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In the last CaRMS cycle, I was interested in Anesthesiology and Family medicine, and ultimately matched to my back up speciality in family medicine. Currently I am a new R1 in FM and I and I was wondering what options are available to switch my residency position perhaps to internal medicine? I wish I have explored other alternatives, such as IM with a fellowship in pain medicine whilst in medical school.   I wrote my USMLEs and scored 240 and 255 on both USMLE 1  and 2 respectively.  I'm  currently considering the possibility of switching residency to IM in Canada or perhaps going through the match process in the US to ultimately match to IM or Anesthesia. However, i was wondering what are the options to switch out residency? When do people reach out to their PD? Do you go through carms again to switch your residency.

Appreciate any help on how one may transfer during residency -as I understand that transferring residency is quite rare.

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1 hour ago, carmsregrets said:

In the last CaRMS cycle, I was interested in Anesthesiology and Family medicine, and ultimately matched to my back up speciality in family medicine. Currently I am a new R1 in FM and I and I was wondering what options are available to switch my residency position perhaps to internal medicine? I wish I have explored other alternatives, such as IM with a fellowship in pain medicine whilst in medical school.   I wrote my USMLEs and scored 240 and 255 on both USMLE 1  and 2 respectively.  I'm  currently considering the possibility of switching residency to IM in Canada or perhaps going through the match process in the US to ultimately match to IM or Anesthesia. However, i was wondering what are the options to switch out residency? When do people reach out to their PD? Do you go through carms again to switch your residency.

Appreciate any help on how one may transfer during residency -as I understand that transferring residency is quite rare.

Are you a CMG or an IMG?    That will likely matter.

Life is too short to do something you don't like, but have you looked into the various avenues within FM? Some provinces are more progressive with a fair amount of opportunities. FM guided pain medicine isn't big in many provinces, but sounds like you can carve out a niche in Ontario. Lots of variables.

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9 minutes ago, JohnGrisham said:

Are you a CMG or an IMG?    That will likely matter.

Life is too short to do something you don't like, but have you looked into the various avenues within FM? Some provinces are more progressive with a fair amount of opportunities. FM guided pain medicine isn't big in many provinces, but sounds like you can carve out a niche in Ontario. Lots of variables.

CMG but went to a three year medical school.  I  feel like i want to specialize and not be a generalist.

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Why not do 2 years of FM and apply to the FPA (+1 anesthesia) programs. You may not be able to practice anesthesia in a big academic centre, but there are certainly lots of employment opportunities outside the city where you can do prob 80%+ anesthesia and still do some other stuff on the side.

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1 hour ago, carmsregrets said:

In the last CaRMS cycle, I was interested in Anesthesiology and Family medicine, and ultimately matched to my back up speciality in family medicine. Currently I am a new R1 in FM and I and I was wondering what options are available to switch my residency position perhaps to internal medicine? I wish I have explored other alternatives, such as IM with a fellowship in pain medicine whilst in medical school.   I wrote my USMLEs and scored 240 and 255 on both USMLE 1  and 2 respectively.  I'm  currently considering the possibility of switching residency to IM in Canada or perhaps going through the match process in the US to ultimately match to IM or Anesthesia. However, i was wondering what are the options to switch out residency? When do people reach out to their PD? Do you go through carms again to switch your residency.

Appreciate any help on how one may transfer during residency -as I understand that transferring residency is quite rare.

I have no idea how applying to the US match works if you're currently in residency in Canada or if it's even possible - can't comment on that.

In Canada you have 3 options:

  1. Stick with FM as the above poster says and find your nice, do hosptialist, pain etc. Do this anyway while you're doing other options because as you say transferring is rare so want to be prepared.
  2. Apply to any open second round positions in CaRMS next year. I think IM is compeditive so probably will be few spots, if any, and high demand/competition from unmatched, attempted transfers like you're doing, IMGs, etc.
  3. Try to transfer. Approach the PD or other staff in the IM program at your institution, do electives in IM, see what you think. At some point ask the IM PD about transfer (or your FM PD to vouch for you if you have a good rapport. You will have the highest chances if your local IM program will take you, otherwise you apply to your PGME office for a national transfer which is even more rare.
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Anecdotally one of my classmate transferred from FM after 1st year to Anesthesia, both in Ontario, but at different universities. So it is possible to transfer, but I am unsure of the details as to how he did it. He did mention when he was in FM he did try his best to do electives in anesthesia elsewhere, maybe that's how he got insight into any open spots. Alternatively the ON government does have a MOHLTC funded re-training program, but for that you have to have finished your 1st residency, and have practiced for at least 1 year, https://www.health.gov.on.ca/en/pro/programs/hhrsd/physicians/reentry.aspx

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Transfer is your best bet to get what you want, hardly ever any spots left in round 2. Anecdotally, i have been aware of multiple FM transfers into Anesthesia in Ontario, as some programs lose their Anesthesia residents that transfer out into other fields.   You should start contacting programs to put out feelers for internal transfer. I wouldn't tell your own FM PD quite yet.

While in your FM program, work very hard to be a top resident, as you will need good standing and strong evals to get that later transfer.

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Transfers are possible but difficult. Over clerkship, I have seen the following transfers in recent years. However, keep in mind that there are  probs were people who were interested in transfers but were not successful ....Try to transfer, and if that does not work you can try the US or re-entry once you are done with your FM residency. 

Rads --> ortho ( 3 years ago)

FM--> peds ( last cycle)

IM--> FM ( last cycle)

Gen Surg --> FM ( last cycle)

Neuro--> FM ( last cycle)

FM--> IM( last cycle)

peds --> neuro

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