Advice on switching to Rad Onc

[ChemoRads]

I am looking for advice on a switch to radiation oncology. I am currently finishing up my preliminary year and matched into an advance PGY-2 radiology position in a major city. I did a radiation oncology rotation my fourth year of medical school and loved it. Unfortunately I discovered it too late in the process and was already applied for radiology. It's something I have thought about all year long and want to go all in the process of switching.

If any of the spots go unfilled in the SOAP would I be able to apply for them?

If I want to apply this cycle will I have to drop from my current radiology program?

When and how do I have a discussion with my current radiology program?

What would you suggest be the best way about switching to radiation oncology?

Thanks again

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[Gfunk6]

Since I'm pretty far removed from the Match, I'm sure others can answer your questions more intelligently. However, to kick start the conversation, I'll throw in my two cents.

If any of the spots go unfilled in the SOAP would I be able to apply for them?

Since you did not participate in the Match, you are not eligible to participate in the SOAP. However, if a Rad Onc program goes unfilled after the SOAP, it is possible that they would solicit candidates from outside the Match. In this scenario, you would be eligible.

If I want to apply this cycle will I have to drop from my current radiology program?

Do NOT drop out of your current residency program until you have a signed contract for a Rad Onc position. I cannot emphasize this enough! Right now, you have a good future as a diagnostic radiologist which you should not compromise unless you are 100% certain you have something else lined up.

When and how do I have a discussion with my current radiology program?

This is a really tough situation and needs to be thought out carefully. I suggest that you try to squeeze in a "Rad Onc elective" to re-confirm if you really want to switch fields. If you still feel that Rad Onc is your calling, you have a range of options but none are really ideal:

1. Engage your Radiology PD early, tell him that you want to change fields if possible, request permission to interview. This is the most honest approach but your PD may use this information against you by not renewing your contract in favor of someone else BEFORE you have secured a position, that would be a disaster. Also, telling the PD that Radiology is not your preferred field may negatively color your future evaluations and rotations.

2. Stay mum until you are able to interview with a few Rad Onc programs. If you have a position, THEN tell your PD. This is the least honest approach but the safest from the perspective of your future career. On the one hand, if you are unsuccessful in obtaining a Rad Onc position then no one will be the wiser and you can carry on as if nothing happened. If you do get a position and leave then it may leave your fellow residents in a lurch in terms of coverage, rotations, etc.

What would you suggest be the best way about switching to radiation oncology?

In your situation, dropping out of your current residency and re-entering the Match doesn't sound like a good idea. I would look for residency programs that are adding spots outside the Match (you can look in this forum and the ARRO website, but content is nearly always cross-posted). Alternatively, try cold calling a few programs in your geographical area of interest.

 

[sim13]

I am a current pgy-1 also starting a residency in radiology in july. Our stories our pretty similar so let me share with you the roller coaster I've been through this past yr. In last year's match i applied to rad onc and did not match so I used the SOAP to get into a radiology residency. (I thought radiology was a good choice, maybe I could do IR, get into IR oncology, who knows). However, after starting my prelim year I decided radiology is not for me- I hate procedures and the thought of sitting in a reading room all day is terrible. This past october a spot opened up outside of the match that i applied for and got. When I told my program director at the radiology residency that i intended to break my contract with them and take the rad onc spot, she informed me that technically what i did was a match violation. i had an NRMP contract through the SOAP with the radiology program and talking to another program constituted a match violation. Obviously all of this was accidental on my part. I had talked to multiple program directors as my current prelim program as well as the dean of student affairs at my med school. they all encouraged me to apply for the spot.
Long story short, the NRMP found out and not only did they ban me from going to this rad onc program, they are currently investigating my case and will most likely be giving me at least a 1 yr penalty where I cannot apply in the match and cannot take any job at an NRMP affiliated institution during the penalty time. (meaning, staying at my current program to continue medicine and hopefully do heme onc is not an option). My only choice is going to my radiology residency in July or be unemployed.
Some "fun facts" I have learned during this whole process. This year the NRMP instituted an "all in" policy. this policy states that no program is allowed to offer spots outside of the match for pgy-2 advanced spots. all of these need to go through the match. So the program that offered me the spot technically should have never been offering the spot in the first place.
The NRMP allows you to submit a waiver request to release you from your contract. This must be completed by Jan 15 of the year you start training. So it is too late now to get such a waiver. So what i should have done is applied for the waiver and never told my radiology program anything. it's obviously too late to get the waiver now. It seems like it would make sense if a)the program you have a contract with agrees to release you, b)the program you want to go to wants you to come and c)the applicant is agreeable to everything. These three things were all the case with my situation and yet the NRMP stepped in and will not allow me to go to the rad onc program. (the way that the NRMP found out about the whole thing is a very long story, so i will spare you that.) but they were very agreeable to letting me out of my radiology waiver. they basically told me they would let me out of it, I just couldn't go to any NRMP-affiliated program. so basically my options were urology, optho, or unemployment.
so bottom line, my advice would be to reapply in the match next year and not to apply to anything right now in fear of getting a match violation.

