Is it possible to switch residencies if after a year or two u decide that u like a different field of medicine better?
Yes it is possible. The problem is you will be looking for a PGY-2 slot (unless you want to repeat your internship. Ed
They switch within the same specialty or to different specialties. Once you set upon a specialty, most people will end up practicing that specialty for life, so it's a big decision. If you're not happy in the specialty you started out with, it's in everyone's best interest (your program, yourself and your future patients) to find out one that's better for you. However, it's best to give a specialty at least a year before deciding. Lots of people hated internship (myself included) and it's easy to convince oneself that a different specialty would be better.
How do residency program directors consider a person who switches programs (whithin the same specialty)?
Happens all the time (especially in a field like General Surgery). Changing programs in the same specialty is a different breed - happens too, but its a much more delicate situation. If you have legitimate reasons for wanting to switch programs (ie, like a spouse job transfer, etc.) and you are open and upfront with your current PD, then it will be easier and you will face much less rancor. That said, finding an advanced training spot in some specialties can be difficult but if you have the support of your PD, he/she can be valuable in assisting you in finding open spots.
like Kimberli said, it's much easier when the PD supports you. I actually switched residencies despite the active interference of my old PD, who wanted to make sure I couldn't leave his program despite the fact I had very legit reasons for leaving. It's much more difficult but doable. Most PDs want to hear that you have good reasons to leave (usually family), not that you're just shopping around for a better program. It's much easier to match in a program you enjoy and stay there. I wish I could have done it that way.
I meant switch into a different specialty like going from IM to Derm. How difficult is it to do switch into a different field?
If the new field is derm, I would imagine it is very hard regardless of the support from your PD just because of the general difficulty in matching into derm. To put it another way, if you didn't have the board scores, research, clinical evals to match in coming out of med school, you probably won't be able to transfer into that specialty from a different field.
The process is much less difficult going from a competitive field to a less competitive field (there seems to be at least 1-2 former surgery residents in the entering anesthesiology class at our school every year). This is much more difficult going the other way - for example, the medicine intern I'm working with tried for ophthalmology last year and did not match, scrambled for the medicine position she's in now, tried again but this time also interviewed at neurology programs, and ended up matching at a high-powered neuro program (but was unsuccessful in matching ophtho). All of the advice above is right on. A couple of upperclassmen at my school who were genuinely undecided about their specialty opted to skip the match process their senior year, use the remaining MS-IV electives to better explore their choices, set up research work for the following year and applied successfully the following year. It's hard to explore specialties and buff up the ol' CV during the typical transition/prelim year. Also keep in mind residents have a limited number of years of funding support through the Medicare funding of GME depending on specialty (I think 3 for medicine, 5 for general surgery, etc.) So if you burn up 3 years in General Surgery, and decide to change into medicine or anesthesiology, you will be a far less attractive candidate since the new program would not receive Medicare funding for part of your training.
I've heard "calling around" as good advice for finding openings elsewhere. There is a related SDN forum with suggestions for Web resources for finding openings: http://forums.studentdoctor.net/showthread.php?t=114231
