Is it better to get dismissed or resign from residency?

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SadNutellaGirl

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I am currently an intern in a DO FM residency. I am returning back to the medical field after taking a 3 year break. I was super excited when I first started , but once I started IM rotation in mid August, everything started falling apart. I realized I forgotten a lot of medicine and was criticized daily for not reaching resident standards. I was placed on probation and by the end of February the administration will make a decision whether to keep me or not. Although I feel like I improved over the months, but I always feel like there's so much I don't know and with the long hours, it seems almost impossible to regain the medical knowledge that is required to be a doctor. I actually did above average on the in-service exam so I guess I know something, but for some reason I'm having a lot difficulty recalling information . I find it even hard explaining to patient simple things or about their diagnosis.

I feel like I lost all enthusiasm for it and starting to thinking maybe this isn't the right field for me. My first choice was psychiatry. The only part of my job that I enjoy is talking to people and learning about their lives and stories. I like the counseling aspect of it - which I know is a little part of FM, but it isn't the focus. I am not too sure if the residency will keep me or not...but if it seems like they are leaning towards dismissing me - is it better to quit, get dismissed or makes no difference. Is there any chance I can reapply to psychiatry in the future or would I pretty much be black listed

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They're going to look at your evals either way. There's a question in many jobs apps, licensing apps... that asks if you ever resigned because of impending termination. I guess it's better to finish 12 months of residency, get a medical license, then get another degree in psychology or counseling and practice that since that seems like something you like but still be able to prescribe like a psychiatrist with your medical license.

Good luck, focus on review materials. I know a girl In our program take a leave of absence then come back. She was diagnosed with ADHD I guess. I would think about doing a medical reentry program for physicians that have left medicine then decide to re-enter because those programs coach you like a medical student/resident and help you address deficiencies.
 
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They're going to look at your evals either way. There's a question in many jobs apps, licensing apps... that asks if you ever resigned because of impending termination. I guess it's better to finish 12 months of residency, get a medical license, then get another degree in psychology or counseling and practice that since that seems like something you like but still be able to prescribe like a psychiatrist with your medical license.

Good luck, focus on review materials. I know a girl In our program take a leave of absence then come back. She was diagnosed with ADHD I guess. I would think about doing a medical reentry program for physicians that have left medicine then decide to re-enter because those programs coach you like a medical student/resident and help you address deficiencies.

Thank you so much for replying! I read your post a couple of days ago but I didn't get a chance to reply. The ADHD part really got me thinking....I feel like I thought I had it several years ago, but when I went to a psychologist , after 5 min of talking he diagnosed me with something called internal dialogue ( talking to yourself all day...or I guess thinking all the time) and he pretty much said I didn't have it even though he didn't ask me any screening questions. So thanks to your post, I decided to bring it up with the psychologist that I've been for depression and anxiety ( due to the probation) and she is now doing a psychological assessment of ADHD for me. I have one more test I have to take before she can give a definitive diagnosis - but she says it seems I most likely have the inattentive subtype . Most of my life I thought I was daydreaming, but now that I am in the work field, I'm constantly told to pay attention, I can't seem to focus or even process what people are saying sometimes, I'm disorganized, always late to work, forgetful...so many things....I feel like if I really have the diagnosis, the decade of struggles I faced makes sense. So thank you again for mentioning that, it may have led me to finally figuring out things! Your co-resident , how long of a leave of absence did she take? Did you or anyone think she might've had it before she was diagnosed? When she came back, do you know if she was doing better at work?

I didn't even know about these medical re-entry programs. I started looking into it as well. Is it similar to an externship, or more tailored to your unique problems? I feel like I would definitely benefit from that, I just don't know if my residency would allow me to do that and return.

And that one year internship to get license....do you know if its possibly to take the Step 3 after the one year , or does have it to be done within the year? And what about FM boards?
 
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They haven't dismissed you yet. I would absolutely put everything into this program. See if you can fix what's going wrong before they dismiss you. I'm less experienced with this - but perhaps the others on here can chime in. Better to disclose that you're being evaluated for ADHD and potentially getting treated/take a LoA, talk to the program director and ask for a 1-2 month re-eval after being treated?

Step 3 shouldn't be on your radar right now. Try to save your residency first. Residents in my program have taken it any where from before residency to end of 2nd year.
 
