How hard is to match into a 'more competitive' IM position as a PGY2?

[experiment113]

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[gutonc]

There are no PGY2 IM positions in the Match.

Your options are:
1. Stay where you and power through.
2. Go back into the Match as a PGY1 and then talk to PDs where you get interviews about the possibility of starting as a PGY2 (or progressing early after a "trial period").
3. Cold call programs that you consider more reputable and ask if they have any open PGY2 spots.

 

[chessknt]

There are no PGY2 IM positions in the Match.

Your options are:
1. Stay where you and power through.
2. Go back into the Match as a PGY1 and then talk to PDs where you get interviews about the possibility of starting as a PGY2 (or progressing early after a "trial period").
3. Cold call programs that you consider more reputable and ask if they have any open PGY2 spots.

These are your choices and there is one big asterisk he forgot—your pd has to release you for 2/3 to happen. Depends on your pd of course but I think most would not find the reason that their program sucks donkey dick to be a compelling reason.

 

[experiment113]

These are your choices and there is one big asterisk he forgot—your pd has to release you for 2/3 to happen. Depends on your pd of course but I think most would not find the reason that their program sucks donkey dick to be a compelling reason.

What about swapping just to be in the NE?

 

[chessknt]

What about swapping just to be in the NE?

You still need a compelling reason and you’d need to find someone willing to swap from their “good” program for your “bad “ one. I’d just stop entertaining this idea all together if I were you, far more likely to backfire.

 

[gutonc]

These are your choices and there is one big asterisk he forgot—your pd has to release you for 2/3 to happen. Depends on your pd of course but I think most would not find the reason that their program sucks donkey dick to be a compelling reason.

Just want to point out that this is not technically true. You can resign from a program on your own at any time. If you do it after 45 days, there's no risk of NRMP violation. That said, you're going to want a LOR from that PD, and from that perspective, the above statement is true enough.

What about swapping just to be in the NE?

Again, something you can certainly pursue, but not a compelling reason from your PD's perspective.

I will add an additional option:
4. Resign from your current position, sit out the year (please don't ask what you should do with your time, that's on you to figure out) and reapply for PGY1 IM spots next year. This is the highest risk/highest reward option, but I think the risk side far outweighs the reward side.

 

[Redpancreas]

Hi all currently an incoming PGY-1 IM resident. I SOAPed into my current IM position from the preferred field I wanted. While I am grateful for even having an IM residency, I don't go to a reputable program with any in house fellowships.
If I were to apply to the match as a PGY1 for PGY2 IM positions, how hard is it to get into a 'more reputable' position?
I have a 230 step 1, high 230 step 2, and good grades, research, and ECs.
Thanks.

To answer your literal question, it is impossible because no PGY-2 positions exist in the match and if you're then going to ask about PGY-1 positions, nothing you're going to get the first time around will be as good as what you got the first time around. Understandably you had to SOAP and may consider yourself a US MD, but that really doesn't carry as much weight as you think it does if you're applying outside of your cycle.

I have read tons of posts about people trying to do similarly convoluted things. Don't do it. This is a terrible, terrible reason to transfer or reapply. You're basically trying to play the system in plain sight. The transfer most likely won't work because when asked why you wanted to transfer, your future PD will want to know from your current PD what happened and your current PD won't have a good reason so that prospect is dead on arrival. If you want reapply to the match for a PGY-1 next year (and sit out this year), your competitiveness as an applicant drops substantially. It's one thing if you're taking this risk to go from your current situation to a top 20-30 IM program, but that's not what's going to happen. Your Steps are slightly lower than average and you will be an former US AMG. You may get low tier academic places to interview at, but will they rank you? When programs ask you why you left your perfectly legitimate IM program to reapply, you're not going to be able to say you did it for optics for fellowship because it sounds so lame. If you make up some vague story about a family member, that's also potentially suspect because it implies there's issues that may come up again. Others have discussed options you can entertain, but I think there's only one realistic path to get Cards/GI now and it's not too complex. 1) Bust your butt with research now, 2) do aways, 3) do a chief year (you'd lose one year by going to another program anyways), and match your preferred field. Rinse and repeat with hospitalist years if needed. You have hospitalist as a fall-back if you get tired of doing this. Don't overestimate the competitiveness of these fellowships. You may not match immediately but if you really want it, with persistence you can get it.

