Are you obligated to interview where you did an away rotation?

[deleted413795]

I hope this is not redundant, as I was unable to find a similar topic via search.

I am currently applying for residency and did an away rotation. Going into the rotation, that program was high on my list (hence why I did the rotation), but after rotating there I am not interested in the program or the geographical area. The program is 1,000+ miles away, and not close to any of my other interviews.

Am I obligated to interview in this situation? Each specialty is a small world, certainly some are much smaller than others. I would hate to make enemies because I didn't want to spend two days and money for a plane ticket, but at the same time I do not want to spend $300-$400 and the time if I do not need to.

Any advice or experiences with this would be appreciated. Thank you for taking the time to read and/or respond.

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[Law2Doc]

You are not obligated. But most people do because an away rotation is essentially an audition and your likelihood of having sold yourself favorably won't be the same in a few 20 minute interviews.

 

[Dral]

I'd only skip it if you feel you have zero desire to train there and would rather go unmatched than end up there.

 

[deleted413795]

You are not obligated. But most people do because an away rotation is essentially an audition and your likelihood of having sold yourself favorably won't swing in a few 20 minute interviews.

Thanks so much for the responses! I am a bit confused by what you mean Law2Doc. Honestly, I do not even plan on ranking the program, so going to the interview would be purely for not making any enemies or jeopardizing my chances at another program because of that program holding a grudge. My actual evaluation by the program in question during my away was very positive.

 

[Law2Doc]

Thanks so much for the responses! I am a bit confused by what you mean Law2Doc. Honestly, I do not even plan on ranking the program, so going to the interview would be purely for not making any enemies or jeopardizing my chances at another program because of that program holding a grudge. My actual evaluation by the program in question during my away was very positive.

Unless you'd rather soap than go to a program you should rank them, even if it's the bottom of the list. There's always someone who free falls on their rank list.

But no, they won't hold a grudge.

 

[Winged Scapula]

Why did you apply if you didn't like it there?

 

[deleted413795]

@Winged Scapula The application submit date was in the middle of my rotation there, and I just didn't know that I didn't like it that much at that time.

@Law2Doc Not to sound arrogant, but I am applying in a specialty that is not competitive, especially for American grads, and I applied to way too many programs. I still have over 20 other interviews, so not matching seems highly unlikely. Also, I'm not even sure I am going to pursue residency training at this point. Consulting, insurance, pharma, etc. all sound relatively appealing.

 

[Law2Doc]

@Law2Doc Not to sound arrogant, but I am applying in a specialty that is not competitive, especially for American grads, and I applied to way too many programs. I still have over 20 other interviews, so not matching seems highly unlikely. Also, I'm not even sure I am going to pursue residency training at this point. Consulting, insurance, pharma, etc. all sound relatively appealing.

That's fine. I'm simply a proponent of going to every interview you can that time and money permits because I've definitely known people who ranked a decent number of places and still ended up scrambling/soaping. It's a very subjective process and you can do very well and still end up somewhere in the middle of every programs rank list. Every March there are whine threads of depressed people who ended up with their last or near last choice in relatively "noncompetitive" fields and many aren't FMG/IMGs.

 

[deleted413795]

I certainly understand that philosophy. If money and time were no object, I would agree. That advice will be good to have in the thread if anyone else looks it up in the future.

Honestly, I would probably be relieved in March if I didn't match, but my regrets and complacency regarding medicine are topics for a different post.

Thank you all for your comments, even if some of them were punitive and judgmental. Prime evidence of why people are reluctant to use outlets such as this.

 

[ThoracicGuy]

@Winged Scapula The application submit date was in the middle of my rotation there, and I just didn't know that I didn't like it that much at that time.

@Law2Doc Not to sound arrogant, but I am applying in a specialty that is not competitive, especially for American grads, and I applied to way too many programs. I still have over 20 other interviews, so not matching seems highly unlikely. Also, I'm not even sure I am going to pursue residency training at this point. Consulting, insurance, pharma, etc. all sound relatively appealing.

