I want out.

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Reverseperistalsis

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This is a throw-away account. I just learned that I matched low on my list, which is massively devastating for my family. This was unforeseen, as I ranked by geography, which included 2 non competitive programs in a non-competitive specialty. The program I ended up at is a good one for sure...but for my spouse and kids, again, devastating doesn't begin to describe it.

I realize that my matched program doesn't deserve to be short a resident after demonstrating faith in me. With that said, I am a non-trad who had a great career beforehand. I have plenty of student debt, but in short, I want OUT. I consider myself to be one of the few for whom suicide matching would have been the best option. I feel that life is too short to continue on this soul-crushing path, especially at the expense of my family. Also, my program deserves a complement of residents that will be "all in", and truthfully, I won't be. Insert obvious statement here: I should only have ranked places I was willing to go. Well, that ship has sailed. May others learn from my idiocy.

To sum it up: I want out. I want to forget med school ever happened and go back to my prior career, debt be damned. I realize that I'm still very shell shocked and would like to hear of a) others who pulled out of their match commitments and b) general thoughts on ramifications of this that I may not have thought of yet. Much appreciation to respondants, and congrats to those who are happy with their match results.
 
This is a throw-away account. I just learned that I matched low on my list, which is massively devastating for my family. This was unforeseen, as I ranked by geography, which included 2 non competitive programs in a non-competitive specialty. The program I ended up at is a good one for sure...but for my spouse and kids, again, devastating doesn't begin to describe it.

I realize that my matched program doesn't deserve to be short a resident after demonstrating faith in me. With that said, I am a non-trad who had a great career beforehand. I have plenty of student debt, but in short, I want OUT. I consider myself to be one of the few for whom suicide matching would have been the best option. I feel that life is too short to continue on this soul-crushing path, especially at the expense of my family. Also, my program deserves a complement of residents that will be "all in", and truthfully, I won't be. Insert obvious statement here: I should only have ranked places I was willing to go. Well, that ship has sailed. May others learn from my idiocy.

To sum it up: I want out. I want to forget med school ever happened and go back to my prior career, debt be damned. I realize that I'm still very shell shocked and would like to hear of a) others who pulled out of their match commitments and b) general thoughts on ramifications of this that I may not have thought of yet. Much appreciation to respondants, and congrats to those who are happy with their match results.

I guess it depends on what you matched in, how long it is, and what kind of career you had before. I agree with you that if I could choose this again, I would not choose medicine. As much as I like being a doc and helping others, it's a tremendous price to pay and with the increasing amount of never ending paperwork, ridiculous requirements from hospitals, complaining patients, etc. it's just exhausting. Like you I'm in a position where if I quit today, I would still live a comfortable life, given the fact that I have businesses and what not, but I am a few years out from finishing this so I guess I'll finish it up. But if I were able to talk to my 20 something self when I started all of this, I would not do it again. So much needs to change in Medicine that it'snot even funny.
 
OP, as I said in previous posts, it seemed to be a rough year. I'm sorry your result is difficult to swallow. Best wishes whatever you decide.
 
I think you'll have to explain to us why this is so terrible for your family other than distance -- at least given that you're saying you want out (a very questionable decision) and that debt be damned (it won't be).

Totally understand geography and its importance, but your post raises the question of what's so uniquely difficult for your family that countless others haven't gone through before you.

Sorry your match day wasn't happier. I was shaken up on mine three years ago (also a distance thing) but as it turned out, it's been a great experience in ways beyond just a good program.
 
Just to be clear: not the OP. I'm pretty happy with my result, but was astounded at how many classmates matched below #5. Feels like I dodged a bullet actually.
 
I think you'll have to explain to us why this is so terrible for your family other than distance -- at least given that you're saying you want out (a very questionable decision) and that debt be damned (it won't be).

Totally understand geography and its importance, but your post raises the question of what's so uniquely difficult for your family that countless others haven't gone through before you.

Sorry your match day wasn't happier. I was shaken up on mine three years ago (also a distance thing) but as it turned out, it's been a great experience in ways beyond just a good program.
 