 

[darklabel]

I looked into it as I wasn't super jazzed about where I ended up and even had a good reason (wife worked elsewhere). I didn't even care about prestige. I ended up powering through and am happy I did.

Don't transfer for a better program and DO NOT re enter the match as a PGY-1 (this will royally screw you). No one will leave a better program for yours unless they have a great reason so the chances of finding someone to switch is almost zero. Usually people switch places of similar competitiveness or you're punching down. Unless you're at a desirable location, I wouldn't bother with residentswap. Give it a try, but I think you'll be wasting money.

You could reach out to PDs but I have a feeling it will be fruitless. Nothing to lose with that but you'll get the response of they're full (I've tried in the past and it was for non-competitive places). Just don't mention anything to your PD.

As for re-entering the match, I'll tell you now not a single place more competitive than where you are will even interview you unless you have connections and most places won't bother. Usually only people who want a complete residency change should do it and absolutely CAN'T live with what they're doing now. Re-entering for the same residency is career suicide. You'd have to tell them a good reason why you left a perfectly good IM spot for another and saying its for fellowship would get you low on the ranklist if you even make it that far. Lying about family will backfire too since you can't limit yourself geographically for something like this.

As others have said, I recommend powering through and forgetting to transfer. I only recommend transfers to people for a career change and are ok with the very real risk of ending up with nothing. Do research, go to conferences, and do aways your 3rd year. Get chief as well. Put this energy into doing that instead of transferring. Worst thing that happens is you become a hospitalist and keep applying. At least you'll have a job with good income at the end instead of ending up with nothing and unmatched.

Good luck!

 

[Redpancreas]

I looked into it as I wasn't super jazzed about where I ended up and even had a good reason (wife worked elsewhere). I didn't even care about prestige. I ended up powering through and am happy I did.

Don't transfer for a better program and DO NOT re enter the match as a PGY-1 (this will royally screw you). No one will leave a better program for yours unless they have a great reason so the chances of finding someone to switch is almost zero. Usually people switch places of similar competitiveness or you're punching down. Unless you're at a desirable location, I wouldn't bother with residentswap. Give it a try, but I think you'll be wasting money.

You could reach out to PDs but I have a feeling it will be fruitless. Nothing to lose with that but you'll get the response of they're full (I've tried in the past and it was for non-competitive places). Just don't mention anything to your PD.

As for re-entering the match, I'll tell you now not a single place more competitive than where you are will even interview you unless you have connections and most places won't bother. Usually only people who want a complete residency change should do it and absolutely CAN'T live with what they're doing now. Re-entering for the same residency is career suicide. You'd have to tell them a good reason why you left a perfectly good IM spot for another and saying its for fellowship would get you low on the ranklist if you even make it that far. Lying about family will backfire too since you can't limit yourself geographically for something like this.

As others have said, I recommend powering through and forgetting to transfer. I only recommend transfers to people for a career change and are ok with the very real risk of ending up with nothing. Do research, go to conferences, and do aways your 3rd year. Get chief as well. Put this energy into doing that instead of transferring. Worst thing that happens is you become a hospitalist and keep applying. At least you'll have a job with good income at the end instead of ending up with nothing and unmatched.

Good luck!

This guy's been through it and knows.

