transferring residency in same specialty

[medsurgeducator]

I am a PGY1 just inquiring about possibility of transferring residencies. How does this work--do you have to wait/look for an open PGY2 spot? Is it possible to transfer in outside of the match (if you are for example transferring to a program where you have many connections, etc.) and repeat intern year, so you don't have to wait for an open spot, or do you have to go through the match again? I know transferring is rare and should only be done with good reason so just trying to figure out protocols.

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[gutonc]

This is going to sound pedantic, but you don't "transfer" residency in the same way that you transfer from one UG or med school to another.

There are a number of different ways to do this, and a lot depends on the specialty. The first, and most important question you have to answer is "why do you want to move to a new program?" Location? Perceived program quality? Subspecialty opportunities? Recognize that you landed where you did for a variety of reasons, all of which will follow you on the next step of this journey.

Let's get the "legalities" out of the way. Today is July 23rd. You have another 22 days to stick it out at your current program before you can quit and try to find a new PGY1 spot without violating the Match agreement and most likely forfeiting your opportunity to find another training spot in the Match between 2 and forever years.

Now the realities. The only positions in the Match for categorical residencies are PGY1. So if you're planning to finish this year out and find a PGY2 spot, you will have to do it on your own. Options include a whole bunch of variously updated/legitimate websites which list open PGYX positions, connections and cold calling.

Now, let's say you do find a program to accept you as a PGY2...with rare exceptions, you're going to start out as an intern again, at least for a few months. The program doesn't know you, you don't know the hospital/system/residents/attendings. This is actually good for you. If you're a strong resident, in 3-6 months, they'll move you back up to PGY2 and, depending on the program and length of your residency, might even graduate on time. In the 3 years that I was paying attention, my solidly mid-tier program accepted about a dozen PGY2 transfers. Only one of them (a prior med student at the institution who was an intern at one of the HMS programs and transferred back for family health reasons) was able to slide into being a PGY2 straight away. The rest spent 3-12 months back in intern-land and at least 2 weren't renewed at the end of that year.

From your vague and incomplete information, it sounds like you may want to try to go back to your med school's program, which is really the only semi-safe bet, insofar as safe bets exist in the medical training world (your safest bet is obviously to stay put). So step 1 is going to be getting yourself a signed PGY-Whatever contract from that program before making any other moves.

 

[medsurgeducator]

This is going to sound pedantic, but you don't "transfer" residency in the same way that you transfer from one UG or med school to another.

There are a number of different ways to do this, and a lot depends on the specialty. The first, and most important question you have to answer is "why do you want to move to a new program?" Location? Perceived program quality? Subspecialty opportunities? Recognize that you landed where you did for a variety of reasons, all of which will follow you on the next step of this journey.

Let's get the "legalities" out of the way. Today is July 23rd. You have another 22 days to stick it out at your current program before you can quit and try to find a new PGY1 spot without violating the Match agreement and most likely forfeiting your opportunity to find another training spot in the Match between 2 and forever years.

Now the realities. The only positions in the Match for categorical residencies are PGY1. So if you're planning to finish this year out and find a PGY2 spot, you will have to do it on your own. Options include a whole bunch of variously updated/legitimate websites which list open PGYX positions, connections and cold calling.

Now, let's say you do find a program to accept you as a PGY2...with rare exceptions, you're going to start out as an intern again, at least for a few months. The program doesn't know you, you don't know the hospital/system/residents/attendings. This is actually good for you. If you're a strong resident, in 3-6 months, they'll move you back up to PGY2 and, depending on the program and length of your residency, might even graduate on time. In the 3 years that I was paying attention, my solidly mid-tier program accepted about a dozen PGY2 transfers. Only one of them (a prior med student at the institution who was an intern at one of the HMS programs and transferred back for family health reasons) was able to slide into being a PGY2 straight away. The rest spent 3-12 months back in intern-land and at least 2 weren't renewed at the end of that year.

From your vague and incomplete information, it sounds like you may want to try to go back to your med school's program, which is really the only semi-safe bet, insofar as safe bets exist in the medical training world (your safest bet is obviously to stay put). So step 1 is going to be getting yourself a signed PGY-Whatever contract from that program before making any other moves.

Thank you for all the information this is very helpful. I definitely recognize transferring residency isn't something that is easily done or is to be taken lightly, which is why I was just putting a feeler out there to get an idea of how impossible or possible it may be. And I apologize for being vague, wasn't sure how much information was necessary; there were a number of family dynamics/health factors that arose only towards the end of the match process and now into intern year that have shifted my perspective on things.