Unique things about my situation:
- the city is unacceptably dangerous. My teenage kids will not be able to safely attend public school, and we won't be able to afford private school

-my wife is self-employed with clientele locally

-we have family in our current area, which my kids have always had, and I am unwilling to take that away from them.

-we have a uniquely great real estate situation which we are unwilling to give up.

I realize this must sound ridiculous, but I was banking on it not coming to this. I already know this was a huge mistake.
 
Unique things about my situation:
- the city is unacceptably dangerous. My teenage kids will not be able to safely attend public school, and we won't be able to afford private school

-my wife is self-employed with clientele locally

-we have family in our current area, which my kids have always had, and I am unwilling to take that away from them.

-we have a uniquely great real estate situation which we are unwilling to give up.

I realize this must sound ridiculous, but I was banking on it not coming to this. I already know this was a huge mistake.

What specialty? I think this is important. If you say something non-competitive, fine, maybe financially is not worth it. If you say Derm or Ortho then it's different. That disclosure would help.

With that said - I would suggest you take a second and breath. It may be the shock of you not matching where you wanted, and that's understandable. But I would give it a bit of time to see if the shock settles. If you leave medicine permanently it will all have been in vain. If you quit on your program you may not be able to return to Medicine and get another residency. If you start and complete a year it may give you options. If you start and you really hate it and cannot switch into something you want then at least you have not burned bridges. Keep in mind that without any clinical training your MD/DO is not worth the paper it's printed on. You can always decide on doing something short like occupational/preventative medicine (wish I would have done that really), and be out in a few years with a completed residency and you'll have a number of options.
 
Just to be clear: not the OP. I'm pretty happy with my result, but was astounded at how many classmates matched below #5. Feels like I dodged a bullet actually.

To be completely honest, when I read the OP I thought it was you. Glad things worked out.

@Reverseperistalsis We always warn people going into this process "I'm going to do whatever it takes to be a doctor!" is easy to say before you're actually in the suck. Likewise, "I want to get out, consequences be damned" is easy to say before you actually have to live with those consequences.

Quitting and moving on is definitely doable, and nobody can make that decision for you. But you have to be absolutely sure that you're okay with not having the option to practice medicine ever again- the most likely outcome of breaking your Match contract. Your options with a year of residency under your belt (and the ability to be licensed) aren't exactly vast, but they are far better than what you'd have if you quit now.

Also, not knowing what your prior career was, none of us can advise you on the level of financial stability/lifestyle for your family you'd likely end up with. Medicine isn't the only profession that provides all that, but not many others provide quite the same combination of security and flexibility once you are done with training.

I recommend taking at least a month to let the sting fade, before making any major decisions. If you're already strongly considering breaking this contract, you might as well take some time to think it through rationally first. Doing it later rather than now won't really affect the consequences for you.
 
Unique things about my situation:
- the city is unacceptably dangerous. My teenage kids will not be able to safely attend public school, and we won't be able to afford private school

-my wife is self-employed with clientele locally

-we have family in our current area, which my kids have always had, and I am unwilling to take that away from them.

-we have a uniquely great real estate situation which we are unwilling to give up.

I realize this must sound ridiculous, but I was banking on it not coming to this. I already know this was a huge mistake.
you could always go post this in the SOAP thread...i'm sure there is someone there that would be gleefully switch with you.
 
Sacrifice it for a year to get your internship credit. That at least gets you a medical license... Anyone can do something for a year.
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Just curious, I'm fantasizing on breaking my match (but unlike Reverseperistalisis, I don't have a career/business to fall back on beyond bartending)...

My question is:
Theorectically, if Reverseperistalisis had matched into pediatrics, would you tell him to do that for the intern year? Can one get a medical liscense if one quits after finishing PGY1 in peds?
 
Just curious, I'm fantasizing on breaking my match (but unlike Reverseperistalisis, I don't have a career/business to fall back on beyond bartending)...

