returning to residency...

[saph238]

HI I was wondering if anyone out there can give me some advice. I'm considering applying to FM programs in NYC. I'm a mom of two very young ones-one year old & 4 week old. As such, I am very interested in a part-time program but no such programs exist here in nyc. Moving isnt an option as my husband has a business here & is in a post graduate program with several projects underway. I have 2 questions:

1. How would I go about investigating a program's willingness to add a part-time spot without scaring them off from matching me. Should I just cold call around before applying for 2011?

2. What can I do in the meantime to brush up on my skills & show my interest in the field? I have been out of medicine since 2008 (when I graduated) d/t back to back bed-rest pregnancies! I am also not in the same city as my med school so I cant really ask my alma mater for help in this regard.

My stats: AMG 2008, Did really well in FM. Have (I was told) great LOR's from IM, FM, Psych. mid 80%'s Step1/2, no failures/red flags. My orginal interest was in psych & I matched to a program in 2008 but had to put it off as above & now want to switch to FM.

Any advice would be much appreciated. Thanks in advance.

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[deleted87716]

https://www.theabfm.org/residency/parttime.aspx

 

[saph238]

thanks for that link bluedog I appreciate it. I guess I am just curious as to how to go about introducing the idea to a program. I was actually told by one secretary that if I bring it up I wont get a spot, so I am afraid to mention it at interviews. Meanwhile if I just cold call maybe they will just give me a standard answer of "we don't offer that here."

 

[deleted87716]

I suspect your chances of landing a part-time spot are just about nil.

There is no advantage to the program, and considerable disadvantage. There are plenty of unmatched applicants in the scramble to fill available spots...full-time.

I suggest you go back full-time. You're already at a disadvantage by being out for three years. Residency is a brief period in your life...find a way to make to work. The odds of securing a part-time practice opportunity once you're done are considerably higher.

 

[saph238]

I get what you're saying & I kind of figure the same. But my babies being babies is also a brief time I didnt realize how hard it would be to be away from them...I dont know if I have the stomach for it.


Anyway what about getting my feet wet before starting? Any ideas?

 

[deleted87716]

I get what you're saying & I kind of figure the same. But my babies being babies is also a brief time I didnt realize how hard it would be to be away from them...I dont know if I have the stomach for it.

As the old saying goes, if being a doctor was easy, everyone would do it.

Perhaps you should explore other options.

 

[saph238]

yes, now that the baby is here I've started doing that too.

Thanks again!

 

[tootsweet]

I get what you're saying & I kind of figure the same. But my babies being babies is also a brief time I didnt realize how hard it would be to be away from them...I dont know if I have the stomach for it.


Anyway what about getting my feet wet before starting? Any ideas?

I'm with BD on this one and think you should go back full time. This is your chance to build a career that will be there when your children have flown the coop. Moreover, although you will be missing much of 3 young years, they will need you more in a few years than they do now ..to go to their games..help them with homework, etc. In a few years, they will know and remember when you are not there - unlike the infant stage. It will only get harder as they move into the young child stage. A doc-mom can be a fantastic role-model and as a FP, you'll be able to dictate your hours and work-part time, even 2 days a week if you want to..or just teach. The possibilities are endless but you need to complete residency to be credible.

Finally, even if you go to residency and choose to take off time afterwards, you are building an insurance policy for you and your children. Life is uncertain and unless you are independently wealthy, you may regret not building an exit strategy should the need arise. I'm saying this as a mother and wife.

As far as getting back in the game, I'd take the time to study and complete Step 3 if possible. I've heard of some people doing this during their year(s) off before starting residency.

Good luck!

 

[JackADeli]

...considering applying to FM programs in NYC. ...mom of two very young ones-one year old & 4 week old. As such, I am very interested in a part-time program but no such programs exist here in nyc. Moving isnt an option...

...I suggest you go back full-time. You're ...Residency is a brief period in your life...find a way to make to work...

...think you should go back full time. This is your chance to build a career that will be there when your children have flown the coop...

...take the time to study and complete Step 3 if possible...

I agree with BD & others. I just wanted to tweeze out some finesse points for you.

1. Did you do any residency at all? If not, you may be approaching some of the limits in the elegibility to complete your USMLE exams. This will make all you concerns pretty mute.

2. Other options for part time employment may include working at a lab or university. As you note, the NY programs do not apparently have part time slots... thus, if moving is not an option, much of your concerns are again mute. Takes you back to the lab option.

3. I am all about being family friendly, etc.... But, you are an adult, clearly highly educated on human anatomy and physiology. You made a choice to be pregnant and have kids. That is your right and I applaud you for it... But, you now need to take responsibility for that choice. Throughout these forums and accross the nation in ALL specialties, you will find discussions of residents being pregnant and completing residency. Further, outside the realm of healthcare, you will find plenty of less "advantaged" mothers that make the sacrifice of working 1 or 2 jobs to provide for their kids. Again, you need to decide if you want to be a practicing physician. That decision is not looking in the mirror and saying, "I really, truely do want to be a physician...BUT....". Rather, choosing to be a practicing/licensed physician means looking in the mirror and saying, "I want to be a physician, it takes hard work and sacrifice AND I will make those tough choices and sacrifices.".

