A Guide to Creating and Processing the Documentary Requirements for Your Switch

A Guide to Creating and Processing the Documentary Requirements for Your Switch

Jan 14, 2023 Published by Kathrin O'Neill

Upon deciding that you would like to switch residency programs halfway through your current training due to specific personal or professional reasons such as lack of fulfillment, toxic work environment, or personal preferences, you might find yourself stuck in the middle of a transition for a few years because of the guidelines that are in place to regulate the residency training process. Although the entire procedure is not as soul-crushing as many make it out to be (mainly due to the lack of information about the whole endeavor in the first place), the process could become quite tedious, especially when it comes to the tons of documentary requirements that you must prepare for each step in the process.

Sure, one might think that the requirements are not that different from what you had prepared when you first applied for residency – and that is not that far off from the truth. Most of the documents that you will be submitting will be processed similarly to when you applied for the first time, making the transition certainly seem like starting all over again from scratch. Of course, what you have now is experience, and perhaps that core skill will go a long way in ensuring that you will no longer be making the same mistakes you did in your initial application.

Despite being relatively similar to the previous requirements that you had to process, what makes the requirements of this transition even harder to process is the accompanying anxiety associated with bailing from the program that you once promised your total commitment to – which is not necessarily an unnatural thing to feel, considering that it might have been a hard decision by itself to even consider switching programs in the first place. After all, you will be either talking to your program director for a written release and recommendations, you might be consulting your PGME office for your evaluations, and you may even come across your previous colleagues along the process, only to not know what to say to them now that you have taken on the road that no one usually dares to take.

Throughout this process, you need to remember that despite the anxiety and fear that you are feeling, most of your colleagues are professional enough to understand the circumstances from which you decided to make the switch. Of course, you could not expect the same professionalism from everyone else, but that is a risk that you must take if you do not want to end your relationship with your current program on unfavorable terms. Whatever happens, you need to remember that you are following your calling and that your commitment has never been in question throughout your medical career – or at least you need to help yourself believe that truth for you to have peace of mind throughout this procedure.

The Requirements

Upon inquiring in various institutions that offer programs that piqued your interest, they may already provide you with a list of the requirements that you have to submit for your application to be processed by their admissions committee. Do note, however, that this list of requirements is simply a standardization of most requirements posted in various universities, and it does not mean, by any chance, that this will be applicable in all programs that you will apply to. This only aims to highlight what is required in most institutions and what most likely will be required from you upon applying to your chosen program.

  • Complete letter of intent
  • Written request addressed to the program director of the program you are applying to
  • Written release coming from your current program director
  • Updated curriculum vitae (CV)
  • Complete In-Training Evaluation Report accessible either through your own file or through the PGME office of your current institution

If you are already considering switching training programs[WT1] , you may want to update some of the documents from this list that you could already process, such as your CV, or you may search for standardized document templates from renowned websites online to further allocate more time into creating the content instead of planning the design and format of the document itself. After all, you are trying to market your skills and capabilities in practicing medicine instead of highlighting how you were able to use vibrant colors in designing the structure of your CV (which, of course, is not necessarily a bad thing to have for your documents occasionally).

When to Process these Documents

The application process for residency programs, even when it comes to your initial Matching process following your first year of applying for residencies, is highly competitive due to the scarcity of available slots in various institutions in contrast to the number of applicants who are trying to get into their program of choice. Of course, the acceptance rate could be affected by your performance in your Step 1 and Step 2 exams, your interviews, and your recommendation letters. Still, nothing makes an applicant stand out more than due diligence – or tardiness in the case of infamy and negative reputation.

Timeliness is an essential aspect of medicine, and it is so because the practice of medicine is exceptionally time-sensitive from diagnosis to treatment. Without proper timing, various protocols and aspects of their approach could fall apart in minutes. This does not only mean receiving failing marks from a particular test, but instead, it endangers the lives of the patients they are handling during actual consultations. As such, for you to build a positive connection with the program that you are planning to apply to, you must take notice of your timeliness in meeting deadlines for the requirements that they are asking you to submit.

As much as possible, submit the necessary documents weeks before the actual deadline so as they could have enough time to review your documents while simultaneously relaying your work ethic way before they could even get to that part in your CV.

How Should you Submit these Documents?

When processing your documents, you may come across the dilemma of whether you should submit the documents in person or whether you should simply email the paperwork and call it a day. Of course, either one has merit, but deciding the right way to submit these documents should generally not require that much thinking.