My question is:
Theorectically, if Reverseperistalisis had matched into pediatrics, would you tell him to do that for the intern year? Can one get a medical liscense if one quits after finishing PGY1 in peds?
can you get a license ? yes...do you have any real expectations of getting a job? not really...
 
Once you start down the path to becoming a doctor there's no good way off that path and it only gets worse as you go. Even in the best case scenario where you stay in your home town you won't see much of your family. At this point you're going to have to finish this thing or return to square one. Both options will have consequences on your life both positive and negative. You have a few months to figure out which option is better overall.
 
What specialty? What dangerous city? How far away is that from your current location?

If you moving will truly cripple your wife's profession and kids' safety, move on by yourself for the first few months.

Training is temporary, the pain of suffering through your massive debt and being halfway trained is long term. You could always get a small apartment and live by yourself until your family is more ready to make the move.
 
I attended 13 different public schools growing up...in all corners of the country...most of which were in rough areas. Your kids will survive one year (presumably in NYC). And if you are trying to tell me that there isn't one average public school in the city which you are moving...I'm calling BS.

Unless your wife pulls in six figures...she's going to have to leave her job...that's the smart financial decision for your family.

You could be a geo bachelor for a year...I've done it. My family and I survived.

You don't have to go to residency...you could quit. It would be a foolish decision. But it's your decision to make.
 
We see this kind of thread every year, and frankly it's a bit embarrassing to hear people who beat many odds along the way and actually managed to match into something of their choosing acting so entitled. People rank a bunch of programs but apparently mentally haven't wrapped their mind around falling to the bottom of their list. But guess what -- in virtually EVERY year some people fall deeper than their top few choices. Some don't even match. If you are lucky enough to match, you are getting the absolute best place that wanted you back. The ones you liked better simply didn't want you -- so forget about them -- they turned you down. You are acting like the guy, not nearly as cool as he thinks, who won't go to the prom because he can't go with a cheerleader. It's narcissism. ( you can spin it as geography or family issues, but you applied, interviewed and ranked the place so that argument came and went, sorry).

If you want to be a doctor, there's really only one path for you. Attend your contractually obligated intern year and either finish out the residency there, or while there try to match into something totally different in the next match. Those are IMHO the realistic routes to becoming a doctor now. And don't complain -- you agreed to this contractually by ranking the program. There were no surprises. And many many threads like this on SDN every year that you could have learned from.
 
Not sure from your post whether you're looking for advice, or next steps. My only advice is to not make this decision alone. Ask your wife and kids what they want. Don't assume that "you know best".

If you refuse to take your matched PGY-1, all you do is contact your program and the NRMP and tell them that. They will sanction you as a match violator, and your career in clinical medicine will be basically over. But you will be free to do whatever you want instead. It's very simple. It will be even faster if, in your letter, you acknowledge that this will be a match violation and you accept the consequences.
 
You will never get a spot if you break the deal. Just show up on 7/1.

Family will adapt. Some us ate the bullet and others didn't. It is what it is. Move and upward. Especially since it appears you did match in the specialty you wanted.

As someone else who got geographically shafted I think that's s*** advice. It's pretty easy to spew that BS when you're not going through this.

I'm not thinking about breaking my match like OP is, but you seem to think like being separated from loved ones for years is a minor inconvenience, which is fairly insulting. It's a serious, life-changing event.
 
As someone else who got geographically shafted I think that's s*** advice. It's pretty easy to spew that BS when you're not going through this.

I'm not thinking about breaking my match like OP is, but you seem to think like being separated from loved ones for years is a minor inconvenience, which is fairly insulting. It's a serious, life-changing event.

I'll finish that sentence for you: ... which should have been kept in mind from the beginning of the entire process. Not the residency application process, the med school application process. Every year there are posts from people who plan to only apply to a few schools because of geographic restrictions. Every year those people are warned that geographic limitations only get harder as you get further along. The binding nature of the Match is always mentioned. It isn't a bait and switch situation.
 
As someone else who got geographically shafted I think that's s*** advice. It's pretty easy to spew that BS when you're not going through this.

