lmm comments on I am switching to biomedical engineering and am looking for feedback on my strategy and assumptions - Less Wrong Discussion
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Getting the actual programming skills is easy if you're smart. Getting the evidence that will lead people to hire you is harder. Large companies tend to go by the book; you will need the qualifications or something unusual like a personal recommendation from someone in the company. Startuppy places it's more about fitting in with the culture and talking/coding well in interview. If that's the kind of job you're after you'll probably be fine as a self-taught programmer if you can perform under interview pressure and you conform to the right stereotype. (it's possible I'm being excessively cynical here)