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I am currently an intern in a DO FM residency. I am returning back to the medical field after taking a 3 year break. I was super excited when I first started , but once I started IM rotation in mid August, everything started falling apart. I realized I forgotten a lot of medicine and was criticized daily for not reaching resident standards. I was placed on probation and by the end of February the administration will make a decision whether to keep me or not. Although I feel like I improved over the months, but I always feel like there's so much I don't know and with the long hours, it seems almost impossible to regain the medical knowledge that is required to be a doctor. I actually did above average on the in-service exam so I guess I know something, but for some reason I'm having a lot difficulty recalling information . I find it even hard explaining to patient simple things or about their diagnosis.

I feel like I lost all enthusiasm for it and starting to thinking maybe this isn't the right field for me. My first choice was psychiatry. The only part of my job that I enjoy is talking to people and learning about their lives and stories. I like the counseling aspect of it - which I know is a little part of FM, but it isn't the focus. I am not too sure if the residency will keep me or not...but if it seems like they are leaning towards dismissing me - is it better to quit, get dismissed or makes no difference. Is there any chance I can reapply to psychiatry in the future or would I pretty much be black listed

As an intern, how much as you supposed to know? Main thing you should know is how to gather information, come up with differentials, and propose treatment in an efficiency way. Lots of the differential would be the same as the medical history anyways.

There is a chance that FM isn't for you. But that isn't best determined by how well you do on an IM rotation.

Rule out ADHD. Make sure you read every day, at least 10 minutes a day on the cases that stumped you. Based on the 80/20 rule, some illnesses will appear more frequent than others. Make sure you know those cold (i.e. HTN, DM, HLD, hypothyroidism, COPD, etc.). Start with really simple text, such as First Aid that you used as a medical student. Once you know the basics, then advance to the textbooks or UpToDate articles.

I agree with trying to stick it out. It is getting more and more difficult to get into residency.

P.S. And if you can, try to transfer to psychiatry. It is a vastly better field, but that is coming from someone who may be biased. =)
 
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I am currently an intern in a DO FM residency. I am returning back to the medical field after taking a 3 year break. I was super excited when I first started , but once I started IM rotation in mid August, everything started falling apart. I realized I forgotten a lot of medicine and was criticized daily for not reaching resident standards. I was placed on probation and by the end of February the administration will make a decision whether to keep me or not. Although I feel like I improved over the months, but I always feel like there's so much I don't know and with the long hours, it seems almost impossible to regain the medical knowledge that is required to be a doctor. I actually did above average on the in-service exam so I guess I know something, but for some reason I'm having a lot difficulty recalling information . I find it even hard explaining to patient simple things or about their diagnosis.

I feel like I lost all enthusiasm for it and starting to thinking maybe this isn't the right field for me. My first choice was psychiatry. The only part of my job that I enjoy is talking to people and learning about their lives and stories. I like the counseling aspect of it - which I know is a little part of FM, but it isn't the focus. I am not too sure if the residency will keep me or not...but if it seems like they are leaning towards dismissing me - is it better to quit, get dismissed or makes no difference. Is there any chance I can reapply to psychiatry in the future or would I pretty much be black listed

I would say it depends. If you CAN find a position in Psych, I would try to start that conversation now. I am not sure whether residency training has gotten worse in the past few years or what, but I have seen a lot more threads on probation/termination/dismissal. I do recall my PD mentioning something towards the end of my residency that evaluations had become much more detailed. So I don't know. So if FM is not for you, I would look at other options. FM I would imagine is surprisingly challenging because why it's easy to get into, you do have to know a lot to remain in the program. So perhaps something a little less clinically inclined, particularly if you have taken a long clinical break. I would say Psych or occupational med might be good options.
 
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Hey thanks for your input guys! Yeah I was thinking if I do get diagnosed with ADHD, I can have my psychologist write a letter and I can write a LOA and hopefully turn this probation thing around . From what I read, work cannot discriminate against people who have ADHD and are supposed to provide accommodations if requested.

