinical work in the US with actual responsibility (vs. an observership)?

I have nothing against it, and as an IMG I figure the clinical experience would be good for me and my CV, and it pays a lot better than research, but I just want to know what the hell this position actually is. I don't want to call myself an 'intern' when I'm really nothing of the sort. And I want to know how to identify myself when I apply again for a real residency in the fall. Thanks!

Hi drdel,

I am in the similiar situation as you having no interviews till now and I'm looking for other options. Can you please express your experience at that place? Did it help you? How to find such openings? Thank you.

 

[Winged Scapula]

Hi drdel,

I am in the similiar situation as you having no interviews till now and I'm looking for other options. Can you please express your experience at that place? Did it help you? How to find such openings? Thank you.

This is nearly a four-year-old thread the OP has not posted since April 2013 and is not likely to respond to your question.


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