second guessing residency choice

originally posted in med students general discussion- apologies if not the correct place

Hi Guys: apologies if this is mentioned somewhere, but I just spent the last hour looking at all threads here and in the residency/fellowship forums.

So…I haven’t posted on here in awhile, this place was where I got my motivation to begin my journey as a non-trad to medicine. I am now a 4th year, 2 months from graduating, and have successfully matched! I know, I am excited, and should be more so…but I am having an issue that I was hoping perhaps I could get some advice/guidance on.

At the end of 3rd year there comes a time where a medical student must make the biggest decision of his/her life…and I cannot begin to say how big this was for me and how I struggled so very much with it and honestly probably never really knew for certain what specialty to pick… my school has us all scattered for 3rd and 4th years in diff locations and offers no guidance and has no program directors or a teaching hospital assoc with it (D.O. program). I hesitantly chose psychiatry because it was something that I honestly thought would give me the best satisfaction for the long-term…not looking just the fun/thrill of things while i’m still relatively young…I had reservations about it, and honestly I probably should have just applied to transitional years/prelim programs b/c honestly I really have never felt at peace about it or anything really… I’ve learned a lot about myself this 4th year and seen many different specialties and environments and honestly wasn’t ready to make the decision at that time…but what’s done is done… I want to be happy about my decision so badly; perhaps it’s just “the grass is greener” feeling I have when i’m on other rotations like radiology (currently) or have other friends so excited to be going off to their programs of choice, but I just keep second guessing myself.

Honestly, I probably second guess most things in life, but this feels so huge b/c it’s such a monumental decision…I feel like you have to choose the RIGHT thing now b/c there’s a long painful road if you want to change…unlike mid-level positions where you can change jobs on the dime…not so when you’re talking about another residency…I know the future is bright in psych and I can likely help many people who greatly need it…but I just can’t get out of this funk right now…any advice/guidance from this wonderful group of experienced folks? Thanks so much, you have been wonderful throughout all these years and helped me become a physician…I humbly come to you for advice.

Word to the wise: Do your absolute best while you’re at your current program – it is easy to slack when it’s not your cup of tea. That will bite you. Be a great resident, positive and motivated, keep your opinions of everyone 100 miles away from the flagpole, when you do your off service rotations, attack them in terms of studying for them, reading up on patient cases, etc. – Talk to your advisor at your 6 month meeting and if you still feel that you made a mistake, couch it in soft terms, then at your 3/4 year meeting, you can begin to open the door for possible openings in something you really want to do where you’re currently at, just in another program. They can facilitate that. Above all else, do NOT piss off the program director – they talk to each other and their word is taken over everyone else’s. Residency can be VERY political so watch it.

I do have something to suggest here. When you rank a residency that is a binding decision. What you may not realize is that it is binding for the FIRST year only. When you start at your residency, you will likely sign a contract, which is for the upcoming year.

So here is what you COULD do. Are there any other residencies at the same hospital? If not, do you have some idea of other directions you might want to pursue MORE than psychiatry? Check out your schedule for the first year. I don’t know if psychiatry is one of those specialties where you don’t do the usual 1st year rotations (ER, IM, Surgery, etc). If so, you might use any elective rotations to get some more general medical experience. Then if the first year shows you that it is truly not your cup of tea, you could scramble for positions (which will likely be 1st year slots) in next years match, in the area you like more. Wouldn’t burn your bridges where you are till then.

However, if there are multiple specialties at your program, some folks with understanding program directors are able to transfer “in house” as it were after the first year. Just one year burnt, not having to do 2 whole residencies, and some valuable additional experience. You may not be totally painted into a corner.

Best of luck.