 

[deleted4401]

That's an absolutely horrible story. Don't even know what to say. If the radiology program director turned you in, she is an absolutely terrible person. Is there any recourse?

 

[sim13]

Thanks for the sympathy-yeah, it's been a rough year.
My understanding of what happened with the NRMP finding out about the whole thing is that the radiology program director told the DIO (whatever that stands for, the person in charge of all residencies at an institution) at the radiology program and that person told the DIO at the rad onc institution. So technically she did not turn me in to the NRMP directly. The DIO and PD at the rad onc institution, who were unaware of my radiology contract, wanted to be transparent to the NRMP and let them know what had happened. Last i heard they were also under investigation because they should not have interviewed me in the first place. Hopefully they are not getting punished, but it is unfortunate how they are the ones who turned me in, even though it was with good intentions per se.
The whole situation is very unethical. I have had attendings and mentors at my current prelim program suggest i pursue a law suit. I don't think it will be successful. It's ok though, the lady at the NRMP assured me that my "crime was not that aggregious" (exact words) so i would probably not get a 3 yr penalty. But I could potentially get 2 years. That was 3.5 months ago and still no decision.
My advice to anyone who didn't match this year, do not scramble unless you know for sure that the specialty you are choosing is one you would love equally to rad onc.

 

[653106]

so why programs are offering spots out of match? also did they allow you to stay at your rad program

 

[sim13]

I think it's because they don't know the rule. The program i got the offer from had no idea about the rule.
And yeah, they are allowing me to stay at the rads program. That's the only option I have, but at least I have that one I guess. May be kinda awkward since the PD knows I don't want to be there.

 

[653106]

I just read it, yes. In fact only way you can get off cycle spot and be within NRMP las is either:
do a waiver before Jan 15 and have it accepted before you contact programs
or
just match to a PGY-1 spot without any PGY-2
if you violate and have PGY-2 and match in another PGY-2 off cycle you can be reported and have sim13 outcome (sorry for that) or get lucky and not be reported (is it worth taking the risk?)
My issue is programs should know the policy, and it seems most do not

 

[medgator]

this is a good point.
here is the NRMPs FAQ on the all in policy:
http://www.nrmp.org/allinpolicyexceptionsstatement.pdf

I only did a quick read of it, but it seems as if, from this point forward, if one goes unmatched and takes an intern year with the hopes of getting a spot outside the match for the following July (like myself and numerous others have in the past), it's not actually possible and would be a match violation for the rad onc program.

Is that how others are interpreting it?

I think so. You are OK if you're looking to transfer programs, but that's about it. Here's a few paragraphs I thought were pertinent from that document:

However, PGY-2 or higher positions in categorical programs and PGY-3 or higher positions in advanced programs are not subject to the Policy because the NRMP does not match for those positions.

Unique circumstances: Within the NRMP's R3 system, program tracks can be created for
 International medical graduates with funding from their home countries
 Combined clinical-research programs where the first year is not clinical training
 Unexpected openings in advanced specialties where a PGY-2 position can be filled in the year of The Match

That bolded line doesn't make sense to me, because there is no feasible way for a 4th-year medical student to take a spot like that. I guess what it means is that current interns/residents (or people doing research who've completed an internship) will have to enter a unique match just for those PGY-2 spots that open up mid-year. Basically, you won't be able to take these newly-added/unexpected spots without going through the NRMP. Sounds like a racket to me.

