Previous CA-3 looking for open CA-3 position

[mspocanos]

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I had to stop training in 2014 while in the midst of my CA-3 year due to a medical disability. Now looking to return to an open CA-2 or CA-3 position.

 

[deleted87051]

Wow CA-3 year.

Best bet is to reach out to your old program. Are people you know still there? Can they go to bat for you?

 

[vector2]

2014? Unfortunately there's almost zero chance you meet even CA1 competency at this point and I'd be surprised if there was an option other than the match and starting as an intern again.

 

[mspocanos]

2014? Unfortunately there's almost zero chance you meet even CA1 competency at this point and I'd be surprised if there was an option other than the match and starting as an intern again.

ABA and ACGME gave me what is in their policies about what credit I can get for all the training done before. Per policy, I would have through CA-2 credit. I am willing to repeat the CA-2 year however as I can use the practice since I have been out for so long.

 

[mspocanos]

Wow CA-3 year.

Best bet is to reach out to your old program. Are people you know still there? Can they go to bat for you?

Good point. Will def look into that.

 

[vector2]

ABA and ACGME gave me what is in their policies about what credit I can get for all the training done before. Per policy, I would have through CA-2 credit. I am willing to repeat the CA-2 year however as I can use the practice since I have been out for so long.

Despite what the rulebook says, be honest with yourself. What do you think your skills and medical knowledge *truly* are after so long away from training? CA-2 is a subspecialty year. Do you really believe it's safe or wise to jump into congential diaphragmatic hernia or mitral valve replacement when you haven't even held a laryngoscope or placed a peripheral IV in three-quarters of a decade?

Also, I'll tell you now that most program directors could not care less what the ABA and ACGME say in regard to this matter. I'll say it again- starting again an intern is probably your best outcome and getting an R spot as a CA-1 would be a miracle.

 

[Big Swinging Doc]

I'm not sure why Vector2 is so discouraging.

No, it's not like riding a bike, but nor is it like you are asking to be anesthetizing neonates solo on day 1. You will do fine.

You are undoubtedly aware that any application that comes with an asterisk will be shuffled to the bottom of the pile. Program directors undoubtedly have enough drama when they recruit from clean files. However, there are plenty of absolutely desperate programs. I wouldn't advise you to get your heart set on a top-tier university based program, but HCA has huge numbers of programs where they have been forced to recruit from the Caribbean and lesser DO programs for their entire existence. Now, if you are a lowly DO or IMG with mediocre scores who was barely scraping by in 2013, that's a different story. But if you have a domestic MD and above average facility with the English language and no personality disorders that can't be disguised for a 30-minute zoom call, you should be fine.

Finding the perfect CA-3 opening is going to be the trick...but this board proves that more programs are losing residents at every year of training that I would have thought possible, so somewhere you'll find somebody looking for a space on the call calendar to fill. If you leveled with them and said that you'll probably need a couple of months as a refresher course to get yourself up to speed before you start the clock on your CA-3 year, who is going to argue with that? At my (very well respected) program, every July they had a real manpower crunch when they had just lost an experienced class of senior residents and fellows. I know they would have been thrilled to have a CA-3 who wouldn't be scheduled to graduate for another couple of months.

You'll find something. Don't get discouraged.

 

[Morzh]

Your likelihood of success is going to depend on what program directors think after they hear the "full" story.

To leave training in the midst of PGY4 year and then remain out for 7 years is highly unusual. You have your right to medical privacy / HIPAA, but the practical reality is that you are going to need to be pretty open and forthcoming with them about your disability history for anyone to seriously consider "taking a risk" on you. Programs, state licensing boards, and hospitals are allowed to ask you some fairly detailed questions about your health in order to determine if have any cognitive or physical impairments that could impact your ability to train, perform, and safely care for patients. They'll also be very curious about what you've been doing with your time for the past 7 years. As well as what your former program thought of you prior to you leaving.

Scenario A: You had a cancer diagnosis and spent the past several years undergoing treatments and are cured / in remission and looking to finally move forward again? I think you'd have a pretty high chance of success, especially if you have strong recommendations from your last program.

