Wrong Residency

[NotAProgDirector]

I matched this year to a moderately competitive specialty in the southeast. Although the program wasn't my top choice due to distance from family and friends, I was pretty happy that I matched into the specialty and looked forward to starting residency. However, as soon as orientation week came around, I realized that I have made a huge mistake. I am not happy. I dislike the city for it is far away from anything I'm used to. Complete different culture. I also fear that the specialty will deprive me of any meaninful relationship I might have in the future. I am seriously considering switching specialties such as EM but don't know how to go about it. My PD is really nice and I would feel like an a$h$ for doing this to him. but I just can't see myself in this field anymore and I'm afraid I'll sink into depression soon although I'll have to finish my intern year. Another thing is that the way my program or specialty is structured means I won't get much time off for interviews. So is there a relatively painless way to switch to another specialty without hurting many feelings and going on many interviews???

There is no "painless" way to do this. Someone is going to feel the pain, the question is whether it will be you, your program, or some combination thereof. Regardless:

1. If this is a competitive specialty, there are probably lots of people willing to take your place. Given a reasonable amount of notice, I expect your PD could find a replacement for you. You should review what your contract states -- usually 3 months notice would be acceptable.

2. Finding a new spot for you will be more difficult. Easiest would be to reapply in the match, but as you point out your interview time will be limited.

3. Buyer's remorse is very common at the beginning of the year. Before you make any rash decisions, you should try to stick it out for at least 3-6 months to be sure you're really unhappy in this field. If it's a competitive field, this is likely to be your last chance in it.

4. I would consider working in your program for three months. At the beginning of October, if it's not going well, then you consider sitting down with your PD and reviewing your options. If you give your notice then, you'll finish 3 months later -- end of december. This would allow you to interview in January for the match. (Note that if things are not going well, you should start getting your ERAS stuff together in early september).

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