Choosing second residency

[Hemoperitoneum]

I am a PGY3 and have recently decided that I made a mistake when choosing my residency. I do not enjoy the field, and can not imagine happily working as an attending. My PD and I decided it was best for me to resign and look for a second residency. He is willing to provide me with a letter of recommendation. I have decent board scores, good residency reviews, and above average inservice exam scores. My current choices are to reapply as a PGY1 for next July, or take a PGY2 spot in another residency at my current hospital. The PGY1 spot will allow me to get a more structured, more involved education at a Level I trauma center; the PGY2 spot will provide me with a well-rounded but more relaxed education at a small community hospital. I am torn between taking a spot now vs finding a part time job in research or urgent care and reapplying for a PGY1 postiton. Unfortunately, I am limited geographically due to my spouse's medical practice. Any advice?

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[docbill]

I am a PGY3 and have recently decided that I made a mistake when choosing my residency. I do not enjoy the field, and can not imagine happily working as an attending. My PD and I decided it was best for me to resign and look for a second residency. He is willing to provide me with a letter of recommendation. I have decent board scores, good residency reviews, and above average inservice exam scores. My current choices are to reapply as a PGY1 for next July, or take a PGY2 spot in another residency at my current hospital. The PGY1 spot will allow me to get a more structured, more involved education at a Level I trauma center; the PGY2 spot will provide me with a well-rounded but more relaxed education at a small community hospital. I am torn between taking a spot now vs finding a part time job in research or urgent care and reapplying for a PGY1 postiton. Unfortunately, I am limited geographically due to my spouse's medical practice. Any advice?

If it is a 3 year program? Just finish it. If it is 4 or 5 years... then I don't know.

 

[Hemoperitoneum]

Current program is 5 years.

 

[gutonc]

Current program is 5 years.

So you want out of Gen Surg and into EM.

Are both of these spots guaranteed or are you going to be going through the Match to get the R1 spot? If they're both sure things, go with the one where you like the other people in the program and the curriculum more. If that doesn't help you figure it out, go with the one where you won't have to do extra training.

 

[Hemoperitoneum]

Neither spot is guaranteed. I've been told that I could most likely have the PGY2 spot available currently at my hospital by the med ed department. As for the PGY1 spot, I almost went there for residency originally when deciding between specialties and still have contact with some of the attendings and other residents. They have told me I'd be a very competitive candidate for a PGY1 position. I don't want to rush into a decision, but I don't want to lose the PGY2 spot if that is best for me.

 

[Buzz Me]

Is your CMS funding going to be exhausted if you start a 3- or 4-year EM residency as a PGY-1? (This is assuming you finish your PGY-3 year in Gen Surg.)

 

[turquoiseblue]

can you do EM-pgy2 with using a PGY1 surgery as a prerequisite? i did not know that was possible.

 

[shopsteward]

I am a PGY3 and have recently decided that I made a mistake when choosing my residency. ... My PD and I decided it was best for me to resign and look for a second residency. ....Any advice?

You say you've recently decided this: how recently? And with what level of certainty? Unless there is a big hurry in making a decision (eg you have a short time to decide on a quick jump across to the PGY2 residency and this would definitely be the right decision for you) it may be better to take your time with this decision, and make sure that any choices you make are the ones which, in the long run, you will regret the least. Despite what you've said to your PD, if the right decision for you might still be to stay on where you are, would that be possible?

Do you have the chance to stay where you are until you have secured a PGY1 position next July? Could you cope with staying on that long? Will your program director be happy for you to stay on that long? It's a much more comfortable position resigning from one job if you already have the next job lined up. If not, how much of what may have been said informally might you be able to get guaranteed in writing?

Your PD may be wonderful, but he will have the best interests of his program at heart, and in a situation like this that may not be the same as having your best interests at heart. Is there a residents' adviser you can talk to? What about other sources of unbiased and expert advice from people who know you and know the system you are in? (Don't try HR unless they have a specific, independent, service for advice like this: it's the job of HR to be on the side of the PD.)

One vital thing is to keep your program director as happy as you can, so that you continue to be offered those letters of recommendation - from what you say about your in-service reviews and exam scores this is no more than you deserve, but having talked about resignation is a potential red flag, and you don't need any more. (This last may be too pessimistic a reading of your situation: I hope so.)

Good luck