Switching Advice

[medstudent0786]

Hey guys,

Long story short, my heart isn’t in my speciality. I’m thinking about re-applying into the speciality where my heart is for the 2021 cycle.

Spoke to my PD, was honest, and he told me today he will not be holding my spot should I fail to MATCH into new specialty.

I feel like it’s malignant of him to do so. I understand me leaving would leave an open spot in the program, but we are far from that right now. I don’t know interview season will even go and if I even will get any interviews. And if I do end up with interviews, will I even MATCH.

Should I continue on in applying?

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[Private_MD]

Hey guys,

Long story short, my heart isn’t in my speciality. I’m thinking about re-applying into the speciality where my heart is for the 2021 cycle.

Spoke to my PD, was honest, and he told me today he will not be holding my spot should I fail to MATCH into new specialty.

I feel like it’s malignant of him to do so. I understand me leaving would leave an open spot in the program, but we are far from that right now. I don’t know interview season will even go and if I even will get any interviews. And if I do end up with interviews, will I even MATCH.

Should I continue on in applying?

Depends - without more info we can't advice. What did you match into and what are you trying to match into? It's not malignant to try to match a spot. you are voluntarily giving up your spot, no one seems to be firing u. leaving a spot open has ur classmates doing more work which i can assure you is not going to be fun for them.
so if you are going from less competitive to more competitive - be aware. if the other way - perhaps more of a chance.

 

[medstudent0786]

Depends - without more info we can't advice. What did you match into and what are you trying to match into? It's not malignant to try to match a spot. you are voluntarily giving up your spot, no one seems to be firing u. leaving a spot open has ur classmates doing more work which i can assure you is not going to be fun for them.
so if you are going from less competitive to more competitive - be aware. if the other way - perhaps more of a chance.

IM to OB.

And I completely understand his reasons, as I highlighted in my OP.

I just feel like it’s way to early for him to ask me to make a choice.

I don’t even know right now if I will get interviews.

I don’t understand from his end, why we can’t just reassess the situation later on, and why not even in March?

Should I get interviews and MATCH, he would still have from March to June to find a replacement for me. Which I personally feel is ample time.

I just don’t understand why he asked me to make a choice today, solely because I asked for an LOR.

 

[aim-agm]

I don’t understand from his end, why we can’t just reassess the situation later on, and why not even in March?

Should I get interviews and MATCH, he would still have from March to June to find a replacement for me. Which I personally feel is ample time.

I just don’t understand why he asked me to make a choice today, solely because I asked for an LOR.

Some reasons the PD would take this approach:

If he is taking an applicant through the Match he can fold the recruitment process into the PGY1 recruitment.

3 months is not a long time to put out recruitment notice, accept applications, interview, evaluate and accept people on the front end, and on the back end the position needs to be budgeted, on-boarded, paperwork etc.

The pool of candidates he will have to choose from after the match is those who decided to switch specialties late (after October) and those who failed to match, which is a less desirable population than the people who are applying to the match.

There are others. It's not anything overwhelming but it would require significantly more work, stress, and uncertainty on the programs end.

 

[medstudent0786]

Some reasons the PD would take this approach:

If he is taking an applicant through the Match he can fold the recruitment process into the PGY1 recruitment.

3 months is not a long time to put out recruitment notice, accept applications, interview, evaluate and accept people on the front end, and on the back end the position needs to be budgeted, on-boarded, paperwork etc.

The pool of candidates he will have to choose from after the match is those who decided to switch specialties late (after October) and those who failed to match, which is a less desirable population than the people who are applying to the match.

There are others. It's not anything overwhelming but it would require significantly more work, stress, and uncertainty on the programs end.

That makes sense to me. But assuming that I leave my position, it leaves an open PGY-2 position essentially (since I’m to finish out the year). And so I would assume filling that (due to less number of applications and candidates) would be possible in a span of March to June (vs. a PGY-1 spot that has hundreds to thousands of applications).

 

[smq123]

IM to OB.

And I completely understand his reasons, as I highlighted in my OP.

I just feel like it’s way to early for him to ask me to make a choice.

