Any advice?

[foggystud]

I am a 3rd year in desparate need of advice. I came into the medical field from another career, in which I was pretty successful. However, medical school proved to be far more difficult for me. I found that I could study just as hard, or harder than my fellow classmates, and not do as well. I made mostly B's and C's in my classes, and I barely passed step 1.
Now I have basically decided to pursue anesthesiology, but I feel like it's basically a pointless decision, because thanks to my performance these pass 3 years, I am less than a mediocore student. I know I need to do really well on step 3, but based on step 1, i'm not even sure if that's possible.
Is there any advice on trying to match into anesthesiology? What programs in particular should i try to do away rotations at? Are there any programs in the US that would even consider me to be a legitimate candidate?
Sorry to sound so cynical, but i'm just feeling very down about my situation.

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[EtherMD]

I am a 3rd year in desparate need of advice. I came into the medical field from another career, in which I was pretty successful. However, medical school proved to be far more difficult for me. I found that I could study just as hard, or harder than my fellow classmates, and not do as well. I made mostly B's and C's in my classes, and I barely passed step 1.
Now I have basically decided to pursue anesthesiology, but I feel like it's basically a pointless decision, because thanks to my performance these pass 3 years, I am less than a mediocore student. I know I need to do really well on step 3, but based on step 1, i'm not even sure if that's possible.
Is there any advice on trying to match into anesthesiology? What programs in particular should i try to do away rotations at? Are there any programs in the US that would even consider me to be a legitimate candidate?
Sorry to sound so cynical, but i'm just feeling very down about my situation.

You are down but not out. Look for the weakest Programs out there and do an externship. If you rank the ten weakest programs in the USA you stand a good chance of landing a spot particularly if you are a "likeable", competent person that did an externship at that program.

 

[The_Sensei]

I am a 3rd year in desparate need of advice. I came into the medical field from another career, in which I was pretty successful. However, medical school proved to be far more difficult for me. I found that I could study just as hard, or harder than my fellow classmates, and not do as well. I made mostly B's and C's in my classes, and I barely passed step 1.
Now I have basically decided to pursue anesthesiology, but I feel like it's basically a pointless decision, because thanks to my performance these pass 3 years, I am less than a mediocore student. I know I need to do really well on step 3, but based on step 1, i'm not even sure if that's possible.
Is there any advice on trying to match into anesthesiology? What programs in particular should i try to do away rotations at? Are there any programs in the US that would even consider me to be a legitimate candidate?
Sorry to sound so cynical, but i'm just feeling very down about my situation.

Look at all the places that didn't fill in the Match this year. Do a rotation at as many of them as you can. Rank those. Pray.

 

[jennyboo]

I am a 3rd year in desparate need of advice. I came into the medical field from another career, in which I was pretty successful. However, medical school proved to be far more difficult for me. I found that I could study just as hard, or harder than my fellow classmates, and not do as well. I made mostly B's and C's in my classes, and I barely passed step 1.
Now I have basically decided to pursue anesthesiology, but I feel like it's basically a pointless decision, because thanks to my performance these pass 3 years, I am less than a mediocore student. I know I need to do really well on step 3, but based on step 1, i'm not even sure if that's possible.
Is there any advice on trying to match into anesthesiology? What programs in particular should i try to do away rotations at? Are there any programs in the US that would even consider me to be a legitimate candidate?
Sorry to sound so cynical, but i'm just feeling very down about my situation.

Are your grades just "bottom two thirds of the class" (like me) or do you actually have failing grades, repeated classes, etc? If my medical school had grades instead of honors/pass/fail, I would definitely have been "mediocre" (i.e. probably in the bottom two thirds of the class), but that might actually just mean "average." If you don't have failed or repeated classes, then might I suggest that you really just have "average" grades?

If you really do have failing marks or repeated classes, then yes, that is a significant hurdle to overcome. A barely passing board score is also a hurdle to overcome. In that case, networking is your biggest friend (as it is your best friend even if you are a top student). Spend time with your local anesthesia faculty and residents (do a rotation, to start with), ask for their advice, and consider doing one or two away rotations.

Consider taking Step 2 early. If you do so, ask for advice on how to study (sample study schedules, etc) from students who have done well. (Tip: My school had a "learning specialist" who supposedly gave advice on taking the boards. He was completely useless. Students who've actually taken the boards recently and done well are the ones who can help the most.) Stick to one book to read (Crush Step 2 is good) and one question source (Kaplan is good) -- people who do well read less, not more. Don't read too many books -- just know one of them really well.

