Effect of traditional internship on one's residency
Started by bla_3x
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I just read this link:
http://www.saem.org/inform/osteo.htm
It seems like there may be an issue with funding your last year of residency, but there are some programs that require an internship year (Lincoln, BUMC), so I don't know how that works. This link suggests asking each program.
-K
http://www.saem.org/inform/osteo.htm
It seems like there may be an issue with funding your last year of residency, but there are some programs that require an internship year (Lincoln, BUMC), so I don't know how that works. This link suggests asking each program.
-K
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APACHE3 said:
I'm confused - which post is that a response to?
If the OP does an AOA internship and then selects a 4-year allopathic EM residency, the question still remains, will the last year be funded? Maybe it's not an issue if the OP goes to a 3-year program. Honestly I don't know the answers, but I have similar questions as the OP.
-K
From the link provided above:
This makes no sense to me.
I mean, if I chose to do an AOA internship and then "start over" at a three-year Allo EM residency, then I should be considered as a PGY I and have no funding conflicts...one would think 🙄
Why would that year not be funded, what's the logical, meaningful reason for such a policy???
This makes no sense to me.
I mean, if I chose to do an AOA internship and then "start over" at a three-year Allo EM residency, then I should be considered as a PGY I and have no funding conflicts...one would think 🙄
Why would that year not be funded, what's the logical, meaningful reason for such a policy???
It was my understanding that you are considered a PGY-2 since AOA and
allo residencies are all funded from the same sources. For example, at Newark Beth Israel's program, MD residents are 1-3 whereas DO residents start at PGY2 (2-4).
Is there anyone out there who knows the answer to this for sure?
allo residencies are all funded from the same sources. For example, at Newark Beth Israel's program, MD residents are 1-3 whereas DO residents start at PGY2 (2-4).
Is there anyone out there who knows the answer to this for sure?
bla_3x said:
R
Redneck
I don't even start school until this Fall, so I'm not of much value here...
Regardless, here are my thoughts. Why would someone worry about this? I mean a contract is signed, if I'm not mistaken, agreeing to the terms of the resident's duties and compensation at the start, so wouldn't funding be a concern of the program to hold up their end of the bargain - not the resident's? Assuming this is true, why undertake a resident knowing you can't fulfill the contract and compensate them?
Or am I speaking of things I have no knowledge of?
Regardless, here are my thoughts. Why would someone worry about this? I mean a contract is signed, if I'm not mistaken, agreeing to the terms of the resident's duties and compensation at the start, so wouldn't funding be a concern of the program to hold up their end of the bargain - not the resident's? Assuming this is true, why undertake a resident knowing you can't fulfill the contract and compensate them?
Or am I speaking of things I have no knowledge of?
Redneck said:
I think you're missing the question. The problem is not -- you have a contract signed and now you won't get paid. The problem is, if the program does not get funded for your last year, and they are not happy about the prospect, then you may not match there. Period. In addition, I believe that a contract is only per year, renewable each year. The contracts are not "4-year" contracts, but maybe that's only at the hospitals I've rotated through.
-K
bla_3x said:
bla_3x;
I'm doing exactly what you asked about (I start my AOA internship in July '06), so I've done a bit of research about this:
The program still gets funded - there are two different classifications of funding that come from CMS: DME (direct medical education) funds and IME (Indirect medical education) funds. IME funds are by far the more significant number (by more than 2:1).
CMS will pay for a certain number of years of postgraduate medical education, which has already been set, at FTE (full time equivalents) of DME and IME. If one goes over this number (does an internship or moves from one residency type to another), it's not that the program is not funded at all, they are only funded at 1/2 FTE for the DME funds (the smaller of the two). So, in effect, the program loses less than 1/4-1/3 of the total funding they would have received if the resident were not over the number of the "original training period" years.
It is not uncommon for people to get one or two years into residency, decide that field isn't for them, and then transfer to another residency type. The accepting residency doesn't get full funding for the final year or two of training, but they also get a resident with 1 or 2 years of training already under their belt - so, theoretically, the added experience of the resident may make their workflow that much faster, resulting in more income for the facility and less money lost for training the resident.
OK, maybe a bit far-fetched as far as the explanation goes, but that's what I tell myself. If you're interested in EM as a specialty, you can look at various web sites to see if they have ever accepted a person with previous training. Of the programs in which I am interested, all of them have accepted multiple residents with previous training in the past 5 years.
If you want proof, look at http://www.emramatch.org search for almost any EM program and look at the info sheet provided for # of residents with previous training (in the left hand column under Program Information).
Hope this helps answer your question.
jd
bla_3x said:
The difference lies in how HCFA (now called CMS = Centers for Medicare and Medicaid Services) defines allopathic vs osteopathic EM residencies.
They define allo as 3 or 4 years (depending on the category of EM residency PGY1-3, PGY2-4, or PGY1-4) after graduation from medical school.
HCFA defines an osteo EM residency as 3 years after an osteo internship (much like an allo PGY2-4 program).
See the difference? So, in effect, if you complete an internship, you can directly enter PGY2-4 allo programs, any osteo program (which is, by default, PGY2-4) and not run into funding problems.
However, if you do the internship and then enter a PGY1-3 allo program your PGY1 year has already been used by the internship - and although you are a PGY1 to the EM program, CMS sees you as a PGY2.
Hope this clears up some of the confusion...
jd