 

[Meerkatology]

i'm assuming you are doing this to pursue a competitive fellowship. (if not theres like 0 reason to do this)
i'm also assuming your current residency more or less matches ur overall competitiveness as an applicant

since u can't retake ur steps or change that much of ur applicantion, how would you be able to "switch" into a more competitive one as a nontrad method?

in order to switch out, its not just about getting a spot at another place, u also need ur own residency to find a replacement for u. seems like the stars need to align. and as someone said before, switching with someone into the residency u want seems even less feasible

 

[collegestud2013]

As others have said not a good idea to re-enter the Match as it would involve repeating PGY-1 year. However, transferring into a more competitive PGY-2 program is not unreasonable as there's a lot of overlap in competitiveness of applicants across programs. There's a lot of turnover in IM programs, especially when going from PGY-1 to PGY-2 year since people switch programs for a variety of expected and unexpected personal reasons (eg need to be closer to family or SO) or professional ones (e.g. switching out of IM into another specialty, or switching out of a malignant IM program, someone getting kicked out of residency) so programs that lose someone will need to find a replacement outside the Match. It's also not uncommon they may have to lower their competitiveness standards a bit to find a person, especially if a spot opened up unexpectedly.

If O.P. wants to pursue a competitive fellowship and his current program is a "lower-tier" community program that does not have an in-house fellowship in that subspecialty, switching to another that does and has better research opportunities help and happens all the time. Most programs are supportive of interns switching for either personal or professional reasons, unless they're really malignant (eg concerned that they can't find a replacement). Most of these PGY-2 spots outside the Match open up around February-April so start looking around then. Just make sure you have several LORs ready from attendings in your current program as other programs will ask for it.

 

[experiment113]

As others have said not a good idea to re-enter the Match as it would involve repeating PGY-1 year. However, transferring into a more competitive PGY-2 program is not unreasonable as there's a lot of overlap in competitiveness of applicants across programs. There's a lot of turnover in IM programs, especially when going from PGY-1 to PGY-2 year since people switch programs for a variety of expected and unexpected personal reasons (eg need to be closer to family or SO) or professional ones (e.g. switching out of IM into another specialty, or switching out of a malignant IM program, someone getting kicked out of residency) so programs that lose someone will need to find a replacement outside the Match. It's also not uncommon they may have to lower their competitiveness standards a bit to find a person, especially if a spot opened up unexpectedly.

If O.P. wants to pursue a competitive fellowship and his current program is a "lower-tier" community program that does not have an in-house fellowship in that subspecialty, switching to another that does and has better research opportunities help and happens all the time. Most programs are supportive of interns switching for either personal or professional reasons, unless they're really malignant (eg concerned that they can't find a replacement). Most of these PGY-2 spots outside the Match open up around February-April so start looking around then. Just make sure you have several LORs ready from attendings in your current program as other programs will ask for it.

Thanks, I agree repeating is not a good idea... What is the process of transferring to a 'more competitive' program outside the match?

 

[Redpancreas]

As others have said not a good idea to re-enter the Match as it would involve repeating PGY-1 year. However, transferring into a more competitive PGY-2 program is not unreasonable as there's a lot of overlap in competitiveness of applicants across programs. There's a lot of turnover in IM programs, especially when going from PGY-1 to PGY-2 year since people switch programs for a variety of expected and unexpected personal reasons (eg need to be closer to family or SO) or professional ones (e.g. switching out of IM into another specialty, or switching out of a malignant IM program, someone getting kicked out of residency) so programs that lose someone will need to find a replacement outside the Match. It's also not uncommon they may have to lower their competitiveness standards a bit to find a person, especially if a spot opened up unexpectedly.

If O.P. wants to pursue a competitive fellowship and his current program is a "lower-tier" community program that does not have an in-house fellowship in that subspecialty, switching to another that does and has better research opportunities help and happens all the time. Most programs are supportive of interns switching for either personal or professional reasons, unless they're really malignant (eg concerned that they can't find a replacement). Most of these PGY-2 spots outside the Match open up around February-April so start looking around then. Just make sure you have several LORs ready from attendings in your current program as other programs will ask for it.

I'm not writing this post for OP as it seems like he's hellbent on fitting a square peg into a round hole. This quoted post may be well-meaning, but it's wrong.

1. Transferring to another program is done for extentuating circumstances and is allowed at the discretion of the departing and accepting PDs. It doesn't happen all the time. It's not for you and a person you're willing to swap with to decide.
2. A program being open and filling occurs very fast and PDs solicit internal candidates and those they have connections with first. There's no spreadsheet with all this information or fair application process. By the time you hear about an opening it will be filled.
3. Legitimate transfers often require a valid reason. You can't just say I want to re-roll the dice to match at a program with a better name.

