switching residency

Discussion in 'General Residency Issues' started by etinosmas, Nov 14, 2005.

  1. etinosmas

    etinosmas New Member

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    anyone here quit their residency before the year is up to pursue another one? what are the ramifications? what is the proper way to proceed?...if there is one. i don't think it's possible to continue in my current residency and also be able to look for another residency. i'd be spreading too thin. any thoughts. please help anyone who has been in this situation or knows someone who's been in the situation.
    thanks :scared:
     
  2. mackie

    mackie Senior Member
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    Well, most residencies require an intern year, so ideally you should finish this year and then transfer into a new program. But, if you're switching from medical to surgical or vice versa, I suppose it would be pointless to finish the year. Care to share your current specialty and the specialty you're planning to switch to?
     
  3. ramonaquimby

    ramonaquimby I'm a PGY3?! WHAT?!
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    this is key. we have to know before we can answer intelligently ;)
    i havene't even started my residenct yet, but likely to go into FP. i know that if i did feel the need to switch, going into ob or IM would/should be fine, for example. the nice thing is you probably won't have to go through the match. a good talk/interview with a PD may be all you need (unless it's not local).
     
  4. f_w

    f_w 1K Member
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    If you make the decision during internship to change programs, be sure to do everything above board. Medicine is a small world, if you start interviewing for open positions during the year and word gets back to your PD, it might not look so good.
    Once (if) you make the decision, go to your PD and tell him/her that you intend to pursue another specialty. Programs don't like unhappy residents, in most cases your PD will actually be helpful in getting a new position. The match only binds you for the PGY-1 year (or th PGY-2 year in advanced positions).

    As for ramifications:

    - If you don't show up for a NRMP matched position, the PD can block you from starting another NRMP matched specialty for 1 year.
    - Some PDs (or entire programs) get really personally insulted if you leave them. Once you announce your decision to leave, you have to be careful that you don't give anyone ammunition to write bad evaluations on you.
    - It is generally easier to change specialties rather than programs within a specialty. If you do FP and during internship you fall in love with GI it is easier to keep the PD on your side than if you just want to hop to a 'better' program.
     
  5. ramonaquimby

    ramonaquimby I'm a PGY3?! WHAT?!
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    good lord - please NO ONE do this. that would be awful. you really would be black listing yourself. it's never worth it.
     
  6. foster03

    foster03 New Member

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    Anyone have any thoughts on switching from path to psych? Because path has no prelim requirement I'd have to start over as a PGY1 but I could care less at this point.
     
  7. aoycute

    aoycute New Member

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    Can anyone repeat PGY1 in different specialty? How to do that?
     
  8. ramonaquimby

    ramonaquimby I'm a PGY3?! WHAT?!
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    i htnk it's definitely do-able -- the challenge is finding a program that has the money to sponsor a resident who has already used their sponsored dollars, is how i understand it. so my guess is that one would have to end up at hospital that's truly in the black and really wants to take you on as a residnet in their heart of hearts. this is why it's easier to accept switchies who've got a solid year of IM-ish or transitional-ish experience under their belts.
     
  9. 8744

    8744 Guest

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    Amen and amen. Be totally up front. And for God's sake, don't run down your program or your specialty on the interview trail. Your interviewers know you don't like the specialty you're in or you wouldn't be trying to switch. Have clear, positive reasons for the change.
     
  10. Peeshee

    Peeshee Senior Member
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    But, you are bound for the first year since you sign a contract, right? But after the first year, you definitely can switch or leave if you want before you sign the new contract. Is that correct?

    Also, for example, if you switch from FP to IM, or vice versa, would the first year count in either one?
     
  11. MM9

    MM9 Member
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    I switched. It was crazy and stressful but it all worked out in the end. I started a Peds residency but after a month or 2 I accepted what I already knew, I wanted to do PMR. I finished the year (yes it counts as my "prelim": the requirements for most, or at the very least PMR, is "6 months of Medicine, Peds, FP, or Surgery in an accredited residency"), rejoined the match, and was fortunate to match into a great program.

    To clarify the above, I am 99% certain that the rules from the NRMP are this: your matching agreement is to "sign a contract at your program". After you do this, and I suppose work a day or two, you are "free" to quit. Obviously this looks bad, really bad actually, but I do not believe that you would face any NRMP repercussions (PLEASE call the NRMP to confirm this; they are very helpful on the phone). However, DO NOT QUIT mid year unless the circumstances absolutely demand it.

    Some things I learned in the process:

    a) Finish the year. I think this is important, though I know it is hard to be somewhere you don't really want to be, but quitting looks really bad. I'm sure it happens, and people go on to have fine careers, but I would not advise it. While on interviews in my new field, I was actually complimented several times by interviewers for 'sticking it out'.

    b) Do it the right way. Start telling people from the top down, start with your PD, then your Assist PD, then Chief Residents. Definitely be positive. Next personally tell as many attendings as is reasonably possible. You'll have to work with them the rest of the year......better they hear it from you. Then tell your class, of course you can tell people you trust first, but this is big news and tends to spread fast. Everyone will respect your decision, even if they don't like it, as long as you are sincere. Your program director can be a big help in the re-applying process. Mine wrote a letter of recommendation for me and this helped tremendously.

    c) No one knows how the funding stuff works. I still don't. Not one PD or interviewer ever mentioned it. What I understand to be the case is that you are 'locked' into x number of years of funding when you match the first time. I was however, told by a chief of GME that you might be re-classified after matching a 2nd time.....I have no idea if this is true. Anyway, you do not have any control over this so, try not to worry about it.

    Good luck......PM me if you have any other questions.
     
  12. f_w

    f_w 1K Member
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  13. MM9

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    Funny, I was just coming back to post that exact link. Read that publication and look at http://www.aamc.org/advocacy/gme/ , there are some links on the right side of the page about Direct and Indirect GME funding. Basically, the years of Direct funding you are allotted is locked in when you start training, depending on the field you enter. After you use up those years, any subsequent years count as half. For purposes of the Indirect funding you always count in full and apparently this is usually a much larger amount. So the total decrease in funding the institution receives for you is no more than 40-50% (a hospital recieving little to no Indirect funding, which I don't think is possible), and probably more like 10-20% (if indeed the indirect amount is greater the direct). This is a far cry from all the people that warned me that it would be hard to match because the institution would not get paid "anything!" for me.

    Very good point f w, this is definitely something to know about to dispel the myths that are out there, especially in an interview. It would also be impressive to show you understand all this maddness.

    It was wrong of me to suggest that someone not try to fully understand the situation.
     

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