"Shared residency" and "part time residency"

[Poetic Silence]

Hello,

I don't fully understand the concepts of "shared" and "part time" residencies. I understand that a shared residency is when two people fill one resident slot and work as one resident, allowing both to work part time. What I don't understand is whether or not this lengthens the residency. Let's say you share a residency slot in family medicine. You and your partner work 50/50, right down to the dotted line. Does this mean a 3 year residency (including internship) is stretched into six years? How do part time residencies work? Is it possible to do a part time or shared residency in a surgical specialty?

I'm just really curious how all of this works. I tried both SDN and Google searches with no luck. If there's a topic that can answer my questions already in existence, then by all means, please link me. If you do decide to link me to an existing topic, please check back here in case any more questions arise.

I appreciate your help.


Poetic Silence

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[Law2Doc]

Hello,

I don't fully understand the concepts of "shared" and "part time" residencies. I understand that a shared residency is when two people fill one resident slot and work as one resident, allowing both to work part time. What I don't understand is whether or not this lengthens the residency. Let's say you share a residency slot in family medicine. You and your partner work 50/50, right down to the dotted line. Does this mean a 3 year residency (including internship) is stretched into six years? How do part time residencies work? Is it possible to do a part time or shared residency in a surgical specialty?

I'm just really curious how all of this works. I tried both SDN and Google searches with no luck. If there's a topic that can answer my questions already in existence, then by all means, please link me. If you do decide to link me to an existing topic, please check back here in case any more questions arise.

I appreciate your help.


Poetic Silence

Yes, in theory if you only work half the time, you only fulfill half of the year's obligations, thus your residency would be twice as long. Never seen it done for an entire residency though, and most PDs aren't going to be amenable to this kind of flex option.

 

[gutonc]

Yes, any period of time that you share will need to be doubled in order to complete your training. Places tend not to advertise that they accept shared positions but it's not that rare, especially in FM and some IM programs.

My program had a couple of shared positions. One was a couple that entered that way and is in year 4 of 6, the other was a couple that had a kid at the end of intern year and chose to share the spot the rest of the time. So they did 5 years total. All of these people are planning/doing general IM, not specializing.

 

[michaelrack]

think this type of arrangement is also possible in a few psych programs. Not done in surgery.

 

[jdh71]

I assume they do not "share" benefits though? Do they only get paid for the months they work? Or do they take a half salary every month?

 

[Law2Doc]

I assume they do not "share" benefits though? Do they only get paid for the months they work? Or do they take a half salary every month?

They get a half a salary for half the hours. Might not qualify for benefits at all at many hospitals unless they meet the requirements of a full time employee.

 

[gutonc]

I assume they do not "share" benefits though? Do they only get paid for the months they work? Or do they take a half salary every month?

The only people I know who have done this are married couples. So they get the same salary and benefits of one resident. I don't know for certain but I would assume that for administrative purposes they just give full benefits to one of the people.

 

[jdh71]

They get a half a salary for half the hours. Might not qualify for benefits at all at many hospitals unless they meet the requirements of a full time employee.

The only people I know who have done this are married couples. So they get the same salary and benefits of one resident. I don't know for certain but I would assume that for administrative purposes they just give full benefits to one of the people.

Interesting.

 

[Poetic Silence]

This was very helpful information. I appreciate it.

Here's another question, are part time or shared residencies options available in pediatrics? Oh, and are Osteopathic residencies more likely to allow shared or part time options than Allopathic programs?

Just an after thought question. I'm still pre med, so I can look into both pathway options.

But hey, thanks again.

 

[Law2Doc]

This was very helpful information. I appreciate it.

Here's another question, are part time or shared residencies options available in pediatrics? Oh, and are Osteopathic residencies more likely to allow shared or part time options than Allopathic programs?

Just an after thought question. I'm still pre med, so I can look into both pathway options.

But hey, thanks again.

