J1 visa question please help

[surg4422]

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I am in a bit of a tough spot. I am a foreign grad on a J1 visa. I did 2 years of preliminary surgery both at the same institution, I started to grow a little desperate and decided to apply on last year's match for a different specialty. I ended up matching for a PGY-1 in a different surgical specialty. I know that right now it is too soon and I have been doing quite well in my new program. But I feel that something is missing, I feel at a loss and cant stop comparing. I wish I could go back and try to get a Gen surg position by doing some research or finding a spot outside the match. I have read on the ECFMG FAQ that IMG's are only allowed to change specialties once before the end of the PGY-2 year. I was hoping somebody knew if 1) going from prelim surgery to a different specialty counted as a change in specialty and 2) if it did, if it was still possible to get a spot outside the match back in surgery.

I would really appreciate any help you could give me. I know that probably changing programs, going to a new city and stepping outside of my zone of comfort is what has me in a state of shock and that i still need some time before I make a rash decision but I cant stay in something I do not enjoy.

Thanks,

 

[NotAProgDirector]

Although this exists in law, I have never seen this enforced.

I would think long and hard before giving up your current spot. I am not certain you can switch from a clinical to a research J. Doing a year of research is by no means a guarantee of getting a categorical surgery spot, and your funding situation becomes more problematic each year.

 

[surg4422]

Yeah, I know it is not an easy decision. What I am thinking of doing is applying to any PGY3 positions outside the match. If I get an offer, then after that quit.

 

[NotAProgDirector]

As you have completed 2 prelim surgery years, you will not qualify for any PGY-3 spot. At best, you can hope for a PGY-2. Many categorical programs will start you at the PGY-1 level, as you will not get board credit for your prelim surgical years.

 

[surg4422]

I did a PGY-1 prelim and a PGY-2 prelim, so I did advance. That is why I am elegible for a PGY3. However my concern is mostly with ECFMG. If I wanted to change back to surgery, if they would allow me to do so, or lets say even a different specialty, because it would be changing specialties again. So my question was more directed towards the fact that since I changed from a prelim surgery spot to urology and I am now a PGY1 in it. If I was to change back to surgery or lets say anesthesia, if it would be possible because of their rule of only changing specialties once.

 

[NotAProgDirector]

Well, I have good news and (perhaps) bad news.

First, the answer to your question is here. Page 7, last paragraph.

The good news: Prelim surgery does not count as a specialty. So, Urology is your first specialty.

The bad news: You can only change once and must do so before the end of your PGY-2. Since you're now essentially a PGY-3, you can't switch again. The "perhaps" is that the ECFMG might consider you a PGY-1 again, and that would allow you to switch once.

That being said, giving up a urology categorical spot to do research and maybe match back into surgery, when your funding will be decreased and problematic, is IMHO a poor option. The safest thing to do is finish urology and then apply again to GS. If you drop out, you might never get a new spot.

 

[surg4422]

I talked to the folks on ECFMG, it looks like i can still switch, but you are right, the number of years i have for funding are decreased, so I basically would have to say goodbye to a fellowship.

I really dont know what i am going to do... i am truly miserable in this specialty.

Thanks for the advice, it was helpful