Seeking a Residency Transfer

[hotwasabi]

Hey everyone,

It has been a long-time since I have posted here. I am looking for some advice and help, and as the title describes, I am seeking a transfer for a residency position.

I am currently in the unenviable position of needing a new residency position.

Some background information: I graduated from a top 10 college, and top 20 medical school. I applied and matched to residency, in a competitive specialty.

Unfortunately, there have been quite a few issues out of my control, and my program has taken the decision to terminate my employment.

I was given some inconsistent information regarding remediation, probation, suspension, and ultimately termination. My program has refused to help me out in any way.

When I was applying to residency I never expected to need to transfer or re-apply.

Wondering, if anyone had thoughts or suggestions on this situation. Is it feasible to transfer to a different program, when your old program has terminated you and refused to give a letter of reference? Can I sue my former program for wrongful termination? Is it feasible to take credit earned for your past program and apply to a new program?

Thanks for your info and advice.

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[NotAProgDirector]

First, I'm sorry you're going through this. While you're working on a plan for what comes next in your career, make sure you take care of yourself and get help if you need it.

Your post history isn't helpful - your last post was 2015 when you were still applying to medical school.

You mentioned issues that were out of your control. Unfortunately, even if they are out of your control, if they impact your performance then programs can take disciplinary action. Not helpful for you now, but if that happens sometimes the best thing to do is to take an LOA of some sort to address the issues, rather than trying to power through. Easier said than done, as physicians we're trained to power through adversity.

Your program must give you some sort of final assessment. They must share it with you so that you can see the contents. So they can't simply refuse to give you a "recommendation". But, they are allowed to be honest in this assessment, and can (and likely will) talk about the issues that led to your termination. They don't have to say that they "recommend you for a new position". The assessment could be that you worked for them from <date> to <date> and then were not renewed due to performance issues, and not say anything more than that. So, at this point if you can work with them to help craft what this document will say, or at least get to see it so you know where you stand, you can move forward.

You mentioned you're in a competitive field. The chance of getting a new spot in the same field is not good. If your program didn't feel you were ready to progress to the next PGY level, it's unlikely some new program will offer you a spot at that level. Mid stream positions in competitive fields don't open up often. There's some chance if your program is known to be "malignant", but I wouldn't count on it.

So, your best plan forward is probably to get a spot in a new field. You'll need to decide what field that is, and then you'll be able to determine whether your pror training will get you credit. For example, if you decided you wanted to do Radiology instead (assuming that's not what you're doing now), your PGY-1 might count for the prelim year in Rads and you could start as a PGY-2. If you're in a surgical sub you might get some credit towards GS. In all cases, whether you get credit or not is completely up to your new program. You can't somehow "apply" for credit. You should assume that you will start from the beginning again (with the big exception of skipping a prelim year if your prior training would get you credit for that). You need to choose something that is less competitive than what you are currently in. If there's a program in that field at your current institution, you should network with that PD.

For the most part, suing your prior program isn't viable. If you can prove clearly that you were discriminated against due to race/sex/disability etc, then you might be able to. But you're unlikely to get your spot back (and would you really want it?), lawsuits are very expensive, and take forever. If you ran into performance issues because outside "stuff" was happening in your life, you can't sue them because they should have given you more chances or breaks. It's not illegal to be mean or strict. And if you start legal proceedings, other programs may have no interest in taking you, worried that you might just sue them if you ran into trouble again.

So I think you need to be introspetive and figure out what went wrong. Fix it, as best as you can. And apply again for spots. It's too late for the match and SOAP - although I guess you could register for the match today or tomorrow, and then get an ERAS app ready for SOAP (apply to any single program, and then you'll have SOAP access). You will need some sort of letter from your program in your application or it's unlikely to be successful, and it seems unlikely to me that you'll be able to sort that out in time but you could try. Spots do open mid cycle, you'll need to network and be open geographically. And most important, you need to figure out what you want to do next.

