samsee3a

2+ Year Member
Feb 7, 2016
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MD/PhD Student
Hi all, I'm desperate for sincere advice. I recently got matched to community program in IM, and I have just finished 2 months as intern. I found out that the program doesn't meet my expectation and I would like to do GI fellowship which is a competitive fellowship, in addition to that I'm on J1 visa. Will I be able to switch to another program which has in house fellowship? I saw couple of threads mentioned about talking to the PD to get approval, but really I dont know what to say to the PD? I wanna leave because you dont have fellowship?
Thanks in advance
 
Apr 30, 2016
34
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Resident [Any Field]
Tough call especially cause ur img status. What makes you think you can switch into an university program if you didnt match the first time?
 
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samsee3a

2+ Year Member
Feb 7, 2016
8
3
Status
MD/PhD Student
Tough call especially cause ur img status. What makes you think you can switch into an university program if you didnt match the first time?
Thanks for your reply ..
Thats a good question actually, I asked myself this question so many times since I matched .. I have some western experience in Europe , I'm planing to do Step 3 and I started a master degree .. so those could potentially help boosting my CV a bit .. and I do have couple of friends who almost have the same status I have with almost similar Step scores got matched to University Programs ..
So I appreciate your advice guys
 

aProgDirector

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I think you're going to find it very difficult to switch. There's nothing blocking you from doing so -- you're allowed to change programs on a J visa, so all you'd need to do is contact programs, find an opening, get accepted, and switch programs. But openings in good programs aren't common, and I tend to fill my openings with prelims from my own or other good programs that come with good reviews. I'm very unlikely to take someone from a community program that I am not affiliated with, or know something about.

Also note that transferring programs at the PGY-2 stage is possible, but is often a challenge for you. You need to learn the new system without having the benefit of being an intern there, yet fill the PGY-2 role and supervise interns. Many of my transfers have had difficulty with that -- and that makes it more difficult to get the good LOR's you need for a GI spot.

Another path forward for you is to finish your program, then get a hospitalist position on a J waiver at a university program. There's some chance that will be a nocturnist position. Then, with the "free time" you have from that position, you volunteer and do GI research with the GI fellowship program. After your waiver is complete (2 years), you now apply to GI programs with your university hospital medicine experience + GI research + LOR from GI. If that doesn't work, then you have a career in HM, or choose a different fellowship.
 
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samsee3a

2+ Year Member
Feb 7, 2016
8
3
Status
MD/PhD Student
I think you're going to find it very difficult to switch. There's nothing blocking you from doing so -- you're allowed to change programs on a J visa, so all you'd need to do is contact programs, find an opening, get accepted, and switch programs. But openings in good programs aren't common, and I tend to fill my openings with prelims from my own or other good programs that come with good reviews. I'm very unlikely to take someone from a community program that I am not affiliated with, or know something about.

Also note that transferring programs at the PGY-2 stage is possible, but is often a challenge for you. You need to learn the new system without having the benefit of being an intern there, yet fill the PGY-2 role and supervise interns. Many of my transfers have had difficulty with that -- and that makes it more difficult to get the good LOR's you need for a GI spot.

Another path forward for you is to finish your program, then get a hospitalist position on a J waiver at a university program. There's some chance that will be a nocturnist position. Then, with the "free time" you have from that position, you volunteer and do GI research with the GI fellowship program. After your waiver is complete (2 years), you now apply to GI programs with your university hospital medicine experience + GI research + LOR from GI. If that doesn't work, then you have a career in HM, or choose a different fellowship.
Thank you very much for your reply. Actually what I meant was to change at the level of PGY2 level , so is there is a good chances of switching to PGY1 spots now? unless some programs started with unfilled spots?
I did some search and I found some programs that will some interns leaving at end of PGY1 so I could potentially contact the PD for the possibilty of the switch, but the question is shall I be frank with my PD with my intentions of switch or whats the best to say?


Thanks in advance
 

aProgDirector

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You can definitely look for a PGY-2 spot. My middle paragraph above spoke about that. What to tell your current program is difficult -- once a resident tells me that they are looking for a new field/program, I start looking for a replacement. Once I find one, I tell that resident that they need to either commit to their PGY-2 year here with us, or I'll be giving it to the new person. That can leave them with a tough choice if they haven't secured a new position yet. But that's life.

You can try to keep it a secret from your PD, but other programs might want to talk to your PD. You can look without telling them, and then only tell them when you get to the stage that you'll be interviewing -- I think that's a totally reasonable plan. But it's possible that your PD will "find out" though other channels.
 
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samsee3a

2+ Year Member
Feb 7, 2016
8
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MD/PhD Student
You can definitely look for a PGY-2 spot. My middle paragraph above spoke about that. What to tell your current program is difficult -- once a resident tells me that they are looking for a new field/program, I start looking for a replacement. Once I find one, I tell that resident that they need to either commit to their PGY-2 year here with us, or I'll be giving it to the new person. That can leave them with a tough choice if they haven't secured a new position yet. But that's life.

You can try to keep it a secret from your PD, but other programs might want to talk to your PD. You can look without telling them, and then only tell them when you get to the stage that you'll be interviewing -- I think that's a totally reasonable plan. But it's possible that your PD will "find out" though other channels.

How about the options of going through the whole process again and applying to the reiadency from the begining?
 

aProgDirector

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Most programs will not consider you for a PGY-1 year again if you're already doing one. You would then need time to interview at these programs, which your current program might or might not grant you. If you applied to more academic programs in the last cycle, it's not likely you'd do much better this cycle -- all you'd have is 2-3 months of PGY-1 experience. Last, the match is in March and it's not uncommon for programs to want PGY-2 commitments from their interns before that -- you'd need to choose to not sign your PGY-2 contract and hope for another match (and potentially end up with nothing) or withdraw from the match and keep your PGY-2. So, although possible / legal, it's not very likely.
 
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samsee3a

2+ Year Member
Feb 7, 2016
8
3
Status
MD/PhD Student
Most programs will not consider you for a PGY-1 year again if you're already doing one. You would then need time to interview at these programs, which your current program might or might not grant you. If you applied to more academic programs in the last cycle, it's not likely you'd do much better this cycle -- all you'd have is 2-3 months of PGY-1 experience. Last, the match is in March and it's not uncommon for programs to want PGY-2 commitments from their interns before that -- you'd need to choose to not sign your PGY-2 contract and hope for another match (and potentially end up with nothing) or withdraw from the match and keep your PGY-2. So, although possible / legal, it's not very likely.
Thank you . I really do appreciate your advise in my situation.
So it seems difficult to apply for residency all over again, and difficult to switch now during my PGY-1 year.
So its seems like I'm left up with either getting an empty PGY-2 spot in academic program at the end of the PGY-1 and then switch , or take the academic hospitalist pathway during my waiver years then apply for GI spot.
Have you had such an experience like mine with one of the interns/residents before and it worked?