So far my year has been Cardio, EM - both months were fun and enjoyed them. Then in Aug I started IM, and it went on for 2 months...6 days a week for 12 hrs, 8 weeks straight. Pretty much yelled at everyday and constantly being ripped apart of why I am not getting it, why does everything have to be repeated. It was pure hell. It was mentally exhausting, and when I came home I tried to study but it was difficult after having such a hard day and also the burnout fatigue was definitely helping. But then finally in October I had 2 week break - and felt more refreshed and studied a bit too ( they gave me book called Case Files FM to read , which was good, but honestly felt I would've gotten a lot more done if I just read First Aid). When I came back it was 2 weeks of clinic and then they made me repeat EM with clinic on every day I had off ( I was pretty disappointed cuz EM month is the only time you have free days off to study). Then they decided to throw me into three months of Internal Medicine. They said that is the best way to evaluate me and think by being in the most challenging rotation , I'll learn medicine. In a way, yes by repetition , I did learn a lot because I see the same cases over and over again. But I feel like I'm learning things superficially - and maybe a quick reference to Up to date. Like I know what to order - but why am I ordering them? What is the reasoning behind. It makes me uncomfortable how much I don't know and have forgotten. I feel is I really need is to rebuild my foundation - and be given more time to read a review book like First Aid and then move on to Up to date ( AD04 mentioned that above as well).

Residency is already hard due to the demands that are expected on daily basis - getting notes done quick, phone calls, table rounds, dealing with families. People who are super smart and got it together feels overwhelmed sometimes too. But for me, with knowledge deficiencies and the obvious disparity between me and my co-residents, it has just made me feel pretty worthless and like I don't belong there. I am sure I can catch up, I just need time away from everyone with extra help from maybe a tutor/mentor/program.

Although it would be great to be in Psych....but how? Apply for 2020 cycle as a 2nd year? Aren't transfers pretty hard - especially since psych is so competitive. Also is it even possible to scramble into the upcoming DO match without applying to the match?
 
Hey thanks for your input guys! Yeah I was thinking if I do get diagnosed with ADHD, I can have my psychologist write a letter and I can write a LOA and hopefully turn this probation thing around . From what I read, work cannot discriminate against people who have ADHD and are supposed to provide accommodations if requested.

So far my year has been Cardio, EM - both months were fun and enjoyed them. Then in Aug I started IM, and it went on for 2 months...6 days a week for 12 hrs, 8 weeks straight. Pretty much yelled at everyday and constantly being ripped apart of why I am not getting it, why does everything have to be repeated. It was pure hell. It was mentally exhausting, and when I came home I tried to study but it was difficult after having such a hard day and also the burnout fatigue was definitely helping. But then finally in October I had 2 week break - and felt more refreshed and studied a bit too ( they gave me book called Case Files FM to read , which was good, but honestly felt I would've gotten a lot more done if I just read First Aid). When I came back it was 2 weeks of clinic and then they made me repeat EM with clinic on every day I had off ( I was pretty disappointed cuz EM month is the only time you have free days off to study). Then they decided to throw me into three months of Internal Medicine. They said that is the best way to evaluate me and think by being in the most challenging rotation , I'll learn medicine. In a way, yes by repetition , I did learn a lot because I see the same cases over and over again. But I feel like I'm learning things superficially - and maybe a quick reference to Up to date. Like I know what to order - but why am I ordering them? What is the reasoning behind. It makes me uncomfortable how much I don't know and have forgotten. I feel is I really need is to rebuild my foundation - and be given more time to read a review book like First Aid and then move on to Up to date ( AD04 mentioned that above as well).

Residency is already hard due to the demands that are expected on daily basis - getting notes done quick, phone calls, table rounds, dealing with families. People who are super smart and got it together feels overwhelmed sometimes too. But for me, with knowledge deficiencies and the obvious disparity between me and my co-residents, it has just made me feel pretty worthless and like I don't belong there. I am sure I can catch up, I just need time away from everyone with extra help from maybe a tutor/mentor/program.

Although it would be great to be in Psych....but how? Apply for 2020 cycle as a 2nd year? Aren't transfers pretty hard - especially since psych is so competitive. Also is it even possible to scramble into the upcoming DO match without applying to the match?

Sorry you are in what appears to be a nasty program. Yelling and making people feel like garbage never helped anyone. I would try to go for Psych or Occupational Med.
 
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Although it would be great to be in Psych....but how? Apply for 2020 cycle as a 2nd year? Aren't transfers pretty hard - especially since psych is so competitive. Also is it even possible to scramble into the upcoming DO match without applying to the match?

I think it is possible to pre-match into a program, but those types of programs tend to be sweatshops. You my find yourself out of the frying pan and into the fire -- 80 hours a week, yelling, etc. I'm not sure you would be happy there.

You can apply as PGY-2 (if you finish the current year) or even as PGY-1. To maximize your chance, apply as both. You will need your PD to be on board.

