Rural IM program, far from home. Transfer?

[WolfLarson]

Advertisement - Members don't see this ad

Hey guys,

I am 33 years old. I had a long journey into medicine, and completed medical school at one of the big Carribbean Universities in summer 2025. I applied for the Match in September without a Step 2 score (was still writing) and got 2 IVs (one was from my top choice that I rotated at). I finished my Step 2 end of November and got a 228. I know its not a high score and wont make excuses (I got nervous/thrown off on timing while scoring 241 on NBMEs).

Needless to say I didnt match (probably related to score or maybe the programs didnt recieve my score update on time) and had to SOAP. I applied half and half to IM and FM programs and got around 7 FM IVs and 1 IM IV (it was recruiting for their third class and was only 7 hours from home by car). Many of the FM programs were in good locations too. On the third cycle of SOAP I got an offer for IM at a rural hospital on the midwest but I never interviewed at the program, I only applied to programs that offered visas and this was one of them. I initially got excited and accepted it as I didnt think I would match (since I am Canadian and need a J1 visa). But now looking back I realized I made a dumb mistake.

The program is almost on the other side of the country from where my family lives (Southern Ontario) and its in a small town so my SO cant find a job in her specialty (non-medicine) in this town and has her mom to take care of as well so she just cant quit her job. I offered to try to take care of us both but she refused saying that it would be too difficult to do on a resident salary. My grandparents (who largely raised me bc parents were always working) are in their 90s and I worry I wont see them again when I leave for residency. My mom is also aging. I am also grappling with the fact that I will be 36 when I finish residency and it will be significantly harder to find a new SO if it doesnt work out with this one due to distance (I am at the stage of my life where I no longer care abt partying much or looking for girls) plus I value her.

So now I am in a bind (of my own making), I cannot quit before the NRMP 45 day deadline without getting a match violation and being unable to match in the future. And i cannot quit residency after the 45 days are up and reapplying without other programs being leery. This makes it so that I need to transfer to a program closer to me. I do not care if its IM or FM (and want to go back to work in canada eventually). Would I be able to do it after 45 days? This way the program can potentially find someone to start off cycle and I can be closer to my family. I know I am not a strong applicant and need a visa at that but I really would like to know what to do.

Edit: should I talk to the PD and explain the situation after the 45 days are up and thank him for taking a chance on me and ask him to help me find a position to transfer to? I have not been able to sleep much the past few days as a result of worrying about this so I decided to ask here

 

[DrMetal]

The program is almost on the other side of the country from where my family lives (Southern Ontario) and

I don't care if the program is on the other side of the planet . . .you're quite lucky to have matched. Take it! Don't be silly. SO? This is a spouse, or a boy(girl)friend? Tell him or her to find a job in the nearest possible location.

It's IM, it's only 3 years. It's either this, or you don't practice medicine at all.

 

[WolfLarson]

I don't care if the program is on the other side of the planet . . .you're quite lucky to have matched. Take it! Don't be silly. SO? This is a spouse, or a boy(girl)friend? Tell him or her to find a job in the nearest possible location.

It's IM, it's only 3 years. It's either this, or you don't practice medicine at all.

Its my girlfriend. I realize that I am lucky to have matched and very thankful. If I was younger and my family was younger, I would take it and run.

The nearest possible location for her to find a job would be in Calgary (or Seattle which is a 17 hour drive) and thats a 6 hour drive or so away. Dont know if she would be willing/able to in her specialty.

 

[CopaceticOne]

Do you want to be a practicing physician or not?

It is really that simple. If yes, just go and complete the residency with the only IM program in the entire country that decided to give you a chance.

Sorry (but not really) to be so blunt, but that is exactly what your situation is.

 

[ThoracicGuy]

Its my girlfriend. I realize that I am lucky to have matched and very thankful. If I was younger and my family was younger, I would take it and run.

The nearest possible location for her to find a job would be in Calgary (or Seattle which is a 17 hour drive) and thats a 6 hour drive or so away. Dont know if she would be willing/able to in her specialty.

You might have to go long distance for 3 years then if she's someone you want to stay with.

 

[gutonc]

This is your chance to be a practicing physician. Based on what you've shared, this is probably your only real chance. Either take it and make the best of it, or move on with your life to another career.

That, while it may sound harsh, is the calculus you're dealing with here.

 

[DrMetal]

Its my girlfriend. I realize that I am lucky to have matched and very thankful. If I was younger and my family was younger, I would take it and run.

The nearest possible location for her to find a job would be in Calgary (or Seattle which is a 17 hour drive) and thats a 6 hour drive or so away. Dont know if she would be willing/able to in her specialty.

Calgary ain't so bad?! I heard the Flames are building a new stadium.

Specialty? As in medical specialty? What does she do, pediatric rheumatology?

Take the spot. Don't be a fool. Do the long distance thing for 3 years. If she's not willing, let her go. (if she was your wife and bearing your children . . I'd give different advice).

