Switching next year

[emed455]

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Hi everyone,
I did not match into Emergency Medicine this year (mostly due to changing my mind and not applying until the end of November) and scrambled into a categorical IM spot. I still REALLY want to try for EM next year. How would I go about asking for letters of recommendation next year from attendings, without those attendings going right to my Program Director (making him very angry with me)? I would try to schedule interviews during my vacation, but I think I will also be taking Step 3 at this time (required before Dec. 31st). Also, what if I apply, make my director angry with me, and then don't match again? Also, when would be an appropriate time to tell my PD that I am trying to switch? Thank you so much, everyone!

 

[dragonfly99]

Difficult situation.
Personally, I'd keep the fact that I'm applying on the down-low at least until I knew I had some interview(s). At some point, if you get interviews, you'll have to tell the PD, because I doubt you'll be able to schedule every single interview during your vacation, unless your program is much more flexible than mine was as an intern.

One thing you could do that would probably help you, would be to try and fix it so that you get an ER rotation during the 1st 6 months or so of the year. You can then tell the ER attending(s) that you are interested in ER, and try to get at least one LOR from your ER rotation. Depending on the size of your hospital, and the relationship between IM and ER attendings there, the ER docs may or may not tell the IM department what you are trying to do.

You might end up having to do an entire IM residency, and then doing ER after that...I know at least one person who has done that.

I kind of wonder why you didn't try to scramble into an IM prelim year, rather than categorical, if you are that dedicated to ER. What you did was safer for you in terms of having a full, guaranteed residency, but if you have no intentions of staying x 3 years you've sort of painted yourself in a corner vis a vis your IM program director.

 

[scab]

Can I ask what state are you in that you were able to do IM scramble?

 

[dacrocytic]

Hi everyone,
I did not match into Emergency Medicine this year (mostly due to changing my mind and not applying until the end of November) and scrambled into a categorical IM spot. I still REALLY want to try for EM next year. How would I go about asking for letters of recommendation next year from attendings, without those attendings going right to my Program Director (making him very angry with me)? I would try to schedule interviews during my vacation, but I think I will also be taking Step 3 at this time (required before Dec. 31st). Also, what if I apply, make my director angry with me, and then don't match again? Also, when would be an appropriate time to tell my PD that I am trying to switch? Thank you so much, everyone!

this is a very touchy situation I would def not tell anyone in your program, news tends to travel at the speed of light

 

[NotAProgDirector]

As DF has mentioned above, you are in a bit of a pickle.

1. You're going to try to interview during your vacation, but you'll find that's difficult. You may only get 2 weeks at a time (or some programs will give you all 3-4 weeks at once), and there is no guarantee that your vac time will be during the time you would interview at programs, and it will be very hard to schedule them all in a narrow window, and it will not be a very restful vacation which will make your internship that much harder.

2. Match day is mid March. You will be given a PGY-2 contract to sign long before then. Some PD's will let you wait until after match day to sign you PGY-2 contract if you don't match. Some will give your spot away. Signing a PGY-2 contract and then matching is a match violation (I think).

Best option is to get a spot outside the match, if at all possible.

 

[peppy]

Have you seen the blog of the poster who used to go by Panda Bear? He didn't match on his first application to EM so he scrambled into FP, then reapplied to EM and matched. He talks a bit about that here:
http://pandabearmd.com/blog/2006/03/22/the-residency-match-part-4/

So at least you know you're not the only one and it can be done.
I thought I had heard that some states allow you to take Step 3 even before starting residency. Perhaps you could investigate that option to give yourself more leeway in scheduling interviews.
I hope things work out for you!