Switching from Family Medicine to Psychiatry and credits given

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DRZIVAR

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Hello all. I am a psychiatry resident and had a question. I am under the impression that if you have done family medicine (which I did not finish) and trying to switch to psychiatry they should give you a year of credit and basically start you at PGY 2. I have heard that instead of 4 years you can be finished in 3. My program here is only giving me and incoming surgery resident only 6 months of credit. The program tells me that decision was made by ABPN (American Board of Psychiatry and Neurology). I I remember calling the board and the board said decision was made by program however I am not sure. Can someone shine a light on this for me. My fourth year is all electives and if I do not need to that last year that will be interesting.
Also one of our residents is taking leave in middle of third year for pregnancy and birth. My program tells me that she can come back during 4th year and make up those rotations in 4th year and still complete the program. I have not heard that before. Can a program just do that? That sounds like the elective months are worthless. I feel like if a resident takes time off they still need to make that time up so instead of 4 years they will finish in 4 year and 2 ro 3 months based on their leave. Anyone has input on that??
 
This is probably not the best forum for this question, so a mod will likely move it to the residency forums.

Last time I heard about this situation in terms of time off, it is at the discretion of the PD. It's that way since every person has a unique situation. Someone who takes off to have a 2 month experience abroad by their own choice may have 2 months tacked on at the end while someone who was forced to take 2 months off due to illness that was out of their control may not...or they may only have to do 2 more weeks or something.

In terms of credit given, again, I think that's probably program dependent based on guidance from governing boards (like ABPN).

Did you have psych months in Family medicine and does your current program do intern year psych months (I believe most do)? Your co-resident coming from surgery almost certainly did either none or one or so at most. That may be where things are coming from. If you didn't do psych months during your family med residency, your current program may have felt that only a 6 month increment of credit be given.

I understand where you are coming from comparing your situation to the pregnant resident (almost seems like double standard), but it's probably a bit of an apples to oranges comparison as far as your program is concerned.
 
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Why would they give you a year of credit for family medicine? Unless your family medicine intern rotations included neurology or inpatient psychiatry, I'm surprised you're getting more than 4 months credit. Concur with the above poster that you're trying to compare apples to oranges with PGY3/4 to PGY1 rotations. Ultimately, of course, yes, your program can do all of what you described.
 
This is highly variable depending on your past rotations and how your new program is structured. In many psych programs, PGY-4 is not all elective. Even if they claim it to be all electives, it may be electives within certain categories or parameters.

The majority of transfers are not going to finish psych in 3 years and few will need a full 4. Being off-track with graduation and doing some amount of time between 3-4 years is customary.

Pregnancy is totally different. You can take FMLA, use sick time, use vacation time, etc. Some programs will allow light electives of 4th year to be done from home in 3rd year while “out”. The person then returns PGY-4 to complete 3rd year and then do the rest of PGY-4. Rotations like developing lectures, research, writing papers, psych in the cinema, etc may be accomplished with your little one napping next to you on leave in some programs.
 
In my program I've seen it go a few ways.

One resident completed a traditional DO rotating internship. He was given the credit for the 4 months of IM that our program requires. He was allowed to use those four months in PGY-1 as elective time and ended up fast tracking to C&A after 3rd year. He got to end third year a little early.

Another resident had completed her FM residency and applied to psych during her pgy-3 year. She didn't have to redo the IM component of PGY-1 or the two months of neurology and used those 6 months for electives. She did some psych in FM residency so ultimately she will graduate after 3 years and change.

Saw someone transfer from a psych program to ours and he had to give up some of his PGY-4 electives to get some more state hospital experience that he didn't get in his PGY-1 at the other program.

Saw someone transfer from our psych residency to another psych residency after PGY-2. She had to repeat PGY-2, essentially making psych a 5 year program for her.

Pregnancy/childbirth/parental leave is a protected item according to the American Board of Medical Specialties. Programs are required to give up to 12 weeks of leave for new parents per year per child without it affecting length of training. So if you theoretically had four kids, one each year, this policy would mean you could get 12 weeks each year. I'm sure it doesn't actually pan out that way, but it's how I read that.

