Fresh Advice- switching programs within same specialty

[buckley]

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Okay...Suppose you didn't match in your number one advanced program last year but ended up in their prelim program (and you have an advanced spot at a different institution). Now an opening comes up and you are invited to apply...

1) Can you change programs in the same specialty? I read here that it's not possible--a match violation-- but I am told by people in my institution that it is done not as uncommonly.

2) I am quite unsure if I want to change, simply because I feel a sense of loyalty to my advanced program who took a chance with me. But people at my institution said that if I give them adequate time they will find a resident to fill their spot too.

3) If I do decide to stick to my advanced program, what would be a good excuse? I really feel uncomfortable applying---I mean, I just feel it would be awkward if they don't get me, and if they get me and I refuse.

The pro's for me is really just the idea of not moving again and not getting used to another set up.

Has anyone been in a similar position?

Thanks!

 

[NotAProgDirector]

Okay...Suppose you didn't match in your number one advanced program last year but ended up in their prelim program (and you have an advanced spot at a different institution). Now an opening comes up and you are invited to apply...

1) Can you change programs in the same specialty? I read here that it's not possible--a match violation-- but I am told by people in my institution that it is done not as uncommonly.

It absolutely is a match violation. You can resign from your current advanced match any time you would like up until mid January, but only if you decide not to pursue that field. You are not allowed to drop your match to get a "better" spot.

Can this be done anyway? You can try. The NRMP is honestly unlikely to notice unless someone brings it to their attention. Worst thing that happens to you is to be labeled a match violator -- you'll be barred from the match for a number of years, not a punishment as long as you don't plan a fellowship that participates in the match.

The program is the one on the line. If they are caught doing this, they can be barred from the match. That's not good.

2) I am quite unsure if I want to change, simply because I feel a sense of loyalty to my advanced program who took a chance with me. But people at my institution said that if I give them adequate time they will find a resident to fill their spot too.

Maybe. Maybe not. In some ways you're just pushing your current program's problem (an open slot) onto someone else.

3) If I do decide to stick to my advanced program, what would be a good excuse? I really feel uncomfortable applying---I mean, I just feel it would be awkward if they don't get me, and if they get me and I refuse.

Not sure what you mean by this. Nobody's "getting" anyone. This would all be outside the match. Either they offer you a spot, or they don't.

 

[dragonfly99]

I am confused about what your current situation is.
Are you currently a medicine prelim intern, and have a neurology (or some other field) PGY2 spot lined up for NEXT year somewhere else?

My understanding is you're a medicine prelim somewhere that you tried to match into an upper level spot (say, neuro...) and didn't, but you matched at that hospital for a prelim year. Now you have a PGY2 set up in another place that you matched in to, and are now are thinking of backing out of. You are thinking of backing out b/c your current hospital (where you are doing the prelim year) is saying they are going to offer you a PGY2 spot.

I would say, yes, people do this. They change programs within the same specialty. Some people do it even though the Match frowns on it.

Well, the PD's on this site are not going to like this, but I would say if it's October and you wouldn't be starting until next July, and you want to stay at your current hospital, you should do that. You should only do it if you feel your current hospital has a better program and will treat you well. If the NRMP finds out about this you will be called a "match violater" but that really doesn't mean diddly and there are tons of people and programs that get that label. They can't really do anything to you except if you needed to use the "Match" again within a couple of years. If you do switch, you better be damn sure you have a signed contract in your hands (from your new hospital) that is BINDING because you do NOT want to be stuck with no spot for next year. So I would not say anything to the program where you are currently matched for your PGY2, until/unless you KNOW you have been offered the spot at your current/PGY1 hospital and you KNOW you are going to take it AND you have signed the contract.

Of course, there are ethical considerations also. Do you want to ditch the hospital that originally accepted/wanted you for the PGY2 year? However, I would argue that hospitals and residency programs use residents all the time for the things they need, and I think at some times in the past I felt false senses of loyalty to do things as a student and resident that really weren't in my interests. Hospitals, training programs, and other trainees are looking out for their own best interests so you better look out for yours. Medicine is a dog eat dog profession in some ways, and if you got offered a spot at a hospital that you think has better training, and/or a better "name" and you like it as well or better than the place you were "supposed" to go, perhaps you should just take it. Don't be indecisive though - decide what you want to do and then do it, but make sure you understand the implications of what you are doing and that you have all your ducks in a row.

 

[buckley]

Yup, I am a prelim medicine intern who has an advanced program in a different hospital in a different state in an altogether different area of the country...
THANKS FOR THE ADVICE🙂 I'm really just confused. I didn't think I would have this "choice" in my hands. And I'm definitely factoring the consequences of my choices. I do want to pursue fellowship immediately after residency, and I do feel a certain loyaty to my matched program. Still, more than ever, I gues I'm a little scared of moving again an adjusting. But I guess I could say I am also looking forward to it. AAArgh! Don't be inecisive...don't be indecisive...