Complicated Question

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winters57

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Hey everyone, so I'm in a strange position and was hoping to get some advice here. I applied into ophtho this year and unfortunately did not match. I made a dumb decision of not applying to any categorical backups so my game plan was to do my prelim year and apply into IM and hopefully be able to go into GI in the future. Here are my stats:

US MD Grad (Low tier)
Step 1: 247, Step 2: 235 (mistakes were made..)
2nd quartile (1 Honors, 5 HP, 2 P, strict 80 percentile shelf requirement for H which hit me hard on some rotations).
5 publications (3 ophtho, 2 other) and 2 poster presentations

The complicated part of this all is that I was convicted of reckless operation and physical control after I submitted my application this year. There is no excuse for this and I take full responsibility for it, have learned a hard lesson from it and hope to be able to move on from it. I never had an issue with the law previously but it is what it is. I was planning on doing my prelim year, applying broadly and hoping that I would be able to overcome this and match into a decent program considering the rest of my application is strong in terms of activities, volunteering, etc. Recently, I talked to my home program and they would be willing to switch me to a categorical spot even though I applied prelim and I feel I would have a very strong chance of matching there. It is a small community based program and wanting to go into GI I am a bit nervous about whether I should take them up on this or not as I know it is a competitive fellowship. I feel if it wasn't for the misdemeanors I received I wouldn't really question going the prelim/reapply route. I probably would do my prelim year at my home institution since it would be more flexible for interview season and my PD truly supports me for anyone who would have any questions. I have friends from my school with lower stats and experiences who are doing IM and are interviewing at a lot of great programs. I guess I'm in a unique position and just wanted to see what people think. I appreciate any feedback and am willing to give more information if needed, thanks.
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winters57 said:
Hey everyone, so I'm in a strange position and was hoping to get some advice here. I applied into ophtho this year and unfortunately did not match. I made a dumb decision of not applying to any categorical backups so my game plan was to do my prelim year and apply into IM and hopefully be able to go into GI in the future. Here are my stats:

US MD Grad (Low tier)
Step 1: 247, Step 2: 235 (mistakes were made..)
2nd quartile (1 Honors, 5 HP, 2 P, strict 80 percentile shelf requirement for H which hit me hard on some rotations).
5 publications (3 ophtho, 2 other) and 2 poster presentations

The complicated part of this all is that I was convicted of reckless operation and physical control after I submitted my application this year. There is no excuse for this and I take full responsibility for it, have learned a hard lesson from it and hope to be able to move on from it. I never had an issue with the law previously but it is what it is. I was planning on doing my prelim year, applying broadly and hoping that I would be able to overcome this and match into a decent program considering the rest of my application is strong in terms of activities, volunteering, etc. Recently, I talked to my home program and they would be willing to switch me to a categorical spot even though I applied prelim and I feel I would have a very strong chance of matching there. It is a small community based program and wanting to go into GI I am a bit nervous about whether I should take them up on this or not as I know it is a competitive fellowship. I feel if it wasn't for the misdemeanors I received I wouldn't really question going the prelim/reapply route. I probably would do my prelim year at my home institution since it would be more flexible for interview season and my PD truly supports me for anyone who would have any questions. I have friends from my school with lower stats and experiences who are doing IM and are interviewing at a lot of great programs. I guess I'm in a unique position and just wanted to see what people think. I appreciate any feedback and am willing to give more information if needed, thanks.
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What is "reckless operation and physical control?"

Keep in mind that doing a prelim year and reapplying is not an easy route. Also keep in mind that it will be very difficult to match into a "top-tier" IM residency as a reapplicant.

More importantly, do you actually want to do IM and/or GI?? Keep in mind that GI isn't nearly all that interesting in real-world clinical practice, and procedurally a lot less satisfying than ophtho.
 