 

[smq123]

Its my girlfriend. I realize that I am lucky to have matched and very thankful. If I was younger and my family was younger, I would take it and run.

The nearest possible location for her to find a job would be in Calgary (or Seattle which is a 17 hour drive) and thats a 6 hour drive or so away. Dont know if she would be willing/able to in her specialty.

Wait, Calgary would be a 6 hour drive from your residency program?

Thats totally doable. Lots of people do long distance during residency with longer distances. I did long distance for two years with someone who was a 4 hour FLIGHT away. (The last year, they moved slightly closer, it was only a 2 hour flight.) We’re still together, and that was over a dozen years ago. Do you share a kid with this girlfriend?

 

[WolfLarson]

Wait, Calgary would be a 6 hour drive from your residency program?

Thats totally doable. Lots of people do long distance during residency with longer distances. I did long distance for two years with someone who was a 4 hour FLIGHT away. (The last year, they moved slightly closer, it was only a 2 hour flight.) We’re still together, and that was over a dozen years ago. Do you share a kid with this girlfriend?

No I do not. We were planning on going to NYC together before the match (that was where my top choice was and where I got my LORs from) and having a kid there. Dunno how realistic it would be now

Do you want to be a practicing physician or not?

It is really that simple. If yes, just go and complete the residency with the only IM program in the entire country that decided to give you a chance.

Sorry (but not really) to be so blunt, but that is exactly what your situation is.

This is your chance to be a practicing physician. Based on what you've shared, this is probably your only real chance. Either take it and make the best of it, or move on with your life to another career.

That, while it may sound harsh, is the calculus you're dealing with here.

Why would a transfer be impossible (even to FM) (assuming that is what you are inolying?

Calgary ain't so bad?! I heard the Flames are building a new stadium.

Specialty? As in medical specialty? What does she do, pediatric rheumatology?

Take the spot. Don't be a fool. Do the long distance thing for 3 years. If she's not willing, let her go. (if she was your wife and bearing your children . . I'd give different advice).

Wait, Calgary would be a 6 hour drive from your residency program?

Thats totally doable. Lots of people do long distance during residency with longer distances. I did long distance for two years with someone who was a 4 hour FLIGHT away. (The last year, they moved slightly closer, it was only a 2 hour flight.) We’re still together, and that was over a dozen years ago. Do you share a kid with this girlfriend?

Not yet. But the question is if she would agree to come to Calgary

There is also the question of my grandparents, they cant fly due to poor health. Worried I will not see them again

 

[DrMetal]

No I do not. We were planning on going to NYC together before the match (that was where my top choice was and where I got my LORs from) and having a kid there. Dunno how realistic it would be now




Why would a transfer be impossible (even to FM) (assuming that is what you are inolying?




Not yet. But the question is if she would agree to come to Calgary

Kids are the real marriage. No kids . . . no dice. Many a girlfriends I thought about having kids with but didn't happen. Life got in the way, or maybe a restraining order . . .

 

[WolfLarson]

Kids are the real marriage. No kids . . . no dice. Many a girlfriends I thought about having kids with but didn't happen. Life got in the way, or maybe a restraining order . . .

I will be 36 when I finish. It gets significantly harder to find a partner then

 

[smq123]

Why would a transfer be impossible (even to FM) (assuming that is what you are inolying?

You’re not a fundamentally different or better candidate 45 days into residency than you were when you submitted your rank list a few weeks ago. Transferring into a family medicine position two months into residency will be very difficult and unlikely - otherwise, they would have taken you in the SOAP.

 

[DrMetal]

I will be 36 when I finish. It gets significantly harder to find a partner then

Meh, that's debatable . . .but ok, then you have a decision to make. Become a doctor, or stick with your gf (how'd you manage in the Caribbean for 4 years?)

Take your grandparents out of this decision. They're in their 90s, in poor health . . . yes, they're going to die soon (sorry to be crass). Congrats to them for making it to their 90s, they've won the game. No matter what you do next in life, there's a good chance that "you'll never see them again". They could die right now while you're chatting on SDN. There's no sense in basing a major life decision on them. They would agree and advise you the same.

 

[WolfLarson]

You’re not a fundamentally different or better candidate 45 days into residency than you were when you submitted your rank list a few weeks ago. Transferring into a family medicine position two months into residency will be very difficult and unlikely - otherwise, they would have taken you in the SOAP.

The things is between SOAP round 2 and 3 I was getting multiple calls from a rural PA FM program expressing their interest. I suspect they were going to send me an offer in round 4. In addition there was a nother program which had the PD call me the night before and express interest. I have another Canadian friend in a similar situation as me who also got only 7 FM ivs and didnt match in SOAP last cycle. This cycle he got 17 IVs from FM programs around the countrynand matched a pretty good one close to home.

 

[TeddyBoomBoom]

I will be 36 when I finish. It gets significantly harder to find a partner then

Bruh…from a social capital perspective:

36 yo physician >>> 33 yo non-physician

Just sayin…

 

[WolfLarson]

Bruh…from a social capital perspective:

36 yo physician >>> 33 yo non-physician

Just sayin…

Starting again with a girl in her late 20s/early 30s at 36?

