Graduation date after residency start date

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Medstart108

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This is a hypothetical, but i'm wondering what happens if you graduate from medical school in the UK a week after you start residency in the US?

Would they let you take a day or two off for your graduation or no?

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This is a hypothetical, but i'm wondering what happens if you graduate from medical school in the UK a week after you start residency in the US?

Would they let you take a day or two off for your graduation or no?
You couldn't start residency. Your ECFMG certificate wouldn't be ready because you didn't have a diploma and you'd lose your spot.
 
Not sure how graduating after residency start date works. I know that if ECFMG is late, some programs will give you vacation time first until you get it and then get you started. Varies from program to program.
 
Not sure how graduating after residency start date works. I know that if ECFMG is late, some programs will give you vacation time first until you get it and then get you started. Varies from program to program.
It works like this.

You forfeit your Match.

The End.
 
Asking for a day or two off in your first week at work to attend a graduation ceremony in another country may not be a good idea.

If all the formalities for graduation have been completed in advance of the ceremony, it may be possible to get the school to send out the paperwork in advance, which would take care of the "need paperwork by start date" problem.
 
This is a hypothetical, but i'm wondering what happens if you graduate from medical school in the UK a week after you start residency in the US?

Would they let you take a day or two off for your graduation or no?

if you are asking if you can schedule vacation time early in July to attend graduation, then yes…most people would not use vacation time so early in the intern year (since you will be facing most of your intern year with wides stretches of time without the break that vacation time allows)

but if you are asking can you graduate after july 1 and still make a july 1st start date, then no…as gutonc mentioned you need to have ECFMG certification on the 1st day of residency…if you don't you will most likely have to forfeit your spot….it would most likely take way too long to start the process after july 1st and i can't imagine there are that many programs that would be willing to wait that long for an intern.
 
Actually not all programs allow vacation in July.

Everything else above is accurate.

You cannot participate in the match without having completed all the exam requirements for the ECFMG certificate.

You cannot accept a match position unless your school verifies that you will have graduated and completed all the requirements by July 1.

If you will have officially graduated "on paper" and you're just asking about attending a graduation ceremony then that may be acceptable. However as noted above, some programs do not allow for vacation during July and depending on the distance you need to travel you may not have enough time off in the schedule to attend the ceremony.
 
Ok just checked yeah it doesn't seem possible to go directly from medical school in the UK to residency in the US. Final year exams are in June over a 3 week period. It would be impossible to have your diploma and apply for ECFMG by residency start.

It makes sense that most do FY1 and 2 before entering residency in the US.

Thank you for the answers everyone
 
Actually not all programs allow vacation in July.

Everything else above is accurate.

You cannot participate in the match without having completed all the exam requirements for the ECFMG certificate.

You cannot accept a match position unless your school verifies that you will have graduated and completed all the requirements by July 1.

If you will have officially graduated "on paper" and you're just asking about attending a graduation ceremony then that may be acceptable. However as noted above, some programs do not allow for vacation during July and depending on the distance you need to travel you may not have enough time off in the schedule to attend the ceremony.

Could you elaborate more about this part? Id never heard of it before.
 
Could you elaborate more about this part? Id never heard of it before.
Part of the match application includes verification from your medical school that you will graduate on time and be ready to start residency by July 1.

If this verification is not provided by your school, you will be automatically withdrawn from the match by the NRMP.
 
Part of the match application includes verification from your medical school that you will graduate on time and be ready to start residency by July 1.

If this verification is not provided by your school, you will be automatically withdrawn from the match by the NRMP.

Perhaps for foreign grads it's different and I'm not going to discuss that myself because I have no idea on that, but as far as american grads go, it's definitely doable and possible to start later. I started residency later and my program did not have much of an issue with it. They kept my spot and were happy to have me come in when I did after I explained the situation to them. So this idea that you will lose your spot, etc. is not so cut and dry.

I guess I tend to be on the less harsh side of medicine from an ideology standpoint. I don't believe in ridiculous rules, regulations, etc. that are arbitrary and that people who are typically not involved from the ground up in this make up. For example, why do we start residency on July 1? Why is med school 4 years? Why can't people start residency at different times? Why does the NRMP require 45 days to stay in a program if you want to leave - why not 60 or 200?

I dislike arbitrary rules significantly. I also think more program directors than not are more flexible than what a lot of people think. Sure there are some intransigent, nasty ones, but many program directors out there actually - *gasp*! - care about their residents and want them to succeed, so they are willing to accomodate within reason.
 