 

[ReOxygenation]

Woah. That's unnecessarily evil of the NRMP and your program. This whole process is BS (and this is coming from a fully matched person). It's still an imperfect and corruptible system which honestly does not have the best interest of the applicant at heart. There is no reason for the NRMP to have done that other than to protect their own "policy." And under what authority do they have the power to forbid you from pursuing your medical training? It's simple fear that a program can't participate in Match. I say good. Revolt and start handing out contracts as you please, programs. Why do programs want to operate with these restrictions is beyond me. Clearly applicants are the scapegoats and powerless against the evil that is the NRMP.

 

[Radbio22]

Agreed, what exactly is NRMP realistically trying to do, other than gain complete control over the process for the sole intent of having the ability to impede an applicant from pursuing the career they have worked so hard to achieve. The system should be in place to prevent such atrocities from occurring, not be the reason they occur. It should be able to make concessions to help candidates, not impose rules that neither benefit the candidate nor the training program.

 

[Gfunk6]

so bottom line, my advice would be to reapply in the match next year and not to apply to anything right now in fear of getting a match violation.

I'm so sorry this happened to you. We very much appreciate your crucial and honest input into this thread so that future re-applicants can avoid running afoul of the NRMP.

 

[deleted4401]

It's just so capricious, mean spirited, and violates the spirit of medical ethos - "First do no harm". By letting him go to the rad onc program hurts no one.

Instead of teaching others to play by the rules, maybe these arbitrary rules should be changed. I hope something can be done. Sounds like not, but to monopolize the secondary selection process sounds like it hurts more than helps candidates.

I think what burns me is that I violated the match, and instead of being a-holes about it, the program i matched to let me go, knowing I'd be better off, while in your case they acted biliously.

 

[RadOncDoc21]

It's just so capricious, mean spirited, and violates the spirit of medical ethos - "First do no harm". By letting him go to the rad onc program hurts no one.

Instead of teaching others to play by the rules, maybe these arbitrary rules should be changed. I hope something can be done. Sounds like not, but to monopolize the secondary selection process sounds like it hurts more than helps candidates.

I think what burns me is that I violated the match, and instead of being a-holes about it, the program i matched to let me go, knowing I'd be better off, while in your case they acted biliously.

No doubt, the system in place now sucks... I think we all violated the rules at some point. Sounds like the PD is being a jerk.

 

[napoleondynamite]

Dude, sim13 your story just infuriates me - really sorry that you have gone through that load of bullcrap with the PD and the freaking NRMP. It's just shameful. Shameful!!!!

Not only is it cruel and lame that the PD would not let you out of your contract, it is also not very smart. Why would a program want a less-than-happy future resident to be entering their program?! That's the stupidest thing I ever heard to try to force someone to come to work and do a job they obviously don't love. I can't believe the kind of crud we have to put up with sometimes in our profession. Where else on this Earth would this kind of crap happen..maybe the military?? But at least then you can have pride for love of country or something. This is just pure, unadulterated screwing with someone's life and it ain't right. I'm pissed for you dude. I hope somehow it can work out for you..hang in there.

 

[radiaterMike]

ND- from what I read above the PD was willing to let sim13 out, but the NRMP would not allow it.

The all in policy is meant to protect the applicant so that he/she is not put in the awkward position of getting a 'take it or leave it' offer from a program outside of the match. Obviously their appeal process is severely flawed. The major culprit in this situation is the rad. onc. program. While sim13 is also at fault, this is not a criminal case (despite the NRMP's choice of words) where ignorance of the laws is not a justifiable excuse. To me, it is understandable that an applicant, who does not have the resources of a DOI (whatever that is) and other administrators, would not completely understand the rules, and an appeals process could easily determine there was no ill intent. A 1+ year ban is unjustifiable and could be pursued legally- although given how long legal proceedings take, it would not get you anywhere.

With respect to all in-- it is an institutional (i.e. all programs within that institution) policy to accept or reject (and totally abandon the match) it. So a program cannot revolt without all the programs in the institution doing so.

There are rare situations where an all in program can accept someone outside of the match- such as a resident dropping out or getting booted (very unlikely) or after an increase in the number of spots (not rare, but not common either).

Dude, sim13 your story just infuriates me - really sorry that you have gone through that load of bullcrap with the PD and the freaking NRMP. It's just shameful. Shameful!!!!

