If you're not going to do residency, Is there a good reason to do a PGY-1 year?

[WHN]

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I failed to match last year (US MD) into my chosen specialty and scrambled into a prelim med spot. Over the past few months I have come to the realization that I have probably made the wrong career choice and am about ~80-90% sure that I want to leave medicine completely. I am virtually certain I will not reapply for residency through the match this year. The reason that I say 80-90% and not 100% is that I realize a small part of what I'm feeling now is anxiety over being dumped into something as overwhelming as internship in a few days. But this has been a long time coming as I have almost left the field multiple times already. I had great grades, scores, med school etc, and I feel that I didn't match because it must have been obvious in interviews that my heart wasn't in it and I lacked the drive to get through it.

The question I have now is if I should try to survive the intern year or if I should just quit now. I'm committed in the sense that I have already relocated, settled in, and been through orientation, but I'm struggling to see the point. I didn't drop out of med school because I was advised that finishing and getting the MD would leave me more options than dropping out, even if I planned to leave medicine because it is never good to have a failure on your resume. Am I in the same boat again? Do I need to finish this?

Part of what is holding me back is the fear of closing the door on medicine. I have many great options outside of medicine available immediately. But I'm always worried that one day I'll find myself struggling financially and drown in what-ifs and kick myself for throwing away a 200k education when I'm unemployed and can't pay the bills. The money isn't as much of an issue right now. I have very little student loan debt, which I suppose is why I have this option of leaving. I wouldn't have that much of a problem with just sticking it out for a year except for the time commitment. I, admittedly, was not the most well-informed or prepared med student, and didn't quite understand what the demands of an internal medicine internship were. I understand now that it will be pushing 80 hours per week with 14 hour days. Complicating this whole mess is that I have obligations that I cannot get out of outside of work that require 2-3 hours of my time per day. This was hardly ever a problem in med school (and would have been manageable if my first residency choice had worked out), but I see it being a HUGE problem now. Something would have to give, and that something would be sleep. They EXPECT us to run off of 6 hours of sleep during wards months, and I'm not sure I can run off of 3-4 hours of sleep per night for an entire year. I feel exhausted even after orientation. Which leads me back to my original question, is it worth it to finish pgy-1 and take step 3 or should I just write off the 4 years and $200k and pick up where I left off before going to med school? What kind of doors will a medical license keep open for me should I need them?

Finally, if I were to quit say 1-2 months in, how much would I be screwing over my current program and interns?

 

[rokshana]

you leave now or in 1-2 months after starting you're screwing the program either way…

and you leave this prelim spot or don't start…it is gonna be very hard to comeback and find a spot if you decide that you want to get back into medicine.

as a USMD you can get a license after a year (not sure how much good that really can do, but…)…if you decide that there is some specialty you want to do that requires an intern year or there is an unexpected opening, you will be able to consider it.

 

[ThoracicGuy]

I failed to match last year (US MD) into my chosen specialty and scrambled into a prelim med spot. Over the past few months I have come to the realization that I have probably made the wrong career choice and am about ~80-90% sure that I want to leave medicine completely. I am virtually certain I will not reapply for residency through the match this year. The reason that I say 80-90% and not 100% is that I realize a small part of what I'm feeling now is anxiety over being dumped into something as overwhelming as internship in a few days. But this has been a long time coming as I have almost left the field multiple times already. I had great grades, scores, med school etc, and I feel that I didn't match because it must have been obvious in interviews that my heart wasn't in it and I lacked the drive to get through it.

The question I have now is if I should try to survive the intern year or if I should just quit now. I'm committed in the sense that I have already relocated, settled in, and been through orientation, but I'm struggling to see the point. I didn't drop out of med school because I was advised that finishing and getting the MD would leave me more options than dropping out, even if I planned to leave medicine because it is never good to have a failure on your resume. Am I in the same boat again? Do I need to finish this?