Away rotations -- these are your networking opportunities. If your board score is barely above 182, you might consider rotating at "average" programs rather than "top 5" programs. Look in the "Anesthesiology FAQ" sticky threads at the top of this board -- if the program is NOT mentioned as a "top first, second, or third tier" program in that discussion, then I would say it is "average" and therefore fair game for you. That's not to say you should necessarily avoid any program mentioned as a top first/second/third tier (in fact, some of these programs might be excellent choices for you to do a rotation) -- but for the away, you may not want to spend your time and money at UCSF, MGH, or JHU. (Heh -- even though they're on the list of programs that didn't fill during the past couple of years).

If you look at the match data, anesthesia is a specialty of "average" competitiveness. That means your chance of matching may still be good.

 

[PMPMD]

foggystud, sent you a PM

 

[Heeed!]

I concur with the doing away rotations and networking comments. If what you have said is true, your application needs more of the intangibles.
It always comes down to who you know. Once the people who make the residency decisions are behind closed doors, anything can happen. You could get selected with sub-par numbers because you're easier to get along with than someone with better numbers.

But, play the game smart. If you know your application is not as strong, and you'll take a gas spot anywhere, work hardest to get into the less-desireable programs/locations. Good luck.

 

[excalibur]

I was in same situation as you a year ago, and I did what everyone here is saying. Play the game smartly. Scout out the programs no one wants to go to and perhaps do away rotations there.

I barely passed step 1 as well and I got into University of Arkansas. Did not do an away there though. So definitely apply there, and scout other programs.

 

[zippy2u]

Damm Foggy, you sound a lot like the anesthesia graduates of the mid 90s. A common story and I include myself. C=MD in medical school. All we knew or cared about was that we passed the 1st test of the NBME--couldn't tell ya the score. Had a heartbeat, and could speak fairly good English when not partakin' in Heiniken and chasin' womins around the bar. Never got sick and always showed up for work. I applied to one program and got accepted and showed up at the front door ready to work. That's way old skool; today it's an entirely different animal with all these bigtime Gunners. Lotsa memories and wouldn't change a thing. Warmest regards, ---Zip

 

[loveumms]

Don't get down and think you are hopeless.

Do everything above posters have told you but, don't just apply at the bottom tier programs. Apply broadly - put some middle tier programs in too. I don't think you have a shot at the big names but, what the heck you could add one or two in. Who knows - this whole process is totally random and if you know some people and they are willing to make calls for you, you might be surprised at what you can pull.

Write a kick ass personal statement and remain enthusiastic. I have a classmate who didn't do all the well on their boards and still got an interview at a big name (didn't match there but, still go the interview which is pretty great).

So, strengthen the rest of your application, do some aways, make friends with anyone who can help you and don't be afraid to ask for their help and keep at it

 

[foggystud]

Honestly, I did not expect these replies. I thought everyone except maybe 1-2 people would say, learn to love family practice. I appreciate all of the replies, and I'm starting to apply for externships at some less than desirable locales, that didn't even come close to filling this year.
I've been feeling so alone, like I'm the only person who sucks at test taking. I did engineering before, and that came so easy.
Thanks for the great advice, and I honestly feel a lot more positive about my situation.

 

[Noyac]

Say hello, Family Practice.

 

[Coastie]

Harsh, Noyac! lol...

Foggy, I sent you a pm. All is not lost. Read it, get back to me with questions.

 

[Planktonmd]

Say hello, Family Practice.

So you had to bust his buble

 

[Flycatcher]

Write a kick ass personal statement and remain enthusiastic. I have a classmate who didn't do all the well on their boards and still got an interview at a big name

Agreed, and I wish to elaborate on the value of the personal statement, which is something I often think gets short shrift. The typical advice I heard was all, "write something boring and safe so they won't think you eat babies." But I believe the PS can be very valuable if written well and made interesting (I heard as much from PDs, too). Your grades and scores are numbers, your Dean's and rec letters are what other people say about you, but the PS is the only chance for them to hear your voice before inviting you to interview. It's the only opportunity to seem like a real person, rather than a collection of data. Work hard when writing it to show that you are a cool, interesting, enthusiastic person who they would be fortunate indeed to have training with them for 3-4 years.