Perhaps for foreign grads it's different and I'm not going to discuss that myself because I have no idea on that, but as far as american grads go, it's definitely doable and possible to start later. I started residency later and my program did not have much of an issue with it. They kept my spot and were happy to have me come in when I did after I explained the situation to them. So this idea that you will lose your spot, etc. is not so cut and dry.

Its not different for AMGs vs IMGs/FMGs except for the involvement of ECFMG for the latter. And while it may not be cut and dry if the applicant is using the NRMP they are pretty clear about the rules:

Section 2.1 of the Match Participation Agreement states that applicants must meet ACGME® and institutional requirements prior to the start of training in order to be eligible for the position. If you learn you are ineligible to honor your binding commitment, you must immediately notify the NRMPin writing so that the NRMP can determine whether you and/or the program qualify for a waiver. You also must request a waiver if you are ineligible to honor a position you obtained during the Match Week Supplemental Offer and Acceptance Program® as a result of your delayed graduation status.
VERIFICATION OF CREDENTIALS - US Seniors
The NRMP requires medical schools to verify the expected graduation date of every U.S. senior registered for The Match be verified by the NRMP school official. U.S. seniors whose graduation credentials are not verified by their schools will be withdrawn automatically by the NRMP.

VERIFICATION OF CREDENTIALS - NON US Seniors

  • The NRMP works with NRMP school officials to verify the credentials of previous graduates and Fifth Pathway enrollees/graduates of LCME-accredited schools, students/graduates of Canadian medical schools, and students/graduates of osteopathic medical schools.
  • Students/graduates of international medical schools must submit either a notarized copy of a full and unrestricted license to practice medicine in a U.S. jurisdiction or an Educational Commission for Foreign Medical Graduates (ECFMG®) candidate number. The NRMP works with the ECFMG to verify that applicants have completed the examination requirements for certification. For additional information on verification of credentials for Match eligibility, visit the ECFMG website.
Thus, if prior to the match your medical school does not verify that you will graduate on time, you will be withdrawn from the match. If subsequent to the match you find out you won't be able to start on time, you have to apply for the waiver. Waivers are given although it is not automatic and the policy is used to prevent people from switching out their matched position for "something better".

So while I agree that arbitrary rules are unfair, in this case they are reasonable. The discussion about program directors being willing to work with residents is one I agree with. Obviously if you are a good candidate with a reasonable request to start late, most will consider it and grant it (providing a match waiver is given) if at all possible. I don't think that is relevant to the OP's concern however. It may be feasible to look for a alternate start day position but she can't start July 1, which is what she was asking about.
 
Part of the match application includes verification from your medical school that you will graduate on time and be ready to start residency by July 1.

If this verification is not provided by your school, you will be automatically withdrawn from the match by the NRMP.
Not to start a whole argument, but I've honestly never seen any source that states that NRMP/ECFMG checks with medical schools to ensure students graduate by July 1st, at least for FMGs.

Everywhere it says that NRMP checks with ECFMG to make sure that the student is eligible to begin July 1st, and in clarifying that they say that means having passed Step 1/CK/CS.

Now obviously if you're graduating late you should make that known, but I've heard of students matching and then having to take vacation in their first month since they didn't graduate in time. So I don't know how that would work if ECFMG/NRMP is checking with medical schools.
 
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Its not different for AMGs vs IMGs/FMGs except for the involvement of ECFMG for the latter. And while it may not be cut and dry if the applicant is using the NRMP they are pretty clear about the rules:
You are wrong, sorry.
Nothing like this is going to happen. This holds true only for US graduate. Everyone else (ECFGM (international) graduate) goes a different way.

I'm not talking about what the residency requirements are. I'm talking about what are the basic rules according to Match system. And it goes this way:

ECFMG candidate has to have a Step 1 and Step 2 CK and Step 2 CS passing score by the date of ROL confirmed at NRMP system by ECMFG. Otherwise he is withdrawn from match. Nothing less but nothing more.
To be eligible to start residency he has to have a ECFMG certificate. Which means he has to graduate and to have the steps 1,2 passing scores confirmed by ECFMG before starting

You just overlooked a magic phrase there in that nrmp statement which says:
have completed the examination requirements for certification.

 
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Not to start a whole argument, but I've honestly never seen any source that states that NRMP/ECFMG checks with medical schools to ensure students graduate by July 1st, at least for FMGs.

Everywhere it says that NRMP checks with ECFMG to make sure that the student is eligible to begin July 1st, and in clarifying that they say that means having passed Step 1/CK/CS.