"A Reckless Operation is a misdemeanor traffic offense that carries four (4) points against your Ohio Driver's License. Reckless Operation covers a whole host of traffic mishaps, from driving more than 20 miles over the speed limit to striking an inanimate object. What Reckless Operation is not associated with, is drugs or alcohol. There are no mandatory penalties associated with a Reckless Operation conviction. However, should your license be suspended by the court for a Reckless Operation conviction, the reinstatement fee which must be paid to the BMV at the conclusion of your suspension is $40.00.

"Physical Control/Under the Influence is also a misdemeanor traffic offense, but because it is considered a non-moving offense, it carries zero (0) BMV points. "Physical control" is defined as being in the driver's position of the front seat of a vehicle and having possession of the vehicle's ignition key while under the influence alcohol or drugs, but not actually operating the vehicle."
 
This is a complicated situation. You have several paths forward:

1. Match prelim IM, then try to match again categorical IM next year. You will find that getting enough time to interview for new programs will be difficult. Internship is a job, interviews can come anytime from October through January. Also, as mentioned above, many programs will not consider you because you've already done an internship. You will also run into funding problems, which may be an issue at some programs (but not others). Your chances of getting a "brand name" program are not good on this pathway.

2. Match prelim IM, then try to find an open PGY-2 spot. Many prelims try to do this and are successful. You just won't know what programs might be open, there's no centralized system (you just hunt around), and coming from a community program you might find it difficult to get a univ program to take you. Staying at the same program is always an option, and often the easiest solution. The PGY-1 to 2 transition in IM is the most difficult -- switching programs at the same time is VERY difficult. You'll need to start new research projects, learn a new system, etc. It would be very unlikely that you could complete a PGY-1 at one program, transfer to a PGY-2 elsewehre, and then apply for a GI fellowship at the beginning of your PGY-3 -- you almost certainly will need a gap year.

3. Match prelim GS. In that case, you'd have to restart as a PGY-1 in IM. This would help solve the re-match issue, but getting enough time to interview while a surgical prelim will be very complicated.

4. Don't match at all, do something for a year, and re-apply next year. This option gives you the most flexibility. You'd want to try to stay clinically active in your gap year. If your school allows something like this, it's worth considering. I wouldn't pay an entire extra year of tuition, though. You could then get more IM experience and letters.

None of these options include re-applying for Ophthal next year. If you want to do that, then the only options that work are #4 where you dual apply, or #2 where you stay at your prelim program and they agree to allow you to apply and if you don't match, stay as a PGY-2. Both of these options have problems, but might work.
 
I realized after all that, I didn't mention your legal issue. You haven't given us all the details (which is understandable). Some programs may see this as a concern. Some will not care. Much depends upon the details, especially if alcohol or drugs were involved. It makes matching now a safer option. However, you are legally required to update your application with anything new that might affect program decisions. I think this qualifies. So I think you need to tell all of your prelim programs about this.
 
Yeah it is alcohol related, basically a DUI where the charges were reduced. I haven't seen anywhere to update programs on this on ERAS, I guess you mean to just update them individually?

May be better to take up the offer I have then since I feel that being so recent it will be looked on harshly, which I understand. I guess it's the punishment for my wrongs.
 
There's no way to change your ERAS application, so you'd need to update them individually. Since it is a DUI issue, it might affect your licensing. You'll still get a license, but you might be put in a monitoring program. It will be state dependent. Also likely to depend on the details -- if you were trying to "sleep it off in your car because you knew you were too intoxicated to drive" and get charged because you had the keys in your pocket rather than in the trunk of the car, that might not be seen as a big deal. If you were drunk and caught driving 20 miles over the limit or caused a crash or worse and the charges were reduced, then you might have more of a problem.

Rather than seeing this as "punishment for your wrongs", you should look at it as a chance to turn things around. If you let this define you, it will. Own your mistake, become a better person for it.
 
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winters57 said:
Yeah it is alcohol related, basically a DUI where the charges were reduced. I haven't seen anywhere to update programs on this on ERAS, I guess you mean to just update them individually?

