That being said, I would really appreciate hearing from others that have switched residencies how they went about it. When is a good time to tell the PD? Should I go through the match again or try to speak to hospitals individually? Any and all help would be wonderful!
The ease with which you can transfer out of one program and into another program varies by program and by specialty. Some programs, for example as in psychiatry (eg., Stanford and University of Washington), have set aside a certain number of slots for incoming PGY2 residents; some of the new PGY2's switch from other psychiatry programs whilst others switch from other specialties. The PGY2-4 cohorts at the University of Washington are populated with numerous people who formerly trained in family medicine, internal medicine, ophthalmology, obstetrics/gynecology, and surgery; some of them finished their prior residency programs whilst others finished only the PGY1 year.
That said, I don't know of any internal medicine programs that have spots set aside from incoming PGY2 transfers. If you can't locate any programs with set-aside PGY2 spots, then basically you either (1) cold-call residency programs to inquire about whether or not they anticipate having any open PGY2 spots, or (2) check various clearinghouses that post residency program vacancies. In psychiatry, for example, the APA maintains a
Web site with listings of vacant residency positions; I do not know whether there is an analogous site for internal medicine -- you may wish to do some research and check the Web sites of groups like the AMA and the ACP.
In terms of whether it will be easy to transfer out of your present program, it would be hard for anyone to make an objective assessment without more details/history. Sometimes the process can be very easy. At Duke, for example, a few years ago one of the medicine interns started thinking early on that she wanted to switch into psych, and
it just so happened that around the same time one of the psych interns was looking for a back door into the Duke medicine residency. So basically what happened is that they met with their respective program directors (medicine and psych), and then met with the program directors of the other programs (psych and medicine) -- and once the program directors signed off on the switch, they did so. I think the switch happened sometime in January. As another example, one of my friends wanted to switch out of his general surgery program near the end of his PGY2 year. It just so happened that around the same time one of the anesthesiology residents dropped out as a CA1. So my friend spoke with the anesthesiology program director, sent in his application materials, and he was accepted some time around April to start as a CA1 (so yes, his PGY2 year basically didn't count) in July.
Regardless of how the PGY2 spots are open, you generally send in your application by September, which is about the time you would apply if applying as a new intern in the regular Match. Some programs take PGY2 transfer applications through the Match process whereas others do not.
Scheduling your interviews as an intern is fraught with difficulty. The people I know who switched out of internal medicine programs basically scheduled their interviews during a clinic block and begged their attendings to look past their absences. If scheduling interviews was that difficult for my internal medicine colleagues, I can only imagine that it would be even more difficult for you as a general surgery intern.
I would recommend that you let your program director know of your intentions early on. From your program director's perspective, losing a resident is a pain in the ass, especially if the wards are resident-dependent; because then s/he will need to find a new resident to cover the quitting resident's duties. High-quality residency programs generally don't have a problem finding new residents to transfer in. But it's kind of like the global market for doctors: the U.S. poaches doctors from Canada and the U.K., Canada and the U.K. poach doctors from South Africa, and so forth. So programs at the bottom of the barrel in terms of quality tend to get the shaft. However, it can be difficult even for top programs to replace a departing PGYII, i.e., a 3-year program will need to find a new PGYIII. For example, Stanford's emergency medicine residency recently lost one of its PGYII's (who transferred out to follow her husband geographically), and they were unable to recruit a resident who would join as a PGYIII -- so last year, all of the PGYIII's had to give up their "research week" (read: under the table vacation week) because the program director needed them to cover the shifts.
Aside from the obvious reason that you should be a nice person and let your program director know as soon as possible about your intentions to transfer, there is also nothing to be gained by keeping it from your program director. You will have to let her know sooner or later. And besides, most programs will require you to provide a letter from your program director that is at least a letter of good standing ("Dr. So-and-So is a resident in our program and he hasn't been kicked out yet") or better yet is a letter of recommendation ("Dr. So-and-So is a resident in our program and I was sorry to hear that she wanted to transfer out, but I think she would be an asset to your program").
In the worst case scenario, your program director will be extremely unhappy that you have decided to transfer out, and he will be so pissy that you won't want a letter of recommendation and would prefer that he simply write a letter of good standing instead.
If you begin the process of applying to transfer, you do not necessarily have to resign your PGYII slot at your original program. Again, that may vary from program to program, but I haven't heard of it happening. But it depends on the timing. An important issue for you to consider is that around January is when residents generally sign their contracts for the PGY2 year. There is a possibility that by then you will not have heard back from the programs to which you are applying to transfer. In such a situation, you would be faced with the terrible decision: (A) sign the PGY2 contract and prematurely forfeit the opportunity to transfer out; or (B) do not sign the PGY2 contract and take the risk of not getting accepted as a transfer, in which case you will not be in any program at all come July.
-AT.