Does residency funding always follow you?

[genessis42]

I know there's different sources like CMS, ThCGME, HRSA, and that's tied to your length of training. This makes it tough to switch from 3 year program to a specialty that may take longer.

What happens if you move from a place that is HRSA-funded to one that is Medicare?

Does that mean I technically haven't used up CMS funding?

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[NotAProgDirector]

You're asking a complicated question, which is impossible to answer.

In general, most of the funding for residency programs comes from CMS. HRSA funding includes a separate program for stand alone children's hospitals with residency programs, and ThCGME which sponsors outpatient programs that are not directly affiliated with a hospital. If your funding comes from one of these, or other, sources, then your CMS GME funding remains fully intact. However, if while in one of these programs you rotate at a hospital and they decide to submit you for reimbursement via CMS -- then your funding can be used. Usually, the residency program and hospital will have an agreement about whether this will happen or not.

There is no way to figure out how much of your funding is left.

In many cases, residency programs don't really care. ONce you are beyond your IRP, you still get partial funding -- 100% of IME and 50% of DME. Since IME is usually much bigger than DME, this often comes out to 80-85% of funding levels. And many programs are over their cap anyway, so then they just claim someone else with full funding.

 

[genessis42]

Yeah I was confused. If I'm starting again as a PGY2 spot at a different program, I worried that it would be 100% IME and 50% DME since I have 18 months done at a primary care program and technically used up 2 years.

And the primary care programs want the last 2 years of residency to be in the same program

I guess the THC GME to a CMS switch is always going to be a complex web since it's not the same source

Am I worrying too much about swapping?

 

[Apollyon]

And the primary care programs want the last 2 years of residency to be in the same program

I don't think it's "want" at all - it's a requirement of ABFM (for one). "Want" implies exceptions or non-compliance. There aren't any (to my knowledge).

 

[NotAProgDirector]

You're leaving out some core details. Not clear why you're changing, and from/to what fields.

GME funding (I believe) is by month, so if you used 18 months and started in a 3 year program, you'd have 18 months left. I could be wrong about that.

 

[genessis42]

I'm going from FM to FM with 18 months done in one of them. They told me I'm required to start as a PGY2 again if I take a vacancy in a different program and the PDs know that too.

 

[smq123]

I'm going from FM to FM with 18 months done in one of them. They told me I'm required to start as a PGY2 again if I take a vacancy in a different program and the PDs know that too.

Yes. You have to restart as a PGY-2, since ACGME policy states that the final two years of residency have to be in the same program.

The funding question is probably moot - are you worried that you won't receive a salary for the last 6 months of PGY-3?

 

[genessis42]

It's more about finding a position to start in July 1st as a PGY2 again outside of the match. Several programs told me their DIO is the one who figures it out.

And my situation complex because I was not in a CMS program and was HRSA

 

[NotAProgDirector]

This is such a niche issue, it's going to be impossible to get an answer from us regarding what funding is available.

The (perhaps) bigger issue is why you're changing from one FM program to another. If it was performance problems, or if there is a long gap, those are likely to be bigger issues than funding.

 

[Apollyon]

You're leaving out some core details. Not clear why you're changing, and from/to what fields.

No WAY!! Say it ain't so!!