IM intern looking to switch to psych

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I apologize everyone, I know this subject has been touched on before.

I just started intern year and I know in my heart IM is not for me.

I have extensive experience in psychiatry but ultimately chose IM to be closer to family. I know now that being in psych is even more important than that.

I know I need to talk to my PD. My question is, when should I go to talk to him? ASAP? Or should I wait for a rotation or two?

Should I try to re-enter the match or look for PGY-2 spots? Or both?

Do I have to stay with my current program the whole year if I re enter the match?


Thank you for any thoughts or guidance
God Bless

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You should go to the NRMP site and look for the number of days you are contractually obligated to work before your leaving isn't a match violation. It is probably 60 or something like that. If you can be honest with your PD, he/she may be able to adjust your vacation time to let you go on interviews. I recommend you complete this year as this will allow you to look for PGY-II positions, and PGY-I positions with more experience. Sticking it out will look better than leaving and waiting for the next cycle.
 
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Thank you so much for taking the time to reply. I will do just that
Agree that your best bet is to work hard at your intern year and then try and find a PGY2 position. You'll probably even still be able to graduate on time (in four years) at most programs, you just won't get the elective time you would have gotten otherwise.
 
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I have heard these are hard to come by? Can I re enter the match and seek out pgy2 spots at the same time?
 
I have heard these are hard to come by? Can I re enter the match and seek out pgy2 spots at the same time?

You’ll want to complete intern year and apply to psych pgy1 and 2 spots. It’ll be a tough road. You won’t have full funding, so many places will consider any FMG to be a better applicant. Apply broadly and talk to your home psych PD’s both from now and med school.
 
You’ll want to complete intern year and apply to psych pgy1 and 2 spots. It’ll be a tough road. You won’t have full funding, so many places will consider any FMG to be a better applicant. Apply broadly and talk to your home psych PD’s both from now and med school.
Does this really factor in so heavily at most places? I suspect it matters more to smaller programs/hospitals. At larger hospitals with lots of trainees and specialty programs, I'd imagine the psych PD doesn't even think about the GME money. That's completely baseless speculation on my part, though.
 
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It depends on how dependent on CMS money the program is. Some don't get much, others have to have it. Places with PGY-II slots are obviously ready for this. The OP needs to be very geographically flexible and will be much better off getting a PGY-II position if possible.
 
Does this really factor in so heavily at most places? I suspect it matters more to smaller programs/hospitals. At larger hospitals with lots of trainees and specialty programs, I'd imagine the psych PD doesn't even think about the GME money. That's completely baseless speculation on my part, though.

High variability. I’ve sat in on high-up meetings at a large university system with 3+ separate psych residencies. It was determined that no specialty could accept a resident without full funding. If any PD messes up and takes such resident, the loss of funds would be pulled from department funds and effect department wide hiring, etc. The result was department chairs instructing all PD’s to not interview anyone without full funding.

Other programs have had other sources of funding and aren’t bothered by this for PGY-2’s.
 
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Does this really factor in so heavily at most places?
This is not an issue for large institutions which typically have many more residents than their medicare cap allows for anyway. In the current era medicare is only of many different funding streams for GME (the VA, HRSA, DoD, states, counties, and hospitals themselves are others), and many hospitals are reliant on residents as cheap labor so willing to pay for them anyway. It is utterly ridiculous that the federal government should pay for graduate medical education at all. The whole thing is an epic scam.
 
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It depends on how dependent on CMS money the program is. Some don't get much, others have to have it. Places with PGY-II slots are obviously ready for this. The OP needs to be very geographically flexible and will be much better off getting a PGY-II position if possible.


I am very geographically flexible and would be grateful for any spot, anywhere. I’ve read PGY2 spots are just found by calling as many programs as you can. Is this the only way?
 
What don’t u like about IM?
 
What don’t u like about IM?

I don’t hate it so much as It’s just not psychiatry. I always find myself asking about the one psych issue, ie bipolar and wanting to ignore the plethora of other chronic medical comorbidities the pt might have
 
I don’t hate it so much as It’s just not psychiatry. I always find myself asking about the one psych issue, ie bipolar and wanting to ignore the plethora of other chronic medical comorbidities the pt might have

Why not use your electives to do psych or psych related fields like addiction medicine or look into some of the mental health fellowships for primary care. There's plenty of Psychiatry in outpatient clinic and chances are depending on how need based your area is you may end up treating bipolar.

Liking Psych just a bit more isn't really a good reason for transferring. You should transfer if you really don't like IM. Just wanting to treat Psych isn't a good reason because you'll be trained how to handle most of the actually treatable psych.
 
I am very geographically flexible and would be grateful for any spot, anywhere. I’ve read PGY2 spots are just found by calling as many programs as you can. Is this the only way?
I would say e-mailing programs. Most PDs don't expect openings and also don't get a lot of warning when they happen so a lot of reaching out and some luck is involved.
 
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