Atypical potential applicant wondering about my chances

[TurkeyJerkey]

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[Wordead]

Hello distinguished soon-to-be medical colleagues,

Here is my fairly unique situation:

Just wrapping up an MPH year between M3 and M4. Am set up to apply to pediatrics but after working through some personal hangups and reflecting on my clerkship experiences and the kind of work I find fulfilling, I've finally realized that ENT is an excellent fit for me. Maybe I would subspecialize in peds, maybe not, but I like the adult stuff, too, and the opportunity to solve problems for both populations is just another huge plus for me anyway.

My rundown:
-Step 1: 259
-Step 2: 265, passed CS (took it at the start of the MPH year)
-Clerkships: H in IM/Peds/FM/SurgSubspeciality (including 3 weeks of ENT that earned me stellar evals from residents but not much attending facetime); HP General Surgery/Psych/OBGyn
-During my MPH year at my upper-mid-tier MD home school, I concentrated in biostats/epidemiology. Going to have a couple posters/potential papers related to neonatology stemming from the "practicum" portion.
-Other research: Have a first-author paper in PLOS One from an undergrad neuroscience lab (for which I performed inner ear surgery on birds! ), two co-author papers in Cancer Cell and PNAS from an ovarian cancer lab, and a poster and first-author paper in a mid-tier surgical journal from a retrospective chart review on breast biopsies. Briefly started chart review for a prospective ENT study back in M1 but the institute I was working at went through a change and my involvement ended at that time.
-Extracurricular stuff: I've been really involved in helping out the school- some work improving our health center, peer tutoring/counseling stuff, directing a preclinical material review course this year, was a co-author this year on the required student experience survey for the upcoming LCME re-accreditation cycle. Also some volunteering with health insurance exchange outreach stuff, etc.
-Haven't spoken to faculty yet and I'm unknown in the department, but got some feedback from someone, who just did a research year and matched, that my chances are great and I should go straight through with peds as backup while immediately getting involved in ENT database projects leveraging my new data analysis skills.

Advice/feedback/dire warnings? I greatly appreciate the wisdom on these boards.

In your situation, a year off doing research is the difference between matching at a top program and a mediocre one (if at all). Just my opinion though.

 

[doc05]

Hello distinguished soon-to-be medical colleagues,

Here is my fairly unique situation:

Just wrapping up an MPH year between M3 and M4. Am set up to apply to pediatrics but after working through some personal hangups and reflecting on my clerkship experiences and the kind of work I find fulfilling, I've finally realized that ENT is an excellent fit for me. Maybe I would subspecialize in peds, maybe not, but I like the adult stuff, too, and the opportunity to solve problems for both populations is just another huge plus for me anyway.

My rundown:
-Step 1: 259
-Step 2: 265, passed CS (took it at the start of the MPH year)
-Clerkships: H in IM/Peds/FM/SurgSubspeciality (including 3 weeks of ENT that earned me stellar evals from residents but not much attending facetime); HP General Surgery/Psych/OBGyn
-During my MPH year at my upper-mid-tier MD home school, I concentrated in biostats/epidemiology. Going to have a couple posters/potential papers related to neonatology stemming from the "practicum" portion.
-Other research: Have a first-author paper in PLOS One from an undergrad neuroscience lab (for which I performed inner ear surgery on birds! ), two co-author papers in Cancer Cell and PNAS from an ovarian cancer lab, and a poster and first-author paper in a mid-tier surgical journal from a retrospective chart review on breast biopsies. Briefly started chart review for a prospective ENT study back in M1 but the institute I was working at went through a change and my involvement ended at that time.
-Extracurricular stuff: I've been really involved in helping out the school- some work improving our health center, peer tutoring/counseling stuff, directing a preclinical material review course this year, was a co-author this year on the required student experience survey for the upcoming LCME re-accreditation cycle. Also some volunteering with health insurance exchange outreach stuff, etc.
-Haven't spoken to faculty yet and I'm unknown in the department, but got some feedback from someone, who just did a research year and matched, that my chances are great and I should go straight through with peds as backup while immediately getting involved in ENT database projects leveraging my new data analysis skills.

Advice/feedback/dire warnings? I greatly appreciate the wisdom on these boards.

It's not my specialty, but sounds like you have very little exposure to a very very competitive field. Most applicants to competitive specialties have lots of exposure prior to applying. Talk to faculty at your school.

 

[TurkeyJerkey]

In your situation, a year off doing research is the difference between matching at a top program and a mediocre one (if at all). Just my opinion though.

Fair enough. Just curious, to help my learning process for formulating my goals- what are the inherent trade-offs of not getting into a top program? Reputation of the name obviously, but in terms of training does it typically mean lower/less diverse caseload?