...It must be based on a satisfactory reason for being part-time.

I do not suspect the ABFM will consider family convenience an acceptable justification...especially given the past and present examples of numerous residents maintaining active, full time training with pregnancy and/or children at home.

FP is often regarded as one of the most family friendly residencies you can enter. That being said, your questions/plans suggest a lack of commitment and probable expectation that your training and the training of your fellow residents comes secondary to your home family circumstances. It is time for you and your significant other to have serious discussions and for you to have some introspective reality checks as to what you want as a opposed to what might seem "nice".... If you haven't completed all your USLE steps, the clock is ticking and you may have already made a definitive decision on this matter.

 

[paiute]

i would seriously look into becoming a mid-level provider. the training programs are so much easier and you will be doing basically the same job as the FP. pay is not that much less, even equal in some cases. you already have a great knowledge base.

less prestige? yeah, but you and your kids will probably be happier.

 

[Apollyon]

pretty mute. again mute.

Dude, "moot". "Moot".

 

[JackADeli]

Dude, "moot". "Moot".

Thank you. I am fluent speaking & reading in 3-4 languages.... but don't claim to be the spelling bee winner!

 

[Apollyon]

Thank you. I am fluent speaking & reading in 3-4 languages.... but don't claim to be the spelling bee winner!

Hey, so am I...and I was the spelling bee winner! However, I am NOT a CT surgeon!

 

[JackADeli]

...I am NOT a CT surgeon!

Neither am I, so, other then not winning the spelling bee, we have much in common!!!
Are CT surgeons good spellers?

 

[JackADeli]

So, I made a quick read of the USMLE step 3 requirements... Most states require you sit for step 3 within 3-7yrs of passage of step 1. However, looks like per my interpretation, New York does not have a time limit. But, you should know, if you exceed other states time limits, you may have difficulties getting other state licenses. I knew a colleague of mine that waited to take the exam late into residency (PGY5). Our state of training had a longer time limit. Then, when he went to do fellowship in another state, he ran into alot of blocking from the state med-board. Ultimately, he was able to get a "trainee" license, complete fellowship and go to another state.

I think plenty of graduating med-students and residents are not aware of these time limits and how they may impact your ability to be licensed and practice in different states.

 

[J-Rad]

If you truly want to do a part time residency, wouldn't the best way to approach a program be to find someone else who wants to do a part time residency? Obviously the logistics of this isn't completely straight-forward or easy (have to find a person and both of you have to meet the programs slection/desirability criteria), but if you found the other 1/2 schedule filler, I would think the process would be much easier at the tail end of the inquiry process (my thought on this is from a husband/wife pair who started an AOA FM residency as split, part time residents so they could be home with their baby). Just a thought.

 

[schizo]

 

[schizo]

no offense, but u cant eat the cake and have it too. In fact, when thousands of candidates are applying for residency, and are willing to give everything that they've got, I dont see any programs picking someone partime over a fully dedicated resident.
Even if you have super high board scores, I dont see why a program will pick you over a full timer.
If your heart is not into medicine, why dont you pursue a masters degree and just work from home?
MEDICINE is nothing but full time dedication.

 

[Dillatar]

I have to agree with Jack here. To get through your undergrad and med school there were, no doubt, many points of self denial. This is another one of those points.

Finish the race, my friend! Your so close to being able to practice. Three years will go by quickly and it's not like your not going to be able to see your kids at all during residency. You will still be there with them the great majority of the time.

 

[michaelrack]

go back to your original plan of psychiatry. Except for the medicine/neuro months during the intern year, most of a psychiatry residence is 40-50 hrs per week, which would probably be similar to the time committment of a "part-time" family practice residency.

 

[JackADeli]

go back to your original plan of psychiatry. Except for the medicine/neuro months during the intern year, most of a psychiatry residence is 40-50 hrs per week, which would probably be similar to the time committment of a "part-time" family practice residency.

I would say, with the exception of OB rotations, my colleagues and friends in FP residency have had relatively <60 hour weeks and much time off as the norm throughout residency. The internship is obviously the most hours/labor intensive. Their trining has in many respect mirror FP practice with mostly Mon-Fri outpt clinic experience/training. But, after that, many of my friends have moonlighted for anywhere $150-180k/year because of the amount of free time.

 

[michaelrack]

I would say, with the exception of OB rotations, my colleagues and friends in FP residency have had relatively <60 hour weeks and much time off as the norm throughout residency. The internship is obviously the most hours/labor intensive. Their trining has in many respect mirror FP practice with mostly Mon-Fri outpt clinic experience/training. But, after that, many of my friends have moonlighted for anywhere $150-180k/year because of the amount of free time.

sounds like a pretty good deal. Maybe I should have done FP/psych instead of IM/psych

 

[MeowMix]

Their trining has in many respect mirror FP practice with mostly Mon-Fri outpt clinic experience/training. But, after that, many of my friends have moonlighted for anywhere $150-180k/year because of the amount of free time.

My program is considered to be very family friendly, but our life as senior residents is nothing like this vacation that you describe.