Part of what is holding me back is the fear of closing the door on medicine. I have many great options outside of medicine available immediately. But I'm always worried that one day I'll find myself struggling financially and drown in what-ifs and kick myself for throwing away a 200k education when I'm unemployed and can't pay the bills. The money isn't as much of an issue right now. I have very little student loan debt, which I suppose is why I have this option of leaving. I wouldn't have that much of a problem with just sticking it out for a year except for the time commitment. I, admittedly, was not the most well-informed or prepared med student, and didn't quite understand what the demands of an internal medicine internship were. I understand now that it will be pushing 80 hours per week with 14 hour days. Complicating this whole mess is that I have obligations that I cannot get out of outside of work that require 2-3 hours of my time per day. This was hardly ever a problem in med school (and would have been manageable if my first residency choice had worked out), but I see it being a HUGE problem now. Something would have to give, and that something would be sleep. They EXPECT us to run off of 6 hours of sleep during wards months, and I'm not sure I can run off of 3-4 hours of sleep per night for an entire year. I feel exhausted even after orientation. Which leads me back to my original question, is it worth it to finish pgy-1 and take step 3 or should I just write off the 4 years and $200k and pick up where I left off before going to med school? What kind of doors will a medical license keep open for me should I need them?

Finally, if I were to quit say 1-2 months in, how much would I be screwing over my current program and interns?

You say you stuck through med school because getting the MD would leave more opportunities than without. That's true, but it's more true that getting through a residency to be board certified gets you opportunities that you otherwise would not have. An MD that doesn't complete residency doesn't have much luck in finding a job. If you do find a job, you likely won't have any insurance companies that will let you be in their network.

I assume your obligations are some sort of family issue. Perhaps there are others that can help out for you.

Making it through one year is better than quitting now or even in 1-2 months. You're hurting others as well as any possibility of residency in the future.

 

[WHN]

as a USMD you can get a license after a year (not sure how much good that really can do, but…)

This is my question.

I will almost certainly not be doing a residency come July next year. How much benefit will the PGY-1 year and step 3 provide me years down the road in terms of (1) either finding work if I ever get desperate and need it, or (2) feel that I'm ready and actually want to complete a residency.

 

[ThoracicGuy]

This is my question.

I will almost certainly not be doing a residency come July next year. How much benefit will the PGY-1 year and step 3 provide me years down the road in terms of (1) either finding work if I ever get desperate and need it, or (2) feel that I'm ready and actually want to complete a residency.

1. You are eligible for a state license with one year completed training.
2. If you quit now, the chances of someone giving you another chance at residency will be negligible. As it is, if you just finish a year and wait too long to continue, it will be difficult if not impossible.

Are you sure that you aren't just feeling overwhelmed with the new system and once you get really into it, when things start to make sense, that you will like it more?

 

[sazerac]

With that state license (USMD + one year residency) but no board certification, the most popular (only?) employed options to practice medicine will be with urgent care and prison medicine.

Those might be handy options, considering the other alternative you offer means never being able to practice any medicine.

 

[Law2Doc]

This is my question.

I will almost certainly not be doing a residency come July next year. How much benefit will the PGY-1 year and step 3 provide me years down the road in terms of (1) either finding work if I ever get desperate and need it, or (2) feel that I'm ready and actually want to complete a residency.

For both those scenarios you would be likely SOL if you didn't have pgy1 and step 3 under your belt. Also bear in mind that you have a finite window to complete all the steps. People change their minds back and forth all the time. A few years from now you may realize you are in a different place mentally and would consider being a doctor again. Best not to close these potentially lucrative doors.

Your initial post doesn't suggest you've found something you like better, it just suggests you have soured on medicine after not getting the specialty you wanted. If that's the case, you will likely change your mind again when you have time to think more clearly.

 

[tdram]

Also bear in mind that you have a finite window to complete all the steps.

The expiry window appears to be based on the state. There are states where there is no limit: New York, North Carolina, Delaware, Florida, Kentucky, Michigan, New Hampshire. This website appears to have a good summary: https://www.medicallicensuregroup.com/states/

In addition, there are states where Step 3 can be taken without any post graduate training. I believe this is possible in New York and Connecticut at least, and likely more.