Now obviously if you're graduating late you should make that known, but I've heard of students matching and then having to take vacation in their first month since they didn't graduate in time. So I don't know how that would work if ECFMG/NRMP is checking with medical schools.

umm, they check to see if you have ECFMG certification…de facto checking to see if you graduated since you CAN NOT get ECFMG certification without a diploma…and then ECFMG verifies with your medical school that you have, indeed, graduated from medical school.

ECFMG Verification is what you have when you have passed step I, CK, and CS as an I/FMG and you must be verified to be able to participate in the match…otherwise NRMP will automatically pull you from the match.
 
You are wrong, sorry.
Nothing like this is going to happen. This holds true only for US graduate. Everyone else (ECFGM (international) graduate) goes a different way.

I'm not talking about what the residency requirements are. I'm talking about what are the basic rules according to Match system. And it goes this way:

ECFMG candidate has to have a Step 1 and Step 2 CK and Step 2 CS passing score by the date of ROL confirmed at NRMP system by ECMFG. Otherwise he is withdrawn from match. Nothing less but nothing more.
To be eligible to start residency he has to have a ECFMG certificate. Which means he has to graduate and to have the steps 1,2 passing scores confirmed by ECFMG before starting

You just overlooked a magic phrase there in that nrmp statement which says:

I'm not sure how I can overlook a "magic phrase" when you are quoting me using that phrase. Seems to me that I haven't overlooked anything. I'm also not sure why your response to me was so abrasive.

As a foreign born holder of an ECFMG certificate and who has participated in the match process as an applicant, resident, fellow and now faculty reviewing applications, I stand by my comments. I have been through the process in many iterations; it appears from your posts that you are a first time applicant who has not completed the process yet.

When applying through the match, regardless of what the "residency requirements" are, all ECFMG applicants are required to have completed the above examinations (which you have so kindly bolded for us) by the date of the ROL. No argument there.

However, where you are in error is that there IS more.

ECFMG engages in a process of primary source verification in which they not only verify that the student is enrolled, but that they are enrolled in a medical school that is listed in IMED, and that they will complete 4 years minimum of medical training and will have/have completed all the requirements for the final medical diploma. Thus, even prior to graduation and award of the ECFMG certificate, your school is required to inform ECFMG, via a sealed and stamped document, that you have completed the requirements above.

As rokshana notes above, ECFMG will verify that the applicant is eligible to stay in the match past the ROL date by verification of examination completion; this verification also notes that everything except the final diploma is completed. However, if your school does not verify that you have completed (or will complete) all requirements and EXPECTED GRADUATION DATE, then ECFMG will not verify you for the NRMP and you will be withdrawn. Its not just completing exams and there ya go.

Once you have completed the requirements for graduation and are awarded your diploma, ECFMG will get the final documentation, again using primary source verification, which consists of your final transcript and the actual diploma. The new process of electronic source verification should make the process much smoother and hopefully quicker (as well as less stressful, as sending one's original diploma through international mail was a bit nervewracking to say the least).

Finally, I think you and some others are confusing the fact that it is possible to start late, with the OP's question of whether she can graduate after July 1st and start on July 1st. Every year there are some matched residents who cannot start on July 1 - either due to visa issues or delays in receiving the ECFMG certificate or medical license (I had to start fellowship a week late because my NJ license took awhile to process). Those are reasonable and programs deal with them all the time. But that is a totally different situation than what the OP is asking about - she cannot (as she herself investigated and found out) start on July 1 when she hasn't officially graduated, even if she has completed all the requirements.

I hope that clarifies things.
 
[phone misclick - deleted by me]
 
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I'm not sure how I can overlook a "magic phrase" when you are quoting me using that phrase. Seems to me that I haven't overlooked anything. I'm also not sure why your response to me was so abrasive.

As a foreign born holder of an ECFMG certificate and who has participated in the match process as an applicant, resident, fellow and now faculty reviewing applications, I stand by my comments. I have been through the process in many iterations; it appears from your posts that you are a first time applicant who has not completed the process yet.

When applying through the match, regardless of what the "residency requirements" are, all ECFMG applicants are required to have completed the above examinations (which you have so kindly bolded for us) by the date of the ROL. No argument there.

However, where you are in error is that there IS more.

ECFMG engages in a process of primary source verification in which they not only verify that the student is enrolled, but that they are enrolled in a medical school that is listed in IMED, and that they will complete 4 years minimum of medical training and will have/have completed all the requirements for the final medical diploma. Thus, even prior to graduation and award of the ECFMG certificate, your school is required to inform ECFMG, via a sealed and stamped document, that you have completed the requirements above.

