Leaving after NRMP 45 day policy

[manny24]

Since NRMP has a 45 day policy to prevent match violation. How often do people leave after 45 days? What are the pros? and are there any cons?

---

Members don't see this ad.

 

[deleted480308]

Do you have somewhere to go?

 

[gutonc]

Since NRMP has a 45 day policy to prevent match violation. How often do people leave after 45 days? What are the pros? and are there any cons?

The pros are that you won't be at a program you don't want to be at.

The cons are that you probably won't get to be at another program in the future. Of any sort, in any location.

 

[Dr.LeoSpaceman]

The pros are that you won't be at a program you don't want to be at.

The cons are that you probably won't get to be at another program in the future. Of any sort, in any location.

So you're telling me there's a chance...

 

[manny24]

The pros are that you won't be at a program you don't want to be at.

The cons are that you probably won't get to be at another program in the future. Of any sort, in any location.

If it's that detrimental to one's career, why even have the rule?

 

[deleted480308]

If it's that detrimental to one's career, why even have the rule?

Do. You. have somewhere to go?

 

[ThoracicGuy]

If it's that detrimental to one's career, why even have the rule?

It's a free country...

 

[Piebaldi]

The pros are that you won't be at a program you don't want to be at.

The cons are that you probably won't get to be at another program in the future. Of any sort, in any location.

Not necessarily. Positions can be found, and people do manage to successfully switch. The whole 45day rule is idiotic to say the least. In the real world, people don't have "45 day rules" - they can leave an employer if they so choose, just as the employer can fire you if they so choose.

 

[spartanwarrior]

Since NRMP has a 45 day policy to prevent match violation. How often do people leave after 45 days? What are the pros? and are there any cons?

why beat around the bush? Just say you are not happy with your match result. life goes on.

 

[Dr.LeoSpaceman]

Not necessarily. Positions can be found, and people do manage to successfully switch. The whole 45day rule is idiotic to say the least. In the real world, people don't have "45 day rules" - they can leave an employer if they so choose, just as the employer can fire you if they so choose.

This is not true. If you are a contracted employee, your employer can certainly attach conditions to your quitting within a given period of time. Non-compete clauses, paying back singing bonuses, etc. The match contract is no different.

 

[Mad Jack]

Not necessarily. Positions can be found, and people do manage to successfully switch. The whole 45day rule is idiotic to say the least. In the real world, people don't have "45 day rules" - they can leave an employer if they so choose, just as the employer can fire you if they so choose.

It exists to keep the match honest. Without it the process would have little binding power. With regard to quitting and firing, there are a great number of legal agreements which have penalties on the hiring or firing side if you are in a contract. Often these penalties are financial, but many contracts also have noncompete agreements that bar you from employment in a given area or field for a period of time. The match does this by barring you from participation in the match itself, but does not ban you from training in medicine or practicing medicine.

 

[Piebaldi]

This is not true. If you are a contracted employee, your employer can certainly attach conditions to your quitting within a given period of time. Non-compete clauses, paying back singing bonuses, etc. The match contract is no different.

Not talking in medicine - i'm talking 99.9% of non medical jobs.

 

[Piebaldi]

It exists to keep the match honest. Without it the process would have little binding power. With regard to quitting and firing, there are a great number of legal agreements which have penalties on the hiring or firing side if you are in a contract. Often these penalties are financial, but many contracts also have noncompete agreements that bar you from employment in a given area or field for a period of time. The match does this by barring you from participation in the match itself, but does not ban you from training in medicine or practicing medicine.

I get that I frequently think differently - but think that that's part of the problem with medicine - overly restrictive. people should be able to do what they enjoy professionally especially after so much training and work. so if someone matches into residency/field x, but then they find out hey i dont like this, or whatever they shoudln't really in my opinion be bound to it. they should be able to change. what does 45 days really do - nothing. you can still quit after 45 days.
and some programs waive this to be honest - i know someone who matched in specialty x, decided they made a mistake, and then told their PD, their PD was cool with it, and transferred into a different field. shouldn't be the end of the world. people should be able to follow their dreams and what makes them happy.

