quiting

[grhopper]

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hello everyone,

i was wondering if someone can help me with my situation. i matched into a program this yr, which i am very happy about. however, due to unforeseen circumstances i dont think that i will be mentally fit to start my program starting this july. I have not notified my program yet and plan to do so soon. my question is, how would this affect me if i want to go back into the match again next yr.

 

[AndrewFM]

I'm sorry you're not feeling ready to start the program. The mental fitness is very important.

My best piece of advice is tell your program ASAP and be as upfront and honest as possible. They might be able to give you a leave of absence (maybe unlikely)

but the thing is, if it is revealed (and it may be absolutely necessary) that you had a position in the past, you want your program to be able to say positive things about you, instead of saying "he/she was deceptive and seemed to be hiding something"

privacy laws would prevent them from commenting on your specific troubles, but they can talk in generalities about you.

 

[Winged Scapula]

Regardless of how you feel and what your program feels about it, you will be violation of the match (presuming this position was obtained in the NRMP).

The NRMP has to be the one to release you from the match contract; if they do not, you are prevented from participating in the match for 3 years, I believe.

See this for further information: http://www.nrmp.org/res_match/policies/violations.html

 

[dragonfly99]

Is this something a couple month leave of absence could take care of? If so, I think it would make your life a lot easier later if you could do that, rather than trying to do the whole match over next year.

I think Aprogramdirector is right about the Match violation thing, too. I would think the NRMP would agree to let you out of your match, though, if you have a solid medical reason for needing to do so.

 

[peppy]

Is this something a couple month leave of absence could take care of? If so, I think it would make your life a lot easier later if you could do that, rather than trying to do the whole match over next year.

Yes, if possible I think this would be a much better option than trying to get out of your contract. Make sure you tell them you're happy about coming to the program and would like to work out a way to stay in it, then see what options they can offer you.
Hope things work out for you!

 

[grhopper]

Thank you everyone for their advice. Some of the advice appears to be a good idea, but unfortunately for me I am not sure how long it will take me to get over my issues. I mean I really dont want them to give me an leave of absence for x amount of months and when it is time to start I might still not be ready. To tell you the truth I have serious family issues that has turned my life upside down. I seriously think that I will not be mentally stable anytime soon and strongly believe that it is unfair for the patients under my care and the program if I am not 100%. My biggest concern is how ugly is my situation in regards to future match once I get my issures straighten out.

 

[dragonfly99]

Perhaps you could talk with the program director of your program that you matched into, and explain your situation (if not too painful for you) and maybe ask them if they would give you an outside of the match spot for the next year. If it's something like psych or fp, and they really liked you this year during interviews, maybe they would. It's just an idea, and I doubt you could get a contract now, which means you are still taking somewhat of a risk, but at least you'd know that you tried. As you said, you also want to be fair to your patients, as well as yourself...it seems to me you have not a lot to lose by being honest with the place that you matched, since you are thinking of trying to break your contract anyway.

Part of this also depends on how strong of an applicant you were this year as well. I mean if you have 250 boards and matched into derm, I'm sure you could get SOMETHING next year, if not derm. If you just skated by on boards and were near the bottom of your class, then you're taking more of a risk by sitting out a year. I think if you are an average US grad, you likely can find something next year, but in general it's harder to get a good match the 2nd time around.

 

[mcl]

Thank you everyone for their advice. Some of the advice appears to be a good idea, but unfortunately for me I am not sure how long it will take me to get over my issues. I mean I really dont want them to give me an leave of absence for x amount of months and when it is time to start I might still not be ready. To tell you the truth I have serious family issues that has turned my life upside down. I seriously think that I will not be mentally stable anytime soon and strongly believe that it is unfair for the patients under my care and the program if I am not 100%. My biggest concern is how ugly is my situation in regards to future match once I get my issures straighten out.

Keep in mind that most, if not all, programs have confidential Resident Assistance Programs that can provide some level of mental health care and counseling to help you deal with your issues. Whatever it is that you are coping with, it can help to know that a) you are not the first, and b) you are not alone. Whether you realize it or not, the program where you matched has a lot invested in you already and would be able to offer you some support and stability so you can ultimately succeed.

I'd encourage you to talk to your PD as soon as possible and let him/her know what is going on so that together you can come up with a plan that is best for you, your potential patients, and your program.

 

[DarthNeurology]

hello everyone,

i was wondering if someone can help me with my situation. i matched into a program this yr, which i am very happy about. however, due to unforeseen circumstances i dont think that i will be mentally fit to start my program starting this july. I have not notified my program yet and plan to do so soon. my question is, how would this affect me if i want to go back into the match again next yr.

I have seen people who have had serious family issues, and it can cause a lot of havoc in medical school and residency. You are totally correct in acknowledging this early, i.e. before starting residency and then having it impact your training and perhaps even having you be fired from residency which would likely end your medical career.

Go the nrmp website, there are ways to get out of the match "legally" in terms of nrmp so you won't be a match violator. I would do this first and use nrmp as a third party so that if nrmp lets you off the hook then your current programs will never have talked to you and all they can say is that nrmp excused you from the contract. Your PD will not be your "friend" if you do get the exemption from nrmp, so it is better to not give them ammunition.

If the nrmp won't do it, then you have to go the residency program, and make sure you haven't signed anything, and ask to be excused from the match deal. If you explain your situation well then likely the PD will be sympathetic and won't make a big deal about it.

Never ever, ever, ever use a psychiatrist via a medical school or a residency program.

Let me say that again, Never ever, ever, ever use a psychiatrist via a medical school or a residency program.

I have seen students/residents who are friends do this do this and it can have bad effects. While it may be "confidential" psychiatrists who are heavily affiliated with a school or residency program do give under the table assessment to PDs and school administrators. Happens all the time and you can't prove a thing in the end. They aren't necessarily on your side, but just want to make sure they don't have someone who is "unstable", ethics in terms of confidentiality don't apply to the physician patient. 100% go to a psychiatrist outside of the hospital you work at then it really will be confidential.

If you do talk to the PD don't say that you think you might be "mentally unfit", just say you have personal issues that are private dealing with your family, most people will respect this. Whatever you say could circulate in the rumor mill about you. Telling a PD where you aren't going to report for duty in July that you are "mentally unfit" is not going to win any fans and the PD could blab about you to other PDs. Don't go to your current PD and blab your whole story, keep it confidential. If you decide to email them say it is a private and confidential family matter which you feel could significantly distract you from duties as a resident and that you have elected to take a year off while the issue resolves and that you fully expect to be able to apply again for residency in 2010.