Doomed to scramble

[Annette]

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My chances of getting a transitional residency. My applications were late, and now my transcripts, dean's letter, and letters of rec haven't even been sent to ECFMG let alone uploaded. Something about running out of paper for the transcripts, hurricanes, and other general miscommunications. And to top it all off, I am not even certain what I want to do, so scrambling is even less appealing. I need your help.

I am considering pulling out of the match, and trying next year. At this point in time, I am so confused, I am not certain that I can see all the ramifications. What pitfalls do you see?

 

[cushing]

you sound like your ****ed

 

[Farrakh]

Annette, this post is more for Cushing -

damn dude... I hope you're not as blunt with your patients!

As for your situation Annette, I hope eveything works out.. I know the scramble is freaky in that you WILL get something or another - but WHERE is the key issue... Many programs give you just a few hours to 24 hours to decide if you want to sign up with them. Others will call u in for an interview. The real question is: are you willing to get up and move to a program you know nothing about because they have a spot open in a field MAYBE you want to be in... this is what happened with a friend of mine. He made a really bad rank order list, didn't match and during post-scramble called hosp after hosp in every state. He finally got something but had NO IDEA about the program. Well, to make a long story short - he's not happy and wishes he did something else for a year and then re-applied for the match. However, there's always the option to go to a program you like, find a matched student and go Soprano on his/her ass. I hope it doesn't come to that.

Farrakh 😉

 

[Magree]

Hi:

I have a friend in a similar situation as Annette. What happens if he does take a year of to say do research? Some programs seem to not want to people who have been away from the wards for a year. Can anyone comment? Thank you.

Cheers,

M-

 

[Freeeedom!]

Annette,
Are you a carribbean student?

 

[Annette]

Yep, freedom, I'm a caribbean student. My school is new, so this whole match thing is as new to them as it is to me. Also, my timing of being in England put me behind as well (it isn't all the school's fault).

And don't be too hard on cushing. I've got the feeling he is so right.

 

[Freeeedom!]

Annette,

Why did you choose caribbean...and a new one at that? It seems the SCHOOL has *****d you.

 

[Farrakh]

I am a product of Carribean-school-upbringing also (UNIBE in D.R.) and I have not had any problems with paperwork, deadlines, etc. But then again, each school is different - not to mention how much time they have to get the paperwork in order. No school, U.S. or otherwise, can meet deadlines that are too close when it comes to official documents.

peace,
Farrakh 😎

 

[e2k]

Scrambling sucks, but it's not the end of the world. I know a few people who have scrambled and gotten transitionals that lead to great categoricals, and even some people who slid right into categorical spots.

Don't drop out of the match unless you're really sure your documents won't arrive on time.

Also, you didn't mention what you wanted to do. If you want Med, Peds, or FP, you'll almost certainly be scramble away. If you want one of the more competative specialties, you can get a transitional and then apply again.

Lots of great residency slots go unfilled every year. Harvard was polling for Emergency medicine residents this year...you never know.

Good hunting
ERIC

 

[dr figs]

yo wasup farrakh! hmmm lets see if u can figure out who i am....we went to school in the banana republic and i knew it was u asking about that hotmail problem but wasnt quite sure! hope everything is chillin w/u...peace


😀

 

[Farrakh]

Dr Figs,

I sent you a message, but I don't know if you got it... I can see you're from Florida, but I can't figure out who u are.. reveal yourself, please! 😛

Farrakh 😛

 

[Sheerstress]

Annette:

Do you have a faculty mentor or advisor? You'll probably want to talk it over with someone in that capacity if you haven't already.

Doing a transitional year wouldn't be bad (I myself did one); Ken Iserson does a good job of explaining the pros and cons in his book (Iserson's Getting Into a Residency).

One thing you should consider is how it would affect your future chances of matching in a specialty. In case you didn't know, all residency programs are reimbursed by Medicare based on your "initial residency period (IRP)," which corresponds to whatever is the length of the specialty you jump into after medical school. In other words, if you were to start in an internal medicine (IM) program, your IRP would be IM, and Medicare would fully reimburse (1.0) your program for 3 years (Any further residency time that you do beyond those 3 years would still be reimbursed, but only by HALF (0.5) as much). Your IRP does not change even if you switch specialties, which is why it can be difficult if you later find you don't like what you're doing (i.e. if you want to switch from IM to say, general surgery).

In the case of a transitional year, it does not establish an IRP (since transitional year is not a specialty), but that year will later be counted as one of the years when you finally do start a formal residency program in a given specialty. In other words, if you later enter an internal medicine program, that program will only be reimbursed 1.0 for two of the three years since one of the years was already used up (in your transitional year). More and more residency programs, particularly in competitive specialties, are this to screen out applicants.

