Dropping/transferring ophtho residency

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Shiloh

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Hello, I have a dilemma. I have matched into ophtho at my home institution in New York for 2008 (my prelim is also in New York but not at my home institution). I have unexpectedly (but very happily) gotten engaged to my boyfriend of 5.5 years. My fiance is in his mid 40's and has not yet fathered children; thus we most likely will get pregnant within the next year. He is from the South and we have agreed that it would be best to rear our children in the South (his family is huge and super supportive). Should I:
1) drop both my prelim and optho spots (and reapply for both in the South)
2) drop the ophtho spot (and still do my prelim in NY and reapply to ophtho in the South)
3) transfer out of my ophtho spot in NY after the first year?

Which is easier (for me)? Which is less frowned upon (being that this is my home institution)? When should I let my PD know? I do not know how I would find out about vacant PGY-3 positions if I were to transfet because there are so few listed on the SF Match website; is it a word of mouth type of thing? :confused:
I hope this wasn't too long, but any advice will be appreciated (even random advice about this topic). Thanks in advance.
PS, here are my stats so that u have a clear picture of what may be best for me.
--Board Scores: Step 1 237/95, step 2 not taken yet
--AOA and class rank: senior AOA and class rank 9/100
--Reputation of medical school: non-reputed/unknown
--Research: 2 ophtho research, 1 ophtho pub; 1 engineering research+pub
--Honors in clerkships: honors in obgyn, medicine, psychiatry, ophthalmology
--# and where you did away rotations: 1 (did not get honors, got satisfactory)
--# of programs you applied to: 40 (13 upper tier, rest middle/lower tier)
--Where invited for interviews: Wake Forest, Yale, Mount Sinai, Georgetown, University of Md,
Mayo, UCSF, UT-Memphis, home school (did not interview at UT-memphis for scheduling reasons)
--Where matched: home school (ranked last on rank list of 8)
--Anything that helped your app: nothing that I can think of
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What part of "legally binding commitment" you did not understand when you applied? You might not be allowed to reapply again if you drop for a reason like that. Unless you are about to get deployed to Iraq or something like that you might not get any sympathy. Can't you fiancée wait until you are done with residency? Or maybe live for a few years in NY? This is ophthalmology we're talking here!
 
I agree with the above. If you drop, I don't think you can match again.

The best thing for you to do is for your fiancee to stay in NY with you until you are done. Programs are generally supportive and allow maternal leaves. I know several people that had children during ophtho residency.
 
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I disagree. I also disagree that your medical school is unknown and non-reputed. The medical schools in NY are not bottom of the barrel lousy, at least not Albany Medical College, SUNY Stony Brook, NYMC, etc.

Life is precious. I would say a happy family life is potentially more important than even being a doctor. How would you feel if your husband was like Mr. Katie Couric (CBS news anchor) who died in his 40's?

Do what YOU feel is right. This could mean living apart and building a lot of frequent flyer miles, trying to transfer to a program in your husband's city (very hit and miss if there will be an opening), trying to transfer to a program in the south (more likely), trying to switch with another resident (very hit or miss but has happened between a Los Angeles and San Francisco ophthalmology resident), or even having a child with your husband and postponing ophthalmology with no guarantee of what the future holds as far as getting a spot. Also consider having a child during internship and not ophthalmology. Even consider being an unwed mother because its not so scandalous now as in the previous century, but examine your religious beliefs first. Good luck.

As far as applying to another program, you are free to do anything you want legally. Just act in an ethical and honest manner and you'll be fine. (disclaimer: I am not a lawyer, this is not legal advice, this is not medical advice, kids, don't do this at home, this McDonald's coffee is hot, etc.)
 
Thanks for all of the responses, I appreciate your opinions. I love ophtho and can only see myself becoming an ophthalmologist. However, family has always come first in my life (and my fiance's life) and I am willing to delay gratification for optho in pursuit of my familial dreams because waiting does not seem like a good idea at this point (ie he's getting older by the day and I'm eager to start a family...lol). At the end of the day, I see it as I'd rather come home to a happy, bubbly family than just to my degree on the wall (of course having both would be the best). I just wanted to find out what would be the best approach to trying to have both (child being cared for by family and doing internship/ophtho residency at the same time)... I did understand the words "binding commitment" when I signed the rank list, but in light of these changes in my life, I'd like to know what all of my options at this point are (even if there are none). Thanks again, you guys are awesome.

