Switching residency after PGY-1 year

[mmiinterviewprep]

Hi PM101 community members!

I will soon be a PGY-2 in FM, and as I am progressing in FM, I am realizing that I don't enjoy  FM very much. I  made a decision to pursue FM early in my 20s when I did not know much about medicine at the time. I am currently realizing that I am quite detail oriented person and I would like to have a deeper understanding of medicine and I'd much prefer to be a specialist. I was wondering what opportunities does one have in terms of switching careers from FM.  I am considering IM, or anesthesia or radiology.

Can anyone share their experience? Or is it unheard of?

[bearded frog]

Transfers happen, but are rare. It's pretty late in the year so extremely unlikely to happen before July especially if you haven't obviously committed to a specific thing you like more. Transfers into FM are more common than out of FM. Most likely to happen within schools, so in theory you would have demonstrated a passion for IM, done a bunch of IM electives, found mentors in IM who would support your transfer, then approach their program if they have an availability, etc. There is a national transfer system but usually only happens around this time and you haven't started the process. I am also not sure how it works if you're finishing residency as a FM, if you can transfer then into a different program (you would enter starting as a R1 or R2 regardless). Alternatively is the second round of the carms match which you can apply to even after finishing but most royal college spots are very compeditive as you're up against unmatched current year grads and IMGs.

To make a long story short, it's possible but not easy. I would seriously reflect on what it is about FM that you don't like, especially as it seems like you're just looking for "not-FM" as opposed to something specifically. What would you do if you couldn't transfer? Is there a trusted mentor you could talk to about your feelings and get an outside perspective?

[robclem21]

I agree with the poster above. The concerning feature about your post is that while you have listed 3 specialties that do require more detail-oriented practice and are unique in their scope, the day-to-day practice of these 3 specialties is drastically different. This suggests that you don't have enough exposure to any of them to suggest you'd be happier in them long-term. Going through the challenging process of switching programs, only to realize you don't like your new program either, and switching again would only be adding extra time to your training, costing you income years, and making your life more stressful than it needs to be.

I don't have much experience with transfers, but I have seen family medicine residents transfer to IM and to anesthesia. It is highly dependent on the school, the PD, and luck. As above, you will need electives and others to vouch for you. However, from family medicine you can do hospitalist medicine and also the FPA +1 program for anesthesia, so you have routes to practice types of those specialties from family medicine.

It sounds like youve put some thought into this already, but wanted to be more "detail oriented" without any exposure/insight into what you're transferring into in my opinion isn't a strong enough reason to transfer when you have options available from your current position.

[lovemedicinesomuch]

4 hours ago, robclem21 said:

 

I don't have much experience with transfers, but I have seen family medicine residents transfer to IM and to anesthesia. It is highly dependent on the school, the PD, and luck. As above, you will need electives and others to vouch for you. However, from family medicine you can do hospitalist medicine and also the FPA +1 program for anesthesia, so you have routes to practice types of those specialties from family medicine.

It sounds like youve put some thought into this already, but wanted to be more "detail oriented" without any exposure/insight into what you're transferring into in my opinion isn't a strong enough reason to transfer when you have options available from your current position.

Although your advise is well intended and makes sense - I think OP needs to be flexible with specialty choice because transfers are not guaranteed ( and that is the main advise one may get when they turn to PGME). You can't be gung ho about one specialty - but that also means you explore all other specialties very well because you may end up in them when you transfer. For instance, a friend of mind wanted plastics and now she is in FM - when she met with PGME they told her to be flexible and consider other surgical specialties and she is now transferring to ortho. 

I would also like to add the point that although FM can offer you flexibility -  you can never be an expert in a topic in FM, because of only 2 years of training. The difference between hospitalist and IM is huge ( one is an expert in their field whereas the other is not).  If the feeling of becoming an expert in your field is important to you, then do switch instead of finding some 'niche' in FM.  Sure FM is flexible - but you won't be an expert in your field. I personally felt no satisfaction in my work in FM because I was not working up challenging cases.  You won't also have deep knowledge in FM ( that is not what FM is meant for). 

I am in the process of transferring and I am in my last 1.5 month in FM- and I can't be happier about the transfer as FM was such a poor fit for my career interests.

If you feel the same like how I felt in FM- I'd look into transfer options - For me, the transfer process was very easy. I reached out to PGME. Then PD of my receiving department interviewed me, a day later I was offered a transfer elective, then transferred over. It is not that hard or challenging to transfer.

[Findanus]

14 hours ago, mmiinterviewprep said:

Hi PM101 community members!

I will soon be a PGY-2 in FM, and as I am progressing in FM, I am realizing that I don't enjoy  FM very much. I  made a decision to pursue FM early in my 20s when I did not know much about medicine at the time. I am currently realizing that I am quite detail oriented person and I would like to have a deeper understanding of medicine and I'd much prefer to be a specialist. I was wondering what opportunities does one have in terms of switching careers from FM.  I am considering IM, or anesthesia or radiology.

Can anyone share their experience? Or is it unheard of?

Since you only have one year left of FM I would recommend just finishing that and then preparing to reapply after you are done. As the first round of carms is not open to you anymore, your options include re-entry programs and applying to the USA. If you do well enough on the USMLE exam you theoretically have a shot of getting into radiology or anesthesia. IM should be easy to match to in the USA. Canadian re-entry programs are province specific and unreliable, but they are an option.

[anotheranon]

unfortunately you can't transfer in your last year of residency, and as we're almost to July that would be you wouldn't be able to transfer I would finish and then re-apply, or try to find a +1. FM docs can do anesthesia or hospitalist!

[GH0ST]

It's somewhat late in my view to change your residency though I suppose it's possible depending on luck and how supportive your program is. You'll have to consider either +1 (but it sounds like you don't even want the title of GP), or apply for re-entry. Seen a few residents who practiced in FM go into PHPM, IM, or anesthesia before. 

I do not agree with the idea of "flexibility" since that shouldn't be a determining factor in making a life changing decision. This person should get increased exposure to these fields before making an informed choice. 

- G

[JohnGrisham]

On 4/27/2022 at 6:06 AM, lovemedicinesomuch said:

Then PD of my receiving department interviewed me, a day later I was offered a transfer elective, then transferred over. It is not that hard or challenging to transfe

Interesting that you had such a smooth experience, colleagues who tried the same had a bit of an uphill battle. Im sure its province/program/school specific no doubt.

[mmiinterviewprep]

5 hours ago, JohnGrisham said:

Interesting that you had such a smooth experience, colleagues who tried the same had a bit of an uphill battle. Im sure its province/program/school specific no doubt.

Its hard to change from FM to most royal colleges, I heard vs. the other way around. I heard from others that 'FM residents' are assumed to not be as competitive as residents from other specialties.

[robclem21]

16 hours ago, mmiinterviewprep said:

Its hard to change from FM to most royal colleges, I heard vs. the other way around. I heard from others that 'FM residents' are assumed to not be as competitive as residents from other specialties.

This is not true. This has everything to do with $$$ and training capacity than competitiveness.