How do you reconcile...

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
tco said:
O rly?

http://www.auntminnie.com/index.aspx?sec=sup&sub=res&pag=dis&ItemID=102467
Click to expand...
Yawn. I knew you would post that. That was a D.O. program in which residents have no such protections. Much different than the ACGME world. Details, my friend, details! You're a radiologist. ;)
Members don't see this ad.
 
  • Like
Reactions: 1 user
DermViser said:
Yawn. I knew you would post that. That was a D.O. program in which residents have no such protections. Much different than the ACGME world. Details, my friend, details! You're a radiologist. ;)
Click to expand...

You think the debauchery will end there? With all the cuts that are happening in medicine, don't take anything for granted. Especially with the ACGME.
 
tco said:
You think the debauchery will end there? With all the cuts that are happening in medicine, don't take anything for granted. Especially with the ACGME.
Click to expand...
Right now, it has ALWAYS been a rule that if you're a resident in an ACGME program and your program closes down, the position and funding you have for your years go with you, which you can then take to another program to take you and they get that funding. This is done for the resident's protection as these things happen.
 
Members don't see this ad :)
DermViser said:
Most are quite nice and have fun times. They aren't the anti-social isolated type.
Click to expand...
Like I stated previously I was being very stereotypical. I have met plenty of rads, not just residents, and they have drastically varying personalities- and you're right- many of them are quite nice. However, there are some, not all, who are the stereotypical, quirky, socially awkward type. Again, most are not, you are right about that.
 
DermViser said:
Right now, it has ALWAYS been a rule that if you're a resident in an ACGME program and your program closes down, the position and funding you have for your years go with you, which you can then take to another program to take you and they get that funding. This is done for the resident's protection as these things happen.
Click to expand...

I wouldn't be willing to take the bet that this remains the case with all of the cuts that are happening. That's all that I'm saying. Medicine is not the same field as it was even a year ago, as you well know.
 
tco said:
I wouldn't be willing to take the bet that this remains the case with all of the cuts that are happening. That's all that I'm saying. Medicine is not the same field as it was even a year ago, as you well know.
Click to expand...
What in God's name are you talking about?!!? This has absolutely nothing to do with cuts. These things happen all them time, including in Derm, where programs have lost accreditation or closed down for many reasons. If you're a R-3 in an ACGME program, and your program shuts down, you get credit for the years you've completed and you can take your remaining funding and go to another program along with your funding to finish your GME. This isn't difficult to understand.
 
Last edited:
tco said:
I wouldn't be willing to take the bet that this remains the case with all of the cuts that are happening. That's all that I'm saying. Medicine is not the same field as it was even a year ago, as you well know.
Click to expand...
Are you suggesting even ACGME residents will soon no longer be protected?
 
DermViser said:
What in God's name are you talking about?!!? This has absolutely nothing to do with cuts. These things happen all them time, including in Derm, where programs have lost aaccreditationor closed down for many reasons. If you're a R-3 in an ACGME program, and your program shuts down, you get credit for the years you've completed and you can take your remaining funding and go to another program along with your funding to finish your GME. This isn't difficult to understand.
Click to expand...

RJGOP said:
Are you suggesting even ACGME residents will soon no longer be protected?
Click to expand...

I'm not suggesting anything. To say that the impact of federal cuts on reimbursement is not going to have no impact on training is short sighted, I feel. It's all hypothetical on my end, but medicare is not an unlimited source of funding. Just try to get into the best program that you can, and you're not going to have a problem. Don't go somewhere because they're going to pay you more or buy you tickets to a sporting event.
 
tco said:
I'm not suggesting anything. To say that the impact of federal cuts on reimbursement is not going to have no impact on training is short sighted, I feel. It's all hypothetical on my end, but medicare is not an unlimited source of funding. Just try to get into the best program that you can, and you're not going to have a problem. Don't go somewhere because they're going to pay you more or buy you tickets to a sporting event.
Click to expand...
Again this has nothing to do with residents who match into a program. Federal cuts may shutter programs or won't cause new programs to be made, but for those in a residency training program, you are relatively protected. If your program closes in the middle of your training, you take the remaining funds ALREADY ALLOCATED to you by the federal govt. and move to another program within that specialty.
 
DermViser said:
Again this has nothing to do with residents who match into a program. Federal cuts may shutter programs or won't cause new programs to be made, but for those in a residency training program, you are relatively protected. If your program closes in the middle of your training, you take the remaining funds ALREADY ALLOCATED to you by the federal govt. and move to another program within that specialty.
Click to expand...