I don’t even know right now if I will get interviews.

I don’t understand from his end, why we can’t just reassess the situation later on, and why not even in March?

Should I get interviews and MATCH, he would still have from March to June to find a replacement for me. Which I personally feel is ample time.

I just don’t understand why he asked me to make a choice today, solely because I asked for an LOR.

While I understand why you're upset, what your PD is doing is quite common. Basically once you decide to apply to another specialty, you run a very real risk that you will end up with nothing - no spot in your new specialty, and you will have forfeited your old spot.

3 months actually isn't a tremendous amount of time to find a replacement and get their paperwork completed and in with the GME office, for starters. Furthermore, your PD may just not see the point in continuing to train someone who, as you said, does not have their heart in the specialty.

 

[Private_MD]

IM to OB.

And I completely understand his reasons, as I highlighted in my OP.

I just feel like it’s way to early for him to ask me to make a choice.

I don’t even know right now if I will get interviews.

I don’t understand from his end, why we can’t just reassess the situation later on, and why not even in March?

Should I get interviews and MATCH, he would still have from March to June to find a replacement for me. Which I personally feel is ample time.

I just don’t understand why he asked me to make a choice today, solely because I asked for an LOR.

finding someone reasonable takes time. dosen't just happen overnight. waiting until march is not reasonable.

 

[phantomlimb]

OP make sure you are 100% sure you want to switch to OB before you make this decision. As a current OB resident, I will say that it has honestly gotten MUCH more competitive recently, I have multiple friends who were great candidates who did not match last year from a mid tier MD school even with great board scores, grades, totally normal great people with longstanding commitment to the field, have heard similar stories from my co-inerns. You are already starting at a big disadvantage having to explain why you want to switch to a completely different field after starting another residency (I would argue that IM and OB are at complete opposite ends of the spectrum in terms of patient population, type and pace of work), especially if you are being compared to applicants who were committed to the field early on. OBGYN is a small field compared to IM (many programs have only 4-6 residents per year), so there are a lot fewer opportunities in terms of the match process. I don't want to fully discourage you because OB is awesome and I wish you all the best with the switch but even if you are a great candidate I would consider applying to a backup specialty (something like FM or even anesthesia if that appeals to you) if you will truly lose your job entirely just by applying.

 

[aim-agm]

That makes sense to me. But assuming that I leave my position, it leaves an open PGY-2 position essentially (since I’m to finish out the year). And so I would assume filling that (due to less number of applications and candidates) would be possible in a span of March to June (vs. a PGY-1 spot that has hundreds to thousands of applications).

I transferred specialties from this past year. It's a bit much to explain to the ins-and-outs but suffice it to say it is far more difficult on the program to do it your way. It is not useful to continue to debate this, it is a fact.

If you have an OB program at your institution then it would be a good idea to reach out to them and discuss. Maybe they can help advise you on your specific situation.

Another thing to remember in this journey is:
Being a doctor in your desired specialty>Being a doctor>>>>>>not being a doctor
It sounds like you'll be running a risk of not being a doctor if you try to go for OB, so make sure it is worth the risk and that the risk is minimal.

 

[Private_MD]

IM to OB.

And I completely understand his reasons, as I highlighted in my OP.

I just feel like it’s way to early for him to ask me to make a choice.

I don’t even know right now if I will get interviews.

I don’t understand from his end, why we can’t just reassess the situation later on, and why not even in March?

Should I get interviews and MATCH, he would still have from March to June to find a replacement for me. Which I personally feel is ample time.

I just don’t understand why he asked me to make a choice today, solely because I asked for an LOR.

Granted that I highly dislike OB - but I would not switch from IM to OB. I take it you are in your first year of IM? IM first year blows for everyone. IM has a lot of opportunities - for fellowships, for non clinical options in the future if you ever went that route, for leadership positions, etc.
OB from my experience tends to be on the more malignant side, you will start from scratch, high liability and I guess as others OB posters have mentioned competitive. So your PD has been upfront with you and honest and teling u that he/she will start looking for someone. If I were in ur position i would not risk it.
You might not match into OB. Why OB? Why the sudden interest? Don't let the frustration of maybe a rough year/rotations make you desperately go in a direction you might regret.
Switches can be successful (I switched and I'm very happy I did. ) But you also risk not ending up with anything and as OB posters mentioned OB is a much smaller field - so what if you don't match? Are you willing to sit out and have to re-apply again? That seems like torture.