The most stringent limit is 7 years from the first step. The way I read the rules of each state, my understanding is if you were to go to a state that has no residency requirement for Step 3, and take it, then it should apply to all the other states as well because they only specify that the steps must be completed with 7 years, they don't require that PGY1 and Step 3 be both completed within 7 years.

Therefore, if the OP were to travel to a state like New York, take the Step 3 exam, then the window to complete the steps is not an issue. At that point, the issue is getting into residency. It will be difficult to find a spot after quitting once, but not impossible. It is hard to believe that it would be impossible given how bad the primary care shortage is right now. A spot in FM in an 'undesirable' location could be had without much difficulty.

Plus, I have talked to several FM programs and they are OK with up to a 3-4 year gap between graduation and residency. Therefore the OP has some time to figure things out and make a dash back into medicine if needed.

 

[ThoracicGuy]

The expiry window appears to be based on the state. There are states where there is no limit: New York, North Carolina, Delaware, Florida, Kentucky, Michigan, New Hampshire. This website appears to have a good summary: https://www.medicallicensuregroup.com/states/

In addition, there are states where Step 3 can be taken without any post graduate training. I believe this is possible in New York and Connecticut at least, and likely more.

The most stringent limit is 7 years from the first step. The way I read the rules of each state, my understanding is if you were to go to a state that has no residency requirement for Step 3, and take it, then it should apply to all the other states as well because they only specify that the steps must be completed with 7 years, they don't require that PGY1 and Step 3 be both completed within 7 years.

Therefore, if the OP were to travel to a state like New York, take the Step 3 exam, then the window to complete the steps is not an issue. At that point, the issue is getting into residency. It will be difficult to find a spot after quitting once, but not impossible. It is hard to believe that it would be impossible given how bad the primary care shortage is right now. A spot in FM in an 'undesirable' location could be had without much difficulty.

Plus, I have talked to several FM programs and they are OK with up to a 3-4 year gap between graduation and residency. Therefore the OP has some time to figure things out and make a dash back into medicine if needed.

Yes, you can sign up via any state to take Step 3. But to get a medical license, states require at least one year of training. For IMG/FMG, some states require up to 3 years of training. The 7 year limit is only for some states, but you are limiting yourself to just those states if you take it later. Yes, you can apply to the medical boards and sometimes they will waive that requirement, but what a hassle.

As far as a gap, yes, there will be some FM programs that will be ok with it. However, the majority of programs out there will screen someone out if their graduation date is too far back, often 3-4 years is enough to get you automatically rejected. It's far easier to get a residency, get through it, and then pay back your loans, get board certified, etc, and go off and do what you want then. At that point you haven't burnt any bridges.

 

[tdram]

It's far easier to get a residency, get through it, and then pay back your loans, get board certified, etc, and go off and do what you want then. At that point you haven't burnt any bridges.

That's a lot of work, and many years of life, for a backup plan. The OP in this case seems to have very few loans, has immediate job opportunities, and has no desire to practice medicine except as a backup if she can't find any other job.

In that case, I believe that the next 3-5 years should be spent gaining experience in the field the OP actually wants to work in, as opposed to spending it on her last-resort backup plan. That backup plan is just too expensive to be worth it.

Remember that medicine doesn't qualify you for anything other than medicine. In other fields, you will likely need additional degrees, additional certifications, and years of experience. Age is also a bigger issue in many other fields than it is in medicine. If the OP does not want to practice medicine at all, I would suggest moving on now and getting started in another field instead of wasting more precious and time and energy in something she has no desire to do.

Taking Step 3 might not be a bad idea as it is a relatively small investment compared to doing a full residency, and will keep the door open as it will prevent the steps she has taken from expiring. It is harder to get a residency at that point, yes, but hopefully she won't have to exercise that option, and because she got the MD and did the steps, the door is definitely open.

