Transfer, take year off, or suck it up....

[BolderNewfy]

So I am a finishing my intern year at a small comunity program in internal medicine where I matched as a categorical. I graduated from one of the better caribbean medical schools and actually did quite well on my boards (upper 230s on both steps). I am a US citizen.My girlfriend(now fiance) and I both matched at the same program. I have been unhappy with internal medicine from the beginning of my intern year but know that it is common to be unhappy during your intern year and so decided to stick it out and hope that I would come to enjoy it more. Now Im three months away from finishing intern year, and while I am better at internal medicine, and less stressed I still dont think that internal medicine is the best choice for me. My questions and apprehensions are manifold;

1) Internal medicine is incredibly stressful, and I see it in the attendings face everyday. The hours for the hospitalists dont seem that great and the focus of hospitalist work is on throughput ie moving meat as fast as possible. I just dont think this is the kind of environment I want to work in. I am not inerested in subspecialization either. Private practice seems even more stressful from what Ive seen and experienced. Am I crazy for thinking that the life of a psychiatrist would be less stressful, and provide me more time to interact with patients.

2) My desire is to switch into psychiatry but have heard a lot lately about rapid increase in graduation rates and am concerned that if I give up a sure thing at a program I may end up with nothing. Is psychiatry competitive these days. It sure wasnt last year. Ideally I would transfer into the psych program in my city but it is a very IMG unfriendly program ie they have never taken a FMG so I basically would have to leave my wife and my home town behind to pursue psychiatry.

3) Ive considered taking next year off and reapplying for a spot for June 2013. DO people ever complete their intern year and then take a year off or does that look really bad. Again Im concerned that i could leave my program and then not match any where and be stuck paying my 1/3 of a million dollar loans and not able to practice.


So the match results are about to be posted and I feel like right now Im in a critical window to make a decision about what to do. I havent told my program anything and signed my contract for next year. Please Help!. I have lots more questions but had to ditch noon conference to post this......

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[jcu]

I havent told my program anything and signed my contract for next year.

Um. Yea...

 

[Arcan57]

So I am a finishing my intern year at a small comunity program in internal medicine where I matched as a categorical. I graduated from one of the better caribbean medical schools and actually did quite well on my boards (upper 230s on both steps).

Being from "one of the better carribbean" schools is not really a selling point, FWIW. There is a tremendous variety clinical jobs available to an IM boarded physician. Some hospitalist programs have caps (especially ones that act as adjuncts to an IM program), if you're willing to accept a hit in pay you can work part-time or go risky and try and build up a boutique practice.

Your situation is rare enough that I doubt anyone is going to be able to offer useful information regarding your chances of living a blissful life as a psychiatrist. If you think you will be miserable doing IM in any form (and are willing to ignore that there are some pretty laid-back IM subspecialties), that your fiance will be ok with a long-distance relationship for at least the next two years (or what they think doesn't matter), and you're willing to run the risk of not finding a psych spot and losing your current spot than go for it.

 

[deleted103644]

Finish your IM residency and see if you can tack on a psych residency. There used to be many people double boarded in med and psych, it's less common now but still doable.

There's a funding issue, but it should still be possible. Leaving your IM program on bad terms would be a horrible idea, better to stick it out and add psych later if you're still gungho about it.

 

[futuredo32]

Finish your IM residency and see if you can tack on a psych residency. There used to be many people double boarded in med and psych, it's less common now but still doable.

There's a funding issue, but it should still be possible. Leaving your IM program on bad terms would be a horrible idea, better to stick it out and add psych later if you're still gungho about it.

With the funding issues, how likely is it to "tack on" a second residency? (I'm actually currently doing psych and wishing I had done psych/fp or psych/im)
To the OP, you might want to check the APA website now and then, they sometimes have pgy2 spots - here's one that I saw. Institute of Living/Hartford Hospital And they are looking for someone who did a pgy1 in fp, im, or peds. Good luck

 

[gutonc]

So I am a finishing my intern year at a small comunity program in internal medicine where I matched as a categorical. I graduated from one of the better caribbean medical schools and actually did quite well on my boards (upper 230s on both steps). I am a US citizen.My girlfriend(now fiance) and I both matched at the same program. I have been unhappy with internal medicine from the beginning of my intern year but know that it is common to be unhappy during your intern year and so decided to stick it out and hope that I would come to enjoy it more. Now Im three months away from finishing intern year, and while I am better at internal medicine, and less stressed I still dont think that internal medicine is the best choice for me. My questions and apprehensions are manifold;

1) Internal medicine is incredibly stressful, and I see it in the attendings face everyday. The hours for the hospitalists dont seem that great and the focus of hospitalist work is on throughput ie moving meat as fast as possible. I just dont think this is the kind of environment I want to work in. I am not inerested in subspecialization either. Private practice seems even more stressful from what Ive seen and experienced. Am I crazy for thinking that the life of a psychiatrist would be less stressful, and provide me more time to interact with patients.

