Switching Fellowship Specialties Outside the Match?

[anon12380]

Hello,

I matched into a fellowship in my backup subspecialty. Recently, a new program in my desired subspecialty began accepting applications for an out-of-match position. I’ve already submitted my CV, and the program has requested additional documents and indicated they plan to interview me in the coming weeks.

I’ve received strong informal reassurance that my current fellowship PD would be supportive if I pursued this alternative opportunity, as they have other internal candidates that they would like to bring in (he inferred this). To put it another way, they would let me go. That said, I’m trying to clarify the formal process. Specifically, would I need to go through the NRMP waiver process in this situation, or could I technically resign from the matched program on July 1 if I receive an offer from the out-of-match position? Or could I simply not go at all? Would I or the newly accredited fellowship program in my desired specialty suffer any consequences?

I would be very grateful for any insight or guidance!!

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[gutonc]

You and your matched program could request a waiver. Or you could do your NRMP mandated 45 days and resign and then start the new program, with your matched program picking up a new fellow at the 45 day mark). The first option is more "right" but will take longer. The second option leaves all 4 parties (the two programs and 2 new fellows) in the lurch for a month and a half. I can see a 3rd way where all 4 parties are in agreement and just "make it happen" and ignore the NRMP. But I suspect that there are risks there for everyone involved too.

The wisdom of @NotAProgDirector would be greatly appreciated here.

 

[anon12380]

You and your matched program could request a waiver. Or you could do your NRMP mandated 45 days and resign and then start the new program, with your matched program picking up a new fellow at the 45 day mark). The first option is more "right" but will take longer. The second option leaves all 4 parties (the two programs and 2 new fellows) in the lurch for a month and a half. I can see a 3rd way where all 4 parties are in agreement and just "make it happen" and ignore the NRMP. But I suspect that there are risks there for everyone involved too.

The wisdom of @NotAProgDirector would be greatly appreciated here.

Thank you for the response 🙂

If I request the Waiver and my program writes documentation in support, is there any chance the NRMP says no (even if it does not meet one of their stated qualifications, like switching before January 15)? I also read their Waiver policy, and it seems I would have to technically request the Waiver first, but I do not want to do that since I have not been formally offered an out-of-match fellowship spot. The condensed timeline is also difficult to consider, but again, I honestly think my current fellowship program would not care if I do not show up in the first month since a) the fellowship is small and fellows are not essential to the workings of the department, and b) the first month is orientation.

In an ideal world, I interview, I get offered a spot, I request a Waiver, and while undergoing the onboarding with my new fellowship, I get the Waiver Request approved by NRMP. In the event NRMP denies the request, I would violate it by not attending, and then I cannot participate in NRMP again (not sure what would happen to the new program ,assuming they were unaware of everythin,g as would be my preference)

It's not that I dislike my current fellowship either, so going there on July 1st is still tolerable. This is more of a "shoot my shot" opportunity, but the consequences are difficult for me to predict.

 

[NotAProgDirector]

This situation is a complicated mess for the match.

Sure, your ideal plan is to get a new spot before resigning your current spot. Totally understand. But it's a match violation. You agreed, when you signed the match agreement, not to do that. So, when you submit your waiver, they may be upset that you've already hunted for a new spot. Regardless, likely nothing will come from this. Submit the waiver, and just start your new program on July 1. Your only risk is that the NRMP might ban you from the match going forward - not a problem if this will be your last training. Technically they could block this new program from using the match for this, but they won't do that.