Switching specialities : when to tell PD

[deleted1078679]

I’m an intern. SDN has been very helpful as I know no one who has done this and my program is not a “share your feelings and concerns” type of program. Kind of toxic, including my Co interns- but that’s not even why I’m trying to transfer.

I have an interview in 2 weeks with a program in that new speciality I want —- interested in me! Via a connection.

I have not told my PD yet, they are new to being PD. The faculty and DIO has said many times to us from orientation to now - do NOT try to transfer -like a fear tactic, & told us make sure we have somewhere secure before we do. They are going to be very angry and I will feel this- it’s only a 15 total resident community FQHC program.

My contract said 30 day notice.

The PD for the program I want to transfer to- told me that they want to speak to my current PD (I don’t know when)

-TLDR: My question is , SHOULD I tell my PD about my wanting to switch BEFORE or AFTER the interview ?

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[ThoracicGuy]

The risk of waiting is that the new PD may call up your current PD before you have a chance to talk to them about it. It would be worse for your PD to find out that way than from you.

Is this for a transfer this year or is this for a spot in the match for starting next year?

 

[deleted1078679]

The risk of waiting is that the new PD may call up your current PD before you have a chance to talk to them about it. It would be worse for your PD to find out that way than from you.

Is this for a transfer this year or is this for a spot in the match for starting next year?

I don’t see why they would call my current PD without even speaking to me via interview or phone as yet. Only email
It’s outside of the match- so they said we would discuss if it’s better for me to transfer as a PGY- 1 mid way or as a PGY-2

 

[EthylMethylMan]

IMO you might as well tell your PD. I’ve never heard of a residency transfer where the receiving program didn’t want a letter from the current PD. So he/she will almost certainly have to know before the new gig is secure.

 

[gutonc]

I would personally wait until after your initial interview. You may hate the new PD/program and decide your current program is better after all.

Do you want to burn that bridge before you even get a chance to walk over it yourself?

 

[NotAProgDirector]

At this point, I agree with @gutonc. The danger is that you apply, and before they even reach out to talk to you, they decide to contact your PD. That danger has passed. So now, you tell them that you have not yet spoken to your PD, you'd like to interview. If you mutually decide to continue forward after that, you'll talk to your PD so the two can have a conversation.

 

[dozitgetchahi]

I’m an intern. SDN has been very helpful as I know no one who has done this and my program is not a “share your feelings and concerns” type of program. Kind of toxic, including my Co interns- but that’s not even why I’m trying to transfer.

I have an interview in 2 weeks with a program in that new speciality I want —- interested in me! Via a connection.

I have not told my PD yet, they are new to being PD. The faculty and DIO has said many times to us from orientation to now - do NOT try to transfer -like a fear tactic, & told us make sure we have somewhere secure before we do. They are going to be very angry and I will feel this- it’s only a 15 total resident community FQHC program.

My contract said 30 day notice.

The PD for the program I want to transfer to- told me that they want to speak to my current PD (I don’t know when)

-TLDR: My question is , SHOULD I tell my PD about my wanting to switch BEFORE or AFTER the interview ?

I’m amused that they have to warn their residents repeatedly “do not try to transfer”. That suggests that transferring is a popular activity at this particular program, and/or that they’re well aware that their program treats residents like yesterday’s garbage. I never heard any sort of warning about this at my GME programs.

 

[bengx]

Rule of thumb: do not tell anyone until the position is secured.

 

[cj_cregg]

Rule of thumb: do not tell anyone until the position is secured.

I cannot imagine any halfway decent program would be willing to accept a transfer resident without an evaluation from current PD/faculty.

 

[bengx]

I cannot imagine any halfway decent program would be willing to accept a transfer resident without an evaluation from current PD/faculty.

Unless the current program has a noxious reputation.

 

[Apollyon]

Unless the current program has a noxious reputation.

You don't get it. An accepting program does their own due diligence. As a resident, you don't have any leverage, The new program won't take the resident without contacting the current one. You are using jargon from the business world.

 

[twospadz]

As someone who transferred from Neurology to Psychiatry, the desired program will have to speak to your old program before they extend an offer to you. You might as well let your program know now because it will give them time to look for a new resident. Sometimes programs will still hold your position in case you do not transfer or get a position.

Getting an offer without the old program contacting your residency program does not exist unless you previously trained at that place.

 

[RangerBob]

Unless the current program has a noxious reputation.

I think you have things reversed.