2) My desire is to switch into psychiatry but have heard a lot lately about rapid increase in graduation rates and am concerned that if I give up a sure thing at a program I may end up with nothing. Is psychiatry competitive these days. It sure wasnt last year. Ideally I would transfer into the psych program in my city but it is a very IMG unfriendly program ie they have never taken a FMG so I basically would have to leave my wife and my home town behind to pursue psychiatry.

3) Ive considered taking next year off and reapplying for a spot for June 2013. DO people ever complete their intern year and then take a year off or does that look really bad. Again Im concerned that i could leave my program and then not match any where and be stuck paying my 1/3 of a million dollar loans and not able to practice.


So the match results are about to be posted and I feel like right now Im in a critical window to make a decision about what to do. I havent told my program anything and signed my contract for next year. Please Help!. I have lots more questions but had to ditch noon conference to post this......

The way I view it, you have 3 options, two of which involve either being unemployed or virtually single (or both) next year. The third requires you to continue in a specialty you may not be well suited for.

I will say however that this is the absolute worst time of year to be an intern. You've been getting your ass handed to you daily for almost 9 months. The weather probably sucks where you are and it's dark when you get to or leave work (or both). You're at that spot where you realize that you know enough to be a competent intern but not nearly enough to be "in charge" as an upper level resident and that scares the crap out of you. In short...this is not the time to make a hasty decision about your future.

In any event, here are your options:

1. Suck it up and finish. This is definitely the safest option and probably the one you'll hear the most. Doesn't mean it's the best option for you, but it would be for the bulk of people. You seem to have a pretty skewed vision of what a career in IM is or can be. I know people who function like the people you describe (and they tend to make a f***ton of money doing it) and plenty of others who work 30-50 hours a week, outpatient only, no call, no hospital coverage, etc and make $150-250K in a very desirable part of the country. You can also try to score a psych spot after finishing IM residency. You'll be less desirable than a new grad but more desirable than somebody who didn't finish his first residency.

2. Bail on your program and try to get a psych spot post-SOAP this year. This is so unlikely to be successful that I'm just going to go ahead and say that this won't happen for you, period. If you take this route you are highly likely to end up unemployed next year and, best case scenario, far away from your fiance. Note that this will result in virtually the same outcome as if you took next year "off" and applied for psych then.

3. Go ahead and start next year in IM and in the meantime, try to put together a viable app for psych. Best case scenario here is that you find a spot and wind up apart from your fiance for a year. Worst case, you still have a job as a PGY3 IM resident.

 

[NotAProgDirector]

I couldn't have done a better job than this.

I expect that there will be NO spots after SOAP is done. In fact, I am guessing that SOAP will end early, by the 4th or 5th round, because everything is gone.

Agree that your best bet is to continue as an IM PGY-2, apply in ERAS for psych next year. If the local program has never taken an IMG, I doubt they will change that pattern for you -- but you never know, perhaps if you do everything you can to start spending time with / meeting / working with them, they might.

Only you can decide whether a year apart from your spouse is better than finishing 3 years of IM (and that assumes that your fianceevis in a 3 year program, if she is in something more than 3 years, then it's more than a year apart.

 

[Samoa]

I couldn't have done a better job than this.

I expect that there will be NO spots after SOAP is done. In fact, I am guessing that SOAP will end early, by the 4th or 5th round, because everything is gone.

Agree that your best bet is to continue as an IM PGY-2, apply in ERAS for psych next year. If the local program has never taken an IMG, I doubt they will change that pattern for you -- but you never know, perhaps if you do everything you can to start spending time with / meeting / working with them, they might.

Only you can decide whether a year apart from your spouse is better than finishing 3 years of IM (and that assumes that your fianceevis in a 3 year program, if she is in something more than 3 years, then it's more than a year apart.

Why do think it's going to be over early? I foresee a small number of competitive applicants getting multiple offers in the first round, essentially hogging them until round two, when they're released again and all those applicants are off the market. Then a slow-motion car wreck for the next 7 rounds, until programs have run out of applicants they consider acceptable. I think most spots will be gone, but there will be the same kind of spots left as before.