PS :laugh: to your disclaimer eyerepairman.
 
I agree with those who said do what is best for you.

However, the reality is that you must consider this a choice between what you want with family and becoming an ophthalmologist.

I think it is HIGHLY unlikely you will match into a program again. I doubt any program will take a chance that you could match with them and change your mind again and leave them looking for someone else who may not be as good a candidate after a match.

I can tell you that at most programs, they would most likely move down one spot to fill a position with the next person on their list rather than take that chance.

It may not be fair but it is the reality of these situations.
 
I hope you like internal medicine or family practice. Probably a small community program with a lot of FMGs is what you are looking at should you choose to practice medicine.
 
Hi. Is this the 1950's? You are going to drop everything you have worked for to run off and be susie homemaker because of the conveniently timed proposal of your 40-something (practically on his death bead) fiancee? The choice is not happy bubbly family vs. cold diploma on wall. This is your career. You will spend 40 hours a week or so engaged in career activities until you retire so if you really can't imagine doing something else besides ophtho then you should not hastily discard your only guaranteed chance to enter your favored field. You are unlikely to get a spot (barring a miracle) at the specific location you happen to be raising your family in, and once your kids arrive, it is highly unlikely that you would want to leave them for a long commute or worse. You will most likely have to settle for a second-best residency that is geographically suitable only. Right now you have flexibility to continue your training, start a family, and on graduation day you push your stroller southbound right out of NY with diploma in hand.

Reality is that 50% of marriages end in divorce, so how would you feel if 5-10 years from now (provided he is still alive) your then husband has a midlife crisis, leaves you, and then you are stuck sans happy family and either unemployed (if you do the SAHM thing) or practicing family medicine or some other undesirable back-up choice. You'd possibly think "wow, this sucks!"

You don't have to plan to live in NY forever. You can raise your kids in the south if you are so determined. You can even start to have them during residency (that is what I did, and I highly recommend it. FMLA rocks!). I don't see why your fiancee (who I expect should love you and have your best interests in mind) would be so inflexible to cause you to choose between him and your hard earned career. True love knows no bounds, right? If your marriage is contingent on moving to the south now versus in 4 years, you need to have a talk with Mr Right and do some soul searching as this does not bode well.

I am not trying to be harsh but you need to look at things without those rose colored glasses and be practical.
 
you know what ophthobean-brain, you sound just like one of those typical, type A, manic, "bow down to me because i am a doc, but don't know s$%t" premadonna docs... how dare you talk about someone elses fiancee dying, or "even if he is alive until then"... this is someone who is asking for sincere advice on a forum of her peers... frankly, with words like that i am even surprised that any poor bloke even married you... i don't feel sorry for you at all... i feel sorry for your program and more importantly, your patients... you are worthless and do not deserve to be in the health care profession, let alone an ophthalmologist... can some moderator please ban this biatch!!!
 
OphthoBean said:
1)your 40-something (practically on his death bead) fiancee?
2)Reality is that 50% of marriages end in divorce, so how would you feel if 5-10 years from now (provided he is still alive)...
Click to expand...

Highly inappropriate post! You can deliver the same message without these ridiculous and opinionated lines...:thumbdown:
 
Good post Ophthobean. I would suggest you ignore futureidoc's vitriol, and I would suggest DiveMD get a better sense of sarcasm. In any case, I agree with the gist of your post.

Shiloh, if you truly want to be an ophthalmologist, then there are some compromises that will need to be made. There's no reason you can't have kids or get married or whatever but if you put those ahead of your career (a valid choice, if you desire) then why should a program be willing to make exceptions to accomodate someone who is not committed? There are plenty of people who truly want to do ophthalmology and are just as qualified as you. I don't mean this as an insult, I say this because I believe there is a large pool of applicants who are generally equal and for whom circumstance and luck of the draw is very important.
 
Shiloh said:
he's getting older by the day
Click to expand...