In my PS, I focused on my love of scuba diving and tied it into my love and medicine and research. In all but four individual interviews, I was asked about diving; often it dominated the conversation. I don't think at all that I got my interviews or matched solely because of my PS or scuba diving, but I am certain that my PS presented me as an interesting person that programs wanted to meet and work with, on top of credentials that (hopefully) identified someone they wanted to train.

Whatever scores you did or didn't get, foggy, you are making it through medical school, which is not a trivial task. Believe that you are someone with something to offer any residency program, no matter how lofty. Apply to a lot of them, upper- mid-and lower-tier, and I believe someone will take you up on your offer to be an awesome resident for them. Good luck.

 

[EtherMD]

Honestly, I did not expect these replies. I thought everyone except maybe 1-2 people would say, learn to love family practice. I appreciate all of the replies, and I'm starting to apply for externships at some less than desirable locales, that didn't even come close to filling this year.
I've been feeling so alone, like I'm the only person who sucks at test taking. I did engineering before, and that came so easy.
Thanks for the great advice, and I honestly feel a lot more positive about my situation.

Dude, unless you smoke the next National Exam you are wasting your time with First Tier programs. I recommend you spend your effort and time on getting into the Third Tier programs and lower unless you have a major connection at a higher rated program. You will most likely match at one of the lower ranked programs. If you follow this advice you may get your First or Second choice in the match. This way you get to decide how malignant a program you want to be at for 3-4 years. That said, if you want to add a few second tier programs into the mix why not? But, the BULK of your effort needs to focus on the likelihood you will "match" with that program. If you do an away rotation at a program you have a real shot at getting into it will improve your chances come match time next year. Remember, you only have so much time to do away rotations so be smart with that time.

 

[Flycatcher]

I recommend you spend your effort and time on getting into the Third Tier programs and lower unless you have a major connection at a higher rated program. You will most likely match at one of the lower ranked programs. If you follow this advice you may get your First or Second choice in the match. This way you get to decide how malignant a program you want to be at for 3-4 years. That said, if you want to add a few second tier programs into the mix why not? But, the BULK of your effort needs to focus on the likelihood you will "match" with that program.

Heh, apparently, this is my "Disagree with EtherMD Day."

Actually, I don't fully disagree with Ether, here, but just as a matter of degree. I agree that for away rotations, you should be very selective and not choose a place just because it's 1st-,2nd- or whatever tier. If you can, get some advice from the Program Director at your place or an Anesthesiologist mentor you've acquired about recommended away rotations, based on your grades and scores and med school. But as far as applying when the time comes to 2nd- or even 1st- tier places, I say why not. Thanks to ERAS, it's just a few mouse clicks and $8 more (I think).

Unless you don't want to spend the money or can't handle the rejection, I see no reason not to cause as wide a net as possible. Let them say you have no chance, but maybe you'll be pleasantly surprised by some program you thought totally out of reach. To its favor, Anesthesiology is much more accepting of a wide range of scores and even degrees than other specialties of even average competitiveness (most 2nd-tier internal medicine won’t even interview DOs). At least with the application process, why bother to limit yourself a priori?

 

[lushmd]

Flycatcher YGPM (off-topic).

 

[badgas]

Just apply to a LOT of programs. If you want to apply to the "first tier" then go ahead. Personally, unless you have a big name PD calling for you, I would say that is a waste of time. There is a reason that the first tier plays musical chairs with the job of not filling each year. They have big heads. They think they are too good for their applicants, are all about numbers and barely rank anyone. They will have cutoffs for step 1 around 220-230 and that lesson can cost you as much as $25 per application. My advice is to apply to a LOT of programs... as in 60+. You may get 10 interviews... go to all of them and rank all of them. I put some programs not listed on the all mighty SDN tier post well above some 1st and 2nd tier programs on my list. So just because the average SDN poster with 260 Step 1 doesn't consider your possible program worthy, doesn't mean that you won't be happy there. Best of luck next year.

