are preliminary residencies limited to PGY1 only?

[pro1212]

hi there
I am an IMG and preparing for USMLE , my question is about the preliminary and transitional year residencies

Are they limited only for PGY1 ? or can PGY3 be illegible for application ?

IF it's possible for PGY3 to apply to these programs , do they decrease my chances in the next match ( as i will be older graduate )?

Is it beneficial to go for these residencies or to aim for the full 3 y or more residencies ?

sorry for being nonspecific in my post , but that's due lack of detailed information about residencies

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[gutonc]

hi there
I am an IMG and preparing for USMLE , my question is about the preliminary and transitional year residencies

Are they limited only for PGY1 ? or can PGY3 be illegible for application ?

IF it's possible for PGY3 to apply to these programs , do they decrease my chances in the next match ( as i will be older graduate )?

Is it beneficial to go for these residencies or to aim for the full 3 y or more residencies ?

sorry for being nonspecific in my post , but that's due lack of detailed information about residencies

Wut?!

If you're already a PGY3, why do you need a PGY1 spot?

 

[Law2Doc]

hi there
I am an IMG and preparing for USMLE , my question is about the preliminary and transitional year residencies

Are they limited only for PGY1 ? or can PGY3 be illegible for application ?

IF it's possible for PGY3 to apply to these programs , do they decrease my chances in the next match ( as i will be older graduate )?

Is it beneficial to go for these residencies or to aim for the full 3 y or more residencies ?

sorry for being nonspecific in my post , but that's due lack of detailed information about residencies

Agree with gutonc -- some critical part of your story is missing such that it's hard to advise you. If you are already several years into a US residency but have left/not had your contract renewed, and are planning to reapply for the match to go into something else, just get a license and do a year of "moonlighting" type work in some urgent care someplace. You will earn more and work less than if you were an intern again. The only thing you accomplish by doing a prelim year is using up another year of funding eligibility. But sure, there is no rule prohibiting you from applying for a prelim year late in your training.

 

[Buzz Me]

I'm confused. You're a PGY-3, looking for a prelim PGY-1 spot in order to "increase your chances" at another residency?

 

[pro1212]

i meant by PGY3 that i graduated since 3 years in my home country , i still did not get involved in any residency program in the US

i asked about if i am an old graduate when applying to ERAS , if i graduated since 3 years . I used PGY3 as a term for that , i did not know that's a term used for resident already

if i did not get a match , can i benefit from matching for transitional or preliminary residencies then in the next year apply for matching in the residency i want like IM for example

that's what i meant , sorry by confusing you by using some terms i am not familiar with

Mohammad Abd-al-maaboud
Egypt

 

[gutonc]

i meant by PGY3 that i graduated since 3 years in my home country , i still did not get involved in any residency program in the US

i asked about if i am an old graduate when applying to ERAS , if i graduated since 3 years . I used PGY3 as a term for that , i did not know that's a term used for resident already

if i did not get a match , can i benefit from matching for transitional or preliminary residencies then in the next year apply for matching in the residency i want like IM for example

that's what i meant , sorry by confusing you by using some terms i am not familiar with

Mohammad Abd-al-maaboud
Egypt

Then the answer to whether a "PGY3" can apply is yes. Your prior training outside the US is irrelevant. As far as any residency program cares, you will be a PGY1 when you start training, even if you've practiced in your home country for 20 years.

As for whether or not a prelim spot would help you out, the answer is, "it depends." Do not aim for prelim spots (unless you're trying to get into an advanced residency like Gas, Neuro, PMR, etc) but if you are unsuccessful in the Match, a prelim IM spot would be better than nothing. A prelim surgery spot on the other hand would be worse than nothing.

 

[Law2Doc]

...A prelim surgery spot on the other hand would be worse than nothing.

Well, I'd say "worse than nothing" is a bit strong -- a lot of IMGs come up short when looking for a spot in the prematch, scramble, etc. because they have no decent track record of performance in US clinical settings, and don't appreciate that US residency directors see a long career in a foreign country as meaningless if you didn't cap it off with a year of clinical experience in the states in some fashion. So if this was a concern about you, at least completing an intern year, even if it's surgery, will allow a PD to write you a letter saying you conducted yourself professionally and got along with patients and your english was adequate and you weren't a drag on the team (assuming all this is true). Will that necessarily lead to another residency looking at you? Maybe not, but I think you lifted yourself to a spot slightly better than nothing (which was your starting point).

And OP, you are not a PGY anything until you start your US residency. As gutonc indicated, you could have worked 20 years as faculty at the best foreign teaching hospital, but to practice in the US you start at PGY-1 if you can match into something. There are more than a few foreign trained doctors driving cabs in the states.

 

[Nellyakgo]

The only thing you accomplish by doing a prelim year is using up another year of funding eligibility.

Is there a per person (per resident) limit to the number of years of funded training - i.e. residency - one may get?

And I presume fellowships are not in the same pool.

 

[gutonc]

Is there a per person (per resident) limit to the number of years of funded training - i.e. residency - one may get?

And I presume fellowships are not in the same pool.

Yes, and yes fellowships count. But it's not as straightforward as you probably think.

The amount of funding you get is based on the length of the first categorical residency you match into. So if you match into IM or Peds, you get 3 years, Path, OB or Psych gets you 4, Gen Surg and Surgical subspecialties = 5. But any prelim training counts against that time. So if you did, say, a Surg prelim year and then match into a GS program after that (and don't have to repeat a year), or into an Advanced specialty, you're golden. But if you do that prelim surg year then match into IM or something, you lose a year of funding.

