I'm an MS4 and just now becoming interested in Rad Onc. Where do I go from here?

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MaybeRadOncMS4

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Hey guys, please let me know if there is a better place/thread to put this but I was hoping to get some advice.

I'm an MS4 and just started looking into Rad Onc when I recently heard a friend of a friend matched into it. So far I have no actual clinical experience - I'm just making judgments based on things I've read or heard.

I have started getting everything together to apply for anesthesia, and while I like anesthesia well enough, I initially decided on it because I had a pretty good relationship with some of the residents and attendings and had no strong feelings about any of my core clerkships.

So, I'm not sure how to proceed. My anesthesia rotation starts in just over a week and I don't have time to do another rotation before applications are due. I worry that if I try to switch into a Rad Onc elective and end up disliking it, I won't be able to get good anesthesia letters, but vice versa I won't even be able try Rad Onc before applications are due.

From what I can tell, I don't have a super competitive application for Rad Onc, but I don't have a weak one either (Step 1 is high 240s, a few pubs in a different oncology field, top 20% class rank at mid tier state school not AOA).

One of the Rad Onc attendings is on a committee that I'm also on which is meeting late next week and I plan to ask him what he thinks in person, but any advice I can get from you guys would be appreciated.

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Have you not actually done an anesthesia elective yet? I don't really understand how you could be this close to application time and have decided on a specialty without having done a rotation in it yet.

Regardless, for either specialty, I would think you would need at least two months of rotations to get the necessary experience and letters of recommendation to put a good application together. I did 4 rad onc rotations before matching, but I think 3 would have been plenty. If you can schedule a rad onc rotation to follow your anesthesia rotation, do it. After those two months you should have a better idea of which one you want to apply for. But by that point, ERAS will probably already be open for submission.

Your board score and class rank should make you a good applicant. Your oncology research definitely will help you too. If this were April and you were asking this question, I would probably say you had plenty of time to get an app together for this cycle, but being so close to submission time, and considering that you don't have a clear idea what you want to do, an extra year may be what you need. It's not unreasonable to postpone graduation for a year so you can do some away rotations and more research, if that is an option your school would support.
 
Thanks for the response. Sorry, I should have been more clear - I did an anesthesia elective in my third year which is how I connected with a few of the residents and attendings. I would have done the fourth year elective this month, but they don't allow students to rotate during the month that the new residents are learning the ropes. Talking with the anesthesia faculty they don't seem to think that it will be a major hindrance if I don't have another full elective before applications if I decide to go that route.

We only have 10 weeks of MS4 before ERAS gets sent out, and thus far I've used the first 4 weeks doing one of our required rotations as well as a radiology elective. I only have 6 weeks left, so like you mentioned scheduling rad onc after anesthesia isn't really feasible since applications would be submitted 2 weeks into the rad onc rotation.

I was planning on switching my next rotation from anesthesia to rad onc so that I would at least have one 4-week rotation under my belt, but it sounds like even that wouldn't necessarily be enough to maximize my chances of matching with this cycle? I've thought about pushing back graduation by a year, but I'm not sure how that works with tuition and everything since I've already started MS4. I will speak with student affairs to see what that would entail.

Thanks, I appreciate the advice!
 
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Thanks for the response. Sorry, I should have been more clear - I did an anesthesia elective in my third year which is how I connected with a few of the residents and attendings. I would have done the fourth year elective this month, but they don't allow students to rotate during the month that the new residents are learning the ropes. Talking with the anesthesia faculty they don't seem to think that it will be a major hindrance if I don't have another full elective before applications if I decide to go that route.

We only have 10 weeks of MS4 before ERAS gets sent out, and thus far I've used the first 4 weeks doing one of our required rotations as well as a radiology elective. I only have 6 weeks left, so like you mentioned scheduling rad onc after anesthesia isn't really feasible since applications would be submitted 2 weeks into the rad onc rotation.

I was planning on switching my next rotation from anesthesia to rad onc so that I would at least have one 4-week rotation under my belt, but it sounds like even that wouldn't necessarily be enough to maximize my chances of matching with this cycle? I've thought about pushing back graduation by a year, but I'm not sure how that works with tuition and everything since I've already started MS4. I will speak with student affairs to see what that would entail.

Thanks, I appreciate the advice!

So, I mostly agree with Carlin, but I wanted to play a small bit of devil's advocate, in that I know of more than few people who matched last year with only one home rotation. That said, the vast majority had at least two rotations, one home and one away.

So I would make your big decision as such: "Do I want to match at a top 20 program?" If yes, then take a year off, do more research and rotations and then apply.
If no, "Would I be happy matching nearly anywhere?" If yes, then apply this year!

