Planning a transfer

[Goro]

Thanks! I was just somewhat surprised I saw a place that required 3 letters of recommendation. How is that even possible for a transfer lol that's why I asked.

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[Qpworueury]

View attachment 372365

It just seems like a lot is the only point I'm making if you can't use the ones from medical school

 

[guytakingboards]

It just seems like a lot is the only point I'm making if you can't use the ones from medical school

It’s literally finding 1 non-PD letter. The other two will be your prelim and current advanced PDs.

 

[dozitgetchahi]

This! Proof. Troll. There is no way in the world someone got through med school, step 1, step 2, and reasons like that.

Unfortunately, I think this guy is 100% legit. You’re assuming that every doc has SDN level street smarts, which is definitely NOT the case in my experience. I’m not at all surprised that some personality disordered person in medicine could have done all of this. We’d like to think that the long medical training process selects for people who actually have their **** together…and while it does to some extent, it also lets lots and lots of people through who don’t (come see the doctors in rural America, and you will be rapidly disillusioned).

Also, a surprising (disturbing?) number of these people don’t necessarily wash out of medicine, as everyone keeps saying in this thread. The system is not nearly as self cleaning as everyone seems to think.

 

[LucidSplash]

Thanks! I was just somewhat surprised I saw a place that required 3 letters of recommendation. How is that even possible for a transfer lol that's why I asked.

By asking the attendings that have worked with you this year. It’s the same setup as otherwise unmatched prelims go through. Everyone will want to know you can come up with at least 3 people to vouch for you and frequently one of them will be your PD.

Also, you’ll need people you can use as references for the rest of your life. They don’t always ask for letters (although they do at times) but every time I get credentialed at a new hospital, or renew credentials at a hospital, or apply for some kind of society membership, they will ask for non-partner colleagues who will be a reference. Many times they will want the division chief and/or chair of the last place you’ve worked. I needed letters of reference to become a fellow of the ACS and the SVS as well.

You’ll need people to like you and be willing to vouch for you professionally. Forever, or at least until you quit medicine or retire.

 

[Dr.LeoSpaceman]

You’ll need people to like you and be willing to vouch for you professionally. Forever, or at least until you quit medicine or retire.

What I like to do is to take a wait-and-see approach. I try to figure out if I'm going to need a reference, then if so, let someone else ambush that reference with a request for feedback.

 

[Qpworueury]

By asking the attendings that have worked with you this year. It’s the same setup as otherwise unmatched prelims go through. Everyone will want to know you can come up with at least 3 people to vouch for you and frequently one of them will be your PD.

Also, you’ll need people you can use as references for the rest of your life. They don’t always ask for letters (although they do at times) but every time I get credentialed at a new hospital, or renew credentials at a hospital, or apply for some kind of society membership, they will ask for non-partner colleagues who will be a reference. Many times they will want the division chief and/or chair of the last place you’ve worked. I needed letters of reference to become a fellow of the ACS and the SVS as well.

You’ll need people to like you and be willing to vouch for you professionally. Forever, or at least until you quit medicine or retire.

I guess my concern is with how frequently fast these transfer spots show up, it could take someone a month to write a full letter? How can you compete ? The spot could be gone by there

 

[LucidSplash]

I guess my concern is with how frequently fast these transfer spots show up, it could take someone a month to write a full letter? How can you compete ? The spot could be gone by there

I guess other people who are honest with their programs might have an advantage by having their letters available in advance. Or maybe you’ll luck out and everyone else will try your planned tactic and then it will be a level playing field.

 

[Qpworueury]

I guess other people who are honest with their programs might have an advantage by having their letters available in advance. Or maybe you’ll luck out and everyone else will try your planned tactic and then it will be a level playing field.

You really think letting people know that you want a transfer without an open spot is a good plan?

 

[xffan624]

You really think letting people know that you want a transfer without an open spot is a good plan?

Well, give your plan a go, and let us know how it works out. You're making a large assumption that you're pretty much guaranteed to get the first open spot that's available. Once you apply to the first one the cat's out of the bag.

 

[LucidSplash]

You really think letting people know that you want a transfer without an open spot is a good plan?

I think you know what we think of your plan.

But you asked how you’re supposed to get letters and avoid people getting a jump on open spots. What do you think all those people who want those spots are doing?

