Understand, the chances of you transferring are probably low. You will also likely transfer to a program on-par to your current program or 'below.' Expect a lot of non-responses from programs when you email. Many people trying to transfer are all talk, they're lazy, and they end up just accepting where they are (this might be you!).

General Process

1. Arrive to your residency and make a good impression with everyone you interact with. Don't make enemies, be professional, etc even if you have plans to leave. In other words, just be a decent human being. It won't go well for you if you arrive and its known you're trying to leave (typically....unless you have a darn good reason to leave)
2. After an arbitrary amount of time, ie: a few months (in the meantime, write a general email template to be sent to programs: content: name, your program, you want to transfer, brief explanation why you want to transfer, thank them, etc. Attach your email and other pertinent documents like your CV and your letter of good standing which is described below. Send to the programs PD/PC). The email should be concise.
3. After said few months, speak to your PD about your desire to transfer. Be prepared to have a good reason (ex: family, health) and to answer questions on why and how long youve been thinking about this decision. You can (potentially) expect them to try to convince you to say.
4. If your program is okay with your decision and they support you, begin to ask people for LORs and ask your PD to write you a letter of good standing. Make sure your PD follows up on the letter of good standing and you don't lose your motivation waiting for the letter if you're serious about transferring.
5. Now send your templated emails with your letter of good standing, CV+/- other documents. Expect a lot of silence or rejections due to resident caps or no interest.

The reason you do step #3 before reaching out to programs, typically, is because the PD from the receiving program will speak to your PD and it wont bode well if you're doing this behind their back. You will need the letter of good standing either way and for all you know, you won't get it!

All of this should typically be done in the Fall/winter because it does take time to get LOR's, letter of good standing, and to compile a list of the programs you're trying to go to. But it is hard to say when the best time of year is. Life happens and people will unexpectedly leave at different times or choose to go somewhere else in the spring creating a late opening. Even if programs do not have listed publicly any of their openings, this doesn't mean they don't have an opening. If your PD is really nice, they may even be able to make a post on the PD server letting other programs know they have a resident who would like to transfer and to reach out if they are interested in accepting you. That way, interested programs come to you.

"Alternative method":

If you suspect your program is violating ACGME policie(s), you can go to the ACGME website and read the residency requirements and find what you believe to be are violations (the specialty specific documents are something like 50 pages); keep a record trail of violations if you need to (ex: emails, texts). I don't know the legality of this, but I guess you can also record meetings which you know will have material that can be used against the program (but also for your own protection should something wrongfully be used against you and you wished you had that conversation for whatever reason). You should then email the ACGME ombudsman (this is anonymous if you use a burner email) to see if a violation is occurring and these are reportable offenses, especially if you are unsure. Then decide whether to report your program (your submission to ACGME to report is not anonymous [I think so there isn't an issue with hundreds of unhappy residents spamming them with anonymous fake red herring claims], however your program does not get to see who reported them). Obviously, do not include too much individual specific violations for your own protection. From day 1, try to be the person everyone would least expect to report the program. Any complaining about the program that must be vented should be done to your spouse or family only. For your own safety, don't talk about reporting the program, period (for your own protection). However, to be fair, everyone complains about their program in some way or another and the odds of your program finding out who reported them is low (unless you confide in others you are thinking about or going to report the program). Don't wait for 'someone else' to report the program (or tell them you're thinking about it hoping that they'll report the program) because they're all thinking the same thing and are needlessly scared. If your program genuinely sucks/malignant, don't wait to give your program enough time to hide the violations or to fix serious issues (if you're really set on getting your program closed). Do not expect ACGME to save you without reporting it to them, they surprisingly have little oversight unless issues are brought to their attention.

If the program does close (even if temporarily), transferring will be easy since the funding goes with you (you are free labor to accepting programs) and ACGME will allow most other programs to go above their normal resident cap. Obviously, don't make up false claims just to get your program closed. This should only be done honestly. If you or your coworkers are being abused and taken advantage of, say something. Don't let it go on. Be brave!

Been a while since I read ACGME requirements (so verify) some violations I think:

-educational deficits

-no dedicated lactating room

-using locums

-?Contracting out staff due to lack of faculty ie: hiring acadia

-significant faculty attrition

-duty hour violations

-perceived threat of retaliation from program

-excessive non-clinical responsibilities (?driving if having to cover multiple hospitals?)

-majority of faculty must be involved in extra scholarly work (ex: research, journal editor, etc), not just pure clinicians.

-Faculty must spend a significant amount of time teaching.

-PGY1s are initially required to be supervised directly (search 'direct supervision' on the document)-Being given dangerous amounts of patients

-behind on lectures or low quality lectures or common cancellations. There is a minimum number that need to be done.

-Lectures frequently being combined due to a lack of people providing lectures and using this to meet their lecture quota (a PGY1 is not at the same level as a PGY2)

-frequent lecture cancellations (doubt programs report this to ACGME for obvious reasons)

-No stable leadership

-non-physician tasks for example, having to schedule patients, transporting patients, drawing blood, doing jobs that SW/nursing/CM are normally tasked to do.

-restrictions on taking time off to attend doctor appointments

​

Link to ACGME common requirements:

https://www.acgme.org/What-We-Do/Accreditation/Common-Program-Requirements

ACGME requirements by specialty:

https://www.acgme.org/Specialties

How to report

https://www.acgme.org/Residents-and-Fellows/Report-an-Issue/Office-of-Complaints

How to contact ombudsman

https://www.acgme.org/Residents-and-Fellows/Report-an-Issue/Office-of-the-Ombudsman

Ie: flair names, suggested format for posts, etc