Which specialties can't accept a transitional year as an intern year?

[RussianJoo]

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Just wondering what specialties won't accept a transitional year as a requirement for an intern year? I know that Derm, Radiology, and Anesthesia will.

 

[BlondeDocteur]

Will: Derm, Rads, Anesthesia, Rad-Onc, PM&R, Ophtho, Occupational Med

Won't: Neurology, Genetics, all categorical residencies (obviously)

Not sure: Advanced EM programs

 

[RussianJoo]

Thank you Blond Docteur, you're my Hero!

 

[ftn]

many neuro programs do accept transitional year as PGY1.

 

[PeepshowJohnny]

many neuro programs do accept transitional year as PGY1.

Yeah, I met some neuro people at some of my TY interviews. The gist is that they PREFER Internal Medicine Prelims, but most TY's qualify or can be modified to qualify.

The other issue is, since neurology is such a noncompetitive specialty, I imagine many of their applicants may have trouble getting interviews vs. the radiology/rad onc/derm crowd.

 

[BlondeDocteur]

I think you need at least 9 months of internal medicine for your neuro prelim. I didn't know TYs could be modified to that degree!

 

[Taurus]

The structure of the TY depends on the specialty you're going into. For example, rad onc requires 9 inpatient months while rads is 6. Your TY PD will work with you to make sure you satisfy the requirements for your field.

 

[dragonfly99]

I didn't think neuro programs accepted TY's either. You have educated me.
I'm pretty sure the neuro program at the hospital where I trained doesn't accept them, though...in fact, most of their neuro residents did internship at our hospital in IM.

 

[Ludicolo]

The structure of the TY depends on the specialty you're going into. For example, rad onc requires 9 inpatient months while rads is 6. Your TY PD will work with you to make sure you satisfy the requirements for your field.

Correct. 9 months of IM for rad onc, 8 for neuro, 6 for PM&R and rads, etc. Or some combination of rotations (IM, peds, EM, FM, surgery) that provides a similar duration and scope.

Also - if I'm not mistaken - these don't have to be all general inpatient IM months. Medical subspecialties like ID, rheumatology, and cardiology count. Ambulatory rotations count.

 

[Law2Doc]

...
The other issue is, since neurology is such a noncompetitive specialty, I imagine many of their applicants may have trouble getting interviews vs. the radiology/rad onc/derm crowd.

That was my impression as well. If you aren't ROAD or Radonc, your odds of getting a TY aren't usually good enough to even worry about the issue. The TY interviews tend to be more competitive than the most competitive specialties because you have the best of each vying for them.

 

[danzman]

That was my impression as well. If you aren't ROAD or Radonc, your odds of getting a TY aren't usually good enough to even worry about the issue. The TY interviews tend to be more competitive than the most competitive specialties because you have the best of each vying for them.

How does this work in the DO world? My understanding is that pretty much any and everybody can get a TY and then set themselves up for a competitive spot the next year. At my school they told us this is the best thing to do if you want to go into Derm or Ortho but don't have the numbers. If you do an osteopathic TY can you then apply for an allo pgy2 spot? What if you didn't want a competitive spot, say something like IM or ER, but you didn't know for sure and thus did a DO transitional year but then decided for whatever reason (location etc') that you wanted an allopathic IM or psych spot? Would you have to start over? Would they even consider you?

 

[RussianJoo]

How does this work in the DO world? My understanding is that pretty much any and everybody can get a TY and then set themselves up for a competitive spot the next year. At my school they told us this is the best thing to do if you want to go into Derm or Ortho but don't have the numbers. If you do an osteopathic TY can you then apply for an allo pgy2 spot? What if you didn't want a competitive spot, say something like IM or ER, but you didn't know for sure and thus did a DO transitional year but then decided for whatever reason (location etc') that you wanted an allopathic IM or psych spot? Would you have to start over? Would they even consider you?

im and psych don't have a requirement for a prelim year or transitional year so yes you would start all over if you went into IM or Psych.

 

[danzman]

im and psych don't have a requirement for a prelim year or transitional year so yes you would start all over if you went into IM or Psych.

The way it was presented to me was that if your grades were sub par you could do an osteopathic TY and it would make you more competitive the next year for allo spots and DO spots, even those that had no prelim/transistional year requirements. So would someone who couldn't match into an allo or a DO spot (again for whatever reason) stand a better chance at picking one up the next year if they did a transitional year? I was told that this was a big plus to the DO students because its so hard for MDs to get transitional year spots and pretty easy for DOs to get them. How would PDs view your application if you did a DO transitional year but then tried to get a PGY2 allo spot, or even start over in IM psych ER etc'? Again, at my school we were told that this was almost a must to get a competitive spot.

 

[BlondeDocteur]

I think you are confusing the Osteopathic Traditional Rotating Internship (TRI) with the allopathic Transitional Year.

 

[danzman]

I think you are confusing the Osteopathic Traditional Rotating Internship (TRI) with the allopathic Transitional Year.

I was told that they were essentially the same thing. That doing a traditional rotating internship (DO) was much like another 3rd year of medical school, where you did more rotations in various different general specialties. I was told that this was just the DO version of the allopathic transitional year, and that it could act as your pg1 year for things like gas, but most people used it to pad their aplications to more competitive residency or for the ability to practice in those certain states that require it. Am I way off???😕

 

[RussianJoo]

There definitely might be licensing issues if you don't complete the full allopathic residency
i.e. if you do a DO transitional year and then sign a contract to start at a pgy2 year in an IM allopathic program. Also I know for allopathic programs that medicaid only pays for your first residency (or something like that) so an IM program is 3 years, but if you jump around and have to complete it in 4 years then the last year of your residency madicaid won't pay the hospital to pay you so the hospital will have to pay you out of pocket. if i am not mistaken so you're risking that as well by doing a DO tranisional year. Just apply straight into IM if you want it. IM is very easy to get, there are unfilled spots every year. Also you're a DO, plenty of hospitals would rather take you over an FMG.

