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Can non-IM programs also shorten their residency to do a fellowship?


MarsRover

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The standard IM training program is 4 years, but the royal college lets them all finish after 3 years to pursue a fellowship. Is this possible with anesthesia, gen surg, etc? If I as anesthesia wanted to do ICU or chronic pain. Could I use my 5th year to start working toward that - or must I completely finish my residency first and then do the fellowship?

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On 2/5/2022 at 1:41 PM, MarsRover said:

The standard IM training program is 4 years, but the royal college lets them all finish after 3 years to pursue a fellowship. Is this possible with anesthesia, gen surg, etc?

No, you must do the full number of years for these specialties, although you may be able to focus on one aspect through electives, etc. Medicine (and pediatrics until this year's entering residents) are unique in that you could start a royal-college certified fellowship after only 3 years. Now peds will require you completing the first four years first, and for non-royal college fellowships (ie chronic pain, complex care, etc.) you had to finish the full residency. For anaesthesia and surgery AFAIK there are no royal-college fellowships so you need to complete them before moving on. Note that there are subfellowships of IM fellowships (ie. hepatology after GI) which you cannot start until finishing the RC fellowship as well.

 

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14 minutes ago, bearded frog said:

No, you must do the full number of years for these specialties, although you may be able to focus on one aspect through electives, etc. Medicine (and pediatrics until this year's entering residents) are unique in that you could start a royal-college certified fellowship after only 3 years. Now peds will require you completing the first four years first, and for non-royal college fellowships (ie chronic pain, complex care, etc.) you had to finish the full residency.

I haven't heard much about this, is there a consensus that this is positive/negative? Did graduating paediatric residents feel 1 year of extra training would have been helpful or needed?

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It's new for this year's R1s. Requested by the fellowship PDs. I haven't seen any documents but I've been told that the first year of fellowship if done as an R4 is in many ways a write-off as your priority is (appropriately) studying and passing the royal college board exams for gen peds, and not focusing on the fellowship. In practice there was a good proportion of people doing fellowship after R4 anyway, and some provinces only allowed sub-specialization in a specific year of training (R3 in Ontario? if I recall). Downsides are you no longer save a year if you're gunning a subspeciality (IE you only did peds specifically to do neonatology and have no interest in general peds) and the buffer in some provinces of being able to apply again in 4th year if you don't match in 3rd year.

I don't have a personal opinion as I did gen peds then a non-RC fellowship so not sure which I personally would have preferred. I do like that it's being standardized at least, and the royal college exams are being moved up to the start of R4 instead of the end, but I personally think the exams should be at the end of 3rd year then people can apply for fellowships or jobs without that over them in 4th year (and provide a buffer for the few who fail the exams on their first attempt, can retake at end of 4th year)

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