First, as a premed you have to realize that circumstances are going to change in the many years it will take before you are a resident. Rules may change. Slot numbers and availability of flex options will change. And you don't even know what field you will want yet. Most med students change their minds at least once during med school, and just because you think you might like peds now doesn't mean you are still going to like it after you have tried it on for size. You may come out of your peds rotation realizing that it isn't something you want to do for a living. Or you may fall in love with pediatric orthopedic surgery or child psych some other kid oriented path. Or something totally different you never thought you would like. So I wouldn't worry about residency options just yet.

Second, in terms of allo, whether these options are "available" is totally up to the facility and program director. It's not like these shared residencies are created and available. Someone has to want you, and another person in similar circumstances, bad enough to allow some modification to the normal rule. Meaning it would rather have two good residents part time than do the easier option of getting one person full time. There are administrative and other costs associated with having multiple people, and it impacts things like the inservice exam when folks are only part timers (and thus get benefit of only half the teaching/training, which can impact the scores adversely). Plus it impacts what you do with things like benefits, it potentially doubles the medmal insurance costs, and so on. So it's not the norm, although it happens.

Nobody can tell you what will be "available" because shared spots are never really available until someone asks for it. For the same reason, nobody is going to be able to tell you whether this is more common in osteo versus allo residencies; I would assume that since there are so many times more allo residency slots as osteo there are probably more shared residents in allo, although as a percentage, who knows. These spots aren't advertised or publicized -- they are created on an as needed basis at the whim of the residency higher-ups and so there is no way to compare or estimate "availability".

Honestly, when you get to residency, you may find that it makes more sense to plow through and finish up your obligation in 3 years rather than drag it out for 6. There may be career implications for not doing it at the normal pace. It may preclude fellowship options. Rules may change in the longer interval, creating additional licensing/professional obligations for you that you might have avoided had you finished faster and been grandfathered in. Often ripping a bandaid off fast is the smarter option than easing it off slowly and feeling every inch independently.

 

[NotAProgDirector]

Note that you can search for this on FREIDA. Choose "optional criteria" and under "Employment policies and benefits" choose "Part time / Shared position".

 

[DrRoss2013]

Hi,
I am looking for a partner for a shared residency in Int med in NJ for 2013 match...Please post or PM me if interested. Thanks

 

[mlw03]

what the heck is a shared residency?

 

[Poetic Silence]

what the heck is a shared residency?

That question has already been answered in this thread. Read thru it and find out.

 

[dragonfly99]

Have only heard of this being done in fp and occasionally IM. I'm sure there are other specialties where it has been done. In general it's not very convenient for the program. I don't think surgeons would ever do this, but I guess never say never...there would be many problems with doing this for surgery or any specialty that involves a lot of invasive procedures (cardiology subspecialty, for example).

 

[Law2Doc]

Have only heard of this being done in fp and occasionally IM. I'm sure there are other specialties where it has been done. In general it's not very convenient for the program. I don't think surgeons would ever do this, but I guess never say never...there would be many problems with doing this for surgery or any specialty that involves a lot of invasive procedures (cardiology subspecialty, for example).

It wouldn't make much sense in surgery because half a week where the hours ended up above 80 would still be full time hours and the program could end up obligating itself to benefits for another full time employee.

Also I think readers have to be aware that these sharing deals are very very rare, and generally only created by a PD to not lose somebody good, which usually means they have to actually know you are good, so I wouldn't expect this to be as common right at the onset of residency.

 

[NotAProgDirector]

The NRMP lists the following programs as accepting shared pairs (for last year's match):