But that's just a guess.

 

[NotAProgDirector]

Why do think it's going to be over early? I foresee a small number of competitive applicants getting multiple offers in the first round, essentially hogging them until round two, when they're released again and all those applicants are off the market. Then a slow-motion car wreck for the next 7 rounds, until programs have run out of applicants they consider acceptable. I think most spots will be gone, but there will be the same kind of spots left as before.

But that's just a guess.

We're all guessing here.

My guess is this: If I had a spot open in SOAP and was interviewing people, if there was a superstar and I thought they were likely to take a different offer, I might not offer them a spot at all. If I did, my #2-8 might disappear in the first round. So, I'd probably go safe -- pick from the middle of the pack someone who seemed very likely to pick me. Therefore, I expect that about 50% of all spots will be taken in each round. This is a complete guess. If so, by the end of round 4, there will be (0.5)^4 = 6% of spots left, and it will be all but over (although, to be fair, the NRMP will keep the system running until all 8 rounds are complete or 100% of spots are gone).

I could be totally wrong.

 

[Samoa]

We're all guessing here.

My guess is this: If I had a spot open in SOAP and was interviewing people, if there was a superstar and I thought they were likely to take a different offer, I might not offer them a spot at all. If I did, my #2-8 might disappear in the first round. So, I'd probably go safe -- pick from the middle of the pack someone who seemed very likely to pick me. Therefore, I expect that about 50% of all spots will be taken in each round. This is a complete guess. If so, by the end of round 4, there will be (0.5)^4 = 6% of spots left, and it will be all but over (although, to be fair, the NRMP will keep the system running until all 8 rounds are complete or 100% of spots are gone).

I could be totally wrong.

Interesting. So it might still be helpful to let a program know that they're your first choice among the programs you've spoken to?

 

[RadOncDoc21]

We're all guessing here.

My guess is this: If I had a spot open in SOAP and was interviewing people, if there was a superstar and I thought they were likely to take a different offer, I might not offer them a spot at all. If I did, my #2-8 might disappear in the first round. So, I'd probably go safe -- pick from the middle of the pack someone who seemed very likely to pick me. Therefore, I expect that about 50% of all spots will be taken in each round. This is a complete guess. If so, by the end of round 4, there will be (0.5)^4 = 6% of spots left, and it will be all but over (although, to be fair, the NRMP will keep the system running until all 8 rounds are complete or 100% of spots are gone).

I could be totally wrong.

Why does this sound like a modified nfl draft... Obviously I don't know much about SOAP except what I use to wash with. Is this system better or worse than scramble? I would hate having to wait around.

-R

 

[deleted103644]

Why does this sound like a modified nfl draft... Obviously I don't know much about SOAP except what I use to wash with. Is this system better or worse than scramble? I would hate having to wait around.

-R

It's definitely better for applicants. Some people who would not have matched anyway will complain, but it's a much fairer system than the old version where the fastest fax machine won.

 

[MassiveAttack]

I think what is important to realize first is that what you are going through is normal and common. If you truly feel that you want to do psychiatry, you can totally do so.

These programs listed below take applicants OUTSIDE of the match, so no need to go through ERAS or the match. These would be for individuals who completed a year of residency and who can start as a PGY2 in Psychiatry. These are all great programs too. The key is to apply early to these, as these spots go quickly. I would say contact the programs, most of them have the applications online and apply by mid summer.

- Stanford (takes 2 people generally)
- Yale (takes 4 people)
- Johns Hopkins
- USC (I think they still take PGY2)
- University of Washington (takes 4 I believe for their Seattle track)
- there are others, I just cannot remember, I think one of the New York programs does this too.

Good luck !!

 

[BolderNewfy]

Thanks for the help everybody!

Still a couple questions.

1) If I spoke with program director and told them that I wont continue on and assuming we part on good terms, Would leaving my current residency and taking a year off to find a different residency look bad?

2) is all the talk about increased graduation true and should I assume that in the next few years residency positions are going to get much more difficult in general and expecially for someone like me (caribbean grad)?

3)Hospitalists love to quote how they decrease length of stay at hospitals but at the expense of turning medicine into McHospital ie moving meat. Am I crazy for thinking this, and is it any different in psychiatry?

4) since I signed my contract for PGY2, am I screwed or legally obligated to continue on if I expressed extreme unhappiness and a desire to leave to my PD. BTW my PD is like a hundred years old and is from the era of medicine where people thought residents should be punished.....

