Switching Residencies
Here's an inspirational story that shows it's never to late to find the right specialty!
03/15/13
Dr. Barone,
I wanted to share my singular story with you. I'm a Canadian citizen and an IMG, and I matched into and obgyn residency last year. I was extremely happy about it, and was looking forward to starting. However things didn't work out so smoothly, and my dad passed away in early July. I started residency a month late as a result. I realized very quickly that choosing obgyn was a mistake, and I was very confused. The thought of having to continue with this residency for the next 4 years and then obgyn for the rest of my life was really stressful and made me anxious. I spoke to my program director about my feelings, and that I intended to reapply for a residency in family medicine. He was supportive, wrote me a good LOR, and I resigned from my position. By the time I had submitted my application, however, it was the end of October, and my letters didn't get uploaded until mid November. By January I still had no interview offers, so I began cold calling programs as a last resort and fortunately one program had a last minute cancellation and offered me an interview at the end of January. It seemed against the odds, and with only one interview and with my history of having left my old residency position, I managed to match this year as well! I also wrote and passed my step 3, and am now really excited to be starting a new life. I just wanted to let people out there know that it's okay to change specialties, and that with a little persistence and even just one interview, it is possible to match into a field that you really want.
Sincerely,
M. S.
Some Questions:
1. Did you need a visa?
I did need a visa. My obgyn program sponsored me for a J1 visa, which is good for up to 7 years. My family med program will also have to sponsor me for a J1, so I'll have to re-apply for a new one with the Canadian government, since my place of employment has changed.
2. Do you think getting the step 3 played a role in you matching?
I actually took step 3 after the interview, and didn't get my score back until after the rank lists were submitted, so my step 3 didn't really have much to do with it. I did however during my interview tell them that I intended to write it in the near future.
3. Did connections help?
I think connections did have a little bit to do with it. One of the interns in my obgyn program had just graduated from the family medicine program that I matched at (so this is his second residency). He did put in a word for me when I first applied, but the program never got back to me. Fortunately, they had just had a cancellation when I called, and during my interview I talked about how I knew that intern well and that we worked together while I was in obgyn.
4. What about the interview? Was it hard explaining the switch?
I had really rehearsed what I would say about my switch. It wasn't as difficult as I thought, and I explained that the surgery aspect of obgyn was really appealing to me since I was really good at surgery (and still am), but that during my intern year I missed the other aspects of medicine such as working with kids, and male patients, and the elderly population, as well as dealing with other medical problems other than just pregnancy. I also realized that the lifestyle wasn't something that I could keep up with 20 years down the road. I had done a family medicine and geriatrics elective during the first few months of my intern year, so I told them that I enjoyed being on those rotations and had more interest in it than I did during my months on labor and delivery.
5. Anything else you would recommend to students looking to switch residencies?
For other students looking to switch residencies, I would say do it early, within the first year. Intern year is hard for everybody, and it's okay to have bad days, but if you dread getting up every morning and the best part of your day is leaving the hospital, and you have little interest or energy to look up interesting cases or articles, then it probably has to to do with you not enjoying the specialty you picked. My other friends who were doing ob absolutely loved it, regardless of the very early morning and little free time they had. It's scary to think about, and even more scary to tell anybody about it, but most program directors are understanding and chances are they will support you and write you a good letter. A letter from the PD is EXTREMELY important.
One thing to keep in mind is that programs only get resident funding for the number of years it takes to complete their FIRST specialty. For example, I started in obgyn, so the program can get up to 4 years of funding for training me. I completed about 6 months of my intern year, so I've used up 1 year of funding. I have 3 years of funding left, which is perfect since family medicine is 3 years. I had switched to sugery, however, then the surgery program would only get 3 years of funding, and the other 2 years are unpaid for, so i probably wouldn't match into surgery. This is something that was brought up during my interview, and something that PDs take into consideration. Thats why I say switch early if you're sure you picked the wrong specialty the first time.
Also, the NRMP agreement requires you to complete a certain number of days in the specialty you matched at (i think it's 60 days, not sure anymore), so you can't leave your program before that time.
For those on a J1 visa, you have to leave the country as soon as you resign, so talk to the PD and plan ahead, so you leave the country before your program terminates the contract. My PD entered my last day as Nov 16th, and I left the country a week before that. It could affect your chances of getting another J1 for your next placement if you stay in the country and you are no longer employed. Thankfully for me Canadians don't need visas to enter the US as tourists, so after Nov 16th I came back as a tourist to pack up the rest of my apartment. 