Resident funding

Started by mommd22
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mommd22

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hi everyone, I have some very specific questions, I hope someone here is knowledgeable about this and can give me some insight.

I completed an IM PGY1 successfully.
Since then, I've had time off, worked outside healthcare, and now I'm doing a post-doc (diff specialty) at a prestigious place.

I am reapplying for residencies through ERAS - for many subspecialties - but have barely received interviews.

I understand that funding for the PGY1 position is a problem - that because I've already successfully completed a PGY1 I will not be funded as a resident . But is this true for all specialties?

I was told over the phone by more than a couple places that this is a main issue and is the reason why they aren't inviting me. It's hard to believe that unless I apply to super hard specialties like rads, anesth, neuro, etc where the MATCH is for a PGY2, I can't get funded.

Is this true???? :shrug: And if so, what kinds of choices do I have? Because my board scores are just not good enough to get into the specialties I just mentioned. They're barely OK to get an interview if I had no issues at all. AND on top of that, I'm an IMG. :bang:

I'd appreciate an answer. :help:

Thanks so much for the input!
 
mommd22 said:
hi everyone, I have some very specific questions, I hope someone here is knowledgeable about this and can give me some insight.
Click to expand...

You basically answered your own questions here. When you say you're applying for many different specialties, which ones? How competitive? Why not back into IM, esp at your prior program?

I understand that funding for the PGY1 position is a problem - that because I've already successfully completed a PGY1 I will not be funded as a resident . But is this true for all specialties?
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The funding question has been asked and answered a million times. Please do an advanced search. The reality is that you will be down 1 year of fully funded training (for anything other than an advanced program or IM) but even after you run out of primary funding, you will still get funded @ 50% of DME (salary) + 100% IME (everything else) which works out to ~70% of total costs depending on the program. This is how all fellowships are funded and is usually not a huge issue for most programs.

Which brings us to this...

I was told over the phone by more than a couple places that this is a main issue and is the reason why they aren't inviting me. It's hard to believe that unless I apply to super hard specialties like rads, anesth, neuro, etc where the MATCH is for a PGY2, I can't get funded
Click to expand...

This is them trying to let you down easy. "No baby...it's not you, it's me." Actually, it's you.

Is this true???? And if so, what kinds of choices do I have? Because my board scores are just not good enough to get into the specialties I just mentioned. They're barely OK to get an interview if I had no issues at all. AND on top of that, I'm an IMG.
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And here's why. You're an IMG with borderline board scores and a gap in your training (which you don't need to explain to us but needed to be explained well in your PS). Assuming nothing comes of the few interviews you have or the Scramble, your best bets would be to get help from the person you're working for now and your prior training program.
 
gutonc said:
This is them trying to let you down easy. "No baby...it's not you, it's me." Actually, it's you.

And here's why. You're an IMG with borderline board scores and a gap in your training (which you don't need to explain to us but needed to be explained well in your PS). Assuming nothing comes of the few interviews you have or the Scramble, your best bets would be to get help from the person you're working for now and your prior training program.
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I agree.

The funding issue especially for a *single* year is not a big deal for most programs when evaluating good candidates.

Therefore, I suspect they are simply letting you down easily. The presumably long gap between clinical training, leaving a program (assuming you were a categorical IM resident), and low board scores mean that you aren't the most competitive candidate which means that programs that *might* consider taking less than full funding, aren't interested in doing it for you.
 
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If you're so hostile towards my question, why take the time to answer it? I sincerely apologize for annoying you, but I'm new to this site, so the fact it's an "asked and answered" question, is unknown to me. I will do the advanced search and read more. I'm coming to this site for an "education" on the system and how to appropriately respond to it. I like the straight forward answers, but don't like the rude overtones. Unnecessary.

I'm applying to psych (doing a post-doc in this now), FM, IM, neuro.

I was a categorical IM in a very nice hospital - which I got very lucky to match at. It was my first choice, never expected to end up there (my board scores were the same then). Had some personal issues, and I had to leave. It didn't end on the best of terms with my program, but my PD said he'll write an excellent letter for me, really wishes me success, and we've been on great terms over the last couple years. My other LOR is amazing. My PS explains everything and I think should convince them to take me for an interview - but reality is that step 1 is everything, and mine is lacking. I know the reason very well why I'm not receiving many interviews. I'm not surprised. But I need to work with what I have, not cry about the past. I'm doing a post-doc in psych currently.

Having said that, I'd like to clarify your response.

Would the year of reduced funding only apply to the repeated PGY1 year of IM and FM? What other specialties would this reduced funding be for? Is psychiatry one of them as well, or would the hospital receive full funding for me for all 4 years?

Thanks for your time.
 
mommd22 said:
Having said that, I'd like to clarify your response.

Would the year of reduced funding only apply to the repeated PGY1 year of IM and FM? What other specialties would this reduced funding be for? Is psychiatry one of them as well, or would the hospital receive full funding for me for all 4 years?

Thanks for your time.
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The reduced funding counts for everything except IM, and then only if the program gives you full credit for your previously completed intern year (which they don't have to do...it's not uncommon for programs to have those who have completed some training do part of the intern year over again) and only makes you do 2 years of the program.

As WS pointed out, for strong applicants switching programs, the reduced funding is generally a very minor issue. Any program that tells you that's the only (or main) reason they're not interviewing you is straight up lying to you.
 
I would start by reviewing this thread.