I'm not thinking about breaking my match like OP is, but you seem to think like being separated from loved ones for years is a minor inconvenience, which is fairly insulting. It's a serious, life-changing event.
It's definitely not a minor inconvenience but you (a) applied, (b) interviewed, and (c) ranked this place. You didn't get geographically shafted, you had multiple decision points at which you considered the geography and pushed ahead, deciding that if this was the best you got, you'd make it work. So inconvenience, sure. Shafted? Not so much-- this was your doing, not NRMPs. You told THEM what your next choice was.
 
It's definitely not a minor inconvenience but you (a) applied, (b) interviewed, and (c) ranked this place. You didn't get geographically shafted, you had multiple decision points at which you considered the geography and pushed ahead, deciding that if this was the best you got, you'd make it work. So inconvenience, sure. Shafted? Not so much-- this was your doing, not NRMPs. You told THEM what your next choice was.

I was well aware when interviewing and ranking. The alternative is to not match and have 300K of debt and no job. That is not the point.

My point was gambling and being wrong (as it turned out for myself) is still emotionally jarring. Am I simply allowed to state that?
 
I was well aware when interviewing and ranking. The alternative is to not match and have 300K of debt and no job. That is not the point.

My point was gambling and being wrong (as it turned out for myself) is still emotionally jarring. Am I simply allowed to state that?
Gambling and being wrong does not equate to being shafted. Your outcome is still better than those people who had to soap into programs they know nothing about in cities they've never visited, and a LOT better than the bunch who still have nothing. You got one of your choices, so celebrate. If you want to liken it to gambling, you got two pair and split the pot and are whining that you didn't get a full house and take it all. Your career is on track and it's one you've contemplated as a possibility for months so it's hard to join your pity party.

A lot of us had unexpected hurdles on this path, and you need to dust yourself off and jump over them, not wallow in pity. There's always someone else who would kill to have what you are $&@&ing on.
 
As someone else who got geographically shafted I think that's s*** advice. It's pretty easy to spew that BS when you're not going through this.

I'm not thinking about breaking my match like OP is, but you seem to think like being separated from loved ones for years is a minor inconvenience, which is fairly insulting. It's a serious, life-changing event.

You don't know JDUB or his issues so you can't begin to assume he doesn't understand the situation.

You didn't have to apply to those programs, you didn't have to accept their invite and interview, and you certainly didn't have to rank them. This is YOUR fault and YOURS only. Deal with it like a responsible adult, or be a child about it.
 
Thank you to all, I appreciate the solid advice, especially at a time when I fully recognize that I'm not at all rational. It is an excellent point that there's no benefit to rushing into this decision. At the same time, the program is >3 years, so initially moving without my family wouldn't solve the problem- they'd either eventually have to come, or we'd be apart for the duration. (The program is barely within reasonable driving distance from where we are now.)

I am not comfortable giving any remotely- identifying info in case I do decide to see this thing through. Suffice to say my prior career was something with excellent flexibility in terms of hours and geography, which is very well paid (though admittedly, not as well as anything in medicine) and in high demand.
 
OP, you're having a knee jerk reaction to a bad outcome. I had similar feelings and was seriously thinking about not showing up on day 1 of PGY-1 year. You will adapt at it will be worth it. Don't make life changing decisions when you are emotional. If, after one year, you still want out, then get it out. But at least you will know you gave it a fair shake and you can get a license if you need to, which will allow you to work in some capacity. Your family can put up with it for a year. Families all over the country have to put up with worse.
 
Unique things about my situation:
- the city is unacceptably dangerous. My teenage kids will not be able to safely attend public school, and we won't be able to afford private school

-my wife is self-employed with clientele locally

-we have family in our current area, which my kids have always had, and I am unwilling to take that away from them.

-we have a uniquely great real estate situation which we are unwilling to give up.

I realize this must sound ridiculous, but I was banking on it not coming to this. I already know this was a huge mistake.