May be better to take up the offer I have then since I feel that being so recent it will be looked on harshly, which I understand. I guess it's the punishment for my wrongs.
Click to expand...

Dude, that sounds bad. Like unemployable bad. I'd seriously consider taking the categorical IM spot.
 
Thanks a lot for the responses aProgDirector. I have grown from it and truly have changed the decisions I make because of it. I really learned a life lesson from it as cliche as it sounds. Nothing I put in paper can really change what people in your position see of me and I'm coming to realize that. Appreciate doc05's responses as well, thanks for the feedback you all.
 
If you have a clear path to snag a categorical spot... I'd say go for it and make it a slam dunk. Go to work everyday with a chip on your shoulder and work like heck, claw for every research opportunity and stay late even when unnecessary. Be visible and a problem solver. You do that, many doors will open for you.

It's very late to hope for a different outcome, and as aProgDirector stated the only programs open to you are likely prelim spots. Take the categorical and run with it, dude.
 
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winters57 said:
Hey everyone, so I'm in a strange position and was hoping to get some advice here. I applied into ophtho this year and unfortunately did not match. I made a dumb decision of not applying to any categorical backups so my game plan was to do my prelim year and apply into IM and hopefully be able to go into GI in the future. Here are my stats:

US MD Grad (Low tier)
Step 1: 247, Step 2: 235 (mistakes were made..)
2nd quartile (1 Honors, 5 HP, 2 P, strict 80 percentile shelf requirement for H which hit me hard on some rotations).
5 publications (3 ophtho, 2 other) and 2 poster presentations

The complicated part of this all is that I was convicted of reckless operation and physical control after I submitted my application this year. There is no excuse for this and I take full responsibility for it, have learned a hard lesson from it and hope to be able to move on from it. I never had an issue with the law previously but it is what it is. I was planning on doing my prelim year, applying broadly and hoping that I would be able to overcome this and match into a decent program considering the rest of my application is strong in terms of activities, volunteering, etc. Recently, I talked to my home program and they would be willing to switch me to a categorical spot even though I applied prelim and I feel I would have a very strong chance of matching there. It is a small community based program and wanting to go into GI I am a bit nervous about whether I should take them up on this or not as I know it is a competitive fellowship. I feel if it wasn't for the misdemeanors I received I wouldn't really question going the prelim/reapply route. I probably would do my prelim year at my home institution since it would be more flexible for interview season and my PD truly supports me for anyone who would have any questions. I have friends from my school with lower stats and experiences who are doing IM and are interviewing at a lot of great programs. I guess I'm in a unique position and just wanted to see what people think. I appreciate any feedback and am willing to give more information if needed, thanks.
Click to expand...

Granted that the match is almost over in terms of interviews, but I guess you have two options. One, take IM spot. It might not be Harvard but it's a spot. It allows you to not waste a year, and to match. You can always wait out for SOAP. Obviously that is a gamble. It seems like every year there are good programs that have open spots. Again is it a gamble you want to take.
The thing is though, unfortunately you did not match in Ophtho. Would it be likely that you'd match next year? Who knows. I would assume your first go around would be the most likely if you were to match.
With that said there is really no guarantee of fellowships - for any of us - coming from any program. Plenty of good candidates fail to match in fellowships yearly.
If you dont match into GI are you going to be ok being a hospitalist/IM doc? If the answer is no, then I would not take the position.
If the answer is yes, then again I would take the position that you are being offered.
There is no guarantee that you'd match into GI from any program. So you always have to be ok with the base specialty.
For me for example, I went into PM&R really knowing I wanted to do pain. I did not know whether I'd match into pain but figured I'd be ok doing PM&R if that was the case regardless.
Also I am not sure how the legal issue would affect a GI fellowship - I assume some programs will care and others wont? But again given that it's a competitive fellowship, it might be an obstacle regardless of the program.
Meaning if I were you I'd take the spot, unless you can't bear the idea of being an IM doc if you don't match into GI.
 
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