what happens if you don't get a residency?

[MiesVanDerMom]

Is just a medical degree worth anything? That's my $250,000 question.

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[gutonc]

Is just a medical degree worth anything? That's my $250,000 question.

In a word...no.

 

[atsai3]

Is just a medical degree worth anything? That's my $250,000 question.

Plenty of M.D.'s eschew residency and go work for McKinsey and Bain -- and make out like bandits.

-AT.

 

[dragonfly99]

A few people do go into consulting, etc. However, my impression is that it's not so easy to just stroll into places like Kinsey and get a job. I only know of 1 person who did that from my entire time in med school, and this was one of those so-called "Top 10" or "Top 5" med schools where consulting companies would go looking for undergrads and grad students to hire...

 

[peppy]

If it were easy to get decent jobs with a medical degree without going through a residency, nobody would put up with all the crap in residency.

(I say that as someone who is currently post-call yet who keeps getting paged anyway)

 

[LOVE OB]

First you PANIC like I did. Then get regain your composure and get some help, and go through that PAINFUL scramble process (cruel and unusual punishment) with a lot of help from family and friends. THEN you get to start all over again and apply to residency programs the next September... and PRAY!!! Doesn't that sound like fun???

 

[gutonc]

This is usually when drjosephkim shows up and says "there are lots of opportunities out there for non-residency trained doctors." That will be the only thing he will post though...I'm guessing access to such "opportunities" requires a little "opportunity cost."

I agree that if mid-6 figure consulting jobs were so easy to get 50% of grads would be blowing off residency and going that way. The reality is that they are definitely out there...for people whose stats would likely get them any residency spot in any specialty that they wanted.

For the mid/low-tier applicant who fails to match, outside of the scramble, a nice $35K/yr lab tech job is going to be a pretty good deal.

 

[Law2Doc]

Plenty of M.D.'s eschew residency and go work for McKinsey and Bain -- and make out like bandits.

-AT.

Agree with the others that you are badly misusing the word "plenty". There are maybe a couple of folks who go this route each year (out of 17,000 US grads). Most of the time these are folks who could have done the consulting route instead of med school anyhow -- it's not like med school makes you hugely valuable to consulting firms. I sure wouldn't bank on this as a realistic path. Truth of the matter is that being a professional isn't going to be a huge impediment to other careers, but it isn't going to be a huge help either. If it were, more people would probably consider other paths besides residency.

 

[moto_za]

Can't you just do an internship year, then get licensed and practice as a general practitioner?

 

[gutonc]

Can't you just do an internship year, then get licensed and practice as a general practitioner?

Legally? Yes.

Practically and realistically? No.

 

[moto_za]

Legally? Yes.

Practically and realistically? No.

Please explain.

 

[SouthernSurgeon]

Please explain.

Practice groups won't find you a desirable hire.

Insurance companies will be less likyly to include you in your provider network so you will depend on out-of-pocket customers.

Hospitals might not grant you privileges.

Malpractice coverage will cost you more.

 

[gutonc]

Practice groups won't find you a desirable hire.

Insurance companies will be less likyly to include you in your provider network so you will depend on out-of-pocket customers.

Hospitals might not grant you privileges.

Malpractice coverage will cost you more.

Groups will not hire you.

Insurance companies will not include you in their network.

People paying out of pocket will not pay for your poorly trained services (unless you drastically undercut other docs in the area).

Hospitals will not grant you privileges.

 

[Denatured]

Could be like that crazy old GP I read about in a paper a few months back where he was taking 3k from a illegal immigrant to pop out his gall bladder...in his home. Apparently he's been doing it for decades and when he killed that illegal immigrant with too much local anesthetic they just banned him from performing more surgeries.

 

[agill786]

Groups will not hire you.

Insurance companies will not include you in their network.

People paying out of pocket will not pay for your poorly trained services (unless you drastically undercut other docs in the area).

Hospitals will not grant you privileges.

Sorry to revive such an old post. But why won't groups hire you? If you can prove that you are a competent physician by working per diem, won't that suffice. With the rise of NP's and PA's taking over Family Practice/GP roles, it just doesn't make much sense.

I would understand that due to the higher malpractice and lack of privleges at major hospitals, it would be difficult to be reimbursed as much as a Family Practitioner, but still I think that there are still job opportunities in groups, don't you think?

From a patient's perspective, MD/DO Dr. gives me more comfort than seeing some PA, or Nurse. Just my opinion.

 

[smq123]

Sorry to revive such an old post. But why won't groups hire you? If you can prove that you are a competent physician by working per diem, won't that suffice. With the rise of NP's and PA's taking over Family Practice/GP roles, it just doesn't make much sense.

I would understand that due to the higher malpractice and lack of privleges at major hospitals, it would be difficult to be reimbursed as much as a Family Practitioner, but still I think that there are still job opportunities in groups, don't you think?

No, I don't think so. I think you're not thinking this through.

* Almost every single job opportunity for FP positions in group practices that has come to me from recruiters or through the AAFP journal require that you be "Board Certified/Board Eligible." In order to be either, you have to finish a residency.