 

[gutonc]

Thanks for the help everybody!

Still a couple questions.

1) If I spoke with program director and told them that I wont continue on and assuming we part on good terms, Would leaving my current residency and taking a year off to find a different residency look bad?

It won't really look "good." You can potentially improve how it looks with whatever you decide to do in your year off, but it won't be a positive thing.

2) is all the talk about increased graduation true and should I assume that in the next few years residency positions are going to get much more difficult in general and expecially for someone like me (caribbean grad)?

Yes and yes. Of course, if you're going for psych, it's less of an issue than if you wanted to get into derm or ortho. But a rising tide lifts/swamps all boats.

3)Hospitalists love to quote how they decrease length of stay at hospitals but at the expense of turning medicine into McHospital ie moving meat. Am I crazy for thinking this, and is it any different in psychiatry?

I have no idea how it is in psych. I don't think all hospitalists work this way. I also don't think you really listened to what I said about other practice options in IM besides hospitalist medicine. But whatever.

4) since I signed my contract for PGY2, am I screwed or legally obligated to continue on if I expressed extreme unhappiness and a desire to leave to my PD. BTW my PD is like a hundred years old and is from the era of medicine where people thought residents should be punished.....

Kind of. That's what a contract is after all. But the vast majority of people won't bother to seek legal redress against a resident who violates a contract like this...it's not worth the hassle. But he can completely hose you when you re-apply for residency in the future.

 

[TexasPhysician]

I would stick it out in IM. You will have funding issues either way you look coming from an IM program as I understand it. Funding is becoming a big issue. Even FMGs with lower scores may be seen as more valuable at the funding level. Once you start a US residency, your funding clock starts ticking.

The better and more cushy psych programs rarely take any Carib grads. I go to a non top 25 psych program and we did not interview any Carib grads this past year. There are some psych programs that have designated PGY-2 spots, but even those are competitive. You are late to the process, and you would likely need a wait a year - making you less competitive.

You may well find a spot in psych, but is the chance at moving away from family and possibly being out a residency worth the chance?

Why not complete the IM program and do a more relaxed fellowship? The lifestyle of endocrine, allergy, rheum, etc are all pretty good. You have a sure thing, and only 2 years before being board eligible.

 

[BolderNewfy]

The problem with fellowship is that I am at a community program and getting a good fellowship spot is pretty much not going to happen coming from a community program. Also from my experience a lot of the specialists work a lot as well. for instance:

GI- not interested in scoping people all day. also they work a lot and have to do emergency cases all the time.

Cards- Way too long hours and high stress. Not interested either

Allergy- impossible to get unless you come from acedemic program

Rheum- not interesting at all, at least to me.

pulm Critical care- horrible, No damn way.
Heme Onc- see above
ID- could be interesting i guess...just not that exciting and the pay is worse than a generalist

If IM has the potential to provide a great lifestyle then why is it so easy to get? And also in my area there has been a recent mass exodus of IM primary care docs who burned out and left.....


In addition I feel like specializing just for the lifestyle is a bad idea. Ive pretty much come to the conclusion that I am stuck doing IM for now. It makes me sad knowing Im stuck doing something I dont really belieive in. I feel like I could really be a good psychiatrist and advocate for psychiatric patients.

 

[TexasPhysician]

There are plenty of IM jobs at urgent care places that work shifts like 8-5 or noon-8. See Care Now out of Dallas as an example. Similar urgent care places are popping up everywhere. No call. You start at a more average salary, but it climbs. I know FP people there pulling 260k+.

 

[BolderNewfy]

Also I don't fully understand the funding thing. Could someone explain it to me. Am I somehow worse off to transfer having completed a categorical year of medicine as opposed to a prelim year? Also would I be a funding problem if I tried to do something like PMR which starts second year?

 

[TexasPhysician]

Also I don't fully understand the funding thing. Could someone explain it to me. Am I somehow worse off to transfer having completed a categorical year of medicine as opposed to a prelim year? Also would I be a funding problem if I tried to do something like PMR which starts second year?

As I understand it - You have funding for the # of years included in the first categorical residency that you match. So in IM you are funded for 3 years. If you switch to psych, there is no funding for your PGY-4, and when budgets are tight, this could be a deal breaker. Had you matched into ortho surgery, you would have had 5 funded years and thus enough to switch into psych. I could be wrong here, but this is my rough understanding. Others may know better.

