quitting after internship?

[ladyintern]

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hi guys,

i have seen lots of people on here advise not to quit residency until you complete your intern year. what exactly can you do if you do complete your intern year but not a residency? say in gen med or peds? can you become a GP? is there anything you can do with just a license?

 

[elwademd]

depends on the state in which you desire to practice. but many states, california for one, allow you to be a licensed physician without restrictions after your internship (i.e. not a tiered license).

so, you'd be a licensed physician... but not board eligible (which isn't actually a designation, its just understood you didn't finish residency).

you could do urgent care. you could work in an outpatient clinic. presumably you could work in a hospital, provided you were able to get privileges after just an internship.

you just would not be able to tout yourself as "board certfied".

 

[dragonfly99]

There isn't much you can do (clinically) with just 1 year of training. And in all honesty, someone with just 1 year of training isn't really qualified to practice in today's world. Some states won't let you get a license without 2 or more years of training either, though there are several where you can get one.

Usually people just get moonlighting jobs in their residency programs once they get their licenses. Most urgent cares, doc in the boxes, or hospitals would never ever hire someone who didn't finish some kind of residency. It's just not legally viable for them...if you screw up and they get sued, they don't have a leg to stand on. They would be better off hiring a "board certified" NP or PA, who is "fully trained" and can do basically what someone with just an intern year could do, and would be paid the same or less.

One very important point to consider is that many, many insurance companies will not pay a doctor, and most hospitals won't credential one, who hasn't finished a residency. In fact, many insurance companies and many medical practices won't hire someone who isn't "board eligible" (meaning you finished residency and are getting read to take your specialty exam, such as the American Board of Internal Med certifying exam). It's hard to get a job without being "board certified" much less without even finishing a residency.

I think quitting residency is a VERY BAD idea in most cases, unless you plan on no sort of clinical career whatsoever. Taking a year off to do research or something, and/or switching residencies after an intern year is a better plan. Really one shouldn't quit any job/career without a concrete plan of what to do next.

A person could do an MPH with no residency, or do an MBA (with or without doing an internship) and then do something nonclinical. There are a few areas you can switch/get in to with just an internship to start. I heard that one can do sleep medicine, but I don't personally know any sleep medicine docs. I think you can also do a preventive medicine residency, which I think is 1-2 years after internship...that's usually for more public health type jobs with less direct patient contact, I think. You could check out some of those areas.

 

[elwademd]

There isn't much you can do (clinically) with just 1 year of training. And in all honesty, someone with just 1 year of training isn't really qualified to practice in today's world. Some states won't let you get a license without 2 or more years of training either, though there are several where you can get one.

Usually people just get moonlighting jobs in their residency programs once they get their licenses. Most urgent cares, doc in the boxes, or hospitals would never ever hire someone who didn't finish some kind of residency. It's just not legally viable for them...if you screw up and they get sued, they don't have a leg to stand on. They would be better off hiring a "board certified" NP or PA, who is "fully trained" and can do basically what someone with just an intern year could do, and would be paid the same or less.

One very important point to consider is that many, many insurance companies will not pay a doctor, and most hospitals won't credential one, who hasn't finished a residency. In fact, many insurance companies and many medical practices won't hire someone who isn't "board eligible" (meaning you finished residency and are getting read to take your specialty exam, such as the American Board of Internal Med certifying exam). It's hard to get a job without being "board certified" much less without even finishing a residency.

I think quitting residency is a VERY BAD idea in most cases, unless you plan on no sort of clinical career whatsoever. Taking a year off to do research or something, and/or switching residencies after an intern year is a better plan. Really one shouldn't quit any job/career without a concrete plan of what to do next.

A person could do an MPH with no residency, or do an MBA (with or without doing an internship) and then do something nonclinical. There are a few areas you can switch/get in to with just an internship to start. I heard that one can do sleep medicine, but I don't personally know any sleep medicine docs. I think you can also do a preventive medicine residency, which I think is 1-2 years after internship...that's usually for more public health type jobs with less direct patient contact, I think. You could check out some of those areas.

while i agree with you in principle, you'd be surprised at the number of docs in a city of large size (la for example) who didn't finish a residency and have a "successful" (definition depends on the person) practice.

in east la (where i was in residency), there were/are a number of neighborhood clinics that are, for lack of a better word, shady. there are plenty of people and practices who don't worry about getting sued, they want the money coming in. someone may put his/her name on the practice and insurance rolls, and have underlings, i mean physicians with a license without finishing a residency working the clinic... seeing the patients in the hospital, etc.

this probably doesn't happen at academic centers, but small community hospitals and outpatient clinics in poor neighborhoods is another story.

