Should I switch from internal medicine to neurology at the end of PGY-1? - USMLE Forums
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IMG Residency Match Forum International Medical Graduates (IMGs) discussing the residency matching process.

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Old 01-21-2012
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Question Should I switch from internal medicine to neurology at the end of PGY-1?

I am an international graduate applying for both neurology and internal medicine, and neurology is my first choice. I am applying for internal medicine because I like it too (although not my favorite specialty) and because H1b visa is my only option, while not many categorical neurology programs sponsor H1b visa.
Now I have just got a pre-match from an internal medicine categorical program that is willing to sponsor me H1b visa. I am thinking of completing my first year and then switch to a neurology program. In this way, I guess I will be able to transfer the H1b visa to a neurology program that does not sponsor H1b visa. In addition, I can fulfill my first year of prelimary medicine training.
However, I understand the program director will be reluctant to let any residents go (although this program has 12 residents per year), because he will have to find other people to fill the spot. In addition, will the PD get so angry that he terminates my H1b visa immediately or file law suits against me?
In addition, is it really easier for a program to accept H1b transfer than to sponsor H1b by itself? In fact, a few very strong neurology programs offer me prematch, but they only sponsor J1 visa. Unfortunately, my government does not support J1 visa at all. And I also got interviews from quite a few programs that do not guarantee preliminary year.
Do you think it is very risky to switch to a neurology program after PGY-1?
Or should I wait until the end of the PGY-3 to enter a neurology program? However, I am not sure if American government will fund a second residency. In addition, since H1b visa is only good for 6 years, how can I enter a fellowship after 3 yrs of IM plus 3 yrs of neuro?
Any input will be greatly appreciated!
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Old 01-21-2012
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I am not an expert in this issue but here's what I think.

I think that it will be extremely difficult for you to get PGY2 neurology position from a program that is willing to transfer your H1B visa. It will be the same difficulty that you faced right now, no difference next year.

The prospect of another neurology residency after finishing IM would also face the same issue, would they be willing to sponsor you H1B visa?

I'd say, go and take that prematch, and as the year goes along, you'll make stronger connections and you might find a way to switch. Connections matter in this regard and if you were able to make connections during your IM residency you might be able to find a PGY2 neurology.

The PD will be angry at you, yes. But that's it, he/she cannot do anything more than being angry at you In fact, they are obligated to write for you a factual letter of recommendation. Your contract is for one year and you can choose not to renew it, it's legal.

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