 

[smq123]

Hey guys,

Long story short, my heart isn’t in my speciality. I’m thinking about re-applying into the speciality where my heart is for the 2021 cycle.

Spoke to my PD, was honest, and he told me today he will not be holding my spot should I fail to MATCH into new specialty.

I feel like it’s malignant of him to do so. I understand me leaving would leave an open spot in the program, but we are far from that right now. I don’t know interview season will even go and if I even will get any interviews. And if I do end up with interviews, will I even MATCH.

Should I continue on in applying?

Granted that I highly dislike OB - but I would not switch from IM to OB. I take it you are in your first year of IM? IM first year blows for everyone. IM has a lot of opportunities - for fellowships, for non clinical options in the future if you ever went that route, for leadership positions, etc.
OB from my experience tends to be on the more malignant side, you will start from scratch, high liability and I guess as others OB posters have mentioned competitive. So your PD has been upfront with you and honest and teling u that he/she will start looking for someone. If I were in ur position i would not risk it.
You might not match into OB. Why OB? Why the sudden interest? Don't let the frustration of maybe a rough year/rotations make you desperately go in a direction you might regret.
Switches can be successful (I switched and I'm very happy I did. ) But you also risk not ending up with anything and as OB posters mentioned OB is a much smaller field - so what if you don't match? Are you willing to sit out and have to re-apply again? That seems like torture.

After looking up the OP's post history, it appears that he/she had applied for OB two years ago and didn't match.

Last year, the OP applied for OB, with an IM back up, Still didn't match into OB, managed to match into IM.

OP - don't push your luck. Be grateful for what you got. It is highly highly unlikely that you will successfully match into OB the third time around, after failing to match into OB/gyn twice. Trying again would be a terrible gamble, especially since your PD told you that he will not save your spot.

Try and figure out what you like about OB. If it's just women's health advocacy and reproductive health - you can arrive at those through IM. You do not have to be an OB/gyn to care for women. If it's c-sections and deliveries, try switching into FM (a far easier transition) and then try for an OB fellowship that will grant you c-section privileges. But trying to match into OB again, for the third time, when you know that means losing the IM spot that you do have, is a terrible decision and incredibly risky. I understand that your dream was to be an OB/gyn but, unfortunately, it is time to let that dream go.

 

[rokshana]

Hey guys,

Long story short, my heart isn’t in my speciality. I’m thinking about re-applying into the speciality where my heart is for the 2021 cycle.

Spoke to my PD, was honest, and he told me today he will not be holding my spot should I fail to MATCH into new specialty.

I feel like it’s malignant of him to do so. I understand me leaving would leave an open spot in the program, but we are far from that right now. I don’t know interview season will even go and if I even will get any interviews. And if I do end up with interviews, will I even MATCH.

Should I continue on in applying?

This is not unusual...you really can’t expect them to wait til March to see if you match elsewhere...they are not being vindictive...they are reacting i their best interest...
You have the choice of either trying to change specialties and take the risk of not matching or staying where you are...you can’t have it both ways...

 

[rokshana]

IM to OB.

And I completely understand his reasons, as I highlighted in my OP.

I just feel like it’s way to early for him to ask me to make a choice.

I don’t even know right now if I will get interviews.

I don’t understand from his end, why we can’t just reassess the situation later on, and why not even in March?

Should I get interviews and MATCH, he would still have from March to June to find a replacement for me. Which I personally feel is ample time.

I just don’t understand why he asked me to make a choice today, solely because I asked for an LOR.

Because that’s not ample time...he needs to know now...during interview season if he needs to interview for someone to take your spot...he will get better candidates than trying to soap for someone later.
You are either being selfish or obtuse.