I definitely will continue on in my intern year and have no intention of dropping out. Sounds like finding an open PGY2 spot would be ideal, but I imagine difficult...so to follow up with some other options--is it easier to be "accepted" as a new intern instead of hoping for an open pgy2 spot? So as you're saying, could I try to transfer in as a pgy2 in name, but really a new categorical intern in practice such that I'm not really taking a pgy2 spot? Or would it be simply easier to redo the match process and try to match to the desired program? All of this is contingent I know on the desired program accepting me, but it was a program that seemed to think highly of me and I have good support at.

In short I care more about ending up at the right place for the next several years, even if that means adding on an additional year of repeat training. Thanks for the advice I am very appreciative.

 

[operaman]

Transferring programs is unusual but it happens. Basically, you will need to find an open spot or a swap if you want to do this. Absent an open spot you would need a really understanding set of PDs who would be willing to make it happen.

I’ll give one example from the ent side - a year or so before me there was a couple who actually met on the interview trail. Since they had just met they weren’t couples matching and matched to separate yet similar top programs. They ended up getting married and wanted to be together, so they both talked to their PDs and arranged something where one left his program, did a research year and was taken the next year outside the match. Or something like that - can’t recall details now. But both completed training and are actually now both on faculty at the program he left!

So yeah it happens. You’ll need the blessing of your PD and wherever you’re hoping to land too. Tread carefully and have good reasons and if you decide to make moves keep everything above board. Best time is probably after PGY1 - avoids match violations and there are often some open spots out there after intern year.

 

[gutonc]

Thank you for all the information this is very helpful. I definitely recognize transferring residency isn't something that is easily done or is to be taken lightly, which is why I was just putting a feeler out there to get an idea of how impossible or possible it may be. And I apologize for being vague, wasn't sure how much information was necessary; there were a number of family dynamics/health factors that arose only towards the end of the match process and now into intern year that have shifted my perspective on things.

I definitely will continue on in my intern year and have no intention of dropping out. Sounds like finding an open PGY2 spot would be ideal, but I imagine difficult...so to follow up with some other options--is it easier to be "accepted" as a new intern instead of hoping for an open pgy2 spot? So as you're saying, could I try to transfer in as a pgy2 in name, but really a new categorical intern in practice such that I'm not really taking a pgy2 spot? Or would it be simply easier to redo the match process and try to match to the desired program? All of this is contingent I know on the desired program accepting me, but it was a program that seemed to think highly of me and I have good support at.

In short I care more about ending up at the right place for the next several years, even if that means adding on an additional year of repeat training. Thanks for the advice I am very appreciative.

If there's a single program that you're talking about, the first step is to talk to the PD there and see if the rapport you seem to think you have with the program leadership is mutual. If it is, and they want you, they can make it work.

If the program is a place that you ranked higher than where you matched, you need to be honest with yourself about how highly they really do think of you.

In any event, step 1 is to talk to them.

 

[HemeOncHopeful19]

Transferring programs is unusual but it happens. Basically, you will need to find an open spot or a swap if you want to do this. Absent an open spot you would need a really understanding set of PDs who would be willing to make it happen.

I’ll give one example from the ent side - a year or so before me there was a couple who actually met on the interview trail. Since they had just met they weren’t couples matching and matched to separate yet similar top programs. They ended up getting married and wanted to be together, so they both talked to their PDs and arranged something where one left his program, did a research year and was taken the next year outside the match. Or something like that - can’t recall details now. But both completed training and are actually now both on faculty at the program he left!

So yeah it happens. You’ll need the blessing of your PD and wherever you’re hoping to land too. Tread carefully and have good reasons and if you decide to make moves keep everything above board. Best time is probably after PGY1 - avoids match violations and there are often some open spots out there after intern year.

Apparently the ENT interview trail is a lot more fun than the IM one…

 

[operaman]

Apparently the ENT interview trail is a lot more fun than the IM one…

Maybe! It’s a much smaller group so you definitely see the same people over and over again. There were a lot of formal and informal social events too so you did get to know a lot of people. And then you end up seeing each other at meetings and then by the time fellowship season rolled around I knew just about everyone interviewing in my subspecialty.

You know, I think this is another casualty of virtual interviews - the loss of camaraderie across the field. The only way I know all these random stories from ent is because I got to hang out with a lot of people in the field and just talk.

 

[medsurgeducator]

If there's a single program that you're talking about, the first step is to talk to the PD there and see if the rapport you seem to think you have with the program leadership is mutual. If it is, and they want you, they can make it work.

If the program is a place that you ranked higher than where you matched, you need to be honest with yourself about how highly they really do think of you.

In any event, step 1 is to talk to them.

Thanks so much. There is a single program I'm thinking about. And of course there is no way to really know, but it was suggested many times I was "ranked to match" there, and I ended up ranking it lower for various reasons, which I now regret. Seems like a good idea to see feel out what my standing really was with the program--probably don't want to go down this rabbit hole if they didn't think too highly of me. Thank you for your advice.