Question re: funding for spots?

[TreeOfLife]

I am currently completing a transitional year internship. I have applied to and interviewed at both PGY2 and PGY1 (4yr) programs this year. Several people have mentioned, in passing, that a PGY1 (4yr) program would not be able to get funding for me in the PGY4th year because I will be entering the program, having completed an internship, and already at the PGY2 level. In other words...because I have already completed an internship, they won't be able to get funding for me to complete another one. I have posed this dilemna to many program directors and noone yet has really been able to give me a definitive answer. Are they not able to tell me that they wouldn't rank me because of this? What are the politics around this issue and what might "naive" me need to know about how to approach this subject. For the few programs that I am really interestd in, I'd like to call the PD to discuss the issue but want to know my facts beforehand. Also, who is the governing body over these funding issues...perhaps I could call and pose the question to whomever is giving the funding?

If you've got any advice or information on this, I'd really appreciate it. Also, I hope there aren't any other issues I may not be aware of in re: to being eligible to match into an 07' PGY2 spot considering that I will be completing my internship by June rather than one would typically do. What do most people do when they have that year off, in between? Research maybe? Moonlight? Do programs worry about what you'll do?

Good luck to everyone as you start thinking about your rank lists!!!

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[MM9]

Check out: http://www.aamc.org/advocacy/library/gme/gme0001.htm which as some links on this issue including this nice brochure: http://www.aamc.org/advocacy/library/gme/dgmebroc.pdf. There is also a seemingly newer, version of the pdf here: https://services.aamc.org/Publicati...=version19.pdf&prd_id=88&prv_id=110&pdf_id=19. There seem also to be links to the contact information you seek.

In summary, there are 2 types of funding, Direct and Indirect. These amounts vary based on several factors such as the number of Medicare patients, the average stay of these patients, a "hospital specific amount", the position of the sun, and the temperature in Toledo, Ohio (ok, I made the last 2 up). When you match into a field, you are 'locked' into how many years of full Direct funding the government will give your program. For example, if you match into IM you have 3 years of full Direct funding (they count you 1.0 when they do the math). Once you use up those 3 years, since you are obviously completely useless, you count as half a resident. I'm not kidding, when they do the math you are counted as 0.5.

The fact that some specialites require a prelim or transitional year is factored into the system (see question 11). When you match into PM&R you will be allotted 4 years of full funding. The transitional year you are currently finishing will count as 1 of those 4, so you will be left with 3 years.

This maddness is only true for the Direct funding; for the Indirect funding you count as a whole person for as many years as it takes.

The brochure above shows some nice examples of the math. It also mentions that for most hospitals, the Indirect funding "far exceeds" the Direct. It goes on to say, “So as a percentage of the hospital’s total Medicare medical education payment, the financial impact of a resident beyond the initial residency period may be small.”

Hope this helps.

 

[DrGucciGal]

TreeofLife: I am in the same situation as you. I called one of the 4 year programs that I interviewed with today and they said that I would surely not get the funding because I have already done an internship. However, for those 3 year programs that I have interviewed with for a 2007 spot, regarding what to do with the year off, one program director suggested that I work in an ER for a year. "Seeing lumps and bumps" as he put it. Basically, you could get paid 3 times (or more) than you would as a resident. But you have to pay your own insurance (I think). I have also considered (a) research (put I don't know how easy it is to put this together) (b) staying in my current residency program for another year (which is clearly a waste of time, since it would be another boring year of internal medicine, yuck!)

Good luck to you, I am sure that you will find a position this year!