Thanks for the advice- I am actually not planning on switching specialty, though. If anyone has switched within the specialty please let me know.
Thanks!
The difficulties involved in switching into a particular psychiatry residency training program depends on how many 'borders' you are crossing. Are you switching from another specialty? Are you switching from one institution to another institution, or are you staying at the same institution? Switching from one program to psych within the same institution may be easier than switching from one psych program to another psych program at a different institution, but it all depends. Pretty much every program has its own method of dealing with PGYII transfers. Here are a few examples of what could happen with transfers:
- Some programs, like UW and Stanford, have PGYII spots open every year that are filled through a Match-like process.
- At Duke, several years ago one of the medicine interns started thinking early on that she wanted to switch into psych, and it just so happened that around the same time one of the psych interns was looking for a back door into the Duke medicine residency. So basically what happened is that they met with their respective program directors (medicine and psych), and then met with the program directors of the other programs (psych and medicine) -- and once the program directors signed off on the switch, they did so. I think the switch happened sometime in January.
- Last year, one of the UW psych interns transferred into another psych program out of state.
Regardless of how the spots are open, you generally send in your application by September, which is about the time you would apply if applying as a new intern in the regular Match. Although you get interviewed along with the other MSIV's participating in the Match, in many instances you will hear back from the program prior to Match Day. For example, UCSF accepted one of their new PGYII's the week before Thanksgiving last year.
(If the program fills the PGYII slots through the Match, then you would apply on the Match timetable and you would hear back from the program on the Match timetable.)
I would recommend that you let your program director know of your intentions fairly early on. From your program director's perspective, losing a resident is a pain in the ass, especially if the wards are resident-dependent; because then s/he will need to find a new resident to cover the quitting resident's duties. High-quality residency programs generally don't have a problem finding new residents to transfer in. But it's kind of like the global market for doctors: the U.S. poaches doctors from Canada and the U.K., Canada and the U.K. poach doctors from South Africa, and so forth. So programs at the bottom of the barrel in terms of quality tend to get the shaft. However, it can be difficult even for top programs to replace a departing PGYII. For example, Stanford's emergency medicine residency recently lost one of its PGYII's (who transferred out to follow her husband to a new job in another city), and they were unable to recruit a resident who would join as a new PGYIII -- so last year, all of the PGYIII's had to give up their "research week" (read: under the table vacation week) because the program director needed them to cover the shifts.
Aside from the obvious reason that you should be a nice person and let your program director know as soon as possible about your intentions to transfer, there is also nothing to be gained by keeping it from your program director. You will have to let her know sooner or later. And besides, most programs will require you to provide a letter from your program director that is at least a letter of good standing ("Dr. So-and-So is a resident in our program and he hasn't been kicked out yet") or better yet is a letter of recommendation ("Dr. So-and-So is a resident in our program and I was sorry to hear that she wanted to transfer out, but I think she would be an asset to your program").
In the worst case scenario, your program director will be extremely unhappy that you have decided to transfer out, and he will be so pissy that you won't want a letter of recommendation and would prefer that he simply write a letter of good standing instead.
If you begin the process of applying to transfer, you do not necessarily have to resign your PGYII slot at your original program. Again, that may vary from program to program, but I haven't heard of it happening. But it all depends on the timing. One issue that you may encounter is that generally the interns sign their PGYII contracts in January. Suppose you had applied to transfer to a different institution back in September, interviewed in November, and by the time January rolls around have not yet heard back from that institution whether your transfer application was accepted? In that type of situation, you basically would have to forego signing up for a PGYII contract at your current institution and
hope that your transfer application is successful. If the gamble pays off and you are accepted, then it works out great. But if your transfer application is rejected, then you would be left with no residency options for the following year (because presumably by that time your program direct will have already filled the spot that you declined to accept).
The issue of transferring residencies within psych has been discussed on SDN in several previous forums. Doing a search of the forums may be fruitful.
Hope this helps,
-AT.