Leaves of absence during residency

[UniqueDoc]

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Hello all:

I may be applying for a transfer to a different program soon but had concerns about some issues I may have while attempting to apply to a different specialty. I had to take a medical leave during PGY-1 and also another leave due to some personal issues.

Do leaves of absence during residency training need to be declared in the ERAS application? If yes, do program directors ever ask specific questions about the reason for a medical leave?

Any advice is sincerely appreciated.

 

[NotAProgDirector]

Usually, any LOA needs to be documented. ERAS asks whether your medical education was ever interrupted. And any MSPE or letter from a PD will document an LOA.

You do not need to explain the reason for the LOA. You can leave it as a "medical" issue, or "personal" issue, or simply state that it was an LOA without any clarification. Employers cannot ask you for more details. However, employers (i.e. a new residency program) might infer that your LOA is a sign of some chronic medical / psychiatric problem, and therefore be nervous to hire you. Note that this isn't legal, but there really isn't much to do about it because there are usually other reasons programs can give for not taking you.

So, if this was an issue that is completely resolved, you might be best to just disclose it and be done with it. If it has the potential to be a chronic recurrent issue, then you might be better off being vague.

 

[UniqueDoc]

Usually, any LOA needs to be documented. ERAS asks whether your medical education was ever interrupted. And any MSPE or letter from a PD will document an LOA.

You do not need to explain the reason for the LOA. You can leave it as a "medical" issue, or "personal" issue, or simply state that it was an LOA without any clarification. Employers cannot ask you for more details. However, employers (i.e. a new residency program) might infer that your LOA is a sign of some chronic medical / psychiatric problem, and therefore be nervous to hire you. Note that this isn't legal, but there really isn't much to do about it because there are usually other reasons programs can give for not taking you.

So, if this was an issue that is completely resolved, you might be best to just disclose it and be done with it. If it has the potential to be a chronic recurrent issue, then you might be better off being vague.

Thank you, a ProgDirector. Your replies are always so helpful. The only person that knows about the details of my leaves is my program director. From what you shared, it looks like as long as the program director who writes the letter doesn't include the personal leave details in the letter, then they won't be disclosed.

One thought came up, though. What if the two program directors talk? Mine may unintentionally divulge too much verbally, especially when questioned. This makes me think it is better to just be open about the issues, as painful as it is. It still may be seen as a risk to hire me, however. A series of leaves probably looks pretty unreliable on paper, whatever the causes may have been.

Thanks again for your advice.

 

[ThoracicGuy]

Hello all:

I may be applying for a transfer to a different program soon but had concerns about some issues I may have while attempting to apply to a different specialty. I had to take a medical leave during PGY-1 and also another leave due to some personal issues.

Do leaves of absence during residency training need to be declared in the ERAS application? If yes, do program directors ever ask specific questions about the reason for a medical leave?

Any advice is sincerely appreciated.

Are you looking to change to another program in your same field or to another program? I know you had an extensive thread about your unhappiness of your current location. What you're saying here makes it sound like you are a PGY2 or later. How much time do you have left?

Does your current PD know about your wish to move and are they supportive of this? You would need their support in this. You will risk not having any position, though, if there isn't a program available in the location you seem to want...

 

[ThoracicGuy]

Thank you, a ProgDirector. Your replies are always so helpful. The only person that knows about the details of my leaves is my program director. From what you shared, it looks like as long as the program director who writes the letter doesn't include the personal leave details in the letter, then they won't be disclosed.

One thought came up, though. What if the two program directors talk? Mine may unintentionally divulge too much verbally, especially when questioned. This makes me think it is better to just be open about the issues, as painful as it is. It still may be seen as a risk to hire me, however. A series of leaves probably looks pretty unreliable on paper, whatever the causes may have been.

Thanks again for your advice.

If it gets to the point of considering an interview, I can guarantee that the two PDs will talk. Some of the details will probably be disclosed as well and they will be said in private, so you'll never really know exactly what was said.

 

[Doctor4Life1769]

If it gets to the point of considering an interview, I can guarantee that the two PDs will talk. Some of the details will probably be disclosed as well and they will be said in private, so you'll never really know exactly what was said.

Apparently the IMG in the other thread claims the PDs didn't talk, seems kinda odd.

 

[ThoracicGuy]

Apparently the IMG in the other thread claims the PDs didn't talk, seems kinda odd.

I'd be shocked if they didn't...

 

[Doctor4Life1769]

I'd be shocked if they didn't...

