<font face="Verdana, Arial, Helvetica" size="2">Originally posted by turtleboard:
What I have heard is that switching fields is next to impossible, but I suppose that's for someone who's already boarded in something (HCFA funding and all).•
That is largely true. Unfortunately, HCFA funding rules give advantage to those who start in longer residencies, ie: surgical training. For example, you would be able to switch mid-stream (provided you find a spot) if you started a Gen Surg residency (which funds you for 5 years) then decided to switch to a 3 year EM program in PGY2 - you would still have 4 years of HCFA funding left. And for those stellar candidates, I've been told programs *may* overlook the loss of extra funding (but don't count on it). However, the reverse is not true - as the regulations stand it appears to be next to impossible to switch from a shorter residency (ie, EM) to a longer one without your new program losing funds for you during the last couple of years.
<font face="Verdana, Arial, Helvetica" size="2">The scramble occurs through NRMP too? I had no idea how that worked, to be honest. I haven't heard anything in the way of 1s not being able to use the NRMP match for reapplication, but just assumed that that's not how it worked.
The way I understand the scramble to works is as follows:
The day after everyone finds out whether or not they matched, those who are enrolled in the NRMP and have a user id and password can log onto the NRMP site and get information about Unfilled programs.
After noon on that day, unmatched applicants are allowed to start contacting programs to secure a residency spot. During this process, you can use ERAS to transfer your applications to programs to which you did not originally apply. There is no charge for this service, provided it takes place during a certain period (ie, I think they only allow you to do it for a couple of days, and am not sure if there is a limit on how many apps you can transfer for free. However, it is only available for those who enrolled in the NRMP, used ERAS and were unmatched. It is not available for those not enrolled.)
Now technically I do not believe you have to be enrolled in the NRMP to participate in the scramble as long as you can obtain a list of the unfilled programs and send them your information yourself. I am sure this is how many people obtain spots outside of the match - people who either couldn't finish their stuff in time for the NRMP or were otherwise unable to participate in the match.
The NRMP rules state that if you are matched to a program, you are contracted to start your residency there. Every year, however, matched applicants look at the list of Unfilled programs and see "better" spots listed there and try to get out of their NRMP contract. To be honest, I'm sure this happens and I am NOT sure what the consequences are. NRMP regulations say that if you do no accept the position you matched to you are unable to enroll in the match or scramble for a position for 1 calendar year. I am not sure how they get the information - if there is some reporting that the programs do, etc. if students do not accept the positions offered them. I suppose it would be up to the program to report that Student X did not accept the match position offered. If they could fill the spot right away perhaps it isn't a problem.
Since I have been curious about this issue over the last couple of years I have seen people asking about getting out of their NRMO contract, I think I'll try and find out when I start in July.
I can find no regulations preventing people from matching into a PGY1 spot then using the NRMP for future spots. As a matter of fact, on the interview trail I met a PGY3 who was wanting to switch programs mid-stream (from 1 surgery program to another, so HCFA funding was not a problem). He had the approval of his PD and Chair and they let him know which programs had openings, and he applied for PGY3 spots through the NRMP at these programs. Not sure how you note this - if you state in your personal statement or what. Maybe I was confused about this. But I do know there is no restriction on using the NRMP to get PGY2 spots in programs that list PGY2 openings.
Does that make sense?
Anyway, that's my take.
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