Psych to IM Residency

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JosephStar

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Hi everyone, after a lot of soul searching I have realized that I want to be an oncologist. Has anyone switched from a psychiatry residency to an IM residency? What was the process like and how difficult was it to switch? My psychiatry program is an academic program and I have decent stats, step 1: 240+ step 2: 260+. My concern is that I really want to go into a heme onc fellowship. Does switching specialties in residency destroy my chances at an IM fellowship? I'm guessing a big factor will be if I can transfer into an academic program vs a community program. Ideally I would love to do an internal switch into my institutions IM program.

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Your chances of a Heme/Onc fellowship will be the same as anyone else's in your residency class. In fact, some might see your prior psych training as a benefit. You'll need to find an IM PGY-1 position, you will get very little (if any) credit for your psych PGY-1. I completely agree that switching inside your institution is often the easiest pathway. Speaking to both PD's is the next step Good luck!
 
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Nothing much to add to @NotAProgDirector's excellent response except to say that it's late in the year for this kind of a move, since contracts for next year are already out and probably signed and returned. But if you have your PD's support, that will certainly make things easier.
 
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@NotAProgDirector @gutonc Thank you so much for the advice, I truly appreciate it. I should have specified in my original post but I am a post match MD4. I just had a lot of exposure to Heme Onc this year through an elective, shadowing, and doing a lot of my own research on the field. It shocked me just how much I enjoyed this specialty. I feel like it has a lot of the same qualities that led me to choose psych in the first place. I feel bad thinking about switching before even starting my residency but my heart is telling me that I should be an oncologist. I understand that there is a 45 day work period where you are binded by the NRMP. Should I reach out to my PD and the IM PD after that or would it be best to wait until a couple weeks before eras opens to programs at the end of September? Assuming the IM PD at my program wants me would I be able to do an internal switch early in the year or is it almost guaranteed that I would have to wait until the end of my PGY1 year to switch? I want to do this in the most professional way possible and I don't want to screw my program over by leaving them down a resident. Thank you!
 
It's unlikely that the IM program somehow has an opening. It's possible that someone will be unable to get a visa or otherwise unable to start, although man yprograms will wait for 3-4 months for those people hoping things will sort themselves out. Chances are, you should plan to be in the match again next year. It might be possible to transfer into the IM program, but I wouldn't count on it. Will also depend upon whether you're competitive for that program or not.

Start your psych program, and talk to your PD.
 
what specifically draws you to heme onc - the patient population, the medicine, etc? I think post-match is a prime time for doubts and reconsideration of life plans, but there's always a need for psych care for heme onc patients, if switching doesn't work out and you think you could be satisfied going that direction
 
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FWIW I know of someone who switched from Neuro to IM after really blowing away their supervising residents/attendings during their IM prelim year. Pretty sure our institution already had independently funded spots and/or sufficient financial flexibility and rotation capacity to temporarily add a resident on top of the usual cohort. So one of your goals is to really impress while on your medicine rotations and hopefully to be on those rotations relatively early in intern year.
 
I should have known there was more to the story.

Bottom line, start your residency and proceed as if you are going to be a psychiatrist. If it turns out that's not how you want to proceed, and IM (with the hope of getting a H/O fellowship) is how you really want to proceed, then start the conversation with your PD and the local IM PD.

How is your intern year arranged? At my residency, the psych interns were split and half did all IM for the first 6 months of the year and psych the 2nd half, and the other group did the opposite. If yours is set up like this, I would encourage you to do psych first if possible to make sure it's not actually what you're interested in.
 
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Omph, this is just about the worst time in your career to switch. It's literally breaking a conctract. Concur with starting your residency like you were planning to be a psychiatrist.
 
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There's plenty of IM months during intern year of psychiatry, as well as inpatient psychiatry. It would be quite easy to switch after intern year, as well as get credit, if you decide IM is for you.
 
There's plenty of IM months during intern year of psychiatry, as well as inpatient psychiatry. It would be quite easy to switch after intern year, as well as get credit, if you decide IM is for you.
Switching, assuming you're a strong psych intern, will be relatively straightforward.

"Credit" is a concept that you should forget exists. If you continue on at the same institution you might get "time off for good behavior" from an inpatient or ICU rotation or two, but you're still going to take 3 years to finish the IM residency.
 
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