 

[experiment113]

I'm not writing this post for OP as it seems like he's hellbent on fitting a square peg into a round hole. This quoted post may be well-meaning, but it's wrong.

1. Transferring to another program is done for extentuating circumstances and is allowed at the discretion of the departing and accepting PDs. It doesn't happen all the time. It's not for you and a person you're willing to swap with to decide.
2. A program being open and filling occurs very fast and PDs solicit internal candidates and those they have connections with first. There's no spreadsheet with all this information. By the time you hear about an opening it will be filled.
3. Transfer is contingent on a valid reason. You can't just say I want to reroll the dice to match at a program with a better name.

Hey listen chill out, no need to be passive aggressive. I'm listening to everyone's advice.

 

[Redpancreas]

Thanks, I agree repeating is not a good idea... What is the process of transferring to a 'more competitive' program outside the match?

There's no process. You can search around during February-May to find any residents who are looking to transition to where you're at. I guess there's no risk. In reality, what's going to happen is you're going to remain at your program where in order to do a competitive fellowship you need to network outside and do a chief year.

 

[Redpancreas]

Hey listen chill out, no need to be passive aggressive. I'm listening to everyone's advice.

I'm just setting the record straight. That way, someone else doesn't make an account to discuss the possibility of this based off of this thread on March 19th next year when they don't match where they want to.

 

[experiment113]

I'm just setting the record straight. That way, someone else doesn't make an account to discuss the possibility of this based off of this thread.

That's a better answer than what you posted. Setting the record straight doesn't mean you need to be passively aggressive.

 

[tantacles]

That's a better answer than what you posted. Setting the record straight doesn't mean you need to be passively aggressive.

The response wasn't passive aggressive. It was appropriately honest. Honest does not equate to aggressive.

 

[experiment113]

The response wasn't passive aggressive. It was appropriately honest. Honest does not equate to aggressive.

The definition of passive aggressiveness is expressing negative feelings or thoughts about someone without directly addressing someone. That person said 'I'm not writing this post for OP' while then typing a derogatory thing about me. It clearly was passive aggressive, go read a dictionary. And your last sentence, it should be 'Honesty does not equate to aggressiveness.' I thought we all learned how to write proper sentences in grade school.

 

[Redpancreas]

The definition of passive aggressiveness is expressing negative feelings or thoughts about someone without directly addressing someone. That person said 'I'm not writing this post for OP' while then typing a derogatory thing about me. It clearly was passive aggressive, go read a dictionary. And your last sentence, it should be 'Honesty does not equate to aggressiveness.' I thought we all learned how to write proper sentences in grade school.

Look dude. Like tantacles said, I’m being honest. I could have replied to you directly saying how I thought you were grasping at straws, etc. but I figured you’re free to do what you want, but I still wanted to get this point across. I wasn’t trying to express some ill will towards you. I’m not the smartest guy and have been through plenty of bad situations myself. I happen to know a little bit about transferring having been in a situation that made me educate myself on it. I have talked personally to people in all walks of life including those being dismissed from residency to those who have decided that XYZ wasn’t for them to people who essentially weren’t happy with their match results. The last situation is really the worst reason (not the worst situation) to switch residency programs. I am sure collegestud2013 meant well with what he said and that maybe he’d seen many successful resident transfers but the notion that this is something that happens all the time as if there’s some transfer portal for residency programs is misleading. Initially when many decide to transfer they first think it’s going to be straightforward. It’s all but that. If it were a different field, PDs would understand. You’re basically looking to tell your current PD that you think you’re better than their Program and want out. Your only chance is to try to orchestrate a swap with resident with a legitimate reason (not the same as yours). Most of these don’t pan out. Maybe you’ll find someone who’s looking to be at home to help an ailing sick relative who wants to be at your IM program while you can transfer to theirs. There’s a few people on SDN looking at tsuff that and I suggest you make a post there, check ResidencySwap regularly, and in general keep your ears open. It’s not a very fruitful process.

