jumped ship

[sin]

My wife became pregnant last fall (a few months into her 2nd year of OB/Gyn residency). Though she wanted to quit mid-year, her chairman and program director brainwashed her into finishing out the year (they basically threatened legal action for breach of contract, as well as hinting that she would be blacklisted...but that's another story). Anyway, despite the 110+ hr work weeks and Q2 call (up to a week before she delivered!), our baby daughter turned out healthy. My wife went back to work a few weeks after delivery, and finished out the year, and finally quit the program (Thank the Lord!!!!). She wants to take a couple years off to take care of the baby, and plans to go back to residency. Fortunately, she has come to her senses and is going to try to find a position in emergency medicine, instead of OB/gyn. So she will be basically starting all over. Before applying, she is planning on taking her Step III this fall, in order to get her license so that she can work/moonlight in an ER, to get some experience before applying. My question is

1) Is there anyone out there who has moonlighted/worked in an ER, though not in a residency program (Is it still called moonlighting if you're not currently in a residency program?)

2) Any suggestions on how to approach trying to get a position in emergency medicine, given her background

3) What's the likelihood of getting a position outside the match so that she doesn't have to go thru ERAS again

4) If she does have to go thru the match again, can she use her old letters of rec?

5)Anyone else out there in the same situation (or knows someone in a similar situation?)

Though things are somewhat hectic right now, I am really happy that my wife was able to escape that godforsaken field, and that our baby turned out healthy. I truly believe everything happens for a reason. By the way, did I mention that OB/gyn sucks!

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[Sessamoid]

Originally posted by sin

1) Is there anyone out there who has moonlighted/worked in an ER, though not in a residency program (Is it still called moonlighting if you're not currently in a residency program?)

With only two years of ob/gyn residency and a new license, it'll be somewhere between almost impossible and completely impossible to find work in an ER depending slightly on your location. The problem is two fold. No one will want to hire such an inexperienced person who has never worked in that environment before and nobody in their right minds would insure such a practitioner. No practitioner should WANT to work without even a minimum of training, if for no other reason than for the sake of the patients that she would not be qualified to treat.

Plus, I doubt you'll find any residency that would allow her to continue moonlighting in her first year or two.

2) Any suggestions on how to approach trying to get a position in emergency medicine, given her background

Time to do the application process all over again. Since she hasn't burned all her bridges she'll be able to get letter of rec from her previous faculty, which is good because she'll absolutely need those.

3) What's the likelihood of getting a position outside the match so that she doesn't have to go thru ERAS again

Slim to none. None if she doesn't have any close personal contacts in a position of power in an EM program.

4) If she does have to go thru the match again, can she use her old letters of rec?

Not sure. I think she'll probably need them, but letters from her former ob/gyn faculty will be far more important.

5)Anyone else out there in the same situation (or knows someone in a similar situation?)

I had several people in my EM program at the time who were retraining after a first residency.

 

[sin]

Originally posted by Sessamoid
[I had several people in my EM program at the time who were retraining after a first residency. [/B]

Thanks for your reply (in both forums!). Can you tell me more about these people who switched into EM? What did they switch from? and did they switch directly in EM or was there a period when they were not in residency?

 

[Sessamoid]

Originally posted by sin
Thanks for your reply (in both forums!). Can you tell me more about these people who switched into EM? What did they switch from? and did they switch directly in EM or was there a period when they were not in residency?

The IM guy in my class was IM faculty coincidentally at my medical school as well. We both ended up matching into the same EM residency. He was mostly doing shifts in the ER at my medical school (a very segregated old-school ED with separate surg/IM/and ob sections).

The pediatrician was straight out of his chief-resident year, which was a PGY-4 year for him.

The FP guy had been faculty at a FP residency for a few years, worked an ER for a few years after that, and found himself slowly being squeezed out of the market by residency-trained grads. He also realized that despite his generalist training, he wasn't properly trained for the job he was doing. Even though he was vastly knowledgeable, he said he would have gone back for the EM residency even if the job market hadn't changed.

In case you don't know, the main reason that residency programs are hesitant to take previously-trained physicians is that it hits them in the bottom-line. Residency training in the US is fairly heavily subsidized by the government. The length that the government subsidizes a particular resident depends on the normal length of residency training that the particular resident intially goes into. So somebody who enters a surgical residency is subsidized for a total of up to 5 years, even if he changes into family practice after his first year. His total residency time would still be 4 years, so the gov't will subsidize all four years since it's less than the 5 they originally budgeted. That makes it difficult to nearly impossible for people to switch from short residencies to longer ones, like family to surgery. The family resident wanting to change is only budgeted 3 years of gov't subsidy, so if he tries to apply to surgery after one year of family, the surgical residency would get subsidy only for the first two years. After that, they have to eat the cost.

I'm not a program director, but thats how it was explained to me by my program director a few years ago.