Make sure you look at the AAMC handout. Many of the links in the thread don't work, but the one in post 23 works.

If you started in a categorical IM residency program, then you have 2 years of full funding left no matter what specialty you are applying to.
 
Well- How about this scenario?

1) Someone who started a PGY-1 residency in IM, but DID NOT COMPLETE YEAR- what happens with funding for that situation?

2) Also- as for "letting people down easy" I'd like to put my 2cents in- On actual interviews, sitting in front of the PD this has been brought up... so no, it's not necessarily just letting an applicant down easy.

3) What about the applicant who has completed an ENTIRE residency? I.e. Finished 3 years of IM and is applying to Anesthesia? Or the Resident who finished Peds and is now applying to Derm? These are common situations.

All this funding topic is completely confusing, I wouldn't doubt if program administrators were just as confused as we were.
 
1. Any time you've used counts. So if you did 9 months of IM, you have 2 years 3 months left. Once you do any time in IM, your total time is set at 3 years.

3. In that case, all further training is funded at the reduced rate.
 
alittlestory said:
2) Also- as for "letting people down easy" I'd like to put my 2cents in- On actual interviews, sitting in front of the PD this has been brought up... so no, it's not necessarily just letting an applicant down easy.
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IMHO its an entirely different story if its being brought up AT INTERVIEW. That means that you are a good enough candidate to interview and that they are seriously considering you, but that the funding *might* be an issue.

For the OP, she is not receiving interviews and is told that the funding is the reason why. The fact remains that if she were a good enough candidate, she would at least get interviews and *then* if she proved not competitive enough, she might be ranked lower than other candidates because of the funding issue. The fact that they won't even consider her for an interview tells me something.
 
mommd22 said:
Is psychiatry one of them as well, or would the hospital receive full funding for me for all 4 years?
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Even though your funding would still be set at 3 years from IM, the nice thing is that at least in psych you should be able to get credit for your year of IM so you wouldn't be starting all over.
Are you having trouble getting interviews in psych?
If you're interested in psych, I'd definitely cast a broad net and you should be able to find a program that won't mind that you started in IM. It is pretty common for people switching from FM or IM to be accepted into Psych residencies as PGY-2s. Some programs in psych even try to reserve a spot for people switching from other fields.
 
peppy said:
Even though your funding would still be set at 3 years from IM, the nice thing is that at least in psych you should be able to get credit for your year of IM so you wouldn't be starting all over.
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Maybe...not necessarily. PDs can give credit for this, but they're not required to. And Psych only requires 6 mos of IM so maximum credit is likely to be 6 mos, not a full year...but better than nothing.
 
gutonc said:
Maybe...not necessarily. PDs can give credit for this, but they're not required to. And Psych only requires 6 mos of IM so maximum credit is likely to be 6 mos, not a full year...but better than nothing.
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I can't guarantee that every program would be willing to accept people switching from IM or FM, but it is pretty common. I have seen it happen in my own program.
The ABPN website mentions that they will accept a PGY-1 in IM or FM as a first year for psych even though it doesn't follow the normal pattern of a psych internship.
ABPN website said:
Two patterns of training are acceptable:
1. Three-Year Psychiatry Residency Program
A broad-based clinical year of ACGME-accredited training in internal medicine, family medicine, or pediatrics; or an ACGMEaccredited transitional year program that included a minimum of four months of primary care; or an ACGME-accredited residency in a clinical specialty requiring comprehensive and continuous patient care.
AND
Three full years of postgraduate, specialized residency training in a psychiatry program accredited by the ACGME
OR
2. Four-Year Psychiatry Residency Program
Four years of training in an ACGME-accredited program in psychiatry is acceptable. A psychiatry PGY-1 must include at least
four months in internal medicine, family medicine, and/or pediatrics. This training must be in a clinical setting that provides
comprehensive and continuous patient care. No more than one month of this requirment may be fulfilled by an emergency
medicine rotation, as long as the experience predominantly involves medical evaluation and treatment rather than surgical
procedure. Neurology rotations may NOT be used to fulfill this four-month requirement.
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i have a ?

I matched to a 4 year residency and it's my 4th year. What happens to the medicare funding if I quit or the hospital fires me at this point? Does medicare stop reimbursing the hospital?
 
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I think the OP got straight answers, and he/she didn't like them. I don't think the people posting were rude...at least that wasn't my impression. They were giving free advice that I think was good.
Agree w/above comments... I don't think the funding is the only reason the person is not getting interviews. She/he now has 3 red flags:
1) IMG
2) low board scores
3) already quit residency once and states it was due to "personality issues" or conflicts.
I'm not entirely unsympathetic since I know that residency can be very political, not unlike a large corporate environment. However, psych is not all that competitive and not being able to get interviews at all is unusual. Would suspect that the previous PD's promise of a ringing endorsement letter is probably not entirely true/correct...he/she may have told the OP that to avoid unpleasantness but then writing (or saying) something a bit different.Nevertheless, you (the OP) are where you are, and you have to work from there. The psychiatry postdoc I would think would be helpful.

I would think it might be helpful to apply to both PGY1 and PGY2 psych programs. Any input from others?

You could also try combines programs like med/psych or fp/psych. I'm not sure of the relative competitiveness of those versus straight psych (maybe more competitive since there are less spots?).

It seems like in this situation trying to find an off-cycle or out of match spot, while trying to do the Match at the same time, might be helpful. Also, being willing to more anywhere/everywhere might be necessary.
 
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