Position Swap Advice: Switching Residency or Match Waiver

[zc9191]

Hey,

Seeking some advice.

Recently matched a categorical general surgery residency position, but a medical issue came up that will likely make it difficult for me to complete a gen surg residency. For this reason, I am now interested in pursuing IM (a field which I throughout loved and definitely see myself practicing happily for 30+ years). Some background info:
US IMG
250+ Step 1
260+ Step 2
Excellent grades and extracurriculars

I was wondering whether I should pursue a match waiver on medical grounds and either attempt to find an open position for this year, as unlikely as it may be to find one this late in the season (or pursue a waiver and take this year off while working with an internist in an unpaid research position--in order to obtain letters of rec and reapply for the match in September). My school also informed me that I would be able to skip graduation and stay on as a student for another year if I pursued a waiver (so that I may complete some sub-I's, obtain letters from internists, and reapply for the match)

My other option would be to just start intern year and try to switch out after 45 days if I find that it is too difficult for me with my medical condition (not too sure how my PD would react if I pursued this route...I love gen surg, but seriously doubt I'd be able to succeed in my current state and don't want to put myself or the program in harm's way).

My question is whether having an approved match waiver on my file would be seen as a sort of "red flag" by programs when I reapply for the match. I spoke with the NRMP and they said that it is not a red flag per se, but that programs are able to see that you had previously matched, and that I should be prepared to answer any questions they may have regarding this. Would having a match waiver be a hinderance in any way and prevent me from getting as many interview invitations as I would if I were to reapply for the Match during my upcoming intern year in gen surg?

I am at a crossroads and have no idea what I should do at this point in time. Any advice would be greatly appreciated.

In summary: US IMG with competitive board scores matched into categorical general surg position, but will likely be unable to complete residency successfully given unforeseen medical condition (I have a note from my physician stating such). Wondering whether I should pursue a match waiver and reapply in IM next year (either graduating and taking a research year or skipping graduation and staying on as a student which would allow me to complete a couple of sub internships in IM) or try to start intern year and switch out after the minimum 45 day commitment?

Alternatively, would it be possible to switch with another recently matched categorical resident in IM seeking a gen surg spot prior to beginning intern year?

Thanks!

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[TraumaLlamaMD]

It’s going to be a lot harder to apply for a new spot while in the midst of a surgery intern year. If available, I’d take the extra year of school and get specialty-appropriate letters, time off to interview, etc.

 

[patomd1]

Similar thing happened to me last year - abruptly got sick overnight, was in a wheelchair, and symptoms too unstable at that time to even get through residency orientation. From the beginning (two months before residency started) I was in touch with my program director regarding my situation which I think is key. I went on a medical leave at first, then did not qualify for long-term disability, so asked if I could defer the rest of the year and start with the next incoming class. I was able to keep my medical insurance, but no longer received short term disability pay. The GME office at my program took care of the NRMP waiver and we agreed I would reapply in the match next year to secure my spot in order to start with the next class. Although I am improved, I don't think I have the stamina to endure an intern year at a very rigorous program so am currently in touch with my PD regarding switching into a specialty that allows me to be more sedentary (pathology, psychiatry). He is amazing and very supportive so will likely end up signing another NRMP waiver. I will likely be reapplying this fall (unless a spot opens up). Yea it's two years off residency, but oh well - I needed that time to get my health back on track and figure out my future plans. I was set on a procedural heavy specialty for years, but the reality of it is my physical abilities are different now so I will need to adjust. Not sure what your medical issues is - but I would 100% recommend taking the year off. In my case, it took me 6 months to get out of a wheelchair, and several more months to find the proper medication regimen to control my symptoms. This would have been impossible during intern year and the added stress would have only set my health back.

A friend asked another PD whether an NRMP waiver affects chances of re-matching as long as you are forthcoming with your response when reapplying it should be fine - medical issues happen. According to him, they see it as a red flag when an applicant is shady about it as they start to suspect substance abuse as the cause for the lapse in training. Best of luck to you and happy healing!

 

[Happy_001_001]

Hey,

Seeking some advice.

Recently matched a categorical general surgery residency position, but a medical issue came up that will likely make it difficult for me to complete a gen surg residency. For this reason, I am now interested in pursuing IM (a field which I throughout loved and definitely see myself practicing happily for 30+ years). Some background info:
US IMG
250+ Step 1
260+ Step 2
Excellent grades and extracurriculars

I was wondering whether I should pursue a match waiver on medical grounds and either attempt to find an open position for this year, as unlikely as it may be to find one this late in the season (or pursue a waiver and take this year off while working with an internist in an unpaid research position--in order to obtain letters of rec and reapply for the match in September). My school also informed me that I would be able to skip graduation and stay on as a student for another year if I pursued a waiver (so that I may complete some sub-I's, obtain letters from internists, and reapply for the match)

My other option would be to just start intern year and try to switch out after 45 days if I find that it is too difficult for me with my medical condition (not too sure how my PD would react if I pursued this route...I love gen surg, but seriously doubt I'd be able to succeed in my current state and don't want to put myself or the program in harm's way).

My question is whether having an approved match waiver on my file would be seen as a sort of "red flag" by programs when I reapply for the match. I spoke with the NRMP and they said that it is not a red flag per se, but that programs are able to see that you had previously matched, and that I should be prepared to answer any questions they may have regarding this. Would having a match waiver be a hinderance in any way and prevent me from getting as many interview invitations as I would if I were to reapply for the Match during my upcoming intern year in gen surg?

I am at a crossroads and have no idea what I should do at this point in time. Any advice would be greatly appreciated.

In summary: US IMG with competitive board scores matched into categorical general surg position, but will likely be unable to complete residency successfully given unforeseen medical condition (I have a note from my physician stating such). Wondering whether I should pursue a match waiver and reapply in IM next year (either graduating and taking a research year or skipping graduation and staying on as a student which would allow me to complete a couple of sub internships in IM) or try to start intern year and switch out after the minimum 45 day commitment?

Alternatively, would it be possible to switch with another recently matched categorical resident in IM seeking a gen surg spot prior to beginning intern year?

Thanks!

Hi, were you able to make a swap? email me at [email protected]