This is what the OP said. She is making it sound like her fiancee is practically J. Howard Marshall or something. My parenthetical comments were in direct response to the OP's implications that mid 40's is so so old. That and someother poster's Mr. Katie Couric's 40 something death. In case y'all didn't know it is not that common to die that young so it is not necessary to promote a sense of panic.

Futureidoc and Divemd you take everything literally. You wouldn't detect sarcasm unless it hit you over the head like a cast iron pan, apparently.
 
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futureidoc said:
you know what ophthobean-brain, you sound just like one of those typical, type A, manic, "bow down to me because i am a doc, but don't know s$%t" premadonna docs... how dare you talk about someone elses fiancee dying, or "even if he is alive until then"... this is someone who is asking for sincere advice on a forum of her peers... frankly, with words like that i am even surprised that any poor bloke even married you... i don't feel sorry for you at all... i feel sorry for your program and more importantly, your patients... you are worthless and do not deserve to be in the health care profession, let alone an ophthalmologist... can some moderator please ban this biatch!!!
Click to expand...

Futureidoc. I am going to complain about YOUR highly inappropriate commentary. I didn't call anyone names yet you called me a "biatch" and "worthless". Your personal attack is not called for or appropriate.

BTW it is prima donna (operatic role) not "premadonna". Or did you in fact mean docs who is about to become Madonna-like? You shouldn't use words you don't understand.
 
DiveMD said:
Highly inappropriate post! You can deliver the same message without these ridiculous and opinionated lines...:thumbdown:
Click to expand...

:rolleyes:

ETA: this is a rolling eyes/sarcasm smilie...just in case it needs to be spelled out for you.
 
Please do a google search for divorce statistics (so you can find the ones you like best) so you can understand I am not way off base. If you want anecdotes head over to General Residency Issues. There is a poor guy there whose wife is leaving him in his prelim year and other SDNers share their sad tales too.
http://forums.studentdoctor.net/showthread.php?t=387473

I belong to other women's message boards, and it is heartbreaking to have gone through women's news of dating, engagement, wedding plans, family planning, and then divorce. Some women defer completing college. Some leave careers and burn bridges behind them. They struggle much more than the ladies who put full faith in their marriages but also were practical enough to have a back up plan in the event of unfortunate marriage circumstances.

You are not going into marriage planning to divorce or anticipating the untimely death of a spouse (very rare, but tragic when it happens...I felt awful for my classmate who was 8 mos pregnant doing CPR on her new husband as he died in her arms from unexpected cardiac arrest...he was 28) but you have to have a means to care for yourself and your kids in case you find yourself without a husband for whatever reason. Don't close any doors on your career opportunities unless you are sure you could be satisfied with a second or third choice in the future.
 
OphthoBean said:
Please do a google search for divorce statistics (so you can find the ones you like best) so you can understand I am not way off base. If you want anecdotes head over to General Residency Issues. There is a poor guy there whose wife is leaving him in his prelim year and other SDNers share their sad tales too.
http://forums.studentdoctor.net/showthread.php?t=387473

I belong to other women's message boards, and it is heartbreaking to have gone through women's news of dating, engagement, wedding plans, family planning, and then divorce. Some women defer completing college. Some leave careers and burn bridges behind them. They struggle much more than the ladies who put full faith in their marriages but also were practical enough to have a back up plan in the event of unfortunate marriage circumstances.

You are not going into marriage planning to divorce or anticipating the untimely death of a spouse (very rare, but tragic when it happens...I felt awful for my classmate who was 8 mos pregnant doing CPR on her new husband as he died in her arms from unexpected cardiac arrest...he was 28) but you have to have a means to care for yourself and your kids in case you find yourself without a husband for whatever reason. Don't close any doors on your career opportunities unless you are sure you could be satisfied with a second or third choice in the future.
Click to expand...

I do agree with the essence of your message but not with the way you deliver it. BTW, you sarcasms suck…
 
OphthoBean said:
. I didn't call anyone names yet you called me a "biatch"
Click to expand...

I REALLY DO NOT LIKE TO MICRO-MANAGE FORUMS. THIS IS AN OPEN FORUM WHERE FREE SPEECH AND IDEAS ARE PERMITTED AS LONG AS IT IS DONE IN A TACTFUL, NON-THREATENING AND NON-DEROGATORY MANNER. WE SHOULD REFRAIN FROM REFERRING TO EACH OTHER IN THE ABOVE MANNER. I WILL KEEP THIS FORUM OPEN AS LONG AS WE RESPECT THESE RULES.
 