As rokshana notes above, ECFMG will verify that the applicant is eligible to stay in the match past the ROL date by verification of examination completion; this verification also notes that everything except the final diploma is completed. However, if your school does not verify that you have completed (or will complete) all requirements and EXPECTED GRADUATION DATE, then ECFMG will not verify you for the NRMP and you will be withdrawn. Its not just completing exams and there ya go.

Once you have completed the requirements for graduation and are awarded your diploma, ECFMG will get the final documentation, again using primary source verification, which consists of your final transcript and the actual diploma. The new process of electronic source verification should make the process much smoother and hopefully quicker (as well as less stressful, as sending one's original diploma through international mail was a bit nervewracking to say the least).

Finally, I think you and some others are confusing the fact that it is possible to start late, with the OP's question of whether she can graduate after July 1st and start on July 1st. Every year there are some matched residents who cannot start on July 1 - either due to visa issues or delays in receiving the ECFMG certificate or medical license (I had to start fellowship a week late because my NJ license took awhile to process). Those are reasonable and programs deal with them all the time. But that is a totally different situation than what the OP is asking about - she cannot (as she herself investigated and found out) start on July 1 when she hasn't officially graduated, even if she has completed all the requirements.

I hope that clarifies things.
Sorry, I didn't mean to be abrasive.
I just thought that you copied the statement without careful reading.
There is something right in what you're saying now but I still believe that there is something wrong in what you said before.
Maybe it's just a misunderstanding and we are talking about the same but maybe some things changed since you were getting through whole process b/c ecfmg tries to make a whole process more "online" and simpler during last years.

At the very beginning of the process even before you can schedule your first Step's exam you have to fill in an "Application for ECFMG certification". In that form you have to say (among other) what is the expected day of your graduation. After that you get another form which has to be delivered to your school officials and they have to fill it in and with other stuff to send it to ECFMG. They may be required to confirm your expected day of graduation too (since I am not the school/ecfmg official I can't say what exactly they have to tell to ecfmg).
BUT afterward the school is no longer involved in that process until you finish it, get the diploma and want the certificate.
Since you can start this process after completing first 2 years of MD it may takes another 4 years until you get your diploma thus during such a long time your expected day of graduation may easily change.
Since your are not expected to inform the ecfmg about that change it means that from the very beginning ECFMG knows the date (from you and maybe from school too) but they don't know whether is it correct right now.

After that you go to schedule and sit for the step's exams and you're preparing for the Match. Before the ROL date NRMP asks ECFMG about your credentials. They ask for Step 1, Step 2 CK and Step 2 CS passing score. You're withdrawn from matching system when any of them is missing. Ofc they could ask ECFMG about your expected date of graduation (ecfmg knows it from the very beginning) but they don't do that.
Unless you're the NRMP/ECFMG official please show me a proof when saying otherwise.
There are many reasons why to believe that NRMP doesn't ask...
- They would say that
- They would say that it matters and what your expected date is supposed to be (same like they say what you're expected about usmle exams)
- ECFMG has the information but it can be 4 years old thus out of date and ECFMG has no chance to get up-to-date info at the ROL time
- It's not their business what a deal you have with PD about your starting date (some residencies starting date is negotiable)
- They can't even say that anyone with exp. date X can get through process on time but anyone with date Y can't (unlike with US grads)
-....

So... yes... most likely he is going to lose his matched residency spot right after PD realizes that he is not able to start on time.
But he is not going to be withdrawn from nrmp match system because of late date of graduation. The only reason to be withdrawn is missing Step 1/ Step 2 CK/ Step 2 CS passing score.
In fact it doesn't really matter right now b/c no one is willing to rank him (knowing he is not able to start until the autumn (since it takes few more days to deliver everything to ECFMG and then another 4-6 weeks until issuance of the certificate and maybe another couple of weeks to get a license)) but I haven't see any proof that expected date of graduation anyhow matters for nrmp and that they're asking about it.

This is my view. I'm getting through the process right now and I've read hundreds of pages about these processes at official websites. I'm not saying that I have to be right but I have no reason to believe that it goes another way.
 
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Perhaps my experience is unusual then as both my residency and fellowship programs *did* request dates of graduation for any ECFMG applicant they were planning on ranking. I had assumed this was the norm (as I also recalled my medical school filling out a form which stated my expected date of graduation - because I delayed graduation to take some extra electives - so we were having a bit of a conversation about when I would be finished) and that the NRMP was also aware of it; thank you for the clarification, it appears that this may be program specific.
 
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