Getting back into Residency Program

[MedSobe]

Hello Everyone:
I was wondering if I can get some guidance/advice about my situation. I did PGY1 (IM) in 2001, was in a categorical program (I'm a foreign med. grad. have green card) My father got seriously ill during my training, I decided to go back home after finishing my first year. My father passed away the same year. I came back and tried to match couple of times. Started working different jobs in hospital (Med. Assistant and research associate) and enrolled in a masters program. I graduated this year and very motivated to get back into program. Applied last year, got only one interview for Anesthesiology for PGY2; The PG was concerned about lapse in my clinical medicine. I am studying to take Step 3 and re-apply for 2010.
I appreciate some advice about:
1. Are there any chances of me getting back in a program?
2. What would help to improve my chances?
3. Can I re-apply for PGY1?

Thank you:

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[dragonfly99]

I'm interested to hear aprogramdirector's advice on this.
I think you'll have a hard time getting into any of the more competitive specialties (that includes anesthesiology) or any specialty requiring procedures, just because of the lapse in your training.

Can you get a letter of recommendation from some faculty member at your old internal medicine program?

It seems that internal medicine or family practice would be your best bets for getting in somewhere. You might need to take Step 3 as soon as possible...some states require that all the USMLE steps be taken within a certain number of years...you DEFINITELY need to check on this. Also, what about the Step 2 clinical skills exam? Will you need to take that? I am not sure...I know it wasn't required years ago, but now it is, at least for recent graduates.

If you just want to be a physician in the US, and don't care a lot about the specialty, you might be able to try some of the more unusual specialties, like medical genetics or preventive medicine...I'm just thinking.

 

[dragonfly99]

Make sure the programs you apply to know that you didn't get fired,and that you had a reason for leaving after PGY1.

I would think you could apply to PGY1 internal medicine spots...probably would be easier to get accepted than as a PGY2 IM...PGY 2 is hard b/c you have to supervise other people, help run the ICU, etc. It is stressful and I can't imagine doing it after being out of clinical medicine for 6 years.

 

[Winged Scapula]

Hello Everyone:
I was wondering if I can get some guidance/advice about my situation. I did PGY1 (IM) in 2001, was in a categorical program (I'm a foreign med. grad. have green card) My father got seriously ill during my training, I decided to go back home after finishing my first year. My father passed away the same year. I came back and tried to match couple of times. Started working different jobs in hospital (Med. Assistant and research associate) and enrolled in a masters program. I graduated this year and very motivated to get back into program. Applied last year, got only one interview for Anesthesiology for PGY2; The PG was concerned about lapse in my clinical medicine. I am studying to take Step 3 and re-apply for 2010.
I appreciate some advice about:
1. Are there any chances of me getting back in a program?
2. What would help to improve my chances?
3. Can I re-apply for PGY1?

Thank you:

As you know the chances diminish the farther you are aware from clinical medicine.

But yes, you can reapply for PGY-1 and frankly, its probably what you need to do. You'll need to start from scratch, prove that you can get back into the swing of things and are up to the task of being a resident.

Its probably easiest to get a PGY-1 prelim surgery position, but unless you wish to be a surgeon (which I doubt) it is not as flexible a year as a prelim medicine would be. Obviously categorical would be best, but at this point you may have to settle for a prelim spot to get your foot into the door.

Check with the NBME regulations on the amount of time lapsed to complete all 3 USMLE steps. I thought there was a limit of 7 years; not sure what you have to do if you have exceeded that limit.

Therefore, you need to check on licensing issues, get some LORs from clinical faculty if possible and apply to every possible program you can afford. Be prepared to scramble if you don't match; let programs know you will take a contract outside of the match (as you are eligible) and have a Plan B. The fact that you got a PGY-2 interview means that you are probably a reasonable candidate except for the time away from medicine. If you can continue to work in a medical field during your time off, that would be helpful as well.

best of luck to you...

 

[Doctor Bob]

1. Are there any chances of me getting back in a program?

Well, sure, there's always a chance. The years since medical school are going to work against you, along with the failed attempts, but at least you kept your foot in the medical field. I'm not sure how much the master's will help. The hurdle you will have to overcome is the lack of clinical experience/knowledge and a Masters degree doesn't address that. The work as a medical assistant, while good because it shows continued enthusiasm for the medical profession, also doesn't really make up the gap.

2. What would help to improve my chances?

You need to overcome the 8-9 years of time off and probably your one best shot will be with Step III. You need to pass it, and pass it well. A failure will probably close this door. A borderline/low pass may as well.

