Fellowship lost accreditation with one year to go. Options?

[CrispyWonTon]

Unfortunately, my program lost accreditation despite working with ACGME. I was a CCM fellow as PGY4 and transferred to my current PCCM track as PGY5. With all programs closing, is there a possibility I can graduate as CCM since I'll have met the ACGME and ABIM clinical requirements by the end of this year.

ACGME has mentioned they have no control over graduation and ABIM are still working on an answer. I was hoping to get some input from SDN. It's been stressful and I'd be thankful for any advice.

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[smq123]

Unfortunately, my program lost accreditation despite working with ACGME. I was a CCM fellow as PGY4 and transferred to my current PCCM track as PGY5. With all programs closing, is there a possibility I can graduate as CCM since I'll have met the ACGME and ABIM clinical requirements by the end of this year.

ACGME has mentioned they have no control over graduation and ABIM are still working on an answer. I was hoping to get some input from SDN. It's been stressful and I'd be thankful for any advice.

Out of curiosity, how much geographic flexibility do you have?

 

[CrispyWonTon]

I'm willing to move anywhere! Location will not be a limiting factor. However I wanted to give due consideration to the option for partial completion as one of my colleagues has burnt out and is not even trying to transfer. I've tried explaining that it would be a complete loss not to apply for transfer. If it's possible to receive a certificate for our training and be board eligible, it wouldn't be a complete loss.

 

[NotAProgDirector]

It's possible. You'd need to work with your current program and the ABIM. You would need to be able to show 12 months of clinical ICU experience at a minimum -- none of your pulmonary training would count towards CCM (perhaps except for bronchoscopy). In general, residents or fellows in combined programs can abort and choose just a single field, but need to meet all the minimum requirements for that field. I expect the ABIM might be flexible in a situation like this, assuming you have 12 months of clinical ICU experience.

If the entire GME system is being closed down at your program (which you somewhat hint at in your post), then you become an orphaned resident and your funding travels with you and programs will usually be granted temporary increases in their complements if they request them. If it's only the PCCM program being closed, then whether or not your funding is released is up to the institution. But it's not always so easy -- if there's concerns that your current program isn't up to standards (and hence is being withdrawn by the ACGME), other programs may be unwilling to take you for only your final year over concerns that your skills may not be at level.

 

[CrispyWonTon]

It's possible. You'd need to work with your current program and the ABIM. You would need to be able to show 12 months of clinical ICU experience at a minimum -- none of your pulmonary training would count towards CCM (perhaps except for bronchoscopy). In general, residents or fellows in combined programs can abort and choose just a single field, but need to meet all the minimum requirements for that field. I expect the ABIM might be flexible in a situation like this, assuming you have 12 months of clinical ICU experience.

If the entire GME system is being closed down at your program (which you somewhat hint at in your post), then you become an orphaned resident and your funding travels with you and programs will usually be granted temporary increases in their complements if they request them. If it's only the PCCM program being closed, then whether or not your funding is released is up to the institution. But it's not always so easy -- if there's concerns that your current program isn't up to standards (and hence is being withdrawn by the ACGME), other programs may be unwilling to take you for only your final year over concerns that your skills may not be at level.

Hi NotAPD,

Thank you for answering!

I do have 12 months of clinical ICU experience including 3 months of SICU/CVICU/NeuroICU as stated by ACGME guidelines.

In regards to funding, you're correct, we are not orphan residents as only the programs were closed and not the institution. The GME however have agreed to temporarily release funding for fellows accepted elsewhere to facilitate training completion.

I do fear the same stigma if I pursue transfer. I have worked extensively in ICU especially during the COVID pandemic in NY for most of my residency. I now have more experience with ECMO, ECPR, post surgical and neurological management on top. In addition to highlighting these along with bronchoscopy and pulmonary experience, I'm unsure how to market myself as a viable transfer candidate.

I am hoping for flexibility on part of the ABIM and again appreciate your input!

The GME did raise concern that they would have to create a temporary increase to CCM in order to facilitate my graduation in CCM but I'm unsure if this is necessary as I am currently a PCCM fellow.