Switching Residency

[deleted595450]

I am an IMG. I have green card. I graduated in 2011. I started pathology residency last year. Unfortunately, I did not perform very well during residency and program director told me to resign otherwise my contract would be non renewed. I have resigned now but my resignation will take effect at the end of this academic year so I will be able to complete one year of pathology residency and get GME credit of one year. Obviously, I want to switch my residency now. I am thinking about some less competitive specialty like family medicine. I am going into SOAP this year but I did not apply formally to any programs and so I have zero interviews. What are my chances of getting into family medicine now? If I am not successful in SOAP will there be a reasonable chance to get into Family Medicine residency next year if I formally apply in September 2014? Or is it just that it is the end of the world for me and I should think about doing something else other than medicine?

My Board Scores are as follows:
1. Step 1 251
2. Step 2 CK 244
3. Step 2 CS Passed on 2nd attempt
4. Step 3 218

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[MadHopsMD]

Firstly, Make sure your residency coordinator gives you a recommendation letter. One that states your struggles, but also your strong points. Sometimes one speciality or program is just not a good fit -- I have personal experience with that. However, both the program and you have to be on the SAME page about your dismissal. And you have to swing it in your favor -- this is probably the most difficult thing to do.

Secondly, You have couple red flags: IMG, Failed CS, resignation from previous program. Usually if you have any red flags, finding a position through SOAP is difficult. I would not even apply this year -- not because you will save money (even though this is nice as well) but because you will technically be reapplying again next year if you do not get in. This looks bad because the programs know you SOAPed.

You have couple good things going for you: a ridiculous high STEP 1 and 2 scores, maturity after doing one intern year....So I think you have a good chance of FM...

...BUT you need to do couple significant things:

-Get references from FM providers along with the previous program director
- Network at conferences. Such as AAFP conference in KC.
-Come up with convincing answers to:
1) Why did you not pass during your first CS? Unlike Pathology you actually see more patients, so you need good communication skills.
2) Why FM instead of pathology?
3) What happened with the pathology program that made you resign?

These three questions will definitely come up.


Remember, most physicians know that medicine is tough. Just like in baseball, you need a fresh start with a new ball team in a new place to rejuvenate oneself. I would not give up medicine just yet.

 

[MadHopsMD]

I am an IMG. I have green card. I graduated in 2011. I started pathology residency last year. Unfortunately, I did not perform very well during residency and program director told me to resign otherwise my contract would be non renewed. I have resigned now but my resignation will take effect at the end of this academic year so I will be able to complete one year of pathology residency and get GME credit of one year. Obviously, I want to switch my residency now. I am thinking about some less competitive specialty like family medicine. I am going into SOAP this year but I did not apply formally to any programs and so I have zero interviews. What are my chances of getting into family medicine now? If I am not successful in SOAP will there be a reasonable chance to get into Family Medicine residency next year if I formally apply in September 2014? Or is it just that it is the end of the world for me and I should think about doing something else other than medicine?

My Board Scores are as follows:
1. Step 1 251
2. Step 2 CK 244
3. Step 2 CS Passed on 2nd attempt
4. Step 3 218

Also I would post this in "ERAS and the Match". There are residency program directors and attendings that frequently comment there more so than here.

 

[smq123]

If the OP would like this thread moved to the ERAS forum, please let me know (rather than crosspost).

I agree with MadHopsMD. Get everything in order before you try to SOAP this year.

 

[smq123]

Per OP's request, moving to ERAS.

 

[deleted595450]

Firstly, Make sure your residency coordinator gives you a recommendation letter. One that states your struggles, but also your strong points. Sometimes one speciality or program is just not a good fit -- I have personal experience with that. However, both the program and you have to be on the SAME page about your dismissal. And you have to swing it in your favor -- this is probably the most difficult thing to do.

Secondly, You have couple red flags: IMG, Failed CS, resignation from previous program. Usually if you have any red flags, finding a position through SOAP is difficult. I would not even apply this year -- not because you will save money (even though this is nice as well) but because you will technically be reapplying again next year if you do not get in. This looks bad because the programs know you SOAPed.

You have couple good things going for you: a ridiculous high STEP 1 and 2 scores, maturity after doing one intern year....So I think you have a good chance of FM...

...BUT you need to do couple significant things:

-Get references from FM providers along with the previous program director
- Network at conferences. Such as AAFP conference in KC.
-Come up with convincing answers to:
1) Why did you not pass during your first CS? Unlike Pathology you actually see more patients, so you need good communication skills.
2) Why FM instead of pathology?
3) What happened with the pathology program that made you resign?

