Finding a new program after ACGME shuts program down

[aenimal]

Does anyone here have any experience with their program being closed?

I'm about halfway through residency in a surgical subspecialty. My program has recently undergone a site visit and it's looking like we are likely to be shut down. Honestly, I'm relieved by this outcome, as the program is completely toxic. However, it's leading to a lot of anxiety about where I might end up.

My husband's work can only be done in certain locations, and we recently had a baby and life would be a lot better if we could be near family for support. I know I will get another spot in the same field, but how much control do I have over where I end up? Am I just given a spot somewhere in a program that has requested more people? Can I specify preferred cities or programs? Would it be unreasonable to reach out to program directors where I'd like to end up (and would they even take me if they're the programs I ranked above the one where I matched but clearly I didn't match there so maybe they didn't like me...)?

Thanks for any insights you all may have.

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[DrMetal]

Does anyone here have any experience with their program being closed?

I'm about halfway through residency in a surgical subspecialty. My program has recently undergone a site visit and it's looking like we are likely to be shut down. Honestly, I'm relieved by this outcome, as the program is completely toxic. However, it's leading to a lot of anxiety about where I might end up.

My husband's work can only be done in certain locations, and we recently had a baby and life would be a lot better if we could be near family for support. I know I will get another spot in the same field, but how much control do I have over where I end up? Am I just given a spot somewhere in a program that has requested more people? Can I specify preferred cities or programs? Would it be unreasonable to reach out to program directors where I'd like to end up (and would they even take me if they're the programs I ranked above the one where I matched but clearly I didn't match there so maybe they didn't like me...)?

Thanks for any insights you all may have.

What subspecialty and how far along are you? Have you officially been told that you can't finish? (sometimes programs allow those that are close to finish).

 

[NotAProgDirector]

It's nowhere near as automatic or simple as you suggest. If your program closes, you'll need to find a new spot. The ACGME sometimes tries to act as a broker, but honestly it usually comes down to you simply finding a new position yourself. If the program closes, the institution can either let the slots go with you (and then any program that takes you can get extra funding) or they can hold onto them -- slots are not specialty specific, so they can just repurpose them to another field if they want -- in that case any program that takes you needs to sort out the funding itself. If the program is "that bad" that it's going to be closed down by the ACGME, you'll need to convince a new program that you actually have the skills you should have.

You can try to direct yourself to a specific city or region, but it will completely depend upon whether there's a program there that can take you. And any program that does take you needs to have enough procedures for all of their current residents plus you.

 

[aenimal]

What subspecialty and how far along are you? Have you officially been told that you can't finish? (sometimes programs allow those that are close to finish).

I have a few years left. I'm not sure I want to finish here once shut down. The retaliation on top of the current environment would be extremely unpleasant. However, definitely preferable to no spot at all.

It's nowhere near as automatic or simple as you suggest. If your program closes, you'll need to find a new spot. The ACGME sometimes tries to act as a broker, but honestly it usually comes down to you simply finding a new position yourself. If the program closes, the institution can either let the slots go with you (and then any program that takes you can get extra funding) or they can hold onto them -- slots are not specialty specific, so they can just repurpose them to another field if they want -- in that case any program that takes you needs to sort out the funding itself. If the program is "that bad" that it's going to be closed down by the ACGME, you'll need to convince a new program that you actually have the skills you should have.

You can try to direct yourself to a specific city or region, but it will completely depend upon whether there's a program there that can take you. And any program that does take you needs to have enough procedures for all of their current residents plus you.

Well that stinks. The person conducting the site visit assured us we would all definitely have spots in our specialty somewhere and that our hospital DIO would be the main contact for helping obtain them.

Fortunately I'm almost finished with my numbers so hopefully that will be viewed positively by other programs. Our caseload is too heavy for how many residents we have, so we're often operating until midnight or beyond, then we round at 5am because our census is so high and the bosses won't let us split the service up into reasonable pieces unless we're over 50 patients because they say it will "toughen us up". We have rampant hours violations and are told to work on our efficiency and not to log certain things as work hours when we bring up the issues to higher ups. Multiple staff are extremely abusive and there's constant harassment and beratement, including for things such as body habitus, loudness of breathing, gender, sexual orientation.