 

[StIGMA]

You would be more competitive as an OBGyn applicant if you finish IM. That may be the thing that gets your foot into an OBGyn program. At least consider that.

 

[medstudent0786]

Thank you everyone for taking the time out to reply!

I have both read and heard of residents in the same position as myself, who chose to reapply and have supportive PDs who do hold their spot. However, I do realize that this kind of kindness should not be expected.

I realized after writing my OP, that CREOG and APGO have a different timeline this year which basically gives a final status to applicants by December 23rd latest (and interview invites are sent on Nov. 10th and 17th).

I would hope that if not March, at least November or December would be a reasonable deadline for me to officially decide on if I want to stay in IM and at my program or not.

However, and like you all have pointed out, the program will at the end of the day look out for itself. These are the cards I’ve been dealt, and so I do need to reach a decision.
Thank you to everyone!

 

[medstudent0786]

You would be more competitive as an OBGyn applicant if you finish IM. That may be the thing that gets your foot into an OBGyn program. At least consider that.

Someone else actually told me this as well, actually considering it! Thank you!

 

[medstudent0786]

After looking up the OP's post history, it appears that he/she had applied for OB two years ago and didn't match.

Last year, the OP applied for OB, with an IM back up, Still didn't match into OB, managed to match into IM.

OP - don't push your luck. Be grateful for what you got. It is highly highly unlikely that you will successfully match into OB the third time around, after failing to match into OB/gyn twice. Trying again would be a terrible gamble, especially since your PD told you that he will not save your spot.

Try and figure out what you like about OB. If it's just women's health advocacy and reproductive health - you can arrive at those through IM. You do not have to be an OB/gyn to care for women. If it's c-sections and deliveries, try switching into FM (a far easier transition) and then try for an OB fellowship that will grant you c-section privileges. But trying to match into OB again, for the third time, when you know that means losing the IM spot that you do have, is a terrible decision and incredibly risky. I understand that your dream was to be an OB/gyn but, unfortunately, it is time to let that dream go.

I’ve actually looked into a women’s health fellowship via IM. Didn’t find that many, but I will continue to ponder this option, thank you!

 

[medstudent0786]

OP make sure you are 100% sure you want to switch to OB before you make this decision. As a current OB resident, I will say that it has honestly gotten MUCH more competitive recently, I have multiple friends who were great candidates who did not match last year from a mid tier MD school even with great board scores, grades, totally normal great people with longstanding commitment to the field, have heard similar stories from my co-inerns. You are already starting at a big disadvantage having to explain why you want to switch to a completely different field after starting another residency (I would argue that IM and OB are at complete opposite ends of the spectrum in terms of patient population, type and pace of work), especially if you are being compared to applicants who were committed to the field early on. OBGYN is a small field compared to IM (many programs have only 4-6 residents per year), so there are a lot fewer opportunities in terms of the match process. I don't want to fully discourage you because OB is awesome and I wish you all the best with the switch but even if you are a great candidate I would consider applying to a backup specialty (something like FM or even anesthesia if that appeals to you) if you will truly lose your job entirely just by applying.

Solid advice! Thanks for taking the time out! Truly appreciate it!

 

[Private_MD]

Dude doing 7 years of residency is insane - don't do it.
Spending your whole life training will only make you miserable.
you ultimately decide what to do - but trust me when i tell you that continuing to train endlessly will not be a good choice. think about you are about to finish IM and then you go into another 4 years of OB - and start as an intern all over again? yikes. Not to mention the massive amount of $ you'd lose by wasting another 4 years of your life training again. Just a thought. Good luck in whatever you decide.

Someone else actually told me this as well, actually considering it! Thank you!

 

[medstudent0786]

Dude doing 7 years of residency is insane - don't do it.
Spending your whole life training will only make you miserable.
you ultimately decide what to do - but trust me when i tell you that continuing to train endlessly will not be a good choice. think about you are about to finish IM and then you go into another 4 years of OB - and start as an intern all over again? yikes. Not to mention the massive amount of $ you'd lose by wasting another 4 years of your life training again. Just a thought. Good luck in whatever you decide.