But there’s a post that there’s ophtho spots open if you want to look at those.

 

[Qpworueury]

I think you know what we think of your plan.

But you asked how you’re supposed to get letters and avoid people getting a jump on open spots. What do you think all those people who want those spots are doing?

But there’s a post that there’s ophtho spots open if you want to look at those.

I have never met someone who's asked for a letter of recommendation w/o a knowing there's an existing transfer spot but I guess we agree to disagree

 

[LucidSplash]

I have never met someone who's asked for a letter of recommendation w/o a knowing there's an existing transfer spot but I guess we agree to disagree

From your extensive experience as an intern who has met tons of transfer residents?

 

[smq123]

I guess my concern is with how frequently fast these transfer spots show up, it could take someone a month to write a full letter? How can you compete ? The spot could be gone by there

Right...it's almost like transferring residencies is logistically complicated and a lot of work, and should only be undertaken if you have absolutely no choice. And no, "I don't like it here," "This place isn't prestigious enough for me," and "I just thought I would end up somewhere better" are NOT good reasons to transfer.

 

[Qpworueury]

From your extensive experience as an intern who has met tons of transfer residents?

Right...it's almost like transferring residencies is logistically complicated and a lot of work, and should only be undertaken if you have absolutely no choice. And no, "I don't like it here," "This place isn't prestigious enough for me," and "I just thought I would end up somewhere better" are NOT good reasons to transfer.

I never said it was complicated. And like the people in this thread have shared, there's been people that have transferred for less.

 

[smq123]

I never said it was complicated. And like the people in this thread have shared, there's been people that have transferred for less.

Assuming that you're not trolling, I am actually genuinely concerned that you are responsible for direct patient care. You repeatedly seem to read into things that don't exist, and you also seem to remember things that just didn't happen.

No one in this thread has said that people have "transferred for less." Not only has it not happened in this thread, but, honestly? "I thought I would end up somewhere better" is possibly one of the "least good" reasons to transfer, ever. It ranks down there with "I don't like the parking situation" and "The cafeteria food here isn't very good" in terms of terrible reasons to transfer.

"I thought I would end up somewhere more prestigious" is just not, at all, a good reason to transfer out of a program that you HAVE NOT EVEN STARTED YET.

 

[Qpworueury]

Assuming that you're not trolling, I am actually genuinely concerned that you are responsible for direct patient care. You repeatedly seem to read into things that don't exist, and you also seem to remember things that just didn't happen.

No one in this thread has said that people have "transferred for less." Not only has it not happened in this thread, but, honestly? "I thought I would end up somewhere better" is possibly one of the "least good" reasons to transfer, ever. It ranks down there with "I don't like the parking situation" and "The cafeteria food here isn't very good" in terms of terrible reasons to transfer.

"I thought I would end up somewhere more prestigious" is just not, at all, a good reason to transfer out of a program that you HAVE NOT EVEN STARTED YET.

Someone literally said above that they had a classmate transfer because of a vague significant other issue to a better program. I feel like we're going around in circles

I know it may be all a joke to you but because of the match I'm stuck with this place for 3-7 years now

 

[NotAProgDirector]

I agree with you that this is going around in circles. Some of your comments on the thread (especially early) were overly simplistic regarding transfer between programs, and this has mellowed as the thread has progressed, and people may be reacting to those early comments. Extrapolating your comments from this thread to impugn your clinical skills is unreasonable IMHO.

Can residents transfer between programs? Yes, it's possible. But it's relatively uncommon. Most of the time it's for some social or other reason. Not uncommonly, this may involve a transfer to a "worse" program although assessing program quality is complicated / eye of the beholder.

Why is it difficult to transfer? Because residency training is relatively linear (PGY-1's become PGY-2s, etc), it takes someone dropping out of a program, or a program increasing in size, to make room. That doesn't happen all that often. Residencies also have a curriculum -- and starting in a program "mid stream" can be very complicated for the resident and the program.

Do I need to tell my PD? There's no law that requires this. However, most PD's are going to be looking for an assessment from a current PD, and many won't want to "waste their time" assessing applicants without that first. No one wants to inherit someone else's problem. Also PD's can be a relatively tight knit group, if I take a PGY-1 from some program into a PGY-2 position, that might leave that other program with an open spot and I don't want to be seen as poaching people from other programs (this is less of an issue in IM where prelim IM interns can fill PGY-2 IM positions).

