Matched position 16

[so721]

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Hi,
I matched my last position in the NRMP match. I am glad to have matched, however, I am having serious doubts about being able to take my kids and wife to the place where I have matched. It's in a very unsafe area and I never thought I would match at my last place.

I was wondering, is there a way to perhaps, release myself from the match? I am a DO student so I am considered independent. Let's say something closer opens up now and between July 1st. Could I just go for that?

Thanks

 

[A Deep Breath]

Congratulations on matching! I realize that you're probably a little shocked, but there must be some part of you that thought the place wasn't so bad to rank it.

I'll bet that you can make a good life for your family wherever you matched. Find out where the doctors live.

 

[splik]

Hopefully will work out for the best and no you can't get out it. Being a DO is irrelevant the match is binding you have to turn up for the first 45 days you can only get a waiver for severe hardship which "I didn't think I would match there" isn't. Hopefully it's not as bad as you think and you could transfer out as a pgy2 as these spots are less competitive and there are several. It is a shock not to match where you want especially if your friends have but things usually work out okay.

 

[JohnBender]

As someone who has lived in a number of very undesirable and somewhat dangerous areas, I can tell you that first impressions can be deceiving and the image you have a place before living there can be inaccurate. In each of these bad areas, I've managed to get comfortable, make friends, have fun, find some really cool and interesting things the city has to offer, and even kind of love the areas in a way. Granted, I don't have my own family to worry about, but my point is that it may not be as dismal as you're expecting. And even the most dangerous cities should be diverse enough that you can find some desirable areas to make a home.

 

[so721]

Thanks guys. The place that I matched is very malignant and I knew that beforehand. However, I thought it's better than not matching, but I do see a few spots locally that are not matched.

I don't know if I would qualify for a waiver at all. I just don't know how I got so low when PD's told me the liked me.

But what is done is done as the saying goes, if I find a PGY2 spot, do I need to have my PD's consent to transfer there?

Thank you

 

[heyjack70]

I assume the dangerous area is adjacent to Johns Hopkins. Find out where the doctors live.

 

[peiyueng]

.

 

[Doctor Bagel]

I can't say much about the malignancy, but regarding the location -- every supposedly dangerous city in the US has safe areas nearby where your family can live. Detroit, Memphis, whatever, they've all got that. I know people who live in areas near those cities, and they don't worry about their safety. Otherwise, I think you've got to go with it even though I know it sucks, both the disappointment and the worries about the program. Keep your head down and work hard. Don't make any waves.

As for transferring, you will need a letter from your PD. If you pursue this (and lots of residents do transfer), phrase it like you want to transfer to be closer to family or whatever. Also, don't bring it up too soon. Spend your first few months just working and again not making waves.

 

[so721]

Hopefully will work out for the best and no you can't get out it. Being a DO is irrelevant the match is binding you have to turn up for the first 45 days you can only get a waiver for severe hardship which "I didn't think I would match there" isn't. Hopefully it's not as bad as you think and you could transfer out as a pgy2 as these spots are less competitive and there are several. It is a shock not to match where you want especially if your friends have but things usually work out okay.

Thanks guys. I am also worried about the fact that it is quite malignant, the program is studded with FMG's from India and Pakistan. I honestly didn't think I would have to worry about it since it was the last on my ranklist. They were looking for DO's as well for some reason. However, I found out from the grapevine that there were a few unmatched positions in my coast so I was wondering.

I know a waiver will be unlikely, but lets say I go there for the first 45 days and then I tell the PD. Will they be able to let me leave and could I re-apply next year or even just go to a closer place that has a vacancy?

I honestly regret not going the DO match as I had some interviews where I would be able to at least work in peace, I honestly feel like I will be chewed alive. The program that I am talking about is considered a place to avoid. I know I brought this on myself though.

Is there a way I can access the unmatched list of programs at all?