Our advice? Follow the instructions. This might be a little on the nose, considering that following the instructions is always a given. Still, there are instances, unfortunate as it might seem, that applicants forget to go back to the most basic advice anyone could ever give someone planning to get into a particular institution. Although the entire process does not necessarily penalize one option over the other, it might be wise to be in the committee’s good graces by either following their indicated mode of delivery or personally inquiring about their preferred method to maximize the connection between you and the program. These are just little things, for sure, but who knows how long these little things will go in the long run?

Potential Helping Hands

During your application process, you will find yourself lost and aimless during the transition, especially if you do not know who to approach whenever you feel like you no longer know what you are doing throughout the procedure. As such, it might be efficient for you to take note of certain personalities that could help you either amp up your application package or even assist you in processing the documents and submitting them to the program that you are planning to apply to.

The first one that should come to mind would be your current program director, who you probably have worked with already for a few months or years during the entirety of your training in their institution. It is undeniable that program directors often have that intimidating presence that discourages any interaction with them (although this is not the case in all aspects), but fret not as they are usually friendly and harmless, especially to those who come to them personally with no underlying intentions and are simply asking for some assistance. Most of the time, they are accommodating, and you could observe this through the testimonials of various professionals who asked their director for help during their transition. Still, you could never disregard the possibility of them having some sort of negative attitude toward your decision to switch programs halfway through the training that you promised to be committed to.

Of course, as always, this is a risk that you should or would have to take, especially considering that you will be communicating with them one way or another during your transition. Your program director, through their connections with various institutions, could help you find a program with an available slot, they could fast-track your written release document, and they could even help you beef up your CV and letter of intent to maximize your chances of getting into the program that you are applying into. Sure, some might be less than willing to help you. Still, if you are lucky enough to be under someone who would even help prepare you for your interview, you certainly were able to score a good program director with your previous search – and we are confident that you will be lucky enough to enter another good program too during your switch.

The other significant individual who could help you process your documents would be your Post Graduate Medical Education Office or PGME Office. This department often handles admissions and transfers in most, if not all, institutions within the country. The PGME office would usually be your go-to for any updates regarding your application or certain openings that they might be aware of, but they could also help your process your ITERs when it just so happens that you cannot access these records by yourself.

Written Request and Written Release

A Written Letter of Request addressed to the program director of the program that you are applying to, and a Written Release provided by your current program director supervising you are two documents that you will inevitably need when you are planning to transfer residency programs between institutions (or possibly even when you are moving within the same university). These documents are significant because they signify that you are already released from your current program and are attempting to apply to your prospective program. Of course, the exact contents of these documents vary depending on what is required from you. However, the record would still be required nonetheless due to its significance in establishing your training status.

When processing the Written Release document, you might have to consult your program director or your PGME office as they are the people who are authorized to release you from your current program and identify you as “qualified” to apply to yet another program. If you are somehow concerned about how to process the Written Request document, you may likewise consult the same authorities to ask for guidelines on creating this letter. You may also consult the institution's admissions office that you are planning to be a part of to ask for pertinent information that they might require to be present in the Written Request.

In-Training Evaluation Report

An In-Training Evaluation Report represents the assessment of a resident’s performance throughout their training within the program through numerical scores and narrative comments sourced from either the supervising physician or the program director overseeing the resident's performance in practice. In most cases, institutions give more weight to the numerical scores as these values summarize the overall performance of the resident through standardized means – determining whether the resident performed satisfactorily during their stay or whether they failed to accomplish the goals that the program wanted them to achieve.

Your In-Training Evaluation Report is often accessible when it is released to you by the program. Still, if you are having difficulties processing them during your transfer, you could always consult the PGME office to ask for help in fast-tracking the procurement of these documents. This is usually requested by most programs that accept transfers to determine whether the resident transferred on their own volition or was removed from the previous program due to misconduct and improper practice.

Letter of Intent

The letter of intent is a significant part of your application kit as this conveys that you are interested in placing a particular institution’s program as a part of your priority program list and that you are intently planning to apply to their program no matter the circumstances.

For sure, you might have already processed this document when you were first applying to your previous program. Still, there are some points that you may want to recall and possibly highlight in making your following letter of intent to maximize the impact and significance of this document in the possibility of you getting accepted to the program of your choice.

