Transitional Year -> Categorical Medicine?

[xaelia]

Hey all,

I matched at Harbor-UCLA for TY - and I'm excited about going to a great program - but I'm a little concerned that, if I wanted to go into a PGY-2 categorical IM spot, that it could be problematic.

Does anyone have any experience with this?

Thanks!

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[Arginine]

I don't have specific details but I have heard of an FP intern at Harbor switching to categorical IM for PGY-2.

 

[Winged Scapula]

Hey all,

I matched at Harbor-UCLA for TY - and I'm excited about going to a great program - but I'm a little concerned that, if I wanted to go into a PGY-2 categorical IM spot, that it could be problematic.

Does anyone have any experience with this?

Thanks!

No personal experience, and I suppose its possible, but it very well likely depends on how much "medicine" there is during your TY. This is because a program is unlikely to take you into an advanced position (ie, a PGY2 spot in IM) if you will not be Board Eligible in their specialty. They may consider you for a R-1 spot (ie, repeating your intern year), if you do not complete enough internal medicine during your TY.

You may say, "I don't care about being Board Eligible/Certified" but your residency program has an obligation to offer that to you. Without the proper training, they cannot...thus, your TY may not offer enough rotations to satisfy the ABIM, or you may have to complete some extra rotations after your PGY-3 year (ie, finish residency off cycle).

Below are the GME requirements for Board Eligibility in Internal Medicine:

Graduate Medical Education (GME)

To be admitted to the Certification Examination in Internal Medicine, physicians must have satisfactorily completed 36 calendar months of graduate medical education accredited by the Accreditation Council for Graduate Medical Education (ACGME), the Royal College of Physicians and Surgeons of Canada, or the Professional Corporation of Physicians of Quebec, including vacation time, by August 31 of the year of examination. Residency or research experience occurring before completion of the requirements for the MD or DO degree cannot be credited toward the requirements for certification.

The 36 months of residency training must include 12 months of accredited internal medicine training at each of three levels: R-1, R-2, and R-3. No credit is granted for training repeated at the same level or for administrative work as a chief medical resident.


Content of Training

The 36 calendar months of full-time medical residency education:

(1) Must include at least 30 months of training in general internal medicine, subspecialty internal medicine, critical care medicine, geriatric medicine, and emergency medicine. Up to four months of the 30 months may include training in areas related to primary care, such as neurology, dermatology, office gynecology, or office orthopedics.

(2) May include up to three months of other electives approved by the internal medicine program director.

(3) May include up to three months of leave for vacation time, parental leave, or illness. Vacation or other leave cannot be forfeited to reduce training time.

In addition, the following requirements for direct patient responsibility must be met:

(1) At least 24 months of the 36 months of residency education must occur in settings where the resident personally provides or supervises less experienced residents who provide direct care to patients in inpatient or ambulatory settings.

(2) At least six months of the direct patient responsibility on internal medicine rotations must occur during the R-1 year.

 

[Long Dong]

I don't have specific details but I have heard of an FP intern at Harbor switching to categorical IM for PGY-2.

Wuddup arg? Gettin crunked up tonight? Not me, gotta work on my poster for scholarship day.

 

[luckyDO]

If you do a traditional rotating internship, then only 6 months of the year will be counted towards your IM residency

 

[Winged Scapula]

If you do a traditional rotating internship, then only 6 months of the year will be counted towards your IM residency

I thought he was doing a Transitional Year (not the DO TRI)? At any rate, the entire year won't be counted towards an IM residency (hence my post above).

 

[xaelia]

So, in theory, if I am able to do six months of general medicine ward time, that would be sufficient during R1 to make transferring into an R2 position possible?

 

[NotAProgDirector]

Not exactly. You would need your new IM PD to petition the ABIM to give you credit for your prior training. Here's the applicable text from the ABIM policy manual:

Training Completed Prior to Entering Internal
Medicine Residency
The Board may grant credit for some or all of the 12-month
requirement at the R-1 level for training taken prior to entering
training in internal medicine. The program director of an
accredited internal medicine residency program must petition
the Board to grant credit in lieu of standard R-1 internal
medicine training. No credit will be granted to substitute for
24 months of accredited R-2 and R-3 internal medicine training.
(1) Month-for-month credit may be granted for satisfactory
completion of internal medicine rotations taken during a
U.S. or Canadian accredited non-internal medicine
residency program if all of the following criteria are met:
(a) the internal medicine training occurred under the
direction of a program director of an accredited internal
medicine program;
(b) the training occurred in an institution accredited for
training internal medicine residents; and
(c) the rotations were identical to the rotations of the
residents enrolled in the accredited internal medicine
residency program.
(2) For trainees who have satisfactorily completed some U.S.
or Canadian accredited training in another specialty, the
Board may grant:
(a) month-for-month credit for the internal medicine
rotations that meet the criteria listed under (1) above;
plus
(b) a maximum of six months of credit for the training
in a family practice or pediatrics program; or
(c) a maximum of three months of credit for training in a
non-internal medicine specialty program.

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Because UCLA harbor has an IM program, you theoretically should be able to get month-for-month credit for all your IM rotations, but you may get no credit for surgical and other rotations. You should at least get 6 months of credit, but I would not count on a full 12 months of credit.

 

[Winged Scapula]

So, in theory, if I am able to do six months of general medicine ward time, that would be sufficient during R1 to make transferring into an R2 position possible?

Not likely. As pointed out by APD above, your new PD would have to petition the ABIM to accept your previous rotations toward IM training. However, since you would have only done 6 months of IM (for example), you would still likely have to extend your residency. I would imagine that many programs would allow you to start as a PGY2, but would expect that you finish off track after PGY3.

 

[xaelia]

Thank you both for your help; it does appear it may be a challenge, but doable. I would still love to hear from anyone who might have any personal experience with this.