Switching to gas after IM

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bigfkd22

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I am a pgy-2 at an osteopathic IM program will start pgy-3 in July. I am interested in pursing a residency in anesthesia after IM. I wasn't the greatest medical student and I didn't take the USMLE. I have below average step 1 comlex scores an average step 2 and above average step 3 scores. I applied broadly for gas as a 4th year and received only 5 interviews and didn't match. Does any one have any experience with a similar situation? Any thoughts about being more or less competitive if I reapply? I am willing to do my intern year over. Thanks for any help.
 
treat is like you would back in medical school.

consider doing research, presenting at an ASA conference. Making phone calls to your local anesthesiology department to see if they can help. Board scores are for med students, at this point its more career change, but you need to show you wont quit anesthesiology residency part way through.

what is it that you want to do? ICU medicine can be done with a pulm fellowship after medicine. pain can be done with a pain fellowship or PMR residency. if you want to do OR medicine, then apply broadly and get connected as stated above.
 
You are not an attractive candidate to most programs because:

1) your COMLEX/USMLE scores are weak

2) most importantly, by doing 3 yrs of IM, you have exhausted your Medicare slot, and any anesthesia dept. that hires you will have to pay your salary, rather than the institution's GME office paying it.

Programs who take IM residents insist on exceptional credentials to justfy the financial hit...
 
Any thoughts about being more or less competitive if I reapply? I am willing to do my intern year over.

After a completing an IM residency you will be a more attractive prospective anesthesia resident than you were as a medical student. The funding argument is a non issue, I have heard that argument for 15 years, and it may be an issue at a few institutions, but a most residencies it is not an issue. Apply to as many residencies as you can afford to and avoid the ones that say on FREDIA that the don't take applicants with previous GME.

Don't waste a year doing another internship. Spend a year working as an IM attending even if you take 6 months off your salary will be better than that of an intern.
 
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Thank you for your advice it is truly appreciated. If I apply I will apply broadly to allopathic spots. I want to do OR medicine no pain. If I wanted to do CC I would just go the IM route. Thanks again for any and all input!
 
treat is like you would back in medical school.

consider doing research, presenting at an ASA conference. Making phone calls to your local anesthesiology department to see if they can help. Board scores are for med students, at this point its more career change, but you need to show you wont quit anesthesiology residency part way through.

what is it that you want to do? ICU medicine can be done with a pulm fellowship after medicine. pain can be done with a pain fellowship or PMR residency. if you want to do OR medicine, then apply broadly and get connected as stated above.
Hello,

This is excellent advice. If you succeed on your first try, you don't need to worry about it, but if not, a year or two of research will increase your chances of finding a spot somewhere.

The most important thing for you at this time is not the finding of a spot, because you will eventually find one, if not this year, next year. The most important thing is to be sure that you want to change specialties for the right reasons, that you want to do anesthesia because you like the scientific and intellectual challenges, because you want to help patients, and that helping surgeons will not make you feel as a second class citizen.

Greetings
 
After a completing an IM residency you will be a more attractive prospective anesthesia resident than you were as a medical student. The funding argument is a non issue, I have heard that argument for 15 years, and it may be an issue at a few institutions, but a most residencies it is not an issue. Apply to as many residencies as you can afford to and avoid the ones that say on FREDIA that the don't take applicants with previous GME.

Don't waste a year doing another internship. Spend a year working as an IM attending even if you take 6 months off your salary will be better than that of an intern.

This is true.

Cambie
 
After a completing an IM residency you will be a more attractive prospective anesthesia resident than you were as a medical student. The funding argument is a non issue, I have heard that argument for 15 years, and it may be an issue at a few institutions, but a most residencies it is not an issue. Apply to as many residencies as you can afford to and avoid the ones that say on FREDIA that the don't take applicants with previous GME.

Don't waste a year doing another internship. Spend a year working as an IM attending even if you take 6 months off your salary will be better than that of an intern.


I have a question about the whole 'funding' issue after someone completes a residency. Is this true concerning switching into Anesthesia only or can it appy to other residencies like Rads, Derm, Peds, etc? Is it really true that if you keep trying you can break into almost any field or is that naive?
 
I have a question about the whole 'funding' issue after someone completes a residency. Is this true concerning switching into Anesthesia only or can it appy to other residencies like Rads, Derm, Peds, etc? Is it really true that if you keep trying you can break into almost any field or is that naive?


In the wake of the failed push for Hilliary care in the early 90's the government changed the GME funding formula. Your residency got only full time funding for the length of the residency you chose first. If you chose a PGY1 year of a three year residency, i.e., FP,or IM, and then switched to a longer residency like surgery or anesthesia. You only got three years paid at the full time rate, the next years were paid at the half time rate, thus the program who gets this money approximately $100,000 per resident per year got less money for taking you versus a resident fresh out of medical school. This was supposed to promote primary care residences and cut down on people doing more than one residency since the second residency would be done at the half time rate.

In the past if you were a weak candidate for a desirable residency i.e. Dermatology or Radiology one way to get in was to do an easy to match residency like IM then apply to the residency you really wanted. But now given the funding issue that many not make you a stronger candidate. Thus doing a year or two of research may be a better route not to loose your funding. Although you can still do a traditional year internship with out having officially chosen a residency. Perhaps if you did a residency in Canada you would not loose your funding.

The funding formula to large GME institutions is very complex and the difference between the full time rate and the half time rate many be a small portion of the funding the institution receives for GME. The funding may also be an issue for the top administrators of the hospital and not trickle down to the level the attendings whose are in charge of ranking new residents.
 
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