Changing residency positions

[Arthrocity]

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So I'm hoping to change into a different residency program at the PGY-2 level (currently a PGY-2 resident), and my question is as follows. I know there is a 45 day contractual commitment to the current program we are in to avoid violations, and I'm definitely going to be fulfilling that, but after that, are we under any obligation to continue in our program? There is something on the NRMP website that says we are supposed to have "good faith" when it comes to the contract we sign. So if we leave after 45 days, is that considered not good faith? Does that mean that there is no way to get out of the program then until the year is out?

Also my understanding is that we can contact programs anytime after the soap that ended back in March, but can we interview prior to the 45 days? Or do we have to wait after 45 days? The NRMP is confusing in this regard. In particular, the website says that we have 45 days to fulfill and technically we can quit after that, but that we cannot take another residency program in the same concurrent year. How does that make sense? For example, if I have spent say 60 days in my program, and then after that I want to enter a different program, I have technically fulfilled my 45 days of commitment, so it should not technically be a violation. But that's technically still entering a different program in the same concurrent year.

Anyone care to chime in?

 

[Doctor Bob]

At this point, the information on the NRMP website is irrelevant to you.
What matters is what is in your employment contract; how much notification is required to terminate the contract as well as what is considered a good faith arrangement. Those issues will be spelled out in the contract that you signed with your residency program.

 

[Arthrocity]

At this point, the information on the NRMP website is irrelevant to you.
What matters is what is in your employment contract; how much notification is required to terminate the contract as well as what is considered a good faith arrangement. Those issues will be spelled out in the contract that you signed with your residency program.

Well I know for sure I have to stay 45 days at least to prevent a match violation, which as mentioned I will absolutely do.

And yes I have looked at my contract and in my understanding I only have to give 1 day notice (of course I would give more). But it says I or the hospital can be released from the contract as long as 1 day of notice is given.

But am I able to interview for other programs at this point? That's the big burning question for me really.

 

[Doctor Bob]

But am I able to interview for other programs at this point? That's the big burning question for me really.

Are you intending to go through the match again, or try to get a spot outside of the match?

 

[Arthrocity]

Are you intending to go through the match again, or try to get a spot outside of the match?

Hopefully outside the match. I am aware that I can apply through the match and interview at that time, but wanted to know if I can interview before the Sept. ERAS timeline.

 

[Doctor Bob]

Hopefully outside the match. I am aware that I can apply through the match and interview at that time, but wanted to know if I can interview before the Sept. ERAS timeline.

If you're going to go outside of the match then the NRMP window is irrelevant. Violating their rules only prevents you from using their service; it doesn't stop you from going outside of the match process.

 

[NotAProgDirector]

There's what you can legally do, and what you should professionally do.

Legally, your requirements are only the NRMP and your contract. If you matched into a PGY-2 position, then you should stay for 45 days to complete your NRMP requirement. You may be looking outside the match for a spot, but you want to leave the option of a NRMP spot open. You've already mentioned that your contract is basically "at will". This is highly unusual, and you should check again. From your description, your PD can terminate you tomorrow for no reason at all. But, if correct, then these are the only two legal barriers.

Professionally, you should give your current employer reasonable notice -- enough time to search for a replacement, change schedules, etc. In general, 3 months is reasonable for a residency.

Nothing stops you from looking for a new spot now, when you find one giving notice (a minimum of 2 months, 3 is better unless your PD doesn't care), and moving to a new position.

 

[Arthrocity]

There's what you can legally do, and what you should professionally do.

Legally, your requirements are only the NRMP and your contract. If you matched into a PGY-2 position, then you should stay for 45 days to complete your NRMP requirement. You may be looking outside the match for a spot, but you want to leave the option of a NRMP spot open. You've already mentioned that your contract is basically "at will". This is highly unusual, and you should check again. From your description, your PD can terminate you tomorrow for no reason at all. But, if correct, then these are the only two legal barriers.

Professionally, you should give your current employer reasonable notice -- enough time to search for a replacement, change schedules, etc. In general, 3 months is reasonable for a residency.

Nothing stops you from looking for a new spot now, when you find one giving notice (a minimum of 2 months, 3 is better unless your PD doesn't care), and moving to a new position.

