Terminating an Early Match Contract

[ENTspot12]

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So let's say that i matched early for ENT, but the place was #16 out of 18 on my list. I was lead to believe i would be matched much higher by some corrupt PDs, but that's another issue. Anyway, this place is in the middle of no where, is not a strong program, and in no way would i be happy completing my residency there. I am married to another MS4 with a child and both our families are here and very supportive of us - it would be tough to leave all this, although i'm sure some people would. So yes, i mean to say that if "forced" to start my residency there, i would drop out after a month or after completing my intern year, leaving the program screwed.

Well, i am considering terminating the contract now and going for gen surg through the NRMP match since i applied and interviewed at a number of programs that i would be happy at. I wasn't even going to rank this place, but in the end put it in and figured it would never come to that. Location is a huge thing for me, and i would just not be happy for 5 years at this program - maybe my priorities are f-ed up, but each person leads their own life and has their own needs. Plus, this will give make for an opportunity for someone else to match there, for the program to have a dedicated/happy resident for 5 years, and for me to do what i need to do. I figured i'd contact the PD and tell him of my intentions - i feel that he would not want to keep a resident there who did not want to be there, especially when he could fill the spot with someone who would be happy and work hard for him.

I have spoken to my dean and he is not being very helpful. Just wondering if anyone else here has done anything like this, or knows of someone who has. A course of action would be nice.

Please, no responses saying "well you shouldn't have put places on your list that you wouldn't be willing to go to" or anything to that effect. I'm just looking for some input that someone may have on the situation. I am tired and cranky and don't need anyone pointing fingers, saying "i told you so" - that is not helpful, and i don't need to be lectured by anyone from this board.

Also, please do not ask me where i go to school, or which residency program will have an ENT position open should i decide to go through with this.

 

[Been there]

This actually happen to a buddy of mine. He matched at a urology program that he doesn't like, and therefore he did what you want to do. He too was a stellar applicant. He tried to match again in urology the following year, but found out from our urology chair that he is "black listed". He was told no-one in the field will take you without alienating the program, which will hurt all students from our school in the future matching in urology.

Here are your solutions:

1) You can terminate the contract if you do not want to be an ENT. The chances that another program will take you is very slim. Since you already matched in ENT, I think you will not be consider for the gen match, but you can scramble for a spot afterward (the best geographic location would be for prelim spots). You can now re-apply for anything except for ENT the following year, or the gen surg program you were at gives you a categorical position as a secong year.

2) Don't terminate your contract and try to transfer out as soon as you get there (keep this on the down low...otherwise, they might kick your ass). Let all your outside ENT buddies know, you want to transfer. That way when a position opens up, you can be the first to apply for it. Many people transfer programs for many reasons including geographic locations. It may not happen in the first year, but you might be able to do it in another year (keep your in service score in the >80%tile). This way you will still be an ENT when you finish.

3) Go there and just try it out, it might change your mind about the place.


I personally would go for solution #2 (that is just my 2 pennies)

Oh yeah, my buddy actually became an ENT-- good luck

 

[ENTspot12]

Thanks for the advice, i figured this can't be that rare of an occurence that no one would have done this before. I realize that i will be black listed from ENT programs for the future. I would be happy going into gen surg anyway (want to go into facial plastics, if that means gen then plastics, then fine by me, so long as i am able to stay in my geographic location). I would actually be happy doing a gen surg residency, but liked ENT a little more.

I got a number of gen surg interviews in my location, so what is the problem with terminating the ENT contract and going through NRMP? What if i didn't terminate my ENT contract and then waited to see what would happen with the NRMP (i wouldn't do this, i'm just presenting it as a hypothetical) - since my application is all in (through eras) all i have to do at this point is submit a rank list to the nrmp. I'm not sure if SF match would tell NRMP, and block me from matching. Therefore, would i need to get a termination of contract letter from the residency i matched with and send that to the SF Match? Would that fix all my problems and give me a clean slate to submit my NRMP list for Gen Surg?

ARGH!!!!!!!!!!!!!!!! Why can't my f-n dean's office just help me out a little - i realize they don't want to be considered a med school that aids in this sort of thing, but someone out there has gotta know something.