Thanks

 

[splik]

how will it help you to have the list of unmatched programs? it will be available soon enough, but by now presumably all the spots have been filled. even if they weren't it wouldn't matter as you have matched into this program and so they won't touch you (as that would be a match violation). if you turn up to your program you can quit whenever they cant force you to stay. the match isn't legally binding and of course you could quit any time. but if you quit before the 45 days or however long it is now you cannot apply through the match again. after the 45 days you can quit and reapply but 1) you will probably require a letter from your program director and if the program is really that awful they could F**k you over, and 2) i dont want to be harsh but if you were not able to get into another program that was better this year, your chances of getting into another program next year aren't better. if you complete the year but you could apply for PGY-2 spots. another possibility would be in a PGy-1 spot opens later while you are intern you could try and switch but these are rare and the above applies - your program might not support you and other programs might not be interested in taking you

hopefully it isnt that awful. would you rather have not matched at all?

 

[eastcoastdr]

First of all, congrats on matching. Second...I know it's disappointing to end up in an undesirable location or program but like you said, it's probably better than not matching.

Also I think you are judging this city/prematurely too prematurely. Have you ever lived there? What do you really know about the city? And you may have heard that it's a malignant program, but thats probably hearsay. Honestly a lot of my classmates (including both of my roommates) both ended up at places low on their list in "bad" locations but now several months into their program they are happy, thriving, and have formed close friendships within their programs. I really don't think it's going to be as bad as you think. I mean there's a whole hospital full of people who live there, so it's gotta be manageable somehow. And hey, maybe because it's an undesirable location, the cost of living will be cheaper compared to NYC/Boston/LA etc! So that could be a huge plus esp if you have a wife and kids to support. Also if you go into this residency program with that kind of negative attitude, then yes, it probably won't be a good experience. My advice is to be optimistic and positive about your program. If in the end the program really isn't for you, then transfer out after finishing pgy-1 year.

 

[peiyueng]

if u r looking for do program, there is one in colton, CA that is mass expanding. They doubled their intern year and added 50% more to their 2nd year. In the next two years, the residency is growing (by count of number of residents) to 200% with an eye to actually growing to 300% of what it is today. Now before you accuse me of telling big tales, let me bring it back down earthly numbers: It is growing from 2 interns to 4; from 2 second years to 3. IN a few years, there will be 4 in each year (growing to 200% of what it is today). And the final wish (may or may not happen) is 6 per year (300% of what it is today.)

give them a call. they are do and in colton ca. Close to LA. Ppl work here and their families get jobs in LA

Not saying you should do it. Just saying there such things exist.

 

[peppy]

Even though it is disappointing to match at your last place program, I assure you that you did the right thing by ranking this program over going unmatched. It's possible those open spots didn't fill is because the applicants saw a problem there that made the program even worse than your #16 choice. Even if some spots were open that you would have liked, there is no guarantee that those open spots actually ARE looking to fill, and that your application would get noticed in the flood of applications during SOAP. You could have quite possibly ended up with nothing, and you can't support a family if you're a doctor who didn't get a residency.

So I would say try to think of it in a positive way: THIS PROGRAM WANTS YOU. They see your potential and they want you on their team. They could have chosen not to rank you if they didn't like you. I have been involved in residency recruitment, and pretty much all American psych programs get a flood of applications from Indian MDs who are desperate to get into America. In fact, I would say that there is a good chance that the Indian/Pakistani residents at your program are actually very experienced and extremely intelligent. At my program, because of the sheer volume of applications from FMGs, we were able to be quite picky about which ones we gave a chance to.
If you make an effort to show a good attitude, work hard without complaining, and try to be respectful/kind to your co-residents, I think you probably will be fine. Even if it is the type of place that people get fired or harassed, you can do things to try to avoid becoming a target. Bring donuts in for meetings, show an interest in people's lives, etc. - go full Dale Carnegie on them. If you are interested in psychiatry, you will need to learn how to deal with hostile people sooner or later anyway. 🙂

Start doing some research on which suburbs are considered safe and family friendly. It's going to be okay. Even the worst slums in American still have nice neighborhoods within driving distance.

 

[so721]

Thanks. I liked your post peppy. I am worried about the malignancy, but whats the worst they can do, just fire me, right? I will do my part on my end.