Shiloh,

Do what you have to do, but don't delude yourself about your chances of ever practicing ophthalmology. You matched at your home program (that you ranked last), and now you are completely screwing them over. Do you think they'll recommend you for another program?

Good luck with a tough decision

P.S. I wouldn't try to take the sympathy route with the "unexpected" proposal/ change of situation story when you talk to your program if they knew you've been with the guy for almost 6 years.
 
With all due respect... Are you freaking ******ed??? I completely understand happiness and family, but the phrase "legally binding" means just that. Tell your to be husband to suck it up and move to NY for 4 years. That or just wait it out.

Your husband can chill and be a soccer dad.
 
daKnuckler said:
With all due respect... Are you freaking ******ed??? I completely understand happiness and family, but the phrase "legally binding" means just that. Tell your to be husband to suck it up and move to NY for 4 years. That or just wait it out.

Your husband can chill and be a soccer dad.
Click to expand...

Buddy, to some ppl family is paramount. I can't say I don't agree with those ppl. I wish to be an ophthalmologist, but on my deathbed, do you really think I'll remember how many retina operations I successfully did? Or cataract procedures? No. In the most probable circumstances, I'd think about my children and my wife. If that happens to be what's the most important to her, then "legally binding" or not, it's incredibly important to her, and I support her decision. If "legally binding" is the thing that holds her back, then so be it. But if not, throw her a freaking bone. Let her seek for a shot to have the best of both worlds that we're all looking for.

Although, to the OP, it seems like you're going to have to stay in NY if you wish to remain an Ophthalmologist. Although if you wait a couple of years to have a kid (I know he's in his late 30's) it'll still work out and you'll still probably have healthy children. Give it a shot. :)

-Ice
 
DiveMD said:
What part of “legally binding commitment” you did not understand when you applied? ... This is ophthalmology we’re talking here!
Click to expand...

Yes, this Ophthalmology, not getting deployed to Iraq, not being told your child has 6 months to live, it's a freaking job. Circumstances change in everyone's life and many a "legally binding commitment" has been broken. It would take the department roughly 1 hour to fill her spot, esp with this much notice. Granted, she would be a pretty hot potato in the future, but if her situation was nicely articulated in a personal statement it would be possible to re-match in Ophto. There are more women faculty at programs who do not exactly share Opthobean's opinion, and feel family life is important.
 
Hi,
I think it's great that you're valuing family first. Too many people get way too obsessed today that they forget what's important in life, and that differs for different people. I think if you prioritize family first.. you should always start with that first...others may place career first.. which is their prerogative.

Regarding your chance to match again... I think you should talk to your prelim PD and your ophtho PD ASAP. This is NEVER a conversation that's fun to talk about... but if you're sure that you will be moving to the South, then you should meet with them ASAP... to give them the chance to offer advice... and if necessary, find a replacement for an empty opening.

It depends on the program, but you may be pleasantly surprised at how some PDs are understanding. Others may not be as understanding. It's a risk you have to take.

If you have time to get prelim out of the way, then great. if you don't.. then that's how the dice rolls. I will say that if you plan on reapplying to ophtho next year during your prelim year.. that could be very difficult and stressful.. having both house duties and traveling for interviews. If that's the case.. I would hold off on prelim and just do more ophtho research to strengthen your application. ALOT of these small niche fields is all about who you get to know and impress.

If you do decide to pull out of the programs, realize that you may be setting yourself up for doing 1-2 more years of ophtho research in order to strengthen your application to get into a program again. Of course this is a hypothetical guess... but generally.. I think programs like to take people fresh from medical school...and if you've been out a few years... you need to 'reprove yourself' in a sense with doing more research or something.

I hope this helps. this is by no means fact... and just my opinion. I only have some exposure to this issue.. because my wife who is a radiology resident is a year apart form me.. and I looked extensively into options for her to transfer residency programs to an ophtho program that I would be interested.. which was basically impossible. So, I decided to stay at my home institution for ophtho which I'm very very happy about still because it's a great institution (and would have been my second choice).