Word

 

[ThoracicGuy]

Word

Wow, reading through some old posts, the OP is an IMG that went through the match at least twice and has a Step 1 score of 204. He only had four interviews as of one of his postings. And for all of that, he ended up matching somewhere on the path to being board certified.

Now he wants to leave his current location and thinks he'll be able to find another place near where his friends/family are at. This is just a total recipe for disaster. I just don't understand it. No place is so bad that they can't get through 4 years if pathology is what he ended up doing...

 

[Doctor4Life1769]

Wow, reading through some old posts, the OP is an IMG that went through the match at least twice and has a Step 1 score of 204. He only had four interviews as of one of his postings. And for all of that, he ended up matching somewhere on the path to being board certified.

Now he wants to leave his current location and thinks he'll be able to find another place near where his friends/family are at. This is just a total recipe for disaster. I just don't understand it. No place is so bad that they can't get through 4 years if pathology is what he ended up doing...

Agree. Bad decision. He should stick it out and finish, then find a job close to friends/family.
I haven't heard of malignant programs in pathology and while I'm sure some exist, that's generally not the stereotype. Usually one hears about it in surg, OB, medicine, and to a degree anesthesia, maybe psych.

 

[UniqueDoc]

Wow, reading through some old posts, the OP is an IMG that went through the match at least twice and has a Step 1 score of 204. He only had four interviews as of one of his postings. And for all of that, he ended up matching somewhere on the path to being board certified.

Now he wants to leave his current location and thinks he'll be able to find another place near where his friends/family are at. This is just a total recipe for disaster. I just don't understand it. No place is so bad that they can't get through 4 years if pathology is what he ended up doing...

Thanks for your response. Yes I do agree, I have some things working against me. Being an IMG and having a low step score for one.

I never said I would move where family/friends are at. I was thinking of doing a shorter residency but in the same location. That would probably be easiest. Transferring within the institution isn't guaranteed though, and that's why I haven't made a decision.

I'm not in pathology, but I'm in another residency which is 5 years long. I still haven't finished intern year but I've returned after a leave of absence. I would have 4.5 years left. I'm actually thinking of transferring to a different field entirely, but that's another issue.

 

[ThoracicGuy]

Thanks for your response. Yes I do agree, I have some things working against me. Being an IMG and having a low step score for one.

I never said I would move where family/friends are at. I was thinking of doing a shorter residency but in the same location. That would probably be easiest. Transferring within the institution isn't guaranteed though, and that's why I haven't made a decision.

I'm not in pathology, but I'm in another residency which is 5 years long. I still haven't finished intern year but I've returned after a leave of absence. I would have 4.5 years left. I'm actually thinking of transferring to a different field entirely, but that's another issue.

Going to a different field is an option, but before you bring it up with your PD, it might be worth talking with the PD of the field your are interested at your current hospital to gauge your chances of their field. That way you haven't burnt any bridges yet to lose your current spot.

 

[candbgirl]

So you have had 2 leaves in six months?


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[NotAProgDirector]

Thank you, a ProgDirector. Your replies are always so helpful. The only person that knows about the details of my leaves is my program director. From what you shared, it looks like as long as the program director who writes the letter doesn't include the personal leave details in the letter, then they won't be disclosed.

One thought came up, though. What if the two program directors talk? Mine may unintentionally divulge too much verbally, especially when questioned. This makes me think it is better to just be open about the issues, as painful as it is. It still may be seen as a risk to hire me, however. A series of leaves probably looks pretty unreliable on paper, whatever the causes may have been.

Thanks again for your advice.

Given your situation, this turns out to be a very interesting question.

In general, if I have a resident who is trying to transfer (or a prelim looking for a PGY-2) and if there have been any performance or other issues, I will discuss with that resident what is on or off the table for discussion. If a resident tells me that the reason for the LOA needs to remain private, then that's what I do. However, this can lead to some difficult conversations - the other PD asks me about the leave, and I tell them that the resident has decided that they want it to remain private, and I can't talk about it. The other PD may become concerned, and decline to consider the person. Similar to if you call a reference about an employee and they say "I can confirm XXX worked here from (date) to (date), and that is all I can say". That's usually a very bad sign.

In this case, it is perhaps more complicated. If you're trying to transfer from one program to another in the same institution, then you're trying to move from one job to another by the same employer. In that case, there are no limits to what the two PD's can talk to each other about. All of your records can be shared within a single employer.

