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vonWillebrand Factor

Is it possible to transfer into the specialty you were unmatched from?

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Title sums it up. Applied to a 5 year specialty program last year without backing up and went unmatched. There were no spots in the specialty 2nd round so I went full family and ended up matching to rural FM. I'm very grateful to have matched at all, especially since I only did 3 weeks FM elective, however after a year of trying I still can't imagine doing FM for life.

Is it even possible to transfer into the specialty I went for 1st round? If anyone's heard of instances of this happening, were there special circumstances (e.g. made connections with the right peeps, someone just happened to switch out of specialty #1)? Specialty I'm referring to had 1st match rate 65-75% if that helps. 

Any advice appreciated! Thanks

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Possible? Yes.

Probable? No.

Easy? Absolutely not.

There's all sorts of bureaucratic hoops to jump through and criteria that need to fall into place in order to facilitate a transfer.

Not to mention that your current PD has to be willing to send you off, with the receiving PD wanting you.

At best you will find a few anecdotes on this forum. 

Give it a shot, but realize you'll most likely have to carve a niche in FM.

You can also try applying in the second round in the future following your training should a transfer not materialize.

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Thanks for the responses! 

Second round application probably won't work since most spots in this specialty fill up first round. I've heard of the re-entry program for physicians who have practiced for at least a year, so might look into that as well. Talking to ppl who have transferred in the past, seems like the process can be quite short and easy... if there are ppl you know in the program and they like you. So not sure about bureaucratic hoops. 

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1 hour ago, vonWillebrand Factor said:

I've heard of the re-entry program for physicians who have practiced for at least a year, so might look into that as well. Talking to ppl who have transferred in the past, seems like the process can be quite short and easy... if there are ppl you know in the program and they like you. So not sure about bureaucratic hoops. 

Curious, does anyone know how this works?

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I'm not too familiar with the process personally, but it's doubtful any listing of potential vacancies is made publicly available by PGME. According to the info on the site, it looks like applicants submit their interest and then it's forwarded to PGME/programs to see if there are any openings.

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On 3/31/2019 at 11:59 PM, freewheeler said:

Not to mention that your current PD has to be willing to send you off, with the receiving PD wanting you.

Why would a PD not be willing to release you? If the receiving PD accepts your transfer into an opening they have I can't see why the current PD would be able to prevent that.

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On 4/2/2019 at 12:27 PM, vonWillebrand Factor said:

Thanks for the responses! 

Second round application probably won't work since most spots in this specialty fill up first round. I've heard of the re-entry program for physicians who have practiced for at least a year, so might look into that as well. Talking to ppl who have transferred in the past, seems like the process can be quite short and easy... if there are ppl you know in the program and they like you. So not sure about bureaucratic hoops. 

I think that it's still up to the program director if they want you : i.e, if you are the most qualified candidate compared to others. 

In Ontario, you can't transfer into specialty as a FM PGY2. I would recommend that you finish FM residency, and try the re-entry program after 1 year as a staff.

The ROS rules are very flexible in Ontario, basically you can't work in GTA or Ottawa for 2 years. I've known IMGs who work in academic hospitals and who avoided ROS with letters of support. 

At end of day, make sure that you are happy in your profession. FM is very rewarding, but it's not for everyone. Best of luck!

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5 hours ago, md2018plz said:

Why would a PD not be willing to release you? If the receiving PD accepts your transfer into an opening they have I can't see why the current PD would be able to prevent that.

Well for one thing, if you are in a small specialty that depends on residents for service, losing one resident can knock out, e.g., a substantial chunk of the call pool, so they may not want to release you for that reason.

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On 4/5/2019 at 5:44 PM, LittleDaisy said:

I think that it's still up to the program director if they want you : i.e, if you are the most qualified candidate compared to others. 

In Ontario, you can't transfer into specialty as a FM PGY2. I would recommend that you finish FM residency, and try the re-entry program after 1 year as a staff.

Hello Daisy, where did you read that Ontario doesn't allow transfers in the last year of family? I have heard of this rule, but the transfer documents only indicate that transfer in the last 6 months is not allowed. 

On 4/5/2019 at 5:44 PM, LittleDaisy said:

The ROS rules are very flexible in Ontario, basically you can't work in GTA or Ottawa for 2 years. I've known IMGs who work in academic hospitals and who avoided ROS with letters of support. 

At end of day, make sure that you are happy in your profession. FM is very rewarding, but it's not for everyone. Best of luck!

That was originally my plan, to do family medicine for a few years, pay back my debt and get other parts of my life going, then attempt the re-entry program. However, there's really no info I could find on match rates for re-entry applicants. It also doesn't indicate if they would be part of the general match R1 stream, or would only participate in second iteration (which would be useless for specialties that have no remaining spots), or if is a completely different beast. Also I would have no idea how feasible it would be to get elective experience across Ontario as a licensed physician and not a learner. 