Is this the match's fault? No, the match has nothing to do with this. Although you got your position in the match (obviously), that's not because of some evilness in the match, but simply because programs that were higher on your list desired other candidates. I don't know what that happened, but it would have happened with or without the match. Perhaps some additional introspection into that would be helpful. The difficulty residents face switching from one program to another mid-training has nothing to do with the match at all.

You're disappointed, and that's a completely reasonable emotion to have given the circumstances. Trying to switch programs is going to be an uphill climb. Your matched program may be much better than you expect. Focusing your energy on switching programs and on maximizing your success in your future program may be at odds with each other, hence may backfire if you focus on switching and are unsuccessful. You mention "3-7 years" which suggests you're considering a fellowship of some sort -- switching programs can make that process more difficult also (if you're in a 3 year program and apply for a fellowship at the beginning of year 3, if you switch that ends up being the end of the 1st year of your second program, and you may not have enough connections / research / etc to do so generating a gap year).

Best of luck, whatever the future brings.

 

[CrispyWonTon]

I'll play devil's advocate for a minute.

Let's say OP's concerns are valid and his PGY-2 institution has serious shortcomings.

Doesn't he suffer more the longer he's at the program? What if his program is shuttered midway?

Medicine is a small world and sometimes the reputation precedes not only the candidate but also the institution they trained.

The way OP is going about this isn't ethical but I understand where he's coming from, he doesn't want to get on a sinking ship while he's still on the shore. Unfortunately OP did rank it for which he needs to take responsibility. Would he have preferred not matching at all if he didn't rank this institution?

 

[cj_cregg]

I'll play devil's advocate for a minute.

Let's say OP's concerns are valid and his PGY-2 institution has serious shortcomings.

Doesn't he suffer more the longer he's at the program? What if his program is shuttered midway?

Medicine is a small world and sometimes the reputation precedes not only the candidate but also the institution they trained.

The way OP is going about this isn't ethical but I understand where he's coming from, he doesn't want to get on a sinking ship while he's still on the shore. Unfortunately OP did rank it for which he needs to take responsibility. Would he have preferred not matching at all if he didn't rank this institution?

As I mentioned previously, nobody here seems to be inherently opposed to the idea of a transfer for OP. We are just saying to do it successfully, it needs to be done in a different way than OP was originally planning.

 

[Qpworueury]

I'll play devil's advocate for a minute.

Let's say OP's concerns are valid and his PGY-2 institution has serious shortcomings.

Doesn't he suffer more the longer he's at the program? What if his program is shuttered midway?

Medicine is a small world and sometimes the reputation precedes not only the candidate but also the institution they trained.

The way OP is going about this isn't ethical but I understand where he's coming from, he doesn't want to get on a sinking ship while he's still on the shore. Unfortunately OP did rank it for which he needs to take responsibility. Would he have preferred not matching at all if he didn't rank this institution?

Thank you for at least recognizing my difficulties

 

[GoSpursGo]

I'll play devil's advocate for a minute.

Let's say OP's concerns are valid and his PGY-2 institution has serious shortcomings.

Doesn't he suffer more the longer he's at the program? What if his program is shuttered midway?

Medicine is a small world and sometimes the reputation precedes not only the candidate but also the institution they trained.

The way OP is going about this isn't ethical but I understand where he's coming from, he doesn't want to get on a sinking ship while he's still on the shore. Unfortunately OP did rank it for which he needs to take responsibility. Would he have preferred not matching at all if he didn't rank this institution?

The problem is he’s not on the shore, he’s already tethered to the ship by his match. And if he had not ranked this program, he would have gone unmatched entirely. And to top it off, this is a catch 22–if the program is indeed so crappy, why would a better program be willing to take a transfer from there?

As @cj_cregg said, there’s nothing wrong with keeping his ear to the ground and seeing if a favorable transfer could fall into his lap. But all things considered, that is unlikely, and there is nothing that can be done right now to make it more likely to work out—so the OP may as well not worry about it for now.

 

[rokshana]

The problem is he’s not on the shore, he’s already tethered to the ship by his match. And if he had not ranked this program, he would have gone unmatched entirely. And to top it off, this is a catch 22–if the program is indeed so crappy, why would a better program be willing to take a transfer from there?

