What if you change your mind after completing your residency?

[nerv12]

If you complete your residency in family medicine and say after a year or two you change your mind and want to do radiology, do you still have to do the radiology residency? so is it like the same process all over again? apply to carms/nrmp and wait for the match/interview etc....do you have to take the board exams again? oh and do program directors take it easy on you since you're a real/certified doctor now?

was just wondering if people actually do change their minds and do you think they actually have the option to switch their medical profession with all those student loans under their belt or would they want to take the load off and then try something else maybe?

appreciate any response!

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[phospho]

If you complete your residency in family medicine and say after a year or two you change your mind and want to do radiology, do you still have to do the radiology residency? so is it like the same process all over again? apply to carms/nrmp and wait for the match/interview etc....do you have to take the board exams again? oh and do program directors take it easy on you since you're a real/certified doctor now?

was just wondering if people actually do change their minds and do you think they actually have the option to switch their medical profession with all those student loans under their belt or would they want to take the load off and then try something else maybe?

appreciate any response!

I'm pretty sure that yes, you have to do a whole residency again. I was reading this thread earlier today which I think in a way answers your question.

FP switch to Gen Surg.

 

[Gallix23]

I believe that you do in drastic changes like that - like FM to Rads.

However, I believe the residency may be shorter for a surgeon who wishes to switch to say interventional radiology, because he clearly doesn't need that one year of general surgery residency.

 

[nerv12]

thanks for your response and the thread, there's a lot of useful info there.

question regarding the funding, the program where you are doing your residency provides the funding right? or in other words, your resident salary? its around $50,000 a year I believe right?

 

[Gallix23]

thanks for your response and the thread, there's a lot of useful info there.

question regarding the funding, the program where you are doing your residency provides the funding right? or in other words, your resident salary? its around $50,000 a year I believe right?

I believe the hospital that you are doing your residency at provides the salary. And I think that 50 grand is the average resident salary, but you can earn more or less depending on the place you're working at.

 

[Rendar5]

It kind of depends on what you're switching form and to. A lot of residencies require you to do a 1 year medical or surgical internship before you go into ur field. If you've already completed that one year you can just go straight to the other field. Radiology does require a prelim year so FP to radiology would have you enter directly into the radiology residency I believe. Now if u're going from one field to another that do not share the same PGY-1 requirement then u'd prolly have to do that whole year.

Keep in mind that switching major specialities may just entail doing another 1-2 year fellowship if they share the required residency. Such as being a nephrologist than going into GI.

As for money, you are paid as a resident. You are a worker with a salary. The pay drastically chagnes from one hospital to the next, and are gnerally similar is similar areas. I'll be around $52K before taxes next year. That is in Long Island. If I did the same field but were in the midwest, I'd probably be looking at $40K a year. So net pay after basic living expenses is roughly equivalent for different locations.

 

[MilkmanAl]

Your salary as a resident comes from Medicare, for the record.

 

[Depakote]

It kind of depends on what you're switching form and to. A lot of residencies require you to do a 1 year medical or surgical internship before you go into ur field. If you've already completed that one year you can just go straight to the other field. Radiology does require a prelim year so FP to radiology would have you enter directly into the radiology residency I believe. Now if u're going from one field to another that do not share the same PGY-1 requirement then u'd prolly have to do that whole year.

Keep in mind that switching major specialities may just entail doing another 1-2 year fellowship if they share the required residency. Such as being a nephrologist than going into GI.

As for money, you are paid as a resident. You are a worker with a salary. The pay drastically chagnes from one hospital to the next, and are gnerally similar is similar areas. I'll be around $52K before taxes next year. That is in Long Island. If I did the same field but were in the midwest, I'd probably be looking at $40K a year. So net pay after basic living expenses is roughly equivalent for different locations.

^agreed.

I've heard that if there is some cross over in the training, you may receive some credit towards the actual residency (not just the intern/prelim year).

An example would be someone who did a year of an OB residency and switched into family medicine. They may get credit for deliveries (and similar procedures) they performed as an OB towards their FP OB requirement. It's very situational specific.

 

[Chonson]

From what I've gathered, Medicare pays a hospital ~$100k for each year of the original residency that a physician matched into. The hospital pays the resident roughly half that and pockets the rest.

If you matched into FP, Medicare will only pay for 3 years of your training. Period. If you were to go back for a different residency, the hospital would have to foot the bill (your salary, as Medicare is not reimbursing them anymore) directly out of its own pocket.

I may be wrong, though...