Again, thanks for taking the time out for solid advice! I’ll say this - should I continue to stick to IM, I’ll definitely assess how I feel when I’m an attending.
Maybe I will eventually end up loving it. Maybe I still won’t like it but I’ll be able to treat it as a job and find fulfillment outside of it so much that I won’t be miserable anymore. Or maybe I’ll be miserable and the rare breed that doesn’t mind re-training in a field I’ve been passionate about since I was a teenager. Who knows!

We have an ED resident now who after being an IM attending for years, decided it wasn’t for her, and being miserable wasn’t worth it.
Regardless, I did start the year off positively and did try to immerse myself into IM. Perhaps it’s just the pressures of intern year getting to me. Maybe I’ll end up loving it, or at least being able to bear it.
The last two years have definitely been a huge upset to me, unfortunately. But I know I’m not the only one out there dealing with such predicaments. And so again, thank you for taking the time out of your busy schedule to advise and guide a random stranger like myself! Much appreciated!

 

[anonperson]

IM to OB.

And I completely understand his reasons, as I highlighted in my OP.

I just feel like it’s way to early for him to ask me to make a choice.

I don’t even know right now if I will get interviews.

I don’t understand from his end, why we can’t just reassess the situation later on, and why not even in March?

Should I get interviews and MATCH, he would still have from March to June to find a replacement for me. Which I personally feel is ample time.

I just don’t understand why he asked me to make a choice today, solely because I asked for an LOR.

Don't do it.

You have a residency spot. Just finish and do an IM fellowship if desired. It sounds like you had a tough time matching into this spot even. Do you really want to risk not matching and having no spot?

I am a practicing OB GYN. The job is ok. Anyone who says it is amazing hasn't been in practice and is protected in training. My partners are great and I enjoy working with them immensely but the field in general is challenging.

Reimbursement continues to get slashed while acuity goes up. I know this is occurring in every specialty.

 

[medstudent0786]

Don't do it.

You have a residency spot. Just finish and do an IM residency if desired. It sounds like you had a tough time matching into this spot even. Do you really want to risk not matching and having no spot?

I am a practicing OB GYN. The job is ok. Anyone who says it is amazing hasn't been in practice and is protected in training. My partners are great and I enjoy working with them immensely but the field in general is challenging.

Reimbursement continues to get slashed while acuity goes up. I know this is occurring in every specialty.

I had a hard time getting into OB for two cycles but had a very high success rate with IM and got a ton of interviews, when I did apply.

That being sad, thank you for your honest advice as a practicing Ob/Gyn. This does bring insight on the cons of the field.

 

[candbgirl]

I had a hard time getting into OB for two cycles but had a very high success rate with IM and got a ton of interviews, when I did apply.

That being sad, thank you for your honest advice as a practicing Ob/Gyn. This does bring insight on the cons of the field.

Wait- you applied two cycles to OB and didn’t match?

 

[Gastrapathy]

Lots of good advice on this thread. You applied IM as a backup (which was obvious to your PD when he ranked you so it’s not surprising he’s not thrilled to have to fill your slot). His response is hardly “malignant” but...if you do decide to finish the program, you’ll need to be on your best behavior from here.

 

[NotAProgDirector]

Other poster's experiences may have had different circumstances. We currently have a resident looking for a possible career change. It turns out that for completely unrelated reasons, we are already up an extra resident. So we are giving them the luxury of trying to match and holding their spot -- since we wouldn't refill it. But we we didn't have this cushion we would probably do the same.

Your contention that they could just fill the spot in March isn't exactly correct -- they need a PGY-2 to fill your shoes, and the good ones are getting spots before January.

 

[medstudent0786]

Other poster's experiences may have had different circumstances. We currently have a resident looking for a possible career change. It turns out that for completely unrelated reasons, we are already up an extra resident. So we are giving them the luxury of trying to match and holding their spot -- since we wouldn't refill it. But we we didn't have this cushion we would probably do the same.

Your contention that they could just fill the spot in March isn't exactly correct -- they need a PGY-2 to fill your shoes, and the good ones are getting spots before January.

This makes perfect sense! Thank you!