I'm going to go ahead and stop you here. Don't count on nonresident jobs being available if you don't match. You wouldn't even be able to get a permanent license yet. Just put that out of your mind. If, after residency, you want to do something else, go for it.

 

[Dral]

Agree. I spent a lot of extra money going on late interviews that I know were low yield. You don't want to look back later and think "Hmm, what if I did that instead."

If you go on the interview, the main thing you'll be saying to yourself is "Hmm, I don't have that few hundred dollars now". That's not too bad.

 

[deleted413795]

I'm going to go ahead and stop you here. Don't count on nonresident jobs being available if you don't match. You wouldn't even be able to get a permanent license yet. Just put that out of your mind. If, after residency, you want to do something else, go for it.

I am going to go ahead and stop you right there. Have you ever been in the position of not wanting to continue in medicine? If you haven't, then you have no idea what it is like to feel like you have no way out, or that your way out is only after 4-5 more years of torturing yourself with residency. I understand that being licensed opens more doors, but completing an entire residency seems like it would do nothing except increase your debt.

@Dral If I go on 15-20 interviews and that one is the difference between me matching or not, I am very much ok with that.

 

[trypanosomiasis]

I am going to go ahead and stop you right there. Have you ever been in the position of not wanting to continue in medicine? If you haven't, then you have no idea what it is like to feel like you have no way out, or that your way out is only after 4-5 more years of torturing yourself with residency. I understand that being licensed opens more doors, but completing an entire residency seems like it would do nothing except increase your debt.

@Dral If I go on 15-20 interviews and that one is the difference between me matching or not, I am very much ok with that.

You said earlier your fear was about starting some bad juju with other places by not taking this interview, now it's about hating medicine and not going in debt? Why not just collect your MD in May, forego the match, and save yourself a few grand, as well as saving a spot for someone who actually wants it, and sparing your presumptive future program the pain of finding a replacement when you drop out?

It sounds like your mind is pretty made up, regardless of what anyone here says.

 

[deleted413795]

You said earlier your fear was about starting some bad juju with other places by not taking this interview, now it's about hating medicine and not going in debt? Why not just collect your MD in May, forego the match, and save yourself a few grand, as well as saving a spot for someone who actually wants it, and sparing your presumptive future program the pain of finding a replacement when you drop out?

It sounds like your mind is pretty made up, regardless of what anyone here says.

Well, you know, like most threads on here it is rare that when you ask a question people just answer it. It usually evolves into something else or they want more information since we all come from different places.

I agree getting out entirely is the best route for me, but it would also be shortsighted to forego the match without a solid strategy for my next step. After all, regardless of what I do, I will still have 200k of debt to deal with and I would rather trudge through residency like I have muddled through medical school rather than have no job and debt that is piling up.

 

[SXMMD]

...I understand that being licensed opens more doors, but completing an entire residency seems like it would do nothing except increase your debt.

I agree getting out entirely is the best route for me, but it would also be shortsighted to forego the match without a solid strategy for my next step. After all, regardless of what I do, I will still have 200k of debt to deal with and I would rather trudge through residency like I have muddled through medical school rather than have no job and debt that is piling up.

I don't think you fully understand what kind of opportunities are opened/closed to you with board certification or lack thereof. Having said that, you know best your own situation and whether or not the advice benefits you, just try not to discount good advice based on your "logical" conclusions which are not contextualized by real experience. You don't know what you don't know, and luckily for you, some of the people posting here do. Weigh the advice objectively and good luck with the outcome!

Also, respectfully 200k is not a heck of lot. 2 years of living like a resident while on an attending salary? You'll clear that with primary care level income, especially if you negotiate loan repayments with your employer. If you don't want to practice medicine perhaps this may not be a reasonable option for you but if you can tough it out you can most certainly clear the slate easily and quickly, with the security of board certification should you need quick cash to stay afloat while pursuing alternative career plans. 1 UC shift a week= $900-$1000 a week in a ton of places...

 

[deleted413795]

I don't think you fully understand what kind of opportunities are opened/closed to you with board certification or lack thereof. Having said that, you know best your own situation and whether or not the advice benefits you, just try not to discount good advice based on your "logical" conclusions which are not contextualized by real experience. You don't know what you don't know, and luckily for you, some of the people posting here do. Weigh the advice objectively and good luck with the outcome!

