PGY 2 and Beyond

[canadian1234]

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If I am mostly interested in PGY 2 and beyond positions (Psychiatry, Preventive Medicine, Family Medicine), although I would accept a PGY 1 offer, is there any point in my registering with ERAS and going through the NRMP match? 😕

I have done one year of residency many years ago and may be given credit for my years in practice.

 

[gutonc]

If I am mostly interested in PGY 2 and beyond positions (Psychiatry, Preventive Medicine, Family Medicine), although I would accept a PGY 1 offer, is there any point in my registering with ERAS and going through the NRMP match? 😕

I have done one year of residency many years ago and may be given credit for my years in practice.

Given the length of time since your internship, it is unlikely that you will get credit for it. Is that fair? Who knows. Moral of the story is that you should pretend that you're a fresh grad (with a good story) and shoot for PGY1 spots in the match (next year, unless you've been interviewing for the last 3 months) or a pre-match spot.

 

[Cuteasaurus]

Why wouldn't a person get credit for an internship already completed? I know my dad did an internship, practiced for about 7 years (IHS), and then went back to do two years of family practice residency. Is there a new rule that now prohibits that?

 

[Shalom77]

I'd think it would depend a little bit on your goals and the kind of residency you want (and specialty)

You can go for spots that didn't fill, opened unexpectedly etc. but that's a subset of programs likely of lower quality and less geographic variety with some exceptions (since even great programs can have residents leave unexpectedly, etc.)

If you go through the match you may (depending on how competitive your application) have a much broader range of choices in terms of quality of program, geography, style of program etc. Is that extra range of choices worth doing another intern year?

The other issue is would being willing to do an intern year make it more likely for programs to seriously consider your application given the length of time since your previous internship. I don't really know. Might be a good question to ask of a program director.

For occupational medicine, though, I think most of those programs have a separate non eras application. At least I recall that the ones I looked at did. In that case - it would seem that going through eras makes little sense.

Or you can play it safe and both register for the match and look for positions outside the match. If you find a PGY2 position outside the match -great. Just withdraw from the NRMP. But if you are having difficulty - then you have your ERAS applications to fall back on. I think since you are such an unusual candidate doing both might be your best option - since I think it's hard to really judge how your application will be received since you are in an unusual position.

 

[gutonc]

Why wouldn't a person get credit for an internship already completed? I know my dad did an internship, practiced for about 7 years (IHS), and then went back to do two years of family practice residency. Is there a new rule that now prohibits that?

There's no rule per se, but if you've been following the saga of the OP, he's been out of practice for many (10-ish IIRC) years as a result of a "disagreement" w/ his local licensing board. Completely different ballgame than the one you describe.

The other thing to keep in mind is that the residency biz continues to get more and more competitive such that even bad FM/IM/Psych programs don't have to take just any warm body just to get the work done these days.

 

[Cuteasaurus]

Ahhh, there is more to the story than what the OP posted in this thread. If you've been out of practice that long, then I agree, it is much more unlikely that you'll be hopping into a PGY2 position.

 

[NotAProgDirector]

Or you can play it safe and both register for the match and look for positions outside the match. If you find a PGY2 position outside the match -great. Just withdraw from the NRMP. But if you are having difficulty - then you have your ERAS applications to fall back on. I think since you are such an unusual candidate doing both might be your best option - since I think it's hard to really judge how your application will be received since you are in an unusual position.

This is great advice. The best way to find an open PGY-2 is to apply for PGY-1's. PD's will notice your year of grad and prior experience, and will decide whether they want to offer you a PGY-2 spot if they have one open.

As others have mentioned, I expect the OP will need to start a PGY-1 over again. Medicine has changed dramatically in the last 10 years, and unless you have been honing your inpatient skills/knowledge over the last decade you risk being poorly prepared for a PGY-2 (at least on the inpatient side of things).

 

[canadian1234]

Thanks so much. Your advice makes sense. Why think either/or when you can think both.
I am thinking of applying through ERAS sometime between today and the deadline with the hope of finding a late position or going through the scramble. Any fallacy to this logic?

 

[gutonc]

Thanks so much. Your advice makes sense. Why think either/or when you can think both.
I am thinking of applying through ERAS sometime between today and the deadline with the hope of finding a late position or going through the scramble. Any fallacy to this logic?

Well, only that although the actual deadline hasn't passed, any actual opportunity to get an interview has. You could certainly scramble at this point but be sure to read all the threads currently going about how much fun the scramble is (not to mention how successful most people are) before you hang your hat on it. No reason (other than wasting cash and potentially ending up in the 9th circle of hell for the next 3-4 years) not to try it though.

 

[NotAProgDirector]

Well, only that although the actual deadline hasn't passed, any actual opportunity to get an interview has. You could certainly scramble at this point but be sure to read all the threads currently going about how much fun the scramble is (not to mention how successful most people are) before you hang your hat on it. No reason (other than wasting cash and potentially ending up in the 9th circle of hell for the next 3-4 years) not to try it though.

Agreed. You are way too late for this cycle. Most programs have stopped accepting applications weeks ago. You're stuck with the scramble, or perhaps trying to find programs that take people only outside the match.

Given your very distant date of graduation and lack of current clinical experience, I expect you will find it very difficult to get a spot in the scramble. In fact, it may be very difficult to get a spot altogether. Your best chance is to plan for next year, try to get some clinical experience in the meanwhile, apply early and broadly. Because you have passed the USMLE's and already have one year of GME experience, you may qualify for a full license in some states and be able to get clinical experience with it.

 

[canadian1234]

Thanks for this. Actually, I have passed the LMCC which is the Canadian equivalent of the USMLE.

Might you know which states might be more open to my application for a full license?

 

[NotAProgDirector]

Thanks for this. Actually, I have passed the LMCC which is the Canadian equivalent of the USMLE.

Might you know which states might be more open to my application for a full license?

I found this on the web:

States that will not endorse the Canadian LMCC or do not accept as equivalent Canadian residency training include Florida, Hawaii, Kansas, Louisiana, Missouri, Nevada, North Carolina, South Carolina and Virgin Islands. Canadians whose basic medical school was outside the United States or Canada in addition are required (with some exceptions for Board certified physicians) to complete the EGFMG's (Education Commission For Foreign Medical Graduates).

I have no idea how old it is. Other sites mentioned that 12 states do not recognise the LMCC but didn't list them. Best option is to choose which states you are interested in and look at their regulations. All of the state boards are listed on the FSMB website.

Remember that you would need to be sure that the state recognized the LMCC and one year of Canadian training for licensure (might depend on what type of training).

Lastly, if you want a residency in the US, I sincerely doubt that any program will look at your application without USMLE scores, especially since your LMCC scores are very distant. So some of this is moot -- if you want further training in the US, you're likely going to need to take the USMLE.