Changing Residency

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ElJimador

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Hello,

For those of you who have switched residencies after your first year, can anyone please give me some advice on the best way to go about this? Technically I am interested to know if I would have to enter the match again or if I would simply send inquiries to different Residency Directors ... also do you have any advice about the best way to break the ice with the current residency director on this subject? I have had a great time in my current residency but I feel that I may need a change - I do not have anything serious to complain about and I do not want to insult or disrespect anyone in any way involved in administering my current program.

I would like to hear your stories if you would share them.

Thank you!

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for psych residencies check the apa clearinghouse (google it.) i know also of 5 programs that take pgy-2. i expect there will be a few more as vacancies open up.
 
I just went through a switch last christmas and am by no means an expert in the process; however, I did learn some things. You can go about this either "outside the match," or, "through the match." Outside the match requires inside connections and offers positions that may give you credit for your training thus far. If you go through the match, you can interview and learn about programs the way that everyone else would, but you have to restart your intern year again. Either way, it helps to have a guide through the process. Your medical school advisor or your program director may be a good choice. If you are entertaining the idea of switching and just looking into it, I would do so with some discretion; howver, once you have finalized your decision to switch it is professional to relay this decision and your reasons to your progarm director as soon as possible. The process takes time, but don't give up or give half effort as you are dealing with your future!

Best of luck in your search and travels.
 
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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!
 
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.
 
Thanks for the info- you mentioned this has been discussed in the past on SDN- I have searched without success-- if you have the links, please let me know. thanks.
 
Thanks for the info- you mentioned this has been discussed in the past on SDN- I have searched without success-- if you have the links, please let me know. thanks.

I think switching programs is easier than specialty - find open programs and apply out of match. If no luck, then go through match next year would be your best bet. What year are you now?
 
I am a PGY-1 now and hoping for a PGY-2 next year ... on the other hand I can't say I would be upset to stay where I am. I just don't want to get on the director's bad side if I do stay.
 
I am a PGY-1 now and hoping for a PGY-2 next year ... on the other hand I can't say I would be upset to stay where I am. I just don't want to get on the director's bad side if I do stay.

If you know anyone at other programs, you can ask them to tell you if there will be any openings at their program. You can also email the PD's as they may know if a spot is opening up for next year, and they'd be recruiting for it now. For instance, we have a spot opening for pg2-3 in June since I'm switching specialties. Psych is a pretty small network so I'm sure you could get a lot of info from emailing the programs directly (ie, an email back saying they don't, but they know that program x,y and z will have openings)

good luck!
 
Thanks for the info- you mentioned this has been discussed in the past on SDN- I have searched without success-- if you have the links, please let me know. thanks.

Do a search for "transfer". You will likely pick up some informative posts.

-AT.
 
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