Need to return for 1 year of additional training

[Cassius1999]

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Hello. I am U.S. citizen who graduated from a U.S. medical school and successfully completed a U.S. ACGME-accredited AP/CP 4-year pathology program. I have been successfully practicing AP/CP pathology for the last ten years. I never passed the ABPath boards during that time. I want to become board eligible again (qualified as the ABPath board calls it). The ABPath board has said in order to become qualified to take the board, I need 1 year of additional AP/CP training.

Since I have been out of residency and medical school for so long, I was wondering if anyone knew how to go about obtaining a position at a training program? I don't know if I can go through ERAS since I don't have a token from Medical School. Should I just contact program directors personally to try to get a spot outside the match? Should I wait until the scramble (SOAP), or after the scramble?

If anyone out there is familiar with this situation or if there are any program directors who know how to do this, your input would be greatly appreciated. Thanks.

 

[Path or bust]

Programs usually have some funded and nonfunded positions available year around. You should contact the program directly in your area.

 

[Cassius1999]

Programs usually have some funded and nonfunded positions available year around. You should contact the program directly in your area.

Thank you, that helps. I can do that. By chance do you know how the application process works? Such as, would it be like applying for privileges at a hospital (university hospital)? Thanks.

 

[univlad]

Could you apply for a general surgical pathology fellowship? See which programs have slots available. You could likely do a few electives in CP if you needed additional CP training.

 

[coroner]

Are you trying to become board eligible/qualified to take AP or CP or both? I would make sure you have a clear idea what kind of rotations are required for your supplemental year e.g. 6 mo. AP + 6 mo. CP, 12 mo. AP only, etc. A fellowship is acceptable training, but it'll be all or nothing e.g. if you did a surg path fellowship, you won't get any CP training which may be required to sit for CP boards. On the other hand, for example, if you're only planning on taking CP boards only, you could apply for a formal fellowship in let's say BB/TM to meet the training requirements. However, if you want to be eligible for both AP & CP, I'm not sure if BB/TM would qualify you to sit for both AP & CP exams. If that's the case, it would mean you'd need an individually tailored 1 yr program combining AP+CP which would obviate applying for a formal fellowship. I'm not sure about this, so check with ABP. Also, double check if the training has to be ACGME accredited or not e.g. if you wanted to take AP boards only and applied for a formal surg path fellowship, most are not ACGME accredited and that may or may not be criteria you would have to meet.

As far as application procedure, I'm positive you wouldn't go thru the match because you're not applying for a traditional residency: you already completed it. Plus, you were already allotted your GME funding for those years. I don't even think you could go thru ERAS if you tried; as ERAS is for 4 yr AP/CP or 3 yr AP or 3 yr CP only applications.

The best place to start would be contacting your former program. If your same PD is there, I'm sure they'll understand and work something out to help you. If you've moved to a different location from where you did residency, then try contacting programs in your area, but they might be less sympathetic to your situation than where you originally trained. Worst case scenario, if programs in your area won't offer you a 1 yr spot, hopefully your original residency program does and you may have to move back there for the year. Do not wait for scramble, SOAP, or whatever the hell they call it now. You're not applying for residency. You are in a unique situation and if you're trying to become board eligible again, you need to start making plans now so the potential program can figure out how to accommodate you for 1 yr whether it's a formal fellowship or individually tailored year of training.

There are a few times when I was in training I recall people doing similar 1 yr stints. The first was a former graduate from our program who went into forensics and never passed boards. He came back [to our program] and did something similar to what you're referring to i.e. supplemental training, and our PD signed off on the form/application to the ABP verifying his training, so he met the necessary requirements. The other person was from where I did fellowship (different than my residency program) and was an IMG who did 4 years AP/CP there, never took boards, and went back to their country. Then, they came back 5+ years later and were board ineligible, so they did a fellowship at their former residency program and got approved and took boards. This is not common, but not unheard of either. Call and make some contacts asap. Best of luck and if you're on the West coast now you can take boards in Tucson!

 

[Torsed]

Fear the CP boards, some tyrant writes those questions which have absolutely no clinical relevance. AP was easier. You need to take a review course (Osler is viable). I don't think a year will be enough to pass the boards after this much time. Maybe you are a brainiac, but you need some mega guidance if you are to pass this ordeal.

I am curious as why you want to be board eligible all of a sudden? Medical staff making you do it? Insurer pressure?

 

[Cassius1999]

Could you apply for a general surgical pathology fellowship? See which programs have slots available. You could likely do a few electives in CP if you needed additional CP training.

That might be an option, especially if I can't find a regular program spot.

 

[Cassius1999]

Are you trying to become board eligible/qualified to take AP or CP or both? I would make sure you have a clear idea what kind of rotations are required for your supplemental year e.g. 6 mo. AP + 6 mo. CP, 12 mo. AP only, etc. A fellowship is acceptable training, but it'll be all or nothing e.g. if you did a surg path fellowship, you won't get any CP training which may be required to sit for CP boards. On the other hand, for example, if you're only planning on taking CP boards only, you could apply for a formal fellowship in let's say BB/TM to meet the training requirements. However, if you want to be eligible for both AP & CP, I'm not sure if BB/TM would qualify you to sit for both AP & CP exams. If that's the case, it would mean you'd need an individually tailored 1 yr program combining AP+CP which would obviate applying for a formal fellowship. I'm not sure about this, so check with ABP. Also, double check if the training has to be ACGME accredited or not e.g. if you wanted to take AP boards only and applied for a formal surg path fellowship, most are not ACGME accredited and that may or may not be criteria you would have to meet.