 

[Law2Doc]

hi guys,

i have seen lots of people on here advise not to quit residency until you complete your intern year. what exactly can you do if you do complete your intern year but not a residency? say in gen med or peds? can you become a GP? is there anything you can do with just a license?

While there isn't that much you can do with just the intern year, the main thing you accomplish is keeping the door open should you decide to return to medicine. You are SOL if you take a lot of time off after med school and never do an intern year, but if you do an intern year, you have more leeway to take some time off and still come back to a residency. So that is really why folks recommend the intern year. With it, you can change your mind and come back. Without it you are often f'ed.

 

[Law2Doc]

A person could ... do an MBA (with or without doing an internship) and then do something nonclinical.

Just FYI, an MBA without any work experience is nearly useless. An MBA is not a pre-professional degree -- you don't get one to get a job. You get a job and then you go back for an MBA. (Or you do a joint degree which presumes you are going to get some clinical work experience before you use the MBA.) But the degree itself isn't useful -- it's about enhancing existing skills, not giving you them de novo. This is the reason the better MBA programs require folks to have at least 2 years of business experience before applying, and why most people in MBA programs are having their tuition paid for by their employers, not on their own dime. It's a foolish degree to get to "get a job". Folks in MD or JD or other pre-professional paths get confused by this because they are in programs where the degree is useful to get their jobs, but an MBA is a different animal, and better to get after you have a job in the industry, to get a promotion, not to get in the door.

 

[Winged Scapula]

We shouldn't assume that the OP is American trained. If you attended medical school outside of the US, many states require you to have 3 years of residency before you are eligible for a license. Clearly, finishing more than internship would be important in this situation.

 

[dragonfly99]

law2doc...I didn't mean to imply that an MBA without any work experience would be useful. I was thinking more for someone who already had a business background (such as someone who had a job before med school).
Agree it wouldn't be useful with no work experience at all. There was a student at my med school who never did any internship or residency...was hired by a pretty well known consulting firm. This might be unusual but we were at a very well known med school...not sure if she had any business background at all...I dont' think so.

elwa...would the OP really want to work in a "shady" clinic?
I just think it's hard to get any real clinical job with long term potential of any kind without having finished a residency of some kind. I'm from the rural midwest, and I remember inquiring toward the end of my 3rd year of residency about getting some jobs in the little town I'm from...the people were surprisingly insistent about wanting to know that I was Board Certified (not even just finished w/residency) before hiring me. Undoubtedly many private practices would hire someone finishing up a residency, with expectation that they'd get boarded within 6 months or so, but for Doc-in-the-Box type places, etc. they are surprisingly rigid about needing only board certified docs (or NP's, PA's, etc.). They told me this was because a lot of insurance companies won't credential a doc who isn't board certified (so he/she couldn't be paid by them). This is also why many urgent care centers won't hire house staff/residents to moonlight there.

 

[michaelrack]

There are a few areas you can switch/get in to with just an internship to start. I heard that one can do sleep medicine, but I don't personally know any sleep medicine docs.

You can't do sleep medicine without completing a residency first. There are no jobs available in sleep medicine for those who have just done an internship.

 

[Faebinder]

As others stated.. IMG/FMG vs. AMG matters.

Unless you are an AMG or an IMG with scores above 85 first try.. I would not recommend ever interrupting an internship... It's practically a career death sentence.

Stopping after an internship does not make you safe either... it allows you a license in some states to possibly moonlight for cash. If you think you are okay with $50/hr for the rest of your life and restricted to certain number of states (incase of FMG restricted to wisconsin ONLY and who knows how long will that last) then you should definitely finish year 2.

After two years, you are generally safe... Now you can get a license to do general medicine in several states (not all states)... but you are getting out of the $50-$75/hr until you are done with residency (or somehow you find this awesome gig).

 

[ladyintern]

thanks for your replies everyone. i did find two things you can do with only an internship -- the public health service and a preventive health residency. don't know much about either one... anyone know anything about them?

 

[dnslay]

I could never figure out why anyone does an MD/MBA *shrug*

Don't get me wrong, some of them are the brightest in the class but still, yeah job experience...