Not only is it cruel and lame that the PD would not let you out of your contract, it is also not very smart. Why would a program want a less-than-happy future resident to be entering their program?! That's the stupidest thing I ever heard to try to force someone to come to work and do a job they obviously don't love. I can't believe the kind of crud we have to put up with sometimes in our profession. Where else on this Earth would this kind of crap happen..maybe the military?? But at least then you can have pride for love of country or something. This is just pure, unadulterated screwing with someone's life and it ain't right. I'm pissed for you dude. I hope somehow it can work out for you..hang in there.

 

[Seldon1985]

I am a current pgy-1 also starting a residency in radiology in july. Our stories our pretty similar so let me share with you the roller coaster I've been through this past yr. In last year's match i applied to rad onc and did not match so I used the SOAP to get into a radiology residency. (I thought radiology was a good choice, maybe I could do IR, get into IR oncology, who knows). However, after starting my prelim year I decided radiology is not for me- I hate procedures and the thought of sitting in a reading room all day is terrible. This past october a spot opened up outside of the match that i applied for and got. When I told my program director at the radiology residency that i intended to break my contract with them and take the rad onc spot, she informed me that technically what i did was a match violation. i had an NRMP contract through the SOAP with the radiology program and talking to another program constituted a match violation. Obviously all of this was accidental on my part. I had talked to multiple program directors as my current prelim program as well as the dean of student affairs at my med school. they all encouraged me to apply for the spot.
Long story short, the NRMP found out and not only did they ban me from going to this rad onc program, they are currently investigating my case and will most likely be giving me at least a 1 yr penalty where I cannot apply in the match and cannot take any job at an NRMP affiliated institution during the penalty time. (meaning, staying at my current program to continue medicine and hopefully do heme onc is not an option). My only choice is going to my radiology residency in July or be unemployed.
Some "fun facts" I have learned during this whole process. This year the NRMP instituted an "all in" policy. this policy states that no program is allowed to offer spots outside of the match for pgy-2 advanced spots. all of these need to go through the match. So the program that offered me the spot technically should have never been offering the spot in the first place.
The NRMP allows you to submit a waiver request to release you from your contract. This must be completed by Jan 15 of the year you start training. So it is too late now to get such a waiver. So what i should have done is applied for the waiver and never told my radiology program anything. it's obviously too late to get the waiver now. It seems like it would make sense if a)the program you have a contract with agrees to release you, b)the program you want to go to wants you to come and c)the applicant is agreeable to everything. These three things were all the case with my situation and yet the NRMP stepped in and will not allow me to go to the rad onc program. (the way that the NRMP found out about the whole thing is a very long story, so i will spare you that.) but they were very agreeable to letting me out of my radiology waiver. they basically told me they would let me out of it, I just couldn't go to any NRMP-affiliated program. so basically my options were urology, optho, or unemployment.
so bottom line, my advice would be to reapply in the match next year and not to apply to anything right now in fear of getting a match violation.

Would be nice to one day read about the NRMP in a nice investigative journalism report - the NRMP is unethical. The match process, the inflexibility of the system after match, the "price fixing" in terms of salary, the pressure for hospitals to go "all in"... I agree that the older system of offering spots randomly to medical students wasn't good either, but with the terrible system we now have in place, we're pigeon holing so many generations of students. Many of you guys have to make a specialty decision by your 3rd yr in med school (some even sooner due to competitiveness). You should be able to change your mind about your long term interests, but with the current system, it would be very difficult to do so if not at the risk of jeopardizing any future at all.

 

[napoleondynamite]

I hope you're right..I just assumed that b/c the PD was the one that mentioned he/she was technically violating the match that they were the ones enforcing the NRMP. Otherwise, how would it ever be possible for people to transfer out of programs, even between radonc? That doesn't happen all the time, but it does happen and my understanding is if both programs are willing and agreeable to the arrangement then it's not a problem. Seems to me if the PD in the radiology program wanted to help sim13, then they could have instead of putting up more road blocks and enforcing the technicalities of the nazi NRMP beaurocracy.

 

[deleted4401]

Legally and by the NRMPs outlandish rules, you might be right.