Only a desperate/horrible program that has difficulty matching anybody would ever extend a position to someone without talking to their current program to find out what kind of resident that person actually is. Plenty of programs have been burned by matching a med student who interviewed and scored well, only to find they're lacking majorly in some capacity (professionalism, ability to accept criticism/learn, fund of knowledge deficits, etc.).

A resident who is transferring? There's a goldmine of attending/program director knowledge available available that isn't present for med students. Unlike med students, residents have supervisors who actually really know that person in depth, and what kind of physician/worker they are.

There is about a 0% probability that any halfway decent program will secure a position with an applicant unless the program is just that desperate. Which means you could very well be matching into a program more noxious/malignant than the one you're trying to leave.

It would be incredibly unprofessional for any program to do this as well--again, a giant crimson red flag.

 

[deleted1078679]

Thanks for all the replies! I got the offer as someone suggested me to the PD. They will need a letter or speak to my PD before contract is formally offered and signed. I did the IV and have been in communication with me onward.
Tney stated tney will send contract in May. We shall see.
Yes my program has gotten worse, telling me tney are watching me 24/7, offering me an intern asking if I am intersted in being chief resident while also praising me that I am above average performance of all the interns there.

 

[LucidSplash]

Thanks for all the replies! I got the offer as someone suggested me to the PD. They will need a letter or speak to my PD before contract is formally offered and signed. I did the IV and have been in communication with me onward.
Tney stated tney will send contract in May. We shall see.
Yes my program has gotten worse, telling me tney are watching me 24/7, offering me an intern asking if I am intersted in being chief resident while also praising me that I am above average performance of all the interns there.

Interns should be watched 24/7. Trust but verify and all.

Unclear on how getting praise from your program is proof of program “getting worse.” Something definitely feels lost in translation.

 

[Crayola227]

You don't get it. An accepting program does their own due diligence. As a resident, you don't have any leverage, The new program won't take the resident without contacting the current one. You are using jargon from the business world.

Yeah what's more is that doing "due diligence" and checking references is absolutely an employment law check the box CYA thing. It's a thing everywhere. No reason a program isn't going to do the same, even if they didn't really give a damn what the old PD said, they would still look really bad if they transferred a resident (especially from somewhere with a bad reputation!) and for any reason there is scrutiny surrounding that resident in the future, and they couldn't say they reviewed a letter or had a chat.

Maybe there are PDs that sloppy but I can't imagine any HR/hospital risk management being OK not checking that box at the least. If there was drama and they found out the PD couldn't even say contact was made, it would not go over well with higher ups. So a PD that doesn't at least nominally have some communication with the old one, is basically a bad situation away from being fired for mishandling hiring. Plenty of people run around being incompetent at their jobs and for a long time. But I usually don't bank on that in some sectors.

I understand the stress and desire that residents have to keep distance between PD in so many situations, but people don't seem to understand that rules of the workplace are rules of the workplace. Obviously you can time the revelation of some facts to either PD but you cannot control them or put them in a black bag .

It's ironic since you pointed out the guy was talking business jargon.

Some industries are more or less litigious. This has bearing on checking references for employment.

Employers that don't can literally be held legally liable for the crappy employees they hire if they don’t.

 

[deleted1078679]

Interns should be watched 24/7. Trust but verify and all.

Unclear on how getting praise from your program is proof of program “getting worse.” Something definitely feels lost in translation.

No one should be watched 24/7 365 days as I was told. I do not live at work. Interns should be guided , supervised and if there is an issue- communicated directly.
You are correct I did not type out all the bad that was said to me in the evaluation, you were not in the meeting I was, the culture this fqhc comm program & other bad events that have happened to me. It’s irrelevant at this point. I got formally offered and got accepted a PGY2 program to psy via letter of intent. I am waiting to sign the contract whenever it comes and continue being tne best intern. I am confident in my skills and humble enough to ask for help and want to get better. But I’m not a beating stick.
Every time they have met with me in a meeting I have cried in the meeting or left crying feeling like crap, even tho they are praising me. They try to instill fear . Perhaps it’s lost in translation and miscommunication, idk. Idc at this point . Just doing my job and love seeing my patients. Some of yall don’t know difference between critical feedback and abuse/ toxicity

 

[deleted1078679]

I agree to telling PD. When the time is right.
The PD at other program told me before they wanted to speak to my current PD and/or letter from PD, I don’t know when as yet.
No problem. I’m glad I waited until after the IV. I do agree with waiting until it’s secure- we were literally told that by our own PC- in orientation as a weird warning while telling us not to try to transfer- multiple times.

