Reneging on residency match for Finance job

[bcat85]

You are a medical student. You know as little about the consequences of match violation as I do. Please shut up. Thanks.

Cool story bro. You know who knows a ton about match violations and their penalties? The NRMP. Instead of wasting time speculating on an internet forum and being a general douche, call them. They'll tell you what you want to know.

---

Members don't see this ad.

 

[belle54321]

If you do not honor your match commitments, then you can be barred from the match from 1-3 years, or permanently according to the NRMP website.

http://www.nrmp.org/res_match/about_res/ensuring.html

You will not likely get a waiver since you are not under "serious and extreme hardship."

No one can tell you what your exact chances of getting back into medicine will be, as the number of AMGs are increasing each year. Not that many old IMGs with low board scores are getting many residency opportunities these days.

 

[mlw03]

I'm trying to give you the benefit of the doubt and not just assume you're a troll. You want answers to very subjective questions. People have answered 1) - you just don't seem to like what they're saying. We've also answered 2). If you want to know what the exact consequences are to breaking a match from the NRMP perspective, pick up a f-ing phone and get the info yourself instead of coming on here and asking it to be spoon fed to you. You may not want to believe some future PD would pick a FMG over you (because you clearly think you're f-ing awesome), but PDs want dedicated doctor, not someone who might bail on their program if they get another offer they see as better. There is no EXACT answer to 2) because there are thousands of PDs across the US, and each make their own choices in concert with an admissions committee. But most of us posting seem to be on the same page - namely, that you come across as extremely full of yourself and not particularly committed to being a doctor. If you do that online, you probably do so in person too, and it's hard to imagine a PD picking someone who a) might leave their program b) might be a huge pain in the arse and c) has been out of medicine for X years. Board scores matter, but as many threads on here show, dedication does too. You give no indication of being dedicate to a career in medicine.

The discussion is in my OP and is, 1) what issues should I be thinking about in valuing a ROAD career, and 2) what are the exact consequences to reneging on a match. Only a few posters have contributed any meaningful insight, and no one seems to know an exact number for 2, including you and some self proclaimed PD, and instead toss around vague generalities. I find it hard to believe there are residencies that would take IMGs who are 6 to 10 years out of med school with low boards after practicing third world medicine and not AMGs w good boards who decided to give medicine another shot, after working 100 hr weeks in one of the most competitive fields on earth.

 

[shopsteward]

OP's main problem is that he has promised two entirely contradictory things to two separate groups of people, and can't work out which group of people to let down.

He should do well in PE, until his ponzi scheme collapses..

 

[WACC]

I see what you're saying.

Keep this in mind though: The programs that take the third-world applicants are usually malignant crap-ass community programs, not much better than third-world programs, that need warm bodies who won't complain. The FMGs fill that role nicely. They'll probably take you if you apply, being a ROAD-ready AMG, but don't expect to be happy with your choice.

The ROAD programs that you are currently a contender for will have a hard time taking you later for two reasons: you left once before, and there are new fresh medical graduates competing with you. It's like going into the ring again with opponents you cannot measure, and there are no guarantees the second time around.

I have no idea how the match works, so I can't really comment on whether leaving is a match violation or not. The match is a ******ed system anyway, so there's that.

Lets say I can accept leaving ROAD behind. precisely how long would i be barred from the match, and what, if any, are the pathways to a spot outside the match? Thanks.

 

[belle54321]

How long you will be barred from the match will depend on NRMP as it can be 1-3 years or permanently. As an independent candidate (anyone who is not a graduating AMG), you don't have to go thru the match, which means you can accept an out of match position. But be aware starting 2013, programs have to be all-in (or all-out) meaning they have to offer all their spots within the match or outside the match. So, probably really bad programs will offer all their spots outside the match. However this may not apply to advanced positions in cases where residents leave the program. So, doing an intern year may give you more options later on.

 

[Medstudentquest]

The discussion is in my OP and is, 1) what issues should I be thinking about in valuing a ROAD career, and 2) what are the exact consequences to reneging on a match. Only a few posters have contributed any meaningful insight, and no one seems to know an exact number for 2, including you and some self proclaimed PD, and instead toss around vague generalities. I find it hard to believe there are residencies that would take IMGs who are 6 to 10 years out of med school with low boards after practicing third world medicine and not AMGs w good boards who decided to give medicine another shot, after working 100 hr weeks in one of the most competitive fields on earth.

I see it as this. If you bail out now, you will definitely be breaking your match contract, and we can't tell for certain you will be banned for 1 year or 5 years or forever because the NRMP does not specifically give a time frame, so we cannot make that time frame up for you. Nevertheless, think about the following. The ROAD specialties are difficult to match into NOW, maybe sans gas, so they are not likely to get easier in the future. There will be more, not less, med students, and AMGs at that, who are fresh out of med school and eager to start, who may have the same or better profiles than you. You might think that you are a superstar, and may have a good profile, but in the ROAD specialties, you are competing with a TON of people with great profiles, who will be fresh out of med school. There is a distinct preference for those who are recent out of med school without a doubt.

So let's say you take your PE job now. You make 250k now, you are working 100 hours, it works out, you are making a ton in a few years, bla bla. Great if that scenario occurs for the next 30 years or whatever. On the other hand, say another recession occurs, there is downsizing, you get laid off with many others in the field. What next? You don't have an MBA, you don't have a finance degree, you only have an MD without a residency, which is worthless. What do you fall back on? Say you say ok this is not looking good, and I want to give medicine a try again. You are 3+ years out of med school, with no internship, no residency, and having been a match violator.