But, in a field like rad onc that starts at PGY-2 and in any given year, may have 10-15 spots open up at various points in the year (because of the unbelievable slowness of another regulatory devil, the ACGME), how does it make sense to have each program open up one spot to a match process?

I'm not sure how it protects an unmatched intern (or an intern in a field that is their second choice) to have to apply through NRMP when a random spot opens up.

Here is my scenario. Didn't match as a PGY-4, so took an intern year position. Reapplied and matched to Baylor for a full year later, so I had a gap. UPMC offers me a spot in May (2 months before PGY-2 would start). I asked Dr Paulino at Baylor if he could offer me a lab or clinical research position with a small salary and health benefits. There was nothing in the budget. I told him I could start without killing a year. So, he signs my resignation letter, and I get to go to UPMC. He got another resident who was probably way smarter than me. I got to start my career sooner. In this new world, I would be stuck and probably peeved that I had to kill a year working as a bartender.

The protections are for PGY-4s, unless someone can give me a scenario where an unmatched (or matched to an undesirable specialty) candidate benefits from the new rules.

ND- from what I read above the PD was willing to let sim13 out, but the NRMP would not allow it.

The all in policy is meant to protect the applicant so that he/she is not put in the awkward position of getting a 'take it or leave it' offer from a program outside of the match. Obviously their appeal process is severely flawed. The major culprit in this situation is the rad. onc. program. While sim13 is also at fault, this is not a criminal case (despite the NRMP's choice of words) where ignorance of the laws is not a justifiable excuse. To me, it is understandable that an applicant, who does not have the resources of a DOI (whatever that is) and other administrators, would not completely understand the rules, and an appeals process could easily determine there was no ill intent. A 1+ year ban is unjustifiable and could be pursued legally- although given how long legal proceedings take, it would not get you anywhere.

With respect to all in-- it is an institutional (i.e. all programs within that institution) policy to accept or reject (and totally abandon the match) it. So a program cannot revolt without all the programs in the institution doing so.

There are rare situations where an all in program can accept someone outside of the match- such as a resident dropping out or getting booted (very unlikely) or after an increase in the number of spots (not rare, but not common either).

 

[radiaterMike]

SimulD- I agree that common sense should prevail. I assume in the eyes of the NRMP, they view themselves as protecting PGY1s applying for a rare spot in the same manner as MS4s applying for 1 of 100+ spots.

Seldon 1995- I agree, though the NRMP has nothing to do with resident salaries, only the matching process. Hospitals/Universities get $$$ from the CMS from which they pay their residents, which is why the salaries are similar (but not the same). Many (most) get money for fewer residents than they actually have.

Legally and by the NRMPs outlandish rules, you might be right.

But, in a field like rad onc that starts at PGY-2 and in any given year, may have 10-15 spots open up at various points in the year (because of the unbelievable slowness of another regulatory devil, the ACGME), how does it make sense to have each program open up one spot to a match process?

I'm not sure how it protects an unmatched intern (or an intern in a field that is their second choice) to have to apply through NRMP when a random spot opens up.

Here is my scenario. Didn't match as a PGY-4, so took an intern year position. Reapplied and matched to Baylor for a full year later, so I had a gap. UPMC offers me a spot in May (2 months before PGY-2 would start). I asked Dr Paulino at Baylor if he could offer me a lab or clinical research position with a small salary and health benefits. There was nothing in the budget. I told him I could start without killing a year. So, he signs my resignation letter, and I get to go to UPMC. He got another resident who was probably way smarter than me. I got to start my career sooner. In this new world, I would be stuck and probably peeved that I had to kill a year working as a bartender.

The protections are for PGY-4s, unless someone can give me a scenario where an unmatched (or matched to an undesirable specialty) candidate benefits from the new rules.

 

[Seldon1985]

SimulD- I agree that common sense should prevail. I assume in the eyes of the NRMP, they view themselves as protecting PGY1s applying for a rare spot in the same manner as MS4s applying for 1 of 100+ spots.

Seldon 1995- I agree, though the NRMP has nothing to do with resident salaries, only the matching process. Hospitals/Universities get $$$ from the CMS from which they pay their residents, which is why the salaries are similar (but not the same). Many (most) get money for fewer residents than they actually have.

