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Looking for advice regarding transferring programs

Discussion in 'Psychiatry' started by koikisi, Aug 2, 2015.

  1. koikisi

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    Hi everyone,

    If you've seen my previous posts, you can see that I have started Intern Year to a very rocky start and am being mistreated on several occasions. I never expected this from a Psychiatry residency, but it is what it is. I am trying to finish the rest of this year on a decent note, but even that will be a challenge considering how my interaction with my PD has been. He does not seem like an evil person per se, but his expectations and demeanor have been quite worrisome for me as I just finished medical school and did not do an observership at his place. Furthermore, everyone else in my program is a foreign graduate from India, Africa etc. that has done extensive Psychiatry experience and some were attendings.

    The workload is also quite intense. I have never heard of any intern at my friends program doing 20 progress notes and 9 H&P's in one day (this was on the day I was on call) with little supervision. I literally am just looking at epocrates for quick things or texting my friends for some of this stuff as to what to prescribe.

    As much as my boyfriend and I wanted things to work out here, It just is not working out and I would like to find another spot somewhere next year, if not this year. I have average COMLEX scores (slightly above average on level 1), passed the PE, and have to take COMLEX 3. I did not take USMLE and my PD knew this, but is now giving me a lot of BS about not taking it (AFTER I MATCHED in front of his medical students & nurses). Some of the medical students have been quite vicious as to making comments about my racial background, I just completely ignored them.

    I want to know if someone has any advice on transferring from an MD program to a DO program or a dually accredited program? I feel like I am just losing in every way whenever I come to work. I try to be nice and friendly with my co-interns and senior residents, but it doesn't help when they start yelling at me for being "too slow" and god know's what else in their native dialect (I'm assuming it is some version of an Indian language).

    I think my PD doesn't want me around either so I may be able to get a neutral letter of recommendation if I finish all my rotations and pass them.
     
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  3. psychattending

    psychattending Program Director
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    It is pretty hard to do a mid-year transfer for a couple of reasons. Most contracts are for the full year (and there is also the Match agreement). ABPN will not give you credit for a partial year and it will typically look bad if you leave partway through a year. I don't know much about DO programs and whether they will will give credit for a ACGME approved PGY-1. If they can't/won't you would have to repeat your PGY-1.
     
  4. MacDonaldTriad

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    In addition to this, some states require you be licensed before you complete 24 months of training and you have to complete 12 months of training at the same program before you can apply for a license. Bottom line is that it is best to finish if you can, but moving is probably better than failing out if you can manage find somewhere to take you.
    Good luck.
     
  5. koikisi

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    I am trying my hardest to be optimistic about staying 12 months, but in all honesty, I don't think I could bear to do a day more than 12 months. My employment contract says nothing about me giving them notice, but gives them 30 days to get rid of me. I think its because nobody typically leaves a residency (it's usually the reverse if anything).

    I know what you mean about the license thing. I know that transfers don't work out typically, but I think it's best for me to try and finish 12 months and see if I can find something outside of the match (secretly looking) without interviewing since I get such little opportunity to get vacation anyhow.

    For whatever its worth, I really thought that interns should be a cohesive supportive bunch instead of trying to find ways to get each other out to help make room for a relative. I also thought that senior residents should try and offer interns guidance as opposed to yelling at them, lying to their faces and just all around being nasty.

    I did not have this experience in medical school at all. I felt that the place where I did my IM sub-I at was extremely malignant, but after coming to my program, that seemed like cake.

    Regardless, my bf has a job nearby and we have signed a 12 month lease at a great rate, so I am trying to just take it one day at a time, but I am actively looking for any exit option that lets me have my sanity and some self-respect. I have never had such a poor self-esteem in my life ever. The culture of my residency program seems to be to bring others down to make you look knowledgable, and that is just not me.

    I will say that the program is quite understaffed as well. A lot of faculty has had to leave and a lot of our didactics are taught by retired Psychiatrists or PhD's who are nearing retirement.
     
  6. Doctor Bagel

    Doctor Bagel so cheap and juicy
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    I've seen a ton of transfers in psychiatry. It's much more common than you might think. Mid-year transfers might be rare, but transfers in between years are pretty common. Things happen and spots open up.
     
  7. koikisi

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    How do I find spots? I have a malignant PD and I don't think he will be happy about me looking for places and offer me support.

    Should I just do it outside of ERAS? I have checked the clearinghouse and it seems if I send my info in, they would need to talk to current PD at least.
     
  8. Doctor Bagel

    Doctor Bagel so cheap and juicy
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    Unfortunately this is what I don't know -- all I can say is it happens a lot because I've seen it happen both in my program and with people I went to medical school with. I suspect networking helps -- do you have friends at other programs who could let you know if a spot opens up? Do you know attendings from medical school who could offer advice? I agree that it makes sense to start making some inquiries before telling your PD that you want to leave, but yeah, I imagine every program would want to talk to your PD eventually. About your PD, it's hard to predict what malignant boss might do, but he might perceive it to be in his own best interest to help you transfer and replace you with someone he likes more. It sounds easier than going down a probation/termination type of route.
     
  9. MacDonaldTriad

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    If you are sure you are unwilling to stay for another year, I think talking to your PD is an option to consider. He/She may not appreciate how much you are struggling, or at least it could temper his/her attacks on your performance if you reflect that you are aware of your shortcomings. Letting him/her know you are looking elsewhere may stave off any efforts towards progressive discipline. The only downside might be the potential retaliation or perceived change in how you are trained once everyone knows you plan to leave.

    Although it is possible you might find an offer before your PD is asked about your performance, this would be very rare and your PD will have to at least summarize your performance if you plan to get any credit for your PGY-I training.

    It is probably too early to tell, but if there is a possibility that your current program will not support your getting credit for your PGY-I year, that would be a very good thing to know as it will change how you look for your next program.

    I still hope things settle down and you find yourself progressing and able to adapt and flourish. This isn’t easy and many people who struggle early on manage to move on.
    :xf:
     
  10. koikisi

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    Thank you all for your advice. I appreciate it during this stressful period in my life. I am looking to try and finish this year to get credit.

    I have friends who went into Psychiatry residencies across the country, so I suppose i could ask them.
    I don't think my PD will be quite supportive of having me find another place since it's going to be hard for him to replace me with someone who "speaks english fluently without an accent"---which according to him was the biggest strong suit when I asked him why he ranked me. He's not genuinely evil, but I don't want to tell him in March that i've found something and then have him fail my rotations.

    I don't have a clear employment contract, but I am going to test the waters without sending in ERAS application.

    It's very sad to such immature individuals in my residency program where they think its okay to harrass a woman because of the way she looks or dresses (this is the level of indecency I am facing in my program with my seniors).
     
  11. xlithiumx

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  12. smalltownpsych

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    Is there something wrong with the way you look or dress? I am asking this sincerely since part of being a psychiatrist is a level of self-awareness because if colleagues are hitting on sore spots, patients will likely do the same.
     
  13. koikisi

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    In my previous profession and my 2 years of clinical rotations (3 months of which were in an inpatient Psychiatry ward) as a medical student, not once was my attire criticized or any objections raised over my looks so I don't know.

    I'm of hispanic descent and the population of residents is primarily Indian & pakistani origin.
     
  14. splik

    splik Professional Cat at Large
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    unfortunately that doesn't mean anything. people are often too embarrassed to bring up appropriate dress for women medical students are often inappropriately dressed. I am not say that is the case with you at is unclear, but male supervisors are particularly reluctant to bring this sort of thing up for fear of litigation. At my program we are banned from commenting on female medical student/resident appearance - it is left to the nurse manager to do.
     

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