Thank you, your last paragraph is exactly what I wanted to make sure about. Based on my understanding that's also what I was under the impression about how things worked, but always like to verify things. Thanks PD!👍

 

[bluebird17]

Simple question can I go through Match while in first year of training? I already believe that Match commitment does not go beyond 45 days of starting training correct? It does not apply afterward in the first year of training. provided Program can terminate residents training and do not renew contract if willing so. which by itself means neither program nor resident is bind by match commitment anymore.

Thank you

 

[Crayola227]

your post doesn't really make sense and while I love me a good necrobump you can easily read multiple more recent threads to have this all explained ad naseum

go to NRMP to understand that yes match is binding if you take time to understand it by reading silly website

yes you may go thru the match again your first year, however it is not a good plan AT ALL

take your match to a program more seriously than a marriage, because between the two one can **** your life WAAAYYY more than the other, no really

match once like your life depends on it (it sorta does) and avoid doing it again at all costs
trying to get out of your program can ruin you in so many ways (yes there are plenty of wonderful kind PDs that will help you on your way... but getting out must be worth taking the small risk of the malicious PD that tries to tank your career for leaving)

your number one goal from day one of medical school is securing a successful one time only match, aim for that
then read SDN threads for damage control

TLDR
please do some SDN & NRMP reading
please try to only match once ever
otherwise damage control will be in order
NEVER try to "sneak match"

 

[bluebird17]

im trying to do some SDN reading as you can see. and on NRMP there is only one short 45 day binding commitment/waiver match violation statement.
instead of freaking me out please be more specific and give me links if you really want to help.

im not trying to sneak the match. im trying to go through it again. and i am sorry if i dont have luxury to easily form the very first time be destined to my profession through match provided I am a foreign graduate. i would be thankful if you give me "damage control link" and any explanation on that.

 

[bluebird17]

Well I know for sure I have to stay 45 days at least to prevent a match violation, which as mentioned I will absolutely do.

And yes I have looked at my contract and in my understanding I only have to give 1 day notice (of course I would give more). But it says I or the hospital can be released from the contract as long as 1 day of notice is given.

But am I able to interview for other programs at this point? That's the big burning question for me really.

I am exactly at same burning point . i looked at my contract it only says ten days written notices. please advice how things went for you as well as is there any clear answer if i can apply go through match . and waiver process does not apply to me!?
I am Pgy1 in categorical position. want to go through match for the promised spot in different specialty which is my home country fully trained specialty.

 

[bluebird17]

your post doesn't really make sense and while I love me a good necrobump you can easily read multiple more recent threads to have this all explained ad naseum

go to NRMP to understand that yes match is binding if you take time to understand it by reading silly website

yes you may go thru the match again your first year, however it is not a good plan AT ALL

take your match to a program more seriously than a marriage, because between the two one can **** your life WAAAYYY more than the other, no really

match once like your life depends on it (it sorta does) and avoid doing it again at all costs
trying to get out of your program can ruin you in so many ways (yes there are plenty of wonderful kind PDs that will help you on your way... but getting out must be worth taking the small risk of the malicious PD that tries to tank your career for leaving)

your number one goal from day one of medical school is securing a successful one time only match, aim for that
then read SDN threads for damage control

TLDR
please do some SDN & NRMP reading
please try to only match once ever
otherwise damage control will be in order
NEVER try to "sneak match"

I want to give you a better reply to make sense:
My current program has no better resident then me.
I have promised spot in a decent program in the specialty which is the one im fully trained in my home country. to get the position i have to apply because the decent program is participating in match. I want to do my old (which is yet still very fresh) specialty so badly that i can even wait to finish my current training, but i highly doubt my value on that highly competitive specialty will stay the same after couple years.

Im just asking if i can legally participate in Match as a first year categorical resident in my current Categorial program. and if waiver applies to me or not.
and no i could not find answers on NRMP website policies and match commitment site.
and yes you could help me alot if you know and could give me clear answers instead of ..ing around with philosophy how match can mass up my life more then marriage. couple divorces have not taken **** out of me so please dont scare me. just help

 

[Raryn]

Simple question can I go through Match while in first year of training? I already believe that Match commitment does not go beyond 45 days of starting training correct? It does not apply afterward in the first year of training. provided Program can terminate residents training and do not renew contract if willing so. which by itself means neither program nor resident is bind by match commitment anymore.