Very true, my frustration went a bit too far about salaries, haha, sorry. Yes we do get money from CMS for our spots (to the hospitals, which is then divided up), and that too is unfortunately at risk...

 

[evilbooyaa]

My only question is that if the NRMP is not allowing things like this, then what happens to the PGY-2 spots that are open every year, for which a MS-4 wouldn't be able to apply for? What is the recourse for someone who wants to do RadOnc that does not match in their first attempt, besides wasting a year? I always heard about re-applying for spots as well as looking outside of the match to jump straight into a PGY-2 spot after intern year.

Was sim13's story complicated due to the fact that he already had a PGY-2 spot lined up when he was re-applying for RadOnc? SimulD, would your experience be considered an NRMP violation at this point, even though you didn't have a contract for a PGY-2 spot the following year?

 

[medgator]

My only question is that if the NRMP is not allowing things like this, then what happens to the PGY-2 spots that are open every year, for which a MS-4 wouldn't be able to apply for?

See my post above. It appears that nrmp wants to monopolize those spots into their system and create a special match for them

 

[IamnotFreud]

My only question is that if the NRMP is not allowing things like this, then what happens to the PGY-2 spots that are open every year, for which a MS-4 wouldn't be able to apply for? What is the recourse for someone who wants to do RadOnc that does not match in their first attempt, besides wasting a year? I always heard about re-applying for spots as well as looking outside of the match to jump straight into a PGY-2 spot after intern year.

Was sim13's story complicated due to the fact that he already had a PGY-2 spot lined up when he was re-applying for RadOnc? SimulD, would your experience be considered an NRMP violation at this point, even though you didn't have a contract for a PGY-2 spot the following year?

So I have read most of this thread given that I am in a position where I'll like to switch into something else and I think there are a number of misunderstandings on this thread. I think how things are done has not only become absolutely ridiculous but also extensively complicated to the point of it being absolutely ludicrous. But given my numerous calls to the NRMP here is what I understand regarding switching/taking outside the match positions.

So indeed residents can switch into different fields and can take PGY-2 spots outside the match if they only have a prelim spot or even if they have a PGY-2. Thing is, you have to at least complete 45 days of your PGY-2 position before you can move on to any program regardless of whether there is another program who would accept you or whether your program is willing to let you go.

So that was a problem in this case. So the person who found the radonc position (sorry I forget your handle) unfortunately violated the match because they were not going to be completing the first 45 days of the radiology residency. So if he had completed internship, worked something out with rad onc program, and completed 45+ days of rads program, and THEN started rad onc residency, there would not have been an issue. Also, you don't HAVE to tell your current program that you want to switch, but you need to let your program that you have switched into know so they can arrange the schedule so that you can start off cycle.

It's sad that this whole thing happened, but I think the rules have become so confusing that it's not difficult to make a misstep. I think it's sad also that we are all running around terrified of violating the match, and screwing up due to nebulous and complex rules that are arbitrary and pointless. But going by technicalities, it's a shame that this poster did not know of this, because ultimately it would have been something that could have been easy to fix-just start off cycle after you did 45 days of your radiology residency and then move on to rad onc.

 

[sim13]

Thanks for the support everyone. It's been very cathartic to share my story on here and know that almost every one agrees with how ridiculous the whole thing is.
In regard to the previous post, there are a couple of things to clarify.
I'm not too sure how to go about doing what you said in regard to getting the rad onc program to agree to start me 45 days after starting pgy-2 year in radiology. just communicating with a program while having a contract with another program is a match violation. (so i kinda did like 3 violations when I applied, interviewed, AND accepted the positionIf the 45 day option would have been presented to me of course I would have jumped on that, no questions asked. The real way to avoid a match violation in my case would have been to get a waiver from the NRMP BEFORE applying for the position at the rad onc program. I have confirmed this with the NRMP policy director on the phone in multiple conversations- they would have granted me the waiver and even AFTER the whole match violation was brought to light, they still were going to grant me the waiver. i just didnt want the waiver anymore because my only option was to be unemployed.
The reason I am not allowed to go the rad onc program, even after 45 days, is that i committed a match violation. and the nrmp found out. so right now my case in under investigation (and according to an email i received yesterday, should be decided hopefully this week) and i will MOST LIKELY get a penalty that lasts at least 1 year. during this year I cannot:
1)re-enter the match
2) take any position outside of the match at ANY instituiton affiliated with the NRMP (so that includes my internal medicine residency.)

so what i will probably end up doing is reapply in rad onc as soon as I can. or possibly come back to my current IM program after my "penalty year(s)(not the best program ever, but I'm pretty happy and it happens to be in my home city) and doing heme onc.

if my radiology PD makes things awkward or treats me in any way unfairly, you better believe I will be ass out the door in 45 days. no questions asked. i guess i could always get a research job or moonlight (passed step 3 so i guess I'm licensed right?) for the remained of the year.

i'll update the thread if any major turn of events happens.

