PGY3/4 Surgery Program Transfer

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Electrocautery

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Hello guys,
I am a general surgery resident and I 've had thoughts of transferring to another program, reason being fellowship placement. So at this point I am not sure of 1) whether I should try it, and 2) the best way to do it.

A few background details:
My current program offers excellent training and has pretty decent grad placements, but we are not big in academics. I will be applying for a very competitive fellowship (during late PGY4) and it will be impossible to get one of the best fellowship spots coming from my current program. I will have plenty of clinical research under my belt and have worked with some nationally/internationally known experts in the field who will hopefully support my app (and I will hopefully still have great absites/logs/letters). I won't be happy to match to "any" program of this specific fellowship. So, my thoughts are:
1) Should I try switching programs? If I could get a spot in a place with great fellowship placements in this specific field, would I have equal chances of matching with the other grads of this program, or will the transfer cut me back? What about looking for a job in the future?
2) If I decide to transfer, I was considering PGY3 vs PGY4. I think PGY4 might be better since 1) there is less competition for a good spot, and 2) I will have completed PGY3 in my current program which really offers a great clinical experience (aka crash test). On the other hand, it will be harder for my program to find a PGY4 replacement than a PGY3 (no prelim pool).
3) If I decide to transfer, I am not sure how to bring this up to my PD. I will feel bad to do it, especially since he supported me when I encountered an issue in the past. I believe I will have to tell him as soon as I make up my mind (before any open positions are announced). Since I will be seeking to transfer for a personal reason, and not a family tragedy, how will he react? What happens if I eventually have this discussion and end up staying in my program?

Complicated issues... I would appreciate advice from seniors/faculty/people who have been there. Thanks in advance!

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Only a PG1 so take this as you may.
I don't think changing programs PG4 is going to help you at all. Will you work with people long enough to develop a great relationship? Would you get new letters there? Will there even be an opening that year at a "better" program?

It also seems like there is a high possibility of leaving sour feelings with your home program. Is it really worth it? Would you be able to get great letters before you leave? What if they call those letter writers and ask why you moved?

From talking to my seniors about fellowship competitiveness, even people at community programs can match into things like Peds and SurgOnc -- more depends on the person than the program. Letters and possibly Absite scores may have more influence than which program you are coming from.

My 2cents. Feel free to tell me to shove off. I've just discussed program type w/ many people in the past so that's why I am chiming in.
 
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