Medical residency queston

My wife is about to graduate from medical school and is going to make her rank list for residences. She has heard of some residents switching their residences. Can she do this, and how is it done?

Switching in what way? Leaving one residency, like surgery, for another, like radiology? Changing programs but staying in the same field? Doing a transitional year internship before entering some other field like orthopedics or dermatology? All of these things can be done; in fact its probably more common now than it was several years ago. Residency is a year-by-year contract; they can’t make you stay if you don’t want to. If she thinks that she may match someplace that she doesn’t want to go, she should not rank that place on her match list, even as a ‘safety’ spot.

Ranking a hospital number one, getting in, and deciding she can’t stand it there. If she does a year and decided she doesn’t like it there, she can choose to go to another hospital the next? Are you sure about that?

Yes. However, she won’t have the infrastructure of the Match to help her do this; she’ll have to make an individual arrangement with whatever program she is trying to get into. Residency programs have people drop out for various reasons and need to fill the gaps. Other programs don’t fill all their slots and are hungry for warm bodies. She’ll have to travel to the other programs to interview (on her vacation time, most likely), and she’ll need to have decent evaluations from the people at her current location.

She shouldn’t expect that she’ll be able to go from one competitive program to another; she’ll probably have to drop down a tier unless she is an outstanding candidate. Residency program directors at most places are not ogres; they don’t want to keep you if you don’t want to be there. The program director will have to be involved in the process, since they have the contacts to know which programs are looking for someone, so you don’t want to burn any bridges bridges. It’s unlikely that you can change programs in mid-year, and your work at the first program may not be counted at the second program (depending on circumstances).

I knew an intern who was going to go on to do orthopedics. She decided that she wanted to be closer to her husband (he was in a different residency out of state) so she arranged to get into a different ortho program. However, they wanted her to repeat her intern year at the other hospital. So, in the second half of her intern year, when she was treated particularly poorly by a chief resident, she up and quit midweek. Her fellow interns were unhappy about that, but the program didn’t go after her to ‘make’ her stay.

I have a close childhood neighbor/friend who has done this twice. Started one year in internal medicine, didn’t like it. Moved to a pathology residency, started again from year one, doesn’t like it either. Now he has interviewed and will be starting an OB/GYN program. Told me he will be starting as a first year (again), but that the program acknowledges that he has more experience than others in that group so they’ll pay him as a third year (not that it is that much difference in pay, I’m guessing).