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.