Second Residency - When will I start?

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Leukocyte

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"Hello everybody", (Dr.Nick, the simpsons 🙂 )

On a serious note, If I may, I had a question. I am a PGY-3 Family Medicine resident who is about to finish residency in a few months, very few months (I started my program off-cycle). As you might already know from my posts, I HATE Family Medicine. I have no idea how I survived three years of FM residency! Needless to say, it was a Horrible and PAINFUL experience. I loved my program though, and my program director and faculty are wonderful and amazing. I also have alot of respect for Family Medicine doctors, but this does not change the fact that I utterly despise and hate FM as a specialty and cannot see myself practicing FM in any way, shape, or form. In fact, I hate clinical medicine all-together. When I first started medicine, I originally wanted to be a Surgeon, but after going through 3 years of INTENSE interaction with patients in a FM residency...I developed a dislike for patient contact. I still like surgery/procedures/working with my hands, BUT I HATE the patient interaction.

So naturally I am looking to do a second residency in a relatively "Non-clinical" medical specialty. I am looking at Radiology or Pathology, and maybe Anesthesiology. I am hoping to start my second residency in July 2011.

My question is:

1) If I apply to Radiology or Anesthesiology, I will naturally have to apply for a PGY-2 position on ERAS. I want to start my second residency in July 2011. However, I am very confused about the starting date. If I apply in the 2010-2011 match through ERAS for a PGY-2 position in Rads or Anes, will I have to wait until 2012 to start my program??? Will I not be able to start in 2011 if I apply for a PGY-2 position?

I know that If I apply to Pathology, I will HAVE TO start at the PGY-1 level in 2011 since Pathology does not require a transitional/prelim year (and I will hardly get any credit from my 3 miserable years of FM)...but I am very confused about my starting date in Radiology and Anesthesiology. Will it be July 2011 or (gasp) July 2012? :scared:

Thank you in advance.
 
Leukocyte - way to keep on keepin’ on.

If you apply to advanced programs this cycle (2010-11) through NRMP, you would match for a PGY2 spot starting in 2012. However, you are an independent applicant. If a PGY2 spot were to become available for 2011, you can sign outside of the match. Keep your eyes and ears open.

Good luck.
 
I know that If I apply to Pathology, I will HAVE TO start at the PGY-1 level in 2011 since Pathology does not require a transitional/prelim year (and I will hardly get any credit from my 3 miserable years of FM)...but I am very confused about my starting date in Radiology and Anesthesiology. Will it be July 2011 or (gasp) July 2012? :scared:

If you apply through ERAS, it would be July 2012.

If you apply outside the match, you may be able to find an open PGY-2 slot that would be ready for you to start July 2011.
 
Thanks Ludicolo and Smq123!!!

I guess I will have to "work", temporarily, as a FM until my "salvation" begins.:scared: But since I already did a FM residency, I might as well sit for the FM board exam. I do not know if it will do any good, but hey.

I cannot wait to start my new residency....patient free!

Thank you agian, you guys!
 
I cannot wait to start my new residency....patient free!

Don't do anesthesia if you want to be patient free. Granted, I love anesthesia and would encourage people to take a look at it...but...

we do many months of ICU, we do pain clinic, we do preoperative assesment clinic, we do the acute pain service and we do consults all the time. Yes, lots of procedues, yes, if on a general anesthesia rotation, there is no rounding or note writing...but don't think you avoid patient contact....you will do a $h*t TON of preops and basic physical exams.

You will see (and talk to) patients all day long.. let's not forget about OB and the squirmy wormy 16 yr olds you will be placing your CLEs in!!! Or the awake patients in your CSXNs etc etc....I could go on and on....

If you hate "Patients" that much...think very carefully before chosing anesthesiology! I am sure you don't want to make the same mistake twice-
 
...3 years of INTENSE interaction with patients in a FM residency...I developed a dislike for patient contact...

...I am looking to do a second residency in a relatively "Non-clinical" medical specialty. I am looking at Radiology or Pathology, and maybe Anesthesiology...
Based on your very strong description of your feelings toward patient interaction, I encourage you to pursue Rads or Path. I would discourage you from anesthesiology. I would also discourage you from practicing FM during this year. I suggest you get creative and look at some other opportunities outside of clinical practice that may be available for someone with an MD/DO. Check out industry and such.
...I might as well sit for the FM board exam...
I would agree. Take the boards... delay may loose you an opportunity to take them. Passing them will remove any doubt that you were competently trained and simply chose to practice another field. Being "dual boarded" can open unexpected opportunities. The only downside in taking them is the expense.
...I guess I will have to "work", temporarily, as a FM until my "salvation" begins...