EDIT: @experiment113

Actual Forum:

Internship, Residency and Fellowship Positions

List upcoming or currently available internship, residency or fellowship positions, positions wanted and position swaps. Co-Hosted with Resident Swap.

forums.studentdoctor.net

Good Reading:

Resident swap?

So there were a bunch of people in my class who were unhappy with their matches, so resident swap was brought up. I'm curious, is this a legit service? Why do they list PGY-1 positions on there if we are contractually bound by the NRMP for 1 year?:confused:

forums.studentdoctor.net

How to transfer residency programs

Transferring may seem overwhelming but with a step-by-step approach you can end up in a program where you are happier for personal or professional reasons.

www.kevinmd.com

 

[rokshana]

The definition of passive aggressiveness is expressing negative feelings or thoughts about someone without directly addressing someone. That person said 'I'm not writing this post for OP' while then typing a derogatory thing about me. It clearly was passive aggressive, go read a dictionary. And your last sentence, it should be 'Honesty does not equate to aggressiveness.' I thought we all learned how to write proper sentences in grade school.

You are new to SDN aren’t you... many times the answers to post aren’t directed to the OP ... generally it’s too late for the OP when they decide to post. But others come here looking for information, advice, etc...and many time we post to give information to them.

in your case, you just need to deal with the cards given to you... you risk losing what you have for trying to change to a “more” competitive place... you were at your most competitive as a senior and you had to SOAP into what you got... you really don’t have much to offer another program... be glad at what you have... a chance to become a trained physician... otherwise that MD is not going to get you that much.

 

[rokshana]

Hey listen chill out, no need to be passive aggressive. I'm listening to everyone's advice.

Really?? Because it’s seems like everyone with the except of a college student has said don’t do this...and yet all you can see is the thin string of hope that someone had offered.

realize that your PD has to let you go... and they have to give you a good recommendation...you really think they are going to be keen on doing that for someone that doesn’t have a good reason for abandoning them when they gave you a chance by taking you on the soap? Doubt it... it won’t be bad ( unless you have bad evaluations and they can) by will be non committal... and we know that is not a good thing.

 

[experiment113]

Look dude. Like tantacles said, I’m being honest. I could have replied to you directly saying how I thought you were grasping at straws, etc. but I figured you’re free to do what you want, but I still wanted to get this point across. I wasn’t trying to express some ill will towards you. I’m not the smartest guy and have been through plenty of bad situations myself. I happen to know a little bit about transferring having been in a situation that made me educate myself on it. I have talked personally to people in all walks of life including those being dismissed from residency to those who have decided that XYZ wasn’t for them to people who essentially weren’t happy with their match results. The last situation is really the worst reason (not the worst situation) to switch residency programs. I am sure collegestud2013 meant well with what he said and that maybe he’d seen many successful resident transfers but the notion that this is something that happens all the time as if there’s some transfer portal for residency programs is misleading. Initially when many decide to transfer they first think it’s going to be straightforward. It’s all but that. If it were a different field, PDs would understand. You’re basically looking to tell your current PD that you think you’re better than their Program and want out. Your only chance is to try to orchestrate a swap on your own given your reason for transfer. Most of these don’t pan out. Maybe you’ll find someone who’s looking to be at home at your IM program while you can transfer to theirs. There’s a few people on SDN looking at that and I suggest you make a post there, check ResidencySwap regularly, and in general keep your ears open. It’s not a very fruitful process.

Your answer was great thank you!

 

[Redpancreas]

Your answer was great thank you!

It also wasn't aggressive. Actively or passively.

 

[experiment113]

Really?? Because it’s seems like everyone with the except of a college student has said don’t do this...and yet all you can see is the thin string of hope that someone had offered.

realize that your PD has to let you go... and they have to give you a good recommendation...you really think they are going to be keen on doing that for someone that doesn’t have a good reason for abandoning them when they gave you a chance by taking you on the soap? Doubt it... it won’t be bad ( unless you have bad evaluations and they can) by will be non committal... and we know that is not a good thing.