I just want to make sure though, if I decide after 45 days, that I can't take it any longer, can I leave and look for an outside match position?

Thanks

 

[hamstergang]

I just want to make sure though, if I decide after 45 days, that I can't take it any longer, can I leave and look for an outside match position?

If you go in there with this mindset, you're going to hate it. Most people find the beginning of residency rough, and you wouldn't want to give up prematurely if your experience isn't actually abnormal.

Plus, if you leave after 45 days, you're screwing over your program and co-residents who now have to make up your slack for 10.5 months. Please don't leave lightly. Remember, you applied to this place, accepted an invitation to interview there, actually went to the interview, and then ranked them. Now all of a sudden, you want nothing to do with them. Seems a little rash.

 

[MLT2MT2DO]

Hi,
I matched my last position in the NRMP match. I am glad to have matched, however, I am having serious doubts about being able to take my kids and wife to the place where I have matched. It's in a very unsafe area and I never thought I would match at my last place.

I was wondering, is there a way to perhaps, release myself from the match? I am a DO student so I am considered independent. Let's say something closer opens up now and between July 1st. Could I just go for that?

Thanks

While I don't condone rash decisions or what I'm going to suggest (if it is even possible), you could look into the legality of leaving the current program for an AOA unmatched program. Personally I found only a small handful of the Psych AOA programs should be allowed to exist, much less have the desire to train there, but to each their own.

 

[so721]

While I don't condone rash decisions or what I'm going to suggest (if it is even possible), you could look into the legality of leaving the current program for an AOA unmatched program. Personally I found only a small handful of the Psych AOA programs should be allowed to exist, much less have the desire to train there, but to each their own.

Thanks, the question is how can i find out which ones are still available? The list is quite old on the website. I also don't think I'm allowed to contact anyone until I get a waiver otherwise it'll be a violation.

 

[splik]

you are not going to get a waiver so please dispel yourself of this notion. the only way you can find out if there are open AOA spots is to contact the programs (there arent too many of them so it shouldn't take too long). as these AOA residencies are not part of the NRMP they might not care about you having matched (it doesn't affect them to take you) where are NRMP participatint programs would be violating the match if they took you. btw the match is essentially a gentleman's agreement, there is nothing to stop you violating the agreement and going to an AOA program should you wish and if one will take you, you just wont be able to apply through the match again and people will think you are not an honorable person (because you wouldn't be).

 

[Doctor Bagel]

Thanks, the question is how can i find out which ones are still available? The list is quite old on the website. I also don't think I'm allowed to contact anyone until I get a waiver otherwise it'll be a violation.

You know, this might work, but I wouldn't go down this road. I'd put a good faith effort into making it work next year as the place you got into knowing that transferring is an option. Unless you have more inside information, you honestly can't know much about a program from one interview day. Also, we get all the horror stories her, but most people survive malignant programs. Not to minimize malignancy in training, but a malignant program is better than no program.

 

[Mad Jack]

Thanks, the question is how can i find out which ones are still available? The list is quite old on the website. I also don't think I'm allowed to contact anyone until I get a waiver otherwise it'll be a violation.

You aren't going to get a waiver unless something serious has happened in your life that would necessitate one, such as a critically ill relative or your coming down with a disease that would require you to relinquish your training position in order to be treated. If they were handing waivers out like candy it would undermine the integrity of the Match, so they are very, very picky about who gets them.

What you should look into is whether there are safer neighborhoods within commuting distance that you could live in. There should be someplace decent within a half hour drive.

 

[so721]

you are not going to get a waiver so please dispel yourself of this notion. the only way you can find out if there are open AOA spots is to contact the programs (there arent too many of them so it shouldn't take too long). as these AOA residencies are not part of the NRMP they might not care about you having matched (it doesn't affect them to take you) where are NRMP participatint programs would be violating the match if they took you. btw the match is essentially a gentleman's agreement, there is nothing to stop you violating the agreement and going to an AOA program should you wish and if one will take you, you just wont be able to apply through the match again and people will think you are not an honorable person (because you wouldn't be).