Also, respectfully 200k is not a heck of lot. 2 years of living like a resident while on an attending salary? You'll clear that with primary care level income, especially if you negotiate loan repayments with your employer. If you don't want to practice medicine perhaps this may not be a reasonable option for you but if you can tough it out you can most certainly clear the slate easily and quickly, with the security of board certification should you need quick cash to stay afloat while pursuing alternative career plans. 1 UC shift a week= $900-$1000 a week in a ton of places...

I appreciate the well written and considerate opinion. Having never been an attending physician, I certainly cannot claim to know all of the options. I have roughly 5 years of work experience in healthcare prior to medical school and grew up in a medical household, so I do like to think that counts for something. I've also had a job for most of my life aside from my M3 year. I agree that 200k is not a heck of a lot.

The thing that makes me hesitant about the board certified comments is that I am applying in pathology. I honestly would not feel comfortable working in an urgent care now, and I cannot imagine I would feel more comfortable after or during path residency. I am sure pathologists have other career opportunities that patient care oriented docs do not have, but my hope would be to get out of clinical medicine as quickly as possible after residency.

UC Denver actually has a webpage dedicated to non-clinical options. Hopefully these things will start getting more publicized in the future.

 

[ThoracicGuy]

I am going to go ahead and stop you right there. Have you ever been in the position of not wanting to continue in medicine? If you haven't, then you have no idea what it is like to feel like you have no way out, or that your way out is only after 4-5 more years of torturing yourself with residency. I understand that being licensed opens more doors, but completing an entire residency seems like it would do nothing except increase your debt.

My point is, do not count on any nonmedical type jobs as an option for you. Pharmaceutical companies, insurance companies, and others usually want people that have had some clinical experience before they would hire you. Many of them would like board certification. Look at all the people that talk about their multiple attempts at matching because they just can't find any job without residency, at least in the medical field.

Completing residency doesn't increase your debt. Sure, your loans would continue to grow at some level, but you are paid a salary for you training. The salary is often at or above the median salary of most families.

If you don't want to be in medicine, that's your decision, but without residency, your MD degree is basically worthless. As a USMD grad, you need at least one year of residency training to even get a permanent license. Without even the ability to get this, many of these nonclinical jobs won't be interested.

Make sure you truly understand these things before you tank your chances at matching.

 

[deleted413795]

My point is, do not count on any nonmedical type jobs as an option for you....

Make sure you truly understand these things before you tank your chances at matching.

I agree with this, hence why I said that I would be going about things assuming I am doing residency unless I had a guaranteed other option. It's just frustrating when you explicitly say something and people don't listen. I guess that must be how a lot of people feel when they talk to doctors.

 

[doc05]

pathology is a good field for anyone not interested in clinical medicine. finishing the residency will open doors for you in the research/biotech world more so than training in a clinical field like IM and peds. so you definitely should do a residency.

as for interviewing at the "audition" site ?? yes, you should. being unmatched would be very unfortunate. also, keep in mind that people leave academia for industry all the time -- that PD may one day become a contact in the real world, don't burn any bridges.

 

[Dral]

If you go with Path, you have AP only if you want to finish faster. But I think CP might help with other positions.

The way I understand it, there is fairly wide variance in Path programs. If you really think you you don't want to be at your audition program for residency and won't regret not going if you don't match, then maybe skip it.

You could maybe just send an email saying, 'sorry, I can't make the interview'.

 

[thehundredthone]

That's fine. I'm simply a proponent of going to every interview you can that time and money permits because I've definitely known people who ranked a decent number of places and still ended up scrambling/soaping. It's a very subjective process and you can do very well and still end up somewhere in the middle of every programs rank list. Every March there are whine threads of depressed people who ended up with their last or near last choice in relatively "noncompetitive" fields and many aren't FMG/IMGs.