This is a silly discussion. I'm saying everything is changing, and you're calling me a fool for suggesting that something that is current cannot change. A circular argument that I will no longer participate in.

Like I said, my suggestion is purely hypothetical. I don't trust the government with anything, especially my job.
 
tco said:
This is a silly discussion. I'm saying everything is changing, and you're calling me a fool for suggesting that something that is current cannot change. A circular argument that I will no longer participate in.

Like I said, my suggestion is purely hypothetical. I don't trust the government with anything, especially my job.
Click to expand...
No I'm calling you a fool, bc you sound like you're wearing a tin foil hat. Even the program you mentioned that closed did so on their own accord, not bc of the federal govt. Those residents (who've moved on and gotten other positions) should be mad at the AOA and St. Barnabas, not the federal govt.

What I am talking about is an ACGME rule, not a federal govt. rule.
 
Last edited:
  • Like
Reactions: 1 user
Members don't see this ad :)
tco said:
This is a silly discussion. I'm saying everything is changing, and you're calling me a fool for suggesting that something that is current cannot change. A circular argument that I will no longer participate in.

Like I said, my suggestion is purely hypothetical. I don't trust the government with anything, especially my job.
Click to expand...
I wasn't arguing against you, I just didn't fully understand what you were saying. I too don't trust the government, and none of us, at least of whom I'm aware of, are clairvoyant, so we have no idea what will happen.
 
DermViser said:
No I'm calling you a fool, bc you sound like you're wearing a tin foil hat. Even the program you mentioned that closed did so on their own accord, not bc of the federal govt. Those residents (who've moved on and gotten other positions) should be mad at the AOA and St. Barnabas, not the federal govt. It's an ACGME rule, not a federal govt. rule.
Click to expand...
The only problem is if the govt. decides not to fund ACGME anymore, then what? I'm not necessarily saying it will happen, but who knows?
 
RJGOP said:
The only problem is if the govt. decides not to fund ACGME anymore, then what? I'm not necessarily saying it will happen, but who knows?
Click to expand...

I don't think totally eliminating funding is ever going to happen. However, if they look at the total supply and demand in practice now and say, "We have an abundance of radiologists right now. We need to decrease funding there and increase funding in X specialty to increase the number of positions." Which programs do you think they're going to cut? It's not going to be the top tier programs...It's going to be the bottom of the barrel programs. If you're at one of those programs because they offered you season tickets to the local baseball team's games, you're going to feel awfully silly if there's no available spots for you to laterally transfer to. My whole point is to go to a reputable academic institution. If you do that, you'll be fine, even if it's "bottom tier."
 
RJGOP said:
The only problem is if the govt. decides not to fund ACGME anymore, then what? I'm not necessarily saying it will happen, but who knows?
Click to expand...
We are talking about 2 TOTALLY different subjects. If the govt. doesn't fund a specific program, the program won't exist to begin with. If it's in the middle of someone'e training then that specific funding for that specific residency goes with that resident somewhere else. Many hospitals specifically don't take residents bc the govt. doesn't pay them enough to offset the costs and lost RVUs to educationally train a resident to begin with.
 
The federal government doesn't care what the ACGME says. ACGME rules vis-a-vis closure are contingent on federal funding, but that's where the relationship ends. Just because the ACGME says funding will follow the resident doesn't mean that the federal government will fall in line, and it's not like a residency program receives a lump sum up front. It seems unlikely that the federal government will drop funding for already enrolled residents, but it's not inconceivable. If you have a well-developed fear of this (whether well-founded or not), then it makes sense to avoid a program that would represent low hanging fruit for Medicare cuts.
 
tco said:
I don't think totally eliminating funding is ever going to happen. However, if they look at the total supply and demand in practice now and say, "We have an abundance of radiologists right now. We need to decrease funding there and increase funding in X specialty to increase the number of positions." Which programs do you think they're going to cut? It's not going to be the top few tier programs...It's going to be the bottom of the barrel programs. If you're at one of those programs because they offered you season tickets to the local baseball team, you're going to feel awfully silly if there's no available spots for you to laterally transfer to.
Click to expand...
I don't know one resident that goes to a program bc of ridiculous perks like baseball tickets. Most radiology applicants choose and rank places based on 1) the quality of radiology education and 2) the ability to garner a fellowship from that place. By the time, most MS-4s have gone thru med school, they're used to people lying to them (i.e. med school admissions and finding the truth when they're in it) and have a high BS detector. Most people applying to bottom of the barrel radiology programs, are people who aren't frankly competitive and thus have to cast a much wider net to land a spot in the specialty.