 

[Raryn]

Complicating this whole mess is that I have obligations that I cannot get out of outside of work that require 2-3 hours of my time per day. This was hardly ever a problem in med school (and would have been manageable if my first residency choice had worked out), but I see it being a HUGE problem now. Something would have to give, and that something would be sleep. They EXPECT us to run off of 6 hours of sleep during wards months, and I'm not sure I can run off of 3-4 hours of sleep per night for an entire year. I feel exhausted even after orientation.

This seems to be the biggest problem.

Obviously I have no idea what these obligations are, but frequently these types of "obligations" are more of a "I feel I should do this, but I don't actually *have* to". As in, can you find someone else to help you with these obligations? Family members? Can you pay someone to do it? Better to lose 10-20k and pay someone to help you through this time (knowing that you will have financial difficulties during the course of the year, but not insurmountable ones) than to pay the opportunity cost of closing your doors to participate in medicine.

 

[NotAProgDirector]

The OP should definitely take and pass Step 3. It's a minimal investment in time and money, and may leave some doors open in the future. Of note, he/she does not need to travel somewhere different to take it. As of right now, you just get sponsored by a state that allows Step 3 with no GME training, but you can sign up to take it anywhere. In any case, all of that is going away in a few months -- you will simply apply to take Step 3 and there will be no state sponsorship (see here: http://www.usmle.org/announcements/default.aspx?ContentId=124)

Whether or not the OP should do a PGY-1 or a full residency is more complicated. Both are a significant investment of time and effort. The value of a PGY-1 is that it gets you a medical license, but the value of a license but no board certification is questionable. There are plenty of threads here on "What can I do with a license and no board certification", and the options are not great. If the OP really dislikes clinical medicine, most of the options in those threads are not going to go well.

The one option not mentioned is "consulting". This is a very vague term. But if you can get hired by McKinsey, it can be a very fulfilling career (if you like that kind of thing). It might also be possible to go work for an EMR company, but my guess is they are going to want someone with real world clinical experience.

 

[dpmd]

I think the main point is that medicine is not a great back up career choice. There are a lot of requirements for entry, and then you have ongoing requirements to maintain active licensure that cost time and money, even if you don't get board certified (which would add its own requirements). If you start the process and decide you don't really like it you should look at it as an either or sort of thing. Either you stick it out and get trained hoping that you start to like it better (or not hate it so much) or you decide to 100% walk away from it. Thinking that you can just come back to it whenever you have trouble getting a job in a different field or decide you don't like that field either (and maybe the reason you dislike it has more to do with general unhappiness with your life than any issue with the field per se) is setting up an unrealistic version of a safety net which may make it easier for you to decide to walk away but then lead to disappointment when you try to come back. Do what is right for you, but do it with the realization that if you walk away now you are pretty much walking away forever.

 

[tdram]

if you walk away now you are pretty much walking away forever.

This is not true at all. Many people leave medicine for various reasons: health, family, other opportunities, etc. and come back.

There is even a whole section of the AMA website dedicated to physician re-entry: http://www.ama-assn.org/ama/pub/education-careers/finding-position/physician-reentry.page. Yes these are fully trained physicians, however, the idea of leaving and returning to medicine is more common than you think.

Residency programs regularly accept people several years away from medicine. IMGs, for example, often apply several years after they graduate.

 

[Gastrapathy]

The reason to complete a PGY1 year is that you will be more likely to get back into GME if you later decide to go back into medicine. You might also find a career in medicine that you like enough to do it part-time. Focus on the shift-work specialties (EM, Anesthesiology, hospital medicine) and see if that is something you'd be able to do. Its simplistic to suggest that getting back in is easy and bailing on a prior commitment will make it harder (you'll either be a match violator or a quitter who has to get a letter from the program you quit).

 

[dpmd]

This is not true at all. Many people leave medicine for various reasons: health, family, other opportunities, etc. and come back.

There is even a whole section of the AMA website dedicated to physician re-entry: http://www.ama-assn.org/ama/pub/education-careers/finding-position/physician-reentry.page. Yes these are fully trained physicians, however, the idea of leaving and returning to medicine is more common than you think.

Residency programs regularly accept people several years away from medicine. IMGs, for example, often apply several years after they graduate.