Thank you

Ignore crayola's melodramatics. The paranoia there is widely known.

You can go through the match in your first year of training, with the caveat being that you will need a waiver if you are a prelim who is doing a different specialty for your PGY2. If you are in a categorical program, your NRMP obligation is complete after 45 days and you do not need a waiver. Many people have done it in the past, and it is completely normal for things like specialty changes.

To do it right, what you want to do is be upfront with your program director. They need to know that they will need to find a potential replacement. Assuming that everyone involved is informed, there will be no penalty to you (except if the deal falls through... so be careful before you pull the trigger).

 

[ThoracicGuy]

I want to give you a better reply to make sense:
My current program has no better resident then me.
I have promised spot in a decent program in the specialty which is the one im fully trained in my home country. to get the position i have to apply because the decent program is participating in match. I want to do my old (which is yet still very fresh) specialty so badly that i can even wait to finish my current training, but i highly doubt my value on that highly competitive specialty will stay the same after couple years.

Im just asking if i can legally participate in Match as a first year categorical resident in my current Categorial program. and if waiver applies to me or not.
and no i could not find answers on NRMP website policies and match commitment site.
and yes you could help me alot if you know and could give me clear answers instead of ..ing around with philosophy how match can mass up my life more then marriage. couple divorces have not taken **** out of me so please dont scare me. just help

Just be careful. If you give up your current program, you run the risk of not getting a new program. I can tell that English is not your first language and I would worry that you might have a hard time finding a program that will take you.

 

[NotAProgDirector]

If I understand your position correctly, you are currently enrolled as a PGY-1 in Program A. You are interested in transferring into Program B in a new specialty, but need to participate in the match to do so. The question is whether this is allowable under the match rules, and whether you will get into some sort of trouble because of it.

1. If you matched into a categorical position, then you have fulfilled your match commitment once you have worked for 45 days. You are free to match into a new program if you would like, and do NOT need a waiver.
2. Participating in the Match while being under contract for that next year is a match violation. This is clearly described on the FAQ page, where the question is asked:

I signed a contract outside the Main Residency Match®. What should I do?

• If you already have registered with the NRMP, you MUST withdraw from the Main Residency Match by the Rank Order List Deadline. You can withdraw by logging in to the Registration, Ranking, and Results®(R3®) system and selecting the withdraw option. Failure to withdraw by the Rank Order List Deadline is a violation of the Match Participation Agreement signed at registration.

Hence, in order to do this you would need to forgo/delay signing any contract for the next year until you get your match results. Your program does not need to hold your spot for you, they can offer it to someone else if they would like.

If you do sign a PGY-2 contract and then participate in the match, Program A could complain to the NRMP. If so, you could lose both spots.

 

[bluebird17]

Thank you so much. Y made my life easy! and yes I think i am ready to not sign a contract, preliminary residents will take my pgy2 and i will wait and pray to get matched the only program I am applying to.

 

[bluebird17]

Ignore crayola's melodramatics. The paranoia there is widely known.

You can go through the match in your first year of training, with the caveat being that you will need a waiver if you are a prelim who is doing a different specialty for your PGY2. If you are in a categorical program, your NRMP obligation is complete after 45 days and you do not need a waiver. Many people have done it in the past, and it is completely normal for things like specialty changes.

To do it right, what you want to do is be upfront with your program director. They need to know that they will need to find a potential replacement. Assuming that everyone involved is informed, there will be no penalty to you (except if the deal falls through... so be careful before you pull the trigger).

thank you so much. I am categorical. and prelims in my program would be happy to take my spot. So i will give someone a nice gift for the New Year..

