Switching Residency Programs

[TuxedoMask]

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I'm a current PGY1 looking to get general info on how to switch programs. I looked through past threads and got semi helpful information, but i feel what's out there is incomplete.

So as backstory. I got into my top residency program and am semi-liking it, but I have huge issues with hospital culture and psychs place within it. Also I'm in a state that invests nothing in mental health which is depressing. I like my co-residents and PD/APDs, but on the ground-level, I do not enjoy working with many of my attendings and the work environments and paperwork burden are awful. I also feel like the main reasons I came have huge issues that need to be ironed out, which all of my upper levels complain of. Many of which have been issues for years now and we're not disclosed on the interview trail.

My Step scores were good and I previously had interviews at many top programs. My evals are great and i have no red flags. I also have various unique app features and programs I am participating in. I plan to keep on and hope the next rotations are good, but I'd prefer to switch if I have to after PGY1 so I can get continuity elsewhere. I also don't want to switch programs unless I know the next program is better.

My main question is, when is the best time to start inquiring about switching, ie contacting programs?

 

[tellme_areyoufree]

No helpful advice here, but I'm sorry you feel so unhappy that it requires such a drastic action :-( I hope it works out for you, and you land somewhere you'll be happy.

 

[TuxedoMask]

No helpful advice here, but I'm sorry you feel so unhappy that it requires such a drastic action :-( I hope it works out for you, and you land somewhere you'll be happy.

Thanks for the support. I'm happy with my peers and location and my partner is happy here. I just hate the work environment and systems where I am. I'd probably be more content here after year 2 when I'm on outpatient, but just want to know all my options so I'm not stuck if things don't turn out well.

 

[MedMan80]

If you do decide to move, I would say make an excuse that involves family reasons: IE: spouse needs to move due to XYZ..they pretty much cannot say no to that..

 

[TexasPhysician]

Transferring without a very good reason to a good program is not easy. You will need your PD’s blessing, LOR’s, etc. Your program may assume that you are 100% leaving and fill your pgy-2 position. If you don’t get in elsewhere, you may be stuck without a program.

 

[24blue8]

Sorry about your situation. If things may get better as an outpatient maybe you could wait it out?

Since its currently interview season, is there anything you can share with applicants that you wish, in hindsight, you had asked or been more cognizant of when you were interviewing?

 

[TuxedoMask]

Thanks for the input everyone. I just wanted to know the possibilities, so I wouldn't have regrets.

As far as advice, I would definitely ask about hospital culture and what the environment is like. Also if there are any financial obstacles to the programs promises of electives or therapy. Unnecessary scut and paperwork burden. And what on service rotation is considered the worst one and why. Don't settle for an off-service answer to this.

 

[liquidshadow22]

Thanks for the input everyone. I just wanted to know the possibilities, so I wouldn't have regrets.

As far as advice, I would definitely ask about hospital culture and what the environment is like. Also if there are any financial obstacles to the programs promises of electives or therapy. Unnecessary scut and paperwork burden. And what on service rotation is considered the worst one and why. Don't settle for an off-service answer to this.

Unnecessary scut and paperwork burden? Many programs have this. It's part of medicine. Residency sucks in general, I wouldnt tell your program unless you are aware of an opening first that is actually interested in you. It's hard to know how good any residency program is until you get there; there are always a lot of unknowns.

 

[MedMan80]

Unnecessary scut and paperwork burden? Many programs have this. It's part of medicine. Residency sucks in general, I wouldnt tell your program unless you are aware of an opening first that is actually interested in you. It's hard to know how good any residency program is until you get there; there are always a lot of unknowns.

While it's true that residency in general sucks, there is a spectrum between programs that are poorly funded and those that are well funded, the poorly funded programs tend to scut out residents and have them run services with minimal oversight..this is not malignant per-say; but certainly not a comfortable experience for any resident working there. Look for programs that are better funded, ask lots of questions about call and try to speak to spouses/family of residents (maybe during the dinners) to gauge how happy people are. That being said, being a resident you are usually a cog in a large system, and low-down on the totem pole and crap always rolls downhill..

 

[Shufflin]

Good points here, but I wish to add that even well-well-funded programs (referring to a West Coast program or 2 here) have been known to scut and dump, pushing residents over the edge (quitting or even suicide).

 

[MedMan80]

Good points here, but I wish to add that even well-well-funded programs (referring to a West Coast program or 2 here) have been known to scut and dump, pushing residents over the edge (quitting or even suicide).

Absolutely, there are shades of Gray out there but by and large funded systems have no need to run shoe string operations like programs with no money need to