Code Institution City Program
1007440C0 U Alabama Med Ctr-Birmingham Birmingham General Surgery
1015140C0 U Arizona Affil Hospitals TUCSON Internal Medicine
1043080A0 UC Irvine Med Ctr-CA ORANGE Dermatology
1043160C0 UC Irvine Med Ctr-CA ORANGE Neurological Surgery
1046080A1 UC Davis Med Ctr-CA SACRAMENTO Dermatology/Research
1046420A0 UC Davis Med Ctr-CA SACRAMENTO Radiology-Diagnostic
1081300C0 Danbury Hospital-CT DANBURY Pathology
1094180C0 U Connecticut School of Medicine FARMINGTON Neurology
1116440C0 Univ of Puerto Rico SAN JUAN General Surgery
1116440P0 Univ of Puerto Rico SAN JUAN Surgery-Preliminary
1170180C0 Loyola Univ Med Ctr-IL MAYWOOD Neurology
1172140C0 VA Medical Ctr-Boise-ID BOISE Internal Medicine
1172140P1 VA Medical Ctr-Boise-ID BOISE Medicine-Preliminary
1203320C0 U Iowa Hosps and Clinics IOWA CITY Pediatrics
1343220C0 Univ of MO-KC Programs KANSAS CITY Obstetrics-Gynecology
1377280C0 Dartmouth-Hitchcock Med Ctr-NH LEBANON Otolaryngology
1548180C0 University Hosp-Cincinnati-OH CINCINNATI Neurology
1548220C0 University Hosp-Cincinnati-OH CINCINNATI Obstetrics-Gynecology
1601320C0 Lehigh Valley Hosp-PA ALLENTOWN Pediatrics
1617420A0 Hershey Med Ctr/Penn State-PA HERSHEY Radiology-Diagnostic
1680040C0 Medical University of SC CHARLESTON Anesthesiology
1710140C0 Texas Tech U Affil-El Paso EL PASO Internal Medicine
1710400C0 Texas Tech U Affil-El Paso EL PASO Psychiatry
1748110C0 Carilion Clinic-Virginia Tech Carilion SOM ROANOKE Emergency Medicine
1748440C0 Carilion Clinic-Virginia Tech Carilion SOM ROANOKE General Surgery
1748440P0 Carilion Clinic-Virginia Tech Carilion SOM ROANOKE Surgery-Preliminary
1784700C0 Med Coll Wisconsin Affil Hosps MILWAUKEE Medicine-Pediatrics
1978320C0 Beaumont Health System-MI ROYAL OAK Pediatrics
1985300C0 Georgia Health Sciences Univ AUGUSTA Pathology
1985440C0 Georgia Health Sciences Univ AUGUSTA General Surgery
2835362C0 U Texas Southwestern Med Sch-Dallas DALLAS Plastic Surgery (Integrated)
2919040C0 Stony Brook Teach Hosps-NY STONY BROOK Anesthesiology
2922260C0 SIU SOM & Affil Hosps-IL SPRINGFIELD Orthopaedic Surgery
2973140P0 Texas Tech U Affil-Lubbock LUBBOCK Medicine-Preliminary
3057140C0 Pitt County Mem Hosp/Brody SOM-NC GREENVILLE Internal Medicine
3057140P0 Pitt County Mem Hosp/Brody SOM-NC GREENVILLE Medicine-Preliminary

 

[Poetic Silence]

The NRMP lists the following programs as accepting shared pairs (for last year's match):

