EM-1 opening:

[MushieCookie]

at Alameda/Highland per SAEM website.

For those in need of a spot...give them a shout.

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[Cucumbers]

if we're matched already, can we switch into this spot?

 

[zinjanthropus]

if we're matched already, can we switch into this spot?

not likely - you are in a binding contract. If everyone agreed to it, there is a possibility but there would need to be some good reasons and some good luck.

 

[southerndoc]

One of our graduating medical students matched into a PGY-1 spot at Highland. She died tragically after being struck by a car. A very unfortunate and untimely death. She was a great person who was always smiling and was well known and liked by our ED residents and attendings.

I hope whoever fills the spot that became vacant after her death will be as nice, caring, and friendly as she was.

 

[dmitrinyr]

On the SAEM site post regarding this opening it states "For currently matched applicants, prior approval from your Program Director is required".

I'm wondering, why would a PD approve this move? Be it that this only applies to people such as myself that scramled for a spot or others that signed outside the match. Still, I doubt that any PD would permit a resident to leave their program this close to July without some amazing reason.

 

[EM2BE]

I'm imagining those that didn't scramble into an EM spot may have a better chance by explaining that a spot is open in EM, the field they really want. Don't remember if you were one of the lucky/unlucky ones in the scramble, so sorry if this is not relevant.

 

[dmitrinyr]

I'm imagining those that didn't scramble into an EM spot may have a better chance by explaining that a spot is open in EM, the field they really want. Don't remember if you were one of the lucky/unlucky ones in the scramble, so sorry if this is not relevant.

I applied this past year and did not match into EM. Upon signing my contract (prelim spot in medicine), I asked the PD if I can get out of it if a miracle happens and an EM spot becomes available and the PD said a firm NO. I would apply for the open EM-1 spot but that would be shady given that I would not have permition from my current PD.

 

[totalbodypain]

I applied this past year and did not match into EM. Upon signing my contract (prelim spot in medicine), I asked the PD if I can get out of it if a miracle happens and an EM spot becomes available and the PD said a firm NO. I would apply for the open EM-1 spot but that would be shady given that I would not have permition from my current PD.

Shady or not. I would apply. It is your future not his. By definition a prelim spot does not lead to completion in any field. Any reasonable program director should realize this and be willing (not necessarily happy though) to help.

 

[dmitrinyr]

Shady or not. I would apply. It is your future not his. By definition a prelim spot does not lead to completion in any field. Any reasonable program director should realize this and be willing (not necessarily happy though) to help.

So in this case does this mean that I can apply without permition from my soon-to-be PD?

 

[southerndoc]

So in this case does this mean that I can apply without permition from my soon-to-be PD?

It's permission, not permition. At any rate, if you apply without your PD's permission and Highland tells you no, then your life will be a nightmare where you are doing your prelim year. That PD will be ticked that you applied anyway after he specifically told you that you couldn't.

 

[Drawing Dead]

I remember my contract had a page that was for mutual breaking of the contract, where you sign, the PD signs, and the contract is void. I would apply to the program (secretly), and if you don't get it, no sweat. If you do, then go to him/her and say "I'm not going to show up anyway, so why don't you do us both a favor and just sign the dotted line"

It's a dirty move, but to be honest, PDs pull dirty crap too. In the end, you want to do EM, not IM, and like stated previously, its a prelim spot anyway, its not a residency.

 

[Sweet Pea]

According to SAEM website, Highland requires prior approval from your current PD. So if you apply without your PD's permission, I highly doubt that Highland would take you, and most likely, your current PD would find out about it.

If you really want to apply, try talking to your PD again.

 

[EM_Rebuilder]

According to SAEM website, Highland requires prior approval from your current PD. So if you apply without your PD's permission, I highly doubt that Highland would take you, and most likely, your current PD would find out about it.

If you really want to apply, try talking to your PD again.