 

[gutonc]

Also I don't fully understand the funding thing. Could someone explain it to me. Am I somehow worse off to transfer having completed a categorical year of medicine as opposed to a prelim year? Also would I be a funding problem if I tried to do something like PMR which starts second year?

Yes...because your "funding clock" starts when you start a terminal residency track. A prelim IM program is not a terminal residency, a categorical IM program is. Therefore, by starting IM cat, your clock is set at 3 years. There's nothing you can do about this so stop worrying about it.

As to whether it's a major issue or not, that will depend on you, the program and how much a particular program wants you. The funding does not go to 0 after your 3 years. It goes to 100% IME (what the program says it costs to train you) and 50% DME (what they pay you in salary/benefits). This works out to something in the 70-75% range of total costs. All fellowships are funded this way.

 

[Baps]

If I'm not mistaken, let's say you were to switch from IM to Psych, there would be no issue for funding because you are allowed 5 years for Psych or FM (but not IM), assuming you only used up 1 year. However, as mentioned above, there would be an issue for funding if you were to switch between IM programs and very few to no IM program would want to rank you.

 

[TexasPhysician]

If I'm not mistaken, let's say you were to switch from IM to Psych, there would be no issue for funding because you are allowed 5 years for Psych or FM (but not IM), assuming you only used up 1 year. However, as mentioned above, there would be an issue for funding if you were to switch between IM programs and very few to no IM program would want to rank you.

Incorrect.

 

[gutonc]

If I'm not mistaken, let's say you were to switch from IM to Psych, there would be no issue for funding because you are allowed 5 years for Psych or FM (but not IM), assuming you only used up 1 year. However, as mentioned above, there would be an issue for funding if you were to switch between IM programs and very few to no IM program would want to rank you.

Wait...what? I'm losing count of the number of ways you're wrong in this post. Go back and read what I (and TexPhys) wrote above.

1. Once you start a terminal residency, your clock is set at the # of years that residency takes. Period.
2. Psych is 4 years, FM, IM and Peds are 3 years. That's all the time you get. So somebody switching from IM to psych after 1 year of IM will have 2 more years of full funding available.
3. There is almost no downside (at least from the funding perspective) to switching between programs in a specialty. If you go from IM program A to IM program B after your intern year, and the program is willing to accept you as a PGY2 in good standing (not always the case, but not uncommon either), you'll have full funding for the length of the residency. If they make you repeat all/part of your intern year (also not uncommon), you have 2 years of full funding left so they have to eat whatever part they make you repeat (1y max).

 

[deleted103644]

If I'm not mistaken, let's say you were to switch from IM to Psych, there would be no issue for funding because you are allowed 5 years for Psych or FM (but not IM), assuming you only used up 1 year. However, as mentioned above, there would be an issue for funding if you were to switch between IM programs and very few to no IM program would want to rank you.

I award you no points, and may god have mercy on your soul.

 

[Droopy Snoopy]

Why does this sound like a modified nfl draft... Obviously I don't know much about SOAP except what I use to wash with. Is this system better or worse than scramble? I would hate having to wait around.

-R

"Yeah so I see here you've got a 246 Step score, but you only run the 40 in 6.65 sooo..."

 

[Baps]

Ha, don't blame me. I'm just the messenger! And where exactly do you get your information from?

 

[jcu]

Where do YOU get your information from?

 

[NotAProgDirector]

Ha, don't blame me. I'm just the messenger! And where exactly do you get your information from?

Look here: (It should be somewhere on the AAMC website also, but google found this) http://med.uth.tmc.edu/administration/edu_programs/Assets/documents/gme/medicare_payments_gme.pdf

To the OP:

I doubt psych is any better. Every branch of medicine has been forced to see more / do more in less time. That's just the nature of the beast. I used to do both inpt and outpt medicine and really loved both of them. Over time, it's become more difficult to do both inpt and outpt care, so now I do only inpt care. I love it. I find I get lots of time to work with patients and care for them. It's crazy busy when I'm on service -- lots of long days, weekends, etc. But it's very rewarding.

This will be true for all fields. The grass is not greener on any other lawn. The key is to find a field that you like, cause you will work hard and put in long hours in all of them. I'm almost certain that, should you transfer to psych, you'll find that you're expected to manage a complex psych patient with multiple meds and all sorts of social issues in 30 minutes, and they'll be 10 minutes late.

