Resuming Residency Possible?

[sweetspring]

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This question is for a PD or anyone with firsthand account of a similar case.

I completed my intern year in a 'top tier' psychiatry program. 9 months in Medicine, 2 Neurology, 1 Psych ER. An intense and rewarding experience, overall.

Medicine interns were offered a 1 month elective rotation. Which I spent working on a species of internal consulting project for one of the hospital system's VPs, a physician who shared my concern for quality of care. The project concerned patient throughput in the ER, where there were significant bottlenecks. Quite unexpectedly, the project turned into an offer to do further work with that department.

I accepted this offer and spent several years managing different consulting projects for the system. Some internal consulting work, some with external consultants. The work was interesting and gratifying in many ways, but the truth is I miss the clinical setting tremendously.

Question: Would it be impossible for me to resume a psychiatry residency? In any program? I graduated in the top 1/3 of my medical school class, scored 200 on exams, won a psychiatry prize in medical school, have several research publications both at the bench and in medical informatics. My concern is that programs won't consider me, given it has been 8 years. Any hope?

 

[Winged Scapula]

First question:

- have you taken and passed Step 3?

Second question:

- are you willing to relocate? Many states require that all 3 steps be completed within 7 years of taking and passing the first step of USMLE.

Third question:

- can you get LORs, from anyone who has insight into your clinical skills?

8 years is a LONG time to be out of medicine. The research, while interesting, is a long way from clinical practice as a psychiatrist. I would not be suprised if you were asked to repeat your intern year given the length of time you have been away from patient care.

However, all is not lost, as psychiatry is not very competitive at many places and if a program finds you interesting enough, you may very well be successful. You will never know unless you try.

 

[sweetspring]

I have taken Step 1 and 2, not 3. Clearly an error. Should have done so immediately after intern year. I have not been away from medicine entirely, as my work has been in the hospital setting, with physicians, on clinical problems. But I recognize this will require a review course.

Luckily, the 7 year statute of limitation does not apply in the two states that interest me (NY and FL). This website provides a chart listing exam requirements by state: www.fsmb.org

LORs are a concern. Likely to be less specific and illustrative than they should be, given the amount of time that has passed. However, the Chief Resident and PD for Medicine did continue in contact with me after intern year, participating in some of the projects mentioned above. The PD even made me an offer to join his department at one point. So they will remember me generally. Psychiatry letters would require a visit to my medical school. Where they will remember me as well, given they awarded me a clinical prize. However, they are unlikely to write with the degree of clinical specificity found in letters for typical applicants. I recognize this is less than ideal.

I also suspect PGY1 would have to be repeated. Which is understandable.

 

[NotAProgDirector]

You will almost certainly have to repeat your PGY-1, or perhaps 6 months.

If you want to apply in this cycle, you are late. You need to get the best letters you can now, including one from your prior internship PD if possible. And you need to get moving, as app season has started and you'd really like to have everytrhing in by Nov 1st.

If you're thinking about next cycle, then if you are still working with a health care institution, you should see if you can get some clinical experience there. Hopefully you are working in a state without a USMLE limit, since you'll need Step 3 and a full license to do so.

 

[sweetspring]

Thank you, I truly appreciate the Attending and PD input.