With that said.. it'll be very very hard for you to transfer or find an opening later on. Especially since transferring or reentry into a residency program.. you're place at the lowest priority of applicants. Programs that have closed for whatever reasons.. those residents gets priority ahead of you to transfer into those spots.

So, you'll most likely have to reapply 2 years ahead if you choose to go that route.
I hope this is helpful,
Goodluck.
 
You need to consider you options very carefully. If you:
1) Drop out of ophtho- your chance of rematching into ophtho is slim to none.
2) Drop out of ophtho and internship- your chance of rematching into any specialty will be low, given that you will have broken both SF Match and ERAS matching rules. This is especially true since if you pursue either options, it means you will be limited geographically (close to your family).

You also need to be careful talking to your program director (PD). While most of us are sympathetic to unforseen circumstances, yours is not. You should probably have considered personal and family issues prior to the match.

You should also take a step back and consider how lucky you are. Things are never perfect for most us. You, however, have matched into ophtho (a competitive specialty that you love) and you also have found someone you love. Now, it is about making compromises to make things work.

Dropping out is not in your best interest. You should consider delay having a family or starting your family in NY. Even if you start your family in NY, you can still rasie them in the South because you will only be in NY for 4 years.

Lastly, please think it through before talking to your PD. This is not an issue to be discussed lightly.
 
I completely agree with VO5.

Do NOT talk about this to your program director until you are sure that you are leaving the program.

Also, you need to decide as soon as possible what you plan to do.. because if you do decide to leave.. you also need to let your PD know ASAP.

But, when you talk about this subject with your PD.. it's a VERY VERY serious thing.. and it's not something to bring up lightly.. or even talk about on a whim. If you even suggest to the PD that you're thinking about leaving.. but haven't decided... it's basically saying you are leaving. So, if you do approach your PD about this.. you need to have already have a decision made up.
 
I agree with some of the posts here. You should not give up this spot and there's no reason to, in my opinion. Everybody faces circumstances where they have to move somewhere else. If he loves you that much, I see no reason why he can't move to NY for 4 yrs. It's not the "middle of no where" we're talking about here. Yes, he might not like it or he might have to leave his current job, but I don't think for him to find another job in NY (or anywhere else) is as hard as getting into ophthalmology. Even leaving his family in the south, he can always visit them. These 4 years will come to an end at some point, then you guys can move to the south happily with a diploma in your hand. Even if you get pregnant next month, you'll still be able to raise your kid(s) in the south as you wish.
 
My father was just about 50 when he had me, and my boss just had his first at 53. Make your choice, just dont expect anyone to believe that you would have any commitment to end up in their residency even if they let you switch to a program down south. Look at it from an employers stand point. Your work history sucks b/c you are almost two years away from a job and you want to break your commitment. You have only been committed to the position for a couple of months. If I were and employer would I take a chance on you? no, unless I was desperate or something was wrong with my program. Also looking at it from an employers view again, "Hello my name is blank, I want to break a legally binding contract so that I can come and work for you in 1.5 years and start a family while I'm working for you, I promise I'll be a hard worker and pull my share...one child later.... I've been a great resident, only missed 3 months of my first year and I worked really hard. Well anyway I'm not getting any younger and my husband isn't either, and well you know how things go, I'm having my second. But I will make up call etc so no one should complain that they have to completely rearrange their schedules around my life, b/c their lives are not as important as my life..." If you look at it as business, which ultimately it is. A hospital can't survive if they can't pay the bills, you are not a good bet.
 
Shiloh,

Ideally you would do both residency and have kids, which is certainly possible. It's seems really crappy how your fiance is making you choose b/w him and your career. Are you sure you can't talk him into having kids while you're in residency in the north east? It's only for 3 years, and then you can move to the south.

It's a tough position to be in. Overall though, you'll probably be happier if you choose a family over the perfect career. It's not like you won't be able to do something with your degree eventually.
 
I think your best bet is to keep your spots and just try to transfer to the south if any spots become available. I would suggest reposting this question in the general residency forum, because I know that there are others on this board who have made the switch in other specialties and they might be able to give you better advice about how to do this without losing your spot or making enemies.
 
Things to keep in mind:
1. Family requires compromise and occasionally sacrifice. It's just a matter of who wants to do it.
2. Things might not happen as you plan.