 

[Crayola227]

there was more than one thread almost identical to this....

my bad reading your first post with non-student status I assumed this was all theoretically and that you had not matched yet, before matching is the best time to avoid re-matching, which, while my sense of humor is to be "melodramatic and paranoid", nothing in my new feature TLDR is wrong

categoricals deciding to switch out after 45 days... in a small program with no shoe-in to take your place? that will always make you VERY unpopular
maybe less so big program w/ shoe in
in fact, taking a prelim --> categorical is no cakewalk for the program or prelim as far as scheduling, depending on requirements for continuity clinic, rotations, etc, all the interns I have known who have made switches have had 3-9 of additional months to complete at their new program

and the people who ridiculed me above pointed out that depending how you handle this you... end up with no second year contract at all? how is that not the third very worst thing that could ever happen that might permanently end your clinical career? (the first two being not finishing intern year or matching to begin with?) especially for an FMG who may have been lucky to be categorical at all?

clarify: the MATCH is binding, it's just binding from the time of match until 45 days after you start your appointment, the fact that you may be under an at will work contract after that does not make it any less binding as it was defined for the time it was applicable, so it was really your confusing of the match commitment with your job contract that I was getting at

the don't try to "sneak match" thing I will always bring up because for all the reasons we've all stated, like having your second year contract given to someone else while you fail to secure a position, it crosses the mind of every single resident looking to transfer if they can get a spot before telling their PD to start hiring their f*ing job right out from under them before they have another one. Any resident that doesn't get nauseated just thinking about telling their PD they want to leave the program... at least understand this is a big deal and should be avoided

TLDR:
looking to switch residencies is always nerve wracking
because it is almost always a pain in the ass to PDs
there is almost always some risk however small for you personally that you end up with no residency
this will almost always make things a bit awkward at a categorical program unless they have a prelim ALREADY there to shoe in
that said do what you must but understand the risks
sneak matching always crosses people's minds but don't do it

 

[bluebird17]

there was more than one thread almost identical to this....

my bad reading your first post with non-student status I assumed this was all theoretically and that you had not matched yet, before matching is the best time to avoid re-matching, which, while my sense of humor is to be "melodramatic and paranoid", nothing in my new feature TLDR is wrong

categoricals deciding to switch out after 45 days... in a small program with no shoe-in to take your place? that will always make you VERY unpopular
maybe less so big program w/ shoe in
in fact, taking a prelim --> categorical is no cakewalk for the program or prelim as far as scheduling, depending on requirements for continuity clinic, rotations, etc, all the interns I have known who have made switches have had 3-9 of additional months to complete at their new program

and the people who ridiculed me above pointed out that depending how you handle this you... end up with no second year contract at all? how is that not the third very worst thing that could ever happen that might permanently end your clinical career? (the first two being not finishing intern year or matching to begin with?) especially for an FMG who may have been lucky to be categorical at all?

clarify: the MATCH is binding, it's just binding from the time of match until 45 days after you start your appointment, the fact that you may be under an at will work contract after that does not make it any less binding as it was defined for the time it was applicable, so it was really your confusing of the match commitment with your job contract that I was getting at

the don't try to "sneak match" thing I will always bring up because for all the reasons we've all stated, like having your second year contract given to someone else while you fail to secure a position, it crosses the mind of every single resident looking to transfer if they can get a spot before telling their PD to start hiring their f*ing job right out from under them before they have another one. Any resident that doesn't get nauseated just thinking about telling their PD they want to leave the program... at least understand this is a big deal and should be avoided

TLDR:
looking to switch residencies is always nerve wracking
because it is almost always a pain in the ass to PDs
there is almost always some risk however small for you personally that you end up with no residency
this will almost always make things a bit awkward at a categorical program unless they have a prelim ALREADY there to shoe in
that said do what you must but understand the risks
sneak matching always crosses people's minds but don't do it

Thanks. I have all those in mind. and yes the third is the worst thing that can happen and there is a very high risk 50/50%. I am literally risking everything and despite the risk i won't sneak. especially that prelims currently my classmates would benefit from my second year spot. and I have very good reputation and great relationship with all the faculty especially PD, and last thing I want to be left with when I am on the street jobless is to have zero chance of talking back to these great people. Thanks again. your advices finally ended up my couple months misery struggle with myself what to do. it was funny that you compared match with marriage. i suddenly thought you overheard me somewhere. How i feel now is exactly like a stable, unhappy marriage, where my husband is very happy.. but me be it this year, next or after i finish my training ill be ready to cheat and sneak out anytime.. and yeah this will be a move of a not vey smart female, leaving relationship before securing a new one.. here you go lot of melodrama and i would gladly receive back irony.. again thanks for discouraging and encouraging 🙂 my first trial on SDN turned out to be very helpful