Most programs in the ROAD specialties will be wary to take someone who has ALREADY BAILED, they don't need to take a second look at your application because they have hundreds of application to fill their few spots, and there are ALWAYS people who don't match despite great profiles. Sure, maybe FM/IM/peds may take you since they are desperate and an English speaking AMG may be better than a FMG who lacks English proficiency and who's profile is dubious, but I doubt you'll be happy in those specialties given your posts.

Further, you refuse to divulge what specialty you have matched into. You keep hinting that it's not radiology. Ok, say you matched into derm. If you did and you reneg on your contract now, you will be 100% done in derm, not only is it a small field and people talk, same scenario if you are in rad-onc, probably even worse.

So that's my 2 cents, in an honest neutral look at the possibilities that you propose. My suggestion as someone else said is to finish your ROAD specialty. It's possible that you may be able to develop your skills in PE on the side, I don't know if that's a possibility or not. If you hate your ROAD specialty then bail then. I would not bail before doing your internship. An MD without an internship/residency is just a very expensive piece of paper.

 

[Medstudentquest]

Lets say I can accept leaving ROAD behind. precisely how long would i be barred from the match, and what, if any, are the pathways to a spot outside the match? Thanks.

Match will be all in/all out starting for the match in 2013. The only spots that may be offered outside the match will be for those people who get fired, leave, etc. Usually these are at the PGY-2 level, so you would need an intern year either way. It's rare to find an open PGY-1 year, most people make it through without significant issues and just stick it out for a yera so you would definitely have to be willing to go through the match for your PGY-1. Spots in ROAD specialties do not open regularly throughout the year, again the only exception may be gas. Derm, rads, ophtho, don't have spots that open up regularly so again you would likely have to go through the match again.

We cannot tell you leave ROAD/stick with PE. I would definitely suggest though, for you to finish your specialty and then bail if you don't like it. PE will still be there in the next 4 years or so, your residency options likely wont' be

 

[WACC]

How long you will be barred from the match will depend on NRMP as it can be 1-3 years or permanently. As an independent candidate (anyone who is not a graduating AMG), you don't have to go thru the match, which means you can accept an out of match position. But be aware starting 2013, programs have to be all-in (or all-out) meaning they have to offer all their spots within the match or outside the match. So, probably really bad programs will offer all their spots outside the match. However this may not apply to advanced positions in cases where residents leave the program. So, doing an intern year may give you more options later on.

Thanks. This is something I didn't know. My gut says it's not permanently as the NRMP website had a case of someone who actively lied about their credentials and was only barred for a few years. As some brilliant poster suggested, I called the NRMP earlier this week and i was told "it's on a case by case basis" and to refer to the website. Right. This is what I paid you bureaucrats thousands for. What is helpful are the personal experiences of people, which is what I was hoping for in posting on a residency issues forum.

 

[Dr. USMLE]

PE, good sir.

Alrite dude, you want to know? Here's how. I f***ing worked my ass off and learned everything an IBD BB analyst learns. I built out merger and LBO models on weekends and evenings. After I finished rounds and work, I crammed in equity research reports on every relevant HC company. I used med school scholarship money to take Training The Street. While other med school cats cried and moaned about "working too hard" and ducked out to chill at home every chance they could find in this bull**** of a year called MS IV year, I spammed every PE recruiter I could find, and every MM Health care PE fund in this country and then some. Finally one medical doctor who turned his back on this s****y field took a chance on me. And when I got my interviews, I killed them. And as I said, I have a pretty baller resume.. That's how, dude.

This post helps put the rest of your posts into perspective. Your current mentality seems to be: "I have sacrificed in order to become decent enough to do well in an interview with a biased PE general partner. I now have a once-in-a-lifetime opportunity in PE. I am willing to risk a 600K career in order to push myself to my intellectual limits in PE and possibly earn log orders more."

That's all fine and good, man, but own up to it. You're not making a balanced, rational decision by turning down a top 1% career to gamble with PE for 3 years. You're making an emotional decision because you're too close to it to have the proper perspective.

From your post, it also seems that you are underestimating the competition. The people I know personally in high finance were 4.0 math and finance concentrations at Harvard and MIT. Your homework is not competitive...you may be able to make up lost ground, but that is highly questionable in this hypercompetitive space.

That said, what's the worse thing that could happen? You'll probably be able to get into a FM/psych residency if PE doesn't work out. Go for it...you are beyond the point of being dissuaded with logic anyway.

 

[WACC]

This post helps put the rest of your posts into perspective. Your current mentality seems to be: "I have sacrificed in order to become decent enough to do well in an interview with a biased PE general partner. I now have a once-in-a-lifetime opportunity in PE. I am willing to risk a 600K career in order to push myself to my intellectual limits in PE and possibly earn log orders more."

That's all fine and good, man, but own up to it. You're not making a balanced, rational decision by turning down a top 1% career to gamble with PE for 3 years. You're making an emotional decision because you're too close to it to have the proper perspective.

From your post, it also seems that you are underestimating the competition. The people I know personally in high finance were 4.0 math and finance concentrations at Harvard and MIT. Your homework is not competitive...you may be able to make up lost ground, but that is highly questionable in this hypercompetitive space.

