Breaking a ACGME contract ? ? ?

[DO bound]

What are the rules for breaking a MD residency contract?

Im a DO (soon to be anyways in 2 months). I am matched MD currently (as of this week of course and my contract is on its way in the mail) but Im having second thoughts of abandoning my osteopathic training. I am willing to seek out an open AOA position.

I know its a big time violation for taking a ACGME contract and seeking out another ACGME position. What about going ACGME --> AOA? Aside from pissing off the MD program, whats the rules? Would anything stop me from taking an AOA contract?

Any knowledge/Insight here guys?

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[BobBarker]

Why?

 

[bigDinLV]

The remaining DO positions are mostly in primary care. Not much was left open for other specialties and i'm sure there are even less available now.

So if you're intereated in primary, I guess you could give it a try. I guess who would care if you become a ACGME match violator and then never apply through the ACGME again. I wouldn't do it myself though.

 

[misery]

Why would you want to go backwards? I feel like I have been set free...your much better off in ACGME.

 

[time2go]

Why would you want to go backwards? I feel like I have been set free...your much better off in ACGME.

Why do you feel like you have been set free? Is the AOA not as desireable as the allopathic residencies???? i think i read another comment similar to this earlier, could you please describe?

 

[Old_Mil]

Any knowledge/Insight here guys?

Yeah; this would be a really bad move. Sort of like turning down an acceptance letter to Harvard Med to go be a garbage collector.

 

[ShyRem]

You can always supplement your ACGME with some OMT on the side. Find a DO in the area. Or go back for OMT updates in the year. There are ways to keep it up without sacrificing your lovely match result. I would also talk to the dean of the nearest DO school and find out when their DO trainings are held. You may be able to work your weekends to get some extra training in there. Get hold of the local osteopathic state board and see what's around your area. There are ways to have both. It's tough, but there are ways.

 

[Buckeye(OH)]

Yeah; this would be a really bad move. Sort of like turning down an acceptance letter to Harvard Med to go be a garbage collector.

Garbage collector? Stop running your mouth.

 

[DO bound]

OK, maybe I should have been more clear. Im not looking to clearify my decision.

My question was;
What are the rules for breaking an ACGME contract and signing an AOA one?

2 things:
-They use seperate matching services, and
-I haven't signed my ACGME contract yet

Anyone with knowledge here?

 

[FlaMedic]

Yeah; this would be a really bad move. Sort of like turning down an acceptance letter to Harvard Med to go be a garbage collector.

What an idiot.

 

[surrender903]

Yeah; this would be a really bad move. Sort of like turning down an acceptance letter to Harvard Med to go be a garbage collector.

the analogies section of the SAT was really hard for you no?

 

[wmc24]

Garbage collector? Stop running your mouth.

old mil has subtlety hated on DO's in other threads previously also. he/she is a real tough guy

 

[PunkmedGirl]

old mil has subtlety hated on DO's in other threads previously also. he/she is a real tough guy

I think we can all agree that he's a little bitter for not getting into a MD med school.

 

[MossPoh]

Yeah; this would be a really bad move. Sort of like turning down an acceptance letter to Harvard Med to go be a garbage collector.

That seems a little extreme. How about turning down a nice private school for an average state school? (Even that is wrong under the right constraints)

 

[FutureInternist]

Turning down Megan Fox for Jessica Alba

 

[Doctor Phil]

Let's say you're applying to both AOA and ACGME programs. The AOA matches first. They have an arrangement whereby the AOA notifies the NRMP and the NRMP drops you from the ACGME process. Presumably, this arrangement goes both ways. The NRMP will notify the AOA that you matched and you will be blocked from taking any official route through the AOA.

So that leaves scrambling, which is what I assume you're considering.

But just so you're clear on the ramifications, here are a few things I hope you're thinking about:

-This means a program you ranked will now be short a resident, which they will try to fill from remaining scramble candidates. If they can't fill the spot, they will lose the funding. If I were them, I'd be pretty unhappy about this whole situation and I might even be wary about accepting DO candidates in the future. This would be a heavy price for your colleagues to pay for your folly.

-On the other end, if I were the director of a DO program and you showed up in this situation, I'd have to wonder why you didn't consider this before, and I might wonder about how much I could count on you. So unless you had a major change of heart and want to go into OMM, you probably ought to come up with a better reason. I think most program directors will frown on the fact that you matched but wouldn't sign the contract. Truth is, participating in the match to begin with is an agreement to sign the contract. You may be able to legally get away with it, but I would think it will be a black mark on your record as you look for a new match and maybe even later in your career.

That's not to say that it's not worth it if you truly feel you gotta do it. But these are some heavy prices to potentially pay. I don't say this stuff to bust your balls, I'm just trying to help you think this through fully.

Please let us know how it turns out and if you find a more specific answer to your question. I do think the AOA is desperate to fill FP residencies, and that will work to your favor if you want to go that route.

 

[ceftazidime]

I agree with the above post. I think another option to satisfy both you and the program you're contracted with is to do your first year in the ACGME residency, and then transfer to an AOA program, hopefully being placed in an advanced position.

I know you have your reasons, but at this point in the game there are very few quality AOA spots still open. To me, it does not make sense to be a "martyr" and sacrifice your own education for the sake of the AOA.

 

[stonewall22]

Read this:

http://www.nrmp.org/res_match/policies/map_main.html#conseq_apps

Also, look at section 2.5 on getting a waiver of the match results.

I have to be honest though...as mentioned above, I can't imagine the PD will look at DOs the same way in the future. You made a commitment, have some integrity and keep your commitment. The reasons you stated for wanting to not honor your commitment don't sound very extenuating to me. If you matched ACGME, depending on the specialty, you're probably a pretty strong applicant. So get a waiver to get your internship year approved by the AOA, and then transfer.

 

[DeLaughterDO]

Matching is a binding contract: breaking that contract without the program's approval is a match violation and you could be forbidden from ever participating in the match again. I am assuming if you cross the NRMP they will let NATMATCH know and you will be screwed both ways. If you are planning on scrambling into an AOA position this year, good luck this late in the game. It's been over a month since the NATMATCH and most likely there are not many spots left. Also, if you do get out of your contract, whatever place you scramble into, the PD will most likely want to talk to the PD of the program you are leaving (if you tell them you were matched to an ACGME program), which may go poorly for you.

You will be treading on very rocky ground if you decide to do this. As ceftazidime noted, it may be best to ride out a year and re-apply next year. I agree with ShyRem in that your state Osteopathic society can help you augment your training, and you can attend the national and state meetings as well.

Training in ACGME does not necessarily mean you are abandoning your osteopathic training, as you so aptly put it...

 

[DO bound]

I know you've all been losing sleep over my decision but I have decided to honor my ACGME contract.

I was in a very particular situation that I couldnt explain due to not wanting to reveal too much info. Bottom line, Im sticking to it.

 

[Doctor Bob]

I know you've all been losing sleep over my decision but I have decided to honor my ACGME contract.

Bottom line, Im sticking to it.

 

[Styria]

Maybe you could do an NMM+1 residency following your ACGME one.