Switch to EM program

[WilburSK]

Hello forum,

I am a pgy1 just finishing up my prelim year in internal medicine before beginning to start my ophtho residency. I recently discovered that I may not be able to complete my ophtho residency due to eye problems (lack of 3d vision, never gave me any problems...just an issue when trying to do microsurgery, nothing else).

I was a strong applicant coming out of medical school: 247 STEP 1, lots of research and volunteering, decent third year grades.

Anyhow, due to my recent discovery, I have been doing some soul searching and I think I am going to switch to EM (this is what I wanted to do when I came to medical school). So...my question is what can I do?

I would like to match well in EM, but I wonder if I will be limited due to having already started residency.

---

Members don't see this ad.

 

[Brigade4Radiant]

Hello forum,

I am a pgy1 just finishing up my prelim year in internal medicine before beginning to start my ophtho residency. I recently discovered that I may not be able to complete my ophtho residency due to eye problems (lack of 3d vision, never gave me any problems...just an issue when trying to do microsurgery, nothing else).

I was a strong applicant coming out of medical school: 247 STEP 1, lots of research and volunteering, decent third year grades.

Anyhow, due to my recent discovery, I have been doing some soul searching and I think I am going to switch to EM (this is what I wanted to do when I came to medical school). So...my question is what can I do?

I would like to match well in EM, but I wonder if I will be limited due to having already started residency.

Talk to your Ophtha PD and see if it would be a problem.

 

[WilburSK]

Do you mean regarding my vision? I have asked, and they thought it best to move on, due to difficulty seeing for surgery

any advice for the transition?

 

[racerwad]

Do you mean regarding my vision? I have asked, and they thought it best to move on, due to difficulty seeing for surgery

any advice for the transition?

No, he meant to get your current PD's blessing about making a change. You can't really change without their ok and you definitely would have trouble getting matched well in any specialty if your PD didn't know or was ok with.

 

[WilburSK]

He was the one that suggested it due to my eyes.

 

[gman33]

Get some advising from multiple sources before you switch.
It would be a shame to move on from a field you like if there is a work around.
The fields are so far apart.

 

[WilburSK]

Thanks for the good advice. I will be sure to think it through and talk it through.

Just humor me for a sec, and say I am going to make the switch. What are my options? Is there a good thread that would describe the process and how bad it hurts in the second residency match?

 

[Apollyon]

What you don't want to do is make it sound like you see EM as a fall back. Something to say is something like, "I really liked EM, but ophtho was a bit more. Unfortunately, I am not going to physically be able to pursue ophthalmology any further. As such, this is a relief, because I did vacillate between EM and ophtho." Or something like that.

 

[WilburSK]

Thanks for the advice. I am mostly concerned about the logistics. Since I have finished my pgy1 prelim internal med year, will that affect my ability to match? Would I go through the regular match or would I have to find an open pgy2 spot? Would i be a less desirable applicant due to my completion of my pgy1 year even though I am a strong applicant?

 

[gro2001]

You will be eligible to accept a spot outside the match. However you may not receive a full year's credit for your intern year. This is what you need to do:

1) If you have done an EM rotation during your prelim year, meet with the EM PD there and discuss your situation. Straight up ask if they would take you. Do the same with the EM PD at your medical school. These are your 'home' programs.
2) Contact faculty from any EM rotations you did either in med school or intern year and get 2-3 SLOEs http://www.cordem.org/i4a/pages/index.cfm?pageid=3743
3) Check the CORD website for EM vacancies frequently http://www.cordem.org/i4a/pages/index.cfm?pageid=3406 Currently there are no openings, just recently there were several. Contact each one as soon as you see an opening.
4) If you have any flexibility over your schedule for the rest of the year, try to set up an EM rotation for the last month or two.
5) It's probably too late to secure a spot for the 2015-2016 year, unless a program doesn't fill in the match. Keep you eye on the scramble, maybe contact your medical school coordinator to help facilitate.

I hope this helps. Good luck!

 

[WilburSK]

Thanks so much! If I could go back and do it again, should I have just tried to do an EM prelim year? I feel like I am really in a bind, but I don't know how I could have done it differently.

 

[gutonc]

Thanks so much! If I could go back and do it again, should I have just tried to do an EM prelim year? I feel like I am really in a bind, but I don't know how I could have done it differently.

There is no such thing. You're not really in a huge bind (assuming you have at least a couple of people you can get SLOEs from, and a good story for why you want to switch) but it's less straightforward and simple than it would have been coming straight out of school.

 

[gman33]

Some logistics.
The majority of programs are 3 years.
Most of these places will want you to do all 3 years.
The prelim in medicine will have little overlap in rotations, maybe 1-2 months at most.
It is possible there may be an open spot somewhere, but you would not be able to come in as a pgy-2 at most places.

Most likely, you will need to go into the match looking for an intern spot for July 2016.
What you do over the next year is up to you.

Can you stay on another year at your medicine program?
If so, you may even want to consider completing 3 years in IM and doing a medicine sub-specialty.

With your stats, you should be able to get into a EM program, but it likely won't be this July.

 

[WilburSK]

Good advice. I will likely try to stay on for another year here in order to still be paid...

But I would be fine with starting as an intern for EM. I just didn't know how badly I will be hurt due to not being a US grad. If I had applied straight up, out of med school, I likely would have matched decently, I don't want to have to go to a bottom of the barrel place if I can avoid it. I didn't know if that would be the case or not.

 

[WilburSK]

I really don't like internal med, so I def don't want to do this as a career. I always like EM, almost chose it anyway. So I am willing to go through a bit of the ringer to make this work

 

[gman33]

I didn't see the non US grad part.
That will hurt a lot.
Not impossible to overcome, but a big difference.
Do not leave your current training program under any circumstances until you have matched into a new position.

 

[Apollyon]

I didn't see the non US grad part.
That will hurt a lot.
Not impossible to overcome, but a big difference.
Do not leave your current training program under any circumstances until you have matched into a new position.

Yeah, but he's an FMG that scored an ophtho spot. I'm guessing not some Caribbean turd, like me.

 

[WilburSK]

Oh sorry, I wasn't very clear. I mean that I'm not a US senior at this point. I am a US MD grad. Sorry for the confusion.

What I mean is that I likely would have matched well in EM had I done it straight out of med school. Since I am now a pgy1, I'm afraid that I'm going to end up at an undesirable spot and will have less good options altogether

 

[Cmercury1]

How did your eyesight issue come up? Did you speak with your IM PD or ophtho PD? I'm an ophtho resident, and while it's true that microsurgery requires good binocular vision, there are varying degrees of it, and there are non-surgical sub-specialties in ophtho if you think you have enough 3d vision to make it through the surgical requirements of residency (barring jeopardizing patient care, of course). Do you have enough binocular vision to examine patients at the slit lamp? How are you sure that you don't have enough vision to successfully complete residency? Have you experienced microsurgery and have you been formally tested for stereopsis? Just questions to consider before you take yourself out of the game for good. Agree with the comment to seek advice from different sources if you are truly still interested in ophtho.

 

[gman33]

Oh sorry, I wasn't very clear. I mean that I'm not a US senior at this point. I am a US MD grad. Sorry for the confusion.

What I mean is that I likely would have matched well in EM had I done it straight out of med school. Since I am now a pgy1, I'm afraid that I'm going to end up at an undesirable spot and will have less good options altogether

In that case, you will be fine.