Transferring from FM to IM

[Gues]

Hi everyone,

What do you think about the chance of transferring from FM to IM? Is it doable? If it is, what advice do you have for me? Many thanks.

[JohnGrisham]

We need more information that this.  Did you apply to IM the first time and not match, so you matched FM back up? Did you match family but now have a change of heart? 

[bearded frog]

Also need to know what province you're in, where you are in your residency, are you in good standing in your program?

[Gues]

On 6/19/2020 at 9:14 AM, JohnGrisham said:

We need more information that this.  Did you apply to IM the first time and not match, so you matched FM back up? Did you match family but now have a change of 

Thank you for your response. 
 

Well, I wanted to do IM. But, I applied for FM as well to make sure that I get in, and I matched to FM. Although I like FM, I really prefer IM which is my passion. I know I only have a chance to transfer in the first year, that is why I want to make sure that I know all the steps.

[Gues]

I will start my FM residency this July. So hopefully I will be in good standing! Any recommendations on that?

[JohnGrisham]

2 minutes ago, Gues said:

Thank you for your response!

Well, I wanted to do IM. But, I applied for FM as well to make sure that I get in, and I matched to FM. Although I like FM, but I really prefer IM which is my passion. I know I only have a chance to transfer in the first year, that is why I want to make sure that I know all the steps.

So you applied broadly to FM and IM, but ultimately didn't get into IM. Did you just not get many IM interviews? what do you think was the reason you didn't match IM? Your best bet is going to be your home program where you will be doing FM at.  Did your home program at least interview you? 

A lot of variables at play. Do you have your IM R1 rotation early in your FM residency? If its early, and you can do well and crush it...get LORs, maybe there is a chance to transfer in.  Maybe not. We don't know why you didn't match in the first place? So hard to say. Maybe it was that you were ranked, but just not high enough - so that in essence they would have been happy to take you, but just not enough spots.

[Gues]

Unfortunately I only got one  IM interview although I applied to all the available programs. I am an IMG so I am not sure if that played a role in it or not. 
The program sent out the schedule, but I don’t have any IM rotation during the first six months. I have one elective that I can do IM. Not sure which rotation in IM I should get for that( CTU?)  

[ACHQ]

10 minutes ago, Gues said:

Unfortunately I only got one  IM interview although I applied to all the available programs. I am an IMG so I am not sure if that played a role in it or not. 
The program sent out the schedule, but I don’t have any IM rotation during the first six months. I have one elective that I can do IM. Not sure which rotation in IM I should get for that( CTU?)  

Sorry to hear that but at the same time congrats on matching to Canada (no easy task for an IMG), and the fact you got even 1 IM interview as an IMG shows that you are competitive IMO. And now you are in the Canadian system.

I have met over the years a couple of FM residents transfer to IM at UofT (and even someone from IM at another *school* transfer to IM at UofT), so it is definitely doable. The biggest thing is that the IM program has to have a spots available that they want to fill. So once the academic year starts I would contact the various programs *across the country* (if you truly want IM that badly), about the possibility of transferring into their program and what you need to do. My school sent out an email around ~ Jan (of my PGY1 year) regarding transfers, be proactive and see what you need to do to accomplish that.

It kinda sucks you don't have any IM rotations in the first 6 months of residency. I would definitely use that 1 elective block in IM, CTU would be the best one only because it will give you face time with the program and the ability to get reference letters and support for your transfer. If you can't do CTU than other GIM electives or subspecialty medicine electives are fine as long as you can make a positive impression and gain support from them.

[Gues]

Thank you for your detailed response and kind words! It was very helpful.

I’ll try to email all programs to see if I have any chance or what the requirements would be. Just out of curiosity, can I ask my program to change my rotations? I have one IM rotation at the end of Y1, I was wondering if I can ask them to have it in the first 6 months instead?

[ACHQ]

47 minutes ago, Gues said:

Thank you for your detailed response and kind words! It was very helpful.

I’ll try to email all programs to see if I have any chance or what the requirements would be. Just out of curiosity, can I ask my program to change my rotations? I have one IM rotation at the end of Y1, I was wondering if I can ask them to have it in the first 6 months instead?

never hurts to ask

[Gues]

Thank you for all your help.

[gogogo]

7 hours ago, Gues said:

I will start my FM residency this July. So hopefully I will be in good standing! Any recommendations on that?

Good luck on transferring! Why do you prefer IM over FM?