Check out this forum (there are people who went through what you are going through):

Is it possible for a resident to switch into a Psychiatry?

Another thought is that maybe FM is for you. This isn't best determined by IM. Being a hospitalist and being an outpatient PCP are two different things. You're pretty much going through a hazing period and it will get better.
 
You shouldn't give up yet... It's probably not easy to get into another program after getting dismissed.
 
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Sorry you are in what appears to be a nasty program. Yelling and making people feel like garbage never helped anyone. I would try to go for Psych or Occupational Med.

I think maybe yelling on daily basis would be an overstatement....but yes, criticized on daily basis is more accurate...but a lot of the times very harshly by one of the heads of the residency program. I think she has good intentions and said she is being hard on me since she wants me to succeed, sorta doing it in a tough love way. It gets tiring though, especially to be constantly belittled in front of my peers . It is def taking a hit on my self esteem. =/

Why occupational med? I don't know much about it then them treating work related injuries.
 
I think it is possible to pre-match into a program, but those types of programs tend to be sweatshops. You my find yourself out of the frying pan and into the fire -- 80 hours a week, yelling, etc. I'm not sure you would be happy there.

You can apply as PGY-2 (if you finish the current year) or even as PGY-1. To maximize your chance, apply as both. You will need your PD to be on board.

Check out this forum (there are people who went through what you are going through):

Is it possible for a resident to switch into a Psychiatry?

Another thought is that maybe FM is for you. This isn't best determined by IM. Being a hospitalist and being an outpatient PCP are two different things. You're pretty much going through a hazing period and it will get better.

How would I apply as a PGY2? Since from what I know - PGY1 has only like 4 months of IM, but rest is all psych. If i come in as a second year, would i still need take all that first year psych stuff?

And yeah this does feel like a hazing period lol. Problem is, I don't seem to enjoy clinic either. That was my original plan - but it hasn't really sparked my interest, but maybe cuz I still don't have good clinical skills/knowledge
 
I think maybe yelling on daily basis would be an overstatement....but yes, criticized on daily basis is more accurate...but a lot of the times very harshly by one of the heads of the residency program. I think she has good intentions and said she is being hard on me since she wants me to succeed, sorta doing it in a tough love way. It gets tiring though, especially to be constantly belittled in front of my peers . It is def taking a hit on my self esteem. =/

Why occupational med? I don't know much about it then them treating work related injuries.

Yeah I understand. I never have agreed that that is a good way to teach - belittling residents, particulalry in front of peers, is a terrible way to do anything. It has destroys and humiliates the resident. Should never be done. While it is true that not every resident should be in the picked specialty (and not saying that that is your case), i do think that destroying a person's self -esteem does nothing but damage that person further and makes them feel more inept and worsens the problem.

occupational med is less clinical, more kind, less competitive, more relaxed, and i think more forgiving. that is why i suggested it.
 
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FM programs don’t do IM rotations. Do you mean inpatient months?
 
Yeah I understand. I never have agreed that that is a good way to teach - belittling residents, particulalry in front of peers, is a terrible way to do anything. It has destroys and humiliates the resident. Should never be done. While it is true that not every resident should be in the picked specialty (and not saying that that is your case), i do think that destroying a person's self -esteem does nothing but damage that person further and makes them feel more inept and worsens the problem.

occupational med is less clinical, more kind, less competitive, more relaxed, and i think more forgiving. that is why i suggested it.

okay thanks, I will look into occupational med and see what it's about. And yes, I feel is very old school way of teaching...I learn far more when somebody isn't yelling at me lol. I'm not sure who really benefits that way
 
Yes sorry, I meant inpatient rotation. I did 2 months straight. Now doing 3 months straight.
Inpatient rotations can be tough on some FM residents, especially the ones that have a few outpatient rotations before doing their inpatient. We rotate with them and the psych residents and they seem to do ok even if they complain a lot.

Just hang in there man...
 
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How would I apply as a PGY2? Since from what I know - PGY1 has only like 4 months of IM, but rest is all psych. If i come in as a second year, would i still need take all that first year psych stuff?

And yeah this does feel like a hazing period lol. Problem is, I don't seem to enjoy clinic either. That was my original plan - but it hasn't really sparked my interest, but maybe cuz I still don't have good clinical skills/knowledge

It depends on the program. Most likely, the extra medicine months would count as electives. So you'll fulfill your core requirements throughout PGY-2 - 4.

Why not post on the psychiatry forum and someone with experience can answer all your question?
 