I think I would be actually. Because on the NRMP website, it says any matching organization and NatMatch would qualify I believe.

 

[splik]

im not talking about you im talking about the program that takes you. you would be violating the match if you go elsewhere before turning up to your matched position. my point is that the nrmp cant do anything about it if you go to an AOA residency because they don't go through the match. They couldnt impose any sanctions on those programs if they didn't use the NRMP (and some of them do, the dual AOA-ACGME programs).

 

[OldPsychDoc]

You know, this might work, but I wouldn't go down this road. I'd put a good faith effort into making it work next year as the place you got into knowing that transferring is an option. Unless you have more inside information, you honestly can't know much about a program from one interview day. Also, we get all the horror stories her, but most people survive malignant programs. Not to minimize malignancy in training, but a malignant program is better than no program.

And I'm not endorsing malignancy--which is fortunately not all that common in psych--but there's a lot of truth to this statement.
Seriously, the numbers were not encouraging to those seeking second chances this year. There were maybe 16 unfilled positions in the entire country after the initial Match. Looking at results for our ranked applicants, there were 13 (roughly 20% of our ranked applicants) in our lower half who were left completely unmatched. This cruel process is only going to get worse, imho.

 

[TexasPhysician]

Thanks, the question is how can i find out which ones are still available? The list is quite old on the website. I also don't think I'm allowed to contact anyone until I get a waiver otherwise it'll be a violation.

Without giving up your matched program, no one can give you excellent advice, but I would strongly consider making the best of the situation for 4 years. I'm not aware of any US city that is so bad off that 4 years would be better than career risks. The current system is not meant to make transfers or changes easily. Your current program is almost assuredly your current best option.

 

[so721]

Thanks for the perspective guys. I think I am going to try and suck it up, as malignant as it can be and just hope I don't get kicked out. Will sleep whenever I can and eat whenever I can. I'm at least going to do it for a year if a PGY2 spot opens up.

 

[DrBowtie]

Thanks for the perspective guys. I think I am going to try and suck it up, as malignant as it can be and just hope I don't get kicked out. Will sleep whenever I can and eat whenever I can. I'm at least going to do it for a year if a PGY2 spot opens up.

It's Psych, not CT Surgery.

 

[MLT2MT2DO]

Thanks for the perspective guys. I think I am going to try and suck it up, as malignant as it can be and just hope I don't get kicked out. Will sleep whenever I can and eat whenever I can. I'm at least going to do it for a year if a PGY2 spot opens up.

Be the best damn intern you can so the PD you're asking a recommendation for PGY-2 feels he has no choice but to give you a glowing recommendation.

 

[JohnBender]

What have you heard that makes you think it's malignant?

 

[so721]

What have you heard that makes you think it's malignant?

Basically what I have heard is that there is very little supervision during in patient months. You are expected to learn everything on your own and you need to pass step 3 by end of year 1 or you are dismissed.

 

[Flushot]

First off, coming from someone who ran the SOAP not too long ago, be very glad you did not have to do it. I reapplied the following year and am very happy where I am, so it is possible to technically try again, but this is also uncommon and difficult.

I understand your concerns but I also don't see those two features as malignant. When I think malignant, I think of work hour violations, public humiliation in front of peers and general despair. Malignant can be evidenced by massive turnover of faculty and residents as well, which you didn't mention. What you said is not ideal but I think you owe this program at least a chance. I mean you're contracted anyway so just do what you can now.

 

[so721]

Be the best damn intern you can so the PD you're asking a recommendation for PGY-2 feels he has no choice but to give you a glowing recommendation.

First off, coming from someone who ran the SOAP not too long ago, be very glad you did not have to do it. I reapplied the following year and am very happy where I am, so it is possible to technically try again, but this is also uncommon and difficult.

I understand your concerns but I also don't see those two features as malignant. When I think malignant, I think of work hour violations, public humiliation in front of peers and general despair. Malignant can be evidenced by massive turnover of faculty and residents as well, which you didn't mention. What you said is not ideal but I think you owe this program at least a chance. I mean you're contracted anyway so just do what you can now.