[bearded frog]

Your best chance by far will be at your own school's IM program. If you happen to be in a province in multiple schools you could explore them too, much harder across provinces. Bust your ass on your FM rotation, get high praise, make your PD love you. See if you can do an IM elective early and rock it, see if you can network with the IM staff so they like you. Meet with the IM program director. If you do all these things there is a chance that, if there is an opening, they might accept a transfer. But also funding is an issue since you're only funded for 2 years.

[Gues]

14 hours ago, gogogo said:

Good luck on transferring! Why do you prefer IM over FM?

Thanks! Well, I always want to practice as a cardiologist. I like FM, it is a great field, but I prefer to work in a field with more focused on a specific area rather than a general one and cardiology is my passion. Hopefully I can transfer.

[Gues]

9 hours ago, bearded frog said:

Your best chance by far will be at your own school's IM program. If you happen to be in a province in multiple schools you could explore them too, much harder across provinces. Bust your ass on your FM rotation, get high praise, make your PD love you. See if you can do an IM elective early and rock it, see if you can network with the IM staff so they like you. Meet with the IM program director. If you do all these things there is a chance that, if there is an opening, they might accept a transfer. But also funding is an issue since you're only funded for 2 years.

Thank you so much for your detailed response! Very helpful! The next 6 months will be very stressful for me then! Do you think it is better if I contact IM programs first or I email the PGME office?

[bearded frog]

2 hours ago, Gues said:

Thank you so much for your detailed response! Very helpful! The next 6 months will be very stressful for me then! Do you think it is better if I contact IM programs first or I email the PGME office?

For your home program and places you're doing electives you can meet with your program director, but you probably won't get very far cold calling other programs without a specific reason for transferring there (ie. you need to tx to that specific program to be closer to your SO/sick relatives, etc), but even then they are more sympathetic to just location changes and not specialty changes. Otherwise talk to your PGME office who will reach out to programs across the country if that's what you want them to do. All that being said, the process won't start until January at the earliest, and realistically not until after carms match so that programs know what their availability is, so in the meantime you need to be doing all these things I mentioned before.

A word of advice, if you come in to your FM program obviously not interested in FM and gunning IM, you're not going to get as much support as if you really push yourself to do the FM thing. If you meet with your PD in December and go, "you know I've been doing really well in outpatient and other aspects of family medicine, and being in this program has been a great experience, but I find that the hospitalist aspect is much more fulfilling, and I think I'd be happier doing IM long term", it's going to look better if you come out of the gate obviously gunning for IM, your FM outpatient evals saying that you did the bare minimum, as an IMG its going to be obvious you matched to a back up and don't really want to be there, nobody is going to go to bat for you.

All that being said, without knowing where you are about to start your residency I'd say your odds are less than 50%. Transfers are uncommon (but not rare). You always have the option to re-apply to CaRMS in the second round next year. IM usually has some openings, this year there were 9 spots after first round, (6 available to IMGs but I don't know how you would be classified as a re-applicant). Note that even if you go this route, you will still need a strong letter from your current PD, saying that he's a great resident but their heart is in IM and based on their performance would make a great IM resident.

[MD2015:)]

I switched from FM to IM after 1 year and I know several other people who switched programs during residency. I am a CMG. I did not apply to IM in medical school because I did not realize that I liked the specialty then. I found out I liked it during PGY1.  I know of some IMGs that tried and they would not let them switch programs - this may depend on the province as there are different types of IMG contracts between provinces. I would ask your PGME office.

[ACHQ]

7 hours ago, bearded frog said:

A word of advice, if you come in to your FM program obviously not interested in FM and gunning IM, you're not going to get as much support as if you really push yourself to do the FM thing. If you meet with your PD in December and go, "you know I've been doing really well in outpatient and other aspects of family medicine, and being in this program has been a great experience, but I find that the hospitalist aspect is much more fulfilling, and I think I'd be happier doing IM long term", it's going to look better if you come out of the gate obviously gunning for IM, your FM outpatient evals saying that you did the bare minimum, as an IMG its going to be obvious you matched to a back up and don't really want to be there, nobody is going to go to bat for you.

Yeah I would agree with this. No one likes someone who doesn't want to be there in the first place.

[Gues]

10 hours ago, MD2015:) said:

I switched from FM to IM after 1 year and I know several other people who switched programs during residency. I am a CMG. I did not apply to IM in medical school because I did not realize that I liked the specialty then. I found out I liked it during PGY1.  I know of some IMGs that tried and they would not let them switch programs - this may depend on the province as there are different types of IMG contracts between provinces. I would ask your PGME office.