* Even working per diem, you will still probably need malpractice coverage if you want to work in a group. (I mean, even if you work locums, you still need malpractice coverage.) And most malpractice insurance companies won't cover you if you haven't finished a residency. If you want work solo without any malpractice coverage, well, that's your own [misguided] choice.

* Insurance companies might not pay for your services if you didn't do a residency. And it's a hard sell to convince patients that they should pay cash to see your less experienced self.

 

[Arcan57]

Sorry to revive such an old post. But why won't groups hire you? If you can prove that you are a competent physician by working per diem, won't that suffice. With the rise of NP's and PA's taking over Family Practice/GP roles, it just doesn't make much sense.

I would understand that due to the higher malpractice and lack of privleges at major hospitals, it would be difficult to be reimbursed as much as a Family Practitioner, but still I think that there are still job opportunities in groups, don't you think?

From a patient's perspective, MD/DO Dr. gives me more comfort than seeing some PA, or Nurse. Just my opinion.

Do a search. There are a bunch of threads where this has been debated. The MD that didn't finish training always thinks there is a way to get back into clinical medicine. The attendings who have knowledge of how medicine actually works state that there are not good options available. Mid-levels get dragged into the discussion, usually under the assumption that a failed doctor is still better than a NP/PA. Discussion finishes with the OP yelling at an attending (JAD being the popular choice this quarter) that they are anti-resident and don't care about the OP's plight.

There are definitely markets where cosmetic medicine is not saturated. However, the start up costs for a new business as well as the expense of the training seminars can make it difficult to raise capital since you are already up to your eyeballs in debt. And other than cutting (which does take training), there aren't many procedures that are still exclusive to MDs. This means it is difficult for a legitimate group to justify employing you solely for the letters behind your name.

 

[JackADeli]

...why won't groups hire you? If you can prove that you are a competent physician by working per diem, won't that suffice...

Because, there is risk to giving rope to hang yourself. The proof they want is a diploma showing you have completed a rigorous and complete course of training.

There are enough residency trained doctors looking for jobs or doing locums. If they can not find an adequately trained and/or experienced physciain (i.e. if there are not enough), the group will suck it up and do without a per diem. Groups are not going to offer there patients ~an untrained physician as an adjunct. On top of that, your incomplete or untrained status potentially adds to their overall overhead and may decrease the reimbursements you obtain for the group for the ~same care.

...From a patient's perspective, MD/DO Dr. gives me more comfort than seeing some PA, or Nurse. Just my opinion.

I like Arcan57's answer.

However, my anecdotal experience is that you (agill786) are mistaken in your interpretation of patient views. Patients are a tricky species with interesting thought patterns. I have often seen them refuse residents because, "they are not real doctors" or "they are not trained doctors" in favor of PAs & NPs because, "They are fully trained". I have also seen numerous patienst specifically noting an internet search that was undertaken to find a "fully trained (i.e. boarded) physician" or some less sophisticated individuals coming to the clinic and specifically asking, "are you fully trained...".

 

[nitemagi]

Liability is the biggest issue that pops into my mind. While hanging a shingle after intern year may have been acceptable 40 or 50 years ago, it isn't the community standard anymore. You open yourself for immense lawsuits now practicing unsupervised without training above and beyond med school or intern year.

The exception might be disaster medicine, where they'll take any help they can get. I'd be curious what Doctors without Borders policy would be. Though that's more volunteer work than a lucrative career.

 

[smq123]

The exception might be disaster medicine, where they'll take any help they can get. I'd be curious what Doctors without Borders policy would be. Though that's more volunteer work than a lucrative career.

Even for the US branch of MSF, they specify that one of the professional requirements of physician volunteers is that they have completed a residency. [http://www.doctorswithoutborders.org/work/field/recruitment.cfm]

 

[JackADeli]

Even for the US branch of MSF, they specify that one of the professional requirements of physician volunteers is that they have completed a residency.

http://www.doctorswithoutborders.org/work/field/recruitment.cfm

Link in quote above will work. They also specify:

1. At least 2 years of relevant professional experience
For physicians, completion of residency.
2. No recent gap in clinical experience greater than 2 years
3. Experience supervising, managing, & training others

I think just completing medical school MD/DO or even completing medical school and only part of residency would not meet those requirements. I appreciate we all want to make sure people have minimum care. However, just because ~ "they are poor" or "they are desperate" does not mean lets throw them the the layer just above the bottom of the barrel. The needy are an ~at risk population and we should think twice about sending them care that is likely less then we would accept for ourselves or our families under the rationalization that we are doing good by giving them something "better then nothing".

 

[JackADeli]

This is usually when drjosephkim shows up and says "there are lots of opportunities out there for non-residency trained doctors." That will be the only thing he will post though...I'm guessing access to such "opportunities" requires a little "opportunity cost."...

Also, these non-clinical MD/DO jobs generally look for something ~a little special, i.e. you have a quality MBA/MPH/MMM/PhD or something. Thus, these do not generally represent the people who had difficulty matching.

So, maybe you can still reach one of these, but it may require spending more cash to obtain some sort of additional degree!