The fact that there are special programs for reentry tells me that as a true backup (meaning you can't get a job and you need one) it just isn't a smart bet. Same applies for getting a residency. Sure with a lot of time and effort some people have done it but a ton have not. That to me makes it not a viable back up option. Now as a "**** is going on in my life now but I plan to return when I can later" option it is possible

 

[Taurus]

This is not true at all. Many people leave medicine for various reasons: health, family, other opportunities, etc. and come back.

There is even a whole section of the AMA website dedicated to physician re-entry: http://www.ama-assn.org/ama/pub/education-careers/finding-position/physician-reentry.page. Yes these are fully trained physicians, however, the idea of leaving and returning to medicine is more common than you think.

Residency programs regularly accept people several years away from medicine. IMGs, for example, often apply several years after they graduate.

If you leave the game, it's extremely hard and painful to get back in it.

Why are people spending so much time convincing this dude to stay in? If you don't want to stay, leave. There's always another person waiting and willing to take your place.

 

[hallowmann]

I know someone in a slightly similar situation. They finished med school at a top 20 school, great stats, etc. The thing is they really didn't feel it was for them, they wanted something else. Go forward 2 years and they still don't want to work as a physician, but they really regret not taking Step 3 and doing a 1yr internship.

They don't want to be board certified or work full time, but they would like to be able to work on the side in an urgent care or something similar just to make money. This is very doable, especially in undeserved areas. You won't make the kind of money a boarded physician makes, but at least you have something to fall back on. He right now is planning to do his intern year and then teach in an elementary school.

My advice is to finish the year and then try something else. See if you can get some help with the obligations and just get through that year.

 

[tdram]

If you leave the game, it's extremely hard and painful to get back in it.

It's funny how we see articles every day about how the system is about to "collapse" because of lack of doctors, and we need 52k more doctors in the next 20 years, yet when an MD steps away for a little while and wants to get back into residency, it's "extremely painful" to do so, even with numerous spots in primary care going unfilled. While the MD finds a bunch of barriers to re-entry, we lower the bar of entry for Non-MDs to fill the gap. The system is not OK with an MD who was away for a few years coming back to finish a residency and practice, but it is perfectly fine with people who did no residency and got most of their degree online practicing completely independently. Even an MD with just 1 year of residency can practice medicine far more safely than a fresh graduate of one of these online programs, yet the insurance company won't cover the MD?

The whole system has become a joke. We need to step back and look at how pointless our "standards" are in the big picture.

 

[ThoracicGuy]

It's funny how we see articles every day about how the system is about to "collapse" because of lack of doctors, and we need 52k more doctors in the next 20 years, yet when an MD steps away for a little while and wants to get back into residency, it's "extremely painful" to do so, even with numerous spots in primary care going unfilled. While the MD finds a bunch of barriers to re-entry, we lower the bar of entry for Non-MDs to fill the gap. The system is not OK with an MD who was away for a few years coming back to finish a residency and practice, but it is perfectly fine with people who did no residency and got most of their degree online practicing completely independently. Even an MD with just 1 year of residency can practice medicine far more safely than a fresh graduate of one of these online programs, yet the insurance company won't cover the MD?

The whole system has become a joke. We need to step back and look at how pointless our "standards" are in the big picture.

There is usually an issue of why that person left residency. That is the true barrier, not just simply a break in residency. There could be knowledge issues, professionalism, work ethic, or others that make it difficult to train that person. If they've had a problem at one place, they will likely have more problems at the next place.

A person that completes a PGY1 year and gets a license does not have complete training AND usually doesn't end up having a supervising physician if they do find a job. Why would an insurance company want to pay someone for what would likely be considered substandard service not in the usual standard of care.

 

[tdram]

A person that completes a PGY1 year and gets a license does not have complete training AND usually doesn't end up having a supervising physician if they do find a job. Why would an insurance company want to pay someone for what would likely be considered substandard service not in the usual standard of care.

