Chances of matching after non renewal ?

[nala97]

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Hey everyone,

I posted back in May when I had about 3 months left on my PGY-1 extension in an unopposed FM program. At that time my program had told me I wouldn’t be promoted and that it was very unlikely I’d even get PGY-1 credit. I was debating whether to just leave with 12 months and a verification letter without pgy1 completion certificate or stick it out through the 15 months and risk it.

I ended up staying, and honestly I’m glad I did. It was during those last months that things finally came together once my ADHD treatment stabilized. My documentation, organization, and reasoning under pressure improved a lot. I regret not getting it sorted sooner because it took months of trial and error to find the right dose, and I’d never been stretched as thin as I was in residency, so I thought I was “managing” when really I wasn’t.

By the end, I did meet all my PGY-1 milestones. I passed step 3. My evaluations reflected substantial improvement, I was officially granted my PGY-1 completion certificate, and one of my attendings even wrote in a LOR that I’m performing at a PGY-2 level. Many of my attendings said I’m at indirect supervision level finally. My PD also gave me a supportive letter.

That said, my contract still wasn’t renewed for PGY-2. Their main concern was that I might regress under new pressures, despite the progress I’d shown. That’s been discouraging, but I know I’ve come out of this stronger, with my ADHD finally well controlled and my workflow in place.

Now I’m at a crossroads and could use some advice. Since I have my PGY-1 certificate, am I basically only eligible for PGY-2 FM openings, or could I still apply to PGY-1 FM spots again?

Appreciate any perspective. Thanks again to everyone who replied to me back in May.

 

[ThoracicGuy]

Hey everyone,

I posted back in May when I had about 3 months left on my PGY-1 extension in an unopposed FM program. At that time my program had told me I wouldn’t be promoted and that it was very unlikely I’d even get PGY-1 credit. I was debating whether to just leave with 12 months and a verification letter without pgy1 completion certificate or stick it out through the 15 months and risk it.

I ended up staying, and honestly I’m glad I did. It was during those last months that things finally came together once my ADHD treatment stabilized. My documentation, organization, and reasoning under pressure improved a lot. I regret not getting it sorted sooner because it took months of trial and error to find the right dose, and I’d never been stretched as thin as I was in residency, so I thought I was “managing” when really I wasn’t.

By the end, I did meet all my PGY-1 milestones. I passed step 3. My evaluations reflected substantial improvement, I was officially granted my PGY-1 completion certificate, and one of my attendings even wrote in a LOR that I’m performing at a PGY-2 level. Many of my attendings said I’m at indirect supervision level finally. My PD also gave me a supportive letter.

That said, my contract still wasn’t renewed for PGY-2. Their main concern was that I might regress under new pressures, despite the progress I’d shown. That’s been discouraging, but I know I’ve come out of this stronger, with my ADHD finally well controlled and my workflow in place.

Now I’m at a crossroads and could use some advice. Since I have my PGY-1 certificate, am I basically only eligible for PGY-2 FM openings, or could I still apply to PGY-1 FM spots again? I’m also open to switching into other specialties like IM or EM, but would those programs even consider me for PGY-1 given my background? And if those options aren’t realistic, what else can I do to stay on track with training?

Appreciate any perspective. Thanks again to everyone who replied to me back in May.

You should still be able to repeat PGY1 year at a new place if you/the program chooses so. Apply broadly to all PGY1 and PGY2 spots. Don't get hung up on location or anything else, right now is the time to try and find a spot.

If that doesn't work, you could consider OccMed or PrevMed (if that area interests you). IM/EM might be a stretch.

 

[nala97]

Hi everyone,

I have just completed an extended PGY 1 year in an unopposed rural Family Medicine program. I matched there through the SOAP scramble last cycle. I was the only IMG who trained outside the Caribbean system and arrived with no US inpatient experience. Early on my progress notes took hours, my inbox overflowed, and I froze during rounds. In February the program placed me on probation for professionalism, documentation delays, and slow real-time reasoning. They added a three-month extension, so I finished PGY 1 at the end of September.

Around the same time I was evaluated for long-suspected ADHD, started treatment right away, and the change was dramatic. Weekly coaching, structured note templates, and timed decision checkpoints also helped. By July every probation goal was met. I could manage a ten-patient census, admit new cases at the same time, and complete notes before sign-out. The CCC recorded that all concerns were resolved, and I graduated in good standing with full PGY 1 credit. My program director’s letter says all concerns are resolved and supports my transfer.