I know I also forgot to mention that a lot of residents do try and leave after PGY1 so I think it is possible. But technically my contract is only for 1 year, if I wanted to leave later on for a PGY2 somewhere else, do I need my current PD's LOR?

 

[splik]

malignant means a toxic program where residents have no rights, no autonomy, high demands placed on them, and are bullied, intimidated and belittled. a program providing little superivison and expecting you to be self-sufficient is not malignant just subpar and you will probably learn a ton anyway

 

[chicagochildpsych]

Basically what I have heard is that there is very little supervision during in patient months. You are expected to learn everything on your own and you need to pass step 3 by end of year 1 or you are dismissed.

I went through a residency like this, now I'm thriving while the guy in office next to mine who trained at mgh can't hang with the big boys in private practice. You are being trained to be a doctor in America, pretty much one of the best positions to be in globally. Stop whining.

 

[OldPsychDoc]

I know I also forgot to mention that a lot of residents do try and leave after PGY1 so I think it is possible. But technically my contract is only for 1 year, if I wanted to leave later on for a PGY2 somewhere else, do I need my current PD's LOR?

As the accepting PD, would you expect me to just give you a position without knowing anything about your performance as a resident? Or vouch for your competence without knowing whether you've successfully completed the requirements for the PGY1 year?
Yes--you do NEED your current PD's letter.

 

[Flushot]

You'll need your PD on board at some point. It's a small world and you can bet PDs will talk if you attempt anything. This is even assuming this place is that bad. It might be rough but it could give you good training with the right approach.

 

[TexasPhysician]

Basically what I have heard is that there is very little supervision during in patient months. You are expected to learn everything on your own and you need to pass step 3 by end of year 1 or you are dismissed.

That sounds like most programs. I consider my program to be excellent, and residents are put on leave if step 3 isn't passed by start of pgy-3. Everyone should take it as an intern anyway. It is easy.

Inpatient is all about learning on your feet.

Make the most of your year. You very well may change your mind.

 

[Firewood]

That sounds like most programs. I consider my program to be excellent, and residents are put on leave if step 3 isn't passed by start of pgy-3. Everyone should take it as an intern anyway. It is easy.

Inpatient is all about learning on your feet.

Make the most of your year. You very well may change your mind.

+1.

You honestly don't need that much supervision during inpatient; I would have preferred less than what I actually had.

And passing Step 3 is not such a hard thing, especially if you take it first year when all that crap is still fresh. The people who struggled with it in my program are the ones who waited too long to take it. All you have to do is pass that one, anyway.

 

[Shikima]

First off, coming from someone who ran the SOAP not too long ago, be very glad you did not have to do it. I reapplied the following year and am very happy where I am, so it is possible to technically try again, but this is also uncommon and difficult.

I understand your concerns but I also don't see those two features as malignant. When I think malignant, I think of work hour violations, public humiliation in front of peers and general despair. Malignant can be evidenced by massive turnover of faculty and residents as well, which you didn't mention. What you said is not ideal but I think you owe this program at least a chance. I mean you're contracted anyway so just do what you can now.

It can also be defined by a program being unable to hire people and is perpetually understaffed.

 

[Flushot]

It can also be defined by a program being unable to hire people and is perpetually understaffed.

This is true but I guess I meant in the context of his other perceived concerns or rather, feel for the program. Being understaffed has a lot of legit reasons for occurring.

 

[Leo Aquarius]

Basically what I have heard is that there is very little supervision during in patient months. You are expected to learn everything on your own and you need to pass step 3 by end of year 1 or you are dismissed.

I raised an eyebrow when I heard "malignant" in the same sentence as "psych residency" and my suspicion is correct. Malignancy is not what you are describing.

Supervision and residency training have nothing to do with passing Step 3. If you study, you'll pass Step 3. If you don't, you won't, regardless of Attending Jane Doe teaching you 24/7 on the wards.