Should have read the whole thread...
Yes, it does sound ridiculous. This is 100% your fault for ranking a program you never would consider going to. You would have been better off leaving it off and going unmatched and trying to SOAP into a different specialty locally or re-entering the match next year while doing a post-doc or something in the meantime. It's not like you will see your family much intern year anyway even if you live with them. You may just have to go it alone for a year and try to transfer or switch into a different specialty back home if it's that important to you.
 
As someone else who got geographically shafted I think that's s*** advice. It's pretty easy to spew that BS when you're not going through this.

I'm not thinking about breaking my match like OP is, but you seem to think like being separated from loved ones for years is a minor inconvenience, which is fairly insulting. It's a serious, life-changing event.
but if you thought that moving that distance or living in that city was detrimental to your family then you SHOULD NOT HAVE RANKED IT...PERIOD.
By ranking such a program, knowing that the match is legally binding, you are saying you knew the risks, discussed them (which means thinking about the what ifs) and decided your medical career had a higher priority...if you did not do this, then it is no ones fault but your own...take responsibilties for your actions...the CW has been and has ALWAYS been don't rank a place that you don't want to be at and would rather SOAP than go to...

frankly can't feel much empathy for someone who managed to match and now is upset that they matched...go read (or talk to your classmates) the thread for those that did not match and see if you really have it that bad...

yes, you may have a moment to feel bad that you did not get your #1, and grieve that the place(s) you wanted so much did not want you...but you matched! you get to pass go, get to train in your specialty, and ended up where you are wanted and looking back may find that the match gods really did know what was best.
 
Thank you to all, I appreciate the solid advice, especially at a time when I fully recognize that I'm not at all rational. It is an excellent point that there's no benefit to rushing into this decision. At the same time, the program is >3 years, so initially moving without my family wouldn't solve the problem- they'd either eventually have to come, or we'd be apart for the duration. (The program is barely within reasonable driving distance from where we are now.)

I am not comfortable giving any remotely- identifying info in case I do decide to see this thing through. Suffice to say my prior career was something with excellent flexibility in terms of hours and geography, which is very well paid (though admittedly, not as well as anything in medicine) and in high demand.

You can't even say how long of a drive the new program is from your current location?
 
I don't mean to be entitled. I fully realize how maddening in this must sound to those who didn't match, and I apologize for that. Even though I thought I'd fully assessed my feelings and hashed it out with my family, I had a very poor understanding of where I actually stood on the matter. When I interviewed at the program I matched at, I thought it was great and would have ranked it over the local programs if it hadn't been for my family. One of my mentors strongly suggested that I rank it in my top 3 because he felt it was so solid in my field. Given these things, it's very possible that I would regret backing out eventually. So maybe I am being childish.

I unfortunately I didn't truly realize how unwilling I was to relocate until it was staring me in the face.
 
I unfortunately I didn't truly realize how unwilling I was to relocate until it was staring me in the face.

You're right, that's very unfortunate. Just don't make any decisions right now while your feelings are hurt. Backing out would effectively end your medical career, and that's not the kind of decision to make in the heat of the moment.
 
Sounds like to me "if it is barely within driving distance" you can see your family on the weekends when not on call. They can come visit you. You can have a long distance relationship and have your wife bring the kids to see you frequently enough. You will survive.

Think about all those people who are married to business men/women who travel all the time. Or pilots, or military service people. Their spouses are gone a lot, and they survive. Heck,some even enjoy it.
 
OP, I can't blame you for feeling s**ty about the decision you made and the consequence you have to accept. This is a common reaction to a bad outcome. Life is full of choices, some are better, some are worse. If you keep thinking about whatif all the time, it will only make you feel unhappy. What if you didn't match anywhere? Isn't this why you ranked that program?

You didn't put yourself through 4 years of sacrifice to say I quit now because I made one bad decision. As you may have heard over and over for the past 4 years, "this too shall pass". Good luck.
 
