DO, low board scores, where to apply?

[wherewillIgo]

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[diesel2202]

Unfortunately, your scores are going to inhibit you a bit. Definitely make the rest of your app shine so if you make it past the filters you have something that is going to stand out. Apply to academic programs and community programs with in-house fellowships. Those will give you the best chances of fellowship in the future.

 

[Mouzer]

Hey dude! Sorry your boards didn't go as well as you wanted them to, that's rough. I wish I could offer advice, but I'm no expert on this stuff, but you could check out the thread below and see where people with a profile similar to yours applied in previous years for some guidance.

Official Eternal IM WAMC Thread

Thought I would start this new thread for WAMC even though still early for upcoming match cycle. I am an AMG in between MS3 and MS4, on research year. I had originally wanted to do derm, but after this year of research, decided that I am more interested in internal medicine. I would like to...

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[Angus Avagadro]

Pulmonary CCM is very competitive and I'm afraid you might get screened with your scores. You might want to consider Anesthesia CCM, although Pulm CCM is more desirable in the job market.

 

[AlbinoHawk DO]

You can likely land a community program with big university association. If applying broadly enough, you could match a low-ranked university program like Virginia Commonwealth University. The key to match Pulm/CC will be how much your in-house fellowship wants you. If you go to a program without an in-house, you have an uphill battle. Don't discount alternative pathways like ID/CC and Nephro/CC

 

[AlbinoHawk DO]

yeah, I'm definitely going to be screened out by programs. My hope is to find a solid community program with an in-house fellowship and then hustle while in residency.
I'd be happy in pulm or as a hospitalist, but if my chances are even 10%, it's still worth it to me to try for pulm/ccm.

Anesthesia is a blood bath this year.....

Looking to figure out how to identify such community programs. Should I just look up programs on residency explorer and visit their pages to see if they offer in-house pulm/ccm?

To what extent if any would a good level 3 mitigate the low board scores? That is if I have a solid level 3, solid research and do well on ICU/wards.

Level 3 has zero effect on your application

"Solid" research is very subjective and as a resident it's not realistic. How can you get multiple good projects published before PGY-3?

Doing well on your rotations in ICU is just important for in-house fellowship and for LOR. Otherwise, it's not like you'll get a grade or something

Most important factors in matching: 1. Your IM program's reputation, 2. Your letters of recommendation, 3. Your interview, 4. No board failures or a target score, 5. Chief Year, 6. Research, 7. Everything else

 

[Angus Avagadro]

Anything you can do to mitigate your scores will help. I agree applying to programs with in house pulm fellowship is your best bet. Uni affiliates would be the best you can do imo. All programs want to avoid their residents having board failures, so improving your test scores will help assuage those concerns. You are going to have to have all the boxes checked for IM and Pulm. Consider it like getting elected. Any personal influence you can garner from IM or Pulm directors. Check all the boxes, work hard, and be teachable, accept criticism with grace. Outside of your program, decisions on fellowship will be largely where you trained and stats oriented. LOR from a well know PD can help.

 

[AlbinoHawk DO]

Thank you both.
What's a good way of identifying uni-affiliated programs or community programs with in-house fellowships? Looking at the bottom of rank lists?

Search backward. Find which community programs have pulm/cc fellowship

 

[ToKingdomCome]

Pulmonary CCM is very competitive and I'm afraid you might get screened with your scores. You might want to consider Anesthesia CCM, although Pulm CCM is more desirable in the job market.

You can’t do anesthesia CCM from IM

 

[Angus Avagadro]

You can’t do anesthesia CCM from IM

Sure you can. You do IM PGY 1 and then match Anesthesia as a PGY 2. Happens all the time. Or you finish IM, then do Anesthesia. I had a practicing internist in my residency class along with a lady who was formerly Chief resident in IM at Mayo Clinic. Now I agree, matching anesthesia CCM directly from IM residency is not possible.

 

[ToKingdomCome]

Sure you can. You do IM PGY 1 and then match Anesthesia as a PGY 2. Happens all the time. Or you finish IM, then do Anesthesia. I had a practicing internist in my residency class along with a lady who was formerly Chief resident in IM at Mayo Clinic. Now I agree, matching anesthesia CCM directly from IM residency is not possible.

I’m literally anesthesia CCM. I know the process. Your original post suggested that he could just apply out of IM without completing an anesthesia residency since you didn’t even mention that.

 

[ToKingdomCome]

I’m literally anesthesia CCM. I know the process. Your original post suggested that he could just apply out of IM without completing an anesthesia residency since you didn’t even mention that.

