Transferring residency programs within the same specialty

[allsadandstuff]

Hello, everyone. I am a PGY1 in a residency program where I barely see my attendings, do not get to discuss the assessment and plan for more than 1 or 2 min with them when I do get to see them, and have never been observed interviewing in the time I’ve been here. The program does not meet the basic expectations that I, rather naively, believed all residency programs would meet by default. In order to avoid getting into any trouble, I will not go into details unless someone offers help/advice via private message. I know that it is basically impossible to switch residency programs without a “good” reason such as taking care of a sick family member, being closer to a spouse, etc. I know cannot tell my program director that I would like to transfer to a residency program that is a better fit for my educational interests and career goals. Despite great feedback from the medical team and the PD, I do not expect to have the full support (or any support at all) from my program director if I shared that I would be happier elsewhere.

Does anyone here know someone who transferred programs within the same specialty, for reasons unrelated to family? Has anyone successfully transferred out of a malignant program? This is difficult to do when the world of medical education is so unlike real life, where one could stay in a current job while sending out resumes to other places. The real world does not require your current boss’ permission to find a job with a healthy culture, good pay, or in my case a solid education. How can one transfer out of a malignant program when other programs require a letter from the current PD? Please send me a private message if you are one of the few, lucky people who have been able to find success in a system that works against us. Thank you.

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[ObsequiousAplomb]

One of my co-residents transferred out of my residency to another residency in the same specialty without a pressing family need.

It was the during pgy-2, and she was upset that had she not passed step 3 the program would not have renewed her pgy-3 contract. She was three months past the deadline for taking step 3, so the program notified her and the 4 other residents that were delinquent in passing step 3 by the time specified in our PGY-1 and PGY-2 contracts of the potential for non-renewal.

So in fall of PGY-2 she started looking for PGY-2 and PGY-3 spots at other programs without early step 3 requirements to start in July. She ended up passing step 3 but was apparently so upset about the potential non-renewal she didn't want to stay with our program. She transferred from a community program with a national reputation to a very affluent program. Like from a state hospital program (90% of the first two years are involuntary psych only) to a facility where all the patients are private pay (100% voluntary), there's an equestrian therapy program, and in general a bougie atmosphere. She needed to repeat the pgy-2 year though.

My program was in no way malignant, but I'm sure she would have described it that way. She wasn't happy with our program from day 1, never seemed to grasp that state hospitals and community systems simply work differently than private systems. The program was happy to help her along her way to another program that would meet her educational needs (more rigidly structured didactics, even more stringent supervision, etc).

 

[comp1]

It's done, but rare and hard. So much of residency is self-education and learning from patients/what you find works. You can make some attempts, but I would most recommend keeping at it and getting whatever you can from what you have. Also, the grass is DEFINITELY not always greener. I've heard of worse than what you're describing.

 

[Desired Member]

I am a PGY1 in a residency program where I barely see my attendings, do not get to discuss the assessment and plan for more than 1 or 2 min with them when I do get to see them, and have never been observed interviewing in the time I’ve been here.

Well darn. I thought this was normal? Maybe the 1-2 minute thing sounds a little short.

 

[alina_s]

I transferred within the same specialty, and in my new program, someone from another class transferred out. It’s probably easiest to do after PGY-1, since there are some programs with additional PGY-2 spots, and it’s possible to complete all the requirements in 3 years.

 

[Bartelby]

I strongly considered transferring for PGY4 year for family reasons. I had a program in discussion with me for a spot but then decided against the transfer due to a change in personal life circumstances. In my experience, having the support of my PD (who I told early on and who was very understanding) was crucial to the process. I'm not sure how you could make it happen without PD support, and for sure you will have to inform them once the idea becomes a serious goal because other programs will want input from your current PD.

Sorry to hear you are in that situation, the teaching sounds far below expectations (if it is the way you describe). Is there any life circumstance you could spin as the "reason" you need to transfer so it doesn't amount to you telling your PD that their program is terrible?

 

[UTsksk]

Lol your message sounded like my program and what our residents went through. One of my bosses would always tell us to reframe and see it as developing experience. So now when we get bombarded with patients we sarcastically tell each other we’re just getting experience.

You can technically transfer and it’s amazing how programs will take some people. From my 4 years at our program I’ve known 3 that have left and found different programs (only 1 of the 3 got into a “better” program). These people had major red flags but still got a shot. None of them made the change for family reasons. If you’re unhappy where you are then you can consider transferring.

 

[mistafab]

I'm going to start by saying most people don't transfer.

With that, what happens if you stay all 4 years? I would come up with strategies to get the most out of your time now.

There are people in my program with the same complaints you have, yet I am a PGY2 who has had lots and lots of feedback. I've had great supervision, discussion of many papers, discussion of treatment plans many times over (etc etc). I've observed attendings interview and they have seen me do this several times. Why the difference between some of my peers and myself (and a few others)? Perhaps my peers and yourself are truly stuck in a malignant situation and I as well as others have just missed it all. Or, perhaps, there are things you can do to be more active in seeking the guidance and learning you are desiring.

One stance is in your hands, the other is out of your hands. You get to choose which frame you move forward with if you don't get transferred.

 

[allsadandstuff]

Also, the grass is DEFINITELY not always greener. I've heard of worse than what you're describing.

I'd be selective about where I'd attempt to transfer-- which makes everything harder, of course.

Is there any life circumstance you could spin as the "reason" you need to transfer so it doesn't amount to you telling your PD that their program is terrible?

It's so sad that it has to come down to this, but I hope I can eventually come up with a good alternative reason. It's hard, though, because "legit" reasons usually involve geography (taking care of an ill family member in X area), and I'd like to throw a wide net to have a chance at getting into a decent program.

