I should caveat my post by noting that it really is the wild, wild west when it comes to transferring. At Duke, for example, last year 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 in January.
That said, on to your questions.
does anyone know of a friend (sdn member who i could contact) who switched from internal medicine residency to psychiatry residency?
I do not have any large sample evidence on how common this occurence is, but there are many programs that take new PGYII psychiatry residents, for example, Stanford and UW. At UW, many of the new PGYII residents either started training or completed training in another specialty and have decided to switch. I can't think of them off the top of my head, but among the seniors there are at least 3 who had completed family medicine residencies and soon after entered the UW program as PGYII's, there is someone who practiced pediatrics for several years before joining as a PGYII, and there is also another senior resident who dropped out after one year of surgery to start as a PGYII. Among the junior residents, there is one who practiced ophthalmology for many, many years before joining as a PGYII; and there are two who dropped out after the intern years of their respective programs (internal medicine, family medicine) and just joined as new PGYII's.
can you apply for a pgy2 spot if you finished your intern year?
Yes. See previous.
is it a problem to go from a 3 year residency to a 4 year program?
Depends on the program you're quitting, and depends on the program you're transferring to. If you're dropping out of internal medicine, then it's possible that the program director may -- after the transfer goes through and you've been accepted to another program -- allow you to use your elective months to do rotations that would count towards a psychiatry residency (e.g., neurology, neurology consult). And whether they actually would count also depends on the program director of the psych program to which you are transferring.
One of the PGYIII's at my program dropped out of internal medicine (after completing her intern year) to retrain in psychiatry. She was able to get credit for some of her months (e.g., neurology), but it wasn't enough to allow her to make a seamless transition. The program director was very flexible and cobbled together a plan for her that has so far worked out well. For example, even though she is a PGYIII she still had some inpatient psych months to make up. (At most programs, only PGYI's and PGYII's will do inpatient psych.)
All in all, because the PGYIV years at most psych programs are 80-100% elective time, there should be a way for you to work something out with the program director of the psych program to which you are transferring.
Some programs set aside a certain number of spots for new PGYII's, for example, Stanford and UW. At those programs, each year there are a certain number of new incoming PGYII's who are expected.
Other programs don't officially set aside slots but they have observed from year to year that it usually turns out (e.g., maternity leave, residents who switch to 50% time or take time off) that spots open up, for example UCSF.
Still other program's don't expect to have openings, but sometimes they may have openings if a resident drops out or some other reason. The APA maintains a clearinghouse of residency vacancies (
click here) that is updated periodically. Looks like UCLA-NPI currently has a spot opening up next year for a PGYII -- does anyone on this forum know the story?
Regardless of how the spots are open, you generally should send in your application by September, which is about the time you would apply if applying as a new intern in the regular Match. Some programs will fill their new PGYII spots through the Match, e.g. UW, and you get interviewed along with the other MSIV's interviewing for PGYI spots. Other programs don't necessarily fill through the Match, e.g., UCSF and Stanford, and although you get interviewed along with the other MSIV's, in most instances you will hear back from the program (i.e., either they extend you and offer or they do not) prior to Match Day. For example, UCSF accepted one of their new PGYII's (a transfer from another psychiatry program) the week before Thanksgiving.
what is the process of switching? what are important things to keep in mind?
Regarding the timing, see previous.
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, because if the hospital is resident-dependent 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, i.e., a 3-year program will need to find a new PGYIII. For example, Stanford's emergency medicine residency recently lost one of its PGYII's (who transferred out to follow her husband geographically), and they were unable to recruit a resident who would join as a PGYIII -- so this 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").
By whom?
I suppose it varies from institution to institution. I had a friend who wanted to quit med/peds (and do straight peds) after 1 year, and when she told her program director he basically gave her such a tongue-lashing she meekly decided to continue on as med/peds. (And now she plans on doing a NICU fellowship.) Another one of my friends wanted to transfer from one derm program to another, and when she announced her intentions her program director gave her an extremely hard time about it.
On the psych end of things, I can't say I've heard of a single instance in which I heard someone getting put down for dropping out of another residency program to join our (psych) program. And many of the residents in my program who had dropped out of other residency programs (e.g., internal medicine) to apply in psych said that their program directors were fairly supportive.
do you have to redo the eras application? new personal statement, new letters?
If you are transferring out of a different specialty, my guess is that you would probably have to write a new essay. And it would also be to your advantage if you got new letters suggesting your suitability for training as a psychiatry resident.
However, if you are transferring from one psych program to another, then it's a little easier. But the rules vary from institution to institution. Stanford, for example, just pulls your old ERAS application (if you had interviewed with them in a prior year). UCSF requests an updated personal statement.
Cheers
-AT.