No I agree with everyone saying to stay, I most likely will because f the disadvantages of leaving. Thanks for your answer!

 

[experiment113]

It also wasn't aggressive. Actively or passively.

Lol.

 

[Redpancreas]

No I agree with everyone saying to stay, I most likely will because f the disadvantages of leaving. Thanks for your answer!

Dude if it was a thing, people would be mass-transferring after match day for prestige, minor family, etc. reasons. In order of priority people want to 1.) Be a doctor 2.) Have their ideal specialty .) Have the ideal location, etc. and for this reason they rank all their programs in XYZ specialty because they don't want to be unemployed with no job prospects. If GME wants to set up a transfer portal, I think that'd be interesting idea.

 

[experiment113]

Dude if it was a thing, people would be mass-transferring after match day for prestige, minor family, etc. reasons. In order of priority people want to 1.) Be a doctor 2.) Have their ideal specialty .) Have the ideal location, etc. and for this reason they rank all their programs in XYZ specialty because they don't want to be unemployed with no job prospects. If GME wants to set up a transfer portal, I think that'd be interesting idea.

That's so true.. I just think telling my PD that 'I want to switch' is pretty much saying I'm better than you. I should be grateful I have a spot. I'll just work hard and see what happens afterwards.

 

[tantacles]

The definition of passive aggressiveness is expressing negative feelings or thoughts about someone without directly addressing someone. That person said 'I'm not writing this post for OP' while then typing a derogatory thing about me. It clearly was passive aggressive, go read a dictionary. And your last sentence, it should be 'Honesty does not equate to aggressiveness.' I thought we all learned how to write proper sentences in grade school.

"derogatory".

 

[experiment113]

"derogatory".

Ok Mr 'Honest does not equate to aggressive.'

 

[tantacles]

Ok Mr 'Honest does not equate to aggressive.'

k

 

[experiment113]

k

Those were quite a bit of dislikes 4 Total Lol. You mad bro?

 

[tantacles]

Those were quite a bit of dislikes 4 Total Lol. You mad bro?

Nah. I just dislike your posts.

 

[experiment113]

Nah. I just dislike your posts.

People like you that make terrible decisions like choosing to do med-peds instead of just meds and regretting it later shouldn't be responding to my questions. Your 'boyfriend' or 'boo' must be disappoint.

 

[tantacles]

People like you that make terrible decisions like choosing to do med-peds instead of just meds and regretting it later responding to my questions. Your 'boyfriend' or 'boo' must be disappoint.

Thanks for your concern.

 

[chessknt]

Lol meds

 

[softball2344]

USMD who matched at a community program in a competitive location (CA). Regretting it and possibly thinking of trying to transfer to a mid tier program in a less desirable part of the country (won’t even bother asking in CA) after my intern year. App was competitive for these types of program I think

Has anyone been in a similar situation and been successful at transferring? If so would love advice. I posted something similar in the general residency issue forum and got advice regarding where or not I should try, but now looking to see if anyone here has actually done this, or knows someone who did it. Feel free to post here or PM. Thanks.

 

[chessknt]

How hard is to match into a 'more competitive' IM position as a PGY2?

.

forums.studentdoctor.net

Read through this first. You'll need support of your PD and either a person to swap with or a program vacancy at the receiving program (swap is much cleaner). Depending on PD and climate of the program it is risky so I would be sure you really have a great reason and truly understand who your PD is before doing it (have residents been fired recently? Does your PD show evidence of vindictive behaviors? Are the chiefs supportive?)

 

[softball2344]

How hard is to match into a 'more competitive' IM position as a PGY2?

.

forums.studentdoctor.net

Read through this first. You'll need support of your PD and either a person to swap with or a program vacancy at the receiving program (swap is much cleaner). Depending on PD and climate of the program it is risky so I would be sure you really have a great reason and truly understand who your PD is before doing it (have residents been fired recently? Does your PD show evidence of vindictive behaviors? Are the chiefs supportive?)