 

[VA Hopeful Dr]

Not talking in medicine - i'm talking 99.9% of non medical jobs.

You think non-competes and paying back signing bonuses are unique to medicine?

I get that I frequently think differently - but think that that's part of the problem with medicine - overly restrictive. people should be able to do what they enjoy professionally especially after so much training and work. so if someone matches into residency/field x, but then they find out hey i dont like this, or whatever they shoudln't really in my opinion be bound to it. they should be able to change. what does 45 days really do - nothing. you can still quit after 45 days.
and some programs waive this to be honest - i know someone who matched in specialty x, decided they made a mistake, and then told their PD, their PD was cool with it, and transferred into a different field. shouldn't be the end of the world. people should be able to follow their dreams and what makes them happy.

No one is forbidden from changing their mind. That's why SDN is full of posts about people changing specialties successfully. But its not asking too much to honor as much of your commitment as possible so as to not screw over the program and other residents.

 

[Dr.LeoSpaceman]

Not talking in medicine - i'm talking 99.9% of non medical jobs.

So am I. Have you had a non-medical job with a contract? Entertainment and sports would be two other areas where there are penalties associated with an individual breaking the contract, and those issues are reported on frequently.

 

[Piebaldi]

So am I. Have you had a non-medical job with a contract? Entertainment and sports would be two other areas where there are penalties associated with an individual breaking the contract, and those issues are reported on frequently.

Entertainment and sports are unique areas. The average tech, finance, admin, etc job does not have a contract, and/or penalties. i'm sure some do. but we are talking about the match- which is training not so much a job.

 

[Dr.LeoSpaceman]

Entertainment and sports are unique areas. The average tech, finance, admin, etc job does not have a contract, and/or penalties. i'm sure some do. but we are talking about the match- which is training not so much a job.

You're still wrong. My wife works in a different industry (food) Her last two contracts have had penalties related to bonused and relocation based on conditions regarding her being in the position for a set period of time. They may not be standard (as on, "part of every contract") but they are exceedingly common.

 

[Piebaldi]

You're still wrong. My wife works in a different industry (food) Her last two contracts have had penalties related to no uses and relocation based on conditions regarding her being in the position for a set period of time. They may not be standard (as on, "part of every contract") but they are exceedinglu common.

My husband works in finance, previously in engineering. He's never had a contract, and he can quit whenver he wants, and his employer can fire him at will. in fact when i was in residency he decided he couldn't stand one of his jobs, put in his notice, and was escorted out that same day to prevent any issues. no contract, can leave at will, no restrictions. Meh that's been my experience for most people i know.

 

[Dr.LeoSpaceman]

My husband works in finance, previously in engineering. He's never had a contract, and he can quit whenver he wants, and his employer can fire him at will. in fact when i was in residency he decided he couldn't stand one of his jobs, put in his notice, and was escorted out that same day to prevent any issues. no contract, can leave at will, no restrictions. Meh that's been my experience for most people i know.

If he's never had a contract, how is the experience relevant to the discussion we're having? Contractual employment is common, though not universal. If you have a contract, you are bound to the terms. I'm not sure how this is a point of contention.

 

[rokshana]

Not talking in medicine - i'm talking 99.9% of non medical jobs.

But this is a medical job, so what is your point?

When you enter the match, you are told this is a binding contract.

 

[Piebaldi]

But this is a medical job, so what is your point?

When you enter the match, you are told this is a binding contract.

Not so binding if it can be broken in 45 days is it? And the point is that it SHOULDN'T be binding. Rules are essentially made by people - there is no reason why this coudln't be changed. Change happens daily - why are we stuck in continuing rigid policies?

 

[VA Hopeful Dr]

Not so binding if it can be broken in 45 days is it? And the point is that it SHOULDN'T be binding. Rules are essentially made by people - there is no reason why this coudln't be changed. Change happens daily - why are we stuck in continuing rigid policies?