That being said;not all programs are the same- I know people who have transferred without a letter from their PD due to multiple reasons. Life happens. This is a job at the end of the day. Follow the contract- so no legal implications. I have a family of lawyers. Other than that, there is no 1 brush general rule to every single thing in life. I’m still navigating this program and I do appreciate this and hope the responses stay civil and a safe space and not judgmental or critical.

 

[LucidSplash]

No one should be watched 24/7 365 days as I was told. I do not live at work. Interns should be guided , supervised and if there is an issue- communicated directly.
You are correct I did not type out all the bad that was said to me in the evaluation, you were not in the meeting I was, the culture this fqhc comm program & other bad events that have happened to me. It’s irrelevant at this point. I got formally offered and got accepted a PGY2 program to psy via letter of intent. I am waiting to sign the contract whenever it comes and continue being tne best intern. I am confident in my skills and humble enough to ask for help and want to get better. But I’m not a beating stick.
Every time they have met with me in a meeting I have cried in the meeting or left crying feeling like crap, even tho they are praising me. They try to instill fear . Perhaps it’s lost in translation and miscommunication, idk. Idc at this point . Just doing my job and love seeing my patients. Some of yall don’t know difference between critical feedback and abuse/ toxicity

This post provided no additional clarity on the situation.

You say you’ve accepted an offer. Have you signed a contract? You agree to telling your current PD “when the time is right” and the new program wants to speak with/have a letter from the PD. So… when are you planning on telling the PD? I’d be surprised if they gave you a contract to sign before getting the current PD’s letter/speaking to PD. What is your plan?

 

[deleted1078679]

Why are you so invested in my own life? Please stop trolling. I made a comment under the entire post answering those questions you just had . If you have difficulty with “clarity” or “closure”, please refer to that

My plan is to secure that job before telling anyone, ie sign the actual contract when I receive it. If the other PD emails me asking me for the letter from current PD, then I tell them.
Other than that, things can change.

My program is not supportive in me switching.
We just had an anonymous resident survey where both programs , residents reported they do not feel they are able to raise concerns without fear of intimidation or retaliation and residents have personally experienced or witnessed abuse, harassment, mistreatment, discrimination or coercion.

I’m not even switching due to that. I want to do psychiatry long term- point blank.
Thanks.

 

[Iamnew2]

I think you have things reversed.

Only a desperate/horrible program that has difficulty matching anybody would ever extend a position to someone without talking to their current program to find out what kind of resident that person actually is. Plenty of programs have been burned by matching a med student who interviewed and scored well, only to find they're lacking majorly in some capacity (professionalism, ability to accept criticism/learn, fund of knowledge deficits, etc.).

A resident who is transferring? There's a goldmine of attending/program director knowledge available available that isn't present for med students. Unlike med students, residents have supervisors who actually really know that person in depth, and what kind of physician/worker they are.

There is about a 0% probability that any halfway decent program will secure a position with an applicant unless the program is just that desperate. Which means you could very well be matching into a program more noxious/malignant than the one you're trying to leave.

It would be incredibly unprofessional for any program to do this as well--again, a giant crimson red flag.

I switched programs from Rads to PM&R- new program never talked to my old program PD and it wasn't a problem. I matched to a pretty decent PM&R program. I think it depends on how competitive the applicant is to be honest. I agree that generally speaking it's ideal, but doesn't necessarily mean one can't match elsewhere.

 

[deleted1078679]

I switched programs from Rads to PM&R- new program never talked to my old program PD and it wasn't a problem. I matched to a pretty decent PM&R program. I think it depends on how competitive the applicant is to be honest. I agree that generally speaking it's ideal, but doesn't necessarily mean one can't match elsewhere.

Thank you. I said basically what you said above! It depends on a lot of factors. I know others like you personally; and maybe I will be 1 of them. All i know for now is they sent me the letter of intent PD signed, and i signed it, and i will await the contract in April.
They told me they wanted to speak to the PD/letter during the interview. After the interview and after I sent all other documents: All 3 USMLE step scores, personal statement, CV, ERAS application, Letters of recommendations from Psychiatrists; they sent more emails communicating and then also most recently the letter of intent. Every program/situation is different. I thought as physicians , we would know, "case by case basis". I am not going to ask for a letter from my PD, unless the program prompts me for it before the contract. There is no need. The program has made it clear they care about their paycheque, and essentially not to try to transfer and not to report them to ACGME.