Scenario B: Your disability was narcotic addiction, and you resigned / entered treatment program after getting caught diverting. I'd say very few anesthesia programs would consider you, although you may have a reasonable shot at starting over in a different specialty if your disease has remained in remission.

Scenario C: You had a detailed history of serious performance and professionalism issues at your last program. They were on the verge of firing you. You are sent to a psychiatrist and receive a diagnosis of bipolar disorder or MDD or something. You ultimately decide to resign from your program. Maybe it was your choice, or maybe the program told you that you could either resign voluntarily or be fired. You've received extensive treatment and therapy, and are in a much better place now. ... this one is tricky, and sadly your chances are probably pretty grim (whether that's fair or not). You are probably seen as high risk with a major red flag. A lot will depend on the specifics like what you've been doing with your time, if you've gotten into any additional trouble in the past 7 years, and if there is anyone at your old program willing to go to bat for you.

There are a million other possible scenarios here, and any additional advice will depend on the details. You are not obligated to share all those details with programs, but the reality is that you will need to be pretty transparent if you are serious about reassuring them about your history.

I also agree that in all reality you are probably looking at starting over again, at least in an advanced / PGY2 or R1 spot somewhere. After a 7 year hiatus (will be 8 years assuming you are looking to start next July) I highly doubt any program will take you as a PGY4 and then graduate you 12 months later. Also, did you even take the Basic exam? I don't think it was out by 2012 or 2013 or whenever you were finishing CA-1. So you'll have to go back and satisfy that requirement, too.

You've clearly been through a lot. Wish you the very best luck.

 

[vector2]

I'm not sure why Vector2 is so discouraging.

There's a difference between being discouraging and being realistic. I'm an anesthesia and critical care attending at a university academic medical center that takes 7 residents a year including occasional R positions. I have some idea what I'm talking about.

No, it's not like riding a bike, but nor is it like you are asking to be anesthetizing neonates solo on day 1. You will do fine.

No trainee is anesthetizing a neonate solo anyway. However the OP isn't proficient enough at the moment to even anesthetize a neonate whilst supervised. Like another CA2 or CA3 would be. Hence the reason I'm saying they should start again as an intern or CA1.

 

[Big Swinging Doc]

Start again as an intern, to learn how to write meaningless H+Ps, enter orders into the computer, and dictate discharge summaries? You must be kidding.

I couldn't do a neonate solo right now. Sure, I'd be an administrative handful if I somehow had to retrain and subject myself to dealing with fragile egos in an academic program, but I know I'd breeze through any sub-specialties, even acknowledgning that much has progressed in the decade+ that I've (thankfully!!) been away from training programs.

 

[vector2]

Start again as an intern, to learn how to write meaningless H+Ps, enter orders into the computer, and dictate discharge summaries? You must be kidding.

Nice line. Straight out of the AANA handbook. Why learn all that useless doctor stuff about managing inpatient pneumonia, sepsis, COPD, MI, CHF, CVA, and renal insufficiency when you can just be an ER nurse for a year before going to "anesthesia school"

 

[mspocanos]

Thanks for all of the advise... I am happy to be forthcoming with the disability circumstances and will likely be applying and letting the program directors decide for themselves. I was a great resident and was on top of my game. As a result, I am confident I will find a spot, though it may take time, and I will likely hear "no" more then once. All I need is one "yes."

 

[Airway]

Thanks for all of the advise... I am happy to be forthcoming with the disability circumstances and will likely be applying and letting the program directors decide for themselves. I was a great resident and was on top of my game. As a result, I am confident I will find a spot, though it may take time, and I will likely hear "no" more then once. All I need is one "yes."

If you have a well connected mentor or pd or chair and left on decent terms I'd ask them to write letters/call for you.

 

[mspocanos]

If you have a well connected mentor or pd or chair and left on decent terms I'd ask them to write letters/call for you.

All over it. Know just the person! Thanks!