Bottom line is, it looks like no matter how hard an MD works to get clinical experience relevant to specialty X, they'll never have the chance given to an M4. Which makes sense I supppose, CaRMS is a one-shot game after all... :(

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17 hours ago, vonWillebrand Factor said:

Hello Daisy, where did you read that Ontario doesn't allow transfers in the last year of family? I have heard of this rule, but the transfer documents only indicate that transfer in the last 6 months is not allowed. 

That was originally my plan, to do family medicine for a few years, pay back my debt and get other parts of my life going, then attempt the re-entry program. However, there's really no info I could find on match rates for re-entry applicants. It also doesn't indicate if they would be part of the general match R1 stream, or would only participate in second iteration (which would be useless for specialties that have no remaining spots), or if is a completely different beast. Also I would have no idea how feasible it would be to get elective experience across Ontario as a licensed physician and not a learner. 

Bottom line is, it looks like no matter how hard an MD works to get clinical experience relevant to specialty X, they'll never have the chance given to an M4. Which makes sense I supppose, CaRMS is a one-shot game after all... :(

It's a rule for PGME at University of Toronto. Each PGME has its own transfer rules. I will suggest that you connect with your PGME office for transfer logistics. 

By the time the answer is released, which is in February every year, you would have been into 18 months of your FM residency training.

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On 4/5/2019 at 10:08 PM, ellorie said:

Well for one thing, if you are in a small specialty that depends on residents for service, losing one resident can knock out, e.g., a substantial chunk of the call pool, so they may not want to release you for that reason.

This doesn't sound right. I can't imagine PGME allowing that to happen.

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16 hours ago, md2018plz said:

 This doesn't sound right. I can't imagine PGME allowing that to happen.

Your program can absolutely refuse to release you and block your transfer. I can only imagine what life would be like for the resident thereafter :unsure:

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8 minutes ago, md2018plz said:

It's no different than quitting. What you're describing  sounds like slave labour. If you have been accepted to another position, you can quit and be released. 

If you quit, you may not be eligible for funding for the second position.  I've seen instances where residents who want to transfer are kept in their originally specialty until the service line demands allow for their release.  If you decide that you want to transfer in July, your program may keep you for an extra year until they can get a replacement through CARMS.  It's really ugly but it happens.  Pagers need to be answered.  

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On 4/8/2019 at 1:17 PM, jnuts said:

If you quit, you may not be eligible for funding for the second position.  I've seen instances where residents who want to transfer are kept in their originally specialty until the service line demands i7allow for their release.  If you decide that you want to transfer in July, your program may keep you for an extra year until they can get a replacement through CARMS.  It's really ugly but it happens.  Pagers need to be answered.  

rip

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20 minutes ago, md2018plz said:

Although I can definitely see this happen in the current  state of med Ed, staff can answer pages. Not saying that it will happen, but it's about time we stand up for ourselves as residents. 

And that's not an indefinite block on your transfer which other users suggested. It sucks though and is unethical. We need to be able to give a 2 week notice IMO. 

It's hard to stand up for yourself in residency because the disciplinary process favors the school and if you get blacklisted you lose a decade worth of training. 

A program can prevent your release because of the already mentioned service needs of the program. You can quit the job like any other but it does complicate matters when you are trying to transfer programs.

Staff can obviously cover the ward and answer pages but the fact is that they don't want to. Not much you can do about that when the match situation is so tight that there is no real alternative to leaving. 

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Here's an example of a story from not too long ago about wanting to transfer out of IM and into rural FM:

https://www.cbc.ca/news/canada/nova-scotia/why-n-s-physician-couldn-t-become-rural-family-doctor-1.4703055

Of course we don't have knowledge of all the details, but it still illustrates a lot of the challenges about pursuing a transfer that have been raised previously.

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To be direct and answer the question, short answer is yes.  I'm sure its already been laid out about the potential difficulties.  I have a close and personal friend who not only matched to General Surgery but then subsequently switched after one year to Anesthesiology.  After 6 months of Anesthesiology, he switched again to PM&R.  

If I've learned anything, it's "never say never."  

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On 4/8/2019 at 2:18 PM, freewheeler said:

Here's an example of a story from not too long ago about wanting to transfer out of IM and into rural FM:

https://www.cbc.ca/news/canada/nova-scotia/why-n-s-physician-couldn-t-become-rural-family-doctor-1.4703055

Of course we don't have knowledge of all the details, but it still illustrates a lot of the challenges about pursuing a transfer that have been raised previously.

That really sounds terrible. I am not too sure why it's not easy to use the OP's funds for internal medicine residency and transfer it into Family Medicine residency. I would definitely think that the FM PD at Dalhousie could have been more receptive and helpful in creating a residency spot?

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