Roadmap to Residency: - AAMC

Roadmap to Residency: FromApplication to the Match and BeyondXI.The Transition from Medical School to ResidencyThis section provides advice and recommendationsfor easing the transitionfrom medical school to residencytraining.A. Insurance programsAfter Match Day, it is important forincoming residents who have graduatedfrom U.S. medical schools to review thespecifications of program- or institutionsponsoredinsurance plans to ensureuninterrupted health, disability, andother coverage between their graduationfrom medical school and enrollment inresidency-sponsored programs. Inparticular, new residents are well advisedto determine whether health and/ordisability insurance plans sponsored bythe residency training program or itsparent institution begin on the first dayof enrollment in the program or at somelater date, and whether those insuranceprograms exclude coverage for preexistingconditions for a specified periodfollowing initiation of coverage. If suchexclusions exist, the temporary extensionof medical school-sponsored insuranceprograms (which may involve thepayment of additional insurancepremiums) might be advisable.B. Financial aid processesMedical students who have receivedfinancial aid from the federal Staffordloan program are required by federalregulations to attend, prior to graduation,a financial aid exit interview. In thatsession, students are provided with informationon the terms of their loans(interest rates, interest capitalization,grace periods, deferment, forbearance,repayment, and consolidation) and ontheir rights and responsibilities.Financial aid administrators alsotypically provide graduating studentswith a summary and/or history of theirstudent loan borrowing. An excellentsource for tracking down informationabout federal student loans (for thosewho borrowed during college orgraduate studies prior to attendingmedical school and who cannot findtheir loans) is the National Student LoanData System (www.nslds.ed.gov).Graduates are well advised to informeach of their loan servicers of their newcontact information as soon as theyknow it, and to verify with their loanservicers the status of each of their loans(i.e., the length of the grace period; thenumber of months before the expirationof any grace period; and the qualifications,application process, and relevantdeadline dates for deferment). Manyloan servicers also provide Web-basedaccess to loan information that affordsborrowers access to their account informationon a 24-hour-per-day, seven-daya-weekbasis. Residents are also encouragedto take advantage of those services.Federal Stafford Loan interest rateschange annually on July 1. The newinterest rates are announced at the endof May. In a rising interest rate environment,residents are encouraged to payclose attention to the May rate changeannouncement. Residents also canbenefit from the AAMC MONEYMAT-TERS listserv, which alerts residents tochanges in student loan programs ofimportance to residents. Residents cansign up for the listserv atwww.aamc.org/debthelp. An impendingsignificant interest rate increase mayresult in residents’ wanting to consolidatetheir federal student loans in orderto lock in a lower interest rate.C. VisasInternational medical graduates who areneither U.S. citizens nor permitted by theU.S. Citizenship and Immigrant Servicesbureau of the U.S. Department ofHomeland Security (http://uscis.gov/) toreside permanently in the United States(i.e., as a permanent resident or greencard holder) must apply for and obtainappropriate visas for themselves and anyaccompanying family members prior toparticipating in a residency trainingprogram.The J-1 visa, a temporary nonimmigrantvisa reserved for participantsin the Exchange Visitor Program, is onevisa type commonly used by foreignnational physicians for this purpose. TheExchange Visitor Program was establishedby the U.S. Department of State toenhance international exchange andmutual understanding between thepeople of the United States and othernations.The duration of stay for Exchange VisitorProgram physicians is limited to the timetypically required to complete a graduatemedical education program. ExchangeVisitor Program physicians with J-1 visasare required to return to their homecountry for at least two years followingcompletion of their residency trainingprogram before being eligible for certainother U.S. visas. The U.S. Department ofState has designated the EducationalCommission for Foreign MedicalGraduates (ECFMG, www.ecfmg.org) asthe sole visa sponsor for all J-1 ExchangeVisitor Program physicians who participatein clinical training programs in theUnited States. In this capacity, ECFMG isresponsible for ensuring that physicians24Association of American Medical Colleges, 2005