As @cj_cregg said, there’s nothing wrong with keeping his ear to the ground and seeing if a favorable transfer could fall into his lap. But all things considered, that is unlikely, and there is nothing that can be done right now to make it more likely to work out—so the OP may as well not worry about it for now.

Well he didn’t say that it was the last place he ranked…he could have gone lower on his list.

Put the teaching point here is don’t rank any place you wouldn’t want to go to, even if it means going unmatched.

 

[GoSpursGo]

Well he didn’t say that it was the last place he ranked…he could have gone lower on his list.

I suppose, though it seems unlikely that any place ranked even lower would have resulted in him being any happier. Regardless, it's more or less semantics. Your underlying point is correct, with the caveat that you need to be REALLY sure that you would rather potentially never match into your preferred specialty instead of going to that program.

 

[Qpworueury]

As I mentioned previously, nobody here seems to be inherently opposed to the idea of a transfer for OP. We are just saying to do it successfully, it needs to be done in a different way than OP was originally planning.

I do admit my original vision of walking into my PDs office with suitcase handing them a letter of resignation that says I'm heading to my dream program now is off the mark

The problem is he’s not on the shore, he’s already tethered to the ship by his match. And if he had not ranked this program, he would have gone unmatched entirely. And to top it off, this is a catch 22–if the program is indeed so crappy, why would a better program be willing to take a transfer from there?

As @cj_cregg said, there’s nothing wrong with keeping his ear to the ground and seeing if a favorable transfer could fall into his lap. But all things considered, that is unlikely, and there is nothing that can be done right now to make it more likely to work out—so the OP may as well not worry about it for now.

The idea would be a better program would want me because I have a strong application in general and just fell through the cracks. That's the idea

 

[cj_cregg]

I do admit my original vision of walking into my PDs office with suitcase handing them a letter of resignation that says I'm heading to my dream program now is off the mark

The idea would be a better program would want me because I have a strong application in general and just fell through the cracks. That's the idea

I say this with a lot of empathy, but you do NOT have a strong application in general. You have a significant professionalism issue that your current and future PD will be obligated to mention, and according to you, you are also coming from a program with a terrible reputation (despite the PD's incredible kindness and generosity to you with regards to this professionalism issue). You need to prepare yourself for the possibility that you will not find a transfer to a "better" program and make sure you are doing things the right way with your current program even as you are planning to seek opportunities to leave, because you may be stuck with them. I am glad you are getting closer to the right track with that.

 

[GoSpursGo]

The idea would be a better program would want me because I have a strong application in general and just fell through the cracks. That's the idea

Agree with @cj_cregg . I feel like we've gone around and around in circles about this, but even if you were a strong applicant on paper coming out of medical school, there is some intangible reason that you did not match higher on your rank list. Even if there was not, you have since managed to offend your advanced program, cause a headache for your prelim program, and be coming from a crappy advanced program where a "better" program will have to help you get up to speed after spending a year at a subpar program.

There is ample evidence that you were not the strong candidate that you thought you were, and that you are additionally a worse candidate today than you were as an MS4. So, maybe you will get lucky and manage a favorable transfer, but chances are that will not be the case.

 

[LucidSplash]

Also, you are assuming there will be openings in stronger/better programs, if there are openings at all. This may happen but it’s more likely that weaker and/or malignant programs will have openings outside the The Match than top and/or super supportive programs. This could easily be an out of the frying pan and into the fire situation.

I guess we’ll see what happens.

 

[Qpworueury]

Also, you are assuming there will be openings in stronger/better programs, if there are openings at all. This may happen but it’s more likely that weaker and/or malignant programs will have openings outside the The Match than top and/or super supportive programs. This could easily be an out of the frying pan and into the fire situation.

I guess we’ll see what happens.

There was actual a few places this year that would be my dream programs that had openings so I think it's incredibly possible

 

[LucidSplash]

There was actual a few places this year that would be my dream programs that had openings so I think it's incredibly possible

Its possible. I don't know about incredibly possible. Tough to know why those spots were open and if that is a fluke or a regular occurrence. If its a regular occurence, gotta ask yourself why. Is the program reputation really deserved? Did the program match a candidate who bailed of their own accord to pursue another specialty or were they fired? A lot of unknowns.

