Is this a good idea if I want to go to a MD EM program? I feel like I need a year to solidify my decision but I don't want to hinder my chances of getting into a 3 year MD program. Any thoughts? Thanks
Doing a transitional rotating internship?
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From a finacial standpoint it will not make a difference because a rotating internship is not a certification granting path. This means that you doing a rotating internship does not create any problems for your future graduate training program. Personally, if I was unsure of what I wanted to do I would take an extra year, because once you have started in a residency switching out is a big pain, and spending the rest of your working life doing something you don't really like is an even greater pain. I don't know if any programs would have a problem with somebody with a year of PG training, I don't see why they would. I would consider it an asset, but I am not a PD either. I hope you get some more answers.
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kumar28 said:
(disclaimer: this is my opinion only)
There is absolutely no reason to do a traditional internship unless you want to enter a program that begins in the PGY-2 year.
Why spend a year doing months of family practice, IM, OB, and peds, while getting paid zilch, when you could be out in practice a year earlier, and getting paid to see patients in the ER?
You get these months during the 3rd and 4th year of medical school. It's not going to be any different as an intern, so why do it? I'm not sure how doing an extra month of OB as an intern can solidify your path in that specialty.
The very reason that I'm applying only to ACGME EM programs (and not AOA EM programs) is that I find no reason that I need to do 4 years when most other people do 3 years for the same board certification.
Another thing to keep in mind is that if you enter a PGY1-3 EM program after completing an internship year, you will be considered the same as all of the new grads as a PGY-1.
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OSUdoc08 said:
There are lots of reasons to complete a TRI and re-apply the next year. I'll give you some of mine:
- There is a high possibility/probability that I will want to practice in one of the "5 states" in the near future. Rather than mess with getting an allopathic program approved by the AOA (when there are at least 3-5 AOA EM programs and a hundred internships within easy driving distance of where I want to train), I'll just take the year. I've heard through the rumour mill that program approval is becoming more difficult - could be only speculation, however.
- I want to move across the country with my soon-to-be wife who is also a 4th year. We discussed it and thought it might be easier to couples match into a TRI and then re-apply for places close together next year than trying to do it this year... besides, see the first point. We didn't want to tempt fate that one of us would be able to get our program approved and the other wouldn't - then we both would be restricted because only one was approved.
- Any extra training one receives is a good thing in my eyes. I may be considered a PGY-1 when I re-start in an EM program, but I can guarantee I won't be functioning as one - I'll have a year under my belt in the "real-world," so to speak. I've spoken to many residents who "started over" and some that didn't - their comments were unanimously agreed that the 2nd year PGY-1s were stronger in their clinical management and comfort with patients.
- What do you think you'll be seeing in the ED? Medicine, Ob/Gyn, pediatrics, and surgical complaints, right? How can added experience in these areas be bad? Sure, monetarily it might hurt to take an extra year, but I have been seriously considering pursuing a fellowship anyhow - which will be one or two years post-residency. I'm already postponing considerable income (and have already given up almost a half-mil just by going to med school), so what's another year of living in the poor house?
Are you intimating that your experiences as a third year medical student are comparable to those as a resident? Even as a second year medical student? I think you vastly overestimate what you will be doing as a third year or underestimate the difference between doing a H&P then presenting to a resident and actually formulating a treatment plan and being responsible for the outcome of a patient. Residency != third year student's level of participation. Even an intern (with his/her limited level of responsibility) >>>> 3rd year med student. These subtleties can make a huge difference and added training in these areas will make one a much better physician in the long run, especially in such a broad field as EM.
One last note: There is a reason many of the most sought after EM programs (Cinci, Denver, Northwestern, Charity, etc) are 4-year programs. Many of the early pioneers of EM thought the field should be 3 years of EM training after an internship - some of which became PGY1-4, others of which became PGY2-4. There were those that thought 3 years were enough and these became PGY1-3. Which is better is another thread unto itself and I won't discuss it - just realize that the 3 year route isn't the only way.. there are many paths that lead to the same goal. Your way may not be mine, and yours is no better.
That sounded almost like an old chinese proverb or something.
I'm done blabbing now.. sorry for the hijack just wanted to retort
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sure, no prob...
