PLEASE ADVISE! Can I still do Rads (2nd residency)?

[Docktah]

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I will start categorical IM next summer. There is a good chance I will not like it and will want to become a radiologist after finishing IM. (I was torn between the two as MS4). Will it be possible to apply for rads residency during IM pgy-2 so I can start right after IM finishes?


I looked for other posts on switching from IM to rads, and people talk about how medicare might not pay for more than 3 years if I start IM categorical... but that it is still somehow possible to do this. Anyone have a more definitive answer?


I CANNOT WITHDRAW FROM THE MATCH AND JUST APPLY FOR RADS NEXT YEAR. Because of my situation I will have to match to categorical IM this year. So please don't suggest that as the solution. I know I should have applied to Prelim IM + Rads because it would make it easier to go down either path. Kicking myself for not doing that in the first place.


Finally, my stats:

US Citizen, M.D., mid-tier US med school, 245+ on Step 1/2, Decent clinical grades (Honors/High Pass). Honors in the rads rotations I did as MS4.

 

[DrBowtie]

I will start categorical IM next summer. There is a good chance I will not like it and will want to become a radiologist after finishing IM. (I was torn between the two as MS4). Will it be possible to apply for rads residency during IM pgy-2 so I can start right after IM finishes?


I looked for other posts on switching from IM to rads, and people talk about how medicare might not pay for more than 3 years if I start IM categorical... but that it is still somehow possible to do this. Anyone have a more definitive answer?


I CANNOT WITHDRAW FROM THE MATCH AND JUST APPLY FOR RADS NEXT YEAR. Because of my situation I will have to match to categorical IM this year. So please don't suggest that as the solution. I know I should have applied to Prelim IM + Rads because it would make it easier to go down either path. Kicking myself for not doing that in the first place.


Finally, my stats:

US Citizen, M.D., mid-tier US med school, 245+ on Step 1/2, Decent clinical grades (Honors/High Pass). Honors in the rads rotations I did as MS4.

A couple things:
Why finish the entire IM residency? Seems like an awful idea if you know you hate it.

You can do a few things:
Apply during PGY1 to the few places that will have PGY2 spots for the following year because people changed their mind during intern year. These will be posted often on Auntminnie. Pros: No lost time. Cons: Limited program selection.

Apply during the normal match cycle during medicine PGY1 for PGY2 spots for two years from now. Pros: Program selection. Cons: Gap year where you could do PGY2 of medicine or have to find a research job for the interim.

Apply for the match during your PGY2 medicine year as you said.
Pros: Program selection. Cons: 2 extra years in IM

Can't help you much on the funding issue.

 

[Nesir]

I don't think the funding thing is an issue. Plenty of people do a full residency then start a radiology residency. I've seen at least a handful of people finish a surgery residency then switch over.

 

[Mac or Miller]

Bowtie summed it up nicely.

Generally the consensus is that the match agreement binds you to start a program, but if you don't like it after you've started, you can leave if another program will take you. So you can do PGY-1 in IM and then roll onward to rads if there is an opening or a program that adds a resident slot on short notice.

Here is how the funding issue works (see the attachment). Once you match into a program that leads to board certification, Medicare will provide full GME funding for the number of years required by that specialty. So once you match categorical IM, you are fully funded through PGY-3 regardless of how you use those 3 years of funding. After that (including fellowships), Medicare will cover 0.5.

Now not all programs fund exclusively through Medicare. Some have full positions paid for by the VA, the state, or the hospital itself. Those programs can pay their traditional matched residents with Medicare and use their VA (or whatever their extra source is) money to pay the second career people.

With that said, programs with sudden openings are often desperate, and desperate programs can find a way to pay you.

 

[Docktah]

Thanks for the helpful posts!

Good to know that some sort of funding will be there even if I finish IM and then try for rads. Sometimes on this side of the match, you feel like you are stuck in whatever path you choose. But nice to know that there is some flexibility later in life 🙂

 

[shark2000]

I had a classmate in my radiology residency who finished his IM residency before doing radiology.

So it is doable. I never thought about funding issue and don't have enough information about it. But have seen or heard about people doing second residency after the first time here and there. I think it should not be a big issue. You can ask more specifically from your GME office.

But, if your final goal is to become a radiologist, finishing an IM residency is a waste of time and energy. Try to find another way.

 

[Lolscan]

My chief resident swapped from IM to Radiology. He did a chief resident year in between going for IM to radiology. So it seems logistically it could be done. You could also be a hospitalist for a year and make bank before being poor R1 again haha

 

[Docktah]

My chief resident swapped from IM to Radiology. He did a chief resident year in between going for IM to radiology. So it seems logistically it could be done. You could also be a hospitalist for a year and make bank before being poor R1 again haha

Wow so he finished IM categorical, and then did a chief year in IM before starting rads? And now he's your chief in your rads program?? That's a lot of training, but nice to know it can be done.