USMLE Forum Archives - The Match & Residency - Switching Specialties
Switching Specialties
adonis123 - 11-18-10 01:50
While it is commonly assumed that specialty choice for residency is an immutable decision, the true stories of the residents above demonstrate that it is possible to change directions after starting residency. Anecdotally it is said that as many as ten percent of all residents switch specialties each year.
Studies looking at resident attrition rates have yielded some data on specialty switching among residents. Attrition rates account for all residents who leave residency programs, not just those who change specialties. This includes residents who leave medicine completely and those who switch to another program within the same specialty. A study of Ob-Gyn resident attrition by McAlister et al. in 2008 (1) noted 2004-2005 ACGME reported annual resident attrition rates of 5.8% in Surgery, 5.1% in Ob-Gyn, 4.7% in Family Medicine, and 2.1% in Internal Medicine. Of 1055 categorical Ob-Gyn residents who entered programs in 2001, 21% (228 residents) had left their original program after four years and were categorized in the attrition group. Within the attrition group 33% (75 residents) switched specialties and 39% (29 residents) moved to primary care residencies.
Longo et al. (2) examined resident attrition from a general surgery residency program over a 20-year period and found a 30% attrition rate. Of the 30 residents who did not complete their training at the program, 63% (19 residents) switched to other specialties, including plastic surgery and medicine most commonly. The most common reasons cited for leaving the program included “lifestyle” and “passion for another specialty.”
Commonly, the decision to change fields is fraught with feelings of isolation and self-doubt.
Attendings who work in medical education often caution new interns and residents who are unhappy in their programs initially to avoid making hasty decision to switch fields. The stress of adjusting to being an intern or a new resident, often in a new hospital system, can be overwhelming. With time to adjust to new responsibilities the specialty may turn out to be the correct fit. But for some interns and residents, time only makes it clear that a change is needed.
Because leaving for another field will impact on the resident’s current program, residents who are thinking of switching often struggle with when to tell others in the program about their plans.Having the program director’s support, however, is important for obtaining a position in a new specialty. Many residency programs require a letter from the program director for applicants who have current/past residency training. Additionally, residents will need time off to attend interviews. Thus, it is unlikely that a resident can successfully switch fields without talking to his current program director.
It is important for residents thinking of switching fields to find someone to talk with that they trust.In the best of circumstances the program director will be supportive of the resident’s struggle, provide advice about making to decision to switch, and assistance in finding a new position.
How one goes about finding a new residency position varies, depending on the type of switch being made. For some residents, especially those who decide to switch early on or who are switching to a field that is drastically different from their current specialty, the easiest way to switch may be to re-enter the match. Going through the match again provides the most options for finding a new first-year position. For residents who have completed training that may count towards the requirements for another field, looking for a position outside the match may make the most sense. Simply calling area programs to ask about openings has been successful for some residents. Additionally, several websites (see below) offer notification of off-cycle positions and application services.
Regardless of what method a resident uses to look for a new position, standard information like a current CV, letters of recommendation, and a personal statement addressing the reasons for switching specialties will be needed. “It is advised to get a letter from program director and a supportive faculty member in one's current program. Getting some of your letter writers from medical school to update the letters they had written for you originally will also help.
The importance of making a convincing case for why one is switching and how the new specialty is going to be a better fit is really essential. Program directors want to be sure that the resident is not simply going to leave the new program soon after starting.
Deciding to leave a residency program to switch specialties is never an easy decision. Residents who switch specialties may fear not finding a new position, facing negative reactions from their current residency programs, and could end up extending the length of their overall training. But for those who have decided to switch fields, the benefits clearly outweigh the risks.
Websites for Off-Cycle Residency Positions:
Resident Swap (www.residentswap.org): Database of currently open residency positions posted directly or advertised on other sites. Also offers application service with options for residents to swap their current position with other users and for couples to search for positions together. $79.99/month, discounts available for 3-month subscription.
FindAResident (www.findaresident.com): AAMC program that supplements ERAS by allowing applicants to post their information and apply to ACGME-accredited off-cycle positions posted by residency programs. $75.00 for applicants, $30.00 for current active ERAS users.