I cannot wait to start my new residency....patient free!...
Again, I discourage a temporary clinical practice. The worst thing that can happen to you while waiting for your new residency is to have some adverse occurence during some ~despised form of clinical practice.
 
So what I have known people to do, is apply through eras (if for anes or rads) for a spot in 2012. While on the interview trail, you tell them that you are applying for an advanced position, but let them know they if they have any openings for 2011 you could start then. Spots open up all the time, either through people transfering to a different program, transfering, spots that go unmatched, and sometimes they just are able to add an extra spot. So im an anes resident, and I too dislike pt contact. However, from a pt contact perspective, anes is MUCH better. Preops consist of an online chart review followed by a 5 minute phone call to the pt (and not even always that). Actually on an ICU rotation now, which is kinda painful, but we just refer to these as "anesthesia appreciation months", although i havent done any pain clinic or seen any consults. Ive posted this before, if i had to chose a specialty besides anesthesia, it would be path. In terms of combining lifestyle and salary its the best. When I did a rotation in path as a med student, one of the INTERNS was taking night classes to get an MPH at the same time. Tell me any other specialty where that is possible! Especially after completing one residency, that might be the way to go. Plus its interesting, and almost no pt contact. Downside is the job market is tight, from what I hear. Well thats my two cents, hope it helps.
 
keep on rocking man! i hope it works out for you. many can understand the frustration.

i say do something unique to help expand your ability to get involved and letters for rads or gas.

you need a creative edge to you that separates you from all the 100s of others applying.
 
Thank you all for your great input. 🙂

JackADeli, I hear you man. I too would rather not practice FM temporarily. However, I am a genuinely trained practioner who completed his clinical training at a very strong (and well known) Family Medicine program. I do have great confidence in the clinical training I have received. The only thing is that I would rather not practice clinical medicine or primary care. It just does not fit my personality, and I realy do not enjoy it at all. You are right though, that if someone does something they do not like (or in my case tolerate), then there is a greater risk for "problems" down the road. That is why I am doing all I can to avoid practicing primary care/FM. And that is why I am ready to subject myself (and my family who depend on me) to, at least, another 4 years for low pay and being treated like the "village bicycle". Believe me brother, I will never even think of doing another residency If I am not currently in utter misery and depression. I have other "mouths to feed", who are waiting fo me to get a real job already...but I cannot in good conscience do something I cannot even stand or tolerate. Money is not everything..well, maybe it is, but my health and sanity are also important to me. Thank you for your advice. Trust me, I will try to avoid practicing primary care as much as I can.

DreamLover, you are right. That is why I am hesitant about going for Anesthesiology. However, the patient interaction in anesthesia is goal directed and focused...unlike FM where "anything goes", and where (as a PCP) you have to deal with EVERYTHING that bothers the patient, be it medical or social! So I will take the pt. interaction in anesthesia anytime over the pt. interaction in primary care. But again, the more limited pt. interaction in Rads and Path sound much more appealing. Thanks for your great input.

wagy27, I initialy wanted to go into general surgery (I still love surgical procedures), but I was also very hesitant to commit to it (terrible life style). So, as a MS-4, I really had no idea what I wanted to do. I had a feeling that I would not like patient interaction, but at the same time was not really to give up hope on clinical medicine. I thought, as a naive MS-4, that radiologists, pathologists, and anesthesiologists were not "real doctors", and thought that my family would be disappointed with me if I chose one of those
"para-medical" specialties. Boy was I stupid for thinking that. I learnt that the hard way...3 freaken years of misery, depression, and pain living as a "real doctor". To those who think Pathologists, Radiologists, and Anesthesiologist are not "real doctors", I say take that stethescope and shove it up your (you know what). Thanks for the input, wagy27.

docdaname, thank you for your insightful input about the pt. interaction in Anesthesia. Again, after going through Family Medicine training, no other form of pt. interaction whould "scare me". The pt. interaction in Family Medicine is THE MOTHER OF ALL CLINICAL PATIENT INTERACTIONS. It triamphs the pt. interaction in ANY other medical specialty, including IM and PEDS. In FM we do not only see IM patients (adults) and PEDS patients (kids), we also see OB, GYN, and off-course PSYC patients. We see it all. As a PCP, you have to manage EVERY single freaken thing the pt. mentions to you...including the very tedious "touchy-feely" social issues. As a Family Medicine resident I often felt like I am a Social Worker! The painnnnnnn!
However, I agree. I would rather go into Pathology or Radiology. If it was up to me, I would choose Pathology...but the bad job market scares me.

