Thursday, April 8, 2010

How To Switch: Get Support

I must say on some days throughout this process I felt like I was crazy. This feeling seems to be pretty universal among specialty switchers with whom I have interacted. So it may sound obvious, but make sure you reach out to people you trust and get some support while going though this. People outside of medicine are great to give you different perspectives. But you will need to find some support from within medicine too. You will need help in figuring out how to proceed and having someone supportive while going through the process will help save your sanity. And from a purely practical and strategic standpoint, you will need to gather letters of recommendation for making your switch. Here are a few places where I turned for support from people within medicine.

Medical School. Initially, especially as I was struggling with whether to stay or go, I did not want my program to know that I was considering leaving. I also wanted to get a sense of what my options were, so turned to my medical school for help. My former dean's letter writer, the registrar's office, and the GME office were all very helpful in giving me big picture advice about how one goes about switching. Faculty in the fields I was considering switching into gave me good information about what programs would be looking for in a specialty-switching applicant. An adviser who had helped me decide to go into pathology gave me some advice about things I could consider within pathology that might be a better fit for my interests.

When I had made the final decision to leave, I turned to my medical school to help me go through the match again. My dean's letter was updated and I had to get some new letters of recommendation. Luckily, the pediatrics department at my medical school and some of my past letter writers were very supportive and helpful with the needed letters. In the end, I could not have switched without having my medical school behind me. I am very grateful that I attended a school that is so supportive of its students and graduates.

My program. Although the idea of telling my program that I was thinking about leaving felt daunting and scary at first, I knew that things would go much more smoothly for all parties involved if I was up front and honest with them. In the early stages, when I was unsure of whether I really wanted to switch, I needed some advice about how to find my niche in pathology. I identified a faculty member with whom I had a good relationship. This faculty member was someone who worked with a lot of residents and was familiar with the training program. I felt I could trust this person to give me good advice and to keep my dilemma confidential. I was right. We had several meetings over the course of my decision making and the faculty member was supportive, gave me things to think about, and also helped me change my schedule a bit to explore areas that might be a good fit for me within pathology. When my decision was final, the faculty member helped me determine the best timeline for notifying my program director.

I spoke to my program director in the early fall. This was the time when I was starting to put together my application for the match and when the program was getting ready to start screening applications. It really well--my program director was very supportive, offered to write me a strong letter for my application, and gave me the date by which I had to tell them my final decision so that they would determine how many positions to take in the next match.

At that time I also spoke with another faculty member, with whom I had worked fairly extensively, about obtaining another letter of recommendation. Ultimately, I ended up with two good letters from my current program to supplement the letters from my medical school. Even though I had re-entered the match, I was till not 100% sure I was leaving until December. I wanted to get some more surgical pathology months in before I made my final decision. Once I realized I was definitely leaving, I told a few of my fellow residents and gave my program director my final decision. I was set to switch.

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