The Residency Switch – An Update

Since I originally published my article about switching residencies, I have been contacted by medical students and many different residents, not just ones thinking about going into Radiology. Some had even already completed residency and a fellowship! Every time, I could just feel that person’s uncertainty and sense of loneliness. I really wanted to do all I could to support them.

So, after all this time, I wanted to share my answers to some of the questions I received the most:

“I have been reassessing my initial specialty choice. How do I know whether it is the right fit for me?”

Many doctors who contacted me tried to make the most of their situation and felt like that was where life had meant to take them. Even with great work environments, like me, they also found it difficult to picture themselves practicing in that field in the long term.

Medicine is such a demanding field that many doctors keep going through the motions no matter how dissatisfied they get because we all become programmed to think that’s how our lives are supposed to be. But I think it’s such an important first step when someone can recognize that they are truly unhappy.

And that’s the thing – once the bad days start to outweigh the good days, it’s time for a change. And if you are less passionate about your specialty in residency, it will likely be a challenge to do it for the next 30+ years, day in and day out of your life.

“What was the process of applying to other residency programs like for you?”

Unfortunately, I’m wasn’t the best person to ask about networking to other programs when switching. Long story short, I reached out to the program director, who remembered me from when I was a fourth-year medical student. The Radiology and the Graduate Medical Education (GME) department were then able to secure funding to take me on as an additional resident. So, I really only “applied” through the Match to one place.

But I do have to warn you that WHEN you decide to make the switch definitely matters. Medicare funds residency positions for all the years that are required of your training. For example, for 3 years of internal medicine residency, you will only have 1 year left of funding if you decide to switch after 2 years. And if you finish an internal medicine residency and then decide to switch – there is no Medicare funding left for you, and you would only be able to attend an institution with private funding. Since I had only done two years of OB/GYN, I still had two years left of Medicare funding, so that my Radiology program had to fund only two additional years.

Also, keep in mind that if your dream residency is competitive, such as dermatology or plastic surgery, finding a spot and private funding becomes much more difficult.

“I’m nervous about telling my current program about switching residencies. Will there be repercussions?”

The feeling is still familiar to me – you are afraid of letting your colleagues down and fear placing more work on others. But I was very pleasantly surprised that my entire OB/GYN program was very supportive. I tearfully blurted out to my program director in her office I was being offered an interview in Radiology. Her immediate gut reaction was, “That’s great!” and she proceeded to tell me switching happens more than I think. My OB/GYN co-residents even congratulated me right after the Match and wished me all the best.

The thing I realized over time in my one and a half residencies is that everyone genuinely wants you to be happy. No one wants a resident who feels defeated on their service, and you’ll probably find the same thing I did – lots of support. And remember that 1/8 of us physicians actually switch residencies, so it’s actually quite common. I can almost guarantee that you will not face any repercussions.

“What if I don’t even match into Radiology (or other specialty)?”

The undeniably scariest part of switching is essentially telling your program you want out and then not even getting accepted into your field of choice. But if you can show programs you are applying to that you clearly have a passion for your desired specialty, you have great odds. It’s better to ask and find out than to never ask at all and be unhappy wondering what if.

But what I do recommend is to take an elective rotation during your residency if you can and as soon as you can. It is a really great opportunity to make connections – if a physician knew you were considering their specialty, they are going to help you.

And you can even try again the following year in the match, too – trust me, trying is better than staying in a specialty you don’t enjoy anymore (but keep in mind you are running lower on funding). Just remember that no medical training is a “waste”; the clinical learning you take with you to your next specialty will always be a benefit.

“What advice can you give to medical students that are between two specialties?”

Be absolutely sure you love that specialty – so much that you wouldn’t mind getting out of bed at 2:30 AM to get to the hospital to perform in that particular field. Ask a ton of questions when you are on the rotation – about the hours, call, what it’s truly like after residency, and life outside of work. Get a feel of what being in that field is really like by truly immersing yourself in the trenches.

This is one of my strongest suggestions for anyone indecisive about what field to enter. If you have the same passion for both specialties perfectly equally, pick the one with a better lifestyle. It’s not something I realized as an eager medical student, but I realized how important my priorities outside of work were as I got older.

“Was switching residencies the right decision for you?”

I can honestly tell you that I never once regretted my decision to switch. OB/GYN is a fantastic field, and I will never stop having the utmost respect and admiration for them. But Radiology is absolutely awesome and was perfect for me. I’m back home after 10 years away and landed my dream job at the academic institution I always wanted to end up at ever since I was pre-med. And my special focus of Abdominal imaging is – you guessed it – Women’s Imaging. I was even appointed the Abdominal Imaging Fellowship director and continue to be involved in the education and guidance of my medical students, residents, and fellows.

I know the fear of uncertainty is the most daunting part of taking that the next step in making a life-changing career choice. Trust me, every once in a while, I even think back about how emotional I was before I switched. I’m thrilled looking back on my original article that was I was able to be a source of encouragement and someone to reach out to for advice. I’m glad I was able to make people feel a lot less alone when making the big residency switch.