Open Spots (www.openspots.com): Free listing of open residency and fellowship positions. Also offers fee-based premium content subscriptions and help with CVs and personal statements
adonis123 - 11-18-10 01:50
While it is commonly assumed that specialty choice for residency is an immutable decision, the true stories of the residents above demonstrate that it is possible to change directions after starting residency. Anecdotally it is said that as many as ten percent of all residents switch specialties each year.
Studies looking at resident attrition rates have yielded some data on specialty switching among residents. Attrition rates account for all residents who leave residency programs, not just those who change specialties. This includes residents who leave medicine completely and those who switch to another program within the same specialty. A study of Ob-Gyn resident attrition by McAlister et al. in 2008 (1) noted 2004-2005 ACGME reported annual resident attrition rates of 5.8% in Surgery, 5.1% in Ob-Gyn, 4.7% in Family Medicine, and 2.1% in Internal Medicine. Of 1055 categorical Ob-Gyn residents who entered programs in 2001, 21% (228 residents) had left their original program after four years and were categorized in the attrition group. Within the attrition group 33% (75 residents) switched specialties and 39% (29 residents) moved to primary care residencies.
Longo et al. (2) examined resident attrition from a general surgery residency program over a 20-year period and found a 30% attrition rate. Of the 30 residents who did not complete their training at the program, 63% (19 residents) switched to other specialties, including plastic surgery and medicine most commonly. The most common reasons cited for leaving the program included “lifestyle” and “passion for another specialty.”
Commonly, the decision to change fields is fraught with feelings of isolation and self-doubt.
Attendings who work in medical education often caution new interns and residents who are unhappy in their programs initially to avoid making hasty decision to switch fields. The stress of adjusting to being an intern or a new resident, often in a new hospital system, can be overwhelming. With time to adjust to new responsibilities the specialty may turn out to be the correct fit. But for some interns and residents, time only makes it clear that a change is needed.
Because leaving for another field will impact on the resident’s current program, residents who are thinking of switching often struggle with when to tell others in the program about their plans.Having the program director’s support, however, is important for obtaining a position in a new specialty. Many residency programs require a letter from the program director for applicants who have current/past residency training. Additionally, residents will need time off to attend interviews. Thus, it is unlikely that a resident can successfully switch fields without talking to his current program director.
It is important for residents thinking of switching fields to find someone to talk with that they trust.In the best of circumstances the program director will be supportive of the resident’s struggle, provide advice about making to decision to switch, and assistance in finding a new position.
How one goes about finding a new residency position varies, depending on the type of switch being made. For some residents, especially those who decide to switch early on or who are switching to a field that is drastically different from their current specialty, the easiest way to switch may be to re-enter the match. Going through the match again provides the most options for finding a new first-year position. For residents who have completed training that may count towards the requirements for another field, looking for a position outside the match may make the most sense. Simply calling area programs to ask about openings has been successful for some residents. Additionally, several websites (see below) offer notification of off-cycle positions and application services.
Regardless of what method a resident uses to look for a new position, standard information like a current CV, letters of recommendation, and a personal statement addressing the reasons for switching specialties will be needed. “It is advised to get a letter from program director and a supportive faculty member in one's current program. Getting some of your letter writers from medical school to update the letters they had written for you originally will also help.
The importance of making a convincing case for why one is switching and how the new specialty is going to be a better fit is really essential. Program directors want to be sure that the resident is not simply going to leave the new program soon after starting.
Deciding to leave a residency program to switch specialties is never an easy decision. Residents who switch specialties may fear not finding a new position, facing negative reactions from their current residency programs, and could end up extending the length of their overall training. But for those who have decided to switch fields, the benefits clearly outweigh the risks.
Websites for Off-Cycle Residency Positions:
Resident Swap (www.residentswap.org): Database of currently open residency positions posted directly or advertised on other sites. Also offers application service with options for residents to swap their current position with other users and for couples to search for positions together. $79.99/month, discounts available for 3-month subscription.
FindAResident (www.findaresident.com): AAMC program that supplements ERAS by allowing applicants to post their information and apply to ACGME-accredited off-cycle positions posted by residency programs. $75.00 for applicants, $30.00 for current active ERAS users.
Open Spots (www.openspots.com): Free listing of open residency and fellowship positions. Also offers fee-based premium content subscriptions and help with CVs and personal statements
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