Just matched and already questions about transferring :-(

[PeasPlease]

---

Members do not see this ad.

I matched into med-peds at a program *way* down my list and am not happy about it. The programs lacks what I was looking for in many respects (but yes, it was still better than scrambling.) I of course intend to show up this summer and try to be an awesome resident. I'm open to the possibility that I might end up satisfied with the program, as I've been known to adjust to situations that seemed far from ideal at first. But it would probably be easier if I'm well-informed about all my options. Hence these questions:

1) Since I'm starting in a 4-year residency, I'll have 4 years of full GME funding, right? If I really can't stand my program but can't find another med-peds spot, I might be willing to transfer into categorical medicine. If it's after my intern year, though, I'd only have 6 months of IM done, which means that a program might make me start from scratch and I'd need 4 PGY years in total to complete residency.

2) I've done some research online about the NRMP's all-in policy beginning next year, and it seems as if exceptions will be finalized in May (http://www.nrmp.org/nrmpannualmeeting2011.pdf, see 2nd-to-last slide). If the policy does indeed make an exception for residents transferring, is there any chance of getting a mid- or upper-tier categorical medicine program to accept me as an out-of-match new PGY-1 in 2013? (I got interviews at such places for med-peds.)

Thanks for any answers / advice any of you can provide. I'm trying to focus on the good points of my program, but I'm still so bummed about my match.

 

[Law2Doc]

I matched into med-peds at a program *way* down my list and am not happy about it. The programs lacks what I was looking for in many respects (but yes, it was still better than scrambling.) I of course intend to show up this summer and try to be an awesome resident. I'm open to the possibility that I might end up satisfied with the program, as I've been known to adjust to situations that seemed far from ideal at first. But it would probably be easier if I'm well-informed about all my options. Hence these questions:

1) Since I'm starting in a 4-year residency, I'll have 4 years of full GME funding, right? If I really can't stand my program but can't find another med-peds spot, I might be willing to transfer into categorical medicine. If it's after my intern year, though, I'd only have 6 months of IM done, which means that a program might make me start from scratch and I'd need 4 PGY years in total to complete residency.

2) I've done some research online about the NRMP's all-in policy beginning next year, and it seems as if exceptions will be finalized in May (http://www.nrmp.org/nrmpannualmeeting2011.pdf, see 2nd-to-last slide). If the policy does indeed make an exception for residents transferring, is there any chance of getting a mid- or upper-tier categorical medicine program to accept me as an out-of-match new PGY-1 in 2013? (I got interviews at such places for med-peds.)

Thanks for any answers / advice any of you can provide. I'm trying to focus on the good points of my program, but I'm still so bummed about my match.

Don't go into residency thinking about transferring. 90% of the time the grass is greener, and six months from now you will hear things from people at some of these other programs that make you realize you dodged a bullet. The match is nice because it puts you into your best choice you were ever going to get. Everything else was just wishful thinking and you might as well put it out of your mind. Transfers happen in very rare cases and usually with significant circumstances behind them unrelated to being dissatisfied with the match ( ie spouse/family out of town, changing specialty altogether). A PD might be understanding in agreeing to let you transfer to be closer to your new fiancé in a new state, or he may understand if you decided you'd rather be a pathologist than in IM or Peds. But he's not going to be understanding if your goal is just to transfer to a better place in one of the same specialties, or a "better" program with more fellowship opportunities, etc. This kind of transfer simply doesn't happen, and you really need to put it out of your mind.

 

[mlw03]

agree with l2d. you signed a contract to go to this program, and trying to transfer to a better program isn't right. think of the converse - the program may not be thrilled with you, and how would you feel if you got a letter from your PD next march saying, "you've been exactly the resident we expected you to be, but someone with a much more impressive pedigree came to me asking for a spot, so we're accepting him/her and booting you. thanks and good luck." how would you feel if that happened to you?

 

[RadOncDoc21]

agree with l2d. you signed a contract to go to this program, and trying to transfer to a better program isn't right. think of the converse - the program may not be thrilled with you, and how would you feel if you got a letter from your PD next march saying, "you've been exactly the resident we expected you to be, but someone with a much more impressive pedigree came to me asking for a spot, so we're accepting him/her and booting you. thanks and good luck." how would you feel if that happened to you?

This is my greatest fear... Can't wait to sign my annual contract!

-R

 

[Groove]

Solid advice from above. Grasp the brake handle on the temptation for impetuous foolishness and ride it out. Second guessing is human nature. One interview and whatever research you did into the program gave you very little insight into how things truly are there, so you might be very pleasantly surprised.

 

[PSurg530]

I matched into med-peds at a program *way* down my list and am not happy about it. The programs lacks what I was looking for in many respects (but yes, it was still better than scrambling.) I of course intend to show up this summer and try to be an awesome resident. I'm open to the possibility that I might end up satisfied with the program, as I've been known to adjust to situations that seemed far from ideal at first. But it would probably be easier if I'm well-informed about all my options. Hence these questions:

1) Since I'm starting in a 4-year residency, I'll have 4 years of full GME funding, right? If I really can't stand my program but can't find another med-peds spot, I might be willing to transfer into categorical medicine. If it's after my intern year, though, I'd only have 6 months of IM done, which means that a program might make me start from scratch and I'd need 4 PGY years in total to complete residency.

2) I've done some research online about the NRMP's all-in policy beginning next year, and it seems as if exceptions will be finalized in May (http://www.nrmp.org/nrmpannualmeeting2011.pdf, see 2nd-to-last slide). If the policy does indeed make an exception for residents transferring, is there any chance of getting a mid- or upper-tier categorical medicine program to accept me as an out-of-match new PGY-1 in 2013? (I got interviews at such places for med-peds.)

