Has anyone switched residencies after pgy1

[Coerulus]

I made major errors in my ROL and ended up somewhere I don't want to be. I ranked an undesirable program above better programs (that were shiny and made me feel happy within their walls during the interview, wtf is wrong with me!). I did this last minute, trying to make my family happy and also thinking that I was ranking a program with lower expectations than the others I interviewed at. I also had a place to live rent free at my current match (but this opportunity is no longer viable.) I knew I was entering a binding commitment, but I had no idea how bad it would sting and how disappointing my match would be. I finally stopped crying yesterday. I've contemplated breaking the match, and I feel guilty about screwing over my matched program.

If I had my number 1 pick, maybe I would not be having an emotional crisis but my bruised narcisistic ego has made me question choosing pediatrics and staying in medicine in general (I almost quit medical school numerous times, even to the point of meeting with the Dean to discuss my exit). I have no fall back plan, have only worked minimum wage jobs, and my bachelor's is worthless.

I read forums on SDN about others who are hating their match [although it seems no one was as dumb as me with their rank list thinking I could be okay ranking somewhere I don't really want to be over better (but more rigorous) programs]. Everyone is saying stick it out for one year, get your medical liscense or try to get a pgy2 position somewhere else.

My question (after likely excessive venting and explaining) is

Has anyone switched after PGY1 into another program? Do residency swaps work or are those websites a scam? Should I show up in July hoping to transfer out in a year? If I show up in July & work one year, will I have any job opportunities?

P.S
I realize that I am a horribly undeserving person, that there are people who didn't match into peds and some who didn't match at all. And that I should stop my whining. It's just that I've spent the last 4 years hating my life, and I don't know if I should sign up for another 3.

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[Vita]

Yes, some people switch after PGY1 year. If you do not go to your PGY1 year, then it is a match violation (as stated in multiple other threads) and you will have a rough time trying to get back into medicine.

There's a list of open peds positions and fellowships on the appd website: https://www.appd.org/communications/positions.cfm

They sometimes post PGY2 positions.

We had a person transfer into our program as a PGY2 because they disliked their matched program (half way through intern year, they started applying to any nonmedical job they could). It was pure luck that a spot opened and they are now very happy here. So, you need to be ready to pounce if you want to move to a specific program and let them know you are interested in case they have an opening.

 

[Coerulus]

Yes, some people switch after PGY1 year. If you do not go to your PGY1 year, then it is a match violation (as stated in multiple other threads) and you will have a rough time trying to get back into medicine.

There's a list of open peds positions and fellowships on the appd website: https://www.appd.org/communications/positions.cfm

They sometimes post PGY2 positions.

We had a person transfer into our program as a PGY2 because they disliked their matched program (half way through intern year, they started applying to any nonmedical job they could). It was pure luck that a spot opened and they are now very happy here. So, you need to be ready to pounce if you want to move to a specific program and let them know you are interested in case they have an opening.

Thank you so much for the link. Do you mind a few more questions?

When is it appropriate to start contacting other programs about openings? Will they think I am a scumbag for trying to leave my matched program?
Did the person who joined your program essentially screw over his previous program?

 

[mvenus929]

One of my classmates switched specialties after intern year, as did another one of my med school friends. The former went into Derm, and took a year off doing research in between PGY-1 and PGY-2. The latter had to repeat his intern year. FWIW, our class is down a resident now, and we manage okay, but we're also a decent sized program. You leaving will impact the program more if there are only 5 people per year vs if there are 25.

By report, we've had people switch into our program as PGY-2s, and they have done well. I don't know how many that has worked for, as the two I know who transferred into our program started off as either a TRI or FM/IM and had to start intern years over again.

 

[Marie0123]

People switch out of residencies for many reasons (to be with a spouse, switch specialties, family reasons, etc.). There are many wrong ways to go about this, but only one right way. Commit to giving it the 'ol college try for a period of time...and work hard. You'll certainly learn a lot and you may even like it! If you still feel the same way you do now, be open with the PD. They'd be much more apt to advocating for you (to other programs) if they feel you are strong of character.

Two things to consider:
(1) You titled this thread 'switching after PGY-1,' but asking when it's appropriate to start contacting programs makes me think you want to leave sooner. Screwing over your current matched program will only hurt your career, so really think about the implications of leaving vs. sticking it out.
(2) Why exactly have you spent the last 4 years hating your life? Because of medical school? I'm not asking you to answer these on the forum...but if medical school hasn't brought you any joy or purpose, you might need to rethink your career. People leave medicine for a myriad of reasons and figuring things out now could save you a lot of time, money, and unneeded stress.

 

[Giic]

Switching after PGY1 (to a PGY2 position elsewhere) is quite doable, and people have succeeded in switching to other pediatric programs (will need a solid reason for why you have to leave, so that your application will be supported by your current program), and people have also switched to other specialties (I know people who have gone to internal medicine or anesthesia, for instance). I'm sure you could reapply through the match and try for a completely unrelated field.

However, I am a little concerned that you may be unhappy in your new program as well - as you allude to having been unhappy for the last 4 years. Do you think the problem is your program, or just that you cannot see yourself in residency?