 

[danzman]

There definitely might be licensing issues if you don't complete the full allopathic residency
i.e. if you do a DO transitional year and then sign a contract to start at a pgy2 year in an IM allopathic program. Also I know for allopathic programs that medicaid only pays for your first residency (or something like that) so an IM program is 3 years, but if you jump around and have to complete it in 4 years then the last year of your residency madicaid won't pay the hospital to pay you so the hospital will have to pay you out of pocket. if i am not mistaken so you're risking that as well by doing a DO tranisional year. Just apply straight into IM if you want it. IM is very easy to get, there are unfilled spots every year. Also you're a DO, plenty of hospitals would rather take you over an FMG.

I totally understand what you are saying about IM and getting a spot. But I was under the impression that many DO's did the OTR year as a PGY1 in order to match into a more competitive spot later on (the examples I was given were derm/ortho/gas). I was under the impression that this was funded as a stand alone year if you are a DO because a few states force DOs who do an osteopathic residency to do one, and did not count towards your residency. What I don't understand is if someone did an OTR, would that lock them into doing a DO residency due to funding or other reasons? If that is the case, then it would be important to understand that by doing an OTR, you would be forced into an osteopathic program. Not that its a bad situation, but that is not how I it was explained to me.

 

[BlondeDocteur]

I can't comment on the funding issues at all, but it is always possible that your school (and the AOA in general) wants to increase the percentage of students who do the TRI/ enter osteopathic training, for reasons entirely independent of helping you match into very competitive non-primary care residencies.

 

[danzman]

I can't comment on the funding issues at all, but it is always possible that your school (and the AOA in general) wants to increase the percentage of students who do the TRI/ enter osteopathic training, for reasons entirely independent of helping you match into very competitive non-primary care residencies.

This may very well be the case, and it would not be a surprise. But would a student who did a TRI be unable to match into an allo spot? Obviously this is a broad question that has many variables, but I was led to believe that allopathic programs WANTED DOs that had done an osteopathic TRI.

 

[RussianJoo]

I don't think anyone of us knows the answer to this. I would suggest calling the AOA or your school advisor with this q.

 

[dragonfly99]

danzman,
If you want to do allopathic IM, you should just go straight in and do it. You don't want to do two intern years, trust me...that is unless your state requires a DO internship for all DO's.

As far as a DO transitional year making you more competitive if you don't have the stats, perhaps your school was talking about more competitive for DO orthopedic or derm residencies? For allopathic derm and ortho residencies, the odds of getting one of those as a DO student would be vanishingly small, even if you are in the top of your class. The allopathic med schools are graduating tons of students who want those residencies too, and even for students who are allo students, to get one of those 2 residencies you pretty much have to be top 1/3 of your class, high USMLE scores and usually have done research, etc.

I share blond doc's concerns about your school perhaps wanting to push the DO TY for their own reasons. I'd be careful and do your own research on this.

I think TY's (whether DO or allo) are a cool concept because they give someone more time to experience different specialty areas, etc. However, the way the allopathic training system is set up it really doesn't benefit the trainee much to do one, in terms of helping a trainee "match better" for PGY2. This is because you pretty much have to simultaneously apply to PGY1 and PGY2 as an 4th year allo student. So you'd already be matched into some specialty for PGY2 even if you were doing a TY and found something you liked better and were good at. Also, pretty much all the allo TY's are taken by people who've matched into competitive stuff like rads and derm, so it's impossible for your average undecided-about-specialty med students to get a TY anyway.

Usually if an allo student couldn't get into his/her specialty of choice, the person might do a prelim surgery or prelim medicine year to try to get some experience and perhaps prove oneself to the higher-ups. Sometimes this works out, and sometimes not. Sometimes students trying to match into subspecialty surgery will have prelim surg spots ranked as a backup...at least if they don't get ortho/plastics/urology, they have a job lined up and can hope to try for an upper lever general surg or subspecialty surg spot again the next year.

I don't know anything about the funding issues.

 

[NotAProgDirector]

Agreed with above.

A TRI will not help much with getting an allo spot. If you didn't generate the grades / board scores in med school, a TRI will not make you more competitive in the allo match.

You will certainly get zero credit for your TRI in the allo system (unless you go to a dual accredited program)

 

[danzman]

Wow. Well thanks to everyone for all the advice.

 

[triathlondoc12]

Old thread I know, but if rads only requires 6 months of IM (including EM, etc) why wouldn't my psych intern year be eligible to count as a first year? My program has 4 months of IM and 2 months of neuro

 

[colbgw02]

Well, it's 6 months of inpatient, not necessarily IM, and I don't think EM counts as inpatient. I've found radiology's RRC internship requirements online via Google, so I'm sure you can read the specific language if you'd like to know for sure if your program would count.

 

[NotAProgDirector]

Radiology tends to be very tolerant of PGY-1 requirements. A psych PGY-1 might be fine. You can contact them to ask.

 

[triathlondoc12]

Thanks! That's wonderful to hear that some are tolerant. 🙂