These three questions will definitely come up.


Remember, most physicians know that medicine is tough. Just like in baseball, you need a fresh start with a new ball team in a new place to rejuvenate oneself. I would not give up medicine just yet.

I just have one question. So, you are saying to me that I should not apply in SOAP in because my chances of getting in SOAP are slim. I just do not get it that how the programs will know that I SOAPed? Or is it just that every time you go into match NRMP takes a record of it and transfer that record to the programs? And, how does getting into SOAP adversely effect my application?

 

[MadHopsMD]

Yes your chances are really slim. If you didnt have the CS fail, I would have recommend it to you...but you just have too many redflags. Again usually people with multiple red flags usually are not successful in the SOAP.

Yes they "download" the application, and they have it in the records. So, they see you as a reapplicant next time you apply. But now thinking about it -- you can only apply to 30 + 10+ 5 (the three rounds of SOAP) programs so only 45 programs. It might be worth a shot, if you can get all your ducks in line. Eg, get deans letter from medical school, your grades from medical school, get 3 references (including your previous program director), write a decent PS as to why family medicine. If you have money and time, I would do it...

 

[NotAProgDirector]

I agree that the OP's chances in SOAP are not great. However, applying this year in SOAP really won't affect their application next year. First of all, in SOAP you can only apply to 30 programs. Yes, there are then the 10 + 5 in the later rounds, but essentially all SOAP spots filled in the first 2-3 rounds so the later apps are not of much value. In the full app cycle, the OP is likely to apply to many more programs. Second, although programs can open prior year ERAS systems to see if people applied the year beforehand, it's rare. It's simply too much work. Applicants in their 2nd or 3rd year of application are definitely at a disadvantage, but that's likely due to the distance from their graduation and/or gap years rather than multiple app cycles (unlike US allo medical school)

So, bottom line, OP has little to gain but also little to lose from applying via SOAP.

 

[Substance]

As a related observation, I certainly find it strange, and somewhat enraging, that if you apply for a "job" in medicine and don't get it, all places where you apply thereafter know about it. It's like a criminal record.

I'm sure a lot of good people fall through the cracks because of this crap. I would wager the OP is one of them.

It's just my opinion, but a failed CS is bullcrap. Everyone knows that it is a totally worthless examination that tests nothing - the standardized actor-patients are the evaluators! It certainly doesn't seem like the OP has major problems with English, so I can only guess as to what the reasons were for his failure. I don't know why it is such a big red flag to fail that worthless thing other than because it is a failure and all failures are red flags in medicine, thoughts turned off.

Furthermore, if you go over to the pathology forum you'll realize that most pathology programs in the USA are scut-factories where they snare in IMGs to do menial technician tasks. The OP probably isn't very good at being a menial technician so his program wants him gone. Blessing or curse?

To the OP: you need to secure a favorable letter of reference from his program director - be very, very clear about this. Some PDs, particularly of scut-heavy IMG sweatshops, are vindictive and will badmouth you in their letter just to make sure you can't rise above them. I can only assume that these applicants didn't make it clear that the letter should be favorable. Most people don't go back on their words, so if you get this assurance from your PD you can probably rest easy.

 

[BornToLose98]

bumping this thread

What if you're in a similar situation only you were doing a pathology residency and you resigned after PGY-2 and you're certain you don't want to do clinical medicine. Is a PhD in pathology more or less the same as an MD in pathology? Is switching to academics better than forging on and reapplying? I'm an old grad now, IMG (> 5 years out).

 

[Naruhodo]

Is a PhD in pathology more or less the same as an MD in pathology? Is switching to academics better than forging on and reapplying? I'm an old grad now, IMG (> 5 years out).

I'm confused by your question. Do you want to go back and get a PhD? Unless there is a topic you feel strongly about dedicating the next 5-7 years of your life to I'd advise against this...Or are you thinking about applying to some of the fellowships (clinical chemistry, micro, biochem, lgg, etc.) that consider candidates with PhDs as well as MDs? That seems like a more reasonable option, if one of those aligns with your interests in pathology.

 

[BornToLose98]

I was under the impression that one can only apply to clinical path fellowships if one is boarded in CP (that would mean completing a residency first).

 

[GoSpursGo]

I’m closing this old thread since you now have your own thread, and there’s no reason to have parallel conversations in multiple places.

The clinical path fellowships do require that you’re board eligible in CP, so yes completing your residency. I think the other user was referencing a separate set of fellowships that ordinarily consider PhD candidates, which may or may not consider you with an MD. I’m honestly not familiar with what those are.