Comparing a PGY-1 year in a different specialty to pregnancy in PGY-3/4 is apples and oranges. Heck, you're lucky they're giving you what you're getting. Try to imagine it the other direction. Would your first program allow a resident transferring from psychiatry to skip the PGY-1 year of IM?

PGY-4 is frequently considered a joke in psychiatry. It is the year that you get more experience as a leader / more experience in general. 2 years of following outpatients is critical in psychiatry due to the long and individualized courses the patients run. It's more important than it seems on its face.
 
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The ABPN generally leaves this vague and let's PDs have a lot of say in how this plays out. You do need 2 months of neuro and 4 months of medicine, but how much "credit" you get for prior training is largely up to the program. It may be hard to play hardball with programs who have multiple people willing to "start over" and fill the program's needs vs. someone who doesn't want to do this. Shop around and get the best deal you can, but there isn't much negotiation once you have started and agreed to the deal.
 
Looking at the OP's post history, they have several red flags (Caribbean IMG, two prior residencies, remediated at one, dismissed from the other, multiple years outside of residency after graduation, denied a medical license in one state). OP, I'd say to count your blessings and do what the program asks without making waves.
 
Looking at the OP's post history, they have several red flags (Caribbean IMG, two prior residencies, remediated at one, dismissed from the other, multiple years outside of residency after graduation, denied a medical license in one state). OP, I'd say to count your blessings and do what the program asks without making waves.
😱. Seconded to count blessings and do/accept absolutely anything that any psychiatric residency asks or offers of you OP.
 
Also one of our residents is taking leave in middle of third year for pregnancy and birth. My program tells me that she can come back during 4th year and make up those rotations in 4th year and still complete the program. I have not heard that before. Can a program just do that? That sounds like the elective months are worthless. I feel like if a resident takes time off they still need to make that time up so instead of 4 years they will finish in 4 year and 2 ro 3 months based on their leave. Anyone has input on that??

Why in the world do you care what your co-resident is doing and if what she is doing is "fair" or not compared to what you're doing? (Also why is your program even telling you what she can or can't do to graduate...)
I'd see residents do this all the time comparing each others schedules and crap, trying to figure out if they got a "fair deal" or something compared to everyone else. They end up getting labeled as whiny problem residents that everyone knows about.

Residency programs have fairly broad leeway in how much they allow you to do or not do in that there are minimum required core rotations/competencies for all residencies but outside of that a lot of the scheduling/rotations are up to the program. Remember that at the end of the day, your residency program director has to sign off on your training for you to even take a board certification exam or get a medical license, so best not to piss them off with quibbling about 6 months of elective time...just moonlight 4th year if you want to make more money. So yeah, like everyone else said, just go with what you get here.
 
Hello all. I am a psychiatry resident and had a question. I am under the impression that if you have done family medicine (which I did not finish) and trying to switch to psychiatry they should give you a year of credit and basically start you at PGY 2. I have heard that instead of 4 years you can be finished in 3. My program here is only giving me and incoming surgery resident only 6 months of credit. The program tells me that decision was made by ABPN (American Board of Psychiatry and Neurology). I I remember calling the board and the board said decision was made by program however I am not sure. Can someone shine a light on this for me. My fourth year is all electives and if I do not need to that last year that will be interesting.
Also one of our residents is taking leave in middle of third year for pregnancy and birth. My program tells me that she can come back during 4th year and make up those rotations in 4th year and still complete the program. I have not heard that before. Can a program just do that? That sounds like the elective months are worthless. I feel like if a resident takes time off they still need to make that time up so instead of 4 years they will finish in 4 year and 2 ro 3 months based on their leave. Anyone has input on that??
I did a year of prelim medicine and entered Psych as a PGY2. Not sure if this is program specific.
 
The answer to your question is that your program has decided not to give you a full year of credit and is blaming that decision on the ABPN because they don’t want to argue with you about it. It’s definitely not an ABPN rule because my residency had regular PGY-2 positions that they gave to people who had come from other specialties and to people who wanted (for whatever reason) to do a pediatrics intern year instead of the categorical intern year.

That being said, none of this matters given your history. It’s a goddamned miracle that you even got into a psychiatry residency. You need to shut up, kiss the ring, and do whatever you can to just graduate because otherwise you’re completely screwed. This is not the time to be arguing with someone about a few months of credit.
 
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