Code Institution City Program
1007440C0 U Alabama Med Ctr-Birmingham Birmingham General Surgery
1015140C0 U Arizona Affil Hospitals TUCSON Internal Medicine
1043080A0 UC Irvine Med Ctr-CA ORANGE Dermatology
1043160C0 UC Irvine Med Ctr-CA ORANGE Neurological Surgery
1046080A1 UC Davis Med Ctr-CA SACRAMENTO Dermatology/Research
1046420A0 UC Davis Med Ctr-CA SACRAMENTO Radiology-Diagnostic
1081300C0 Danbury Hospital-CT DANBURY Pathology
1094180C0 U Connecticut School of Medicine FARMINGTON Neurology
1116440C0 Univ of Puerto Rico SAN JUAN General Surgery
1116440P0 Univ of Puerto Rico SAN JUAN Surgery-Preliminary
1170180C0 Loyola Univ Med Ctr-IL MAYWOOD Neurology
1172140C0 VA Medical Ctr-Boise-ID BOISE Internal Medicine
1172140P1 VA Medical Ctr-Boise-ID BOISE Medicine-Preliminary
1203320C0 U Iowa Hosps and Clinics IOWA CITY Pediatrics
1343220C0 Univ of MO-KC Programs KANSAS CITY Obstetrics-Gynecology
1377280C0 Dartmouth-Hitchcock Med Ctr-NH LEBANON Otolaryngology
1548180C0 University Hosp-Cincinnati-OH CINCINNATI Neurology
1548220C0 University Hosp-Cincinnati-OH CINCINNATI Obstetrics-Gynecology
1601320C0 Lehigh Valley Hosp-PA ALLENTOWN Pediatrics
1617420A0 Hershey Med Ctr/Penn State-PA HERSHEY Radiology-Diagnostic
1680040C0 Medical University of SC CHARLESTON Anesthesiology
1710140C0 Texas Tech U Affil-El Paso EL PASO Internal Medicine
1710400C0 Texas Tech U Affil-El Paso EL PASO Psychiatry
1748110C0 Carilion Clinic-Virginia Tech Carilion SOM ROANOKE Emergency Medicine
1748440C0 Carilion Clinic-Virginia Tech Carilion SOM ROANOKE General Surgery
1748440P0 Carilion Clinic-Virginia Tech Carilion SOM ROANOKE Surgery-Preliminary
1784700C0 Med Coll Wisconsin Affil Hosps MILWAUKEE Medicine-Pediatrics
1978320C0 Beaumont Health System-MI ROYAL OAK Pediatrics
1985300C0 Georgia Health Sciences Univ AUGUSTA Pathology
1985440C0 Georgia Health Sciences Univ AUGUSTA General Surgery
2835362C0 U Texas Southwestern Med Sch-Dallas DALLAS Plastic Surgery (Integrated)
2919040C0 Stony Brook Teach Hosps-NY STONY BROOK Anesthesiology
2922260C0 SIU SOM & Affil Hosps-IL SPRINGFIELD Orthopaedic Surgery
2973140P0 Texas Tech U Affil-Lubbock LUBBOCK Medicine-Preliminary
3057140C0 Pitt County Mem Hosp/Brody SOM-NC GREENVILLE Internal Medicine
3057140P0 Pitt County Mem Hosp/Brody SOM-NC GREENVILLE Medicine-Preliminary

Wow! Thanks for that list. Very helpful. Apparently even neurosurgery has shared residency options. I'm really curious how that actually works.

 

[Law2Doc]

Wow! Thanks for that list. Very helpful. Apparently even neurosurgery has shared residency options. I'm really curious how that actually works.

Bear in mind that it's not really an "option" -- you can seek it but it's going to need to be an exceptional circumstance for it to actually happen. That's just a list of places that haven't ruled out the possibility, in the right circumstances, not that they Are actually regularly amenable to or interviewing for this. My guess is the NS and ENT spots on this list really don't have an issue filling with full time folks and unless there's someone they really really love who unexpectedly has a baby or something, this is a non-starter. The derm, rads, anesthesia and neurology places are advanced residencies, so you would already be a year into residency before that option could be available. The places most amenable to this are going to be the prelim spots that don't fill anyway.

 

[Poetic Silence]

I've seen the terms "preliminary" and "advanced residency" used on SDN when referring to residencies. What do these terms mean?

 

[deleted103644]

I've seen the terms "preliminary" and "advanced residency" used on SDN when referring to residencies. What do these terms mean?

Preliminary = one year program (PGY1)
Advanced = residency that requires a preliminary program first (PGY2-X)
Categorical = full residency that starts intern year (PGY1-X)

Some specialties are predominantly categorical (IM, FM), some are mainly advanced (Derm, Rads), and some are almost even (Anesthesia).

 

[Law2Doc]

I've seen the terms "preliminary" and "advanced residency" used on SDN when referring to residencies. What do these terms mean?

Agree with the prior poster but would suggest, at the risk of being snide, that if you never heard of these terms, the General Residency board is not really the one where you ought to ask (ie not really a question of interest for folks already in residency, the point of this board-- this is a good question for a premed board).

