switching specialties - need PD approval?

[GrandCircle]

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So I know switching specialties has been discussed extensively on these forums...but please give me your opinion on this.

Last year I applied to 2 specialties - one very competitive, one semi (as a back-up). I didn't match in the competitive one, but did in the semi. I had always told myself that I could re-apply as a PGY1 for the competitive specialty; if it didn't work out again, at least I wouldn't lose my current spot. Although I know this is kind of unethical, I think of how often applicants can be mislead by PD's (including myself) and I feel better about it.

So my question is this - do I need approval from my current PD to apply to this separate specialty? Does he/she need to write me a LOR? Or can I just go ahead and apply - if I get in, then I'll let the PD know I'm leaving, and if I don't then I'll just stay put without saying a word.

Any opinions would be greatly appreciated, particularly from any PDs! Thanks!

 

[gutonc]

You will be expected to have a letter from your current PD stating that you are progressing well and are in good standing at your program. Without that letter, your app is nothing but one giant red flag.

 

[NotAProgDirector]

Agree with the above. In general, your app will be stronger with your PD's support.

Also:

1. You'll need time to interview. You'll probably need to go on 10+ interviews. Not sure how you were planning to hide this from your PD. Chances of interview slots falling in your vacation are slim.

2. You'll probably be required to sign a new contract before match day. This may differ between institutions. You can't sign a new contract if you're in the match -- that's a match violation (unless you're matching into an advanced match, then you could sign a 1 year contract for the next year).

 

[GrandCircle]

Thanks for the advice guys/gals. Looks like being upfront with the PD is the way to go. I've got 2 concerns though:

1. I tell the PD, go through the match, and get labeled as the person who doesn't want to be in the program if I'm not successful. That would surely make the following year(s) more difficult. Would it be unheard of for them to not offer me a contract for the next year to make room for someone who more genuinely wants to be in the program?

2. The PD is gonna be like, what the hell man? You just got here, I just interviewed you a few months ago, and you want to leave already? Gonna be one awkward conversation...

If going through these things will increase my chances of matching, I'm more than happy to do them - I just want to make sure that the benefits are worth the risks above. Thoughts?

 

[ilbb]

hi, I am in the same boat. don't know if i have to tell pd about it before I surely have the offer at hand. if I don't tell the pd, can i hide the truth that I am doing another specialty training during the interview?

 

[peppy]

Would it be unheard of for them to not offer me a contract for the next year to make room for someone who more genuinely wants to be in the program?

Well, I'm not a PD so I can't say authoritatively how they would react. Since we do sometimes see stories on this forum about residents having a bad time in residency because of a personality clash with their PD, it seems like it is certainly possible that there would be problems. If they are understanding of your situation it might not matter, but it is certainly possible that they will be offended at being "the backup plan".
The way I'd look at it is that you probably do have to take a bit of a risk here by just telling the program that you've decided it isn't a good fit and that you will be looking for a new program. I don't think you can expect to hang onto your PGY-2 spot at this current place if the match doesn't go your way.
The reason I say that is because I don't think the program would be happy if they were in limbo about whether you'll be there next year or not, since then they don't know if they need to find someone to fill that spot or not until the last minute. I think you need to decide just how strongly you feel that you need to be in a different specialty to be happy and how likely it is that you can have a stronger application this year before you take the leap.

2. The PD is gonna be like, what the hell man? You just got here, I just interviewed you a few months ago, and you want to leave already? Gonna be one awkward conversation...

Well, if it helps, think of it this way: If the tables were turned and they decided you are a bad fit with the program, they probably wouldn't avoid firing you just to avoid the awkward conversation. I would expect that you are not the first resident in the program to ever consider leaving (unless it's a very new program) and they probably won't be terribly shocked by the news.

Good luck. I know this is not an easy sort of decision.