If you are looking for other options...
- There are insurance companies that have positions for people who have gone to medical school
- There are big pharmaceutical/research companies as well
- If the "3 years" is the problem - maybe try to look into shorter programs.... (cant think of any)

There's no need to have a bruised ego. As the poster above me said, people leave medicine for a myriad of reasons, and it's really not a big deal. Just have something meaningful to fall back to.
My advice would be this- Start the residency you matched in, and go with an open mind. Get a feel for it, and commit to at least one year. If you don't like it, then you can search for other options in the background and leave after 1 year.

 

[ser87]

I'm in the position you mentioned above; I'm a pediatric PGY-1 in a large program in the Midwest, and I'm switching to a different program for next year. I did mine entirely to avoid a continued long-distance relationship, and I was very upfront with my current PD about my reason for wanting to switch. To answer some of your other questions, I brought it up during my semi-annual meeting in October. My PD was extremely supportive. I also only reached out to two different programs (in January) asking if they had open spaces, because I was only looking for geographic reasons. One didn't have a spot, the other did, and fortunately things worked out.

I think a part of the reason my request was taken so seriously, as people have suggested above, is because I didn't simply cast a blind net trying to "leave" my current program. I had a particular reason for wanting to switch to a particular region, and people respected that.

 

[DeadCactus]

Leaving because you think your program sucks and you deserve better is going to a bad road to go down. It leaves little reason to support you and little reason for a program to want you. Frankly, you generally have to accept downgrading in program prestige to transfer.

Leaving for a different specialty, a specific geographic location, or for family is more likely to be supported and successful.

Career options in medicine with only PGY-1 training are limited and generally undesirable. Options exist but this forum tends to give an overly optimistic outlook on them in my experience especially in the context of what those 2 additional years would bring to you.

 

[Coerulus]

I'm in the position you mentioned above; I'm a pediatric PGY-1 in a large program in the Midwest, and I'm switching to a different program for next year. I did mine entirely to avoid a continued long-distance relationship, and I was very upfront with my current PD about my reason for wanting to switch. To answer some of your other questions, I brought it up during my semi-annual meeting in October. My PD was extremely supportive. I also only reached out to two different programs (in January) asking if they had open spaces, because I was only looking for geographic reasons. One didn't have a spot, the other did, and fortunately things worked out.

I think a part of the reason my request was taken so seriously, as people have suggested above, is because I didn't simply cast a blind net trying to "leave" my current program. I had a particular reason for wanting to switch to a particular region, and people respected that.

I'm in the position you mentioned above; I'm a pediatric PGY-1 in a large program in the Midwest, and I'm switching to a different program for next year. I did mine entirely to avoid a continued long-distance relationship, and I was very upfront with my current PD about my reason for wanting to switch. To answer some of your other questions, I brought it up during my semi-annual meeting in October. My PD was extremely supportive. I also only reached out to two different programs (in January) asking if they had open spaces, because I was only looking for geographic reasons. One didn't have a spot, the other did, and fortunately things worked out.

I think a part of the reason my request was taken so seriously, as people have suggested above, is because I didn't simply cast a blind net trying to "leave" my current program. I had a particular reason for wanting to switch to a particular region, and people respected that.

My net is so blind.

 

[Coerulus]

Leaving because you think your program sucks and you deserve better is going to a bad road to go down. It leaves little reason to support you and little reason for a program to want you. Frankly, you generally have to accept downgrading in program prestige to transfer.

Leaving for a different specialty, a specific geographic location, or for family is more likely to be supported and successful. I understand

Career options in medicine with only PGY-1 training are limited and generally undesirable. Options exist but this forum tends to give an overly optimistic outlook on them in my experience especially in the context of what those 2 additional years would bring to you.

My matched program most people have never heard of, and is a major downgrade from the peds program at my medical school. I appreciate your point about having to accept a downgrade in program prestige in order to transfer, and I hadn't really thought about how most programs (that I might hope for a transfer) will not want a resident from a lesser program.

And you're right in that my motivation to leave is because I want to go to a better program. My family is relatively close to my matched location, and I can't imagine switching into another specialty. I'm single so I can't play the partner location card.

Thanks for the perspective

 

[Coerulus]

People switch out of residencies for many reasons (to be with a spouse, switch specialties, family reasons, etc.). There are many wrong ways to go about this, but only one right way. Commit to giving it the 'ol college try for a period of time...and work hard. You'll certainly learn a lot and you may even like it! If you still feel the same way you do now, be open with the PD. They'd be much more apt to advocating for you (to other programs) if they feel you are strong of character.

Two things to consider:
(1) You titled this thread 'switching after PGY-1,' but asking when it's appropriate to start contacting programs makes me think you want to leave sooner. Screwing over your current matched program will only hurt your career, so really think about the implications of leaving vs. sticking it out.
(2) Why exactly have you spent the last 4 years hating your life? Because of medical school? I'm not asking you to answer these on the forum...but if medical school hasn't brought you any joy or purpose, you might need to rethink your career. People leave medicine for a myriad of reasons and figuring things out now could save you a lot of time, money, and unneeded stress.