 

[dozitgetchahi]

When I started residency, I was stationed 4.5 hours from my wife and kids. It seemed like a long 3 years, but it ends.

You didn’t come into this situation with great credentials and you’re unlikely to have other options. I have encountered folks in your situation who didn’t take their option to start residency like yours and never ultimately got a residency slot. Take the ticket and go become a trained physician.

(Also, if you’re 33 years old, why on earth would you want to drag this process out another year…especially when you’re not guaranteed getting a job next year? Don’t you want to get this done and over with?)

Also, re: “taking care of us is too difficult to do on a resident salary” - millions of Americans live on about $40-50k/year. No it’s not luxurious, yes it absolutely is doable for 3 years. Anyone who says it’s not possible has expensive tastes that they’re apparently unwilling to compromise for a few years.

 

[anonperson]

Hey guys,

I am 33 years old. I had a long journey into medicine, and completed medical school at one of the big Carribbean Universities in summer 2025. I applied for the Match in September without a Step 2 score (was still writing) and got 2 IVs (one was from my top choice that I rotated at). I finished my Step 2 end of November and got a 228. I know its not a high score and wont make excuses (I got nervous/thrown off on timing while scoring 241 on NBMEs).

Needless to say I didnt match (probably related to score or maybe the programs didnt recieve my score update on time) and had to SOAP. I applied half and half to IM and FM programs and got around 7 FM IVs and 1 IM IV (it was recruiting for their third class and was only 7 hours from home by car). Many of the FM programs were in good locations too. On the third cycle of SOAP I got an offer for IM at a rural hospital on the midwest but I never interviewed at the program, I only applied to programs that offered visas and this was one of them. I initially got excited and accepted it as I didnt think I would match (since I am Canadian and need a J1 visa). But now looking back I realized I made a dumb mistake.

The program is almost on the other side of the country from where my family lives (Southern Ontario) and its in a small town so my SO cant find a job in her specialty (non-medicine) in this town and has her mom to take care of as well so she just cant quit her job. I offered to try to take care of us both but she refused saying that it would be too difficult to do on a resident salary. My grandparents (who largely raised me bc parents were always working) are in their 90s and I worry I wont see them again when I leave for residency. My mom is also aging. I am also grappling with the fact that I will be 36 when I finish residency and it will be significantly harder to find a new SO if it doesnt work out with this one due to distance (I am at the stage of my life where I no longer care abt partying much or looking for girls) plus I value her.

So now I am in a bind (of my own making), I cannot quit before the NRMP 45 day deadline without getting a match violation and being unable to match in the future. And i cannot quit residency after the 45 days are up and reapplying without other programs being leery. This makes it so that I need to transfer to a program closer to me. I do not care if its IM or FM (and want to go back to work in canada eventually). Would I be able to do it after 45 days? This way the program can potentially find someone to start off cycle and I can be closer to my family. I know I am not a strong applicant and need a visa at that but I really would like to know what to do.

Edit: should I talk to the PD and explain the situation after the 45 days are up and thank him for taking a chance on me and ask him to help me find a position to transfer to? I have not been able to sleep much the past few days as a result of worrying about this so I decided to ask here

Bruh, you're a weak candidate and you thankfully matched.

You ever hear this phrase
" Snatching defeat from the jaws of victory" ?

Don't do that.

If your GF breaks up with you over this, that's on her. 3 years to set yourself up for life is a small ask.

And you will be fine if you do end up as a single practicing physician.

 

[ThoracicGuy]

The things is between SOAP round 2 and 3 I was getting multiple calls from a rural PA FM program expressing their interest. I suspect they were going to send me an offer in round 4. In addition there was a nother program which had the PD call me the night before and express interest. I have another Canadian friend in a similar situation as me who also got only 7 FM ivs and didnt match in SOAP last cycle. This cycle he got 17 IVs from FM programs around the countrynand matched a pretty good one close to home.

A bird in the hand...

 

[RangerBob]

I agree with the others here. As a Caribbean grad, I think you're lucky to have matched to a categorical program. We sympathize with your situation, but giving your position up means very possibly/likely not matching into another program.

Be the best intern/resident you can be. If you are really struggling being far from your SO/family, then perhaps if you're a stellar resident and have developed a good relationship with your PD, they will try and help you out. Developing that strong a bond can be difficult in a short time, but perhaps it's possible.

The minute you talk about transferring, your PD will try to find someone to replace you. Again, considering how far down your list you went to soap, there's a very real chance you won't get a position elsewhere, and now you've lost your primary position.

Long distance is hard, but it's very doable. People do it all the time, but often without the benefit of knowing it'll only be three years long. Typically residents get three weeks off per year, and if your SO gets more than three weeks they can drive/fly out to see you even more. You can work with your PD to arrange for at least one "golden weekend" a month as well.