Soo....not to be a downer...but match day brought a very unexpected surprise for me. I was aiming to stay close to my family, but matched into a program that's pretty far from the general area I was hoping to end up in. Anyway, I'm going to go to my new program with an open mind and stay positive.
But just to give me some peace of mind - in the worst case scenario, if it ends up not working for myself and my family - how difficult is it to switch residency programs after a year? Or to switch into a program that has an unexpected opening?
1. Sometime in the fall, you should start sniffing around for open PGY2 spots.
(a) Some programs have scheduled new PGY2 spots (ie., they take new PGY2's every year), whereas (b) other programs only take new PGY2's if someone has left their program. Typically the spots described in (a) are posted on the program's web site-- e.g., the University of Washington takes new PGY2's every year for their psychiatry program (that's just how they are set up). The spots described in (b) are harder to find. Basically it involves you asking your friends at other institutions to see if they have heard of any interns quitting, transferring, or getting fired.
2. In September or October-- the sooner the better-- you should notify your current program director that you intend to transfer out.
Yes, you need to tell your program director
before you have secured a spot elsewhere. Yes, this is fraught with uncertainty. Yes, it could backfire: if you are unsuccessful in transferring out, then you could be stuck at a program with a program director who knows you
tried to transfer out but were unsuccessful. But you still need to do this. At a minimum, it is the nice thing to do, because your program director is going to have to scramble to find a replacement. The more time you give her to advertise, interview, etc., the better. In addition, all programs will need your current program director to at least provide a letter of
good standing (I verify that
blight is a current resident at our program and that she says who she says she is), and some programs may even require your current program director to provide a letter of
recommendation (I really like
blight because she has maintained exemplary performance as an intern, and I will be really sad to see her go).
3. Once you have your program director's agreement to write the letter, then you will apply.
Applications are either formally to the programs in (a), or informally to the programs in (b). Then you start interviewing in October through January. This may be difficult to do if you are on heavy rotations. Nothing you can do about that. You should try to schedule outpatient rotations if possible. If this is not possible, then you should hope that you can get a fellow resident to cover for you (ie., as a jeopardy resident or something).
4. Receiving acceptance notices from transfer programs will not occur on a set schedule.
Some programs may tell you in November that they have accepted you as a transfer resident; other programs may tell you in January; still other programs may inform you on Match Day. There is additional uncertainty at this stage, because many programs require interns to sign their PGY2 renewal contracts sometime in the winter/spring. (For example, my program sent us our renewal contracts in January and expected signatures within a week.) There is a high likelihood that you will need to decline your PGY2 renewal at your current program
before you hear about your acceptance at another program.
-AT.