Rads to IM Residency Reapplication

[pancreas1]

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[RadOncDoc21]

I don't want to bring you down but your Radiology PD holds the keys to your future. I had a rough relationship with my PD from intern year and literally had to beg him to help me apply for an advanced position since everything had to go through him. There wasn't one person that didn't speak directly to him.

I guess my question is why did you decide to leave before finding another position?

 

[rokshana]

unfortunately for you everyone is going to want some input from your radiology PD…you need to find some way to mend enough of the fence that he doesn't block you from a position…maybe he will be more willing to not bad mouth you if you are going into a specialty not radiology…

i take it the resignation is a done deal? i agree with radoncdoc…you really should have tried to secure a position before actually putting in the resignation or at least gotten an agreement from the PD that he would be impersonal in letters or talks for other positions...

 

[NotAProgDirector]

Much will depend upon why your Rads PD feels you are below expected in professionalism. That's the type of issue that translates from one program to another.

You will not get much credit for your TY -- essentially you should plan on starting again as a PGY-1.

 

[pancreas1]

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[Winged Scapula]

I think what you're failing to realize is that it's very unusual to leave a program after 3 years so pretty much everyone is going to assume that you left or resigned because of a major problem; a resignation may save you the embarrassment of being fired but IMHO it signals that you left because you were being forced out not because of a problem with the program. Also leaving without another spot to go to might make one wonder about your decision making ability. So yes, any PD willing to take a chance on you is going to want to talk to your former PD.

 

[NotAProgDirector]

Honestly, it totally depends upon the PD. I've had several residents transfer from to other programs in the same field, and some into other fields. In most circumstances, I was contacted directly by the new PD. In several I was not. I would assume that most programs will want to talk to your PD. It's very important that you're 100% honest with any new program you are talking to about what they are likely to hear from your old program.

 

[tco]

Much will depend upon why your Rads PD feels you are below expected in professionalism. That's the type of issue that translates from one program to another.

You will not get much credit for your TY -- essentially you should plan on starting again as a PGY-1.

Doesn't this depend on the TY program? We have a guy that switched from a PGY3 rads that did a TY at a medicine heavy program back to IM. He only has to do something like one month of wards, one month of CCU, one month of clinic and he's caught up to PGY2 status. He'll graduate on time.

 

[Raryn]

Doesn't this depend on the TY program? We have a guy that switched from a PGY3 rads that did a TY at a medicine heavy program back to IM. He only has to do something like one month of wards, one month of CCU, one month of clinic and he's caught up to PGY2 status. He'll graduate on time.

I'm pretty sure that unless it was an IM prelim he did previously (i.e. not a TY), IM programs can't give more than 6 months credit.

That said, many rads guys do IM prelims, probably more than do TYs. They can get credit for up to the full year if the new program is willing to do it.

 

[tco]

I'm pretty sure that unless it was an IM prelim he did previously (i.e. not a TY), IM programs can't give more than 6 months credit.

That said, many rads guys do IM prelims, probably more than do TYs. They can get credit for up to the full year if the new program is willing to do it.

I know the guy well, and I'm currently in the TY program he did. I'm certain of what I posted earlier. In three months, he'll be a PGY-2 in medicine.

Explain to me why it wouldn't count significantly, please. I have one month clinic, five months IM wards, one month MICU, one month ED. How many more required months of IM does a prelim have vs what I have? From what I understand, like I said, it's one month CCU, one month clinic, and one more month of wards.

 

[gutonc]

I know the guy well, and I'm currently in the TY program he did. I'm certain of what I posted earlier. In three months, he'll be a PGY-2 in medicine.

Explain to me why it wouldn't count significantly, please. I have one month clinic, five months IM wards, one month MICU, one month ED. How many more required months of IM does a prelim have vs what I have? From what I understand, like I said, it's one month CCU, one month clinic, and one more month of wards.

Keep in mind that while the IM RRC has rules about the credit you can get for a non-IM residency/internship, it is completely at the discretion of the accepting PD whether or not you get that credit.

My program accepted several transfer candidates while I was there and every single one of them was required to start at the last level they had completed (transferring R2s started as interns). If their performance was acceptable, after 6 months they were "promoted" and given credit for prior training. I saw some of these folks (OK, 1) allowed to graduate on time. Most graduated 6 months late and a few completed the entire intern year because their performance wasn't up to snuff.

Moral of the story, just because you can doesn't mean you will get all the credit you deserve.

 

[tco]

Keep in mind that while the IM RRC has rules about the credit you can get for a non-IM residency/internship, it is completely at the discretion of the accepting PD whether or not you get that credit.