 

[DocThatRocks]

Look here: (It should be somewhere on the AAMC website also, but google found this) http://med.uth.tmc.edu/administration/edu_programs/Assets/documents/gme/medicare_payments_gme.pdf

To the OP:

I doubt psych is any better. Every branch of medicine has been forced to see more / do more in less time. That's just the nature of the beast. I used to do both inpt and outpt medicine and really loved both of them. Over time, it's become more difficult to do both inpt and outpt care, so now I do only inpt care. I love it. I find I get lots of time to work with patients and care for them. It's crazy busy when I'm on service -- lots of long days, weekends, etc. But it's very rewarding.

This will be true for all fields. The grass is not greener on any other lawn. The key is to find a field that you like, cause you will work hard and put in long hours in all of them. I'm almost certain that, should you transfer to psych, you'll find that you're expected to manage a complex psych patient with multiple meds and all sorts of social issues in 30 minutes, and they'll be 10 minutes late.

Agreed for the most part. The grass is only greener on the other side if you have watered your own lawn first and the grass isn't growing. I am not sure the OP has "watered his own lawn." I don't think any field of medicine is easy and stress-free. The OP seems to discount subspecialties in his field of medicine because they are stressful or too much work or whatnot. I am not sure what he thought life in medicine would be like. It's definitely not a piece of cake, whether you are in psychiatry or surgery. I don't think the OP should leave his spot unless he has lined up a new one.

OP, what if you had to leave your wife to do residency elsewhere? You kind of sound noncommital to IM and your wife. I am not trying to be mean, and feel like you should do what makes you happy, but I am not sure if you know what that is. What if you hopped the fence from the IM grass to the psych grass and it wasn't what you expected it to be?

 

[Law2Doc]

...
If IM has the potential to provide a great lifestyle then why is it so easy to get? ...

as opposed to psych???

Dude, if you have a reason why every alternative is no good, so why ask the question. There are multiple prActice options in IM and multiple fellow options that could work if you didn't have your mind already made up. But you do, so sounds like what you need to do is seek an appointment with the PD of whatever psych program is closest to you on a post call day and go talk it out with him. Lots of people make jumps between similarly competitive specialties, but it almost always involves a heart to heart with the other specialty before you do anything to upset your own program. I sure would never let your PD get wind that you are thinking of leaving until you need him to sign off on going to a Bona Fide residency spot. The grass is not always greener though. I'm betting that you may end up waiting a while, and given that you may be into second year of IM by the time other options open up, the double residency option may end up the most likely beneficial course anyhow.

 

[atsai3]

3)Hospitalists love to quote how they decrease length of stay at hospitals but at the expense of turning medicine into McHospital ie moving meat. Am I crazy for thinking this, and is it any different in psychiatry?

Sorry to be a Debbie Downer, but there is a lot of moving of meat in psychiatry.

 

[Doctor Bagel]

Sorry to be a Debbie Downer, but there is a lot of moving of meat in psychiatry.

Very true. Inpatient medicine is inpatient medicine, and I wouldn't say that my inpatient psychiatry rotations have been easier in terms of turnover, busy work or census.

Also, op, you haven't indicated anything you actually like about psychiatry, which concerns me. You chose IM over psych for a reason, so maybe you should explore that.

 

[deleted103644]

Sorry to be a Debbie Downer, but there is a lot of moving of meat in psychiatry.

Yeah, my psych rotation seemed like glorified social work.

 

[annush]

My good friend did his chief year in IM and knows this well- in terms of funding, it's a wives tale that it's an issue. It ONLY becomes an issue if you FINISH A RESIDENCY then SWITCH into another program. And even then, you get anywhere from 50% upwards of allocation from medicare, which funds these slots.

So, don't worry.

 

[NotAProgDirector]

My good friend did his chief year in IM and knows this well- in terms of funding, it's a wives tale that it's an issue. It ONLY becomes an issue if you FINISH A RESIDENCY then SWITCH into another program. And even then, you get anywhere from 50% upwards of allocation from medicare, which funds these slots.

So, don't worry.

I agree it's not usually a big deal, but your friend is incorrect. It has nothing to do with finishing. You can read about it here: https://members.aamc.org/eweb/upload/Medicare Payments For Graduate Med Ed.pdf

 

[Buzz Me]

My good friend did his chief year in IM and knows this well- in terms of funding, it's a wives tale that it's an issue. It ONLY becomes an issue if you FINISH A RESIDENCY then SWITCH into another program. And even then, you get anywhere from 50% upwards of allocation from medicare, which funds these slots.

So, don't worry.

You know this thread is over 1 1/2 years old, right?