3. Can I re-apply for PGY1?

Sure. Because you were categorical before, depending on what kind of program you match into this time there may be funding issues, but not an insurmountable problem.

 

[Doctor Bob]

By the way when I started to write my reply there weren't any other replies... But dragonfly99 and wingedscapula swooped in like SDN Ninjas.

 

[MedSobe]

Thank you for writing back.
1. I took CS(Clinical Skills) last month, waiting for results.
2. I do have a good recommendation letter from my program director( he has retired now). I explained my circumstances in my personal statement.
3. My Masters is in Clinical Research, worked on clinical trial in Pain Management for more than 2 years ( same program I interviewed for CA-2)
4. I am planning to apply for Family Medicine and willing to go anywhere for training.
5. I checked with Delaware Board, they do not have time time restrictions for taking Step 3. Once I pass Step 3 in DE, would I able to apply only in DE or other states that do not have time restriction for medical license.
I am very motivated to get back to clinical training and saving money to take Kaplan courses to improve chances of having high score.
Appreciate everyone's feedback.

 

[Winged Scapula]

By the way when I started to write my reply there weren't any other replies... But dragonfly99 and wingedscapula swooped in like SDN Ninjas.

 

[Winged Scapula]

Thank you for writing back.
1. I took CS(Clinical Skills) last month, waiting for results.
2. I do have a good recommendation letter from my program director( he has retired now). I explained my circumstances in my personal statement.
3. My Masters is in Clinical Research, worked on clinical trial in Pain Management for more than 2 years ( same program I interviewed for CA-2)
4. I am planning to apply for Family Medicine and willing to go anywhere for training.
5. I checked with Delaware Board, they do not have time time restrictions for taking Step 3. Once I pass Step 3 in DE, would I able to apply only in DE or other states that do not have time restriction for medical license.
I am very motivated to get back to clinical training and saving money to take Kaplan courses to improve chances of having high score.
Appreciate everyone's feedback.

Doctor Bob mentions "failure" more than once. Did I miss something as I don't see any mention of the OP having failed a step?

If you have passed Step 3, then there are no restrictions for licensure except in those states that require more than 1 year of GME for FMGs to obtain an unrestricted license. You don't really need an unrestricted license to be an intern, so this really shouldn't matter in your case.

As noted above, a Master's degree really doesn't add to your application but it is what it is. Having a letter from your former PD which clearly states that you left under personal distress and wasn't terminated is important.

Sounds like you have a reasonable plan. Can you get a current LOR from anyone you are working with now?

 

[MedSobe]

Yes, I have very good recommendation letter from the Director of Pain Mgmt. Program. and other attendings that I worked with on their clinical trials.
I went to Kaplan center yesterday and got info. about courses, planning to take one of their courses (3 different kind). It is expensive, hopefully I will be able to get financial aid. Are there any courses/books I should take other than Kaplan?
Once again, thanks everyone.

 

[NotAProgDirector]

Thank you for writing back.
1. I took CS(Clinical Skills) last month, waiting for results.

As others have mentioned, doing well on CS and Step 3 will help.

2. I do have a good recommendation letter from my program director( he has retired now). I explained my circumstances in my personal statement.

This will also help. You should seriously consider trying to go back to your original program. Because the PD has retired, you might not get far, but you can try. They may remember you, and hopefully that will work in your favor.

3. My Masters is in Clinical Research, worked on clinical trial in Pain Management for more than 2 years ( same program I interviewed for CA-2)

The fact that the program that you did 2 years of research at is the only one that gave you an interview is bad news. They may simply have done so to avoid hurting your feelings. But, as your next point mentions....

4. I am planning to apply for Family Medicine and willing to go anywhere for training.

...this opens up many possibilities. However, you will almost certainly need to apply for a pGY-1. You will not get full credit for an IM prelim year in an FP program, perhaps no credit.

5. I checked with Delaware Board, they do not have time time restrictions for taking Step 3. Once I pass Step 3 in DE, would I able to apply only in DE or other states that do not have time restriction for medical license.

Your choice of states will be quite limited.

 

[Doctor Bob]

Doctor Bob mentions "failure" more than once. Did I miss something as I don't see any mention of the OP having failed a step?

No, you didn't miss anything. But that would be a worry of mine... nearly 10 years out of being a student/resident would, in my mind, ratchet up the odds of failing a board exam. OP just needs to put in that much more work to pass the exam because a failure of step III, when he/she is trying to prove to program directors that the time off hasn't lessened his/her clinical skills, would be disastrous.