 

[TelemarketingEnigma]

How much of your training did you complete? from the timeline of your posts, you should be a PGY-4 now (maybe PGY-3 if a research year was involved), which I suspect provides very different career options/outlook than if you were a PGY-1

 

[GoSpursGo]

Agree with above. Sorry you are going through this, and very unfortunate that it seems your program is going to give you a negative assessment. That more or less is going to end your chances in this competitive field.

Your best bet may be to tell your program that you are intending to leave the specialty, and see if you can negotiate that in exchange for you going away and not being difficult, that you could get a letter that says “hotwasabi came from a strong background and we were excited when he matched at our program. Over the course of his training, he exhibited performance issues which led us to conclude that competitive specialty x was not ideal for his skill set. However, he has verbalized that he intends to switch to alternative specialty y, and we believe this change will allow him to reach his full potential because that specialty better suits him for such and such reasons.”

Who knows. Maybe they will be spiteful and not help you no matter what. But maybe they will determine that it is easier to write that letter and just be done with you. Regardless, I think you need to figure out what alternate specialty you want to apply to and make a convincing case for why the problems you encountered in your current specialty will not be an issue in the new specialty. Hopefully your current program will endorse that line of thinking, but regardless it’s something you will need to be able to verbalize yourself anyways

 

[dozitgetchahi]

Agree with above. Sorry you are going through this, and very unfortunate that it seems your program is going to give you a negative assessment. That more or less is going to end your chances in this competitive field.

Your best bet may be to tell your program that you are intending to leave the specialty, and see if you can negotiate that in exchange for you going away and not being difficult, that you could get a letter that says “hotwasabi came from a strong background and we were excited when he matched at our program. Over the course of his training, he exhibited performance issues which led us to conclude that competitive specialty x was not ideal for his skill set. However, he has verbalized that he intends to switch to alternative specialty y, and we believe this change will allow him to reach his full potential because that specialty better suits him for such and such reasons.”

Who knows. Maybe they will be spiteful and not help you no matter what. But maybe they will determine that it is easier to write that letter and just be done with you. Regardless, I think you need to figure out what alternate specialty you want to apply to and make a convincing case for why the problems you encountered in your current specialty will not be an issue in the new specialty. Hopefully your current program will endorse that line of thinking, but regardless it’s something you will need to be able to verbalize yourself anyways

I agree with this. From what I’ve heard in these situations, it seems like the transfers are more likely to happen if someone is exiting the specialty, and programs from other specialties are more likely to take a look at you if the whole situation can be spun as you switching to another specialty which is a better fit.

 

[hotwasabi]

Thank you for your help. Another thing I was considering was reporting issues of workplace discrimination to ACGME. Does ACGME enforce any specific policies regarding discrimination to the residency program?

 

[voxveritatisetlucis]

Thank you for your help. Another thing I was considering was reporting issues of workplace discrimination to ACGME. Does ACGME enforce any specific policies regarding discrimination to the residency program?

No they don’t look at specific cases

 

[xffan624]

Thank you for your help. Another thing I was considering was reporting issues of workplace discrimination to ACGME. Does ACGME enforce any specific policies regarding discrimination to the residency program?

I mean if you think you have a legitimate complaint of discrimination based on a protected category then that would be an EEOC report, but it's a nuclear option so not something taken lightly. Ideally, you want to maintain a good relationship with your former residency how they report your performance to licensing agencies and other residencies is somewhat up to them. If that goodwill ship has already sailed (difficult to assess based on your post), then maybe consider that. I don't know what it would actually achieve for you, but they're the folks that would handle a complaint of that nature.

 

[NotAProgDirector]

The ACGME has a page about submitting complaints. They have two offices - an Ombudsperson who informally helps, and an office of complaints that creates a formal process. Neither will help in your situation. From their FAQ:

 

[GoSpursGo]

Thank you for your help. Another thing I was considering was reporting issues of workplace discrimination to ACGME. Does ACGME enforce any specific policies regarding discrimination to the residency program?

I agree with others--it's very unlikely to help you, and will just ruin any chance at an amicable split if the chances still exist. I maintain that finding a way to leave the specialty and get a decent letter is your best path forward.