Malignant programs are harder to come by these days, even in general surgery where their numbers have dropped off and the shift is more towards lifestyle considerations. I know because in a meeting the chair of surgery where I train talked about this trend across the US and how some surgery programs are having a hard time filling, and they are making a concerted effort during recruiting season to tout how non malignant they are. The old guard in surgery are super bright because back in the day gen surg was the competitive specialty. Today, not so much on both counts.

 

[masterofmonkeys]

If you're that worried do it for a year and let your wife and kids stay where they are. It's been done before...

 

[Promethean]

I can't get over the part where you did actually rank this place, and now you want to renege.

You ranked it because you wanted a margin of safety in case you didn't get what you believed you deserved. Now, having found yourself in that unexpectedly humbled position, you fail to appreciate your good fortune. You could easily have been without a seat at all. So, now you come asking for, what, advice on how to get out of it and absolution for doing so?

Your opportunity to avoid going there was when you were making your rank list. You said that you understand that you got yourself into this... but you still are asking about how to get out of it.

You took a spot that someone else may have actually really wanted and appreciated. You made an agreement, thinking you would get what you wanted out of it. That agreement doesn't dissolve when things don't go your way. Perhaps a program that challenges you to greater responsibility than you are comfortable with will actually be very good for you.

 

[JustAGuy]

I have a friend in a similar situation who matched into a pretty undesirable program. I'm guessing for a DO with below average stats and multiple red flags it will be hard for him to transfer out to a different program PGY2? How about fellowships? I've read that most are wide open, but what are the chances for a DO with barely passing scores coming from a program with a lousy reputation to get into a top C&A fellowship?

 

[MacDonaldTriad]

I have a friend in a similar situation who matched into a pretty undesirable program. I'm guessing for a DO with below average stats and multiple red flags it will be hard for him to transfer out to a different program PGY2? How about fellowships? I've read that most are wide open, but what are the chances for a DO with barely passing scores coming from a program with a lousy reputation to get into a top C&A fellowship?

Top C&A, only so so. A reasonable C&A, fairly good.

Hay, so721, look at the fine print. Does it say must pass step III by the end of the PGY-I year, or must take step III by the end of the PGY-I year?

 

[so721]

Top C&A, only so so. A reasonable C&A, fairly good.

Hay, so721, look at the fine print. Does it say must pass step III by the end of the PGY-I year, or must take step III by the end of the PGY-I year?

It says take it by end of pgy1

 

[675015]

I have a friend in a similar situation who matched into a pretty undesirable program. I'm guessing for a DO with below average stats and multiple red flags it will be hard for him to transfer out to a different program PGY2? How about fellowships? I've read that most are wide open, but what are the chances for a DO with barely passing scores coming from a program with a lousy reputation to get into a top C&A fellowship?

Why is a friend with below average status, multiple red flags, coming from a "lousy program", and barely passing tests putting the added stress of an expectation of a "top" C&A fellowship? Worry about being a good psychiatrist first during residency and then matching into C&A when the time comes. I wouldn't stress about getting a top program at this time. Seems unnecessary.

 

[MacDonaldTriad]

It says take it by end of pgy1

See this is fairly standard. Take is a lot less frightening than pass.

 

[Promethean]

It says take it by end of pgy1

This place is sounding a lot less malignant by the moment. At this point, it sounds like you have a bad case of buyer's remorse, but that there really isn't anything objectively wrong with the program. After all, you liked it enough to apply, interview, and rank it. It can't be all bad.

I hope that you find peace with your misgivings and really give your match a fair try. If you can set aside your worries and make the best of it, I think it is highly likely that you will end up pleased that things turned out as they did. Only as long as you perseverate on how much better it might have been to end up somewhere else can you be assured of a self-fulfilling prophecy of misery.

Ultimately, every school, every residency program, can give you no more than you put into it. Maybe as time passes and you adapt to this outcome, you will see that you can make an excellent start for your career wherever you may have landed, if you apply yourself.

 

[so721]

I agree with you guys. I'll give it a fair chance. Nothing more i can do at this stage anyways.

 

[Ron Mexico]

Hate to dump on the op but it sounds more like his problem than a problem with the program