DO Neurology vs MD PM&R...Need help ASAP!

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francheezy

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Hey guys,

I was offered a D.O. Neurology residency spot for which I have a week to decide whether I want it. I also am registered for the MD match with only 3 PM&R programs interviewed and ranked.

A quick summary about myself. I'm a 4th yr med student who was placed off schedule due to an injury last January, so instead of graduating last June, I am expected to graduate this June. I have had a huge interest in PM&R ever since clinical rotations during my 3rd year and with speaking to many residents. I love the outpatient side in particular but am also interested in managing brain injury and stroke patients. I have done 4 audition rotations on top of 3 private practice (primarily interventional) rotations in PM&R. I applied to almost every single allopathic PM&R program, however, because of my poor board scores (2 retakes + low passing scores), I was only offered interviews at 3 of the 4 places I auditioned at, and no where else. During my rotations, I felt like I did a great job as I am much more of a people person and have learned a lot through my experiences in all of the physiatry rotations. All the attendings, residents and faculty have said great things about me and I feel like my interview only boosted my ranking with these residency programs. That being said, I am unsure if they will rank me highly or high enough for me to land a spot. One program offers 9 spots, another offers 5 and the last offers 4 spots.

Because I chose to participate in the allopathic match, I did not partake in the osteopathic match. However, out of curiosity I realized that Larkin Community Hospital surprisingly had a couple of Neurology spots open after the Match. I have always found Neurology fascinating in my rotations and also felt it complemented PM&R well. The brain is the most interesting organ IMO and I feel like all the cases would be challenging, rather than the same mundane cases you see everyday in certain other fields. I never chose to pursue it simply bc I didn't think I had the grades for it (my GPA = 3.4 but poor board scores). I applied to the program just out of curiosity of seeing whether I would get an interview and sure enough, I had my phone interview the next day with the program director. She just joined in December and asked me if I would be fine with a program that is changing and still growing. The program has existed for about 3 years and they have had 3 residents each year, except this year they plan on having 4. It is categorical and seems like there is only 1 full-time neurologist on board but there's plenty of experience that can be gained by working with other neurologists at other sites (stroke centers, consult services, etc).

I know there are pros and cons to both fields. I feel that PM&R is a natural fit because it includes everything that I enjoy. However, this new opportunity with Neurology opened my doors to research it more and I realize there is a lot of flexibility here as well, whether its outpatient or inpatient, cerebral or more procedural. I realize that Neuro on average pays more but its also a little more demanding since you also have to be on call at least once a week. PM&R there usually is no call but the pay varies depending on what you do. I would love to match into one of those MD PM&R programs, but should I take the chance by missing out on this specific neurology residency opportunity? Or play it safe and go with what seems guaranteed? Is it even worth going to the DO Neurology program? ANY help will be appreciated as time is of the essence! Thanks!

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I'm not sure why you think because you participated in the MD match you can't participate in the DO match. You can participate with both but will be withdrawn if you match.

As for Neuro vs PM&R, have you taken a look at the hospital? I realize that you may not be near Larkin, but if you are, taking a look to see if you like it might be good. PM&R is generally pretty easy to match from what I hear. However there still is a risk of not matching and ending up doing SOAP; but if you feel very confident, then this shouldn't be a problem.

Ultimately it depends upon your interest. I would say go do what you enjoy over lifestyle.
 
I'm sorry, I meant I did not participate in the D.O. match at all for any programs besides TRI.

I was able to visit the hospital once but I wasn't able to grasp much from the short tour that included visiting buildings outside of the hospital. You can tell the facility was relatively new and a lot less populated with workers and patients but it's still hard to tell the quality of training the residents there receive. I guess that depends more on patient volume coupled with the amount of help the attendings/residents are willing to provide.

I would enjoy both, it seems Neurology has more job openings but I also feel like that is because it has been around longer and people actually know what they do moreso than a physiatrist. But after doing several rotations in PM&R, I already feel like a PGY-1 and understand the amount of healthcare that PM&R provides.

Thanks for your opinion.
 
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http://b83c73bcf0e7ca356c80-e8560f4...tent/uploads/2013/08/chartingoutcomes2011.pdf


- Old data, but page 216 says you have about a 45% chance of matching as an independent applicant with 3 interviews. It is really hard to say. Would you be happy giving up PM&R, or always regret your decision? Unfortunately SOAP-ing would be hard as I think there was only 2 or 3 unfilled spots the past 2 years after the match. I know of one person that didn't match, then did research at the program and was essentially guarantee a spot the next year. Of course they had already finished intern year, and the research year was unpaid, but in the end they get what they wanted.
- On a different note, are you still eligible to complete at TRI (DO) and go on to a ACGME advanced program? I know the AOA botched the merger but I haven't kept up.
 
Obviously none of us can really make the decision for you. However, I will say that we all get last minute, it's almost the match jitters. I would encourage you to stick with what you have always enjoyed. Yes, there is a risk only having a small number of programs to rank. But I have also seen friends change their mind at the last minute and end up getting burned. There is plenty of neuro in physiatry. You'll be able to do EMGs, stroke rehab, etc. Just think hard about what you will be happiest doing. Don't let a whim a few weeks before the match freak you out.
 
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