Also matching anesthesia for a PGY2 “R” spot is also probably much more difficult than matching pulm /CCM. There are so few spots. You’re better off thinking about reapplying the entire 4 years for anesthesia and redoing intern year if you want to go down that route

 

[Ho0v-man]

Pulmonary CCM is very competitive and I'm afraid you might get screened with your scores. You might want to consider Anesthesia CCM, although Pulm CCM is more desirable in the job market.

Bruh, this cats worried about matching IM. He/she’s not getting into anesthesia.

 

[Angus Avagadro]

Bruh, this cats worried about matching IM. He/she’s not getting into anesthesia. I understand that. If CCM Is what they want, there are options other than Pulm CCM which is quite competetive.

I get that. I was pointing out other options if OP was set on CCM. Pulmonary CCM is quite competitive and he has low Stats which will make matching good IM programs tough. A year of IM, a couple in anesth, then CCM. Anesth CCM ran all the ICU's at my old uni, except liver transplants.

 

[Ho0v-man]

I get that. I was pointing out other options if OP was set on CCM. Pulmonary CCM is quite competitive and he has low Stats which will make matching good IM programs tough. A year of IM, a couple in anesth, then CCM. Anesth CCM ran all the ICU's at my old uni, except liver transplants.

Getting into anesthesia is significantly harder than IM right now. This is not a good plan.

 

[FootballAndSkiing]

EM has a path to CCM right? Wouldn't that be the easiest, or does EM make it harder to get a CCM spot?

 

[ToKingdomCome]

EM has a path to CCM right? Wouldn't that be the easiest, or does EM make it harder to get a CCM spot?

Yes. EM can go into anesthesia CCM

 

[ToKingdomCome]

Getting into anesthesia is significantly harder than IM right now. This is not a good plan.

It is even harder to match directly into a PGY2 anesthesia spot as opposed to matching a categorical anesthesia spot. That cat is not giving the best advice. There are plenty of former DO IM programs that have former DO pulm crit programs which is way more doable

 

[ToKingdomCome]

should I be targeting programs with former DO pulm crit programs over low-tier academic uni?

will have 3 pubs by ERAS

yes

 

[ToKingdomCome]

I was thinking ideally I'd would want to match low-tier uni that has its own pulm-crit fellowship, or are you saying I should also rank former DO pulm crit programs over low-tier academic uni if I get that opportunity?

it seems that some of these community programs actually have better match lists in certain fellowships compared to some low-tier academic programs...


does program 'prestige' really matter that much more when comparing these programs?

Prestige doesn’t matter when you’re looking at low tier programs. Just do your best, show interest, and get good letters and you’ll match somewhere.

 

[ToKingdomCome]

Go where you think you’ll succeed. I don’t think it matters low tier academic vs. DO programs with pulm fellowship

 

[Ho0v-man]

I was thinking ideally I'd would want to match low-tier uni that has its own pulm-crit fellowship, or are you saying I should also rank former DO pulm crit programs over low-tier academic uni if I get that opportunity?

it seems that some of these community programs actually have better match lists in certain fellowships compared to some low-tier academic programs...


does program 'prestige' really matter that much more when comparing these programs?

I don’t think it matters too much between the two. I would scrutinize the list at the community programs with better matches. For instance, are all of those matches FMGs with prior research backgrounds and attending experience in their home country?

 

[Drrrrrr. Celty]

should I be targeting programs with former DO pulm crit programs over low-tier academic uni?

will have 3 pubs by ERAS

You're putting your eggs in one basket with that strategy however.

Name branding matters and you only do residency once.

You may find out that after actually being a resident in the ICU you find yourself knowing fully that you cannot do it.

People go into IM residency all wanting to do Cardio/ GI/ CC. Then they slowly find themselves not interested, willing to do it, or just frankly not competitive.

IM residency shouldn't just be a bridge to your fellowship. It's your foundational training for being a internist. So you should also emphasize a program that is going to give you the best training for what you want.

 

[Drrrrrr. Celty]

yeah, usually community programs give better training around here when compared to the academic programs

Depends.

A good community program will prepare you pretty well in how to be a very broadly capable physician. A lot more procedural skill for sure

But a good academic program will get you potentially more because there will be great pathophysiology, more subspecialty medicine, etc.

All I'm saying is don't go to a community program with a PCCM program and makes you see a very heavy list of bread and butter medicine for you to scut/write notes. A lot of programs draw in folks with shiny promises of in house fellowships to then have 20 ppl along side you in a rat race.

And I say this as someone who went to a fantastic community program. It was a beautiful experience and it made me a fantastic and well balanced physician. But I also acknowledge that I missed out on a lot of more complicated cases because they went to the university for things we couldn't do in house.