 

[J-Rad]

Bear in mind that it's not really an "option" -- you can seek it but it's going to need to be an exceptional circumstance for it to actually happen. That's just a list of places that haven't ruled out the possibility, in the right circumstances, not that they Are actually regularly amenable to or interviewing for this. My guess is the NS and ENT spots on this list really don't have an issue filling with full time folks and unless there's someone they really really love who unexpectedly has a baby or something, this is a non-starter. The derm, rads, anesthesia and neurology places are advanced residencies, so you would already be a year into residency before that option could be available. The places most amenable to this are going to be the prelim spots that don't fill anyway.

And you speak authoritatively to this issue because?

 

[deleted103644]

And you speak authoritatively to this issue because?

This is an Internet forum. We all speak authoritatively here, justified or not.

 

[Law2Doc]

And you speak authoritatively to this issue because?

Because of the few rare circumstances I've seen or heard it occur as a resident, and the couple of folks I've heard of who couldn't find such. If you've seen lots of shared residencies at your or your colleagues programs please feel free to counterpoint with equal authority. If you think it's reasonably likely for a premed to expect a shared option down the road I would be surprised, but defer to different viewpoints if you care to offer one based on your own differing experience.

However it's sort of like a rare item or animal -- the fact that you have broad exposure and haven't seen or heard of many allows you to comfortably say it's rare.

Anyone a few years into residency whose classmates and friends are a few years into residency probably has seen enough to form an opinion on how common this is. But if you have differing experiences please weigh in. As with any topic if you don't offer an opposing viewpoint you lose the debate.

 

[dragonfly99]

Law2Doc
I don't see a reason why you feel like you need to be so snide most of the time, although on this particularly topic I mostly agree with you.
Would be EXTREMELY surprised if shared surgical residencies were to occur with any regularity any time soon. In procedural specialties in particular, it is exceedingly difficult to get good at anything if you don't do it with regularity. For example, if I am not in the cath lab for a month or two, I feel like I've forgotten stuff. Surgery is just one of the those specialties where they work a lot of hours and attract the most hard core applicants, and also there just are not ever as many spots in surgical residencies as there are in things like IM, fp, etc. They don't really have a reason to make concessions for people or to do special/extra things to attract applicants, since most surgical residencies fill very easily.

However, I do feel compelled to mention to the OP that just in my time in medicine in the past 10 years I have seen things get better for women trying to get into traditionally male specialties. There are starting to be more women in surgery, etc. and of course there are a lot of women in ob/gyn, which is a specialty where they do surgeries like hysterectomy and other procedures. So I say if you want to be a doctor and are willing to do the work, just go for it. If the only way you'd do it is with a shared residency, I don't think you can count on that. Those might increase in the next few years, but I wouldn't count on that. It's just hard for hospitals to do, because they have to manage a larger number of people but doing the same amount of work, and it is a large administrative burden for them. Plus they might end up losing money on the deal (having to pay 2 people benefits, etc.). The only place I've personally seen shared residencies is I think with an fp program.

 

[deleted103644]

Would be EXTREMELY surprised if shared surgical residencies were to occur with any regularity any time soon. In procedural specialties in particular, it is exceedingly difficult to get good at anything if you don't do it with regularity.

There are some surgery prelims that I could imagine being shared, as they're basically just used as cheap labor with little to no educational benefit. If the hospital allowed those prelim spots to be shared, they could even probably get away with not giving any benefits!

I hope no hospital is that unethical, but I wouldn't be surprised.

 

[Law2Doc]

Law2Doc
I don't see a reason why you feel like you need to be so snide most of the time, although on this particularly topic I mostly agree with you....

was not intending to be snide.

Would echo what you said above that OP etc simply can't count on a shared residency because they aren't common in most specialties.

 

[Poetic Silence]

was not intending to be snide.

Would echo what you said above that OP etc simply can't count on a shared residency because they aren't common in most specialties.

I don't know where you two got the idea that I was aiming for one. This thread is a year old.

 

[Law2Doc]

I don't know where you two got the idea that I was aiming for one. This thread is a year old.

Sorry, I guess it's DrRoss above who is looking for one.