Switching residencies

[giantswing]

General questions:

I'm in a surgery program as a PGY4. If I were to try to go to, say, family medicine how could I do this? I'm guessing my intern year, as it is surgery based, would not be transferable to another program.

Would I reapply through the NRMP? Would another program take me as a "add on?" I signed up for residency swap, and there were no open PGY -1 options.

Is there a "limit" to funding through the ACGME which would limit how many years I could be a resident anywhere?

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[DarkHorizon]

Aren’t you an ortho resident? Why are you looking to switch when you’re so close to finishing? Unless you’re not in good standing, I would stick it out. Would probably need more answers before I can give you advice.

 

[Crayola227]

probably best to finish the residency, and then go back for FM

you could try to find more info about transferring/getting credit, but I would think you might have best luck with ERAS

I don't really know how anyone could swap into your spot, unless they too are a 4th yr ortho resident

as far as money, others will explain better, but despite being out of funding, people can still get spots anyway

 

[evilbooyaa]

You would re-apply through ERAS. You'd have to likely get letters in FM (at least one?) which might be hard. If you're seriously considering a shift in career from Ortho to FM, I'd talk to your PD about it.

There is a limit in regards to funding - you can use up what you'd have for your first residency - meaning if you foregoed your PGY-5 year, you'd have 1 year of funding left.

How much this matters is variable to programs, and I'm not in a position to tell you how much. Given the inherent discrepancy is competitiveness between Ortho and FM, if you were really set on FM and had a good reason why you were transitioning, I think you would match.

 

[ThoracicGuy]

I think even if you don't want to do ortho, finishing and taking your boards would be better than just not finishing you're last year. If you still want fm after your last year, then go back. The whole funding issue isn't going to stop you from getting a spot.

 

[giantswing]

I think even if you don't want to do ortho, finishing and taking your boards would be better than just not finishing you're last year. If you still want fm after your last year, then go back. The whole funding issue isn't going to stop you from getting a spot.

What makes you say that? Esp about the funding issue?

 

[ThoracicGuy]

What makes you say that? Esp about the funding issue?

If you have one year left to go in Ortho, you might as well finish it. Then go into FM training. What if you get into FM training but realize that you really would rather do Ortho? If you've left with one year to go, you'll never get a chance to finish. If you finished your residency, you could leave the FM residency and still have a chance to get a job. You could also moonlight in Ortho if your program allows.

As for the funding issue, your funding wouldn't be zero, but the program wouldn't get the full amount. At many places, particularly places with many residents, that's really not as much of an issue. Plus if you were competitive enough to get an Ortho spot, you're competitive enough to get a FM spot even with a diminished funding amount.

 

[Smurfette]

Other than the advice above, I'd also like to point out the obvious: ortho and FP are about as vastly different as you can get. One thing I would want to know is how after 4 years of ortho did you get to "I want to do FP"? You haven't had any primary care exposure since med school. I'd wonder how much you know about the field---just because it's not competitive doesn't mean it's a fit for you although certainly you'd match somewhere. You'd probably get credit for some months of training but not a full year as I know FP residents get options for ortho electives and such. Did your family situation change and you no longer want something surgical, or did you decide you hate ortho, or are you at risk of not finishing anyhow and want to move on???

If you actually do make it to the end of the 5 years, IIRC in ortho you have to practice for a bit to be BC due to the oral boards requirements. It's not simply taking the exams right away and having the board certification in hand as a back up. Not actually practicing ortho will lead to skill set atrophy, so it's not as easy as the opposite (doing FP and then going into ortho---can more easily go back to FP later than go back to ortho). What I'm saying is if you definitely want/need to walk away, it probably isn't worth finishing that last year.

 

[Shambere]

Other than the advice above, I'd also like to point out the obvious: ortho and FP are about as vastly different as you can get. One thing I would want to know is how after 4 years of ortho did you get to "I want to do FP"? You haven't had any primary care exposure since med school. I'd wonder how much you know about the field---just because it's not competitive doesn't mean it's a fit for you although certainly you'd match somewhere. You'd probably get credit for some months of training but not a full year as I know FP residents get options for ortho electives and such. Did your family situation change and you no longer want something surgical, or did you decide you hate ortho, or are you at risk of not finishing anyhow and want to move on???

If you actually do make it to the end of the 5 years, IIRC in ortho you have to practice for a bit to be BC due to the oral boards requirements. It's not simply taking the exams right away and having the board certification in hand as a back up. Not actually practicing ortho will lead to skill set atrophy, so it's not as easy as the opposite (doing FP and then going into ortho---can more easily go back to FP later than go back to ortho). What I'm saying is if you definitely want/need to walk away, it probably isn't worth finishing that last year.

I disagree, if you can finish that last year. Even if you dont operate there is huge credentials having Ortho in your title, you can do lot of non operative work with that ortho cred, like helping in PR, physical evaluations etc

 

[Dral]

I agree about finishing. Although it's a long road, fm and then a sports medicine fellowship after ortho would be a pretty cool combo (if that would be an interest).

 

[ThoracicGuy]

Or the OP may decide that the grass is finally greener when he's an attending and isn't a resident peon. That attending life is so much better than resident life, it might be worth sticking with it. Only the OP would know.

 

[VA Hopeful Dr]

I agree about finishing. Although it's a long road, fm and then a sports medicine fellowship after ortho would be a pretty cool combo (if that would be an interest).

Seems kinda unnecessary to this FP.

Other than maybe U/S guided injections (not sure if those are taught in ortho or not), not sure what a FM sports fellowship would add to an ortho residency

 

[Dral]

Seems kinda unnecessary to this FP.

Other than maybe U/S guided injections (not sure if those are taught in ortho or not), not sure what a FM sports fellowship would add to an ortho residency

Would one learn more rehab type things during the fellowship? I'm admittedly ignorant as to what a sports fellowship (or what is learned outside of surgery in an ortho residency) entails.

 

[DarkHorizon]

I agree about finishing. Although it's a long road, fm and then a sports medicine fellowship after ortho would be a pretty cool combo (if that would be an interest).

Why would you do that? You learn all that stuff in way more depth in ortho residency. You can just become a non op orthopedist. You’d have far more knowledge and experience than a FM trained sports medicine guy.

 

[Dral]

Why would you do that? You learn all that stuff in way more depth in ortho residency. You can just become a non op orthopedist. You’d have far more knowledge and experience than a FM trained sports medicine guy.

I'm not sure why one would do that. That's why I asked the question in my second post in this thread. I thank you for the answer.