Roadmap to Residency: - AAMC

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Roadmap to Residency: FromApplication to the Match and Beyondholding J-1 visas and their host institutionsmeet the federal requirements forparticipation. ECFMG does not sponsorphysicians for other U.S. visa types.Information about general eligibilityrequirements for the Exchange VisitorProgram can be found at:www.ecfmg.org/evspAn H-1 visa, a visa for a temporaryworker sponsored by an employer, isanother option for international medicalgraduates seeking training in a U.S.residency program. The U.S. Citizenshipand Immigrant Services bureau grantsH-1B visas to temporary professionalworkers who are required to have aprearranged job, either temporary orpermanent, in a professional field beforethey receive a visa. There is an initialadmissions period of three years, withthe possibility of extending one’s stay fora second three-year period. After stayingin the United States for the maximumsix-year period, a foreign citizen isrequired to live abroad for one yearbefore re-entering the United States inan H or L visa category.In ERAS, applicants have the option toenter both their current visa status andthe visa status they expect to hold duringresidency training. This allows applicantsthe opportunity to indicate an expectedvisa change.International medical graduates who areneither U.S. citizens nor permanentresidents are strongly urged to consultpromptly with the directors of theresidency training programs at whichthey are interviewed regarding relevantvisa issues.D. ContractsIt is National Resident MatchingProgram (NRMP) policy that residencytraining programs “are expected toprovide complete and accurate informationto interviewees, including a copy ofthe contract the applicant will beexpected to sign if matched to theprogram and all policies of the institutionregarding eligibility for appointmentto a residency or fellowshipposition. This information must becommunicated to interviewees in writingprior to the relevant rank order list certificationdeadlines.”It is very important that residency applicantscarefully review the contract of anyresidency training program in whichthey are interested prior to finalizingtheir rank order lists because theapplicant will want to be reassured thatthere is mutual compatibility betweenthe institution and the applicant andbecause the match is contingent uponthe applicant being able to meet theinstitution’s requirements.E. HousingSoon after the announcement of matchresults, most future residents begin theprocess of identifying and arranging forhousing near their residency trainingprogram.Depending on their financial circumstances,some residents, knowing thatthey will be residing in the same area fora minimum of three to five years, chooseto purchase a home during the period oftransition from medical school toresidency. Other residents decide to rentrather than purchase so they can familiarizethemselves with the region prior tomaking such a significant investment.Various individual and personal considerationsmust be taken into account byincoming residents as they consider theirhousing options. These include theamount of time available during thealready challenging PGY-1 year toperform home- and yard-related chores,the amount of personal or family disposableincome available for mortgagepayments, and the fact that somegraduates do not have an income sourceduring the transition from medicalschool to residency training.For some residents and in somelocations, a home can be a good investmentduring residency training; for otherresidents and in other locations, therental option is a more reasonablechoice. At the very least, care must betaken to ensure that all relevant financialconsiderations are taken into account inreaching this decision.F. Employment for spousesFor residents with spouses or domesticpartners, the transitional period betweenMatch Day and the beginning ofresidency training provides an opportunityfor the identification of suitableemployment for spouses or partners.Although some programs and theirsponsoring medical schools or hospitalsare able to provide formal or informalassistance in identifying such employmentopportunities, provision of thistype of assistance is often not available.In any event, it may be advisable tosubscribe to the local paper to read joblistings.25Association of American Medical Colleges, 2005
Roadmap to Residency: FromApplication to the Match and BeyondG. SchoolsIncoming residents with school-agedchildren also may use the time betweenMatch Day and the beginning ofresidency training to investigate educationalopportunities for their children inthe new location. Residency programstaff who have children of their own arefrequently good sources of informationabout the quality of individual schoolsand school districts in the region.Identifying an appropriate school districtand school can strongly influence thechoice of preferred housing location fora resident and his or her family. Finally,the fact that residency training programsusually begin on July 1 permits sufficienttime for the enrollment of children inschool and the provision of thedocumentation (e.g., immunizationrecords, records from schools previouslyattended) required to begin school in thefall term.H. Hospital credentialing andmedical licensureThe residency program director andmembers of his or her staff usuallyprovide incoming residents with informationabout what will be required ofthem with respect to hospital credentialingand medical licensure, includingapplication materials for any requiredtraining license. It is important to reviewthis information promptly after it arrivesand to be familiar with hospital and statemedical board policies. It is imperativethat all materials requested by theresidency training program be completedand submitted promptly; failure to do somay result in a delay in beginningresidency training.Incoming residents should be aware thatsome hospitals and some states requireresidents to undergo a criminalbackground check prior to beginningresidency training. Additional informationabout this and other requirementsfor residency training can be obtainedfrom the program director.I. Orientation and programstart datesThe majority of residency trainingprograms begin annually on or aboutJuly 1. Most include an orientationperiod at the beginning of the program,although the length and content oforientation programs vary from institutionto institution. Since orientationprograms may begin in mid- to late-Junerather than on or after July 1, incomingresidents should check with residencyprogram staff regarding expectationsabout program orientation and startdates.J. BudgetingSince the first paycheck for a newresident may not arrive until August 1 orthereafter, beginning first-year residentsare strongly encouraged to set asidemoney, if possible, from fourth-yearmedical school financial aid disbursementsor monetary graduation gifts inorder to ease the financial transition inthe months between medical schoolgraduation and receipt of the firstresidency paycheck. Ensuring thatstudent loans are either in grace or indeferment, if applicable, or in forbearancealso results in peace of mind for thenew resident.Some programs provide incomingresidents with the opportunity to requestan advance on their contract stipend (upto a specified maximum amount) toassist with the financial transition frommedical school to residency training,with their subsequent bi-weekly ormonthly paychecks adjusted accordinglyover the next several months of theirPGY-1 year to repay the advance. Iffinancial circumstances make this anappealing option, check with theprogram director following Match Dayto determine whether this or a similarprogram may be available.Some residents have also reported thatthe services of an independent financialplanner are beneficial at this time intheir lives. In addition, minimal use ofcredit cards and continuing to live wellwithin their means have served manyresidents well at this crucial time.26Association of American Medical Colleges, 2005
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