My program accepted several transfer candidates while I was there and every single one of them was required to start at the last level they had completed (transferring R2s started as interns). If their performance was acceptable, after 6 months they were "promoted" and given credit for prior training. I saw some of these folks (OK, 1) allowed to graduate on time. Most graduated 6 months late and a few completed the entire intern year because their performance wasn't up to snuff.

Moral of the story, just because you can doesn't mean you will get all the credit you deserve.

It makes sense to assess the residents after 6 months and see if they're on par with the other PGY2's. After all, they've spent an entire year out of patient care.

 

[Raryn]

I know the guy well, and I'm currently in the TY program he did. I'm certain of what I posted earlier. In three months, he'll be a PGY-2 in medicine.

Explain to me why it wouldn't count significantly, please. I have one month clinic, five months IM wards, one month MICU, one month ED. How many more required months of IM does a prelim have vs what I have? From what I understand, like I said, it's one month CCU, one month clinic, and one more month of wards.

What makes it difficult to count are the rules of the American Board of Internal Medicine. Apparently I was somewhat mistaken, there is a way to get full credit for internal medicine rotations in a non-internal medicine program, if your PD allows it. It's only allowed if and only if:

1. Month-for-month credit may be granted for satisfactory completion of internal medicine rotations taken during a U.S. or Canadian accredited non-internal medicine residency program if all of the following criteria are met:
   1. The internal medicine training occurred under the direction of a program director of an accredited internal medicine program.
   2. The training occurred in an institution accredited for training internal medicine residents.
   3. The rotations were identical to the rotations of the residents enrolled in the accredited internal medicine residency program.

So if your TY IM rotations were completely identical to the rotations of IM residents at the same institution, you can get full credit for them. Otherwise, the most you can get is 6 months for FM/Peds or 3 months for anything else. The reason your friend has to repeat 3 months is a caveat in the same requirements that states "Before being proposed, the candidate should have been observed by the proposer for a minimum of three months. "

http://www.abim.org/certification/policies/imss/im.aspx

 

[tco]

What makes it difficult to count are the rules of the American Board of Internal Medicine. Apparently I was somewhat mistaken, there is a way to get full credit for internal medicine rotations in a non-internal medicine program, if your PD allows it. It's only allowed if and only if:


So if your TY IM rotations were completely identical to the rotations of IM residents at the same institution, you can get full credit for them. Otherwise, the most you can get is 6 months for FM/Peds or 3 months for anything else. The reason your friend has to repeat 3 months is a caveat in the same requirements that states "Before being proposed, the candidate should have been observed by the proposer for a minimum of three months. "

http://www.abim.org/certification/policies/imss/im.aspx

Thanks for the link. I'm hoping it doesn't become relevant to me (I'm liking IM way more as a resident than I did as a student :-\), but it's nice to know that there is some reciprocity acknowledged among the IM programs.

And yes, our TY program's wards months are exactly the same as IM. We carry the same number of patients, work the same hours, and have the same expectations.

 

[NotAProgDirector]

I agree with the above. In the small number of situations I have been directly involved with, the TY was completely separate from the IM program and hence credit was limited. I don't know how many TY programs are basically sturctured like an IM prelim -- if so, you could receive close to full credit.

 

[pancreas1]

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[rokshana]

Thanks for this information. Is there anything that one can do in between residencies so that new PDs can ask someone else for evaluative material rather than an old PD?

i doubt it…you spent 2 years in that residency…no matter how far away you are, the new prospective PD m/l will want to know how you performed in a previous residency…and if you are far enough away from that residency that they don't think its important you probably will have other issues to contend with...

 

[Law2Doc]

i doubt it…you spent 3 years in the residency...

If he just completed his pgy3 year, and pgy1 was a TY, then he only did two years in radiology, not 3.

I don't think the OP can realistically go anyplace decent without the target program wanting to talk to the PD. All the PDs I've ever worked with would want all the sordid details -- theres real liability at stake if you dont do a modicum of due diligence regarding people who "resign" from their residency -- if whatever he did at the last program is repeated and is something a patient can sue over, it's no defense to say I didn't ever ask why he left the last place... And if other rads programs were already dissuaded by the PD, we know the lapses in professionalism are probably going to be deal breakers.

The fact that OP is still asking about RadOnc, Optho, derm and that he emphasizes that he went to a "top 5" med school suggests to me that he has no clue that he's already tainted goods now. This lack of insight is troubling. He needs to be looking at the bottom of the barrel for chances to redeem himself, not for even more competitive paths. I've seen this story play out before and OP isn't going to like the end results.

 

[DermViser]

I don't want to bring you down but your Radiology PD holds the keys to your future. I had a rough relationship with my PD from intern year and literally had to beg him to help me apply for an advanced position since everything had to go through him. There wasn't one person that didn't speak directly to him.

I guess my question is why did you decide to leave before finding another position?

Why? Were you categorical?