Doing Two Residencies?

[medfoodie]

Hi, I'm entering medical school this fall and I'm not very familiar with how residencies work. I was just wondering, if someone completes a FM residency and works in the field for a while and decides that they would like to specialize in something else, are they able to apply to another residency (i.e. general surgery)? Has this ever been done or is it seen often? Thanks.

[Lactic Folly]

Yes, there are re-entry programs. Not a guaranteed path though.

[JohnGrisham]

There are also a myriad of +1 fellowship programs after doing FM, so you can carve your way to a different niche.

[rmorelan]

the primary problem is you then would not be able to enter (unless something special is going on) the 1st round of carms for most things. If you know in advance you want two fields there is some logic to doing the hardest one first simply because your odds of getting it are higher.

[Birdy]

There are also a myriad of +1 fellowship programs after doing FM, so you can carve your way to a different niche.

There are a couple things I've been wondering about that and I didn't want to make a new thread, so this is close enough. Can you enter practice for a while (say 4-5 years to fulfil an ROS or just pay down debt or something) and then do a +1? And can you do multiple +1s in areas of interest? Say geriatrics and EM?

[rmorelan]

There are a couple things I've been wondering about that and I didn't want to make a new thread, so this is close enough. Can you enter practice for a while (say 4-5 years to fulfil an ROS or just pay down debt or something) and then do a +1? And can you do multiple +1s in areas of interest? Say geriatrics and EM?

 

yes to both.

 

it is often easier to do them right away though - for one thing once you have a family practise you actually have patients to worry about Plus there are issues of timing - the system is of course designed for you to carry on right away and do the next one (and references will be current, knowledge may be more "academic").

 

but you can do more than one, and you can do them later.

 

residents in family do get to enjoy full tax refunds for their first couple of years - that is a big boost to things to keep in mind (a 10K cheque in March can brighten your day).

[Birdy]

yes to both.

 

it is often easier to do them right away though - for one thing once you have a family practise you actually have patients to worry about Plus there are issues of timing - the system is of course designed for you to carry on right away and do the next one (and references will be current, knowledge may be more "academic").

 

but you can do more than one, and you can do them later.

 

residents in family do get to enjoy full tax refunds for their first couple of years - that is a big boost to things to keep in mind (a 10K cheque in March can brighten your day).

I'm probably going to be signing on to the PEI family medicine sponsorship program next year if my interest in family proves as strong as I have always felt it is, but I don't yet know if the program will allow me to do a +1 before I have to return to fulfil the ROS which is why I was wondering.

[GrouchoMarx]

Get it right the first time.

[amichel]

Get it right the first time.

Haha, if only people never made mistakes, never became interested in new things later on, and never had their life circumstances change.

 

I can appreciate the sentiment though.

[GrouchoMarx]

Haha, if only people never made mistakes, never became interested in new things later on, and never had their life circumstances change.

 

I can appreciate the sentiment though.

Speaking from experience. It's hard to move once you've been pigeonholed. I'm still trying. No flexibility in Canada.

[amichel]

Speaking from experience. It's hard to move once you've been pigeonholed. I'm still trying. No flexibility in Canada.

 

No for sure, no disagreement there. Just pointing out that such advice is easier given than followed. As you probably know.

[GrouchoMarx]

No for sure, no disagreement there. Just pointing out that such advice is easier given than followed. As you probably know.

 

I can't say I couldn't have done something different. They don't really talk about this kind of thing in medical school. It's assumed that everyone ends up where they should end up, and those that make mistakes in picking a specialty are somehow flawed.

 

I wish I had used my time to really explore the professional side of fields early; the medical side is hard to figure out when you're in your first and second year because you can't really know medicine until you start clinicals but you can easily find out about things like work/life balance, respect and autonomy, income, and job opportunities. Then you can approach what interests you with research and electives.

 

For instance I thought path was interesting and had a good work/life balance, and both of those things are still true. I neglected to pay attention to the lack of respect and autonomy, the salaried and therefore undesirable income, and the dearth of job opportunities in places I would want to settle. If I had really thought about these things in medical school, rather than going on predominantly the interest in the work, or ignoring the obvious things like the stigma of pathology, I would have taken a different career path.

 

Trying to switch has so far been met with roadblocks and at least one year wasted. 

[mononoke]

I can't say I couldn't have done something different. They don't really talk about this kind of thing in medical school. It's assumed that everyone ends up where they should end up, and those that make mistakes in picking a specialty are somehow flawed.