Thanks for any answers / advice any of you can provide. I'm trying to focus on the good points of my program, but I'm still so bummed about my match.

I know how you feel, same thing happened to me. And I've been told all of the above advice (which is very good advice), but it is still hard to come to terms with the fact that your life for the next 4 years is going to be completely different than how you thought it would be. What I'm going to do is just go there with a positive attitude and give it a try. The last thing you want to do is upset the PD or anyone else because you were unhappy with your match result.

 

[berger911]

in a very similar position. did extremely poor on the match and ended up at the bottom of my list. my husband is still weighing our options and of course there are our 2 daughters. hopefully everything works out for all of us.

 

[Koswus]

agree with l2d. you signed a contract to go to this program, and trying to transfer to a better program isn't right. think of the converse - the program may not be thrilled with you, and how would you feel if you got a letter from your PD next march saying, "you've been exactly the resident we expected you to be, but someone with a much more impressive pedigree came to me asking for a spot, so we're accepting him/her and booting you. thanks and good luck." how would you feel if that happened to you?

You make a good point, it does suck for the residency program in terms of making schedules as well as the rest of the residents might lose elective time and such but if this were to be a similar scenario it would elaborate into "well you were exactly (and by this meaning we're not to thrilled about your credentials and interview and we took you because the other 5 people we wanted didn't come here but you kinda get the job done) the resident we expected so we are going to let you go because someone better came along. Sounds harsher but gives more justification to the program letting you go.

I would say at least try the program and see how it is, if you are really really miserable there you can consider changing. However you might still need a waiver from the nrmp along with at least a letter of good standing from the PD (if not a recommendation letter). I think any reasonable program director at a reputable institution would see that it's better to have a resident that is happy to be there as opposed to miserable. And if your really that miserable well my lawyer friends keep telling me, "you know the contract is legally only for one year right." Definitely give them a heads up though to allow your program to find a replacement.

However, that being said, once you resign your position the program has no obligation to keep it for you in-case you can't find another program. Also the reasons you are leaving will not look very good for fellowship applications. Might be difficult to get another position as well. Your going to have to weigh how unhappy you are against these things and more then likely you will have second thoughts about either route you take.

Despite all that, congratulations on matching! Hope you can be happy wherever you end up.

 

[Law2Doc]

... I think any reasonable program director at a reputable institution would see that it's better to have a resident that is happy to be there as opposed to miserable....

not always. First it looks really bad if residents from one program are jumping to another program in the same specialty simply because they don't like it. So there needs to be a family reason or a change of fields for this not to create egg on someone's face. Second, when a program loses a resident, if they can't be easily replaced with someone if comparable caliber, everyone else ends up with more call. More call makes everyone testy. So keeping one unhappy resident often prevents you from having 10 unhappy residents. Plus the PD may have to spend time recruiting and interviewing replacements, probably not the way he likes to spend his day once match season is over. So your leaving is a hard sell even to a nicer PD. Their inclination will be to try to convince you to finish out the year. You leaving is not costless to them or the program or colleagues.

 

[Top Gun]

I agree with the others. You really should try to stick with the program you matched at. Leaving a program in mid-year creates a major mess for your PD and fellow residents. And telling your PD you want to transfer to a "better" program is an insult to him/her, and to the program. And you are obligated to remain at the place you matched for at least a year according to the NRMP rules. If you really didn't want to be a resident at that program, you shouldn't have ranked it.

Besides, one interview isn't really enough to show you what the program is really like. I would try to stay at that program. It might be a better program than you originally thought.

 

[FutureInternist]

I matched into med-peds at a program *way* down my list and am not happy about it. The programs lacks what I was looking for in many respects (but yes, it was still better than scrambling.) I of course intend to show up this summer and try to be an awesome resident. I'm open to the possibility that I might end up satisfied with the program, as I've been known to adjust to situations that seemed far from ideal at first. But it would probably be easier if I'm well-informed about all my options. Hence these questions:

1) Since I'm starting in a 4-year residency, I'll have 4 years of full GME funding, right? If I really can't stand my program but can't find another med-peds spot, I might be willing to transfer into categorical medicine. If it's after my intern year, though, I'd only have 6 months of IM done, which means that a program might make me start from scratch and I'd need 4 PGY years in total to complete residency.

2) I've done some research online about the NRMP's all-in policy beginning next year, and it seems as if exceptions will be finalized in May (http://www.nrmp.org/nrmpannualmeeting2011.pdf, see 2nd-to-last slide). If the policy does indeed make an exception for residents transferring, is there any chance of getting a mid- or upper-tier categorical medicine program to accept me as an out-of-match new PGY-1 in 2013? (I got interviews at such places for med-peds.)

Thanks for any answers / advice any of you can provide. I'm trying to focus on the good points of my program, but I'm still so bummed about my match.

This is EXACTLY why you NEVER rank a program unless you can see yourself being "stuck" there for 3-5 years !!!
Warning for any current 3rd years !!!

 

[PSurg530]

This is EXACTLY why you NEVER rank a program unless you can see yourself being "stuck" there for 3-5 years !!!
Warning for any current 3rd years !!!

This is not at all helpful. As the OP said, this was better than not matching, but still completely different than hoped for or expected. They have the right to be upset, it takes a long time for the shock to wear off...

 

[Mattchiavelli]

Agree with everyone... Sometimes the match is a reality check but it is what it is.

 

[FutureInternist]

This is not at all helpful. As the OP said, this was better than not matching, but still completely different than hoped for or expected. They have the right to be upset, it takes a long time for the shock to wear off...

High risk, high reward but have to be prepared to get disappointed.
Some people may be OK w/ sitting out a year or going through the scramble (or whatever it has been changed too now), since there may be good programs that did not fill. At least then you know what you're getting into.