Just FYI, an MBA without any work experience is nearly useless. An MBA is not a pre-professional degree -- you don't get one to get a job. You get a job and then you go back for an MBA. (Or you do a joint degree which presumes you are going to get some clinical work experience before you use the MBA.) But the degree itself isn't useful -- it's about enhancing existing skills, not giving you them de novo. This is the reason the better MBA programs require folks to have at least 2 years of business experience before applying, and why most people in MBA programs are having their tuition paid for by their employers, not on their own dime. It's a foolish degree to get to "get a job". Folks in MD or JD or other pre-professional paths get confused by this because they are in programs where the degree is useful to get their jobs, but an MBA is a different animal, and better to get after you have a job in the industry, to get a promotion, not to get in the door.

 

[dragonfly99]

The public health service is where you work in an underserved area providing primary care (for the most part). Not sure if there are other things you can do in the public health service. Be aware you may be sent/dispatched a very very rural area that is isolated, and that you will likely have a lot of patients who are poor, low literacy, etc. For people who are charged up about primary care and the availability of health care for all, I think it could be a rewarding job in some ways, but I also think (having practiced internal med) that you should not underestimate how difficult it is. I also think you need to explore more whether the USPHS really is recruiting/wants people with less than a full residency completed. You really aren't competent to practice on your own yet (no offense to you personally). I would think they'd either not want to hire you, or would want you to complete some sort of residency while working for them.

 

[BlondeDocteur]

I have a friend who's doing the Preventive Medicine residency at Sinai right now, and she is in *heaven.* She works Monday-Friday, 9-4 PM, and will never take call once in the entire 2 years of her appointment. When finished she'll have a few options-- occupational medicine (i.e. directing employee health services), health department work, designing public health awareness and education programs, academics. Since you have to complete a clinical internship and be licensed she can still see patients too if she wishes.

 

[DrJosephKim]

Unless you're planning to pursue a non-clinical career path, make sure to finish a residency.

 

[nsap102]

Anymore input into this thread?

 

[dragonfly99]

The only thing I have to say is that you should think very very very very very hard before quitting after doing just an internship, UNLESS you truly want to leave clinical medicine forever. The future (and present, in many cases) is that you can't really get real clinical "doctor" jobs without having finished a residency, and in many cases having passed your board exam for your specialty as well. I know what I am talking about because I live in and am licensed in a state that has a relative shortage of doctors. Even so, to get hired for moonlighting, etc. they pretty much want you to be at least in your final year of residency, and/or be a fellow (such as someone who finished all of IM and now doing a fellowship). There are enough docs around who ARE licensed and did do a whole residency, so most hospitals or Locum Tenens companies just don't need to take a chance on someone only partially trained. Also they can just hire a PA or NP (such as in an ER or urgent care) who is "board certified" so not much reason to hire a doc with just an internship under his/her belt.

There is a difference between "quitting" and switching to something else (like preventive medicine residency or some other specialty, etc.) though. Regardless, quitting in the middle of the year would be really bad and perhaps the kiss of death for someone's clinical career. Try to figure out what the problem is if you want to quit. Do you hate all clinical medicine? Just hate your current program? Hate your current specialty but might like some other specialty if you could switch?

 

[CambieMD]

hi guys,

i have seen lots of people on here advise not to quit residency until you complete your intern year. what exactly can you do if you do complete your intern year but not a residency? say in gen med or peds? can you become a GP? is there anything you can do with just a license?

You cannot do very much with one year of post med school training. You are not really qualified to work in gen med. You will not be board eligible in any specialty. Why would a med director hire someone with very little training when they can find people who are much better trained. Back in the day when interns worked much more hours they had stronger clinical skills at the end of their internship. This is no longer the case.

Why are you thinking about leaving your residency training program anyway?

Cambie

 

[Pilot Doc]

i have seen lots of people on here advise not to quit residency until you complete your intern year.

Most of the replies to this thread seem to miss the fundamental wisdom of that statement.

If you quit without finishing your internship, you cannot do ANYTHING. Your diploma is the world's most expensive piece of wallpaper.

If you finish an internship, you can do something. You can get a job and keep food on the table.

The importance of this is not to suggest that quitting a residency is OK, it is that quitting an internship is NOT OK. E.g. If you're gonna quit after 7 months, stick it out til the end of the year