I don't mean to be entitled. I fully realize how maddening in this must sound to those who didn't match, and I apologize for that. Even though I thought I'd fully assessed my feelings and hashed it out with my family, I had a very poor understanding of where I actually stood on the matter. When I interviewed at the program I matched at, I thought it was great and would have ranked it over the local programs if it hadn't been for my family. One of my mentors strongly suggested that I rank it in my top 3 because he felt it was so solid in my field. Given these things, it's very possible that I would regret backing out eventually. So maybe I am being childish.

I unfortunately I didn't truly realize how unwilling I was to relocate until it was staring me in the face.

This is just the first in a series of moves that you'll likely have. What happens if you go to fellowship and have to move? What about looking for your first job and can't get a job in the town you'd like to live in?

If you want to be a doctor, then go to the place you matched. A place you were told was a solid place to train by multiple people. Going to a strong program gives you a better chance of ending up where you'd like in the end, but again, nothing is guaranteed. Make the best of the situation and you may find it was the best thing that could have happened to you.
 
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For what it's worth, I am now 2.5 years into my 5 year residency in a competitive field, and I have been dealing with long distance with my SO since I matched. He was unwilling to leave his job, and so I have been three time-zones away during my residency, with plans to move back across the country when I am finished. It's VERY hard and at times I am miserable about it, but I was willing to sacrifice 5 years of my personal life to succeed in my chosen field. It's not ideal and it would have been a million times easier if I had matched at my #1 in the city my SO is in... But I didn't, and we have made it work.

That said, the better thing for you would probably be if your family moved with you. Families move because their spouse/parent gets a new job in a new city all the time, so this wouldn't be an unusual situation. I have a coresident with 4 children who moved his whole family here across the country from where they lived before when he matched. They seem to have adapted fine. I don't believe you that the city is "unacceptably dangerous." There are always suburbs within commuting distance that are safe enough. For example, I grew up in Detroit which is usually considered one of the most dangerous cities in the country with terrible public schools, but there are dozens of very safe, family-friendly suburbs within 30 min of downtown that have wonderful public school systems.

I think you can and should make this work.
 
This is a throw-away account. I just learned that I matched low on my list, which is massively devastating for my family. This was unforeseen, as I ranked by geography, which included 2 non competitive programs in a non-competitive specialty. The program I ended up at is a good one for sure...but for my spouse and kids, again, devastating doesn't begin to describe it.

I realize that my matched program doesn't deserve to be short a resident after demonstrating faith in me. With that said, I am a non-trad who had a great career beforehand. I have plenty of student debt, but in short, I want OUT. I consider myself to be one of the few for whom suicide matching would have been the best option. I feel that life is too short to continue on this soul-crushing path, especially at the expense of my family. Also, my program deserves a complement of residents that will be "all in", and truthfully, I won't be. Insert obvious statement here: I should only have ranked places I was willing to go. Well, that ship has sailed. May others learn from my idiocy.

To sum it up: I want out. I want to forget med school ever happened and go back to my prior career, debt be damned. I realize that I'm still very shell shocked and would like to hear of a) others who pulled out of their match commitments and b) general thoughts on ramifications of this that I may not have thought of yet. Much appreciation to respondants, and congrats to those who are happy with their match results.

Here is one thing you may not have considered, or may not really be taking into full account.

If you bail on this opportunity, you are burning a bridge. That might sound like a great idea right now, but it really isn't. If you ever, ever realized that this was a terrible mistake and an over reaction, there may be no way back in to medicine. I've watched a dear friend who stepped off the path find it impossible to get back on, and that has been the great tragedy of her life.

You and your family have made so many sacrifices to get you to this point. If you put in one year, you can try for a different seat, or quit residency entirely and at least still be able to get a license. If you walk away right now, you get nothing but 4 wasted years.

This is an emotional moment, and your thinking may be clouded. Don't make any irrevocable decisions without careful, rational reflection. You have several weeks to think before you have to decide.
 
As someone else who got geographically shafted I think that's s*** advice. It's pretty easy to spew that BS when you're not going through this.