But...your funding doesn't go to 0 or anything like that. It goes from 100% DME (salary, benefits, etc) + 100% IME (how they pay academic attendings, administrative and other costs) to 50% DME + 100% IME after you use up your funding. The total amount varies between programs but it falls in the 70-80% total funding range. All fellowships are funded this way.

 

[Nellyakgo]

Yes, and yes fellowships count. But it's not as straightforward as you probably think.

The amount of funding you get is based on the length of the first categorical residency you match into. So if you match into IM or Peds, you get 3 years, Path, OB or Psych gets you 4, Gen Surg and Surgical subspecialties = 5. But any prelim training counts against that time. So if you did, say, a Surg prelim year and then match into a GS program after that (and don't have to repeat a year), or into an Advanced specialty, you're golden. But if you do that prelim surg year then match into IM or something, you lose a year of funding.

But...your funding doesn't go to 0 or anything like that. It goes from 100% DME (salary, benefits, etc) + 100% IME (how they pay academic attendings, administrative and other costs) to 50% DME + 100% IME after you use up your funding. The total amount varies between programs but it falls in the 70-80% total funding range. All fellowships are funded this way.

No it's not straightforward, is it. What an understatement. I had to read your post three times to wrap my head around it and I still think I didn't totally get it. I also had to google for DME and IME.

Can you please explain (sorry!) why you would lose 1 year of funding if you did 1 year of prelim surgery then match into IM?

Also you wrote "any prelim training counts against that time" Against what time? Against the total years of funding one would get?

So what determines [how many years of funding one gets ] to start with? If I match into a transitional year or prelim year, it means in the 2nd year I could go -theoretically - anywhere. So how is my funding amount determined at the beginning of that 1st year?

Thanks!

 

[Smurfette]

No it's not straightforward, is it. What an understatement. I had to read your post three times to wrap my head around it and I still think I didn't totally get it. I also had to google for DME and IME.

Can you please explain (sorry!) why you would lose 1 year of funding if you did 1 year of prelim surgery then match into IM?

Also you wrote "any prelim training counts against that time" Against what time? Against the total years of funding one would get?

So what determines [how many years of funding one gets ] to start with? If I match into a transitional year or prelim year, it means in the 2nd year I could go -theoretically - anywhere. So how is my funding amount determined at the beginning of that 1st year?

Thanks!

Not exactly. If you do a prelim surgery year, it will count for surgery and surgical subspecialties. But not IM. So If you decide to go into IM after a prelim surgery year, you get 3 years of funding, one of which you already used for your prelim year. And you will still have to do three years of IM (since your prelim year won't count for IM), meaning that your last year of IM will not be completely funded.

Similarly, a transitional year or medicine prelim year will not count if you go into a surgical subspecialty (exception ophtho, anes), so you would have to do an intern surgery year, and your TY/IM prelim year will use one of your years of funding. Meaning your last year of a surgical specialty will not be fully funded.

If you do a surg prelim year and go into a surgical field, or a IM prelim year and go into IM, or a TY and go into a field that requires a TY, your years of funding are covered provided you subsequently enter as a PGY2. If you repeat your intern year because your prelim year doesn't count or you didn't match into an advanced spot, however, you lose a year of funding. In other words, your ultimate specialty matched into determines the total number of years of funding for residency. Fellowship will give you more years of funding, once you match.

 

[gutonc]

Fellowship will give you more years of funding, once you match.

No. Fellowships are funded at the 50/100 level as they are beyond the initial "funding clock."

But otherwise I loved your explanation of prelim/TY stuff, much clearer than mine.

 

[Nellyakgo]

Thanks to both of you.

When you say funding becomes e.g. 50/100, I'm presuming this means the institution will only receive 50% of whatever the costs of that position would be, including the resident/fellow's benefits package. Is that right?

So in the above case, does the resident/fellow receive only 50% of his/her benefits, or does it mean the institution still has to pay the full benefits and therefore in order not to have to make up the difference from its internal pockets, it prefers to take someone who still has 100% of funding eligibility?

 

[Smurfette]

Gutonc--Oops....didn't do a fellowship so I didn't know that! Thanks for the clarification.

Nellyakgo--it does not mean you only get 50% benefits, it just means the program only gets 50% funding and has to fund the rest themselves. Some residency programs *do* prefer to take people with their full funding left, but if you are a *good* candidate that they think will fit in at the program, this should not be a *major* barrier to overcome (especially if it's just one year of decreased funding). Plenty of people find positions despite the funding issue. But it is a point not in your favor...just not an insurmountable one. Make sense?

Also, if all fellowships are funded at 50%, this would even the playing field at the fellowship level as everyone has the same amount of funding.

 

[gutonc]

Thanks to both of you.

When you say funding becomes e.g. 50/100, I'm presuming this means the institution will only receive 50% of whatever the costs of that position would be, including the resident/fellow's benefits package. Is that right?

So in the above case, does the resident/fellow receive only 50% of his/her benefits, or does it mean the institution still has to pay the full benefits and therefore in order not to have to make up the difference from its internal pockets, it prefers to take someone who still has 100% of funding eligibility?

Please read the whole thread...or at least my posts.

The 50/100 refers to 50%DME/100%IME funding vs. 100/100. DME is what they pay/benefit you. IME is the "cost of doing business" for academic medical centers, similar to indirect costs on NIH grants (which are generally 40-80% of the amount that gets paid to the grantee to do the work). The difference in total Gummint dollars to the institution varies but is in the 70-80% range for a 50/100 position vs. a 100/100 position.

And yes, this is why, given 2 equally qualified applicants, the one with full funding eligibility will get the spot over the one with more limited funding. They can't pay you less than your co-resident with full funding...they have to decide if they're willing to pay extra (although not that much extra) for you if you have incomplete funding.