It's bad. I want to believe there are protections in place to end programs like this without punishing residents, but from what you're saying it sounds like maybe not.

 

[DrMetal]

I have a few years left. I'm not sure I want to finish here once shut down. The retaliation on top of the current environment would be extremely unpleasant. However, definitely preferable to no spot at all.

Sorry, you're in a tough spot. If you were a R1 or a 2, I'd say GTFO and find a new program. If you were a 4, or a 5, I'd say finish. Sounds like you're somewhere in between.

If you can at all find a way to stomach it and finish, and if you're given that opportunity (say if they're not closing the program for another 2-3 years), I still think that'd be best. Whatever you decide to do, wait until everything is official (that you know for sure they're shutting it down) until you make any decisions.

Also: that you know how to multiquote demonstrates you're a SDN veteran . . .smart on you for making an alias.

 

[CajunMedic]

I went through this in 2019 when my EM program closed. Once it's official, the ACGME will open up a list of open positions that you can contact, and programs that are willing to take on extra residents. For us, it was updated daily. I also cold-called and emailed programs I was interested in once I knew particulars (funding status, last day, etc.)

In the meantime, Get unofficial copies of board scores, print out procedure logs, dig out your ERAS app, update your CV. Programs may want that to look at you before they get the official documents from your program coordinator. Plus, once funding is worked out, your program will have a letter to send out with the details.

 

[aenimal]

I went through this in 2019 when my EM program closed. Once it's official, the ACGME will open up a list of open positions that you can contact, and programs that are willing to take on extra residents. For us, it was updated daily. I also cold-called and emailed programs I was interested in once I knew particulars (funding status, last day, etc.)

In the meantime, Get unofficial copies of board scores, print out procedure logs, dig out your ERAS app, update your CV. Programs may want that to look at you before they get the official documents from your program coordinator. Plus, once funding is worked out, your program will have a letter to send out with the details.

Thank you, so great to hear from someone who's been through it!

In the end, were you able to find a spot fairly readily? Were you happier at your new program? Feel free to PM if you prefer.

 

[CajunMedic]

Thank you, so great to hear from someone who's been through it!

In the end, were you able to find a spot fairly readily? Were you happier at your new program? Feel free to PM if you prefer.

I was. I had my first interview within 72 hours of the announcement and had a contract in hand within a week. 4 of us total came to the same program. I am definitely happier at my new program. My old one was good, there was mainly infrastructure issues

 

[aenimal]

For anyone who looks back at this in the future because they have a similar question, I actually had multiple offers of spots at other programs and chose a very highly ranked program in a city that's very good for my family. So, at least right now, it seems this story has a happy ending.

I was very fortunate that my program released my funding to my new program. If anyone has a program where they do not keep their funding, I would do everything I could to not have the program shut down. I have colleagues at a different program that's been shut down who did not receive any funding, and they are having a very hard time finding spots.

I obtained a new spot by cold calling various programs that I liked. They asked for a range of things including letters of recommendation, board scores, annual specialty exam scores, cover letter, ERAS application, CV, med school transcript, case log, etc.

 

[teddy_tu]

For anyone who looks back at this in the future because they have a similar question, I actually had multiple offers of spots at other programs and chose a very highly ranked program in a city that's very good for my family. So, at least right now, it seems this story has a happy ending.

I was very fortunate that my program released my funding to my new program. If anyone has a program where they do not keep their funding, I would do everything I could to not have the program shut down. I have colleagues at a different program that's been shut down who did not receive any funding, and they are having a very hard time finding spots.

I obtained a new spot by cold calling various programs that I liked. They asked for a range of things including letters of recommendation, board scores, annual specialty exam scores, cover letter, ERAS application, CV, med school transcript, case log, etc.

I like this outcome!