Just a technicality but if one has 20 other interviews in a particular specialty (and importantly by extrapolation, is ranking 20 places) then there's no reason to interview at other places. NRMP allows you to rank up to 20 with the fee you pay and charges extra for programs ranked >20. I must admit though that I don't know what the match statistics are for other residencies. Is a probability approaching 1 at 10 contiguous ranks for AMGs and 20 contiguous ranks for IMGs applicable outside of IM?

 

[deleted413795]

@Dral There is indeed a lot of variance in path programs. Some are basically self taught, others are overbearing with structure, and of course there are the malignant programs. The AP or CP suggestion is definitely legitimate. I think if you want to do a specific area of path, doing just one can be ok, but it is three years to do just one or four years to do both, so for looking to get out of medicine, doing both probably makes the most sense.

@thehundredthone For an American grad, applying to 20 programs in path is generally considered more than enough since it is a field with many FMGs, and it has unfilled spots relatively regularly. I applied to over 30 programs, and have interviews at schools that I would never have even been considered at if I were in another specialty. It really is just a different game entirely. I have done a few interviews, and even AMGs with no publications, AOA, etc. seem to match at solid programs.

I am by no means a competitive applicant, but still feel confident that I will match. I have contemplated leaving a medicine since the end of my first semester of Med school. If someone offered to pay back my loans and I could walk away today without my MD, I would take that option in a heartbeat. In light of all of that, I wouldn't be considering canceling an interview if I thought there was a realistic scenario where I don't match.

 

[Law2Doc]

Just a technicality but if one has 20 other interviews in a particular specialty (and importantly by extrapolation, is ranking 20 places) then there's no reason to interview at other places. NRMP allows you to rank up to 20 with the fee you pay and charges extra for programs ranked >20. I must admit though that I don't know what the match statistics are for other residencies. Is a probability approaching 1 at 10 contiguous ranks for AMGs and 20 contiguous ranks for IMGs applicable outside of IM?

The additional charges from NRMP are pretty meaningless compared to what it actually costs to travel to interviews, so I don't think that realistically should even factor in. How many places you interview depends on your own credentials, target specialty and how competitive you are shooting within that specialty. That being said there are always people in soap each year who overestimated their chances, and others who fall deeper down their rank lists then they contemplated. I've seen solid candidates ranked in the middle of a programs match list, and could conceive of those same people ending up at the same depth at lots of places. I don't know the right answer but think some people could save themselves from soap if they did that extra interview or two.

 

[mcl]

Jumping in from the Coordinator's perspective...I would much rather that a disinterested applicant not schedule an interview. Having someone there who really doesn't want to be there drains the energy from the interview day and wastes everyone's time--and it's generally easy to spot the applicants who are just going through the motions. In addition, other applicants interviewing that day are likely to ask about his elective experience once they realize that the other residents already know him. That probably won't end well. I think in the end that the program would appreciate his graciously declining the interview. Blame geography if you need a non-bridge-burning reason, but chances are good that it won't come up.

 

[deleted413795]

@Law2Doc Everyone's experience is indeed unique. In my case, I am not shooting to be competitive as geographic location and work-life balance are my priorities along with a program that does not emphasize research, which rules out quite a few competitive schools. I also just am not planning on doing more than 20 interviews, and am currently sitting at well over 30 offers, so to me it makes sense to cancel one where I know I am no longer interested in the location or the program. Sure, going to every possible interview gives you the best chances of matching in terms of numbers, but that does not necessarily mean it is the best option.

I definitely understand where your cautioning is coming from. There will always be people who overestimate their chances, or that only apply to top tier schools and then end up scrambling for a spot at a community program. It is a good lesson. My question is merely if canceling an interview at an away rotation will screw you over at other places.

@mcl Thank you very much for sharing your perspective, which is an invaluable one. I never thought about how an applicant might talk down a program to other applicants on the interview day. I would never have that kind of audacity, but I do not doubt that there are people in medicine that would do that. I cannot imagine going to an interview and "half-assing" it. Why travel all that way and not give it your best? Oh well, to each their own.