I feel like I say this way too often here:

We have a system that's worked well for literally decades. You want to change it. Its up to you to show a very compelling reason why and explain why losing the protections of the current system is worth it.

 

[Dr.LeoSpaceman]

Not so binding if it can be broken in 45 days is it? And the point is that it SHOULDN'T be binding. Rules are essentially made by people - there is no reason why this coudln't be changed. Change happens daily - why are we stuck in continuing rigid policies?

Where's @ThoracicGuy?

Nevermind. I've got it...

 

[LucidSplash]

So... how would you feel if you Matched at a program. But there is no 45 day rule. Someone that your program ranked higher than you calls them up and says “I don’t like my match, can I have a spot at your place?” Program says sure, tells you that you no longer have a spot, because they gave it to the other guy they liked better.

Contracts work both ways...

 

[Piebaldi]

I feel like I say this way too often here:

We have a system that's worked well for literally decades. You want to change it. Its up to you to show a very compelling reason why and explain why losing the protections of the current system is worth it.

Things change - recently for example USMLE changed to P/F when it had been for decades a numerical system. Many boards are changing the 10 year certification exam to quarterly exams. See how things change? I find the whole 45day thing idiotic at best. What's so great about 45 days? Doesn't do anything other than making NRMP feel like they can destroy poor med students' lives by "banning" them from the match potentially for a significant time.

 

[Mad Jack]

I get that I frequently think differently - but think that that's part of the problem with medicine - overly restrictive. people should be able to do what they enjoy professionally especially after so much training and work. so if someone matches into residency/field x, but then they find out hey i dont like this, or whatever they shoudln't really in my opinion be bound to it. they should be able to change. what does 45 days really do - nothing. you can still quit after 45 days.
and some programs waive this to be honest - i know someone who matched in specialty x, decided they made a mistake, and then told their PD, their PD was cool with it, and transferred into a different field. shouldn't be the end of the world. people should be able to follow their dreams and what makes them happy.

Specialty waivers are very possible. The whole thing exists to ensure you entered the match and participated in good faith. A change of heart with regard to specialty isn't necessarily indicative of bad faith participation, hence why it is much more allowable. I think you seriously underestimate how common contracts that are far more punishing than the match agreement are in the professional world. You are free to not participate in the match if you find the rules so distasteful

 

[VA Hopeful Dr]

Things change - recently for example USMLE changed to P/F when it had been for decades a numerical system. Many boards are changing the 10 year certification exam to quarterly exams. See how things change? I find the whole 45day thing idiotic at best. What's so great about 45 days? Doesn't do anything other than making NRMP feel like they can destroy poor med students' lives by "banning" them from the match potentially for a significant time.

Why? It makes perfect sense to me. Its basically a 45 day out clause. Lots of contracts have similar, as we've all been saying.

 

[Mad Jack]

Things change - recently for example USMLE changed to P/F when it had been for decades a numerical system. Many boards are changing the 10 year certification exam to quarterly exams. See how things change? I find the whole 45day thing idiotic at best. What's so great about 45 days? Doesn't do anything other than making NRMP feel like they can destroy poor med students' lives by "banning" them from the match potentially for a significant time.

Programs can also be banned for violations. It is to ensure the integrity of the system and to keep parties on both sides from screwing each other over. Prior to the match, programs hardballing applicants then tossing them aside was common, as was applicants signing and later abandoning programs. This resulted in everyone getting screwed, but particularly the applicants that lost spots due to program and applicant indecision until the last minute

 

[Piebaldi]

Why? It makes perfect sense to me. Its basically a 45 day out clause. Lots of contracts have similar, as we've all been saying.

What makes 45 days so great?why not 15? why not 90?

 

[Mad Jack]

Why? It makes perfect sense to me. Its basically a 45 day out clause. Lots of contracts have similar, as we've all been saying.

And many of those contracts have enormous financial penalties if broken. You could be on the hook for years of salary if many agreements are broken

 

[manny24]

Things change - recently for example USMLE changed to P/F when it had been for decades a numerical system. Many boards are changing the 10 year certification exam to quarterly exams. See how things change? I find the whole 45day thing idiotic at best. What's so great about 45 days? Doesn't do anything other than making NRMP feel like they can destroy poor med students' lives by "banning" them from the match potentially for a significant time.

