@texaspg
Yes, there are residency programs that only offer 2 weeks vacation. Mostly these are at community hospital/clinic programs, but it’s not limited to just those. Some programs are stingy w/vacation days because of staffing issues.
Whether or nor programs allow moonlighting is very program dependent. US-educated PGY1s cannot moonlight period because they don’t yet qualify for an independent medical license. (IMGs/FMGs cannot moonlight until after PGY3 because in order to qualify for a independent medical license they need to to complete at least 3 years of residency first.) There are a number of reasons why programs forbid external moonlighting–including the potential for work hour cap violations and malpractice exposure.
Many programs that forbid outside moonlighting allow internal moonlighting. I know D1 can pick up extra shifts at any of the several clinical sites associated with her residency program-- like at a walk-in urgent care center or covering an in-hospital ICU shift. Because residents are not fully trained yet, there are only few limited kinds of jobs they can take as moonlighters.
Working at an outside moonlighting site without permission from your residency program is a contract violation and will get a resident fired from residency post haste and without any legal recourse.
@artloversplus I see where you are coming from especially with your DD being in a DO program. DO is a good solid option for some, but it is also a well known fact that going to a DO school unfortunately decreases your chances at matching into competitive specialties especially at MD programs. As you point out, the odds of your DD matching into residency are favorable if she is not specialty selective. Her odds are unfavorable should she choose to match into competitive MD residency programs such as derm, ENT, plastics etc. It can still be done, but it will be challenging. If she wants to be a family physician or do primary care and stay in the US only, then being a DO should not cause too much hardship as far as the match is concerned.
In addition to one’s performance in medical school, Step 1 and now Step 2 scores are vital for competitive specialties. First time DO students have slightly lower pass rates on Step 1 and Step 2 compared to first time MD applicants. When you take a look at the breakdown of scores, a significantly higher percentage of scores in the 240+ range come from MD students compared to DO students. There are many reasons for this, including the fact that most MD schools are geared towards USMLE whereas DO schools are geared towards COMLEX.
At the end of the day … being out $$$ on a post bacc program and not getting into and MD program is awful but probably not as awful as spending $200K+ and not being able to practice medicine in the specialty you want …
@artloversplus I understand where you are coming from especially with your DD being in a DO program. If she isn’t specialty selective and only wants to practice medicine in the US, then her risk of going unmatched is low. However, if she wants to pursue a competitive MD residency such as derm, plastics, rad onc, ENT, then being from a DO school will significantly reduce her chances of matching into these fields. As an example, there are only 32 DO dermatology residency programs and 6,600 new DO entering students for 2016.
At the end of the day, we try to make the best possible decisions. Being in debt 200K+ and not being able to practice medicine in the specialty you want is probably worse than being out 80K.
@iwannabe_Brown You’re comparing the %match rate for DO medical students to the. %acceptance rate of MD medical schools applicants". Seems like a “Get in, then ask questions later” approach … whereby the goal is just get into a medical school even if it’s a DO program and then deal with any issues as they come up. I would not recommend this but to each their own.
If you complete a postbacc program and have a decent MCAT and GPA, you should be able to get into an MD program. If you have a DO offer, accept a DO program ONLY if you feel you would be happy in primary care, otherwise, seek help on presentation and reapply to MD.
FYI for 2016, the limited DO AOA approved residency programs in select competitive specialties for over 6,000 new DO students each year (number is increasing):
18 DO ENT residency programs
8 DO Urology residency programs
11 DO Radiology residency programs
32 DO Derm residency programs
no DO Plastics residency programs
no DO Rad Onc residency programs
@DoctorTO
I do not believe SMP is a safer route to MD than take a DO program. You seem to believe that once got into an MD school, the student will automatically qualify for those listed competitive specialty filed, which is absolutely untrue. That is just like saying if some one got into MIT he will automatically become Gates or Jobs and those went to community college will never be successful.
It all depends on what you do in a school or on a job, if you perform badly in any program, being SMP, MD, DO or even PA, you won’t be successful in any residency and even if you got into a competitive residency, there is no guarantee to be successful. Life is a learning process, there is always a risk of failure.
I bet you that if some one graduated a top student in a DO school with high USMLE scores can get into a Rad or Der residency, OTOH, if some one finish last in Harvard COM and with a low USMLE may only become family practitioner.
@DoctorTO
Perhaps you should ask the DOs in The American Osteopathic College of Dermatology for referrals.
http://www.aocd.org/
Yes, its hard to get into very competitive residency, but that can be done. And I don’t imply my D is going to make it, she is not interested in those specialty anyway at this moment.