 

[EtherMD]

Just apply to a LOT of programs. If you want to apply to the "first tier" then go ahead. Personally, unless you have a big name PD calling for you, I would say that is a waste of time. There is a reason that the first tier plays musical chairs with the job of not filling each year. They have big heads. They think they are too good for their applicants, are all about numbers and barely rank anyone. They will have cutoffs for step 1 around 220-230 and that lesson can cost you as much as $25 per application. My advice is to apply to a LOT of programs... as in 60+. You may get 10 interviews... go to all of them and rank all of them. I put some programs not listed on the all mighty SDN tier post well above some 1st and 2nd tier programs on my list. So just because the average SDN poster with 260 Step 1 doesn't consider your possible program worthy, doesn't mean that you won't be happy there. Best of luck next year.

60 Programs? In my day I applied to 9 and interviewed at 6 (turned the other three down). I ranked all 6 and knew I would match at one of those programs. I stand by my original recommendation to NOT WASTE your time and effort in applying to the "gunner" programs. Unless you smoke your next National Exam they won't even consider you. Instead, apply to 20 programs ( I still think this is too many but the people here will insist) and focus on one or two programs that are Third Tier for the away rotation. If you impress one of these Program Directors you might match at that location. The odds diminish greatly as you work your way up the Tiers.

There a lot of good Third Tier programs. Fine one you like and that fits you.
Best of Luck.

 

[Celsus]

are these tiers in the FAQ section?

 

[urgewrx]

Best advice you'll ever hear: Midwest

 

[Bertelman]

60 Programs? In my day I applied to 9 and interviewed at 6 (turned the other three down). I ranked all 6 and knew I would match at one of those programs. I stand by my original recommendation to NOT WASTE your time and effort in applying to the "gunner" programs. Unless you smoke your next National Exam they won't even consider you. Instead, apply to 20 programs ( I still think this is too many but the people here will insist) and focus on one or two programs that are Third Tier for the away rotation.

Not sure how it was in your day, but in our day, the difference in sending 20 v. 60 applications is a few hundred bucks and a few dozen clicks of the mouse. Not bad considering your future may depend on it. If you had asked me before I sent my 45+ apps, I couldn't have told you which would have invited me. Some surprisingly said yes, some surprisingly said no.

Is it wrong for me to somehow feel good about certain programs not filling this year, after they denied me an interview? You know who you are...

My advice, OP, if you are looking for a program outside your current regional area, have a quick answer on interview day for, "Why Kalamazoo?" You will be asked that question instantly once you exceed a 350 mile radius of your home program.


p.s. Ether, even if we disagree, it's nice to see you contributing to other areas of this forum.

 

[pjl]

From what I have heard and my experiences, if you are not from the west coast, with the lower board scores you may not be all that likely to get an interview.
If you arent hearing from a place that you are very interested, especially if it is out of your geographical area, send them an email about why you like them, and that you would like to find out more/visit/interview. It seemed to me that some places have a strong regional preference but may save spots for those who demonstrate extra interest.
For all the competitive applicants out there, please dont do this unless you are truly interested just because you "need" that 16th interview to feel comfortable. That screws over both the programs and your fellow applicants.

Someone please correct me if I am wrong or drastically different from you, but for you budgeting's sake here are the amounts I remember spending. The cost per application is $60 for the first 10 places, $8 each for 10-20, then $15 for each 20-30, and then $25 each program beyond that. Then there is the $60 per prelim year type for up to 10 places (transitional year/surgery/medicine). Also I think the nrmp was $50 to sign up for. Most places I went, and it sounded like the majority overall will pay for everything you need once you arrive in their city, so your costs will just be plane tickets or driving for actual interviews. My interviewing (5 drive, 5 fly) ended up costing somewhere around 2000 to 2500 plus ~300 for applications. You may want to start planning early with the loans etc.

 

[jennyboo]

I disagree with all the doomsayers who are telling the original poster, "Apply to all the 'bottom of the pile' programs and maybe you'll get something." It's true that it's probably not worth applying to certain programs unless your grandfather is the chief there. BUT the majority of programs in the country are still fair game for you and you should definitely NOT exclude them just because someone told you only to apply to the bottom of the pile. Anesthesia is perceived by medical students to be a competitive specialty but the reality is that it is not highly competitive. A lot of very average candidates (relative to dermatology and plastic surgery, I mean) actually match into top programs. As someone who interviewed more recently than ten or fifteen years ago, I definitely saw a couple of programs on my trail that were begging for people to just come and interview, and there are definitely a good number of programs that are FMG friendly as well. (I'm assuming you're not a foreign or international medical graduate, but as you know, some programs simply have to interview a large range of people in order to fill.)