Great to hear that you could successfully transfer! Any advice for me? When did you start contacting your PGME office?Many thanks.

[JTFW]

On 6/20/2020 at 10:58 AM, ACHQ said:

regarding transfers, be proactive and see what you need to do to accomplish that.

It kinda sucks you don't have any IM rotations in the first 6 months of residency. I would definitely use that 1 elective block in IM, CTU would be the best one only because it will give you face time with the program and the ability to get refere

I was in the opposite side. I transferred from IM to FM. Like other people said, it depends on the province and the school you are in. Generally, bigger school programs like UofT and UBC have 1-2 spots for transfer. However, they are usually CMG spots. For IMG, you do have to fulfill your contract (return of service) so it might be more difficult. I personally know someone who wants to switch from FM to IM and is not able to due to return of service contract. You might have to speak directly to PGME/province/PD. 

[Gues]

1 hour ago, JTFW said:

I was in the opposite side. I transferred from IM to FM. Like other people said, it depends on the province and the school you are in. Generally, bigger school programs like UofT and UBC have 1-2 spots for transfer. However, they are usually CMG spots. For IMG, you do have to fulfill your contract (return of service) so it might be more difficult. I personally know someone who wants to switch from FM to IM and is not able to due to return of service contract. You might have to speak directly to PGME/province/PD. 

Great to hear about your success story! Unfortunately being an IMG makes it even more challenging. I don’t know of any IMGs who could transfer

Also, if you don’t mind, can you share the reason for your transfer? Thanks.

 

[gogogo]

On 6/22/2020 at 7:00 PM, JTFW said:

I was in the opposite side. I transferred from IM to FM. Like other people said, it depends on the province and the school you are in. Generally, bigger school programs like UofT and UBC have 1-2 spots for transfer. However, they are usually CMG spots. For IMG, you do have to fulfill your contract (return of service) so it might be more difficult. I personally know someone who wants to switch from FM to IM and is not able to due to return of service contract. You might have to speak directly to PGME/province/PD. 

If you have the time (either here or PM), could you please elaborate on FM vs. IM? What made you switch from IM to FM and why do you think others do the opposite? Thanks!

[MDinCanada]

6 hours ago, gogogo said:

If you have the time (either here or PM), could you please elaborate on FM vs. IM? What made you switch from IM to FM and why do you think others do the opposite? Thanks!

I don't know a single internal med resident who's happy lol. IM to FM is probably quite common, the main reason being burnout. 

[MD2015:)]

I did not think about switching from FM to IM I was about 3/4 of the way through first year - I had completed a couple months of IM and also 4 months of FM as well as other subspecialties. I did CTU fairly late in the year and loved it and decided to switch to IM. The people in IM at my hospital (senior, chief resident, attendings, IM site director) spoke to the program director to advocate for me to switch. Once the PD said that the switch may be possible then I met with PGME and had a formal interview with IM and then they let me in. Then I told my FM program.

If you already know that you want to switch then I would contact PGME for advice. Not sure what the best timing is to approach the other program. I think halfway through the year once you have a chance to settle into FM would be ideal. If you can do IM rotations in the first half of the year then this would let the IM program have a chance to work with you to see if they would want to take you. The main issue that you may face is that it may be hard or impossible to switch as an IMG. I know several residents who switched residency programs but none of them were IMG. The IMGs that I know of were not allowed to switch.

[MD2015:)]

On 6/29/2020 at 10:30 AM, gogogo said:

If you have the time (either here or PM), could you please elaborate on FM vs. IM? What made you switch from IM to FM and why do you think others do the opposite? Thanks!

I switched from FM to IM because I found out I am a lot more detail oriented than I thought and I wanted the time to be be able to go into depth with clinical cases. I liked acute medicine and complexity a lot more than I thought I would. I didn't like some areas of family medicine (derm, ortho, optho) and so I was happy to not have to see it. There were other areas of FM that were ok but I did not mind going without (peds). I knew that the IM track would be longer and that residency would be tougher so I spoke to a lot of people and did a lot of thinking about the decision. IM residency was tough - tiring and hard. But now I am done it and I am so happy that I had switched programs! If I had to stay in FM then I probably would have done hospitalist and some other stuff and would have found a way to be very happy, but IM ended up being perfect for me.