That said, what's the worse thing that could happen? You'll probably be able to get into a FM/psych residency if PE doesn't work out. Go for it...you are beyond the point of being dissuaded with logic anyway.[/

Couple of points.

The doc got me the first round interview, not the job. Second, a 4.0 from Harvard ug is basically unheard of. One girl got it in the early 2000s, she ended up at Harvard JD MBA and Goldman's internal PE group. Henry Kissinger was knocked out by a single a-. Third, a 4.0 from MIT is pretty lousy, considering their scale. Fourth, finance does not exist as an undergrad concentration or major at H or M.

The firm has better things to do than waste time interviewing people that can't hit the ground running. While I recognize there are risks to my success in PE, performance itself is not one of them. And you don't even know my background anyway, so what's the point of trying to convince you or others otherwise...which isn't even the reason I began this thread.

 

[Dr. USMLE]

Couple of points.

The doc got me the first round interview, not the job. Second, a 4.0 from Harvard ug is basically unheard of. One girl got it in the early 2000s, she ended up at Harvard JD MBA and Goldman's internal PE group. Henry Kissinger was knocked out by a single a-. Third, a 4.0 from MIT is pretty lousy, considering their scale. Fourth, finance does not exist as an undergrad concentration or major at H or M.

The firm has better things to do than waste time interviewing people that can't hit the ground running. While I recognize there are risks to my success in PE, performance itself is not one of them. And you don't even know my background anyway, so what's the point of trying to convince you otherwise.

All of my very close friends who went into it were summa cum laude (3.9+) at Harvard college and MIT (obviously the equivalent on their 5.0 scale). And I would know. One of them was president of PBK at Harvard with a 3.95. Granted, I fudged 3.9s to 4.0, but the point remains. Again, you're being highly unrealistic if you take your performance there to be guaranteed.

 

[WACC]

All of my very close friends who went into it were summa cum laude (3.9+) at Harvard college and MIT (obviously the equivalent on their 5.0 scale). And I would know. One of them was president of PBK at Harvard with a 3.95. Granted, I fudged 3.9s to 4.0, but the point remains. Again, you're being highly unrealistic if you take your performance there to be guaranteed.

There's not many who'd know better than people with my profile. If you have that then we probably overlapped in life.

The summa's and 5s got into mega caps, yes. Coming from a nontrad background, I didnt aim for TPG or Bain, I aimed for a slice that catered to my background. Leave out performance risk for the moment and help me answer the questions at hand.

 

[Substance]

There's not many who'd know better than people with my profile. If you have that then we probably overlapped in life.

The summa's and 5s got into mega caps, yes. Coming from a nontrad background, I didnt aim for TPG or Bain, I aimed for a slice that catered to my background. Leave out performance risk for the moment and help me answer the questions at hand.

A few questions, so that we can help you a bit more:

1. What is your nontrad background?

2. Is it possible to do PE after your ROAD residency?

 

[Medstudentquest]

There's not many who'd know better than people with my profile. If you have that then we probably overlapped in life.

The summa's and 5s got into mega caps, yes. Coming from a nontrad background, I didnt aim for TPG or Bain, I aimed for a slice that catered to my background. Leave out performance risk for the moment and help me answer the questions at hand.

WACC dude, we cannot make the decision for you! We don't know you and I think we have all given you pretty accurate info as to the options. You need to do some serious internal thinking here and decide what is best for you!

Your options-renege on your ROAD match now, possibly be banned from the match for 1-3 years or permanently, which may potentially close the opportunities for you to ROAD again in the future. Also, why give up on ROAD now if you don't even have the other job?!

Option 2 is to just burn bridges and get out of ROAD. If you land your PE job and things work out you may make out better than all of us in the end. But it has high risk, and if things don't work out you will have nothing but primary care to fall back on. If you are ok with that and chancing it, and have no major responsibilities as far as family goes, then it's an option I guess. Just make sure you can live with the options if you take this path.

If I were you, I would complete my residency, or at least start, and if you truly are unhappy then go into option B. I think there is more forgiveness if you start and then change your mind vs if you simply outright quit like this.

Also, you mentioned this person got you interviews but not the actual job yet. When will you know about the job? I would be careful because you will find yourself in a very unhappy situation if you end up with no residency and no PE job.

 

[WACC]

A few questions, so that we can help you a bit more:

1. What is your nontrad background?

2. Is it possible to do PE after your ROAD residency?

Nontrad for PE but trad for medicine. I don't know if this would help for returning to medicine, but my educational creds are from top tier schools.

It's possible to do PE after, as nothing is ever "impossible", the door narrows significantly however. One reason I got this job was because of my educational pedigree, however I matched into a no name program in a ROAD field. If I re apply after residency, these shops consider that to be regressing and it raises a red flag.

 

[Substance]

Nontrad for PE but trad for medicine. I don't know if this would help for returning to medicine, but my educational creds are from top tier schools.

It's possible to do PE after, as nothing is ever "impossible", the door narrows significantly however. One reason I got this job was because of my educational pedigree, however I matched into a no name program in a ROAD field. If I re apply after residency, these shops consider that to be regressing and it raises a red flag.

You have a good attitude.

The name of the program in ROAD is irrelevant if you aren't interested in academics, which in my opinion nobody should be because academics sucks.

They see being a ROAD doc as regressing...hmm, that's interesting. I've never heard of that.