I'm not thinking about breaking my match like OP is, but you seem to think like being separated from loved ones for years is a minor inconvenience, which is fairly insulting. It's a serious, life-changing event.
I am going through it. Did not get where I wanted either. And it affects my family too. But, I knew the deal when I ranked programs. Some win and some lose. If you are not willing to accept what you get, then do not rank it. Nobody made anybody rank a program. We all made that decision. If a place is on your ROL, then you know you might end up there. Medicine is not all fairy tales and lollipops.

Man up and show up. And make the best of it. I am disappointed too and never thought I would drop as far down my rank list either. Shit happens in life....it's how you handle said shit that defines you as a man.
 
There are no guarantees for anyone in the match, and sometimes what you think you want isn't what you actually want. There are people who match to their top choice program and are miserable there (I was one of them), just as there are people like Mr. Hat who match lower down their list and wind up loving their program. As others have said, the best thing to do now is to figure out how to best ease the transition on you and your family, and just go for it. Try to be as positive and optimistic as you can; this may turn out to be the adventure of a lifetime instead of the catastrophe you are currently envisioning. Even if you do hate it, it's still only temporary, and you can apply for an attending job anywhere you want. Now that I am two years out from residency, I am A) glad that I stuck it out, and B) grateful for the quality of the training and education I received, even though the actual experience was far from being pleasant.
 
I understand your frustration, but just remember that when you "want out" there are thousands of people out there who are ready to do anything to be "in".
 
Unique things about my situation:
- the city is unacceptably dangerous. My teenage kids will not be able to safely attend public school, and we won't be able to afford private school

-my wife is self-employed with clientele locally

-we have family in our current area, which my kids have always had, and I am unwilling to take that away from them.

-we have a uniquely great real estate situation which we are unwilling to give up.

I realize this must sound ridiculous, but I was banking on it not coming to this. I already know this was a huge mistake.

Obviously, you only get one life. You're currently not choosing between staying in a war-torn country and fleeing to some other part of earth. The problems you listed are overcome by many residents each year, in some form or another. If figuring out a safe suburb to live in, paying rent, and visiting your family on the holidays is a major ordeal, how are you gonna handle a medical emergency?
 
I am going through it. Did not get where I wanted either. And it affects my family too. But, I knew the deal when I ranked programs. Some win and some lose. If you are not willing to accept what you get, then do not rank it. Nobody made anybody rank a program. We all made that decision. If a place is on your ROL, then you know you might end up there. Medicine is not all fairy tales and lollipops.

Man up and show up. And make the best of it. I am disappointed too and never thought I would drop as far down my rank list either. Shit happens in life....it's how you handle said shit that defines you as a man.

Its nice to know that other families are going through the same thing.

I, like you and OP matched further down my list (but still a fantastic program that I am honored to be at) than what I would have liked. I also have a wife and kids. It broke my heart to tell my 12 year old that we would be moving across the country. We were all disappointed and stunned, especially after receiving such awesome post interview communication programs that I ranked higher.

But like you, I am going show up on July 1 and do the best, professional job that I can because I looked the PD in the eye and told him that's what I would do.

We played the game to win. And like losing, winning has consequences.

@OP, don't make this decision hastily. 3-4 years is a small sacrifice in the grand scheme of things. I do feel for you though.

Best of luck.
 
can you get a license ? yes...do you have any real expectations of getting a job? not really...

So gritting my teeth for a year will not help me that much? I can expect to be in the same position after finishing PGY1 of peds and quitting as I would be graduating medical school without attempting residency?
 
So gritting my teeth for a year will not help me that much? I can expect to be in the same position after finishing PGY1 of peds and quitting as I would be graduating medical school without attempting residency?

Slightly better as you could get a permanent license, but if you get through one year, you can get through three.
 
You want to finish that first year. If you do that, you can at least get a license and work doing locums or urgent care or something that will let you meet your loan obligations.

Also, going back into another residency later is a lot easier with at least a completed intern year than as a totally untrained student, whose knowledge and limited clinical experience is aging out of relevance one year at a time.
 
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