PROGRAM TRANSFER GUIDE

Have you been contemplating a program transfer? Well, you've come to the right place to initiate your journey. Our comprehensive guide will help you manage the transition with confidence and ease. The first thing you need to know? It's not as overwhelming as you may have imagined - especially when you use our step-by-step guide, developed with input from doctors who have already negotiated this very path. Read on, or click to download the guide in a PDF format or in an ePub format for an iPad or other tablet device.
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An Inside View

It only takes a few collegial conversations to realize that everyone knows someone who’s gone through a transfer. That makes it seem commonplace, but when you drill down, few of us actually know how the process works or, more importantly, how to make it work smoothly.

Enter a group of dedicated PARO members who recently took on the task of investigating this issue, collecting information from residents at all Ontario universities who had transferred internally, to a different Ontario university, or from out of province.

Throughout the process of assembling this document, we’ve come to realize that making change is more common than one may think. Most doctors make the choice part way through their program, for either academic or personal reasons. Topping the list are:

        ACADEMIC
        • preference for a different type of medicine
                • concern about job prospects in the field
                • specialty-related factors such as patient acuity and setting of practice

        PERSONAL
                • location and/or hours
                • cultural fit
                • family ties.

Debunking Challenges

Our PARO team also found that regardless of the reason for the transfer, residents typically face common issues, which include: Dealing with the administrative process; concern about perceived stigma, and; lack of transparency in the transfer process.

Let’s break that down.

In terms of the administrative process, many residents worry about securing additional funding, not knowing about available spots, ability to carry over rotations for credits, and adhering to various timelines and requirements of the transfer process.

As for perceived stigma  – either from a home program or transfer program – this has given pause to many a resident. In actuality, most of those we surveyed acknowledged that they did not experience any negativity – throughout the process or afterward. That’s an empowering message. You should never be made to feel like you are giving up or burning bridges. This is your decision and should be fully backed by all involved. If you do end up in a situation where you don’t feel supported, seek out the resources that are readily available to you (including your local PARO General Council representatives).
Finally, lack of transparency: Most residents concur that this has been the greatest hurdle when contemplating a transfer. In fact, it was the impetus behind creating this document. Thankfully, that’s now a thing of the past. In the following pages you’ll find university-specific policy information, document checklists and helpful links, all with the aim of demystifying this process. So, let’s begin!


GETTING STARTED

If you’re considering a residency program transfer, it is your responsibility to initiate the process. Here’s a helpful list of the key individuals/offices you need to contact – depending on which program you are transferring out of/in to:

Council of Ontario Faculties of Medicine (COFM)
In November 2016, COFM released a document entitled, "Principles for Transfers in Ontario Residency Programs". You can find it here.

Resident Doctors of Canada (RDoC)
In addition, RDoC published a helpful document in June 2013 called “RDoC Principles on Resident Transfers.” You can find it here.

National Transfer Guidelines
The PGME Deans approved a set of national guidelines in April 2015 to offer a transparent transfer process to both resident doctors and universities involved.” You can find it here.

Documented Policies on Transferring Residency Programs Specific to the University
Each university has its own policy and guidelines on transferring residency programs, mostly derived from the COFM document. You can find your school here:
Post-Graduate Medical Education (PGME) Office
The role of the Postgraduate Medical Education (PGME) Office is to advise the Resident on the transfer process. Ultimately though, it is your application and you are responsible for all aspects of the process  e.g., gathering and submitting the appropriate documentation, making contact with the programs that you are interested in and making the sometimes tough decision as when to notify your home Program Director regarding your transfer.

Here are some common program transfer FAQ's with advice provided by your PGME Office:

Will the PGME Office send the ITER's to the programs that I am applying to?   
You should have access to your own evaluations and be able to send them to the program that you are applying to.  If you are having difficulty or do not have access to all your evaluations, you can contact the PGME Office to assist.

Would it help it I did an elective?  How do I arrange that?   
An elective is an excellent way to gain exposure to the specialty that you are applying to.  If you are able to organize this at the school that you are interested in applying to, that is even better.  It will provide the program with an opportunity to see you in action.  In order to arrange an elective, however, you will require approval from your current Program Director.  