 

[Perrotfish]

The firm has better things to do than waste time interviewing people that can't hit the ground running. While I recognize there are risks to my success in PE, performance itself is not one of them. And you don't even know my background anyway, so what's the point of trying to convince you or others otherwise...which isn't even the reason I began this thread.

The reason you began this thread was to ask a group of physicians to evaluate the relative risks and benifits of sacrificing a potential ROAD medical career (BTW, you might as well say which one) for a career in finance. The problem is that the compensation from ROAD is in flux, is different for the four specialties in ROAD, and anyway none of us have the slightest clue what the risk:benifit ratio of the finance sector actually is. We know millions/year is possible in finance, but is it plausible? What's the washout rate? What's the average earnings for those who don't wash out? How predictive is your resume of your future success? Without that data its impossible to give anything more than the roughest estimates of the risk you're about to take.

So the only practical quesetion we can answer is: 'what are the consequences of renneging on the match'. If you really reneg, as in you just don't show up to work, I think its been made pretty clear that you'd be banned from the match for a significant amount of time (if not for life), and would have a much harder time matching the second time around in any event. If this doesn't work out you could easily be trading a ROAD career for a lower paying, harder working specialty that you don't want. There does exist such a thing as a waiver for the match which would allow you to leave and still be eligible for a future match, but I have no idea how you obtain one. It should be mentioned that you fulfil the terms of your match after only 45 days on the job, though I'm not clear what happens to you per your contract if you actually walk off the job after that.

FWIW I would go with ROAD not because of the finances but because of the flexibility. A radiologist who makes 400K working 60 hours/week can make 200K working 30 and 100K working 15. They're not lucrative but contracts do exist for extremly light work hours in every field of medicine. My impression of finance (and you can correct me if I'm wrong) is that there is no end to the insane hours until you retire, its all or nothing. Residency hours (or worse) until I die sounds more like a prison sentence than an opportunity to me, and at the very least I would like to keep the option for shorter hours available in case I developed other priorities in the future. But that's just me.

 

[WACC]

The reason you began this thread was to ask a group of physicians to evaluate the relative risks and benifits of sacrificing a potential ROAD medical career (BTW, you might as well say which one) for a career in finance. The problem is that the compensation from ROAD is in flux, is different for the four specialties in ROAD, and anyway none of us have the slightest clue what the risk:benifit ratio of the finance sector actually is. We know millions/year is possible in finance, but is it plausible? What's the washout rate? What's the average earnings for those who don't wash out? How predictive is your resume of your future success? Without that data its impossible to give anything more than the roughest estimates of the risk you're about to take.

So the only practical quesetion we can answer is: 'what are the consequences of renneging on the match'. If you really reneg, as in you just don't show up to work, I think its been made pretty clear that you'd be banned from the match for a significant amount of time (if not for life), and would have a much harder time matching the second time around in any event. If this doesn't work out you could easily be trading a ROAD career for a lower paying, harder working specialty that you don't want. There does exist such a thing as a waiver for the match which would allow you to leave and still be eligible for a future match, but I have no idea how you obtain one. It should be mentioned that you fulfil the terms of your match after only 45 days on the job, though I'm not clear what happens to you per your contract if you actually walk off the job after that.

FWIW I would go with ROAD not because of the finances but because of the flexibility. A radiologist who makes 400K working 60 hours/week can make 200K working 30 and 100K working 15. They're not lucrative but contracts do exist for extremly light work hours in every field of medicine. My impression of finance (and you can correct me if I'm wrong) is that there is no end to the insane hours until you retire, its all or nothing. Residency hours (or worse) until I die sounds more like a prison sentence than an opportunity to me, and at the very least I would like to keep the option for shorter hours available in case I developed other priorities in the future. But that's just me.

Well I never considered delaying my start date to start internship and then quit as my gut was that consequences for reneging wouldn't be extraordinarily punitive. I'm surprised no one has or knows of others who have openly reneged on a match.

If IM or psych is still possible after reneging, then I think giving up ROAD is an acceptable trade-off.

I think it helps if I put out my perspective - the 20s and 30s should be for maximizing wealth to hit a number that allows one to retire well before the norm. if that payoff isn't hit, then you can take something that still provides a comfortable living until the std retirement age. As someone with experience in PE, and top tier degrees, I don't see why that should be so hard though i could be wrong. Again, i understand doctors are an ultraconservative bunch which is why I'm more interested in your thoughts on how hard returning to medicine would be. And if returning to medicine is one of those fallback options, all the better.

 

[Perrotfish]

Well I never considered delaying my start date to start internship and then
quit as my gut was that consequences for reneging wouldn't be extraordinarily
punitive. I'm surprised no one has or knows of others who have openly reneged on
a match.

It's pretty rare for someone to come all this way, decide to go through the match, and then quit before doing even 45 days of residency. It requires giving up entirely, within a 6 month window, despite a huge amount of social and financial pressure not to quit. I know one person who did it, but she never came back to medicine so that isn't particularly helpful

I think it helps if I put out my perspective - the 20s and 30s should be for
maximizing wealth to hit a number that allows one to retire well before the
norm. if that payoff isn't hit, then you can take something that still provides
a comfortable living until the std retirement age.