Thanks had gotten similar advice before. Mainly looking for personal anecdotes here as I am looking for specific advice like when to starting looking, whether or not I should ask PD first, etc. Pretty sure the PD and program in general are the complete opposite of vindictive, was actually the nicest people I met throughout the season. I am naturally a pretty hard worker and have a mellow personalty, not really the type people generally would want to punish so confident if I asked in the right way nothing would happen

 

[chessknt]

I would recommend March/April next year as programs will have an idea of vacancies. Im not sure how likely you are to find a swap or where the best place is for that but as far as vacancies you want to wait until after match but not too close to onboarding as there will be bandwidth for other PDs to interact with you and know if they have something. If you have any connections to the midwest you'll want to tap them to get in touch with an IM PD who might know other PDs in the area.

 

[softball2344]

I would recommend March/April next year as programs will have an idea of vacancies. Im not sure how likely you are to find a swap or where the best place is for that but as far as vacancies you want to wait until after match but not too close to onboarding as there will be bandwidth for other PDs to interact with you and know if they have something. If you have any connections to the midwest you'll want to tap them to get in touch with an IM PD who might know other PDs in the area.

Thanks. That's later than I would have thought, other posts I read through recommended Nov/ Dec to start reaching out even if at that point they might not know. Do you recommend asking my PD before I start looking or after?

 

[Redpancreas]

Thanks had gotten similar advice before. Mainly looking for personal anecdotes here as I am looking for specific advice like when to starting looking, whether or not I should ask PD first, etc. Pretty sure the PD and program in general are the complete opposite of vindictive, was actually the nicest people I met throughout the season. I am naturally a pretty hard worker and have a mellow personalty, not really the type people generally would want to punish so confident if I asked in the right way nothing would happen

I know of someone who did this. They were a rising PGY-2 at a community program in a competitive location (lived in Manhattan). They were in good standing, had Step 1/2 CK >240, they ended up at an low tier academic program, but they ended up having to repeat PGY-1. I think he's doing a hospitalist year now and plans to apply for Cardiology after. I can ask him if you have any questions about the process.

1. You should always start looking first. An away PD will never contact your home PD until you've given permission.
2. There's no specific time to start looking. You will have to wait until residency starts to fulfill your match obligation and afterwards, you need to atleast give it a few months to develop good will.
3. You're going to need a reason to transfer. I would just be straight up that you don't think the program's standard is up to what you feel like you deserve. Anything else (soft family reasons, etc.) will have the PD scratching their head and questioning your motive. It's much better to be direct.
4. Be prepared for your PD to say no.

 

[Redpancreas]

Thanks. That's later than I would have thought, other posts I read through recommended Nov/ Dec to start reaching out even if at that point they might not know. Do you recommend asking my PD before I start looking or after?

After you start looking. It seems shady to keep your PD in the dark but the alternative is to clue them in that you may be thinking of leaving and it may not give you enough time to establish a reputation. The Clinical Compentency committee usually has a good pulse on who's good/bad by 6 months in. I would talk to your PD in Jan. You need to give your first program a chance and doing it after the holiday season makes it seem like you gave it more thought than if you try to do it in early November. You've seen from my previous thread that it's probably a better idea to just put your head down, find outside research/connections, do a chief year, & match but I suppose you have nothing to lose...other than notifying your PD you want to be at a better ranked program. Some PDs may understand and I suppose it's a low enough risk to warrant the potential reward of being able to transfer.

 

[softball2344]

I know of someone who did this. They were a rising PGY-2 at a community program in a competitive location (lived in Manhattan). They were in good standing, had Step 1/2 CK >240, they ended up at an low tier academic program, but they ended up having to repeat PGY-1. I think he's doing a hospitalist year now and plans to apply for Cardiology after. I can ask him if you have any questions about the process.