 

[CrispyWonTon]

I hope it all works out, you need to make sure they are successfully promoting you to PGY-2 at your home program and yet not sign the contract because if you sign, it's binding for both parties. Ideally you will have your PGY-2 Psychiatry contract before your home program renews you for FM PGY-2.

 

[Iamnew2]

I hope it all works out, you need to make sure they are successfully promoting you to PGY-2 at your home program and yet not sign the contract because if you sign, it's binding for both parties. Ideally you will have your PGY-2 Psychiatry contract before your home program renews you for FM PGY-2.

Technically not - aPD can correct me on this since he's the expert, but contract renewals after not bound to the same nonsensical rules as when you start. IF the contract says 30 days, you sign your PGY2 contract and then decide to resign you give them 30 days. Ideally one would give as much notice as possible out of courtesy but it is what it is really - at the end of the day the legalities is what matters.

 

[odyssey2]

I switched programs from Rads to PM&R- new program never talked to my old program PD and it wasn't a problem. I matched to a pretty decent PM&R program. I think it depends on how competitive the applicant is to be honest. I agree that generally speaking it's ideal, but doesn't necessarily mean one can't match elsewhere.

What made you switch?

 

[Iamnew2]

What made you switch?

Many things - found it boring, stressful, no patient interaction, sitting in a dark room all day counting pulmonary nodules drove me nuts, high liability, very isolating, etc. Couldn't do that for 30 years.

 

[LucidSplash]

Please stop trolling.

In the words of Inigo Montoya, I do not think that word means what you think it means. 🤷🏼‍♀️

I genuinely wish you well and hope this works out for you. I just don’t follow your logic regarding having a potential new PD telling you they wanted to talk to your current PD first but then you continuing to hold out on telling the current PD, as expressed in your post and I was conveying my confusion. I suspect others may be similarly lost but who knows. I suspect there is substantial risk to you professionally in blindsiding your current PD if the new PD calls then up before you have given your current PD any expectation of such a call. But that is just my perspective of course.

To be fair, I was responding to a post you made on a forum wherein you have asked for guidance. I still think there is something lost in translation because I don’t totally understand this situation as you have tried to convey it. Your level of defensiveness to my last post seems a little out of place, given I never suggested you shouldn’t transfer or that it wasn’t a precarious situation when trying to leave a program, especially one you perceive as toxic. But maybe that defensiveness shows up in other areas of your life too. Who knows. 🤷🏼‍♀️

But you seem to feel you have a handle on the situation. Good luck. If you don’t want people to invest in you or respond to your posts or ask for clarification, I’m not sure of your goal with the topic discussion in general.

 

[deleted1078679]

I hope it all works out, you need to make sure they are successfully promoting you to PGY-2 at your home program and yet not sign the contract because if you sign, it's binding for both parties. Ideally you will have your PGY-2 Psychiatry contract before your home program renews you for FM PGY-2.

I agree. Thanks for this solid advice. I will definitely not sign the contract for FM program to renew it. I am not sure when renewal of contracts are. But i do know the Psych contract told me April in their LOI. They have no academic reason to not promote me to PGY-2 at my home program, they have already shown me the draft schedule for my PGY-2 year. I have above expected level on written and softcopy evaluations for all of my rotations so far, and will continue to perform well. If push comes to shove, and my hand is forced, I will tell them before and that's just life.

 

[deleted1078679]

Technically not - aPD can correct me on this since he's the expert, but contract renewals after not bound to the same nonsensical rules as when you start. IF the contract says 30 days, you sign your PGY2 contract and then decide to resign you give them 30 days. Ideally one would give as much notice as possible out of courtesy but it is what it is really - at the end of the day the legalities is what matters.

The contract I signed 100% says 30 days, i've read it over and over and given my lawyers in my family to also read over. Legality 100% matters, need to cover myself. I didn't plan on signing my home program PGY2 contract. I will reach out to aPD.

 

[deleted1078679]

In the words of Inigo Montoya, I do not think that word means what you think it means. 🤷🏼‍♀️

I genuinely wish you well and hope this works out for you. I just don’t follow your logic regarding having a potential new PD telling you they wanted to talk to your current PD first but then you continuing to hold out on telling the current PD, as expressed in your post and I was conveying my confusion. I suspect others may be similarly lost but who knows. I suspect there is substantial risk to you professionally in blindsiding your current PD if the new PD calls then up before you have given your current PD any expectation of such a call. But that is just my perspective of course.

