Reapplying as PGY-1

[LeonardMcCoy]

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Hello everyone, thanks for stopping by.

I'm a U.S. IMG who graduated from medical school in 2017 and now doing my PGY-2 year in family medicine.

I began my PGY-1 year at one program, did well, and transferred to another program to continue my education as PGY-2 due to family issues. Maintained good relationship status with everyone at the old program, left on good terms.

My problem began at the new program, where the faculty started to notice deficiencies in my outpatient clinic performance, perhaps something that wasn't picked up by the previous program or just due to lack of exposure or amount experience, oversight, teaching etc. Long story short, after a couple months of informal supervision, they decided to bring my status to PGY-1 and renew my contract as PGY-2 in March this year if things continue improve and milestones are met. Needless to day, it's been very exhausting and stressful. Sometimes I feel as though it's hopeless and I may never be able to meet people's expectations.

I'll have to try my best for the next three months to improve in order to renew my contract with them.

But I also want to be prepared for the other possibility, in which I would not be continuing at this program, and have a plan. What would be my options be then? Do I reapply as PGY-1 again? I've been told that once a resident starts his/her training, medicare(which funds most residency programs) only funds three years of training(at least for those that are three years-long), which means I've already used up half of my funds. Therefore, even if I were to reapply, programs won't be able to accommodate me for full three years. I'm fearful of the worst possible outcome and would really appreciate your guys' insight. Thank you so much in advance.

 

[deleted480308]

Is the program training you well and being fair? Do they seem to want to get you through or want to doscard you?

If your deficits are real and the program is doing well training you I would consider staying and not rocking the boat. If the deficits are imagined and you are being railroaded out then it’s a different story.

Which is the case? Did they say they might drop you?

 

[GoSpursGo]

I would try not to worry about the worst case scenario right now, as there's nothing that you can be doing right now to prepare for that scenario--100% of your effort should be focused on meeting your current program's expectations, and if you wind up not being able to then you can figure out what to do at that point. Suffice to say that the easiest path to you becoming a board-certified physician is completing your training at your current program.

I know this is difficult, but you say that you moved due to some family issues. You need to speak with your family and let them know that over the next three months, your primary focus HAS to be on residency. No signing out early to get home, no leaving outpatient clinic notes to be finished the next day, no asking people to swap calls with you unless you have a REALLY good reason. For the next three months you have to be the PERFECT intern at your program, and the perfect intern is one that nobody notices because they just keep their head down and get the work done.

 

[ThoracicGuy]

I would try not to worry about the worst case scenario right now, as there's nothing that you can be doing right now to prepare for that scenario--100% of your effort should be focused on meeting your current program's expectations, and if you wind up not being able to then you can figure out what to do at that point. Suffice to say that the easiest path to you becoming a board-certified physician is completing your training at your current program.

I know this is difficult, but you say that you moved due to some family issues. You need to speak with your family and let them know that over the next three months, your primary focus HAS to be on residency. No signing out early to get home, no leaving outpatient clinic notes to be finished the next day, no asking people to swap calls with you unless you have a REALLY good reason. For the next three months you have to be the PERFECT intern at your program, and the perfect intern is one that nobody notices because they just keep their head down and get the work done.

This.

Also, this is your second program. If you end up having to find a third program, you will have a hard time at it. You don't want that to happen.

 

[Apollyon]

The last 24 months of FM residency have to be at the same program. So, if you are bouncing around, you might even do 4 years.

And, as far as funding goes - whatever is your first categorical (leading to board eligibility) residency is what sets your "clock". EM, IM, FM, Peds, all 3 years. Gen Surg, Ortho, 5 years. Psych, 4 years. If there is a board, there is a clock for that specialty. That is for "Direct Medical Education" (DME) funds from Medicare. So, someone who starts Gen Surg, and quits in the first year, still has 4 years. Now, the question arises once your clock runs out. Then, it goes to "Indirect Medical Education" (IME) funds. People bandy about numbers, but I don't know - I've heard from 50% to 80% of DME. But, when your clock runs out, you do not go to zero.

However, residency spots paid for by Medicare have not been expanded since 1997. Any new spots beyond then are being paid for by the institution (with DME and IME funds, and various other contrivances).

 

[twospadz]

Your program holds your fate in their hands literally. Ive known residents who have gotten fired in pgy 1 for being incompetent, and entered into a different specialty straight into pgy 2 because their program gave them credit for pgy 1 despite them not deserving it. Even if you re-apply, your program can make your life hell after residency because programs might call them to get information. I suggest you focus solely on busting your tail from here on out and making them believe it would be unwise to get rid of you.

 

[Piebaldi]

Hello everyone, thanks for stopping by.

I'm a U.S. IMG who graduated from medical school in 2017 and now doing my PGY-2 year in family medicine.

I began my PGY-1 year at one program, did well, and transferred to another program to continue my education as PGY-2 due to family issues. Maintained good relationship status with everyone at the old program, left on good terms.

My problem began at the new program, where the faculty started to notice deficiencies in my outpatient clinic performance, perhaps something that wasn't picked up by the previous program or just due to lack of exposure or amount experience, oversight, teaching etc. Long story short, after a couple months of informal supervision, they decided to bring my status to PGY-1 and renew my contract as PGY-2 in March this year if things continue improve and milestones are met. Needless to day, it's been very exhausting and stressful. Sometimes I feel as though it's hopeless and I may never be able to meet people's expectations.

I'll have to try my best for the next three months to improve in order to renew my contract with them.

But I also want to be prepared for the other possibility, in which I would not be continuing at this program, and have a plan. What would be my options be then? Do I reapply as PGY-1 again? I've been told that once a resident starts his/her training, medicare(which funds most residency programs) only funds three years of training(at least for those that are three years-long), which means I've already used up half of my funds. Therefore, even if I were to reapply, programs won't be able to accommodate me for full three years. I'm fearful of the worst possible outcome and would really appreciate your guys' insight. Thank you so much in advance.

It seems they are giving you a chance no? Work your butt off and try to shine. It is definitely the case that months of probation/remediation are stressful. It's a shame that you transferred from a program that seems was a better fit.