1. You should always start looking first. An away PD will never contact your home PD until you've given permission.
2. There's no specific time to start looking. You will have to wait until residency starts to fulfill your match obligation and afterwards, you need to atleast give it a few months to develop good will.
3. You're going to need a reason to transfer. I would just be straight up that you don't think the program's standard is up to what you feel like you deserve. Anything else (soft family reasons, etc.) will have the PD scratching their head and questioning your motive. It's much better to be direct.
4. Be prepared for your PD to say no.

Thanks for this. Yea my family is in the area I matched so I couldn't possibly give a personal reason without straight up lying, planning to be honest. Do you know why he had to repeat a year? Was anticipating trying to find a PGY2 spot, not asking for a PGY1 spot

 

[chessknt]

Oh I thought you had a better reason than telling them their program sucks (like family). That other thread is much more applicable then and I always would posit that you don't understand what you are getting in to by asking this. The PD could just say no but even a supportive PD could develop a vendetta (or could be a façade or other forces might be at work etc) and then youre in a much worse place for asking. I am paranoid because I have seen this happen at 2 good upper mid tier academic programs with really awesome PDs 3x over the course of my training to (what seemed like) good people and the systemic character and confidence assassination that occurred was astonishing. Im sure the trainees didnt see it coming and once it does you can do absolutely nothing to stop it.

 

[softball2344]

Oh I thought you had a better reason than telling them their program sucks (like family). That other thread is much more applicable then and I always would posit that you don't understand what you are getting in to by asking this. The PD could just say no but even a supportive PD could develop a vendetta (or could be a façade or other forces might be at work etc) and then youre in a much worse place for asking. I am paranoid because I have seen this happen at 2 good upper mid tier academic programs with really awesome PDs 3x over the course of my training to (what seemed like) good people and the systemic character and confidence assassination that occurred was astonishing. Im sure the trainees didnt see it coming and once it does you can do absolutely nothing to stop it.

Wow and this was after asking to leave for non-family/ personal reasons? If they were at upper mid tier programs why did they want to leave?

No I do not have a better reason other than wanting better clinical exposure and better job opportunities. This is very much a community program, transfers out certain patients (which I know will bother me immensely) and doesn't have fellowships. I guess I'm just assuming people are reasonable and wouldn't punish me unfairly lol its not like I plan on letting anything affect my work

 

[chessknt]

Wow and this was after asking to leave for non-family/ personal reasons? If they were at upper mid tier programs why did they want to leave?

No I do not have a better reason other than wanting better clinical exposure and better job opportunities. This is very much a community program, transfers out certain patients (which I know will bother me immensely) and doesn't have fellowships.

I have no idea what triggered it. I am just saying you are brand new to being a doctor and until you complete residency you are not safe. I would be cautious above all else in unknown waters--a lot of the protections afforded to you as a medical student will be gone or only nominally present in residency. You'll see how important politics are in medicine but until you do I would hesitate before doing something that could make multiple people irritated (at best) to outright angry.

 

[Redpancreas]

Thanks for this. Yea my family is in the area I matched so I couldn't possibly give a personal reason without straight up lying, planning to be honest. Do you know why he had to repeat a year? Was anticipating trying to find a PGY2 spot, not asking for a PGY1 spot

Yes. The accepting PD wanted him to trial a 3 month period but opted to keep him as a PGY-1 for the year. Did not want to take the risk of not knowing the EMR on transition, etc.

 

[Redpancreas]

I have no idea what triggered it. I am just saying you are brand new to being a doctor and until you complete residency you are not safe. I would be cautious above all else in unknown waters--a lot of the protections afforded to you as a medical student will be gone or only nominally present in residency. You'll see how important politics are in medicine but until you do I would hesitate before doing something that could make multiple people irritated (at best) to outright angry.

People get angry for the stupidest reasons in residency.

OP maybe asking but do it after you know the PD likes you. Get it out of your head for now.

 

[softball2344]

Yes. The accepting PD wanted him to trial a 3 month period but opted to keep him as a PGY-1 for the year. Did not want to take the risk of not knowing the EMR on transition, etc.

Totally understand the trial period but gosh repeating the whole intern year doesn't sound fun. I'll try to get it out of y head for now.