I look forward to your updates.

 

[ThoracicGuy]

I do admit my original vision of walking into my PDs office with suitcase handing them a letter of resignation that says I'm heading to my dream program now is off the mark

The idea would be a better program would want me because I have a strong application in general and just fell through the cracks. That's the idea

But you aren't. You landed where you landed.

 

[ThoracicGuy]

There was actual a few places this year that would be my dream programs that had openings so I think it's incredibly possible

 

[CrispyWonTon]

As I mentioned previously, nobody here seems to be inherently opposed to the idea of a transfer for OP. We are just saying to do it successfully, it needs to be done in a different way than OP was originally planning.

100% the initial fiasco was wholly unnecessary and a little harebrained, OP impulse control is all I can say in regards to that.

 

[VA Hopeful Dr]

I agree with you that this is going around in circles. Some of your comments on the thread (especially early) were overly simplistic regarding transfer between programs, and this has mellowed as the thread has progressed, and people may be reacting to those early comments. Extrapolating your comments from this thread to impugn your clinical skills is unreasonable IMHO.

Can residents transfer between programs? Yes, it's possible. But it's relatively uncommon. Most of the time it's for some social or other reason. Not uncommonly, this may involve a transfer to a "worse" program although assessing program quality is complicated / eye of the beholder.

Why is it difficult to transfer? Because residency training is relatively linear (PGY-1's become PGY-2s, etc), it takes someone dropping out of a program, or a program increasing in size, to make room. That doesn't happen all that often. Residencies also have a curriculum -- and starting in a program "mid stream" can be very complicated for the resident and the program.

Do I need to tell my PD? There's no law that requires this. However, most PD's are going to be looking for an assessment from a current PD, and many won't want to "waste their time" assessing applicants without that first. No one wants to inherit someone else's problem. Also PD's can be a relatively tight knit group, if I take a PGY-1 from some program into a PGY-2 position, that might leave that other program with an open spot and I don't want to be seen as poaching people from other programs (this is less of an issue in IM where prelim IM interns can fill PGY-2 IM positions).

Is this the match's fault? No, the match has nothing to do with this. Although you got your position in the match (obviously), that's not because of some evilness in the match, but simply because programs that were higher on your list desired other candidates. I don't know what that happened, but it would have happened with or without the match. Perhaps some additional introspection into that would be helpful. The difficulty residents face switching from one program to another mid-training has nothing to do with the match at all.

You're disappointed, and that's a completely reasonable emotion to have given the circumstances. Trying to switch programs is going to be an uphill climb. Your matched program may be much better than you expect. Focusing your energy on switching programs and on maximizing your success in your future program may be at odds with each other, hence may backfire if you focus on switching and are unsuccessful. You mention "3-7 years" which suggests you're considering a fellowship of some sort -- switching programs can make that process more difficult also (if you're in a 3 year program and apply for a fellowship at the beginning of year 3, if you switch that ends up being the end of the 1st year of your second program, and you may not have enough connections / research / etc to do so generating a gap year).

Best of luck, whatever the future brings.

Your last paragraph brings up something we see about every March.

Poster is devastated by where they matched, thinking of quitting medicine instead of going there, starts making plans to transfer.

99% of the time we get an update later that year "I love my program, so glad I stayed, really happy here" or various iterations of those statements.

Just saying...

 

[Qpworueury]

Your last paragraph brings up something we see about every March.

Poster is devastated by where they matched, thinking of quitting medicine instead of going there, starts making plans to transfer.

99% of the time we get an update later that year "I love my program, so glad I stayed, really happy here" or various iterations of those statements.

Just saying...

Your last paragraph brings up something we see about every March.

Poster is devastated by where they matched, thinking of quitting medicine instead of going there, starts making plans to transfer.

99% of the time we get an update later that year "I love my program, so glad I stayed, really happy here" or various iterations of those statements.

Just saying...

It's already been a negative experience onboarding. None of the agents know what they're doing, getting incomplete and inaccurate information. Going be fun going here!

 

[guytakingboards]

It's already been a negative experience onboarding. None of the agents know what they're doing, getting incomplete and inaccurate information. Going be fun going here!

That's "within normal limits". If there's a place with smooth onboarding/credentialing I haven't worked there yet.

