Quoted: swapping residency

Started by Doodledog
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Doodledog

Escape artist
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This needs aPD!

I'm currently in a TY program, and I've matched for an advanced PM&R position at a different institution. I was never too happy with the particular PM&R program I matched in to, but happy overall that I matched somewhere in this specialty.

Today I learn that there is another individual who is in a categorical PM&R program and is interested in switching with me for the upcoming PGY-2 year. Based on location, it would be mutually desirable for both of us to switch.

Would this be a violation of match rules on my part if I were to switch positions? Keep in mind, that I have not yet started at this advanced program, and am still doing my internship which is separate. For the other individual, the internship and residency are combined. Because if it is, I don't want to preemptively jeopardize my reputation at the program that I've matched in to by further pursuing this (i.e. contacting the program directors) if this is not possible based purely on match rules.
 
The short answer: It is absolutely a match violation to do this, but perhaps it's possible.

The long answer: There is no question that it's a match violation to do this. Your match is binding upon you to start your PGY-2 year. You could have asked for an automatic waiver of your match if you changed your mind about your specialty, but that deadline passed this month AND doing so would prevent you from starting another PM&R residency.

Why can't you switch? In order to do so, both PD's would need to be happy with the swap. There's no guarantee that you and this other person are of "equal caliber" or that the PD's would be happy with the swap. Theoretically, the NRMP could try to run a system where both you, the other person, and both PD's would put in permission for the swap, and if anyone said "no" then the swap is off and the "no" vote would remain anonymous. However, when only 4 people are voting and the vote is 3-1, you can always figure out who the no is. Personally, I think the NRMP should find a way to help make swaps like this happen -- as long as it's an even swap and everyone agrees. But I understand that significant pressure could be brought to bear on all parties -- Let's say after the match I was unhappy with you matching into my program. Perhaps I and another PD decide to exchange residents. I contact you and tell you that I suggest a swap, warn you that if you don't agree to it I imagine you'd fail out here in your first three months.... you really wouldn't have any choice. Same could work the other way -- you could tell me that unless I agree to the swap, you're going to resign in 1-2 months, etc.

What happens if you speak to both PD's, and everyone is happy with it, and you swap? If no one says anything to the NRMP, then nothing. So, it's still theoretically possible to do so, but you don't want to get the NRMP involved.

One "legal" way to do it (if you or the PD's are worried about the NRMP) is to both start your PGY-2's, then swap after one month (or one day, for that matter). The NRMP only requires that you start your training, you can leave any time you want.