Another point in terms of a research year- will programs be put off that I've taken a whole 6 years to finish med school? Especially considering my step1 score would be >3 years old at the time of applying?

 

[hiya20]

Hey TurkeyJerkey,

I recently matched into ENT for the 2015-2016 cycle so I would be happy to share some of my experiences on how competitive the cycle was this year. From my experience, there are a few check boxes that programs look at: Step 1 score, clinical grades, research, and LORs. You are definitely in the top quartile for your step 1 score and research. I only had 3 publications at mid/low tier journals and several attendings still commented on how much research I had accomplished. The biggest weakness that I see in your application is that you don't seem to have a lot of connections with your home ENT program. This can be a HUGE help when it comes to having your program contact places that your interested in as well as for identifying LOR writers. I agree that you likely do not have to take a year off to make yourself competitive but I would immediately set up some face to face meetings with attendings in your department that are known to be good mentors. If you are able to identify 1-2 mentors that can advocate for you I am pretty confident that you will match at a very good program.

In terms of program reputation vs. training, I matched at what is considered a "top 10" ENT program on Doximity but I can honestly say that while interviewing almost every single institution was more or less equal. Sure some of the big names have more abundant research opportunities but from a clinical stand point I think you will get great training wherever you end up. Of course I am still just an MS4 so take what I am saying with a grain of salt. Again having connections in your department with residents/attendings will allow you to ask them for their impressions of various programs. If you have any questions feel free to PM me. Good luck!!

 

[OtoHNS]

In your situation, a year off doing research is the difference between matching at a top program and a mediocre one (if at all). Just my opinion though.

I know ENT is competitive and all, but come on!

Assuming the OP can get known in his home department and get something ENT-related submitted for publication in the next few months, he/she should be very competitive to match.

Set up meetings with chairman/PD ASAP, try to shadow in clinic/OR, and start attending ENT grand rounds every week. This should not be hard to do with your MPH year and M4 cush schedule.

 

[Wordead]

I know ENT is competitive and all, but come on!

Assuming the OP can get known in his home department and get something ENT-related submitted for publication in the next few months, he/she should be very competitive to match.

Set up meetings with chairman/PD ASAP, try to shadow in clinic/OR, and start attending ENT grand rounds every week. This should not be hard to do with your MPH year and M4 cush schedule.

Well i certainly agree that if those things can be accomplished OP can match somewhere, I guess I just disagree on how feasible it is. He/she has nothing started in terms of ENT research, and is completely unknown to the department and will have a generic letter in all likelihood.

 

[Wordead]

double post

 

[Wordead]

Fair enough. Just curious, to help my learning process for formulating my goals- what are the inherent trade-offs of not getting into a top program? Reputation of the name obviously, but in terms of training does it typically mean lower/less diverse caseload?

Another point in terms of a research year- will programs be put off that I've taken a whole 6 years to finish med school? Especially considering my step1 score would be >3 years old at the time of applying?

What constitutes a "top" program is always a point of contention so I wont delve into it, but I'll say that I think the commonly stated trope of "you'll get great training at any program" is completely overblown. Programs are not created equal. A program that has no fellowship-trained _______ is not going to provide great training in that area. Programs that dont do their own recon are not providing a full H+N experience. The program that rolls 3 deep in all subspecialties? Probably going to provide a pretty well rounded experience.

And case #s are an ok proxy but not that accurate because some programs have high numbers because they do 500 tonsils and some because you operate all day every day. It also depends on how much emphasis on logging cases the program has and such.

I dont know enough to comment on the 6 yrs to finish med school.

 

[TurkeyJerkey]

I very much appreciate everybody's input. Just the sort of advice and food for thought I was looking for.

 

[OtoHNS]

Well i certainly agree that if those things can be accomplished OP can match somewhere, I guess I just disagree on how feasible it is. He/she has nothing started in terms of ENT research, and is completely unknown to the department and will have a generic letter in all likelihood.

If the ERAS deadline was tomorrow, I'd definitely agree with you. It will take some hustling, but the OP certainly has the opportunity to correct these deficiencies in the next 5-6 months until applications are due.

 

[Wordead]

If the ERAS deadline was tomorrow, I'd definitely agree with you. It will take some hustling, but the OP certainly has the opportunity to correct these deficiencies in the next 5-6 months until applications are due.

Well, it's true that he has 4 months until ERAS is due. However, he also has to do a couple aways. To take even a simple chart review from data to published in 4 months with 2 months of aways is gonna be difficult. There's always editing/revisions to be done...it seems to me that with an otherwise strong application, taking a year off and applying with stronger letters and a few ENT-specific pubs he/she would be in a much stronger position.