 

[mpp]

Have you tried contacting the NRMP ((202) 862-6077) to see what their rules are regarding this? You're right, it's probably been done before. Ask them and find out if you are still eligible for the NRMP match.

 

[ENTspot12]

Well, i tried calling them and they wouldn't give me a straight answer. They said that they get a match list from the AOA (osteopathic match) and Military Match, and then remove applicants from the NRMP. They said they do not cross-reference with the SF match or the AUA match. So can i just apply through the nrmp and see what happens? My dean told me i may need to take legal action and get a lawyer in order to take care of this - seems kind of ridiculous when a letter from the chair to end the contract should seem like enough. I asked the NRMP if it would be ok if i faxed them the letter - then would i be able to apply through NRMP like a "normal" applicant? They said that they would review the situation and couldn't make me any promises. I asked what they did in past situations like this and in what situations did they allow someone to apply after matching in an early match - the woman said she had no prior knowledge of these situations and each case would be handled individually. I asked to speak to a manager, and she said that she was the person i needed to speak to and no one else could help me out.

So i turn to you, my fellow medical colleagues. Someone must have some knowledge of a similar previous situation. Please ask your friend(s) what they did if they were in this position. Any help would be greatly appreciated.
ARGH!!!!!!!!!!!

 

[Seaglass]

By matching through the early match you have entered into a legally binding contract. Breaking that contract is a legal action and will require a lawyer. If the NRMP matches you, they are breaking their contract with other NRMP match participants vis-a-vis their promise to only match qualified applicants (which you are not). So yes, you need a lawyer.

I mean, really, you are in breach of contract, and that's an issue for a lawyer. You can't just "decide" that you don't want to honor your contract anymore, if you could then what's the purpose of the contract. That's why you're not supposed to rank places you are not willing to go to.

Casey

 

[ENTspot12]

Now, i thought that i told you not to go pointing fingers and telling me what i should have done.

I am attempting to solicit information here. As i mentioned in my very first post, i realize it is a legal contract and on that premise would ask the PD to break that contract and then go about applying through the NRMP. They would not be in any violation as i will not be bound to another contract. Seems legal to me if the PD agrees.

I am just seeking out what, if anything, others did in this situation.

 

[doc05]

you really ought to get a lawyer, because this sort of thing can get real ugly. Do what you can to get out of the contract so that you can send your rank list into the NRMP.

I am not surprised that your dean's office isn't helpful - don't take it personally, they don't want to get involved because it could mean screwing over future applicants at ENT programs.

p.s. you shouldn't have ranked the program in the first place!

 

[edfig99]

hey ENT...

well looking at the lingo in the ENT match application, it is a binding contract (which everyone is agreement, there's no question about that). Because you already have matched you cannot participate in the NRMP -- at least from one of the clauses in there, though the NRMP doesn't solicit SF match details, the SF Match can (and probably does) provide the NRMP with their match results, and so going through the NRMP without being released from your SF match is impossible.

It does state you may be released with a letter from a PD, and that can serve as your proof that you have no other binding obligation and allow you to participate in the NRMP.

You have to speak to the PD and see if they'll get a letter out to you. Get them to not only agree on phone, but put it in writing -- letter, not email. a faxed letter is okay while you wait for an original. If not, then you need to proceed through legal channels. Programs aren't stupid - they'll break a match rather than letting a resident leave after starting. if there is too much attrition in a program it can threaten accreditation, so there is incentive for the program to release you prior to starting. you'll probably never work in ENT, but you're aware of that.

if you get your release letter, and you interviewed at a few categorical gen surg residencies, then you can go through the NRMP. just don't (and i know you know this already) don't rank anywhere you would not want to be...you're better off going unmatched and scramble for a local spot (at least, that's how it seems to me.)

p.s. you should harass your dean's office -- irrespective of whether they help you or not, the school's already gonna be on a ****list so it doesn't matter. their commitment should be to you right now. if you end up going through legal channels with the match, have some of that energy directed at your dean's office.

good luck.

 

[ENTspot12]

Thanks edgar, basically reconfirming what i've been thinking (and preparing to do) all along. It seems that this will work out in the end, i was just hoping someone else on here had actually gone through a similar situation and could shed some more light on it.