If you are going to apply, and I think you should, You'll have your work cut out for you. First, see if you can arrange to do a 4 week rotation at your home program, as they probably already know you from you being around (Such as through that committee meeting.) Meet with the chair and PD stat to get advice/your face known so you can ask for a letter. Then schedule an away rotation, its okay if it stars in September and you aren't done with it when ERAS goes out! You can still put on your app, and include LOR as they become available.

You will have a whirlwind switching this late, but it is definitely doable.

Cavet for other readers in the future: This advice only applies because they not only have solid numbers but they also already have oncology publications!
 
Thanks! I really do appreciate the help. The last few days have been constant stress trying to get in touch with classmates who are applying to pick their brain and figuring out a (possible) alternate schedule for the rest of the year to maximize the number of rotations I can do.

Thankfully my uni offers two different home rotations, so I can definitely get those during the year. I have started getting everything in VSAS filled out today so I can submit as soon as possible. I completely forgot that you can add LORs after submitting! That makes things seem much more doable.

My tentative plan is to schedule a home rotation for August, and leave my schedule open for an away rotation in September, and another in November (if that's not too late?). Right now I am taking October off to study for Step 2, so I'm hesitant to schedule anything during that time. If I don't fill one of the aways, I can do the second home elective, otherwise I will schedule it for the spring (bonus - it counts for one of our required rotations!).

I've emailed the PD's secretary about setting up a meeting ASAP next week and will follow up on that tomorrow during the work week to make sure it doesn't get lost in the shuffle. As much as I would love to go to a top 20 program, I think I would be happy just matching, but that's something I'll bring up with the PD to see what they recommend.

I'm meeting one of the prelim interns that matched tonight and will run all this by them, but is there anything major that I'm forgetting?
 
Thanks! I really do appreciate the help. The last few days have been constant stress trying to get in touch with classmates who are applying to pick their brain and figuring out a (possible) alternate schedule for the rest of the year to maximize the number of rotations I can do.

Thankfully my uni offers two different home rotations, so I can definitely get those during the year. I have started getting everything in VSAS filled out today so I can submit as soon as possible. I completely forgot that you can add LORs after submitting! That makes things seem much more doable.

My tentative plan is to schedule a home rotation for August, and leave my schedule open for an away rotation in September, and another in November (if that's not too late?). Right now I am taking October off to study for Step 2, so I'm hesitant to schedule anything during that time. If I don't fill one of the aways, I can do the second home elective, otherwise I will schedule it for the spring (bonus - it counts for one of our required rotations!).

I've emailed the PD's secretary about setting up a meeting ASAP next week and will follow up on that tomorrow during the work week to make sure it doesn't get lost in the shuffle. As much as I would love to go to a top 20 program, I think I would be happy just matching, but that's something I'll bring up with the PD to see what they recommend.

I'm meeting one of the prelim interns that matched tonight and will run all this by them, but is there anything major that I'm forgetting?

Seems like your bases are covered. Two things, one November is too late. I'd swap those and do an away in October if you want to do a second one, and then study for Step 2 in November.

That said, you don't need to do two aways if you have a home program, so you could also just do August and September and call it good!
 
Ok, awesome! I'll see what the PD thinks about rescheduling Step 2 vs doing a second away, but personally I would lean towards not rescheduling Step 2 since I already have the hotel booked for CS and all that. That makes me feel better that I can at least put together a solid, albeit not spectacular, application with just one home and one away.
 
Sorry, when you said you had your anesthesia elective coming up, I thought that meant it was your first one. This all seems pretty reasonable. I got a letter from my September rotation so that is definitely not too late. Rad onc tends to be a specialty that reviews apps and sends out interview invitations pretty late compared to other fields, so if you don't send in ERAS right when it opens, it's not a big deal. If you can get two rotations in by the end of September, then I'm with Sheldor, you should def go for it.

And if you do your first rad onc rotation and decide it's not the field for you, it seems like you still have everything in order to apply for anesthesia.

Oh and regarding step 2-- you mention CS, which you probably don't really need to study for. So you could conceivably still do that in October and the push CK back to November and study for that then.

Good luck!
 
I for sure have home rotations scheduled for August and November now, and my schedule is currently open for an away rotation in September which I will work on getting everything submitted for this week. Spoke with the department secretary this morning and she is figuring out meeting times for both the PD and the department chair. Also set up meetings with my research adviser and the dean of student affairs to give them a heads up and get their thoughts, and to see if they have any additional people I should be in contact with.

Now that things are starting to come I can breathe a little easier. Thank you both for your help
 
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