UWorld open so can’t copy and paste - the get in first ask questions later is EXACTLY the approach I’m advocating because I think anyone who is already accepted to a DO program has a much higher chance of being the type of physician they want to be than someone who requires an SMP to have a chance at MD school. Plenty of DOs end up in the most competitive specialties. Obviously being an american MD is a better situation than being a DO but being a DO is a much better situation than an FMG or dropping another $40k on a program that is completely useless if one doesn’t wind up in medical school and rolling the dice a 2nd time around. If having a decent MCAT and GPA for this student is such a sure thing post SMP, the student wouldn’t be looking at an SMP in the first place. We’re not talking about career changers here.
P.S. Have my specialty choice down to 2 and choosing is definitely more nerve-wracking than I expected. Also applying for away electives is the most annoying process ever. So disorganized and inefficient.
D2 is so much happier now that she’s made her specialty decision.
MS3 is done. Next up–Step 2.
I think deep down I’ve already decided but am just being skittish about committing
Got ya.
D1 didn’t commit to her choice until she hit the submit button on ERAS. But now from a position of hindsight, she says she absolutely made the right choice and would have been miserable in the other field. Go with your gut on this…
D2 is back from her vacation (and from being Maid of Honor at BFF’s wedding). She leaves for a national medical conference on Friday, and from the conference will fly to LA for her CS exam. CK is scheduled for the 25th. Specialty Sub-I starts May 30. (Assuming she can get jury duty postponed.)
For away electives, do you pay out of your own pocket or your med school tuition covers it?
IIRC, your tuition covers it, but you do have to pay all your living expenses OOP.
You also need to provide proof of $1M in malpractice coverage. (Contact your Office for Medical Student Affairs to get a letter you’ll need to submit upon acceptance at your away.)
Since tuition covers away electives, is there a limit on how many away electives can one take? and do they allow repeat of the rotations that you already did at your home location?
This is something you will have to ask your school.
In general the number of aways going out of a school needs to balance the number of aways coming into a school. Because of this specific schools may have policies limiting the number of aways an individual student can do. In general you can repeat electives elsewhere for credit, but again this is school-specific. Ask your Office of Medical Student Affairs.
Having done some of the away rigmarole, it’s very school dependent (aside from the no tuition thing, I think that’s pretty much blanket policy for LCME accredited US allopathic students doing electives at LCME accredited US allopathic schools). I’ve definitely seen reference to IMGs having to pay tuition. Housing, food, transportation etc. is not included for anyone as far as I can tell. Most schools also have an application fee of some sort. Sometimes it’s only charged if you end up actually doing the elective (e.g. one school I applied to only charges you the fee in person on day 1), sometimes it’s a one time fee for applying to anything at that school, and sometimes it’s a fee per elective applied to.
How many electives you can do is definitely school dependent both by your home institution and the away institution. In other words a school may say “visiting students can only do 2 electives here” whereas your home institution has no rules for you or vice versa. Obviously one still needs to complete any school required rotations at home and during the height of interview season you can’t really do any electives because of all the time off you need. Studying for Step 2CK also typically eats away a few weeks of the year.
Since no two clinical experiences are alike, generally speaking you can “repeat” things. In specialties where aways are expected, it’s common to essentially do a sub-internship in the specialty at each hospital. Some schools also only offer specific electives to visiting students so while the home students can do all sorts of general surgery subspecialty electives, the visiting students have to just do a gen surg sub-i.
In addition to the malpractice insurance, I’m often being asked to provide BLS certification proof and personal health insurance proof. Again, those are pretty much givens for LCME accredited US allopathic medical students but for others (especially foreigners) it probably isn’t a given.
My son did one away rotation in the month of October. He was going to do another one, but his residency interviews were so loaded in that month, he had to cancel that away rotation.
he chose locations based on “free rent” from my family…lol.
DD is getting ready to apply for fellowship. Another Match to go through, though she has said there generally is more wink-wink, nod-nod during the process as compared to residency. All of the PGY-4’s in her program were unofficially locked in before the Match. She felt that in her specialty fit was very important for residency and is even more so for fellowship. She seems to have a good idea of the programs that will be best for her research interests but as they often only take one person she will apply to twenty or so. Her boyfriend is in a readily transferable area of medicine and plans on going with her. Let the games begin…yet again.
Yep, fellowship application time around here, too
Can I ask a dumb question?
How are those fellowships being get paid? Resident salary, full fledged doctor or better?