I don't understand how retiring before the norm is an advantage if the total number of work hours to reach retirement still approaches the average. I can see the advantage of, say, patenting something and retiring early after a decade of 40 hour weeks, but working a 100 hours/week for the next 15 years so that you don't need to work the 25 after that? Why are your hours less valuable in your youth than when you're middle aged? All the research that's been done suggests you maximize happiness by spreading out leizure and wealth over as much of your life as possible, and that the extremes of the bell curve (wealth/retirement and 100 hour weeks/poverty) are much less conducive to happieness than something in the middle.

 

[gutonc]

The discussion is in my OP and is, 1) what issues should I be thinking about in valuing a ROAD career, and 2) what are the exact consequences to reneging on a match. Only a few posters have contributed any meaningful insight, and no one seems to know an exact number for 2, including you and some self proclaimed PD, and instead toss around vague generalities. I find it hard to believe there are residencies that would take IMGs who are 6 to 10 years out of med school with low boards after practicing third world medicine and not AMGs w good boards who decided to give medicine another shot, after working 100 hr weeks in one of the most competitive fields on earth.

This is why most people think you're a troll...and a jerk.

But to answer your questions (again), the consequences of violating your match agreements are up to the NRMP themselves which is why nobody (but them...after the fact) can give you a precise answer (which you already know...so why are you still asking?). You will more than likely be banned from the Match for some period of time ranging from 1 year to forever.

I think a bigger problem is that, even if/when the NRMP lets you back in, you're going to have a gap of X years with no clinical experience that, no matter how hard you worked hiding fake money from the IRS during that time, will be tough to overcome. And you will also run the risk (that, again, nobody can quantify for you) of pissing off your TY and advanced PDs enough that they will blackball you in the future. Medicine itself is a small world, but I can assure you that all of the Derm (or Ophtho or whatever) PDs know each other, and talk to each other. While I don't think it's hugely likely that this will happen, it's definitely a risk.

Furthermore, the "if a guy from Somalia can get an FM spot in Newark after being out of school 5 years, why can't I get a ROAD spot in LA after being out for 5 years" is kind of a straw man argument. You could probably get that FM spot in Newark. You wouldn't want it, but I'm sure they'd give it to you.

What is helpful are the personal experiences of people, which is what I was hoping for in posting on a residency issues forum.

If you mean people who have violated their match agreements, most of those people are currently posting on the "Starbuck's barista whine and moan" forum, not here.

I think a major issue here is that you're trying to quantify the barely quantifiable and make a logical decision based on those results. It's just not going to be possible. You already know that completing your residency and staying in medicine is low risk/moderate reward. Completing residency then going into PE is low to moderate risk/moderate to high reward...assuming you can still get a PE job then. You also already know that violating your Match agreement and going into PE is high risk/moderate to very high reward. If you complete your training, you'll always have some sort of backup plan if/when the finance thing falls apart...but on the flip side, you may not have that finance job at all in that scenario.

It's time to sack up and make your choice.

 

[Medstudentquest]

It's pretty rare for someone to come all this way, decide to go through the match, and then quit before doing even 45 days of residency. It requires giving up entirely, within a 6 month window, despite a huge amount of social and financial pressure not to quit. I know one person who did it, but she never came back to medicine so that isn't particularly helpful




I don't understand how retiring before the norm is an advantage if the total number of work hours to reach retirement still approaches the average. I can see the advantage of, say, patenting something and retiring early after a decade of 40 hour weeks, but working a 100 hours/week for the next 15 years so that you don't need to work the 25 after that? Why are your hours less valuable in your youth than when you're middle aged? All the research that's been done suggests you maximize happiness by spreading out leizure and wealth over as much of your life as possible, and that the extremes of the bell curve (wealth/retirement and 100 hour weeks/poverty) are much less conducive to happieness than something in the middle.

Absolutely. Not to mention that waiting to enjoy all this "wealth" after you are 40 or whatever seems kinda wild. It makes a lot more sense to try to enjoy life while building wealth. Further, given that most of us are used to working long and hard, I think that most people would find it incredibly boring to retire at an early age. What's the point of working really hard until you are 30 or so and then spending the next 20 years working to retire at 50? I find it wasteful, not to mention boring.

 

[SeekerOfTheTree]

LT, as best I understand, are to either stay in PE and win the lottery, or move to something w/ a minimum payout, ceteris paribus, on the low end of the range between primary care and ROAD.

I appreciate your thoughts. Thanks. The reason I want to take this job now is that it's hard to come by...as one poster above alluded to...people do IBD and McK to get this sort of job. Also, the doctor that ended up being my advocate really put himself on the line to get me an offer. I feel worse about burning him than a residency program that at the end of the day sees me as an interchangeable commodity and pays me a lot less for that privilege too. Good night.

If you already knew you would not want to burn him and you thought this was a ****ty career then why did you post here? I just don't understand. Good luck with your career man.

 

[Oxer45]

The doc got me the first round interview, not the job. Second, a 4.0 from Harvard ug is basically unheard of. One girl got it in the early 2000s, she ended up at Harvard JD MBA and Goldman's internal PE group. Henry Kissinger was knocked out by a single a-. Third, a 4.0 from MIT is pretty lousy, considering their scale. Fourth, finance does not exist as an undergrad concentration or major at H or M.

Finance does exist as an undergrad concentration. Columbia offers IEOR Financial Engineering for the specific purpose of going into wall st. Who do you think developed the CDO's. NYU stern econ major is basically for wall st. Any econ major in Ivy league is basically for getting a job at wall st or becoming a econ professor.

