Switching Residency Programs

[Ronald]

Has anyone out there switched programs during residency?

Here's my story. I'm interested in Internal Med and Family Practice. But i'm not 'sure' sure. I might want to change programs or even SPECIALTY after PGY-1. How does that work and is there anything one should be careful about or look out for? (like the wrath of the program director

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[Winged Scapula]

In addition to "wrath of PDs" please consider issues with HCFA funding. When you start a residency program you are funded through HCFA for x number of years (ie, whatever the length of that particular residency is). This can become a problem if you swtich to a longer residency when you have been funded for a shorter period of time or have to repeat a year (ie, if you were funded for IM then decided to switch to a Surgical specialty which would require longer period of funding as well as repeating your PGY1 year as a Surgical intern). Some programs will not look at candidates who do not have full funding; others will assess on a case-by-case basis.

As for the difference between IM and FP, I'm sure you've looked at both fields in depth. Do you really want to focus on adults and inpatient medicine or do you want to treat the entire age spectrum and largely in an outpatient arena? These are the major differences IMHO. If you absolutely cannot make a choice, consider taking a year off or doing a Prelim year instead of starting a program with a high probability of dropping out.

 

[Ronald]

Kimberli,

Thanks for the advice. I wasn't aware about HCFA funding restrictions. I'll take that into consideration before making a decision.

I have heard that prelim med yr and TY programs are very competitive and difficult to match into. How difficult is it for a Non-US grad to match into a TYP or Prelim pr vs. a categorical program?

 

[Winged Scapula]

Hi Ronald,

As I'm not an IM resident I would not be the best source of competitiveness of Prelim and TY spots. I do know that the Prelim Surgery spots aren't very competitive and are often filled by IMGs (for the obvious reason that if you have a choice to do either a Medicine or Surgical Prelim most would wisely choose Medicine).

I suggested these tracks as backups should you not make up your mind before the match. They can get you into trouble with HCFA funding again should you choose a program which doesn't allow you credit for your intern year (say spent as a IM Prelim or TY).

If you absolutely cannot make up your mind, remember that you are not required to apply right after graduation. While there are restrictions on number of years between Step 1 and Step 3 and some programs prefer candidates who are less than 3 years from graduation, you can probably fairly easily take a year off to do research, etc. while making up your mind.

Best of luck to you.

 

[Ronald]

Thanks Kimberli. Really appreciate your advice.