Once you match thru the NRMP, the clock starts and you have a set amount of money allocated to you in your name in residency training funding for that specialty. That stays with you, till you finish your training at that specific program. If that program suddenly ceases to exist in the middle of your training, that money travels with you bc it doesn't "belong" to the hospital.

Here's a perfect example, there was a Derm program in Buffalo, NY that recently lost accredidation due to all Derm faculty suddenly turning in their resignations. What happened to those who just finished their prelim and those in the middle of the program? They called other programs and explained their situation (which everyone already knew about as that type of info gets around fast) and programs "adopted" them in, knowing that they would also get funding for that extra resident when that person gets on board.

The problem with the St. Barnabas case, was that D.O. residents didn't have that same protection. That's the fault of the AOA. So St. Barnabas took those positions and made them primary care positions, and told the residents, tough ****. That would never happen in the ACGME, which has gone from 80 hr. work week to no more >24 hr call in intern year and nap times, etc. and thus has been more on the side of residents, than expected.
 
  • Like
Reactions: 1 user
colbgw02 said:
The federal government doesn't care what the ACGME says. ACGME rules vis-a-vis closure are contingent on federal funding, but that's where the relationship ends. Just because the ACGME says funding will follow the resident doesn't mean that the federal government will fall in line, and it's not like a residency program receives a lump sum up front. It seems unlikely that the federal government will drop funding for already enrolled residents, but it's not inconceivable. If you have a well-developed fear of this (whether well-founded or not), then it makes sense to avoid a program that would represent low hanging fruit for Medicare cuts.
Click to expand...
I agree 100% with you. The govt. doesn't give a lump sum down payment. It's unlikely the gvt. would forfeit funding, but I wouldn't put anything past them.
 
DermViser said:
I don't know one resident that goes to a program bc of ridiculous perks like baseball tickets. Most radiology applicants choose and rank places based on 1) the quality of radiology education and 2) the ability to garner a fellowship from that place. By the time, most MS-4s have gone thru med school, they're used to people lying to them (i.e. med school admissions and finding the truth when they're in it) and have a high BS detector. Most people applying to bottom of the barrel radiology programs, are people who aren't frankly competitive and thus have to cast a much wider net to land a spot in the specialty.

Once you match thru the NRMP, the clock starts and you have a set amount of money allocated to you in your name in residency training funding for that specialty. That stays with you, till you finish your training at that specific program. If that program suddenly ceases to exist in the middle of your training, that money travels with you bc it doesn't "belong" to the hospital.

Here's a perfect example, there was a Derm program in Buffalo, NY that recently lost accredidation due to all Derm faculty suddenly turning in their resignations. What happened to those who just finished their prelim and those in the middle of the program? They called other programs and explained their situation (which everyone already knew about as that type of info gets around fast) and programs "adopted" them in, knowing that they would also get funding for that extra resident when that person gets on board.

The problem with the St. Barnabas case, was that D.O. residents didn't have that same protection. That's the fault of the AOA. So St. Barnabas took those positions and made them primary care positions, and told the residents, tough ****. That would never happen in the ACGME, which has gone from 80 hr. work week to no more >24 hr call in intern year and nap times, etc. and thus has been more on the side of residents, than expected.
Click to expand...

You'd be surprised at what people in radiology consider when going on the interview trail.

One guy was considering a private program in Florida that had just opened because they had private reading rooms that were sound proof. That's the kind of stuff that I'm telling people to NOT consider. Again, go to an academic program and everything will work out for you.

So, programs will pick up residents because they're already "covered" for their training. However, you also just said that academic programs lose money with residents (something that I've heard frequently this year). So, do you think if reimbursements are suddenly decreased across all specialties, and hospitals are losing even more money, that they're just going to pick up additional residents to go even further into the red?

colbgw02 said:
The federal government doesn't care what the ACGME says. ACGME rules vis-a-vis closure are contingent on federal funding, but that's where the relationship ends. Just because the ACGME says funding will follow the resident doesn't mean that the federal government will fall in line, and it's not like a residency program receives a lump sum up front. It seems unlikely that the federal government will drop funding for already enrolled residents, but it's not inconceivable. If you have a well-developed fear of this (whether well-founded or not), then it makes sense to avoid a program that would represent low hanging fruit for Medicare cuts.
Click to expand...