 

[Paddington]

 

[WACC]

Finance does exist as an undergrad concentration. Columbia offers IEOR Financial Engineering for the specific purpose of going into wall st. Who do you think developed the CDO's. NYU stern econ major is basically for wall st. Any econ major in Ivy league is basically for getting a job at wall st or becoming a econ professor.

Lol. Lmao. Medicine is really full of imbeciles who can't even pass reading comprehension. This is what happens when med schools take their eyes off the ball and stop weighing the verbal section of the mcat. Just lol. I hope for the sake of our society you are doing primary care in the ghetto or something similar.

 

[Top Gun]

You are a medical student. You know as little about the consequences of match violation as I do. Please shut up. Thanks.

The med student is right, dude. When you've violated the match, your chances of securing another residency are pretty much nil. And you would know this too if you had read the NRMP rules. I don't know how any med student could be ignorant of the NRMP regulations, to be honest. Its not like they're hard to find, seeing as how they're listed on the NRMP site.

Anyway, you probably should jump ship and go to private equity, if that's what floats your boat. Your personality seems more suited to finance than medicine, anyway.

 

[WACC]

It's pretty rare for someone to come all this way, decide to go through the match, and then quit before doing even 45 days of residency. It requires giving up entirely, within a 6 month window, despite a huge amount of social and financial pressure not to quit. I know one person who did it, but she never came back to medicine so that isn't particularly helpful

I don't understand how retiring before the norm is an advantage if the total number of work hours to reach retirement still approaches the average. I can see the advantage of, say, patenting something and retiring early after a decade of 40 hour weeks, but working a 100 hours/week for the next 15 years so that you don't need to work the 25 after that? Why are your hours less valuable in your youth than when you're middle aged? All the research that's been done suggests you maximize happiness by spreading out leizure and wealth over as much of your life as possible, and that the extremes of the bell curve (wealth/retirement and 100 hour weeks/poverty) are much less conducive to happieness than something in the middle.

I think Youre mixing lifestyle security with financial independence. Medicine allows a great lifestyle, enough to pretend you are rich, but you will never be truly rich without accumulating the earned income. Finance offers a shot at having both but with more risk. Shrug.

 

[notdeadyet]

What is helpful are the personal experiences of people, which is what I was hoping for in posting on a residency issues forum.

You're getting less help than you hoped because the vast majority of medical school grads keep their word and honor their contract.

 

[DocDanny]

It seems like you are most interested in making as much money as possible. If that is your primary motivator then please go to finance and make your money. I think your personality makes medicine a poor fit for you.

The medical community will do just fine without you.

 

[J-Rad]

Just a friendly reminder to everyone to keep it courteous here, please. By all means engage in (sometimes contentious) discussion, but keep it professional.

 

[dvns11]

i dont even know what to tell you. I have been scouring all the sites all year looking for an open position and you are considering breaking your contract.
Follow your dreams/passion is all i can say.

...and if your passion happens to be OUTSIDE of residency, refer me to the PDs of your transitional year/sdvsnced program so i can get your spot!

 

[Dr. USMLE]

Lol. Lmao. Medicine is really full of imbeciles who can't even pass reading comprehension. This is what happens when med schools take their eyes off the ball and stop weighing the verbal section of the mcat. Just lol. I hope for the sake of our society you are doing primary care in the ghetto or something similar.

There really isn't any reason to behave this way when seeking help. You're right, but you're also being pedantic and ignoring the point. They did concentrations in math and econ with an express interest of breaking into financial services from the get-go. I abbreviated that to "math and finance" to keep it short and relevant. The point remains unanswered: how are you going to compete with other similarly (or more) intelligent competitors who have been formally trained at H and M?

Looking at the data you've given us, you did well on your boards but had mediocre grades in med school and ended up in a no name derm/ophtho program, all of which is inconsistent with your prior pedigree. This suggests that you were outcompeted by many other applicants (with worse pedigrees) for better programs. This is a redflag to PE recruiters for a reason; what makes you think you'll be competitive in PE if you were unable to secure a good ROAD program? It really isn't that challenging and ALL of the people I knew from undergrad would have been able to do it at a top 5 program. You do realize that PE will be the hardest, most intense competition you've ever faced, including your time at Harvard, right?

You also had an informal, mostly self-taught education in finance, specifically HC PE. Why would you think that you'd be able to compete with those formally trained in those areas by H and M professors, who are also probably smarter than you based on your performance in med school?

 

[mlw03]

this guy has posted 26 times on sdn so far, pretty much all in this thread. what more is there to discuss? he asked his question, it's been answered, and now he has to decide what he wants to do with his life. if he's legit, fine, and if he's a troll, it's been mildly entertaining for the last 2 days. either way, i don't see what else there is to debate on this topic.

 

[Perrotfish]

I think Youre mixing lifestyle security with financial independence. Medicine allows a great lifestyle, enough to pretend you are rich, but you will never be truly rich without accumulating the earned income. Finance offers a shot at having both but with more risk. Shrug.

Is the goal to be rich? I always thought the goal was to be happy, and becoming rich was a means to that end. If you have security and you have enough money to live an upper class lifestyle ('pretending' to be rich, as you put it) it seems like you've maximized your wealth's potential impact on your happieness,I'm not sure what financial independence can buy you that you wouldn't already have. If you can get to the point where you can knock out wealth as a barrier to happieness after only 4 years of residency I don't see why you would choose to spend 15 years working more miserable hours for the same result.