The great irony about joining the high-reliability, high stakes medical profession is that a significant amount of the bureaucratic admin work is done by poorly paid and often incompetent staff.

Had a colleague forward an email from a credentialer complaining that I hadn't filled out and returned a reference for my colleague. The rub ended up being that person never sent me an email in the first place. It wasn't even a mistaken email address situation, the person legit never sent the email and just assumed they had.

 

[LucidSplash]

I do locums full-time at the moment which means I go through this credentialing nonsense often. It sucks. Always.

One of places I credentialed at last year kept sending me the wrong procedure privileging forms. They sent me cardiothoracic surgery and could not understand why I did not want to be credentialed to do open heart surgery or lung resections. I explained I do vascular surgery. So then they send me cardiology forms and I again explained that I don’t do heart caths. Finally they sent me general surgery forms which had the open vascular procedures on them and also had to have them add endovascular procedures. And this is at a place that already has full-time vascular surgeons so presumably they should have separate forms for the specialty.

Nightmare. Always.

 

[VA Hopeful Dr]

It's already been a negative experience onboarding. None of the agents know what they're doing, getting incomplete and inaccurate information. Going be fun going here!

That's very frustrating to be sure, but as others have said it's very much par for the course in medicine.

I just spent 3 days of back and forth with accounting here about whether or not a Google Watch would work with our two-factor authentication. They wouldn't take my word for it, multiple websites saying it would work, nor a picture showing it. I had to go to the IT department and use it while they watched and "certify" to accounting that it worked before they would allow me to use my CME allowance to cover the purchase.

 

[DO2015CA]

That's very frustrating to be sure, but as others have said it's very much par for the course in medicine.

I just spent 3 days of back and forth with accounting here about whether or not a Google Watch would work with our two-factor authentication. They wouldn't take my word for it, multiple websites saying it would work, nor a picture showing it. I had to go to the IT department and use it while they watched and "certify" to accounting that it worked before they would allow me to use my CME allowance to cover the purchase.

Lol. It’s almost comical how these places hire the most tech unsavy people for IT jobs isn’t it?

OP, When I started residency I did not have a valid epic acct despite being given the username and password plus being searchable in the system. It took them 2 weeks to fix that. Turned out to be an amazing program with an attentive admin. These things just happen on onboarding

 

[rokshana]

It's already been a negative experience onboarding. None of the agents know what they're doing, getting incomplete and inaccurate information. Going be fun going here!

Lol…if onboarding is the indicator for a good program…well then there are no good programs…
In the last 15 years of having to do credentialing at over 10 places…nothing ever goes smoothly…

 

[Qpworueury]

Lol…if onboarding is the indicator for a good program…well then there are no good programs…
In the last 15 years of having to do credentialing at over 10 places…nothing ever goes smoothly…

The place sucks. I'm transferring first chance I can get

 

[DO2015CA]

The place sucks. I'm transferring first chance I can get

And what if that places onboarding sucks?

 

[Qpworueury]

And what if that places onboarding sucks?

It has absolutely nothing to do with the onboarding. It just sucks. The neighborhood is bad, the interior of the hospital is depressing and old. It's trash.

 

[RangerBob]

It has absolutely nothing to do with the onboarding. It just sucks. The neighborhood is bad, the interior of the hospital is depressing and old. It's trash.

Most of the best training hospitals can be described the same way (other than “it just sucks.”)

Many of my best learning moments and most enjoyable rotations were at ugly/depressing looking hospitals rougher/less fortunate neighborhoods.

I’ve generally found the ritzier the area and the fancier looking the hospital, the poorer the learning experience is. A big part is because such places cater more to the wealthy, who are typically less interested in being seen by a medical student or resident. The poor on the other hand, are generally much more thankful to receive care and attention, and/or they just don’t make a stink about it.

Thats’s of why VA’s were always my favorite hospitals to work at. The VA population is generally appreciative/thankful, down to earth, they get to the point (or if talking a lot, actually have a great story to tell), and they call me “Doc.”

 

[Qpworueury]

[/QUOTE]

Most of the best training hospitals can be described the same way (other than “it just sucks.”)

By all means, please either tell us exactly why the program itself is so horrible and known unanimously by all to be the most horrible program, (for starters, tell us the name of the program/specialty so we can confirm if this is true), or get over it and stop complaining so much about it.