So guys, got some bad news....the GMEC decided to not renew my contract. They gave me two options - resign now or finish the year. I had another month of probation left, but for some reason they already came to the decision. They said the reason for dismissal is for patient safety - they said they had to assign a senior resident to look over my orders and they just can't be doing this anymore. I mentioned that right now I am being evaluated for ADHD and there is a high possibility that I may have it - that with a leave of absence I could get treated for it and as well refresh skills in a medicine re-entry program. But they don't care - they said get yourself treated and focus on your issues , but you can not come here as PGY1 and if you apply anywhere else you will have to start over as a PGY1. They said I could start applying to other programs and they'll help, but they didn't specify how. I tried asking more questions but they pretty much walked out on me after 10 min, saying they had another meeting.

I got removed from inpatient care the next day and I will only have non-patient care rotations. I am so heart broken right now...I know I lost the motivation for it, and this is my fault...but I also feel that when I was telling them that throwing me more and more into inpatient was burning me out and I don't think its helping fix the real problem ( my foundation) , that they just ignored it. I didn't even have any meetings with them for two months, in (November it was weekly) so I felt like they just stopped giving me any support and I fell more into depression.

Right now - is there any hope to get back into residency ever? What are my options? I just want to move forward from this and focus on my future even if there are now only limited options.
 
So guys, got some bad news....the GMEC decided to not renew my contract. They gave me two options - resign now or finish the year. I had another month of probation left, but for some reason they already came to the decision. They said the reason for dismissal is for patient safety - they said they had to assign a senior resident to look over my orders and they just can't be doing this anymore. I mentioned that right now I am being evaluated for ADHD and there is a high possibility that I may have it - that with a leave of absence I could get treated for it and as well refresh skills in a medicine re-entry program. But they don't care - they said get yourself treated and focus on your issues , but you can not come here as PGY1 and if you apply anywhere else you will have to start over as a PGY1. They said I could start applying to other programs and they'll help, but they didn't specify how. I tried asking more questions but they pretty much walked out on me after 10 min, saying they had another meeting.

I got removed from inpatient care the next day and I will only have non-patient care rotations. I am so heart broken right now...I know I lost the motivation for it, and this is my fault...but I also feel that when I was telling them that throwing me more and more into inpatient was burning me out and I don't think its helping fix the real problem ( my foundation) , that they just ignored it. I didn't even have any meetings with them for two months, in (November it was weekly) so I felt like they just stopped giving me any support and I fell more into depression.

Right now - is there any hope to get back into residency ever? What are my options? I just want to move forward from this and focus on my future even if there are now only limited options.

I am so so sorry for this. :(

Are you able to quit instead of getting non-renewed? I would double check if this is possible. Again I would look for more non-clinical options as mentioned before.
Do you have family? Anyone that can offer support right now? I think you need a shoulder to cry on right now.
Obviously with the match rank list having the deadline this week you can't really apply but there might be some positions opening up.
Again if I were you I would try to look into occupational medicine options.

But get your support network in place. That will be necessary to get you through this period. Again so sorry.
 
I am so so sorry for this. :(

Are you able to quit instead of getting non-renewed? I would double check if this is possible. Again I would look for more non-clinical options as mentioned before.
Do you have family? Anyone that can offer support right now? I think you need a shoulder to cry on right now.
Obviously with the match rank list having the deadline this week you can't really apply but there might be some positions opening up.
Again if I were you I would try to look into occupational medicine options.

But get your support network in place. That will be necessary to get you through this period. Again so sorry.

This all happened about a week ago ( but after match). I just took a week to pretty much sulk and question life. I tend to take longer to cope with things lol. I have come to acceptance that I lost this job, but I still having a hard time that my medical career is completely over. I sometimes wonder if my lack of enthusiasm was more due to underlying depression and due to the hardships I was facing than really having no interest in the field. I know I felt pretty okay with family medicine in the beginning, but as things got progressively worse, I felt pretty hopeless.

I think resigning means quitting, right? But as someone mentioned earlier - other jobs will look into the reasons of quitting. Also I was told that if I finish the year, I could get become a state licensed physician. With that I think I need to take my Level 3 boards - and I think I need residency approval. I will find out sometime this week if they will allow me.

I think Psych is not even an option since how competitive it is....but what about FM - would another program bother giving me a chance. One of the residency advisers said to just give up on residency, it will be a 200,000 loss to a program and nobody would want to take that that risk. If I even did reach out to another program - how do I explain this situation?

