Switching specialty: NRMP waiver

[Ams84]

Hello everyone, I'm seeking some advice regarding this particular situation in terms of requesting NRMP waiver. I'm an IMG on a J1 Visa currently doing a PGY1 transitional year. My goal was to match into a PGY2 Radiology, but unfortunately, that did not work and it has been my dream to pursue this specialty. Briefly, I thought feedback and I've been unlucky with the process since I have no red flags (scores, research, letters, rotations) and mainly it came down to my IMG background. Instead, I SOAP'ed into a PGY1 family medicine residency, to be eligible to continue my training in the US and not return to my home country. I signed the contract and started with the ECFMG process to transition. Recently, a new PGY2 advanced Radiology position became available is seeking to fill up the spot.

The reason why I'm reaching out is that this is my only opportunity to pursue a career in Radiology, which is my dream specialty. Unfortunately, I cannot wait to finish my family medicine and then reapply because ECFMG will not sponsor a J1 VISA for a second residency. Also, I cannot switch specialties once I start the FM residency because ECFMG only allows for one specialty switch, which is the switch I'm making from the Transitional year to Family Medicine or Radiology (if I can make this switch).

My program director at the new FM program knows about my career aspirations and goals and is willing to support my transition to the Radiology residency if I'm offered the position. Therefore, I would like to look into these questions to prepare for potential scenarios:

1) I want to confirm that an NRMP waiver is needed in this case and under which subcategory it should be submitted. I believe it might be a change of specialty.
2) If the NRMP denies it. What are the repercussions of violating the match contract besides not being able to apply to the match if I take the offered position? Could I still accept the position if it's outside the Match?

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[NotAProgDirector]

This is a situation which the match has no good solution. And IMHO, needs to be addressed.

You won't qualify for a change in specialty waiver. Those need to be requested prior to Jan 15, so are only for Advanced matches. There is no approved reason "a new position in the field I am interested in has opened up". Neither is there an approved reason for "A position in a better geo location in my chosen field has opened unexpectedly". So you can ask the NRMP and see what they say. A problem is that the process may take some time -- weeks perhaps.

If you do take the spot anyway, the NRMP may block you from using the match again for some period of time. Not a problem, unless the subs in rad are in the match -- some chance you'd be unable to apply for them in the future. Theoretically, they could also declare your rads program as violating the match, and prevent them from using the match at all to fill any positions for some period of time. But they rarely do that, as it ends up hurting students also.

 

[Ams84]

This is a situation which the match has no good solution. And IMHO, needs to be addressed.

You won't qualify for a change in specialty waiver. Those need to be requested prior to Jan 15, so are only for Advanced matches. There is no approved reason "a new position in the field I am interested in has opened up". Neither is there an approved reason for "A position in a better geo location in my chosen field has opened unexpectedly". So you can ask the NRMP and see what they say. A problem is that the process may take some time -- weeks perhaps.

If you do take the spot anyway, the NRMP may block you from using the match again for some period of time. Not a problem, unless the subs in rad are in the match -- some chance you'd be unable to apply for them in the future. Theoretically, they could also declare your rads program as violating the match, and prevent them from using the match at all to fill any positions for some period of time. But they rarely do that, as it ends up hurting students also.

Thank you so much for your response. So this is a new Rad program that got accredited after the match so they did not participate in the NRMP this year, I'm assuming they plan on doing so in the coming match. What about ECFMG and J1 visa sponsorship, can the NRMP prevent ECFMG from sponsoring J1? I read they could inform them about the violation.

 

[NotAProgDirector]

Thank you so much for your response. So this is a new Rad program that got accredited after the match so they did not participate in the NRMP this year, I'm assuming they plan on doing so in the coming match. What about ECFMG and J1 visa sponsorship, can the NRMP prevent ECFMG from sponsoring J1? I read they could inform them about the violation.

I don't know. You're correct that you're allowed only one change of specialty, prior to the end of your PGY-2.