 

[UniqueDoc]

Your comments are well taken, aProgDirector. Thank you. Perhaps transferring within the same institution might not be as easy as I thought. One option is to do an elective with that department if possible and try to get letters of recommendation from their faculty to give me more credibility. Then at least I would have someone to vouch for my performance in their specialty.

I probably also should consider applying to other programs as well. As it is, I don't have a lot of options, other than continuing a 5 year residency I'm not fond of.

This situation is a tough one, and it is pretty hard to predict what will happen. I will probably hold on to it until I find something I'm better suited for. The challenge is speaking with the program director, who is probably not my biggest fan after taking medical leaves of absence. Performance was never an issue, but the leaves were, and that could translate into performance issues for some program directors.

 

[Timmythemic22]

Wow, reading through some old posts, the OP is an IMG that went through the match at least twice and has a Step 1 score of 204. He only had four interviews as of one of his postings. And for all of that, he ended up matching somewhere on the path to being board certified.

Now he wants to leave his current location and thinks he'll be able to find another place near where his friends/family are at. This is just a total recipe for disaster. I just don't understand it. No place is so bad that they can't get through 4 years if pathology is what he ended up doing...

I think that underestimates the level of psychological trauma one can undergo under residency. Each person is unique and the experience of one certainly doesn't denote what this person experienced. If they are so profoundly unhappy, I'd endorse them to leave. Following a more supportive environment for a better well-being trumps continuity of work in my book. Granted I'm making a lot of suppositions about the op, but that's the flavor of what I read. May not have as high paying or prestigious a position, but if that prevents a substance abuse issue, failed relationship, poor physical health/self-care, it seems well worth it.

I'm pulling for you unique, good luck!

 

[ThoracicGuy]

I think that underestimates the level of psychological trauma one can undergo under residency. Each person is unique and the experience of one certainly doesn't denote what this person experienced. If they are so profoundly unhappy, I'd endorse them to leave. Following a more supportive environment for a better well-being trumps continuity of work in my book. Granted I'm making a lot of suppositions about the op, but that's the flavor of what I read. May not have as high paying or prestigious a position, but if that prevents a substance abuse issue, failed relationship, poor physical health/self-care, it seems well worth it.

I'm pulling for you unique, good luck!

Its not that a new environment might be better, because it sure might. It's that he has alot of red flags already and wanting to move to another residency, he has a good chance of ending up with nothing. So then the question is, would the current situation be better than having no residency or not.

 

[Timmythemic22]

Its not that a new environment might be better, because it sure might. It's that he has alot of red flags already and wanting to move to another residency, he has a good chance of ending up with nothing. So then the question is, would the current situation be better than having no residency or not.

It's a valid point. I can only take my personal experience of taking time off from a 'poor-fit' residency to work as a gp for a few years then reapply was so much better an option as I had time to work on my healing and personal growth while doing locums jobs. My experience of course is not theirs, but I'd want that perspective known. It's okay to buck the trend.

 

[UniqueDoc]

Going to a different field is an option, but before you bring it up with your PD, it might be worth talking with the PD of the field your are interested at your current hospital to gauge your chances of their field. That way you haven't burnt any bridges yet to lose your current spot.

Smart idea. The worst thing would be to tell my program director but then be unsuccessful in getting another spot. Nothing like having a resident who doesn't want to be there in the first place. Thank you!

 

[UniqueDoc]

Its not that a new environment might be better, because it sure might. It's that he has alot of red flags already and wanting to move to another residency, he has a good chance of ending up with nothing. So then the question is, would the current situation be better than having no residency or not.

Yeah. That's the question I'm wrestling with now. If I didn't get another spot, I probably wouldn't want this one but at the same time it's easier said when I still have the position. Ten years down the road, I am not sure...

 

[UniqueDoc]

I think that underestimates the level of psychological trauma one can undergo under residency. Each person is unique and the experience of one certainly doesn't denote what this person experienced. If they are so profoundly unhappy, I'd endorse them to leave. Following a more supportive environment for a better well-being trumps continuity of work in my book. Granted I'm making a lot of suppositions about the op, but that's the flavor of what I read. May not have as high paying or prestigious a position, but if that prevents a substance abuse issue, failed relationship, poor physical health/self-care, it seems well worth it.

I'm pulling for you unique, good luck!

Thank you so much Timmy!! I really appreciate your comments. Thank you for expressing your understanding of my situation. I guess the hard part of leaving is the fear of being even more unhappy; ie. not having a stable income/one day regretting my choice to leave when I'm older. But I can tell you for sure that I am profoundly unhappy with both the location and program as well as the specialty. Perhaps I'd be better able to survive a more supportive environment, but I can't have everything I want, especially as an IMG. I have to take what I can get. What I do know is that if I want something enough there is nothing to stop me, however, I'm not sure what I want anymore. It was great that you were able to work as a GP. I wish that option was available to me to support myself if I end up deciding to leave.