Foggy, the point is that despite not having stellar boards or stellar grades, you should probably still be able to get an anesthesiology residency, and one where you will hopefully find a good fit, at that. If you need a little more guidance on which programs are within reach, I found this thread to be very helpful (it's still linked from the FAQ):
http://forums.studentdoctor.net/showthread.php?t=48717

Most of the programs this thread lists under (1) and (2) are extremely competitive (possibly not worth rotating at). Many of the programs under (3) would be considered "great matches" for various reasons, but even though they may be a "reach" (some are a bigger reach than others) their academic standards may not be as competitive as (1) and (2) (though popularity may make SOME, not all, of these, equally competitive). But if you're interested and you have the money to apply, you should definitely apply.

Most other programs in the country that are NOT on this list, are probably "average" and are reasonably within reach. This leaves you probably a hundred other programs, if not more, where you have good chances at getting interviews.

Would I apply to 60 programs? Ehhh, I'm not sure -- I think that might even be overkill, but I think there are a lot of people on this forum who applied to a ridiculously large number of programs, felt it was worthwhile, and now recommend it. I had mediocre grades and good boards, freaked out and applied to 30 -- way too many. Now I think anyone average should apply to 20 (even though many disagree with that) and 30 should be for candidates with handicaps (including the original poster, who has poor boards). No matter how many you apply to, it will still be very difficult in terms of time and money to interview at more than around 15. So apply to enough programs to get 15 interviews -- any more than that and you'll either run out of money, burn out, or physically not have time to make it to the rest.

Focus on locations where you would like to live, and expand your numbers from there. Hey, if your family lives in Baltimore and you'd like nothing more than to move back, apply to Hopkins even if you might not get an interview -- it's all about priorities, and since there are so many programs you have to start narrowing them down by where you're willing to live.

 

[badgas]

Some key advice that I have picked up POST match is that away rotations can be very important. I don't know if it has been like this in the past, but when looking over some of the match lists, I noticed that a large number of programs were taking 6,7,8 or more from their own school! My program coordinator told me that like 6 of 8 rotated with them! I did zero away rotations and got letters only from my own school (without a residency program). I'm extremely lucky to have matched towards the top of my list. In retrospect, that was a dumb move on my part.

 

[Flycatcher]

Drifting off-topic a bit:

I don't know if it has been like this in the past, but when looking over some of the match lists, I noticed that a large number of programs were taking 6,7,8 or more from their own school!

badgas, have you found these various match lists by Googling the specific programs, or is this info compiled somewhere more central? I'm curious about various people I met on the Residency Quest and where they matched, but I'm also committed to being as lazy as possible before starting residency and kinda can't be bothered to do much searching. I mean, all that typing!

 

[Raphael]

Bad gas, you are making some very true points. It is becoming more and more important to rotate at a hospital to get on their residency rank list. Call it unfair, but it almost doesn't matter how good of an applicant you are. If you rotate at a middle tier hospital, and as long as you are not a pornstar/pimp, you get an automatic interview. I know a DO applicant who matched allopathic anesthesia this year at a mid-tier hospital in PA with a 190 step 1, didn't take step 2,and rotated there during the peak of the interview season(Oct-Nov). He told me everyone gets interviews if you rotate there and if you know the great English language of ours, you get placed on the school's coveted rank list. The weird thing is not many people rotated there because the location sucked and the program didn't have the name ring to it that SDNers are ever so magnetized to, so the rank list wasn't that big. So the dude didn't face much competition. He probably was one of the few interviewees of a small pool who ranked the place number 1. He ranked like 2 places, the only 2 he rotated at, and the young man nailed one of them. And no, he didn't have any connections. Is it unfair, to alot of peeps yes, but if you play the game right, you never know when 400 grand/yr could fall in your lap.

 

[amyl]

care to share which mid-tier PA program? pm me if you'd rather. thanks

 

[Coastie]

#1: Do an away rotation.
#2: Rock step II.
#3: Get great letters at home and on the away.

Do anything you can otherwise to improve your app. Do these, you'll be great. Don't, and you may be in trouble. Not every Anesthesiology program is one you want to be at...Alot of scary places out there.

Good luck.

 

[Gem134]

Well, I would think that having done well in your previous career as an engineer would hold some weight. I would not discount that. Engineering is hard!