 

[WACC]

Is the goal to be rich? I always thought the goal was to be happy, and becoming rich was a means to that end. If you have security and you have enough money to live an upper class lifestyle ('pretending' to be rich, as you put it) it seems like you've maximized your wealth's potential impact on your happieness,I'm not sure what financial independence can buy you that you wouldn't already have. If you can get to the point where you can knock out wealth as a barrier to happieness after only 4 years of residency I don't see why you would choose to spend 15 years working more miserable hours for the same result.

I know where you're coming from, and there's an article in the NY Times I recommend you read that offers another perspective. It's called Gilded paychecks - Lure of great wealth affects career choices.

 

[WACC]

There really isn't any reason to behave this way when seeking help. You're right, but you're also being pedantic and ignoring the point. They did concentrations in math and econ with an express interest of breaking into financial services from the get-go. I abbreviated that to "math and finance" to keep it short and relevant. The point remains unanswered: how are you going to compete with other similarly (or more) intelligent competitors who have been formally trained at H and M?

Looking at the data you've given us, you did well on your boards but had mediocre grades in med school and ended up in a no name derm/ophtho program, all of which is inconsistent with your prior pedigree. This suggests that you were outcompeted by many other applicants (with worse pedigrees) for better programs. This is a redflag to PE recruiters for a reason; what makes you think you'll be competitive in PE if you were unable to secure a good ROAD program? It really isn't that challenging and ALL of the people I knew from undergrad would have been able to do it at a top 5 program. You do realize that PE will be the hardest, most intense competition you've ever faced, including your time at Harvard, right?

You also had an informal, mostly self-taught education in finance, specifically HC PE. Why would you think that you'd be able to compete with those formally trained in those areas by H and M professors, who are also probably smarter than you based on your performance in med school?

You don't understand private equity enough for us to carry on a worthwhile conversation on the topic - spend some time learning it and then you can PM me. You are also assuming multiple data points on my background that are either incorrect or incomplete.

 

[WACC]

You're getting less help than you hoped because the vast majority of medical school grads keep their word and honor their contract.

Medical students are human beings, and the vast majority of human beings act out of self interest. If they had the option of PE or something as potentially lucrative as medicine, they would entertain it. Simple as that.

 

[WACC]

This is why most people think you're a troll...and a jerk.

But to answer your questions (again), the consequences of violating your match agreements are up to the NRMP themselves which is why nobody (but them...after the fact) can give you a precise answer (which you already know...so why are you still asking?). You will more than likely be banned from the Match for some period of time ranging from 1 year to forever.

I think a bigger problem is that, even if/when the NRMP lets you back in, you're going to have a gap of X years with no clinical experience that, no matter how hard you worked hiding fake money from the IRS during that time, will be tough to overcome. And you will also run the risk (that, again, nobody can quantify for you) of pissing off your TY and advanced PDs enough that they will blackball you in the future. Medicine itself is a small world, but I can assure you that all of the Derm (or Ophtho or whatever) PDs know each other, and talk to each other. While I don't think it's hugely likely that this will happen, it's definitely a risk.

Furthermore, the "if a guy from Somalia can get an FM spot in Newark after being out of school 5 years, why can't I get a ROAD spot in LA after being out for 5 years" is kind of a straw man argument. You could probably get that FM spot in Newark. You wouldn't want it, but I'm sure they'd give it to you.

If you mean people who have violated their match agreements, most of those people are currently posting on the "Starbuck's barista whine and moan" forum, not here.

I think a major issue here is that you're trying to quantify the barely quantifiable and make a logical decision based on those results. It's just not going to be possible. You already know that completing your residency and staying in medicine is low risk/moderate reward. Completing residency then going into PE is low to moderate risk/moderate to high reward...assuming you can still get a PE job then. You also already know that violating your Match agreement and going into PE is high risk/moderate to very high reward. If you complete your training, you'll always have some sort of backup plan if/when the finance thing falls apart...but on the flip side, you may not have that finance job at all in that scenario.

It's time to sack up and make your choice.

Bottom line is, I wanted a discussion on how long I'd sit out the match for and whether I could get back into medicine and where a/w. It sounds like FP/IM/Peds/Psych is basically it. If that's the case, I'll make my decision on it. I can't believe the NRMP is so f'ed up as to not even give any timetable on how long I'd sit out the match for. Then instead/in addition to all that, I got an discussion on my credentials for PE, whether I'm trolling (lmao), etc. Some of you guys are hilarious - you basically discount anything you see that doesn't fit neatly within your narrow box or line of thinking.

 

[link2swim06]

Bottom line is, I wanted a discussion on how long I'd sit out the match for and whether I could get back into medicine and where a/w. It sounds like FP/IM/Peds/Psych is basically it. If that's the case, I'll make my decision on it. I can't believe the NRMP is so f'ed up as to not even give any timetable on how long I'd sit out the match for. Then instead/in addition to all that, I got an discussion on my credentials for PE, whether I'm trolling (lmao), etc. Some of you guys are hilarious - you basically discount anything you see that doesn't fit neatly within your narrow box or line of thinking. Then again, that's the kind of stupidity medicine breeds. I fear for the future.

I am not a 4th year but I can't imagine dropping medicine completely after 4 years of training. I have spent far too much time in the past 2 years learning a ton of stuff...it would seem like a waste to just leave it for another profession. Especially considering you haven't even worked as an attending yet and dont know if you would like it...