 

[IamnotFreud]

Thanks for the support everyone. It's been very cathartic to share my story on here and know that almost every one agrees with how ridiculous the whole thing is.
In regard to the previous post, there are a couple of things to clarify.
I'm not too sure how to go about doing what you said in regard to getting the rad onc program to agree to start me 45 days after starting pgy-2 year in radiology. just communicating with a program while having a contract with another program is a match violation. (so i kinda did like 3 violations when I applied, interviewed, AND accepted the positionIf the 45 day option would have been presented to me of course I would have jumped on that, no questions asked. The real way to avoid a match violation in my case would have been to get a waiver from the NRMP BEFORE applying for the position at the rad onc program. I have confirmed this with the NRMP policy director on the phone in multiple conversations- they would have granted me the waiver and even AFTER the whole match violation was brought to light, they still were going to grant me the waiver. i just didnt want the waiver anymore because my only option was to be unemployed.
The reason I am not allowed to go the rad onc program, even after 45 days, is that i committed a match violation. and the nrmp found out. so right now my case in under investigation (and according to an email i received yesterday, should be decided hopefully this week) and i will MOST LIKELY get a penalty that lasts at least 1 year. during this year I cannot:
1)re-enter the match
2) take any position outside of the match at ANY instituiton affiliated with the NRMP (so that includes my internal medicine residency.)

so what i will probably end up doing is reapply in rad onc as soon as I can. or possibly come back to my current IM program after my "penalty year(s)(not the best program ever, but I'm pretty happy and it happens to be in my home city) and doing heme onc.

if my radiology PD makes things awkward or treats me in any way unfairly, you better believe I will be ass out the door in 45 days. no questions asked. i guess i could always get a research job or moonlight (passed step 3 so i guess I'm licensed right?) for the remained of the year.

i'll update the thread if any major turn of events happens.

It's complicated, but you are incorrect. The whole thing about talking to a program and it being a violation is if you are going through the match/SOAP program currently, not once you are in your position.

Say you are in your PGY-2 year, it's September and you see a rad onc spot. (This is assuming you are a neutral person, not you currently given the whole match violation thing now). So say you have fulfilled your 45 day committment since it's Sept. in this scenario, you are free to IV for that position with no issue and start it.

The same way if you match into a position, you can go through the match again in Sept. of that year, where clearly you are in contact with programs so that's clearly not a violation.

Does that make sense? I think your issue was a very minor technicality. So your problem is that you got your PGY-2 during SOAP. If you had already been in your PGY-2 spot in October, you would have had no issue talking to another program. How do you think people switch residencies?

 

[sim13]

oh what you're saying totally makes sense. If I would have been a pgy-2 and not a pgy-1 I could have done what i did with no issue. It was because I was a pgy-1 with a contract for pgy-2 that it was a problem.
but yeah, you're absolutely right. just misunderstood you.

 

[IamnotFreud]

oh what you're saying totally makes sense. If I would have been a pgy-2 and not a pgy-1 I could have done what i did with no issue. It was because I was a pgy-1 with a contract for pgy-2 that it was a problem.
but yeah, you're absolutely right. just misunderstood you.

Yep, exactly. I do feel terrible for you though, and I wish things would have worked out for you. The only way you could circumvent this would be programs that go outside the match and are not NRMP affiliated, which I don't know if any rad onc programs do. I would think though, that the program that liked you back then would give you a second shot, or could have delayed your start no?

 

[sim13]

So I found out today that I got a 1 year penalty where I can't reapply in the match. I am debating on appealing it/getting an attorney. But not sure if it is worth it. Any advice from anyone that has had similar issues with the NRMP would be greatly appreciated.