For residents who enter a program only to find they need to transfer to a different program or specialty, the process of switching to a new program can be arduous. And once a resident transfers, how do their old and new programs adjust? Despite a fair amount of residents making these moves each year, not much is known about why residents are transferring, or the implications.
Sarah Nelson, MD, who is in her final year of residency in the neurology program at Tufts Medical Center, saw this situation first-hand. A resident left her residency program just one month after beginning.
“Because of the coverage needed for the hospitals in our program, each remaining resident’s schedule was altered. One major change was that all of this person’s overnight calls for the year needed to be covered by the remaining residents, which seemed to create additional responsibilities that we had not expected.”
This sparked Dr. Nelson’s interest, and she began to search for rules or processes that would better protect residents in this sort of situation. Once she expanded her search and discussions, she found that residency transfer was somewhat of a mystery.
“There are not great or consistent resources residents can use to transfer from one program to another,” she said.
The AMA’s Resident and Fellow Section lists vacant residency positions, one resource that can help transferring residents find new programs. Other resources are informal, such as discussions on message boards.
There are a fair amount of residents who are transferring, according to the Accreditation Council for Graduate Medical Education—about 1,500 residents transferred during the 2012-13 program year, and that amount has remained fairly consistent for the past six years. However, these transfer numbers include residents from neurology, pediatrics and psychiatry* who move to child psychiatry or child neurology, which was part of their original career plan. The data might not present an accurate picture of how many residents are transferring, and it doesn’t explain why they’re transferring.
For residents who match to a program through the National Resident Matching Program (NRMP), those matches are binding. A resident seeking to transfer can request a waiver from the NRMP “for serious and extreme hardship or for change of specialty,” but it’s not guaranteed that the NRMP will grant the waiver, and waiver applicants can’t apply for—or even discuss—positions in other programs until they have the official OK from NRMP.
Between the lack of information and the somewhat confusing transfer process, Dr. Nelson introduced a resolution to the AMA Resident and Fellow Section, designed to facilitate resident transfers.
“Beyond word-of-mouth and some websites that can be used on a voluntary basis, there currently does not appear to be a consistent process or centralized resource for residents seeking programs or vice versa,” the resolution says. “Such inconsistency, along with strict timeframes and the variety of reasons for which residents may transfer programs, can lead to temporary or permanent unfilled residency positions in programs affected by a transfer.”
As a result of the resolution, adopted during the section’s 2014 Annual Meeting, the AMA-RFS will study:
- How often residents are transferring programs, and how they go about making these transfers
- The reasons behind their decisions to transfer
- The difficulty—or ease—of finding alternate residency positions
- How residency transfers affect training programs and current residents in programs
Tell us: Have you, or did you, ever consider transferring residencies? What reasons motivated your decision to leave, or to stay? Tell us in a comment below or on the AMA-RFS Facebook page.
*Note: An earlier version of this story used the word "psychology" instead of "psychiatry."