PharmaTope, thanks for the encouragement and advice. Good luck to you too, my friend.

Thank you all again.
 
Thank you all for your great input. 🙂

JackADeli, I hear you man. I too would rather not practice FM temporarily. However, I am a genuinely trained practioner who completed his clinical training at a very strong (and well known) Family Medicine program. I do have great confidence in the clinical training I have received. The only thing is that I would rather not practice clinical medicine or primary care. It just does not fit my personality, and I realy do not enjoy it at all. You are right though, that if someone does something they do not like (or in my case tolerate), then there is a greater risk for "problems" down the road. That is why I am doing all I can to avoid practicing primary care/FM. And that is why I am ready to subject myself (and my family who depend on me) to, at least, another 4 years for low pay and being treated like the "village bicycle". Believe me brother, I will never even think of doing another residency If I am not currently in utter misery and depression. I have other "mouths to feed", who are waiting fo me to get a real job already...but I cannot in good conscience do something I cannot even stand or tolerate. Money is not everything..well, maybe it is, but my health and sanity are also important to me. Thank you for your advice. Trust me, I will try to avoid practicing primary care as much as I can.

DreamLover, you are right. That is why I am hesitant about going for Anesthesiology. However, the patient interaction in anesthesia is goal directed and focused...unlike FM where "anything goes", and where (as a PCP) you have to deal with EVERYTHING that bothers the patient, be it medical or social! So I will take the pt. interaction in anesthesia anytime over the pt. interaction in primary care. But again, the more limited pt. interaction in Rads and Path sound much more appealing. Thanks for your great input.

wagy27, I initialy wanted to go into general surgery (I still love surgical procedures), but I was also very hesitant to commit to it (terrible life style). So, as a MS-4, I really had no idea what I wanted to do. I had a feeling that I would not like patient interaction, but at the same time was not really to give up hope on clinical medicine. I thought, as a naive MS-4, that radiologists, pathologists, and anesthesiologists were not "real doctors", and thought that my family would be disappointed with me if I chose one of those
"para-medical" specialties. Boy was I stupid for thinking that. I learnt that the hard way...3 freaken years of misery, depression, and pain living as a "real doctor". To those who think Pathologists, Radiologists, and Anesthesiologist are not "real doctors", I say take that stethescope and shove it up your (you know what). Thanks for the input, wagy27.

docdaname, thank you for your insightful input about the pt. interaction in Anesthesia. Again, after going through Family Medicine training, no other form of pt. interaction whould "scare me". The pt. interaction in Family Medicine is THE MOTHER OF ALL CLINICAL PATIENT INTERACTIONS. It triamphs the pt. interaction in ANY other medical specialty, including IM and PEDS. In FM we do not only see IM patients (adults) and PEDS patients (kids), we also see OB, GYN, and off-course PSYC patients. We see it all. As a PCP, you have to manage EVERY single freaken thing the pt. mentions to you...including the very tedious "touchy-feely" social issues. As a Family Medicine resident I often felt like I am a Social Worker! The painnnnnnn!
However, I agree. I would rather go into Pathology or Radiology. If it was up to me, I would choose Pathology...but the bad job market scares me.

PharmaTope, thanks for the encouragement and advice. Good luck to you too, my friend.

Thank you all again.

no problem. i am not in medicine but i have unique experiences that definitely separate me from others when i went on job interviews. ive had people ask me about the businesses i started that were on my CV.

I am in pharm so my career is a little different. pathology, the bad job market is something to consider 100%. in my field hospitals only have 1 person that does what i do. with that being said, the surplus of people in my field and fact that people do no leave their jobs for 10-15 yrs makes it almost impossible for me to relocate etc. you must consider that with pathology.

just pick something you enjoy though. i.e. if you like procedures go with procedures. don't chase money, lifestyle, etc bc those things, as we have seen, can change OVERNIGHT. just look at the economy in the last year and a half. never before have i seen so many people out of work who went into fields for the lifestyle. its brutal, everyday is like a ticking layoff time bomb...

the beneficial thing you have in medicine is the ability to generate income. I recommend you supplement your income. hit the local LA FITNESS up, start marketing Botox to all those Cardio Bunnies. this can supplement your income as you then go and try to do other things to get you into the field you want. Make it happen man, try to do some "clinical research". i.e. some people jsut need someone to analyze data. this could get you some publications in either field. publications = good when applying to various things. talk to some old professors and others to see what they got going on and if you can contribute. tell them what you are looking to do.
 
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