I'm with Gern on this one. If I were PD, I wouldn't agree to a swap. I'd have to be convinced that the incoming person was someone I would have taken in the match. I'd have that same approach to people coming in outside the match. I don't want to sound unsympathetic, but this is residency and only a few years. There's a lot you're just going to have to suck up and deal with. Once your done, you'll find you have much more geographic freedom. If the reasons are so compelling (my spouse was in a car accident and is a quad and needs an enormous amount of help), then consider contacting the program directly about coming in as a CA-1 after a year. If it's a matter of, "I miss my family," that's not quite so compelling to me. Of course, if you applied to those programs and didn't match there, then odds are against you coming in outside the match of through a swap. Perhaps you'll find a resident and a PD who are cool with a swap, but I wouldn't be. Good luck.