I agree. Last time, you asked 'What if'. If you go to him now with proof of an open spot and your desire to apply with the part underlined must have current PDs permission..... I think any decent human being would allow you. I would certainly argue the 'professional' thing to do is to allow you to apply. If he refuses, all I can say is that is a sad and crappy situation to be in. I would certainly make the chairmen of the department in the know if the PD refuses...unless they are one in the same. It's likely he will stand behind the PDs decision, but you never know...

 

[dmitrinyr]

I agree. Last time, you asked 'What if'. If you go to him now with proof of an open spot and your desire to apply with the part underlined must have current PDs permission..... I think any decent human being would allow you. I would certainly argue the 'professional' thing to do is to allow you to apply. If he refuses, all I can say is that is a sad and crappy situation to be in. I would certainly make the chairmen of the department in the know if the PD refuses...unless they are one in the same. It's likely he will stand behind the PDs decision, but you never know...

I want EM more than anything and I cannot pass up an opportunity for a chance at an EM residency but I really don't want any trouble from my PD. What I obviously don't want is to apply for this position, not get it, having my PD find out that I tried to go behind his back after he told me that I couldn't get out of my contract and then have a nightmare of a prelim year (that is if my contract doesn't get voided by the PD for pulling this stunt). Plus it's more like than not that my PD will have to write me a letter of "good standing" when I'm reapplying and so I don't want to be on his bad side.

 

[EM OR BUST]

Just explain to him the situation, and ask him again. If he says no he says no, but you will never know unless you ask.

 

[dmitrinyr]

Just explain to him the situation, and ask him again. If he says no he says no, but you will never know unless you ask.

I agree. I'll go talk to him tomorrow.

 

[Cucumbers]

So you can void your NRMP contract if your current PD decides to allow you to change programs?

 

[dmitrinyr]

So you can void your NRMP contract if your current PD decides to allow you to change programs?

I do not have an NRMP contract as I scrambled for my position. If I would have matched into a spot then there would be no discussion as NRMP rules say that I must start the year at the residency who matched me. If I would be a PD and I had a prelim that wanted to pursuit his/her dream career, regardless of how it might inconvenience me or my program, I would let them at least apply. Still, I understand that the PD has to look out for his/her program especially this close to the start of another year and that a possibility of a resident leaving in may or june will give them headaches and panic in the near future. I am a bit biased in my opinion though.

Regarding voiding NRMP contracts, it can be done theoretically. This is very unlikely as you would have to have two incoming residents that would agree to switch to each other's residency programs, two understanding PDs who will agree to this headache and then you would still need NRMP to agree to it.

 

[southerndoc]

dmitrinyr, as mentioned previously, I would not do this behind your PD's back. I can't see a PD holding it against you for asking again, but I do not know your PD.

The PD is primarily concerned about having a warm body to take call and not place additional burden on the other prelims and residents in his program. That is why he will be reluctant to have you leave the prelim year.

 

[Cucumbers]

did this spot ever get filled?

 

[bulgethetwine]

I do not have an NRMP contract as I scrambled for my position. If I would have matched into a spot then there would be no discussion as NRMP rules say that I must start the year at the residency who matched me. If I would be a PD and I had a prelim that wanted to pursuit his/her dream career, regardless of how it might inconvenience me or my program, I would let them at least apply. Still, I understand that the PD has to look out for his/her program especially this close to the start of another year and that a possibility of a resident leaving in may or june will give them headaches and panic in the near future. I am a bit biased in my opinion though.

Regarding voiding NRMP contracts, it can be done theoretically. This is very unlikely as you would have to have two incoming residents that would agree to switch to each other's residency programs, two understanding PDs who will agree to this headache and then you would still need NRMP to agree to it.

Go for it -- any PD who doesn't give you this latitude doesn't deserve the title.

Best of luck, mate.

 

[GassiusClay]

I'm an intern finishing up and have become more interested in something more medicine. Never thought being an intern would do this to me.

So ER has its appeal. But can a guy going into gas at a big name institution jump ship into a more primary care field? I know ER is competitive, but I'd like to get an idea from those out there who made the switch from gas to ER.

If anybody can give me their experience of both fields (switching in either direction), it would be great. Please send a PM.