Non renewal contract after PGY-1 year

[maximusilv2002]

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I am in a Categorical PYG 1 Internal medicine year... I want to change specialty the next year to neurology... When Do I have to tell my program director that i have been accepted in a neurology residency starting the next year???. will there be any problem If I tell them sooner??? Do I have to wait till mid of Intersnship in order to tell them?? I dont want to lose my PGY-1 Year since I need it in order to start neurology residency. Thank you guys 4 ur answers... I really appreciate.

 

[Bitsy]

Um, I'm not sure how you're going to be able to apply for another categorical program without a letter from your PD (especially since you need 1 yr credit from your program to enter a neurology program), so I'm pretty sure you're going to have to let them know before being "accepted" into another residency program. You need to let them know ASAP if you're planning on leaving them after this year. I imagine the longer you put this off thus putting your program in a jam for next year, the less likely you will have a good letter from your PD (although its a little difficult since you've only been there for a few months).

 

[snowbank]

I dont have any personal experience here, so thats my disclaimer, but I can tell you what happened to others I know personally.

My own opinion is the sooner you tell them the better. If youre leaving categorical IM, then the PD has a right to know and to find a replacement. Otherwise he may not let you leave if you told him later. Thats what happened to a friend. Apparently he applied for an advanced position and categorical IM at the same time (which I wonder why the hell he did, but thats another story). So when he found about both matches - he didnt tell his IM PD that he was planning to leave. Come April May when the advanced program's PD started making evaluation calls to the IM program to find out how her incoming residents were doing. IM PD said whoa - wait a minute - he's coming to your program? I didnt know, and he didn't tell me! Im not letting him leave my program since he didnt tell me plus he's committed in a legally binding agreement (match) to me.....

Now Im interested in how you matched in categorical medicine, and then matched in neurology?! You must have applied together at the same time right? Just curious....

 

[NotAProgDirector]

Agree with above that it's probably better to let your PD know what your plans are earlier rather than later, but the above story can't be true as written.

First, you have a contract for 1 year, so even if you talk to your PD you have a spot for the year.

Second, the match does not allow you to match both categorical and advanced. You can match Categorical, or Prelim+Advanced, or Prelim alone, but that's it. It is possible to match Categorical and then find an out-of-match advanced spot, and then delay telling your PD (which doesn't help anyone). That's just mean.

Third, even if you do that, the match is only binding to start the year. You're not match committed for the second year, or in fact not for the second day either. As long as you show up on day 1, your match commitment is resolved. Your PD can't make you stay. Your contract will have some sort of termination clause that will require some amount of reasonable notice -- likely 3-4 months -- and as long as you do that you are fine. If you were to just pack up and leave your program could theoretically sue you for damages, but that's really unlikely. They would certainly report this as unprofessional behavior to anyone requesting your records, and that would be bad.

So, assuming that you matched to ONLY categorical medicine but now are interested in neuro, you simply tell your PD of your plans, apply for neuro spots, and see what happens. Remember that if you MATCH into a neuro spot, it's not until 2012 so you could still stay for a PGY-2 in medicine if you wanted. Or, you might find a PGY2 spot open for July 2011.

What could go wrong?:
1. Your PD could be really upset and make your life miserable for the rest of the year. Unlikely.
2. Your PD could give away your PGY-2 spot to a new person, and then you could not get a new neuro spot. That leaves you with nothing. This is a real possibility. The match is in mid March, and many PD's will be uncomfortable waiting that long to find a replacement for your PGY-2 spot.

 

[turquoiseblue]

i dont know this for sure, but personally, although it doesn't sound good, i wouldn't tell anyone about your neuro situation until you sign the contract for the neuro spot, because the PD could try to do something bad to you. you want to avoid that as much as possible. i would just say you got accepted into a neuro spot when you get accepted and sign their contract and apologize for having to leave, but you feel that is your true calling. im sure ur pd will understand at that point, but not before that. he/she may try to make your life miserable. don't tell them anything about it until it is set in stone that you've been accepted. if they expect a PD letter, well that is probably when you'll have to tell your PD. hopefully this is at least a few months in advance..which would be hopefully adequate time for them to make changes....im sure you don't have to tell them a year in advance before you even get into neuro.

hopefully someone else with this experience can give some input here, because i haven't experienced this first hand.

 

[snowbank]

Agree with above that it's probably better to let your PD know what your plans are earlier rather than later, but the above story can't be true as written.

Second, the match does not allow you to match both categorical and advanced. You can match Categorical, or Prelim+Advanced, or Prelim alone, but that's it. It is possible to match Categorical and then find an out-of-match advanced spot, and then delay telling your PD (which doesn't help anyone). That's just mean.

Thanks for the info and detailed reply PD. I agree, normally you cant match in 2 programs, but in this internal medicine was thru ERAS/NRMP, and the advanced position was ophthalmology, through the SF Match. He matched in both ophth. AND in categorical int. med. SF match comes out in Jan, so he found out then, but NRMP rank list is due later in February. So youre right, it doesnt entirely make sense, and I dont know why someone would do such a goofed up thing, but hey, apparently there's always a first time for everything!

 

[NotAProgDirector]

Thanks for the info and detailed reply PD. I agree, normally you cant match in 2 programs, but in this internal medicine was thru ERAS/NRMP, and the advanced position was ophthalmology, through the SF Match. He matched in both ophth. AND in categorical int. med. SF match comes out in Jan, so he found out then, but NRMP rank list is due later in February. So youre right, it doesnt entirely make sense, and I dont know why someone would do such a goofed up thing, but hey, apparently there's always a first time for everything!

Interesting. If you match in the SF match, you must only match prelim in the NRMP match. But, it does not appear that anyone checks this. So, doing what your friend did is a match violation -- but it;s not clear that anything bad can happen from it. He could be barred from future matches in the NRMP (but no big deal there), or I guess his PD could simply fire him on the basis that his application was fraudulent.

Anyway, don't do this.

 

[Bitsy]

i dont know this for sure, but personally, although it doesn't sound good, i wouldn't tell anyone about your neuro situation until you sign the contract for the neuro spot, because the PD could try to do something bad to you. you want to avoid that as much as possible. i would just say you got accepted into a neuro spot when you get accepted and sign their contract and apologize for having to leave, but you feel that is your true calling. im sure ur pd will understand at that point, but not before that. he/she may try to make your life miserable. don't tell them anything about it until it is set in stone that you've been accepted. if they expect a PD letter, well that is probably when you'll have to tell your PD. hopefully this is at least a few months in advance..which would be hopefully adequate time for them to make changes....im sure you don't have to tell them a year in advance before you even get into neuro.

hopefully someone else with this experience can give some input here, because i haven't experienced this first hand.

Yeah, I would not do this. I don't think the OP will be able to get a neuro spot without a letter from his IM PD. He/she won't be applying as a US senior, since he/she is already in residency. Therefore, neuro programs will want to know what he/she has been doing this year. Once they know that he/she has been in an IM program, they will want a letter from his PD. I doubt he'll get any offers without a PD letter.

 

[dragonfly99]

I would start exploring out of the match neurology programs (i.e. look for open spots for next summer). In the mean time, work really hard at your current residency. If it looks like you are getting/have a chance at getting neurology interviews, then at that point I think you need to come clean to your PD. If you tell him now, then you risk that maybe he'll look for someone to give your PGY2 spot to for next summer, and you may not want that until you know you have a reasonable chance to get into neurology.

Another option is to finish out your intern year, then do research in neurology for a year. If you maintain good relations with your PD, maybe he could help you find a neurologist who needs someone to slave in his lab for a year...