I think it's because after 45 days that person can't just get into another program because intern year already started.

 

[Mad Jack]

What makes 45 days so great?why not 15? why not 90?

Because 15 days wouldn't even be a single rotation, and many of those initially unhappy people that thought their match would be the end of the world settle in by 45 days. 90 days is too long because then programs would be forced to keep residents that are putting lives at risk on-board for a minimum of 90 days, which could kill a lot of people. 15 days is too short to really determine how bad a resident is and to attempt basic remediation.

 

[Mad Jack]

I think it's because after 45 days that person can't just get into another program because intern year already started.

I think it is more about the fact that two weeks isn't long enough for most people to absorb the shock of a bad match. 99% of people eventually chill out and accept their fate, which works out for them and the program. If you only gave it two weeks, a lot of people would bail while they were still in crisis mode and ruin their lives as well as deprive programs of residents and funding.

 

[ThoracicGuy]

Not so binding if it can be broken in 45 days is it? And the point is that it SHOULDN'T be binding. Rules are essentially made by people - there is no reason why this coudln't be changed. Change happens daily - why are we stuck in continuing rigid policies?

For @FaytlND's request...

 

[manny24]

Not necessarily. Positions can be found, and people do manage to successfully switch. The whole 45day rule is idiotic to say the least. In the real world, people don't have "45 day rules" - they can leave an employer if they so choose, just as the employer can fire you if they so choose.

When do people manage to successfully switch?

 

[NotAProgDirector]

The 45 day rule isn't designed to "lock" residents into a program or field. WIthout it, I think the worry is that some people might enter the match to "see how they do" and then plan, if unhappy, to just "decline" the spot. Unclear how realistic that concern is, although there are a few threads about people matching low on their list and having second thoughts, so it would happen. If it happened enough to programs, they might pull out of the match altogether.

Residents also seem to think that, if they resign, it's a piece of cake to find a quality replacement. It isn't.

 

[rokshana]

Things change - recently for example USMLE changed to P/F when it had been for decades a numerical system. Many boards are changing the 10 year certification exam to quarterly exams. See how things change? I find the whole 45day thing idiotic at best. What's so great about 45 days? Doesn't do anything other than making NRMP feel like they can destroy poor med students' lives by "banning" them from the match potentially for a significant time.

Well it didnt really keep you from changing specialties five million times...

 

[Mass Effect]

I think you seriously underestimate how common contracts that are far more punishing than the match agreement are in the professional world

This. In some industries, you sign a 3-year contract or you don't get the job. And if you break your contract, there are often financial penalties and depending on the industry, potential blacklist.

 

[manny24]

The 45 day rule isn't designed to "lock" residents into a program or field. WIthout it, I think the worry is that some people might enter the match to "see how they do" and then plan, if unhappy, to just "decline" the spot. Unclear how realistic that concern is, although there are a few threads about people matching low on their list and having second thoughts, so it would happen. If it happened enough to programs, they might pull out of the match altogether.

Residents also seem to think that, if they resign, it's a piece of cake to find a quality replacement. It isn't.

What are the CONS of leaving after 45 days? Do other programs find out that you left when you re-apply? Do they blacklist you?

 

[gutonc]

What are the CONS of leaving after 45 days? Do other programs find out that you left when you re-apply? Do they blacklist you?

Every program will know that you left a program because you're going to have to account for your time since graduation. You can lie about it I guess, but they'll find out.

And they'll want to know why.

I'm not sure I'd call it blacklisting, but you better have a damn good reason for leaving.

You haven't been at all forthcoming about why you would want to do this but I assure you that whatever it is, your reason isn't good enough.

 

[manny24]

Every program will know that you left a program because you're going to have to account for your time since graduation. You can lie about it I guess, but they'll find out.

And they'll want to know why.