The Basic Points

When thinking about a letter of intent, the essential thought that comes to mind is that the letter should highlight your “intent” or plan to apply into the program of a particular institution – which is not that far off from the expected or, rather, recommended contents of this specific document. A letter of intent is a document that highlights your intention to apply to a program and the following reasons as to why you are competent and qualified enough to be a part of their training program. Of course, there are many ways to go about these contents, but the most essential points that should always be present within your letter are the following:

  • Why are you interested in that program?
  • What makes you a perfect fit for the program?
  • What makes the program an ideal fit for you?
  • What are the things that you could contribute to the program?

You could always vary the general content of this letter, but you should always highlight the following points to convey the reason behind your application better and even further emphasize the significance of the application to yourself and the institution if you are ever accepted.

Why exactly are you interested in that program, and why is it a right fit for you?

In this aspect, you may want to go back to the particular trigger that made you decide to switch programs in the first place. Most often than not, applicants would utilize generic statements that reek of cliches such as “I am applying because I feel like this is where I would grow,” or maybe they would even add a little splash of “the facilities are excellent, and this is the perfect environment for me.” In that case, you may already kiss your application goodbye.

They want honesty and utter dedication, and you could not convey that by using generic phrases. Be original in citing what pushed you to make this choice and why you are placing this program in the top spot of your priority list. Again, they are looking for the alignment between your goals and dedication with their values and capabilities. You could never aim to reach that with empty flowery words.

What makes you a perfect fit for the program?

In this aspect, you could then focus on your goals and what exactly you are trying to accomplish by switching residency programs, let alone choosing their program to change into. What you could highlight in this portion could be your interests that might be aligned with the program that they are offering, you may show reasons as to how you could achieve your goals in this program, and you may even quote specific details that highlight your compatibility with the program, the institution, and the people within.

What are the things you could contribute to the institution, and what have you achieved so far?

You may not necessarily highlight all your achievements for this portion, but you could likewise indicate a few to simply give them a little idea of what skills you have to offer to the institution. In addition to that, you might also want to avoid promising excessive accomplishments as this would sound somewhat disillusioned when you would hopefully want to sound confident and full of aspirations. Always be aware of the line between the two, and you would be good to go for your letter.

Curriculum Vitae

Last but not least is your curriculum vitae or your CV – the pinnacle of all personal documents, the one that has it all, the one that says it all, and the one that will probably make or break your application.

What makes it different from a resume?

A CV is different from a resume in many aspects, but many confuse the two in the sense that their contents are not necessarily that far off from each other. To start, a CV would usually include the educational background first, while the latter’s structure could vary. The CV likewise excludes the “letter of intent” portion in another document entirely, and many individuals often highlight the names of their references or people they worked under. It is also possible for a CV to go for more than three pages, but it is always in your best interest to keep the information concise and organized for the accepting committee to fully understand the skills that you are trying to highlight in your application.

Basic Points to Include

In making your CV, you may include the following essential points as these are often either required or are simply common in most applications that you will see online:

  • Full Legal Name
  • Contact Information
  • Education at the First Part
  • Certifications and License (if applicable)
  • Postgraduate Training (if applicable)
  • Practice Experience
  • Professional or Teaching Appointments
  • Research and Publications with Complete Citations
  • Accomplishments
  • Memberships in Professional Societies
  • References (both professional and personal)

Gapping and Parallelism

Gapping and parallelism are two techniques used in most CVs to keep everything concise and organized – making the document easy to understand and read throughout. Gapping is defined as using phrases to describe specific points to make the entire document shorter and easier to read. Of course, you would have to keep the meaning intact, but it is undoubtedly an effective tool when the applicant knows how to use them effectively. On the one hand, parallelism is an organization technique by which you simply keep your process of writing similar in all aspects of your CV. For instance, if you used phrases through gapping in the beginning portion, you would have to use the same technique for the entirety of the document.

Keeping Everything Simple

This might be somewhat of a given already, but we would like to highlight these points nonetheless:

  1. Never make everything too flowery by using long and drawn-out sentences that would ultimately lead to self-congratulatory remarks.
  2. Avoid excessive descriptions, impossible promises, and exaggerations when describing your performance.
  3. Always use strong language that maintains a perfect balance between concise, impactful, clear, and readable.


In this case, you might want to contact the people that you will be noting as references first before adding them to your CV. Considering that naming individuals you have worked with are more common in CVs than in resumes, you might want to recall certain achievements that you have accomplished in the past and identify the people you have worked with, especially if they are renowned in the medical community as well. Think of it as an indirect recommendation – making your application shine even more if the processing committee recognizes the references you have added.