To be fair, I was responding to a post you made on a forum wherein you have asked for guidance. I still think there is something lost in translation because I don’t totally understand this situation as you have tried to convey it. Your level of defensiveness to my last post seems a little out of place, given I never suggested you shouldn’t transfer or that it wasn’t a precarious situation when trying to leave a program, especially one you perceive as toxic. But maybe that defensiveness shows up in other areas of your life too. Who knows. 🤷🏼‍♀️

But you seem to feel you have a handle on the situation. Good luck. If you don’t want people to invest in you or respond to your posts or ask for clarification, I’m not sure of your goal with the topic discussion in general.

You will not understand as i stated above because I did not type it all out. It's contextual- you do not have context.
My level of defensiveness is misplaced, and stems from you agreeing people should be watched 24/7(That is a stalker). Now you are trying to take jams at me saying my defensiveness maybe shows up in other areas of my life, yet wishing me well ? We are strangers on an internet. You can give your "advice" or "guidance", i do not have to take it, i can respond how I wish, as so can you.
Others have responded quite appropriately and respectfully. We just don't agree, we share different perspectives on life perhaps and that is okay.
Yes there is risk in blindsiding my program director; if the new PD calls up the current PD. We shall see.

 

[LucidSplash]

You will not understand as i stated above because I did not type it all out. It's contextual- you do not have context.
My level of defensiveness is misplaced, and stems from you agreeing people should be watched 24/7(That is a stalker). Now you are trying to take jams at me saying my defensiveness maybe shows up in other areas of my life, yet wishing me well ? We are strangers on an internet. You can give your "advice" or "guidance", i do not have to take it, i can respond how I wish, as so can you.
Others have responded quite appropriately and respectfully. We just don't agree, we share different perspectives on life perhaps and that is okay.
Yes there is risk in blindsiding my program director; if the new PD calls up the current PD. We shall see.

The 24/7 comment was meant slightly tongue in cheek but I suspect that humor was also lost in translation. Unless your PD and the faculty are doing drivebys to your house when you’re off duty, the use of 24/7 is probably not meant literally on your part either.

But I do expect my interns to be well-supervised whenever at work in their professional capacity, as it would be professional neglect by their senior residents and those of us who have served as faculty not to do so.

I am really not trying to argue with or fight you but you seem to be determined to take that stance no matter what I say.

Again, best wishes and I hope you are successful in your quest.

 

[deleted1078679]

The 24/7 comment was meant slightly tongue in cheek but I suspect that humor was also lost in translation. Unless your PD and the faculty are doing drivebys to your house when you’re off duty, the use of 24/7 is probably not meant literally on your part either.

But I do expect my interns to be well-supervised whenever at work in their professional capacity, as it would be professional neglect by their senior residents and those of us who have served as faculty not to do so.

I am really not trying to argue with or fight you but you seem to be determined to take that stance no matter what I say.

Again, best wishes and I hope you are successful in your quest.

Yes, supervised- which is what i said above, already.
As faculty, it's best to be careful what you say to your fellow interns( not on this forum) in a professional meeting.
Things can be interpreted as a threat, as stalking- there are legal implications to our words.

Thanks for the best wishes.

 

[rokshana]

Why are you so invested in my own life? Please stop trolling. I made a comment under the entire post answering those questions you just had . If you have difficulty with “clarity” or “closure”, please refer to that

My plan is to secure that job before telling anyone, ie sign the actual contract when I receive it. If the other PD emails me asking me for the letter from current PD, then I tell them.
Other than that, things can change.

My program is not supportive in me switching.
We just had an anonymous resident survey where both programs , residents reported they do not feel they are able to raise concerns without fear of intimidation or retaliation and residents have personally experienced or witnessed abuse, harassment, mistreatment, discrimination or coercion.

I’m not even switching due to that. I want to do psychiatry long term- point blank.
Thanks.

Dude you posted your life for all to see here and now you are annoyed that someone isn’t being a cheerleader for you poor choices and insight?
Stop posting then and go live your life.
Otherwise expect people here to make comments…sometimes they agree with you… more often not they don’t.

Personally I gotta feeling you are not goi g to have any spot… your current program once they find out you want to leave will not offer you a contract for next year and once the other PD talks to your current PD, is going to rescind( or not offer) a contract…or thy are so desperate they don’t care and to are going from the frying pan into the fire….but you do you!
Good luck…

 

[gyngyn]

Locking thread that is no longer productive.