I have a friend in Oregon who completed his NP degree and works independently, with no supervising physician. He has not completed any residency. Insurance companies have no problem paying him. In fact, he gets paid about the same as a fully trained MD would. Please explain why a person with an MD degree and a PGY1 year, which in itself is more hours of clinical experience than my friend needed to obtain his license, would be offering lower standard service than my friend the NP, who has less formal education and experience?

 

[ThoracicGuy]

That's an issue to take up with the State of Oregon. I personally would not be happy seeing a midlevel provider that was not under direct supervision of a physician. I don't agree with the whole DNP thing either. If it were up to me, insurance companies would not be paying for nonsupervised midlevels. For the PGY1 only MD, they have a bit more training, yes, but they are not likely to be very competent either independently. I'm guessing the quality of care for both of these situations is likely to be substandard.

 

[tdram]

That's an issue to take up with the State of Oregon. I personally would not be happy seeing a midlevel provider that was not under direct supervision of a physician. I don't agree with the whole DNP thing either. If it were up to me, insurance companies would not be paying for nonsupervised midlevels. For the PGY1 only MD, they have a bit more training, yes, but they are not likely to be very competent either independently. I'm guessing the quality of care for both of these situations is likely to be substandard.

That begs the question of whether our standards are too high. The state of Oregon seems to think so, and about a dozen or more others do at this point. According to their standards, our PGY1 only MD, and possibly even our med school only MD has sufficient experience to practice. They certainly have no problem paying nonsupervised individuals with less experience to do the same job. You may not be happy, but the public seems to be OK with it, and the insurance companies are already paying for it. I think our profession needs to adapt to the changing market, instead of maintaining high standards that the consumers increasingly seem to not care about.

 

[rokshana]

That begs the question of whether our standards are too high. The state of Oregon seems to think so, and about a dozen or more others do at this point. According to their standards, our PGY1 only MD, and possibly even our med school only MD has sufficient experience to practice. They certainly have no problem paying nonsupervised individuals with less experience to do the same job. You may not be happy, but the public seems to be OK with it, and the insurance companies are already paying for it. I think our profession needs to adapt to the changing market, instead of maintaining high standards that the consumers increasingly seem to not care about.

really? are you EVEN in medical school? you really think standards could ever be too high? and NO ON coming out of med school today is ready to go out and practice…cocky arrogant 4th years might…until the 1st week of their intern year…

i'm calling troll….

 

[ThoracicGuy]

That begs the question of whether our standards are too high. The state of Oregon seems to think so, and about a dozen or more others do at this point. According to their standards, our PGY1 only MD, and possibly even our med school only MD has sufficient experience to practice. They certainly have no problem paying nonsupervised individuals with less experience to do the same job. You may not be happy, but the public seems to be OK with it, and the insurance companies are already paying for it. I think our profession needs to adapt to the changing market, instead of maintaining high standards that the consumers increasingly seem to not care about.

So you think that physicians should dumb things down and let someone who has one year of residency get to go out and practice just like a board certified doctor?

 

[tdram]

So you think that physicians should dumb things down and let someone who has one year of residency get to go out and practice just like a board certified doctor?

You don't see a problem when a DNP can practice fully independently, with all the rights and privileges of a board certified doctor, and a PGY1 trained MD with a license can't? Can you give me a good reason why that should be the case?

Numerous state governments, the public, and insurance companies have all agreed that you do not need a residency or even an MD level of training to practice medicine independently. What that tells me is that physicians have set a minimal standard for entry to practice that is just too high.

Would you rather the physician shortage be solved by actual physicians with an MD and residency training, albeit 1 year? or prefer that we just continue to flood the market with independent midlevel providers, while trying to maintain standards that society seems not to care about or can't afford to care about. Which one of these two yields better outcomes for patients?

I know I'd rather pick the MD with a PGY1 year over the DNP any day. The fact that one can practice and the other can't is absurd. I think we should go back to the old days where 1 year of residency is all you needed to become a GP. It would be a lot cheaper to train primary care docs and we'd be able to fix our shortage with a better solution than endless midlevel expansion. If someone wants more training, no one's stopping them, and they're free to advertise the fact that they have more years of residency and board certification.