For this reason, you might consider doing a preliminary surgery year (since that specialty's IRP is 5 years), which would not make you a liability in the sense of reimbursement.

Hope this isn't too confusing, but it's something that too many people don't realize until it's too late. I hope it works out for you - good luck!

 

[limejello]

I'm worried about finding a transitional/prelim spot too. Does anyone know how the scramble works? It seems like we would need to go through ERAS again. Any info would be appreciated. Thanks!

 

[Sheerstress]

The scramble is actually pretty straightforward, although you'll have to be prepared. You find out the day before the scramble whether or not you matched (this will be 3/18/2002 for this year's match).

If not, the scramble will take place on the next day (3/19/2002). You will want to have all your ERAS material (all the personal info), personal statement, C.V., board scores, recommendations, transcript, and dean's letter (I think that's everything) at hand.

At 11:30 A.M. EST, filled and unfilled results for individual programs will be posted to the Web. Then, at 12:00 P.M. locations of all unfilled positions are released to applicants and programs. [What this means is that you could sift through all the programs between 11:30 and 12:00 to get a heads up on what programs' specialties will have unmatched positions before they're posted according to specialty at 12:00].

Unmatched applicants may begin contacting unfilled programs at 12:00 noon EST. In other words, at 12:00, it's off to the races! Your medical school will likely provide phone and fax access for you, so like I said, HAVE EVERYTHING READY. The most competitive specialties will probably fill up real fast, whereas others may drag their feet a little. Regardless of what you want, keep in mind that until you've concluded negotiations by phone, you've got nothing.

Again, Ken Iserson's book explains this pretty well. Hope you don't have to go through this.

 

[Annette]

Thanks, Sheerstress about the reimbursement heads up!

 

[Sheerstress]

Further info about the whole residency reimbursement issue can be found at:

<a href="http://www.aamc.org/advocacy/issues/medicare/dgme.htm" target="_blank">http://www.aamc.org/advocacy/issues/medicare/dgme.htm</a>

They have a downloadable pamphlet that should be read by everyone:

<a href="http://www.aamc.org/advocacy/issues/medicare/dgmebroc.pdf" target="_blank">http://www.aamc.org/advocacy/issues/medicare/dgmebroc.pdf</a>

 

[Stinky T]

Originally posted by Sheerstress:
•

Doing a transitional year wouldn't be bad (I myself did one); Ken Iserson does a good job of explaining the pros and cons in his book (Iserson's Getting Into a Residency).

One thing you should consider is how it would affect your future chances of matching in a specialty. In case you didn't know, all residency programs are reimbursed by Medicare based on your "initial residency period (IRP)," which corresponds to whatever is the length of the specialty you jump into after medical school. In other words, if you were to start in an internal medicine (IM) program, your IRP would be IM, and Medicare would fully reimburse (1.0) your program for 3 years (Any further residency time that you do beyond those 3 years would still be reimbursed, but only by HALF (0.5) as much). Your IRP does not change even if you switch specialties, which is why it can be difficult if you later find you don't like what you're doing (i.e. if you want to switch from IM to say, general surgery).

In the case of a transitional year, it does not establish an IRP (since transitional year is not a specialty), but that year will later be counted as one of the years when you finally do start a formal residency program in a given specialty. In other words, if you later enter an internal medicine program, that program will only be reimbursed 1.0 for two of the three years since one of the years was already used up (in your transitional year). More and more residency programs, particularly in competitive specialties, are this to screen out applicants.
•••

Actually, according to the link you provided, if you do a residency that requires a prelim year (Derm, PM&R, Anesthesia, Rads, etc.) then you would get full funding for your entire residency. The AAMC website goes on to state that if you elect to do a residency that does not require you to do a prelim year, that you could only get half the funding during your final year. My interpretation of this would be that a transitional year would be the most attractive option. A program would potentially lose at most 50% of funding for your final year. Plus, you wouldn't have to suffer through an internship in general surgery. 😉

Thanks for the link, it was quite informative.

 

[Sheerstress]

Yes, if the program requires the prelim year, it probably won't make a difference.

Note, however, that while specialties such as anesthesiology or dermaology are reimbursed for 4 years (1 prelim year plus 3 categorical years), certain others such as Emergency medicine are only reimbursed for three whether it's a 3 year or 4 year program (EM residencies have both 3 and 4 year programs. The 4 year programs end up eating the last year).