 

[JackADeli]

My program is considered to be very family friendly, but our life as senior residents is nothing like this vacation that you describe.

That may or may not be unfortunate for you.... I don't know if her experience and the experiences of others I speak with represents innadequate training or better training "program".... One thing I know, she has money and she sees alot of patients/pathology.

 

[saph238]

This is all really good advice, thanks for the time & effort. For the record, when I daydream about my ideal life, it is in clinical medicine. Not killing myself with a surgeon's hours but working 3 days per week seeing patients & coming home to my family feeling fulfilled. I had a blast in MSIII & IV (who didnt in MSIV right?) & was really looking forward to residency. Then I got hit with almost 2 straight years stuck at home unexpectedly & I talk to my resident friends & they sound completely miserable. They complain constantly about their lives & lack of time & they dont even have kids. So I got cold feet & began to get scared I would be an absentee mom & miserable with life on top of it.

I didnt intend to be miserable in residency. I never had that attitude but now I hear all this misery & I had second thoughts. BUt like I said, I really want to practice.

AS far as psych vs FM, it is still somewhat of a question but I figured I'd throw this post in the FM section for now until I figure myself out.

My whole family & husband have all been encouraging me to do residency. I thought I had to sacrifice my career for my kids, but I started to become quite uhappy. Part time would be great--but unrealistic I know. I've been seriously contemplatng this the last few days & since I've been imagining myself reapplying & possibly starting up next July, its funny, my mood has been a bit better. I think I have to suck it up & try to think even though it will be hard it will be worth it & by the time I finish my kids will have just started remembering their childhood lol. Plus, I dont know how happy I would be if I didnt do clinical medicine. I hate research, dont want to only teach, & dont want to work for any kind of firm. I had a business career before medicine & thats why I went into medicine.

So my last question is this: is residency constantly miserable?? I feel like I really need to hear that some people have a good time during residency & actually enjoy themselves (FM specific)!

Thanks again for the advice. I feel I am one step closer to acceptance

 

[saph238]

i would seriously look into becoming a mid-level provider. the training programs are so much easier and you will be doing basically the same job as the FP. pay is not that much less, even equal in some cases. you already have a great knowledge base.

less prestige? yeah, but you and your kids will probably be happier.

Oh & as far as becoming a mid level provider, i'm way past the prestige thing, but wouldnt I have to go back for fulltime clinical rotations anyway say for nursing or PA or dare I say NP anyway? This is when I think if I'm going to put in a 9-5 day for 2-3 years I might as well suck it up & do residency. Unless there is something I've got wrong about this. There isnt too much info out there on MD's to Nurse or PA. Mostly vice versa...

Im not too serious about this options but I am very curious about it

 

[JackADeli]

...So my last question is this: is residency constantly miserable?? ...

I enjoyed much during my residency (surgery). Almost universally, my friends in FM/FP have enjoyed it immensely and were NOT miserable. Those few that were miserable fell into one of two categories...

a) they were fairly miserable personalities to begin with, had alot of "entitlement" issues, could not bend to the program and expected everyone from residents to program to bend to them.... constantly heard the words, "it's not fair" come from them.
b) the program was a miserable program.... these were generally programs that served as stepchild to other programs. Often it was OB the FP/FMs seemed to excessively service.... They were clearly not what one would call family friendly programs.

As for "b" above, I can't speak to NY programs. You will have to look.
As for "a" above, you will have to ask yourself if you can throw yourself into the residency fully and not arrive as a "dependent" rather be dependable.

 

[peppy]

I agree that how "miserable" residency is really depends on where you go. There are a lot of people who are willing to put up with more miserable schedules in the short term to get to where they want to go later, but if your priority is a reasonable schedule you can find programs like that. I think it is easier in Psych though since FP tends to have more inpatient med months
(personally, I'm in Psych, and I can definitely vouch for there being a number of psych programs with extremely reasonable hours and minimal call.)

 

[Doc Oc]

You're focusing on your situation now too much. You won't start until July of 2011, I"m assuming, since the match for 2010 has already occurred. Your kids will be toddlers, you probably won't be nursing, and they will both be under 5 before you finish. I have two kids (ages 4 years and 4 months) and am a 3rd year FP resident. It's hard, you miss things, but you can do it.

 

[2KI]

saph238,
I am in a VERY similar situation as yours. I know this post is old, but please keep me up to date on your decision!

 

[DrJosephKim]

Have you considered pursuing a non-clinical career path? You will probably find more part-time opportunities if you choose this option.

 

[seahawk188]

go check mommd.com, they have a nice forum going on.

 

[chartero]

Have you thought about Occupational Medicine or General Public Health and Preventive Medicine? Residencies are three "years," but one is intern year, one an M.P.H., and the third the real categorical residency part, and they can lead to careers with real clinical content and relatively comfortable schedules.

Have you thought about pediatrics? The field seems relatively friendly to part-time residencies.

Have you thought about committing to at least a preliminary/transitional year, moving the ball down the field and seeing how it goes? Related recent SDN thread: Not so interested in doing a residency. Should I still do intern year? How?