Should I tell my current Program Director that I want to transfer?  
This is definitely a personal decision.  Some residents feel very comfortable speaking to their Program Director, others not so much.  Depending on your reason for transfer, sometimes the Program Director can be very helpful.  The general word of advice from the PGME Office is that the resident shouldnít tell their Program Director until they have secured a position e.g., received a written offer.  Residents struggle with feeling that they are being dishonest or hiding something from their Program Director.  You need to consider how you would feel if you were not successful in your transfer and how this may affect (or may not affect) your future training in the program.  

Should I contact the Program Director of the specialty that I am applying to?  
It is often good for you to make contact with the Program Director, so that they are aware of your application and know your name.  It is a good idea to make a connection with the Program Administrator of the program who can remind the Program Director and keep you application on file.  Do not send repeated emails to the Program as this is likely to annoy people rather than help your application.  The PGME Office will contact their Programs if they express an interest in transfer applicants and once they have gone through their own school processes so often it is a good idea for you to go ahead and make that connection.

Is there anything I should do before I contact the Program Director?  
Find out about the specialty / program you are applying to, read the CaRMS program description, talk to other residents.  

Residency Wellness Director/Officer
Transfers require a great deal of planning and prep, which may impact your personal life, relationships and psychosocial wellbeing. The Residency Wellness personnel at your home school can be an invaluable source of support given that they have experience in counselling other transfer residents.  

Program Directors of Home Programs
Although the PGME Office is the first point of contact, you will eventually need to request a release from your home program, usually via letter from the home Program Director. It is important, at some point during the transfer process, to inform the Program Director of your home program about your intent to transfer. Refer to the PGME Office for guidance on when is the best time to do this, based on your specific circumstances.

CaRMS Website
Utilizing the second iteration of the CaRMS match is one of the methods recommended by (and sometimes the only method accepted by some) residency programs. Refer to our CaRMS-specific section for more details.

Other Residents
It’s a good idea to connect with other residents – senior or chief residents currently in the program you are interested in – for preliminary information. Also helpful is reaching out to residents who have gone through the transfer process themselves. There’s no substitute for a first-hand account of an experience.


TIMELINES

It’s important to note that the process of transferring is variable – it can take anywhere from 2 months to 1 year to complete. So, once you decide to pursue a transfer, the first thing you need to do is contact your PGME Office to understand the requirements. See next section Documents and Policies for specific information on your institution’s transfer policy and requirements.

Putting together an application can take several weeks as most programs request reference letters and ITERs. As well, some programs may require you do an elective with them prior to applying. Then, once submitted, review of your application may take several weeks or even months, during which time you would continue working in your current program.

The last step is usually an interview with the accepting program director. Acceptance is generally granted shortly after this and you are then required to obtain a letter of release from your current program director. Even after an acceptance of transfer and a release from your home program there may be a lag in start time while you wait for a spot to open up.

The quickest processes are those in which the accepting program is within the same university, is familiar with the resident already, and has an open spot.

For your own planning purposes, be aware that applications done through CaRMS tend to take longer as the CaRMS process is several months long and transfers are dependent on whether there are spots in that subspecialty available in the second round, which is the only round open to transfer residents.


DOCUMENTS AND POLICIES

Each university has its own process for program transfers, but there are documents you will need regardless of the school. Here’s an at-a-glance checklist to help you start to get organized.

––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
What you may need
✔ Cover letter of intent
✔ Written request to receiving Program Director
✔ Written release from current Program Director
✔ Curriculum Vitae
✔ ITERs
✔ Foreign medical school transcripts - if applicable
––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––

For more specific information, simply search below and find your home school and its transfer requirements.

McMaster University
1. Transfer Request Form: All residents seeking transfer must complete this form and submit it by January 31st to the PGME Office. The form is available on medportal, under “Policies and Procedures”
2. Letter of Offer: Once this has been received from the program you are applying to, a copy must be given to the PGME Office.
3. Letter of Written Release: You may receive a conditional offer of acceptance into a program, contingent on release from your current program. You should meet with your current program director to request written release. Then, a copy must be given to the PGME Office.

Western University
1. Email or Letter to Manager of PGME Office: Residents need to send a letter to initiate the inquiry into the transfer process, which may result in a meeting with the Postgraduate Dean and/or Associate Dean for Learner Equity and Wellness.
2. After January 31, the PGME Office will contact the program to which transfer requests have been made to inquire about their capacity.
3. Notification to the Current Program Director: If the receiving program accepts you for transfer, the current program director should be notified of the transfer and a transfer date should be agreed upon.