 

[Law2Doc]

@Law2Doc Everyone's experience is indeed unique. In my case, I am not shooting to be competitive as geographic location and work-life balance are my priorities along with a program that does not emphasize research, which rules out quite a few competitive schools. I also just am not planning on doing more than 20 interviews, and am currently sitting at well over 30 offers, so to me it makes sense to cancel one where I know I am no longer interested in the location or the program. Sure, going to every possible interview gives you the best chances of matching in terms of numbers, but that does not necessarily mean it is the best option.

I definitely understand where your cautioning is coming from. There will always be people who overestimate their chances, or that only apply to top tier schools and then end up scrambling for a spot at a community program. It is a good lesson. My question is merely if canceling an interview at an away rotation will screw you over at other places.

@mcl Thank you very much for sharing your perspective, which is an invaluable one. I never thought about how an applicant might talk down a program to other applicants on the interview day. I would never have that kind of audacity, but I do not doubt that there are people in medicine that would do that. I cannot imagine going to an interview and "half-assing" it. Why travel all that way and not give it your best? Oh well, to each their own.

Nah it won't you screw you over to not interview. But again the point is you got to audition for them for weeks instead of hours, so if the rotation went well it was probably a place where your odds are just better. I conceptually agree with mcl but from the applicants point of view I think you don't need to do things just for the program's sake. Plenty of people pretend to love a place on interview day and then rank it like a backup. It's part of the process.

 

[thehundredthone]

The additional charges from NRMP are pretty meaningless compared to what it actually costs to travel to interviews, so I don't think that realistically should even factor in. How many places you interview depends on your own credentials, target specialty and how competitive you are shooting within that specialty. That being said there are always people in soap each year who overestimated their chances, and others who fall deeper down their rank lists then they contemplated. I've seen solid candidates ranked in the middle of a programs match list, and could conceive of those same people ending up at the same depth at lots of places. I don't know the right answer but think some people could save themselves from soap if they did that extra interview or two.

It's difficult to analyse this, because I'm not sure that ranking >20 in a single specialty is applicable within 2SD of the bell curve of applicants. Given the way the match works, candidates in the middle of all (let's say 20) programs' lists will still likely match at one of them because the programs probably won't all get their top choices either.

I think it matters more that a US graduate applicant apply to a range of places from reach to safety, than sheer numbers. Some people could save themselves from SOAP if they did that extra interview or two at a program that was actually feasibly within reach, and ranked them too.

 

[Law2Doc]

It's difficult to analyse this, because I'm not sure that ranking >20 in a single specialty is applicable within 2SD of the bell curve of applicants. Given the way the match works, candidates in the middle of all (let's say 20) programs' lists will still likely match at one of them because the programs probably won't all get their top choices either.

I think it matters more that a US graduate applicant apply to a range of places from reach to safety, than sheer numbers. Some people could save themselves from SOAP if they did that extra interview or two at a program that was actually feasibly within reach, and ranked them too.

In some of the more competitive fields there really are no safeties and the range is very tight. There's also often a reason some programs are more popular than others so it's sometimes a hard sell to tell someone to replace an interview at s place s/he'd love to go with one that's objectively more attainable. Most people are going to go to all the great interviews they get and if they have to make cuts its going to be the places that they weren't as excited about, even if they had better odds of getting those latter spots.

I think the statistical view, that someone in the middle of each list "ought" to match somewhere is great conceptually, but I think some of us have seen it not pan out more than a few times-- and I'm betting telling someone they statistically beat the odds won't be much solace. I'm not sure "playing the odds" is always such a good idea with something as important as your career, when the cost of doing one more interview, in the greater scheme of things, isn't that prohibitive.

 

[thehundredthone]

Most people are going to go to all the great interviews they get and if they have to make cuts its going to be the places that they weren't as excited about, even if they had better odds of getting those latter spots.

I'm not saying to play the odds, I'm saying this is what needs to change, to improve these applicants' chances. If a candidate attends 20+ interviews but all at places that are out of reach, they're still not doing themselves any favours. So sure, apply and interview at 20+, just try and choose some you have a better chance at.

 

[NotAProgDirector]

In this case, the OP has 20+ pathology interviews. He/she has little to worry about. There's nothing wrong about declining an interview that you have no interest in.