As far as application procedure, I'm positive you wouldn't go thru the match because you're not applying for a traditional residency: you already completed it. Plus, you were already allotted your GME funding for those years. I don't even think you could go thru ERAS if you tried; as ERAS is for 4 yr AP/CP or 3 yr AP or 3 yr CP only applications.

The best place to start would be contacting your former program. If your same PD is there, I'm sure they'll understand and work something out to help you. If you've moved to a different location from where you did residency, then try contacting programs in your area, but they might be less sympathetic to your situation than where you originally trained. Worst case scenario, if programs in your area won't offer you a 1 yr spot, hopefully your original residency program does and you may have to move back there for the year. Do not wait for scramble, SOAP, or whatever the hell they call it now. You're not applying for residency. You are in a unique situation and if you're trying to become board eligible again, you need to start making plans now so the potential program can figure out how to accommodate you for 1 yr whether it's a formal fellowship or individually tailored year of training.

There are a few times when I was in training I recall people doing similar 1 yr stints. The first was a former graduate from our program who went into forensics and never passed boards. He came back [to our program] and did something similar to what you're referring to i.e. supplemental training, and our PD signed off on the form/application to the ABP verifying his training, so he met the necessary requirements. The other person was from where I did fellowship (different than my residency program) and was an IMG who did 4 years AP/CP there, never took boards, and went back to their country. Then, they came back 5+ years later and were board ineligible, so they did a fellowship at their former residency program and got approved and took boards. This is not common, but not unheard of either. Call and make some contacts asap. Best of luck and if you're on the West coast now you can take boards in Tucson!

Thank you for that info. I won't waste time with ERAS or SOAP. To be safe, I will follow the board's recommendation of a regular residency spot (funded or unfunded). 6 months AP (surg, autopsy, cyto, etc) and 6 months CP (micro, heme, BB, chemistry, etc). Travelling isn't a problem so I will contact as many programs as possible. Now that you mention, now is the best time so a program director will have a better idea about spots before the match, or very soon after. I didn't know anyone during my training who had to do something like this, however, my sister knew a few people who had to do this. She trained in Anesthesiology, and because they have a short eligibility period (2 or 3 years?) some former residents would have to come back and do an additional year if they didn't pass boards soon enough. Again, thank you for the post. It is very informative and very encouraging. I appreciate it.

 

[Cassius1999]

Fear the CP boards, some tyrant writes those questions which have absolutely no clinical relevance. AP was easier. You need to take a review course (Osler is viable). I don't think a year will be enough to pass the boards after this much time. Maybe you are a brainiac, but you need some mega guidance if you are to pass this ordeal.

I am curious as why you want to be board eligible all of a sudden? Medical staff making you do it? Insurer pressure?

The hospital I am currently at requires board certification or board eligibility to maintain full staff credentials. Right now, I have been relegated to temporary status. Most U.S. hospitals require certification or eligibility for full privileges. Most private labs don't require it. My malpractice insurance has not changed, which is good. Most patient's private insurance doesn't discriminate, however, my state's Medicare reimburses 1.5% less for my cases due to not being board certified. I recall signing a form acknowledging that.

I plan to also redo Osler and maybe attend the annual ASCP resident conference in Chicago. Also, there are many options with recorded lectures and practice exam software on the internet for a subscription fee. A few that come to mind include Board Vitals, Oakstone and Damjanov.

 

[Cassius1999]

I want to post an update on my search for a pathology program for 1 year of additional AP/CP training. I am happy to report that I have been successful in securing a spot. The process was a little more challenging than I thought. Early on in February, most programs I contacted did not have any spots available. However, as the Match approached, and as some PD's realized they may not fill, many wanted to keep my contact info on file in order to get back to me. Then, after the Match, I was contacted about a few spots that were unfilled. I signed on with a good program in the southwest.

After my experience, my advice to anyone finding themselves in the same position, is to contact the programs just before the Match (early March) and to follow-up with them just as Match-week ends. Even those programs with vacancies in upper level positions, tend to put those up for the Match, so they can't just enroll a Match ineligible old timer whenever. Plus, the Match rules are very strict, so programs have to wait until the Match is over before offering unfilled spots to non-Match candidates (like me).

Thanks to everyone who responded to my thread.

 

[coroner]

Are you doing a combined AP/CP year to try to become board eligible again for both AP & CP exams or are you just taking one? Anyway congrats, and get used to calling some people "doctor" who may be younger than you...haha

 

[AZpath]

Good work. Too bad this had to happen. I got a feeling it will be a great experience for you.

You now have 10 years practical experience in private practice to share with them too.
They get an experience attending not just a resident.