You can technically transfer and it’s amazing how programs will take some people. From my 4 years at our program I’ve known 3 that have left and found different programs (only 1 of the 3 got into a “better” program). These people had major red flags but still got a shot. None of them made the change for family reasons. If you’re unhappy where you are then you can consider transferring.

The programs that your peers transferred to-- did they have the applicants go through the usual process of sending applications with a letter from their current program director? That's the main barrier I'm facing. I had applied to a couple of programs and emailed asking if they could pre-screen my application before I spoke with the program director. Unsurprisingly, they replied they don't do that. That's why I'm so upset that medical education can't work like the real world, where you can get a job offer *before* telling your boss you quit. Sigh.

 

[OldPsychDoc]

Are you quite certain of your lack of expected support from your current PD?
Most PDs I know would far rather facilitate the transfer of an unhappy resident than keep them around to fester in resentment for 3 more years. (Although frankly, since they do need to sign off on your competency to be promoted to PGY2, they also aren't likely to overlook any personal factors that might not change in a different program for you.)

 

[UTsksk]

I'd be selective about where I'd attempt to transfer-- which makes everything harder, of course.


It's so sad that it has to come down to this, but I hope I can eventually come up with a good alternative reason. It's hard, though, because "legit" reasons usually involve geography (taking care of an ill family member in X area), and I'd like to throw a wide net to have a chance at getting into a decent program.


The programs that your peers transferred to-- did they have the applicants go through the usual process of sending applications with a letter from their current program director? That's the main barrier I'm facing. I had applied to a couple of programs and emailed asking if they could pre-screen my application before I spoke with the program director. Unsurprisingly, they replied they don't do that. That's why I'm so upset that medical education can't work like the real world, where you can get a job offer *before* telling your boss you quit. Sigh.

I don’t know specifics, but I do know it was off cycle and our PD was contacted to give their stamp of approval. It seems that in order to get to another program your PD will have to be involved in some way.

 

[carolinesagrera]

Hey everyone, Caroline here. Posting here for future transferees seeking guidance. I successfully transferred residency programs within the same specialty (psychiatry) after my PGY1 year. Through my process, I learned so much about various ways to do it and some unspoken rules about the process.

If you're feeling overwhelmed, hit me up!

 

[Stagg737]

The programs that your peers transferred to-- did they have the applicants go through the usual process of sending applications with a letter from their current program director? That's the main barrier I'm facing. I had applied to a couple of programs and emailed asking if they could pre-screen my application before I spoke with the program director. Unsurprisingly, they replied they don't do that. That's why I'm so upset that medical education can't work like the real world, where you can get a job offer *before* telling your boss you quit. Sigh.

Going to echo what a few others have said, how sure are you that your PD won't be supportive about helping you transfer? Yes, there are legit malignant programs with vindictive PDs, but I highly doubt this is common. I went to a program in the midwest and we had someone from a combined program transfer because he wanted "a more prestigious and research based program closer to his SO". In reality, we all knew he just didn't like the midwest city we were in and wanted to transfer to NYC (which was not really near his SO). From what he and other attendings said, PD was supportive of helping him transfer and he left after our intern year.

What you're describing doesn't sound malignant, just like it's not a program with very good education. If you know you have a really bad relationship with the PD or other residents have had problems or warned you about them, then I'd definitely be wary. I wouldn't just assume that though, as most PDs probably don't want residents that don't want to be there as it just makes things worse for everyone. Plus, the longer you wait to try and transfer, the harder it would be.

 

[SubzDoc]

She needed to repeat the pgy-2 year though.

Wow. Things would have to be bad for me to agree to repeat a year of residency, and I liked my residency.

So much of residency is self-education and learning from patients/what you find works.

True, I would not have gotten half as much out of residency without self-study and extracurriculars. But there needs to be balance. If OP's assessment is accurate, that is not nearly enough educational support, especially in PGY1.

As far as program directors supporting a transfer or not, unless the PD is secretly unhappy with the OP, there will be a bias toward keeping them rather than going out of their way to help effect a transfer. A decent PD would still support an unhappy resident despite the reasons to keep them. If the program is truly malignant, as OP suggested, they could very well try to undermine the transfer.

 

[Kingbika]

Hello, everyone. I am a PGY1 in a residency program where I barely see my attendings, do not get to discuss the assessment and plan for more than 1 or 2 min with them when I do get to see them, and have never been observed interviewing in the time I’ve been here. The program does not meet the basic expectations that I, rather naively, believed all residency programs would meet by default. In order to avoid getting into any trouble, I will not go into details unless someone offers help/advice via private message. I know that it is basically impossible to switch residency programs without a “good” reason such as taking care of a sick family member, being closer to a spouse, etc. I know cannot tell my program director that I would like to transfer to a residency program that is a better fit for my educational interests and career goals. Despite great feedback from the medical team and the PD, I do not expect to have the full support (or any support at all) from my program director if I shared that I would be happier elsewhere.

Does anyone here know someone who transferred programs within the same specialty, for reasons unrelated to family? Has anyone successfully transferred out of a malignant program? This is difficult to do when the world of medical education is so unlike real life, where one could stay in a current job while sending out resumes to other places. The real world does not require your current boss’ permission to find a job with a healthy culture, good pay, or in my case a solid education. How can one transfer out of a malignant program when other programs require a letter from the current PD? Please send me a private message if you are one of the few, lucky people who have been able to find success in a system that works against us. Thank you.

Just FYI your profile is private, was looking to DM you but cannot.