When contract season arrived, the program did not offer me a PGY 2 position. After remediation my PD told me it would not be wise to stay because the earlier stigma would follow me, and I agreed. Being under that scrutiny was damaging to my spirit. Looking back, I wish I had chosen a program with stronger resources for IMGs. My contract ended with PGY 1 completion, and I am now jobless and searching for any opening, PGY 2 if possible or even a fresh PGY 1 if a program will consider me. I have emailed a dozen Family Medicine programs with openings and was very honest about my situation, attached my packet, and the PD’s endorsement, yet I have received no replies.

I have strong letters of recommendation, including one from my PD and two faculty who witnessed my turnaround, but the words probation and non-renewal seem toxic. I love Family Medicine and cannot imagine another specialty, but at the moment I feel hopeless and a failure.

I would be grateful for advice:

- Should I mention the probation, contract end (which my program director doesn’t mention and refers to it as a ‘transfer’) plainly in every email, or wait until asked?

-Are mid-year PGY 2 transfers realistic, or should I focus on finding a new PGY 1 spot, and is that even possible with a completion certificate?

Thank you for reading. Any guidance, reality check, or hopeful story would mean a lot.

 

[NotAProgDirector]

Applying again via ERAS for PGY-1 spots is a reasonable choice. As long as you're not on a visa, there's no problem with that. If you are on a J visa, it is absolutely not allowed (and in that case you can't be in the US as you'd be out of visa status, which is a whole other problem). In your PS, you could mention that you're interested in PGY-2 spots if available. When I have an open PGY-2 spot this time of year, looking in ERAS applications is a common solution. Some programs might consider starting you as an off cycle PGY-1 now, and then promoting you to PGY-2 once you prove you're ready (3 months or so).

Ask your prior PD for help. Sometimes open PGY-2 spots are advertised to PD's, and if so you want to know about them.

As mentioned already, PM or OM are also possibilities since you have the PGY-1 done.

If you decide to submit an ERAS app, you need to do so ASAP. It's already late to do so.

 

[hallowmann]

Hi everyone,

I have just completed an extended PGY 1 year in an unopposed rural Family Medicine program. I matched there through the SOAP scramble last cycle. I was the only IMG who trained outside the Caribbean system and arrived with no US inpatient experience. Early on my progress notes took hours, my inbox overflowed, and I froze during rounds. In February the program placed me on probation for professionalism, documentation delays, and slow real-time reasoning. They added a three-month extension, so I finished PGY 1 at the end of September.

Around the same time I was evaluated for long-suspected ADHD, started treatment right away, and the change was dramatic. Weekly coaching, structured note templates, and timed decision checkpoints also helped. By July every probation goal was met. I could manage a ten-patient census, admit new cases at the same time, and complete notes before sign-out. The CCC recorded that all concerns were resolved, and I graduated in good standing with full PGY 1 credit. My program director’s letter says all concerns are resolved and supports my transfer.

When contract season arrived, the program did not offer me a PGY 2 position. After remediation my PD told me it would not be wise to stay because the earlier stigma would follow me, and I agreed. Being under that scrutiny was damaging to my spirit. Looking back, I wish I had chosen a program with stronger resources for IMGs. My contract ended with PGY 1 completion, and I am now jobless and searching for any opening, PGY 2 if possible or even a fresh PGY 1 if a program will consider me. I have emailed a dozen Family Medicine programs with openings and was very honest about my situation, attached my packet, and the PD’s endorsement, yet I have received no replies.

I have strong letters of recommendation, including one from my PD and two faculty who witnessed my turnaround, but the words probation and non-renewal seem toxic. I love Family Medicine and cannot imagine another specialty, but at the moment I feel hopeless and a failure.

I would be grateful for advice:

- Should I mention the probation, contract end (which my program director doesn’t mention and refers to it as a ‘transfer’) plainly in every email, or wait until asked?

-Are mid-year PGY 2 transfers realistic, or should I focus on finding a new PGY 1 spot, and is that even possible with a completion certificate?

Thank you for reading. Any guidance, reality check, or hopeful story would mean a lot.

I wouldn't mention any probation or contract unless its explicitly documented in your information from the program or you are explicitly asked about it.

I would not expect a mid-year PGY2 transfer, maybe PGY1, or in rare situations new or expanding programs will have PGY2 spots to fill at random times. I would just apply as above to as many PGY1 and PGY2 programs you can. You have the advantage of being able to attend every interview, etc, and you should.

I have seen people in your situation join programs as PGY1, PGY2, mid-year PGY1, so any of those are possible, but you have to apply aggressively, get as much support from your past program as you can, and be very flexible and adaptable.