I have spent several hours researching "leaving medicine," and it is something I fantasize about :/ I want to figure things out now like you suggest, but idk if I can make the scary leap to quit medicine before I even graduate.

I have to sign the contract for my matched program in the next few days, and I can't bring myself to do it yet. I'm going to figure out who I can talk to at my med school... trying to figure out who I'll least upset. Im going to make my school and my letter writers look real awesome suggesting I want to break the match

 

[Marie0123]

I have spent several hours researching "leaving medicine," and it is something I fantasize about :/ I want to figure things out now like you suggest, but idk if I can make the scary leap to quit medicine before I even graduate.

I have to sign the contract for my matched program in the next few days, and I can't bring myself to do it yet. I'm going to figure out who I can talk to at my med school... trying to figure out who I'll least upset. Im going to make my school and my letter writers look real awesome suggesting I want to break the match

I hear you, you must be really stressed out. Is there a mentor or counselor at your med school that you're particularly close to? Who knows you well and can give you good advice?

If it were me, I would put in a full year to the best of my ability and hope that I find inspiration within that year, but that's of course the best case scenario. At the end of the day, you have to do what's right for you. If you want to leave medicine, breaking the match now might be better than being noticeably miserable for PGY-1...your matched program would likely agree because that would affect the whole program. If you don't want to leave medicine, then put in your time and try to transfer out to a more rigorous program.

 

[HipsterLorax]

Can I ask you a question?

And you're right in that my motivation to leave is because I want to go to a better program.

It seems like you've been questioning having a career in medicine for awhile now, so why the emphasis on switching to another program? It sounds like if you're truly unhappy in medicine, switching to a more "prestigious" program won't fix that. Maybe you can explain what drove you to "almost quit medical school numerous times". Was that during pre-clinical years and struggling with classes? Or were you miserable all 3rd year? If so, why?

I'm not trying to divert from your motive here (potentially switching residencies), but this sort of seems like:
a) buyer's remorse OR
b) you are actually just unhappy with medicine

Maybe a bit of both, but I think some introspection could help you figure what's best for you.

 

[DSK]

One of my classmates switched specialties after intern year, as did another one of my med school friends. The former went into Derm, and took a year off doing research in between PGY-1 and PGY-2. The latter had to repeat his intern year. FWIW, our class is down a resident now, and we manage okay, but we're also a decent sized program. You leaving will impact the program more if there are only 5 people per year vs if there are 25.

By report, we've had people switch into our program as PGY-2s, and they have done well. I don't know how many that has worked for, as the two I know who transferred into our program started off as either a TRI or FM/IM and had to start intern years over again.

Hi,
I'm an FM intern (in an osteopathic residency program) and interested in switching into a pediatric residency because I realized a bit late that I really enjoy pediatrics and I may want to specialize further. I am very willing to repeat intern year if it means I can specialize in pediatrics. I know you mentioned that some residents in your programs switched in from different specialities and had to start from the beginning. Can you give me some insight on how they went about this process or if they would be willing, I would love to be able to reach out to them for advice. I am nervous because I am just starting intern year and applications are starting to open up soon so I don't know how that leaves time for new solid recommendation letters or any new additions to my application. In addition, I have not had a chance to build a solid relationship with my current PD yet and I don't want to violate the match rules, so I don't know when the appropriate time to discuss this with my PD would be. I'm certain the programs I apply to would want a supportive letter from my PD, but would it be too late in the application cycle to get a letter from her in October/November?

Any help/advice would be very much appreciated! Thanks

 

[mvenus929]

Hi,
I'm an FM intern (in an osteopathic residency program) and interested in switching into a pediatric residency because I realized a bit late that I really enjoy pediatrics and I may want to specialize further. I am very willing to repeat intern year if it means I can specialize in pediatrics. I know you mentioned that some residents in your programs switched in from different specialities and had to start from the beginning. Can you give me some insight on how they went about this process or if they would be willing, I would love to be able to reach out to them for advice. I am nervous because I am just starting intern year and applications are starting to open up soon so I don't know how that leaves time for new solid recommendation letters or any new additions to my application. In addition, I have not had a chance to build a solid relationship with my current PD yet and I don't want to violate the match rules, so I don't know when the appropriate time to discuss this with my PD would be. I'm certain the programs I apply to would want a supportive letter from my PD, but would it be too late in the application cycle to get a letter from her in October/November?

Any help/advice would be very much appreciated! Thanks

All the people I know who switched from a FM program to Peds switched to the Peds program associated with their FM program. We used to have TRI residents rotate on general wards with us and one of them became a resident at our program the following year. One was a FM resident and also rotate with us for general wards, and joined us the following year. Another was a classmate of mine who matched into FM and decided to switch to Peds, and went to the Peds program at the same institution as his FM residency. I don't know how they went about doing it...whether they applied everywhere or just to the other program they ultimately matched into.

So, do you do rotations with Peds residents at all? Is there a way you can get those early in the year so that you can 1. Figure out if Peds is really what you want to do, and 2. If you will fit into the program?