I now am convinced you’re a troll not because of your magical thinking/apparent inability to adapt to circumstances or act in a professional/ethical manner even when specifically advised by countless well-intentioned strangers, but because there is a literal 0% chance your program wouldn’t be able to identify you from all your posts. And they would be very upset to see how you’re trashing them.

If you actually are real, you need to delete all your posts. It wouldn’t surprise me if your PD is well aware of these threads and already trying to find someone to fill your spot for when you leave for “greener” pastures or, perhaps more likely, get dismissed/non-renewed.

Sorry if I’m being rude here, and again I wish you all the best, but please act more becoming of your station as a physician

I'm not worried. No one looks at this part of student doctors network. I edited my posts by the way so you can't retrieve the whole story. There's no way I'm telling people what program this. I don't want my current peers to know that I'm this discontent

 

[Psyche0248]

I wouldn’t say I use SDN frequently (especially this section), but it is near the top of the physicians/specialties section, so it’s hard to miss. I clicked this thread because I recognized your user name from your previous thread (about sending those emails), which had been pretty hard to miss, too. If I were a program director, I’d probably be checking this forum occasionally. All it takes is one person to recognize your situation (like one of your PDs), and all bets are off. Your complacency about this is the biggest indicator to me that you’re trolling, but I enjoy the entertainment.

 

[DO2015CA]

I wouldn’t say I use SDN frequently (especially this section), but it is near the top of the physicians/specialties section, so it’s hard to miss. I clicked this thread because I recognized your user name from your previous thread (about sending those emails), which had also been pretty hard to miss, too. If I were a program director, I’d probably be checking this forum occasionally. All it takes is one person to recognize your situation (like one of your PDs), and all bets are off. Your complacency about this is the biggest indicator to me that you’re trolling, but I enjoy the entertainment.

Ya most of us that have been around a while believe it’s a troll but are engaging because sdn has gotten stale from an entertainment standpoint and OP is doing a good job making it just believable

 

[guytakingboards]

Most of the best training hospitals can be described the same way (other than “it just sucks.”)

Many of my best learning moments and most enjoyable rotations were at ugly/depressing looking hospitals rougher/less fortunate neighborhoods.

I’ve generally found the ritzier the area and the fancier looking the hospital, the poorer the learning experience is. A big part is because such places cater more to the wealthy, who are typically less interested in being seen by a medical student or resident. The poor on the other hand, are generally much more thankful to receive care and attention, and/or they just don’t make a stink about it.

Thats’s of why VA’s were always my favorite hospitals to work at. The VA population is generally appreciative/thankful, down to earth, they get to the point (or if talking a lot, actually have a great story to tell), and they call me “Doc.”

On top of that, there's a couple other things that make those rough-looking hospitals great training environments.

Wealthy people tend to take care of themselves. The spectrum of pathology is both narrower and less advanced. In big-city county hospitals you can get all sorts of pathology, a lot of which is advanced. In my residency it wasn't uncommon to get initial presentation stage 4 cancer, initial presentation de-compensated cirrhosis, or some exotic infectious bug from the tropics/Africa.

Rough-looking hospitals tend to be resource poor, which sucks as a trainee, but it trains you to be self-sufficient. You really need to know how to navigate the EMR, the local politics, XYZ, whatever it takes to get the job done. Fostering that "do whatever it takes" mentality as a trainee is super helpful as an attending. It makes you someone people can rely on.

Volume. I trained in a resident-run residency based at a county hospital. My attending colleagues who trained at the ivory tower residency programs on the whole can not handle the volume me and my co-residents can. They had fellows who did all the work and never had to carry the burden of the entire service. I did a ton more procedures than them in residency too.

But to your last point, agree 100% on VA's. Absolutely the most appreciative patient base I've ever worked with.

 

[Goro]

I'm not worried. No one looks at this part of student doctors network. I edited my posts by the way so you can't retrieve the whole story. There's no way I'm telling people what program this. I don't want my current peers to know that I'm this discontent
[/QUOTE]
The magical thinking is strong in this one

 

[Apollyon]

But to your last point, agree 100% on VA's. Absolutely the most appreciative patient base I've ever worked with.

The thing I like is, no scumbags. If someone got a dishonorable discharge, they're not eligible for care at the VA.