I'm not sure I'd call it blacklisting, but you better have a damn good reason for leaving.

You haven't been at all forthcoming about why you would want to do this but I assure you that whatever it is, your reason isn't good enough.

Did not match in desired specialty, therefore SOAPed in another specialty. Now regretting SOAPing instead of reapplying.

 

[ThoracicGuy]

Did not match in desired specialty, therefore SOAPed in another specialty. Now regretting SOAPing instead of reapplying.

So your application want good enough to match the first time based on where you selected to apply. You now have a spot and have a chance to be a practicing doctor.

If you break your 45 day commitment, you would be banned from participating in the match for up to 7 years. Programs participating in the match that would take you in that situation could find themselves banned for up to 7 years.

If you do 45 days and then leave, your chances of ever finding another residency spot in any field will be much much harder, if not impossible.

What field did you want and which did you soap into? You can potentially have options depending on what they are.

 

[Piebaldi]

Well it didnt really keep you from changing specialties five million times...

Not five million - once. Let's not make up stuff. From Rads to PM&R, that's it.

 

[GoSpursGo]

Did not match in desired specialty, therefore SOAPed in another specialty. Now regretting SOAPing instead of reapplying.

Two points:

1) If you're going to quit after 45 days, you need to have a really good plan for what is going to make you a successful applicant next time around. Given that you decided to SOAP rather than reapply, I see only downside to reapplying--you're going to be a year out from graduation, you're going to have a massive gap in your CV after you quit, and you're probably going to wind up with a pretty unhappy PD letter attached to your application as a result of quitting. I get that you wish that you were going into another specialty, but not everyone gets his or her first choice--you applied and gave it your best shot, and the tough answer is that you were not competitive. Quitting the job you got and hoping that you're going to be more competitive next year is magical thinking.

2) I make this point every now and then: for future applicants, if you're applying to a competitive specialty, you really need to decide what your backup plan is in advance of match day. If you're convinced you can only be happy in one specialty, then commit to delaying graduation to improve your app and reapplying in a worst case scenario. If you could be happy doing something else, then SOAP and/or dual-apply with a less competitive specialty. But don't get caught blindsided when you don't match and feel like you "have" to SOAP. Otherwise you can wind up in an unhappy position like the OP.

 

[Ironheme]

I appreciate your honesty. I feel sorry for the program you soaped into, as they likely had many other applicants and chose you, thinking you would be there for the entire time. I also feel sorry for the person that they ranked after you who would have gotten that spot.

Sounds like you panicked because you didn't match and felt pressured into soaping.

On the other hand better to know now than halfway through. Best bet is to give the program and yourself a chance in this specialty. If you still don't think it's for you come August/September, reapply. Work hard, be grateful, get your program director's support and make connections. People can change their mind about specialties, but do it in the best way for yourself and the program.

 

[deleted1042638]

So am I. Have you had a non-medical job with a contract?

The United States Army. And I wasn't allowed to just quit. And after my enlistment I was still in the "IRR" for 5 additional years.
You asked...

 

[manny24]

Will programs find out that you matched and left after 45 days when you reapply?

 

[Smurfette]

Will programs find out that you matched and left after 45 days when you reapply?

Yes. You will have to account for every thing you do from med school onward and explain any gaps. Your graduation year is also a "flag" that something happened. It is also disclosed any time you apply for a license or hospital privileges until you retire. Assuming you are able to find a new residency program.

 

[LucidSplash]

Will programs find out that you matched and left after 45 days when you reapply?

In addition to what Smurfette said, most programs want a letter from your PD, regardless if you were only there for 45 days.

 

[akuko2]

Not so binding if it can be broken in 45 days is it? And the point is that it SHOULDN'T be binding. Rules are essentially made by people - there is no reason why this coudln't be changed. Change happens daily - why are we stuck in continuing rigid policies?

I totally agree. My previous contract required some ridiculous stuff on it. I had to hire a lawyer because it included that I had to be circumcised within 45 business days of begging work at that establishment. Thankfully my legal council was able to cut that part off for me.