 

[Timmythemic22]

Thank you so much Timmy!! I really appreciate your comments. Thank you for expressing your understanding of my situation. I guess the hard part of leaving is the fear of being even more unhappy; ie. not having a stable income/one day regretting my choice to leave when I'm older. But I can tell you for sure that I am profoundly unhappy with both the location and program as well as the specialty. Perhaps I'd be better able to survive a more supportive environment, but I can't have everything I want, especially as an IMG. I have to take what I can get. What I do know is that if I want something enough there is nothing to stop me, however, I'm not sure what I want anymore. It was great that you were able to work as a GP. I wish that option was available to me to support myself if I end up deciding to leave.

You can pm me some time if you do go down that gp road, I'll see if I can provide some advice.

 

[Arcan57]

Thank you so much Timmy!! I really appreciate your comments. Thank you for expressing your understanding of my situation. I guess the hard part of leaving is the fear of being even more unhappy; ie. not having a stable income/one day regretting my choice to leave when I'm older. But I can tell you for sure that I am profoundly unhappy with both the location and program as well as the specialty. Perhaps I'd be better able to survive a more supportive environment, but I can't have everything I want, especially as an IMG. I have to take what I can get. What I do know is that if I want something enough there is nothing to stop me, however, I'm not sure what I want anymore. It was great that you were able to work as a GP. I wish that option was available to me to support myself if I end up deciding to leave.

There's a very real chance that if you leave this job it's the last one you'll have in medicine. You've managed to get into residency as an IMG which speaks to a level of persistence and grit. You need to apply that tenacity to being successful at your current residency. There was a particular set of circumstances that led to you getting into residency as an IMG that had already gone unmatched once. My gut is that you're overestimating the chances those circumstances will re-occur. But that's not the probability you really care about. The chances those circumstances will re-occur in a way that leads to a less malignant residency in a better location/specialty is what you should focus on.

 

[UniqueDoc]

You can pm me some time if you do go down that gp road, I'll see if I can provide some advice.

Thank you. I certainly will.

 

[UniqueDoc]

There's a very real chance that if you leave this job it's the last one you'll have in medicine. You've managed to get into residency as an IMG which speaks to a level of persistence and grit. You need to apply that tenacity to being successful at your current residency. There was a particular set of circumstances that led to you getting into residency as an IMG that had already gone unmatched once. My gut is that you're overestimating the chances those circumstances will re-occur. But that's not the probability you really care about. The chances those circumstances will re-occur in a way that leads to a less malignant residency in a better location/specialty is what you should focus on.

You are right about having tenacity and grit. Thank you for reminding me. At times I don't feel like I have it but it certainly took a lot of effort to get where I am. I persevered after not matching, built up my resume, and found myself a spot. The sad part is that I didn't know what I was getting into, though I thought I did. I was so focused on the journey that I didn't realize what the end goal would be. This specialty is not suited for me. Is it really worth persevering for 4.5 years in a specialty I hate? What if I can't transfer? There is a realistic chance that despite continuing for some more time and attempting to transfer, it would be unsuccessful. I really want to focus on getting a better residency in a better location. Of course, I can't have everything. There is just a lot of risk involved and I need to determine whether it's worth it.

 

[dpmd]

Is it possible you just hate the specialty because of the circumstances of your residency? Once you are out things get a lot better so it might be worth staying and trying to make through.

Alternatively, is it possible your unhappiness is more related to your reason for medical leave (basically is there a mood disorder you are dealing with that will potentially lead to you being unhappy even if you are successful at changing location or specialty)?

 

[UniqueDoc]

Thank for your input, dpmd. That exact situation is something I've given a lot of thought to, but I've come to a conclusion that as bad as a program/city is, I need people around to build friendships with. It hasn't worked so far in residency. Friendship/social networks have always motivated me.

I think the combination of the location, lack of social network and the fact that I don't have a sincere interest in my specialty leads to psychological issues. Perhaps not a mood disorder, but a generally low mood and feelings of not being satisfied. I have been seen by a psych/counselors who do not think that a mood disorder is causing me to feel this way, rather the circumstances around my daily life. Maybe if I genuinely loved what I did, it would be easier to manage without local friends/family. I try to see residency as just a job but it is really a lifestyle.