transfer/switch, residency year, and funding

[magician]

can anyone kindly explain how residency funding works?

if one switches from another specialty to pathology or transfers from one path program to another one and repeats PGY1 (that means losing one year), do you think that the program that one wants to switch to or transfers to will rejects the applicant because of money?

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[peter90036]

the government/medicare funds ~?$150,000?/resident/year (which also covers paying the atendings who *cough*teach*cough* us.

heres aamc's booklet of "information" http://www.uth.tmc.edu/med/administration/gme/pdf_files/medicare_payments_gme.pdf

if a program wants to get you, thats what matters.

 

[yaah]

People switch programs all the time, but I don't know how common it is to repeat PGY1 year...I would say that is uncommon and only occurs in special circumstances like illness or leaving a program before completing the year.

 

[magician]

yaah,

you raised an improtant issue: leaving a program before completing the year.

what is the consequence if one leaves a program before completing the year? does it affect next match? does it count as one year in term of funding?

 

[yaah]

I really don't know. Normally the context is someone leaving one field and entering another, at which point usually you start over as a PGY1. I don't know about changing programs and trying to repeat a year in the SAME field.

 

[coroner]

The earlier post was correct about the government funding every residency spot. The hospital keeps the excess profit after disbursing your income. However, once you begin your first residency, regardless of the specialty, you're locked into being funded for those alloted years. For example if your first residency is IM, the government will fully fund you for only three years, regardless of how many years you complete or what specialty you may switch into later. Suppose you do one year of IM, and then want to do Path; at that point you only have two years of full funding left. With Path being four years, the new program you're in will have to take a financial hit for those two years. You will still be funded, but not the full amount, so although your salary/benefits don't change, the profit from you by the hospital will. Again the earlier post is correct, if the program wants you bad enough, they'll make a case for you to the GME dept./financial board to get in.

 

[mlw03]

The earlier post was correct about the government funding every residency spot. The hospital keeps the excess profit after disbursing your income. However, once you begin your first residency, regardless of the specialty, you're locked into being funded for those alloted years. For example if your first residency is FP, the government will fully fund you for only three years, regardless of how many years you complete or what specialty you may switch into later. Suppose you do one year of FP then want to do Path (like me); at that point you only have two years of full funding left. With Path being four years, the new program you're in will have to take a financial hit for those two years. You will still be funded, but not the full amount, so although your salary/benefits don't change, the profit from you by the hospital will. Again the earlier post is correct, if the program wants you bad enough, they'll make a case for you to the GME dept./financial board to get in.

so how does all this stuff work when a residency program has its residents in multiple hospitals over the course of a residency? i know the IM residents at usf work at 3 hospitals at least over their 3 years. does that government money get split by the institutions? would the same issues still apply to a resident who switches specialties?

 

[coroner]

More or less, yes. The availability of away rotations may be scarce, mandatory (at designated outside hospitals), or optional depending on the program. They would be scarce for example if a program deems that a satisfactory rotation can be done within its own hospital , i.e. they don't want to lose money by reimbursing another institution while their residents are rotating there. So why don't all hospitals keep their own residents for every rotation so they can get maximum profit? A few reasons. The first being that they may not meet ACGME req's. to provide every rotation for a fully accredited program, so they have to send their residents away to other places; also there are pre-existing affiliation agreements between various institutions locally, and lastly, some have more money than others and can afford to allow resdients to rotate at hospitals where they may be interested in obtaining a fellowship/practicing.