I recently matched at a middle of the road university program for internal medicine in the NYC area. After doing a late fourth year rotation in EM and volunteering at an Urgent Care center for indigent patients I want to make the switch to EM. I am planning on starting and finishing my PGY-1 year in IM. I will admit that I did not pass Step 1 till my third try with a 218, but passed Step 2 on my first attempt with a 206. I did not have the greatest deans letter in the world either, but I am an American grad. First off, how can I go upon reapplying? Can I transfer into a PGY-2 spot for EM? Should I call 2-3-4 programs in EM and ask if they have open positions? Or should I just thank my lucky stars I have a residency and just let the whole thing be? Thanks for any help.