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I still have some time and honestly this feels like a moving target so things may shift before I apply, but I definitely feel conflicted/confused and if possible wanted to start to get some input from others. Basically, I'm interested in a subspecialty that recently changed rules/announced that they will consider applicants to their residency after intern year. Technically this is now the fastest route, and I've had 2 program directors from excellent programs tell me they would definitely take the right candidate after PGY-1. However, another program director who I trust shared with me that frankly he wants residents already able to hit the ground running, and he thinks just intern year is not enough. So here's the 3 paths I am contemplating and what I see as pros/cons of each:
1. Combined programs: probably the route I'm most inclined to go with, given that it means I'd be able to establish myself in one place and not have to go through a second set of applications/interviews. Generally 4 years, though some of the programs ask for a commitment of 5 years (tends to be at the most elite institutions, so even though it means an extra year I think I'd be very happy matching those places).
2. Categorical program and then subspecialty residency: If I finished the entire categorical this would take 5 years minimum. I definitely know of someone who added on a chief year, and extra time during his subspecialty so ended up taking 6 and 1/2yrs and was bitter about all this time in training/lost opportunity cost. If I were open with the program director from the get-go, would it still be frowned upon to consider leaving after PGY-1 or PGY-2? I feel like I shouldn't apply to smaller programs because I don't want to leave them in a tough spot if I left early. Is doing this at all a douchebag move anywhere?
3. Prelim program followed by subspecialty residency: Although this may seem like the obvious choice, there's really not many prelim programs near me geographically and it feels somewhat foolish to move our lives just for a year and then move again. Theoretically if all went smoothly I could be done in 3 years, but the gamble seems risky. I wouldn't apply to any prelims at places that had combined programs (as I think that would be sending mixed messages) and that leaves me with just a few prelims at places that I am less excited about. Even more worrisome, what if those 2 PDs were painting too rosy a picture of my odds applying after just PGY-1 and I didn't match at all into my subspecialty and wasn't in a categorical program that I could finish either?
Sorry for the long/ somewhat complicated post, but as I said I am curious for others thoughts.
1. Combined programs: probably the route I'm most inclined to go with, given that it means I'd be able to establish myself in one place and not have to go through a second set of applications/interviews. Generally 4 years, though some of the programs ask for a commitment of 5 years (tends to be at the most elite institutions, so even though it means an extra year I think I'd be very happy matching those places).
2. Categorical program and then subspecialty residency: If I finished the entire categorical this would take 5 years minimum. I definitely know of someone who added on a chief year, and extra time during his subspecialty so ended up taking 6 and 1/2yrs and was bitter about all this time in training/lost opportunity cost. If I were open with the program director from the get-go, would it still be frowned upon to consider leaving after PGY-1 or PGY-2? I feel like I shouldn't apply to smaller programs because I don't want to leave them in a tough spot if I left early. Is doing this at all a douchebag move anywhere?
3. Prelim program followed by subspecialty residency: Although this may seem like the obvious choice, there's really not many prelim programs near me geographically and it feels somewhat foolish to move our lives just for a year and then move again. Theoretically if all went smoothly I could be done in 3 years, but the gamble seems risky. I wouldn't apply to any prelims at places that had combined programs (as I think that would be sending mixed messages) and that leaves me with just a few prelims at places that I am less excited about. Even more worrisome, what if those 2 PDs were painting too rosy a picture of my odds applying after just PGY-1 and I didn't match at all into my subspecialty and wasn't in a categorical program that I could finish either?
Sorry for the long/ somewhat complicated post, but as I said I am curious for others thoughts.