I think unless you had connections, you would not stay in ophtho. You're thinking about breaking a legal contract. Would you rank a place that fires residents to hire other ones they realized they like more? I don't think so.

Why can't your fiancee move up for a few years?

I just had a baby 3mo ago as a prelim and worked so hard to take only minimal time off and meet graduation requirements so I would finish prelim year on time so I wouldn't start ophtho even 1 day late and risk losing my spot. My husband picked up the slack when I went back to work. There's a lot more I can detail on the sacrifice level here that doesn't apply to you so I'll spare you details.

Getting pregnant and staying that way until term isn't as easy as most people think. Not to be negative but it isn't. I wouldn't move or quit based on "I'd like to have a baby." Again, I'll spare details here.

Do what is right for you and your fiancee, our replies are only opinions and suggestions.

:luck:
 
First, please keep discussions on here civil and respect the opinions of others. We don't want to close down threads.

In regard to the original post, this is a personal choice that you and only you can make. I know by experience that this is a choice that MAY prevent you from ever entering ophthalmology again. You signed a binding contract. You matched at a program that may not very happy with you dropping out. You basically placed the program in a bind because they accepted what they thought was an excellent or perhaps outstanding match, but now the program has to scramble and perhaps fill a resident that may not perform as well as you.

These are your options, and I would act now:

1) Call your program and discuss with them about finding a replacement and releasing you so that you may reapply again.

2) If the program is not willing to release you, then you must consider a long distance relationship. I've seen many couples do it. Flights can be cheap if planned ahead. Realistically, you probably will spend more quality time with your husband if you fly "home" to see him than if you're together during a busy residency.

3) If a long-distance relationship is not your cup of tea, then consider not being an ophthalmologist, moving south, and then finding another specialty to practice. If your program does not release you, then you are very unlikely to match again. I know of women who took path #3, broke their contracts, and never became an ophthalmologist.

Good luck!
 
Becoming an ophtho resident in NY doesn't preclude you from raising your children in the South! I wish you the best of luck getting pregnant the first time you try, but it may not happen within the first few months. Still, assuming you get pregnant within the first year, and have a baby during PGY 2, your child would be 2.5-3 by the time you're done with your NY residency. You can then proceed to move to city of choice and raise child there.
 
Dear Shiloh,

Very interestingly I have a simular dilemna that actually may compliment your dilemna. I was accepted into a program in the south and really am considering moving north because of a horrible situation that occured to me recently. If you are still interested in a more southern program please reply to this thread and somehow we should comunicate.
thanks!!!
 
HI,

I'm sending out this note to all ophthalmologist who would be interested in transfering to a PGY4 position at WVU Eye Institute in Morgantown WV. It's an excellent training ground with well over 120 cataracts, lots of oculoplatics, orbital trauma etc. This has not been put on the SF Match yet but will soon. I spoke with the program director and they are looking for someone to fill this position who is reliable, hard working and not coming with alot of problems from the previous institution. If your interested email me your cv and I'll hand deliver it to the program director for consideration. Once again this is an excellent training ground.

Little about me. I'm a DO from San Francisco Coll of Osteo now known as TUCOM. I'm going to be starting my pgy 4 year this july. Whoever reads this and is not interested but knows of someone who would please let them know so they can email me.

email: [email protected]
 
ophtho-bean was icequeen in a previous SDN life!
 
Dear Ndestrukt,
Thanks for your really useful, insightful, and relevant comment on this timely thread. You haven't posted in the Ophtho forum since March and then you search through a month old thread and try to pick a fight? Wow. This community is so fortunate to have such an interesting contributor as yourself. I hope we can all learn from your vast medical student experience regarding ophthalmology, residency, and internship related issues.

I think you may have been Icequeen in another incarnation as she and you share a knack for posting useless and obnoxious comments. :mad:
 
You tell him Ophthobean!

BTW, is it you on the SDN front page or some other DO ophthalmologist from Orange County ;) .
 
Hi there Shiloh,

I recently joined the forum and saw this post. I can put in my two cents about family vs career as a similar thing happened to us, but I'll hold off since its been well over 3 years since the OP. Just wondering though - were you able to switch with another resident, or what ended up happening?!
 
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