Matching problem and specialty switching

[Gpan]

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I have a question. If one tries to match into an allo residency program, but is unsuccessfully so, one is likely to miss the good osteo programs by that time. My question is what happens when one doesn't match in any program at all. Can that person recover in the next year match? Does that look bad on this person's resume? In short, does one have to match into a program after one's 4th year of med school? What kind of option can one have?

About switching specialties, I read on this site that it can be done. I figure one can switch from a competitive residency to a less competitive one. What about the other way around? Can one switch into, say a surgery residency, after spending a couple years in emergency medicine residency?

 

[SocialistMD]

1. Unless you are an osteopathic student, you can't do an osteopathic residency. If you are an osteopathic student (or will be), you should have this moved to the osteopathic forum, as they will probably know more about it than anyone here.
2. If you don't match, you scramble. There are always spots open, although not in all specialties. It is more involved than this, but I don't know that knowing the innerworkings of the match is necessary at your stage of the game (no offense).
3. Yes, it is possible to switch from a "less competitive" residency into a "more competitive" residency. A lot of it depends on luck (being in the right place at the right time) as much as it does hard work.

Again, not to dismiss your concerns, but it is a long way away for you to be worrying about the finer details of this subject right now.

 

[Chargers]

nice

 

[gasping81]

I have already signed PGY-2 contract in a program that has the transitional intern year included (so a categorical vs. advanced).

So what happens in terms of funding if:

A.) Leave in the middle of second year
B.) Leave at the end of second year

And switching into a specialty that requires same amount of post-intern years would be....

Thanks to all. Please PM if you have any particular advice on how to do it.

 

[Chargers]

don't PM, share🙂

 

[NotAProgDirector]

I have already signed PGY-2 contract in a program that has the transitional intern year included (so a categorical vs. advanced).

So what happens in terms of funding if:

A.) Leave in the middle of second year
B.) Leave at the end of second year

And switching into a specialty that requires same amount of post-intern years would be....

Thanks to all. Please PM if you have any particular advice on how to do it.

Your funding is defined by your categorical match. Let's assume that you;ve matched into a program that is 1 year transitional + 3 years categorical training. IN that case, your funding is set at 4 years.

If you switch in your PGY-2 year, you'll have used 1.5 or 2 years of funding (depending on whether you switch midway or at the end of the second year).

Your funding situation will depend on the length of your new program and how much credit you get for prior training.

Note that if you resign after the end of your PGY-1 and start a new program as a PGY-2, you have no funding problem. Your funding becomes fixed once you start a "terminal" residency -- i.e. one which leads to board certification. if you matched into the PGY-2, you can resign before min-Jan 2009 without creating a match violation as long as you are going into a different field.

 

[Chargers]

Your funding is defined by your categorical match. Let's assume that you;ve matched into a program that is 1 year transitional + 3 years categorical training. IN that case, your funding is set at 4 years.

If you switch in your PGY-2 year, you'll have used 1.5 or 2 years of funding (depending on whether you switch midway or at the end of the second year).

Your funding situation will depend on the length of your new program and how much credit you get for prior training.

Note that if you resign after the end of your PGY-1 and start a new program as a PGY-2, you have no funding problem. Your funding becomes fixed once you start a "terminal" residency -- i.e. one which leads to board certification. if you matched into the PGY-2, you can resign before min-Jan 2009 without creating a match violation as long as you are going into a different field.

PGY-1 means residency year 1 right? What does it stand for?

 

[Winged Scapula]

PGY-1 means residency year 1 right? What does it stand for?

PGY = post graduate year

So PGY-1 refers to the first year of training after medical school; typically the intern year.

 

[core0]

Your funding is defined by your categorical match. Let's assume that you;ve matched into a program that is 1 year transitional + 3 years categorical training. IN that case, your funding is set at 4 years.

If you switch in your PGY-2 year, you'll have used 1.5 or 2 years of funding (depending on whether you switch midway or at the end of the second year).

Your funding situation will depend on the length of your new program and how much credit you get for prior training.

Note that if you resign after the end of your PGY-1 and start a new program as a PGY-2, you have no funding problem. Your funding becomes fixed once you start a "terminal" residency -- i.e. one which leads to board certification. if you matched into the PGY-2, you can resign before min-Jan 2009 without creating a match violation as long as you are going into a different field.

Just out of curiosity, could you do multiple transitional internships without fixing the amount of funding? For example a PGY-1 that does a medicine transitional year could then match into a surgery transitional year without setting funding? Could they continue to do this ad-infinitum if they did not get a categorical position?

David Carpenter, PA-C

 

[NotAProgDirector]

Just out of curiosity, could you do multiple transitional internships without fixing the amount of funding? For example a PGY-1 that does a medicine transitional year could then match into a surgery transitional year without setting funding? Could they continue to do this ad-infinitum if they did not get a categorical position?

David Carpenter, PA-C

Yes, but each year "counts". So if someone did three prelim surgery years, and then got a categorical spot, they would have "used up" 3 of their years, and would be capped at 5 (and hence run our of funding).

Most programs will not allow someone to repeat the same PGY level, unless their performance was unsatsifactory.

Theorectially, someone could do this for many years, but that seems unrealistic, not to mention incredibly painful.

 

[core0]

Yes, but each year "counts". So if someone did three prelim surgery years, and then got a categorical spot, they would have "used up" 3 of their years, and would be capped at 5 (and hence run our of funding).

Most programs will not allow someone to repeat the same PGY level, unless their performance was unsatsifactory.

Theorectially, someone could do this for many years, but that seems unrealistic, not to mention incredibly painful.

That makes sense. Or in the case of someone that got into FP they would have no years of funding left.

I was thinking more of someone who needed to stay in their residency for internship. In theory you could move from program to program repeating internships until you had the three years necessary to get an unrestricted license in some states. Kind of a wandering resident.

David Carpenter, PA-C

 

[BlondeDocteur]

Just out of curiosity, how do these caps work with research residencies? Let's say you apply in general surgery and spend three years in the lab, for a total of 8 years. Would your funding have run out? And about fellowships-- is there a limit on years spent pursuing further training?

 

[NotAProgDirector]

I was thinking more of someone who needed to stay in their residency for internship. In theory you could move from program to program repeating internships until you had the three years necessary to get an unrestricted license in some states. Kind of a wandering resident.

That's an interesting idea. I guess you could do a prelim surgery year, a prelim medicine year, and then one year of a psych (or path) internship and theoretically have three years of GME training. However, I expect most medical board would look at that and frown, and refuse to license you. So, I woudn't suggest it.

Just out of curiosity, how do these caps work with research residencies? Let's say you apply in general surgery and spend three years in the lab, for a total of 8 years. Would your funding have run out? And about fellowships-- is there a limit on years spent pursuing further training?

Research time is not funded by medicare at all, so does not count. Most research years are funded through the PI's grant, or out of other discretionary funds.

 

[m3unsure]

Question:

What if you do 1 and 11 months of training? Does that mean you have 1 month + x years left in your current specialty amount of funding? Does CMS funding go month to month or year by year so once you start the year, you lost the whole year.

4 year res
2 yr + 1 mth

5 year res
3 yr + 1 mth

Thanks.