It would kinda be a huge sacrifice with no reward if you quit now...

 

[Law2Doc]

...I can't believe the NRMP is so f'ed up as to not even give any timetable on how long I'd sit out the match for....

Not really surprising. The goal of NRMP is to not have you break the rules in the first place, not have you weigh the cost benefits of breaking them. It reserves the right to decide how draconian it wants to be on a case by case basis. Actually pretty naive to expect an iron clad timetable when their goal is really just to say "thou shall not do this or else..."

suffice it to say if you renege you probably close many doors.

Now troll be gone to your greener pastures of PE. It's clearly what you've been pining for.

 

[Perrotfish]

I know where you're coming from, and there's an article in the NY Times I recommend you read that offers another perspective. It's called Gilded paychecks - Lure of great wealth affects career choices.

It was an interesting article,but I don't think it really addresses my point. The two people profiled were both lured by riches to careers that were both more lucerative and had a comperable or better lifestyle than the careers they left. If you assume purely self interested motivations that's basically a no brainer. You, on the other hand, are proposing transfering from a secure, lucrative field with amazing hours and flexabily to a much less secure position with terrible hours and no flexability, hoping for an even higher paycheck. That's not a no brainer, even assuming you have completely self interested motivations. It seems like the impact on your lifestyle will have a much greater effect on your happieness than the impact on your wealth, not even counting the risk.

Sorry to keep hammering on this point but the idea of seeing someone risk such an incredible bird in the hand for two such painfully theoretical birds in the bush gives me the heebie-jeebies. It's like watching someone go too a roulette wheel and put their life savings on black.

 

[WACC]

Not really surprising. The goal of NRMP is to not have you break the rules in the first place, not have you weigh the cost benefits of breaking them. It reserves the right to decide how draconian it wants to be on a case by case basis. Actually pretty naive to expect an iron clad timetable when their goal is really just to say "thou shall not do this or else..."

suffice it to say if you renege you probably close many doors.

Now troll be gone to your greener pastures of PE. It's clearly what you've been pining for.

What is this toolbag still doing on my thread. Go crawl back in your hole.

 

[michaelrack]

Looks like the options are:

1. Do the ROAD residency.
2. Do PE- don't show up for residency at all- and have verly slim chance at ever getting back into medicine.
3. Do 45 days of residency and then quit to do PE; this would give you a modest chance of getting a psych or primary care residency as long as you did not wait too long (chances decrease markedly after 3 years)

No one can make the decision for you

 

[Oxer45]

A person who studies finance at home and immediately gets a job in private equity is like a teenager studying medical books at home then getting a job as a surgeon.

 

[michaelrack]

A person who studies finance at home and immediately gets a job in private equity is like a teenager studying medical books at home then getting a job as a surgeon.

disagree with your analogy- it is impossible for someone to get a job as as surgeon without the appropriate formal education, and most importantly a medical license. It is possible to learn finance on your own with a year of dedicated study- with the knowledge gained I think an MD with good networking skills could get a PE job.

 

[Taurus]

Here's a Yale MD PhD who dropped out of orthopedic residency at MGH to go work in finance.

Joseph "Chip" Skowron III

Oh yeah, he's going to jail for 5 years too.

 

[Dr. USMLE]

Here's a Yale MD PhD who dropped out of orthopedic residency at MGH to go work in finance.

Joseph "Chip" Skowron III

Oh yeah, he's going to jail for 5 years too.

Haha...

"In perhaps the case’s most unusual twist, one of the victims was the Galleon Group, the hedge fund headed by Raj Rajaratnam, the convicted hedge fund manager who last month received an 11-year prison term, the longest sentence for insider trading in United States history."

You guys should read the Wolf of Wall Street if you get a chance. It's about a pre-med who opted out for finance (and of course eventually ended up in jail).

 

[scootad.]

Please leave and go into PE douchebag - you are selfish, rude, and annoying and your continued presence in the medical field only makes the field worse. Good riddance troll!

 

[WACC]

It was an interesting article,but I don't think it really addresses my point. The two people profiled were both lured by riches to careers that were both more lucerative and had a comperable or better lifestyle than the careers they left. If you assume purely self interested motivations that's basically a no brainer. You, on the other hand, are proposing transfering from a secure, lucrative field with amazing hours and flexabily to a much less secure position with terrible hours and no flexability, hoping for an even higher paycheck. That's not a no brainer, even assuming you have completely self interested motivations. It seems like the impact on your lifestyle will have a much greater effect on your happieness than the impact on your wealth, not even counting the risk.

Sorry to keep hammering on this point but the idea of seeing someone risk such an incredible bird in the hand for two such painfully theoretical birds in the bush gives me the heebie-jeebies. It's like watching someone go too a roulette wheel and put their life savings on black.

Your original point was equating happiness with the guarantee of a lifestyle, not accumulated wealth. The article pretty much addresses that I think.

I think its obvious that to most people if offered a guarantee of 500k/year for life in some job, would jump at it over a risky but higher payoff. Medicine is extremely compelling to such people, who whether they are actually mediocre or fear eventual mediocrity, don't want a lot of disparity between the financial rewards for excellence and mediocrity. But that's obvious, and pointless to carry on any longer.

Worthwhile posts that can now be added to this thread would actually provide more exact numbers or confirmable anecdotes on the consequences of reneging. Thanks.