About relocation for residency

[Allbetsarein]

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Hi,
I've really been stressing out lately about relocating for residency. I'm a MS3 with really really strong ties to my current location. If I have to relocate for residency my home will be broken. I don't know if I can be responsible for that kind of damage.

I've been told that my stats are above average for EM (my only specialty of interest). At this point, I'm strongly considering ranking my home EM program no. 1, another program within 3hrs #2 and local Pre-lim positions next.

What are your thoughts on this plan? Does a pre-lim year help when reapplying? Should I explain my situation to my home Residency Director or is it TMI? If you have any other ideas I'd love to hear them.

Thanks!

 

[filhodeinferno]

Depends on where you are currently located. If it's near a competitive program/ideal location, it's gonna take some luck. If it's in a non desirable area and you truly are above average, then you'll get what you want most likely.

 

[Khaos]

It is a hard question to answer. Why do you think you will be the sole reason your home will be broken? Will it break with or without you there? When I left for college, I was leaving a broken home. I also left a girlfriend there but knew that I was far enough away that my parents wouldn't be willing to drive to see me all the time but close enough that my girlfriend and I were willing to drive back and forth almost every other weekend. Sometimes I wouldn't even let my parents know I was back in town. Shortly after leaving my parents were in a bitter divorce. I saw that coming and knew I couldn't change that even if I stayed. One was an alcoholic and the other was an enabler. The one thing I regret is my sister being in the middle of that divorce being used and manipulated by both my parents. I don't know how much of that I would've been able to stop but wish I was there more often for my sister. That was when I did stop by the house more often, but it was for my sister.

I knew where my future plans were going to lead me and I had to keep going. I had the chance to stay very close to them but decided it was best for myself and wife to move away. I am now an EM physician with 2 children with my then girlfriend. We have been together for 19 years and married for 8.

I would highly reconsider and especially reconsider doing a prelim when you already know what you want to do. If you still think there isn't an option then you have to look at how competitive the programs are that you are applying to. How desirable of a location? How many applications do they take a year? Are you a DO, MD, foreign grad? Do you know anyone there? Have you rated there and worked your a** off showing them everything you had? All of these are factors.

 

[Allbetsarein]

Thanks for your response. Congrats on the longevity of your relationship Khaos, that's a priority for me as well. Why do you say reconsider the pre-lim?

Let me give a few more details/clarify the broken home statement. I am a mother and my husband can't relocate with me, I consider that broken because my family will be separated.

I'm a MD student in a pretty competitive area of the country. I've met some of the big players but I haven't rotated yet. I feel like the Pre-lim is my Hail Mary at keeping my family a unit.

Thanks again

 

[SoCuteMD]

I think applying for prelim positions would be a mistake. If you get a prelim spot, what would you do after your prelim year? If your home program doesn't take you fresh out of medical school, a year as a prelim probably isn't going to change their mind, so if you are choosing to be geographically limited to two programs then you probably need a backup specialty that you would be happy training in. If, with an extra year, your husband would be less geographically limited then a prelim year might be a good choice.

I think you'll probably need to have a very honest conversation with the PD at your home program, but I'd wait until you've started your sub-internship so that you can back up your statement of "I really want to stay here" with "and I think I'd be a great fit at this program, etc."

 

[gutonc]

It always drives me a little crazy when people say their spouse can't move because of their job. Unless s/he is an elected official or owns their own business, it's more that they won't or don't want to, not can't move.

And I agree that a prelim is a bad choice if you're basically planning to suicide match otherwise. You'll never be more competitive than you are coming straight out of school. A prelim won't really help you much. So you need to decide if you'd rather move for EM or do another specialty to stay put if you don't match where you are now.

The good news is you're planning ahead and can be proactive with your current program.

 

[deleted547339]

It always drives me a little crazy when people say their spouse can't move because of their job. Unless s/he is an elected official or owns their own business, it's more that they won't or don't want to, not can't move.

And I agree that a prelim is a bad choice if you're basically planning to suicide match otherwise. You'll never be more competitive than you are coming straight out of school. A prelim won't really help you much. So you need to decide if you'd rather move for EM or do another specialty to stay put if you don't match where you are now.

The good news is you're planning ahead and can be proactive with your current program.

I'd tend to agree. Relocating is hard when you have a job, harder when you have a career. That being said, there are very few people who can truly not relocate.

 

[Allbetsarein]

Thank you all for your responses. The can't for relocation means that it would take more than a year for my soouse to get relicensed and try to rebuild his company from scratch in a new location while maintaining the expenses that we currently have. He is willing, it just isn't realistic.

I understand the rationale for not doing a pre-lim now. Is there any correct way to apply to two specialties at one school? I plan on speaking with the PD but I'm not sure if I should mention a back up specialty at all, not to mention it being in the same program.

Thanks again for all of your comments.

 

[deleted109597]

Long term. Who has more earning potential? Would you be happy doing something else because you were worried about leaving for a short period of time?
Residency is 3 years. The rest of your life is much longer. I lived a state away from my spouse so I could do the field I wanted to do. None of us can answer what is best for you, only you can.

Suicide matching is a terrible idea. A rational discussion with your SO about your chances, and then ranking so you have the best chance to stay nearby but still have a job if you don't is probably your best option. Sure, call in all the favors you can to stay nearby, but don't bet on it.

 

[Tiger26]

One of the girls I graduated med school with applied to every residency at our home institution--I think she ended up in family med or something, which she was ok with.

You have to decide whether your desire to be an emergency physician is greater than your desire not to potentially uproot your family. Only you can make that call.

As others have said, your potential earning power in 3 years is likely much larger than your spouse's as an EP ($300-400k, esp in the midwest and Texas).

Furthermore, the field is so competitive now that if you decide not to go all in, you most likely will never get a spot if you fall past your home program.

 

[gman33]

I really didn't want to move due to family issues.
I was lucky to live in an area with a ton of programs.
That being said, I did interview at a number of programs within 2 hours drive.
Don't know what would have happened if I matched at one of those programs.
Wife probably would have moved. Glad I didn't need to figure that out.

Applying to 1-2 programs in EM is a terrible idea if the goal is to match into EM.
Doing a prelim year and reapplying is a terrible idea.
If you are really set on not moving, apply to other specialties as well.
Your home program may not take this very well if they find out.
I really liked my home program and thought I'd have a good chance of ending up there.
It didn't work out that way.

Don't pin your hopes of ending up at a particular place.

 

[Old_Mil]

"Long term who has more earning potential"

(Not sure we should start honestly answering that particular question...)

I am going to throw one more thing out there: it sounds like your husband has his own company...I don't know how big/small/profitable this company is, how many people it employs, or how the ACA will affect it.

If he finds himself in a place like many business owners where he will not be able to afford insurance coverage for his business and your family understand that by going into EM you are entering a field where many if not most jobs have no benefits. If you or your child have serious health problems this could be a major consideration.

Sent from my BlackBerry 9330

 

[EMedGrrl]

I would definitely recommend talking to the EM PD at your home school, during or after your EM rotation there. If you're a strong candidate, they will likely want to keep you anyway, so it's a win-win. Most PDs seem to want a) people who are personable and will pass their boards, b) people who are going to be happy in their program, and c) a home student or two to demonstrate that their own students want to stay in their program (although this one may be more variable). If you have a frank discussion with the PD about your desire to do EM and stay in your home location and fit all of the above, I'd think they would probably be amenable.