 

[beriberi]

How did this turn out?

I thought this post deserved a bump as the rest of us get ready to submit rank lists...

 

[Galaxian]

yeah, what happened? Does the AAMC have you on their most wanted list? Does the otolaryngologists association have a contract out on you?

p.s. It's gonna take some balls, but I say go for it!

 

[In2b8]

Tough break ENTspot. I hope it all works out well for you. But the rest of us can take something away from your story.

As the rest of us prepare to submit our ROL for the main Match let's keep in mind:

ONLY RANK PLACES YOU ARE WILLING TO GO.

Good luck to all.

 

[CambieMD]

Dude,

take it from an old man. Honor your contract. The truth is you will probably never find another ENT position if you leave. Put yourself in the position of the programs out there. The system would break down if students were allowed to "get out" of their contractual agreements. You are probably a stellar student. The thing is all of this comes down to a job.
Your deans office is thinking what is wrong with this guy.
I knew a girl who went to Tim Buck Too to get a position in ENT.
You are attempting to acquire a skill. That skill can be acquired anywhere. The child care and family issues will work themselves out. You need to find your own way outside of your family.
The general surgey programs may be reluctant to have you under the circumstances that you have mentioned.

I just read your post today. You probably did what you were going to do already.

All the best,

CambieMD

 

[evans267]

I understand your plight.

I also went through the early match in a competitive subspecialty, and matched at a place that was lower on my list but was completely unideal for myself and my spouse. I did exactly what you are talking about.

At the time I went through the match, I wasn't even engaged. My boyfriend at the time proposed to me three days before match day. When I found out where I matched I was devastated. He is in medicine too, but a couple of years ahead of me. We were going to have to live apart, in other parts of the country. There was no way he could transfer because they didn't even have his specialty at the program.

As the year went on, I began to dread leaving more and more. We got married several months later. The thing is, I would have had no problem leaving had I not gotten married. However, my priorities completely changed. My spouse came first, over my career. After much contemplation, I decided to drop out. I was in preliminary internal medicine, so I asked my program director if I could just switch to categorical medicine. She had no problem, and the program was glad to have me. It was very easy.

Letting my other program know was not as easy. I sent them a letter and told them I had decided to do internal medicine. They were very upset, told me I didn't know anything about commitment (which, ironically, is quite the contrary), and yes they basically blacklisted me.

What can I do. I had no idea I was going to get married and I wasn't going to be separated from my spouse. I like internal medicine - sure it is not as glamorous but it makes me happy too. I wasn't going to live my life just to please someone else. I do realize though that I have basically no chance of going into my original supbpecialty. But I am happier, we bought a beautiful house and we are getting on with our lives.

Anyway, so I understand if you do this. Just think very hard about burning bridges and realize that you will most likely give up ENT. I did and I have no regrets.

 

[UserNameNeeded]

Wow, reading evans267 and ENTspot12's stories are depressing-- what kind of horrible profession are we in that we have to sacrifice our marriages and families for some apprenticeship job that devours the prime of our lives?

evans267, I'm so proud you made the decision you made. I hope you have a wonderful life!

 

[turquoiseblue]

ENTspot12,

Maybe it would make your life easier if you just swapped your position. You may want to try residentswap.com. You can try to swap your position with someone doing general surgery who wants to get into ENT by just advertising it on residentswap and also advertise it under 'internships, etc category on SDN to get maximal people to know about it. I know some would love to go into that field and want ENT and not general surgery.

Good luck

 

[gutonc]

ENTspot12,

Maybe it would make your life easier if you just swapped your position. You may want to try residentswap.com. You can try to swap your position with someone doing general surgery who wants to get into ENT by just advertising it on residentswap and also advertise it under 'internships, etc category on SDN to get maximal people to know about it. I know some would love to go into that field and want ENT and not general surgery.

Good luck

If those spots are still available (and the posters haven't found something else to do) 6 years later, there's a big problem.

 

[turquoiseblue]

If those spots are still available (and the posters haven't found something else to do) 6 years later, there's a big problem.

LOL i didn't realize the OP was a post from 2004. but residentswap seems to be the "in" thing these days to get out of a program--just trade! (for anyone that's interested).