 

I wish I had used my time to really explore the professional side of fields early; the medical side is hard to figure out when you're in your first and second year because you can't really know medicine until you start clinicals but you can easily find out about things like work/life balance, respect and autonomy, income, and job opportunities. Then you can approach what interests you with research and electives.

 

For instance I thought path was interesting and had a good work/life balance, and both of those things are still true. I neglected to pay attention to the lack of respect and autonomy, the salaried and therefore undesirable income, and the dearth of job opportunities in places I would want to settle. If I had really thought about these things in medical school, rather than going on predominantly the interest in the work, or ignoring the obvious things like the stigma of pathology, I would have taken a different career path.

 

Trying to switch has so far been met with roadblocks and at least one year wasted. 

I hope it all works out for you. What are you thinking of switching into? I know of someone who switched from path to IM, they were willing to sacrifice the work/life balance for more patient interaction.

[rmorelan]

I'm probably going to be signing on to the PEI family medicine sponsorship program next year if my interest in family proves as strong as I have always felt it is, but I don't yet know if the program will allow me to do a +1 before I have to return to fulfil the ROS which is why I was wondering.

 

usually there are not really restrictions on that - they don't normally get in the way of fellowships.

[rmorelan]

Speaking from experience. It's hard to move once you've been pigeonholed. I'm still trying. No flexibility in Canada.

 

it is true how limited that actually is. such a challenge. Even in residency it is hard to really know your particular field for probably the first year or two (for instance in rads the first year is off service, and the next 6 months are precall which is a different situation for sure etc. You can easily be 1/2 done many residencies before you realize what this isn't really what I wanted etc  and then you are kind of stuck - transfers aren't easy, and funding is limited.

[3change]

...

[ukmedstudent]

Speaking of two residencies, is it common for people to opt out of their current residencies and transfer out?

[rmorelan]

Speaking of two residencies, is it common for people to opt out of their current residencies and transfer out?

 

no not common - but it happens still. 

 

I mean for one thing most people get it right as it were the first time. Plus there is difficulty in moving to another field as others point out. 

 

This another thing like CARMS - a lot stress involved but most people get what they want. The trouble is the relatively few that don't are kind of like a horror story for everyone else which of course ups the anxiety. 

[bearpuppy]

Just wanted to add that if you really wanted to do a second residency, you may be better off applying to NRMP/ERAS. There is no penalty in the US for applying after another residency. However, you probably need to have completed Step3, there may or may not be VISA concerns, and you have to be sure the program would be recognized by Canada if you plan on returning.

[carolynH]

residents in family do get to enjoy full tax refunds for their first couple of years - that is a big boost to things to keep in mind (a 10K cheque in March can brighten your day).

 

Sorry to dig up an old post! I have somehow stumbled upon this when searching on taxes. rmorelan, could you please elaborate on this?  I never heard of this tax advantage. Is it just for Family or did you mean all residents since they usually racked up a huge education tax credit from tuition paid over the past years.

[rmorelan]

Sorry to dig up an old post! I have somehow stumbled upon this when searching on taxes. rmorelan, could you please elaborate on this?  I never heard of this tax advantage. Is it just for Family or did you mean all residents since they usually racked up a huge education tax credit from tuition paid over the past years.

 

yeah it is just the standard tax credits from tuition- it just happens that for a 2 year family residency the taxes you pay over those 2 years is recovered fully by the tax credits.  

 

For the rest of us there effectively a DROP in income in our 4th year despite the pay raises we get, it cannot compete with 9K tax refunds ha, and then the following 5K exam fees etc. Particularly with the upcoming changes as I understanding to the student related tax credits. 

[carolynH]

So you were talking about the education and text book tax credits you racked up over the years. Yes, it could be sizeable! Actually, instead of waiting to get the 9K tax refunds at tax time every year, a faster way to get the money back is to fill out a T1213 form to reduce tax deductions at source. You get a bigger pay cheque every time. Use it to pay down your LOC and save on interest expense!

[rmorelan]

So you were talking about the education and text book tax credits you racked up over the years. Yes, it could be sizeable! Actually, instead of waiting to get the 9K tax refunds at tax time every year, a faster way to get the money back is to fill out a T1213 form to reduce tax deductions at source. You get a bigger pay cheque every time. Use it to pay down your LOC and save on interest expense!

 

absolutely - as long as you have the discipline to actual pay down the LOC . 

 

in general it is  good idea not to give the government interest free loans (which basically is what your tax refund is).