Northern Ontario School of Medicine
1. Email or Letter to PGME Office: Submit your name and preferred programs by January.
2. Additional documentation: The receiving program director will contact you directly to request documentation for review.
3. Letter of Appointment: This will be issued by the PGME Office to successfully transferred residents.

University of Ottawa
1. Proposal for Transfer:  You initiate the process with either an email, letter, or discussion with the Assistant Dean.
2. Written Offer: This will be issued by the receiving Program Director and should be sent to the PGME Office. It should include the expected date of transfer and level of training.
3. Request for Release: This is joint request made by you and the PGME Office.
4. Written Release: This will be issued by your current program, and must be in writing and include all conditions of release. It should be sent to the Assistant Dean, PGME, and the receiving program, and indicate the transfer date.

University of Toronto
1. Email or Letter to PGME Office: Submit your name and preferred programs by January.
2. Additional documentation: The receiving program director will contact you directly to request documentation for review.
3. Letter of Appointment: This will be issued by the PGME Office to successfully transferred residents.

Queen’s University
1. Email or Letter of Request: You must make this request to the PGME Office.
2. Email or Letter of Intent: You should contact the program you are interested in to determine capacity, possibly arrange an elective, and to gather information.
3. Curriculum Vitae, ITERs, and other documents: You will be required to submit these as requested by the receiving program.
4. Release from Current Program: You need to initiate the release request from your current program, and forward it to the PGME Office.
5. Email or Letter contacting RCPSC or CFPC: This is to ensure prior training is assessed and credited towards the new program.

TRANSFER OPTIONS

There are 4 different transfer options available to you. These include:
a) Internal Transfers
b) Transfers Between Universities/Provinces
c) Transfers via CaRMS – Internal + External
d) Transfers for Residents with Return of Service Agreements

a) Internal Transfers
Internal Transfers – transferring to a different residency program within the same university – are the most common, and are usually the easiest to organize.

You have two options when transferring within the same university. The first is through your university’s Internal Transfer Process and the second is through the CaRMS Process as outlined in Transferring via the CaRMS Process. The earliest that you can apply for an Internal Transfer is after January 1st of your PGY1 year. Beyond that initial timeframe, some universities will allow you to apply for Internal Transfers at any time up until 6 months before the end of your residency, while others have an annual or biannual Internal Transfer application process, usually in January. This process lasts several months, and internal transfers are complete at most schools before transfers between different universities or provinces are processed. Check out your own university’s transfer policy for more information.

Requirements
Before you can be considered for an Internal Transfer, most universities specify that you need to complete at least 6 months of residency. If you originally matched into your program through the second iteration of CaRMS, this may increase to 12 months. There is usually also a requirement to have completed at least one rotation in your current program’s discipline – i.e. you haven’t only completed off-service rotations. Finally, Internal Transfers are generally not allowed if you are in the final 6 months of your current program.  This requirement is often waived if there is significant overlap between the program you are in and the program you are hoping to transfer into – for example, from Family Medicine into Public Health and Preventive Medicine.

Generally, programs that you are hoping to transfer into will want you to be as qualified and competitive as an applicant matching to that program through the CaRMS match. Usually, you are expected to have completed an elective or rotation in the program you wish to transfer into, either in the past year or in medical school.  Finally, if you submitted a CaRMS application to your target program when you were in medical school, this application will often be reviewed as part of your transfer application.

You will also need to prepare several documents as part of your transfer application. Check out our Documents and Policies section for more details.

Next Steps
Some schools will email residents periodically in their first and second years of residency to outline the transfer process.  However, at most schools, the onus is on residents to know the timeline and to contact their PGME Office to initiate the transfer process. Check out Getting Started for more information on the initial steps to starting a transfer application, as well as your own university’s transfer policies and timelines.

b) Transfers Between Universities and Other Provinces

The process for internal transfers and for transferring between universities in Ontario and between other provinces is really quite similar. We encourage you to make use of the informational resources as outlined in Getting Started. Some key differences are highlighted here.

There are two ways to transfer programs from one university or province to another. The first is through CaRMS, as outlined in Transferring via the CaRMS Process. The second process is by direct transfer.

If you initially attempt to switch programs within your university and no space is found, you may be placed on an applicant list, or you can inquire whether there is such a list at your institution. Your other option is to contact programs at other universities you would be interested in transferring to by email. If a spot is available at another desired university, you may need to do an elective at the transfer site prior to consideration for them to work with you. Think of this as an opportunity to build relationships.