Sorry Dr. PGY1, you're not qualified enough to be a primary care doc so we'll just fill your spot with the less qualified lady over there who got her degree online, because we've got high standards for you, but not for her, even though you'd be doing the same job. We think you'd kill somebody, but she won't, despite less training. That's what the healthcare system is basically saying. Please explain to me how this makes sense?

 

[WHN]

they would like to be able to work on the side in an urgent care or something similar just to make money. This is very doable, especially in undeserved areas.

This is really possible? If I could finish the intern year and find 20-30 hrs/week work in an urgent care, doc-in-the-box, walk-in, etc., this would be ideal. It would give me time to get everything straightened out and freedom to decide if I wanted to continue in the profession (by pursuing board certification, which I hope would keep me eligible for the match by keeping my foot in the door) without the pressure of having to complete a residency before making the decision to leave. But I was under the impression that urgent care clinics only hired residency trained docs. There is a rural ED around here that hires FP and EM docs part time for $90/hr. But they require residency.

Another problem is that unless I want to pursue a subspecialty that requires an prelim (which is pretty much off the table at this point given that nearly all of them are hypercompetitive and I failed to match the first time), my IM prelim is a bridge to nowhere and this realization that I will suffer for nothing has sunk me into a pretty bad depression. I hate inpatient hospital medicine and would much rather do a FM residency (although I dislike peds and OB, it would be mostly outpatient and be much more tolerable). Unfortunately, as far as I know, to do FM, I would have to start all over again, making this a year of needless suffering. I would much prefer to just quit, focus on paying off the rest of my loans this year (making far more money outside of medicine than I would in residency) and go through the match for FM next year or the year after. I feel like that if I had matched in FM right now, I might not be so eager to leave medicine. I made an 11th hour change out of fear to my rank list and added a prelim IM spot at the bottom of the primary list, and that's how I ended up in this spot. Here's a free lesson for current M4s: Don't do that unless you are cool with doing IM or absolutely must be employeed.

Is urgent care a possibility for a licensed but non-BE doc? For that matter, would I be able to do any sort of job that residents are able to moonlight at? Or are these part-time moonlighting opportunities only available to MDs in residency programs?

 

[msbbc833]

.

 

[ThoracicGuy]

<snip>

Is urgent care a possibility for a licensed but non-BE doc? For that matter, would I be able to do any sort of job that residents are able to moonlight at? Or are these part-time moonlighting opportunities only available to MDs in residency programs?

Most urgent care centers will want board certified docs. Looking at some recent ad listings online:

UPMC affiliated - Req BC
Austin, TX Medspring UC - Req BE/BC
D&Y Staffing, Arkansas - BC not req
VA Clinic, Danville, IL - BC preferred
Urgent Care in MA - BC with 1 year experience
Chandler, AZ - BE/BC
Charlotte, NC - BE/BC, 2 years exp preferred
Erie, PA - BE/BC
Gilbert, AZ - BE/BC, 1 year exp min

So yes, there are a few jobs out there that don't require board certification, but in urgent care, most do.

 

[atomi]

I thought you scrambled into this position per your first post?

The scramble doesn't exist anymore.

 

[tdram]

The scramble doesn't exist anymore.

I'm guessing she meant scrambled in the sense of "ended up in the last minute" because she added it on late or something.

 

[NotAProgDirector]

If the OP is considering an FM residency, you might be better served by a Primary Care IM residency. It would be mostly outpatient, no Peds or OB, and you'd get full credit for your PGY-1 and just need a PGY 2 and 3. Plus, you could even start looking for spots now, and transfer in the middle of the year if a spot was open.

 

[rokshana]

I hate inpatient hospital medicine and would much rather do a FM residency (although I dislike peds and OB, it would be mostly outpatient and be much more tolerable).

have you thought about a primary care track IM spot? these will have more outpt (though you will have to do the minimum number of inpt and ICU orations to be board eligible) rotations…it wouldn't waste your intern year.

oops! 😳 that's what i get for not reading to the end of the posts!