options after intern year

[intern_for_life]

Hello all,

I know this topic has been discussed several times before but I had a very specific question and would appreciate any advice on. I graduated from medical school in 2019. Scrambled into an IM spot, resigned 2 months into the year to pursue pathology residency, matched into a pathology residency in 2020 then wanted to come back to clinical medicine, finished 1 year in pathology and now currently in a transitional year since I couldn't match into a categorical for understandable reasons. I understand finishing a residency is the best scenario but I will have a difficult time matching into residency since my funding clock will expire after this year.

My question is...I am considering finishing up my transitional year and starting a practice. Obviously there will be issues with this and I won't be able to get insurance and it's not realistic doing alone. My brother is currently a hospitalist and is willing to mentor me and work with me but I wanted to seek help with the system and what my possibilities are. Is it possible for me to work alongside my brother and do H&Ps and notes for him while he overlooks my patients? Can I just bill under his name? Will I be able to work if he is covered for insurance but I am not? I guess I am wondering if this is a scenario I can even consider or if I am better off just hunting for a rural urgent care job and keep trying to apply again (i already wasted a lot of money on applications without success last year). I really just want a job, an income to pay bills and loans and feed family, and use my education or training for something useful.

If anyone can share advice or experiences with this it would help a lot.

Thank you.

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[flasheroonie]

Some states allow you to pursue a full license with only an internship, others don't. It depends on your state licensing board requirements. If there's any way to get a residency in anything, that would be the best solution. I can't speak for myself, but I have colleagues who went the road of GP after just an internship or transitional year and they're struggling.

 

[ACSurgeon]

some people do two residencies. ie the funding limit is NOT absolute.

did you resign IM because you wanted to or because you were about to be fired? This might not matter as much if you have good evals from your 1 year in path and your current transition year. You’ll still seem like someone who is a high flight risk but maybe you can convince a program that all this jumping around led you to find your true passion.

some states still allow for a medical license after 1 year. You can open your own practice if you so chose. You should do this knowing you’re providing suboptimal care but you might be able to justify it by comparing yourself to all the NPs who practice independently with a lot less knowledge and training.

have you considered public health or occupational health? These usually require an intern year to do these 1 year programs. You already have that so maybe it’ll work.

finally, with an active license and an intern year you might be able to work for an insurance company or medical device company etc.

You should keep looking for open spots. Try neuro or anesthesia. Try anything with an advanced position since you already have an intern year.

 

[intern_for_life]

Some states allow you to pursue a full license with only an internship, others don't. It depends on your state licensing board requirements. If there's any way to get a residency in anything, that would be the best solution. I can't speak for myself, but I have colleagues who went the road of GP after just an internship or transitional year and they're struggling.

Thanks for the response. Are they struggling with the business aspect of it? With the actual patient care? Struggling financially?

I am only considering this route because my brother who is currently a board certified hospitalist is willing to mentor me if we open a clinic. Would that be a reasonable option and can I make myself useful providing care alongside him?

 

[intern_for_life]

some people do two residencies. ie the funding limit is NOT absolute.

did you resign IM because you wanted to or because you were about to be fired? This might not matter as much if you have good evals from your 1 year in path and your current transition year. You’ll still seem like someone who is a high flight risk but maybe you can convince a program that all this jumping around led you to find your true passion.

some states still allow for a medical license after 1 year. You can open your own practice if you so chose. You should do this knowing you’re providing suboptimal care but you might be able to justify it by comparing yourself to all the NPs who practice independently with a lot less knowledge and training.

have you considered public health or occupational health? These usually require an intern year to do these 1 year programs. You already have that so maybe it’ll work.

finally, with an active license and an intern year you might be able to work for an insurance company or medical device company etc.

You should keep looking for open spots. Try neuro or anesthesia. Try anything with an advanced position since you already have an intern year.

I resigned from IM because I thought I would enjoy pathology more. I was wrong and would rather pursue clinical medicine. I am currently in my intern year and will be finishing it but debating how to approach this. I am very depleted financially with all that applying and moving around so far.

 

[flasheroonie]

As long as your state allows you to get an unrestricted license to practice, the hardest part is the business aspect of it. Insurance companies will be extremely wary to want to work with you and you'll have to end up just accepting cash or doing concierge medicine, if that's what your business model ends up being. Besides, the patients who want a doctor to work with them at the concierge level are the kinds of patients who care about how much education you've had.

 

[Creed_Bratton]

healthcare consulting. my buddy makes 150K, granted that he does not have md/do, just some MA experience and a business degree. he told me it's entirely possible to make around that amount with an md without residency. unless you feel like you must do clinical work.

 

[Dral]

If you want to get the full extent of your degree (meaning boarded in a specialty), I will echo that you look into either a preventive medicine or occupational medicine residency. You may be able to find your way into a family med residency as well.

I feel that even if you work something out with your brother's practice, you are putting his license on the line. If you end up in a legit lawsuit I'm afraid a lawyer would tear both of you a new one.

 

[intern_for_life]

Why does the 1 year license even exist? Seems really worthless. Just get rid of it and stop giving people false hopes of getting something out of their intern year. So how attainable is occ/preventative medicine for a guy applying to a 4th program and out of funding?

 

[Angus Avagadro]

Consider working for an insurance company reviewing claims and studies ordered might be an option. Get some training in basic cosmetics, botox, vein sclerotherapy, hair transplant etc. Cash only, no insurance approval necessary. There are people which 1 yr of training. That are incredibly successful. Some things to consider. Good luck and best wishes!