Edit: I was wrong. See this post for details about funding: http://forums.studentdoctor.net/showpost.php?p=7963134&postcount=8

 

[DLi]

Knowing that this thread is posted in the high school forum, I think it's best to not change your mind after your residency. When you could be making 200K a year, why change you mind to make a measly 50K?

 

[BigRedBeta]

Knowing that this thread is posted in the high school forum, I think it's best to not change your mind after your residency. When you could be making 200K a year, why change you mind to make a measly 50K?

While that makes the most sense financially, most people want to be happy doing their job. As most third and fourth year medical students will tell you, it's difficult to pick a specialty with so little exposure to all the possibilities, and it's nearly impossible to know exactly what life is going to be like as an attending in that field. Throw in being lured by dollar signs, changing family dynamics (most residents are in their late 20's so there are a lot of marriages, children and even a few divorces happening), and the ever important lifestyle, what seemed like the "right" choice at the time can end up being seriously wrong.

It's also not uncommon for older physicians to develop new interests or simply get bored with what they've been doing for 15 years. The statistics for non-medical types say the average person in our generation will have 5-7 career changes (not jobs - careers, as in different fields) so why should being a physician mean that you're immune from wanting to do something different? It just so happens that because of the system, changing specialties requires the cut in pay.

And it does happen. I know LOTS of residents who have switched fields during residency, but also a couple of older physicians who switched too. One was a 55 year old ER attending at a University medical center who decided he wanted to do peds GI. He took a huge paycut and a sweet schedule for a 6 year program that was going to require a move (the medical center in question did not have any peds fellowships).

 

[docB]

This is a pretty important and recurrent topic. I have found that students are very resistant to the fact that as you grow older the decisions you make limit your future options. This is particularly true in medicine but is true in life as well. For example med school vs. vet school, get married or not, have kids or not and so on. The simple fact is that if you go to med school you can't find a way to be a vet on the side.

The choice of residency is a huge decision. While it is possible to change residencies or complete a residency and then go back and do a second residency it is not very common. I would estimate (code for I'm guessing but still) that fewer than 10% of doctors switched or did a second residency.

There are various barriers to switching. And these barriers go way beyond whether or not you'll get credit for what you've done so far.

Wanting to switch makes you look flaky. You may have the best motive in the world but it's hard to sit in that interview chair and proclaim a long standing, never ending devotion to specialty X when the PD knows you are bailing out of specialty Y.

Funding is a huge issue. When you match you are allocated a given amount of residency funding based on the years of your matched residency. If you want to switch and the residency you want to go to takes longer than you have funding for you are asking that program to take a financial hit for you. That's usually a tough sell. For example if you match into a 3 year IM residency and you decide to switch after 1 year to a 5 year surgery residency you have 2 years of funding left and 5 to go (in this example you wouldn't get credit for the initial year) so any program that takes you will be out for 3 years when they could have had a funded resident. You see why it's not that common.

On the other hand it's easier to go from a longer residency to a shorter one. I know a guy who did 3 years of a 6 year surgery residency. He switched into anesthesia with 3 years of funding left. They did give him credit for 1 year and he had to do 3 more but he was funded for them so it worked out. Like I said, possible, not common.

In short, if possible at this point, I ditto what DLi said. It's best not to change residencies although not because you might make less in the new specialty.

Don't get freaked out though. Remember that you'll have a exposure to the various specialties during med school before you have to choose. You get a little exposure during 2nd year and a lot on rotations during your 3rd year.

 

[DLi]

BigRedBeta does put a very good argument for changing residencies, and it's true that one could want another specialty better than another. Since this is in the high school forum, I'd like to remind the OP that you have 4 years of undergrad and 4 years of med school to figure out the field you want to practice in.

 

[nerv12]

Thanks for all your responses again, and especially DocB for that detailed and informative essay lol. I really appreciate it...

But yeah I still have a lot of time to decide but I was just wondering how things works out if one does decide to change their mind.

Thanks again!

 

[Winged Scapula]

I believe that you do in drastic changes like that - like FM to Rads.

However, I believe the residency may be shorter for a surgeon who wishes to switch to say interventional radiology, because he clearly doesn't need that one year of general surgery residency.

Having had a friend who did just this (general surgeon back to radiology residency followed by IR fellowship), he was able to skip the Prelim Med/Surg year but otherwise had to complete the entire Rads residency.

As for the process, yes, one would generally go back through the match to find a position.

Board exams have to be taken in the new specialty as do in-training exams. I don't know if PDs would "take it easier on you since you are a real/certified doctor". The expectations would perhaps be higher. In the case of my friend above, the surgeons certainly were easier on him as a Rads resident because they felt like he knew what he was talking about much more than any other rads resident at the same level. So there's that.