Once there is a potential spot for you, submit your application. You’ll then have to wait for the transfer program residency committee to meet to present your case and gain approval. You may need to wait until after 2nd iteration of CaRMS to see whether funding is available after the initial 1st iteration CaRMS match (institution dependent). The accepting PGME office can provide you with guidance for this timeline. Because of this delay, some residents transferring universities also choose to begin preparations to go through the second iteration of CaRMS as well. See Transferring via CaRMS for more details.

Stories from the Inside
A number of residents shared their experiences about transferring programs between universities and between provinces with PARO. Most transferred to programs of the same specialty, and followed a similar process as described above. Many actually informed their home Program Director early in the process and found they had great support from them, though it should be noted that this is not required. On average, residents said this process was approximately a year long, and that the greatest delays were in arranging electives and securing funding. However, all noted that the accepting program was helpful in facilitating this process.

c) Transferring via CaRMS

Matching through CaRMS is only available to hopeful transfer residents through the second iteration. After deciding to apply for a transfer, it is important to keep track of milestones – these are not actual deadlines but dates recommended by CaRMS to help keep you on schedule. These can be found on the CaRMS website under R-1 Main Residency Match then Second Iteration timetable.  

The online request for registration is open from early December until early January for international medical graduates, United States medical graduates, prior-year Canadian medical graduates, transfer residents and any unmatched medical students.

The online application opens in early January and you will be able to log in using your electronic token, which will be emailed to you after payment has been made. Once logged in, you will be able to complete the registration and begin your online CaRMS application. In late February/early March, the online CaRMS application will close and you will have no further access to your application.  Once file review has been completed, the online CaRMS application will re-open and you will have access to your application. At this time, a list of unfilled residency positions will become available and you will be able to select programs you are interested in.

In early March, applicants who were not able to register for second iteration will be given the opportunity to do so.  An additional fee will be added for applicants who request registration after this date. Following the interview period, in late March, the rank order list (ROL) period begins and gives applicants an opportunity to rank their programs online. The ROL deadline is the only firm deadline in CaRMS; if your ROL is not submitted by this deadline then you will be automatically withdrawn from the second iteration.

Finally, mid April is MATCH DAY!


d) Transfer for Residents with Return of Service Agreements

The following initiatives have an ROS component:
  • International Medical Graduate (IMG) Training Program;
  • Re-Entry Residency Training/Education Program;
  • Repatriation Program;
  • Emergency Medicine Training Program; and
  • Resident Loan Interest Relief Program (RLIRP).
Transfer within same school
Transfers within the same school are permitted. Please refer to the schoolís guidelines on transfers. Individuals with an ROS contract should inform the ministry of any change in speciality within the same school once the transfer is approved and confirmed by the school. Individuals with an ROS contract who have transferred between programs within a school are still obligated to fulfill the terms of their ROS agreement.

Transfer within Ontario
Transfers between schools within Ontario are permitted.  Please refer to the schoolsí guidelines on transfers. Individuals with an ROS contract should inform the ministry of any transfer between schools once the transfer is approved and confirmed by both schools. Residents who have transferred between schools are still obligated to fulfill the terms of their ROS agreement.

Transfer outside of Ontario during residency training
Residents with ROS obligations may apply for a transfer outside of Ontario; however, they are obligated to repay all the costs associated with their training as outlined in the Agreement. Individuals with questions about the terms in their Agreement should contact the Program Officer, Ministry of Health and Long-Term Care at: 416-327-8339 or email: PPUProgramOfficer@Ontario.ca

Transfer outside of Ontario to pursue sub-specialty training
Residents with ROS obligations may pursue sub-specialty training, in Ontario or elsewhere in Canada, through the CaRMS Medicine Sub-specialty Match. For those matched to a position in Ontario, the existing ROS Agreement will carry forward to the sub-specialty training program and the physician will commence ROS following the completion of the sub-specialty program. Those matched to a position outside of Ontario, must commit to return to Ontario to return service in accordance with their agreement upon completion of the sub-specialty training; and, must submit an undertaking (letter) from the other province that any return of service in that province related to the sub-specialty training will be deferred until after the physician has completed their ROS in Ontario.

Contact information
All questions regarding Return of Service should be sent to:
Program Officer, Ministry of Health and Long-Term Care
Telephone: 416-327-8339


Good luck. If you feel like you require additional information or support, please contact the PARO Office at paro@paroteam.ca or 1-877-979-1183.



Copyright PARO 2016