This is what I'm trying to say...I suppose. Just in a more concise and understandable way. An organization can make up all of the rules that they want, but if funding is hacked, who do you think is going to get hit with all of the **** when it rolls? The people at the bottom of the hill.
 
tco said:
You'd be surprised at what people in radiology consider when going on the interview trail.

One guy was considering a private program in Florida that had just opened because they had private reading rooms that were sound proof. That's the kind of stuff that I'm telling people to NOT consider. Again, go to an academic program and everything will work out for you.

So, programs will pick up residents because they're already "covered" for their training. However, you also just said that academic programs lose money with residents (something that I've heard frequently this year). So, do you think if reimbursements are suddenly decreased across all specialties, and hospitals are losing even more money, that they're just going to pick up additional residents to go even further into the red?
Click to expand...
I said that some hospitals don't see it as a good deal for themselves to have residents. Some think it's a good deal. Some think it evens out. It's not all black and white. It's more than just reimbursements or money. If residents put out more RVUs than what they're getting paid in salary and funding, then the hospital ends up on top. They would be worse off if they had to hire attending physicians or NPs/PAs.
 
I love radiology. Honestly I'd probably want to do it if they made 200k a year. Literally can't think of anything more f*cking awesome. I was in the reading room of the doc I'm doing research with and it was like being in control of the deathstar. 10/10
 
  • Like
Reactions: 1 users
PL198 said:
I love radiology. Honestly I'd probably want to do it if they made 200k a year. Literally can't think of anything more f*cking awesome. I was in the reading room of the doc I'm doing research with and it was like being in control of the deathstar. 10/10
Click to expand...

I routinely say to medical teams that wander into the reading room, particularly when they're lost: "You would prefer another target? Then name the system!"
 
  • Like
Reactions: 1 users
tco said:
You'd be surprised at what people in radiology consider when going on the interview trail.

One guy was considering a private program in Florida that had just opened because they had private reading rooms that were sound proof. That's the kind of stuff that I'm telling people to NOT consider. Again, go to an academic program and everything will work out for you.

So, programs will pick up residents because they're already "covered" for their training. However, you also just said that academic programs lose money with residents (something that I've heard frequently this year). So, do you think if reimbursements are suddenly decreased across all specialties, and hospitals are losing even more money, that they're just going to pick up additional residents to go even further into the red?



This is what I'm trying to say...I suppose. Just in a more concise and understandable way. An organization can make up all of the rules that they want, but if funding is hacked, who do you think is going to get hit with all of the **** when it rolls? The people at the bottom of the hill.
Click to expand...
And the best way to avoid that would be to go to a reputable program.
tco said:
You'd be surprised at what people in radiology consider when going on the interview trail.

One guy was considering a private program in Florida that had just opened because they had private reading rooms that were sound proof. That's the kind of stuff that I'm telling people to NOT consider. Again, go to an academic program and everything will work out for you.

So, programs will pick up residents because they're already "covered" for their training. However, you also just said that academic programs lose money with residents (something that I've heard frequently this year). So, do you think if reimbursements are suddenly decreased across all specialties, and hospitals are losing even more money, that they're just going to pick up additional residents to go even further into the red?



This is what I'm trying to say...I suppose. Just in a more concise and understandable way. An organization can make up all of the rules that they want, but if funding is hacked, who do you think is going to get hit with all of the **** when it rolls? The people at the bottom of the hill.[/Q
Click to expand...
 
colbgw02 said:
I routinely say to medical teams that wander into the reading room, particularly when they're lost: "You would prefer another target? Then name the system!"
Click to expand...

So jealous, how many monitors do you have? The one I was in had probably 8-9. I'm a computer geek at heart so there's literally no aspect of medicine that even comes close to radiology for me.
 
PL198 said:
I love radiology. Honestly I'd probably want to do it if they made 200k a year. Literally can't think of anything more f*cking awesome. I was in the reading room of the doc I'm doing research with and it was like being in control of the deathstar. 10/10
Click to expand...
Hence why I laugh at the one Rads guy who hates his job in the Rads forum, forget his name. I mean would you rather be a Hospitalist or a subspecialist that works on the inpatient side of the hospital? I'll admit my bias is towards outpatient medicine.
 
RJGOP said:
And the best way to avoid that would be to go to a reputable program.
Click to expand...
Yes, but what about if you aren't a "superstar"? Then pick another field?
 
PL198 said:
So jealous, how many monitors do you have? The one I was in had probably 8-9. I'm a computer geek at heart so there's literally no aspect of medicine that even comes close to radiology for me.
Click to expand...

