Originally posted by Sheerstress:
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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.
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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.