Occupational med - that is part of preventive medicine residency, right? I was looking into osteopathic programs, I couldn't really find any. I don't think MD programs would accept me at all
 
This all happened about a week ago ( but after match). I just took a week to pretty much sulk and question life. I tend to take longer to cope with things lol. I have come to acceptance that I lost this job, but I still having a hard time that my medical career is completely over. I sometimes wonder if my lack of enthusiasm was more due to underlying depression and due to the hardships I was facing than really having no interest in the field. I know I felt pretty okay with family medicine in the beginning, but as things got progressively worse, I felt pretty hopeless.

I think resigning means quitting, right? But as someone mentioned earlier - other jobs will look into the reasons of quitting. Also I was told that if I finish the year, I could get become a state licensed physician. With that I think I need to take my Level 3 boards - and I think I need residency approval. I will find out sometime this week if they will allow me.

I think Psych is not even an option since how competitive it is....but what about FM - would another program bother giving me a chance. One of the residency advisers said to just give up on residency, it will be a 200,000 loss to a program and nobody would want to take that that risk. If I even did reach out to another program - how do I explain this situation?

Occupational med - that is part of preventive medicine residency, right? I was looking into osteopathic programs, I couldn't really find any. I don't think MD programs would accept me at all

Well MD programs would accept you - I don't see why not. You are not the first and won't be the last person to ever lose a residency. I am not trying to by any means suggest that what's happened is not serious - but it is possible to find a different position.

Again if I were you I would look into occupational med positions. I think Psych is not that competitive, not sure why others think it is, but Psych tends to be more forgiving. I think it's possible that FM was simply too much Medicine. I wouldn't say your career is over. You will have to apply again, broadly, and again I would suggest more non-clinical fields.

I think the advisor telling you to "give up on residency" is ridiculous. While it will be an uphill battle I would imagine that it is possible to find another spot. The match also has not yet happened - today is 2/18. The rank deadline is 2/20 and the actual match is not until 3rd week of March or something like that. So it has not yet happened.

It is very likely that positions will be open after the match is over. You are a DO so that gives you a leg up over FMGs/IMGs you might be competing against.

I would say apply to Psych, Occupational Med, perhaps FM - I think it would not be that difficult of a case to make that you took a 3 year leave and were rusty. I'd imagine that I would be super rusty too if I was away from Medicine for 3 years.

I would not give up entirely on residency. I would fight to try to find a position after the match is done this year, there typically are positions left, people also switch, etc. I think again the best case you can make is - look I took 3 years of leave, and if you do have a diagnosis, get it treated, and that can potentially also help further strengthen your case.
 
FWIW, I'd consider posting this in General Residency Issues. I think you'd have a wider audience of folks who have seen this kind of scenario before, especially PDs, who might provide other strategies. Good luck.
 
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Well MD programs would accept you - I don't see why not. You are not the first and won't be the last person to ever lose a residency. I am not trying to by any means suggest that what's happened is not serious - but it is possible to find a different position.

Again if I were you I would look into occupational med positions. I think Psych is not that competitive, not sure why others think it is, but Psych tends to be more forgiving. I think it's possible that FM was simply too much Medicine. I wouldn't say your career is over. You will have to apply again, broadly, and again I would suggest more non-clinical fields.

I think the advisor telling you to "give up on residency" is ridiculous. While it will be an uphill battle I would imagine that it is possible to find another spot. The match also has not yet happened - today is 2/18. The rank deadline is 2/20 and the actual match is not until 3rd week of March or something like that. So it has not yet happened.

It is very likely that positions will be open after the match is over. You are a DO so that gives you a leg up over FMGs/IMGs you might be competing against.

I would say apply to Psych, Occupational Med, perhaps FM - I think it would not be that difficult of a case to make that you took a 3 year leave and were rusty. I'd imagine that I would be super rusty too if I was away from Medicine for 3 years.

I would not give up entirely on residency. I would fight to try to find a position after the match is done this year, there typically are positions left, people also switch, etc. I think again the best case you can make is - look I took 3 years of leave, and if you do have a diagnosis, get it treated, and that can potentially also help further strengthen your case.

How far are you out from residency? Psych is that competitive. It’s increased in competitiveness over the past 3 or 4 years.
 
OP has already posted something similar in the Gen Res forum. Closing this one to allow that discussion to continue.
 
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