Do you mean, like, in the whole department? Or at a single workstation? A single reading room?
 
DermViser said:
Yes, but what about if you aren't a "superstar"? Then pick another field?
Click to expand...
No, but there are plenty of "reputable" programs which accept lower end residents. Albeit, performing poorly in med school is your fault. So, if you can't get into a higher end reputable program, you brought that on yourself.
 
if rads are taking 210 AMGs, how are they not getting flooded by IMGs?
 
colbgw02 said:
Do you mean, like, in the whole department? Or at a single workstation? A single reading room?
Click to expand...

Don't you have a personal reading room that you consistently use or nah(If so, I meant that)? I'm a noob about the actual day to day operations so...
 
Nah, no assigned workstations. It's pretty much first come, first serve. Our reading rooms are broken down by subspecialty, so I move around based on what service I'm covering that day. There is a workstation in my office, but I share my office. Plus, I often feel compelled to sit in the reading room to make sure the residents aren't wreaking havoc, particularly in July.

But to answer your original question, most of our workstations have 2 monitors, one being a normal desktop monitor and the other being a large high-resolution one that splits down the middle (functionally serving as two monitors). A few places have 4-bangers (so two large ones + desktop), but I find it annoying to have to strain my neck to see the images all the way to my right.
 
colbgw02 said:
Nah, no assigned workstations. It's pretty much first come, first serve. Our reading rooms are broken down by subspecialty, so I move around based on what service I'm covering that day. There is a workstation in my office, but I share my office. Plus, I often feel compelled to sit in the reading room to make sure the residents aren't wreaking havoc, particularly in July.

But to answer your original question, most of our workstations have 2 monitors, one being a normal desktop monitor and the other being a large high-resolution one that splits down the middle (functionally serving as two monitors). A few places have 4-bangers (so two large ones + desktop), but I find it annoying to have to strain my neck to see the images all the way to my right.
Click to expand...

Battlefield on two of them, images on two of them, and the regular desktop is the way to go.
 
Sikkunt said:
if rads are taking 210 AMGs, how are they not getting flooded by IMGs?
Click to expand...
I'm pretty sure there are a lot more than 210 AMGs in a Radiology across the nation in a year. Radiology is still very popular with AMGs for other reasons.
 
Sikkunt said:
if rads are taking 210 AMGs, how are they not getting flooded by IMGs?
Click to expand...
I don't think radiology is as popular internationally. Plus there are more than 210 AMGs.
 
Last edited:
RJGOP said:
What do you mean exactly?
Click to expand...

Go to the Diagnostic Radiology section and look at the bar graph showing number of matched/unmatched applicants for given ranges of Step 1. About two dozen people matched a few years ago with step 1 in the 210 range.
 
colbgw02 said:
Sure, but someone seemed to indicate that radiology took 210 AMGs. That's way off, and the linked document supports that.
Click to expand...

Wait what?

AMG = american medical graduates. As in me and (presumably) you.

Who do you think those 210ers are then?
 
colbgw02 said:
Oh, I thought we were talking about 210 matched AMG applicants. Didn't realize that indicated step I score.
Click to expand...

Ah, gotcha.

I think they were talking about people with 210 Step 1 scores, at least.
 
GuyWhoDoesStuff said:
Go to the Diagnostic Radiology section and look at the bar graph showing number of matched/unmatched applicants for given ranges of Step 1. About two dozen people matched a few years ago with step 1 in the 210 range.
Click to expand...
GuyWhoDoesStuff said:
Go to the Diagnostic Radiology section and look at the bar graph showing number of matched/unmatched applicants for given ranges of Step 1. About two dozen people matched a few years ago with step 1 in the 210 range.
Click to expand...
We were discussing the amount of AMG's accepted, not their step 1 scores.
 
RJGOP said:
We were discussing the amount of AMG's accepted, not their step 1 scores.
Click to expand...

No.

Go back and ctrl+f "210" for this entire thread to see where it began and where you and a few others got confused.
 
You must log in or register to reply here.
Next unread thread

Similar threads

P
Reconciling obesity Guidelines
Replies
10
Views
1K
Donald Juan
Donald Juan
S
Reconciling "Honors in basic sciences" and "Class ranking/quartile" on PD Survey
Replies
18
Views
2K
sunealoneal
S
P
Christian med students: how do you reconcile your religion with your profession?
10 11 12 13 14
Replies
693
Views
56K
BA11
BA11
Top