Neurology chances for IMG; scores in 260s

[leonardo001]

Hi,
I am an IMG and have good scores in Steps, both in high 260s. I have 4 US LORs but 1 is in IM and 3 in Cardio. No Neuro LORs. (one reason being that I didn't intend to apply in Neuro at all; but now Im thinking more and more of it; particularly thinking if I could go into Cognitive Neuroscience after Neuro Residency). What are my chances of match? Should I apply in Neuro along with IM?

Thank you very much guys.....

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[StartingLine3]

No doubt you match, but is there chance you can get a neurology letter? It seems like you were lining up a strong IM/Cards application.

 

[Hank Rearden]

May want to research the cognitive field a little bit first. Cognitive usually means you are seeing dementia patients in clinical practice. My friend in private practice says if he saw nothing but dementia patients all day he would make about $60k/yr. This is because their follow up visits take an hour due to all the social issues, but you can only bill for about a 15 min follow up visit. He has to mix in other patients to stay afloat. Most people I know who do cognitive are academic physicians. Do you have any interest in research and academics? If not, might be better to pick a different specialty. Hopefully reimbursement will continue to change so people are paid more to see these patients, but I just don't think you can make a living at it as a pure clinician currently.

 

[leonardo001]

No doubt you match, but is there chance you can get a neurology letter? It seems like you were lining up a strong IM/Cards application.

Yes I was originally intending to apply in IM and IM only.. I was pretty set on Cardio/Onco...
But, I have had a little bit of change of heart, I don't know why And I am thinking a little bit of Neuro now. It looks difficult right now to get a Neurology letter right now; at least not before September 15.
What would happen if I applied with just IM letters. Would I have any chance ? SHould I even try?
Thank you very much for your guidance!

 

[leonardo001]

May want to research the cognitive field a little bit first. Cognitive usually means you are seeing dementia patients in clinical practice. My friend in private practice says if he saw nothing but dementia patients all day he would make about $60k/yr. This is because their follow up visits take an hour due to all the social issues, but you can only bill for about a 15 min follow up visit. He has to mix in other patients to stay afloat. Most people I know who do cognitive are academic physicians. Do you have any interest in research and academics? If not, might be better to pick a different specialty. Hopefully reimbursement will continue to change so people are paid more to see these patients, but I just don't think you can make a living at it as a pure clinician currently.

Thank you very much for your input. Yes I like research and academics. I planned to go in Onco or Cardio academics otherwise. What would you advise me to do if I wanna at least try in Neuro?
Thanks

 

[Hank Rearden]

I think it might be difficult to match in neuro if you apply this year. I say this because you are clearly playing catch up at this point, and I for one would want to see 2 if not 3 letters from neurologists if you were trying to match at my program. If your application has one neuro letter and 3 IM letters, I would think you are really more interested in IM and neuro was a half-hearted decision.

That leaves you a couple of options. 1) if you are really intent on neuro and not IM, you could take a year off and then apply to neuro next year after getting appropriate number of LOR's. 2) you could go through with IM match and then once you start if you decide you are truly more interested in neuro you could try to scramble into a PGY-2 neuro position. You'd be amazed at how many people give up on neuro after their prelim year - there is guaranteed to be at least a few spots open across the U.S., some at reputable programs.

 

[leonardo001]

I think it might be difficult to match in neuro if you apply this year. I say this because you are clearly playing catch up at this point, and I for one would want to see 2 if not 3 letters from neurologists if you were trying to match at my program. If your application has one neuro letter and 3 IM letters, I would think you are really more interested in IM and neuro was a half-hearted decision.

That leaves you a couple of options. 1) if you are really intent on neuro and not IM, you could take a year off and then apply to neuro next year after getting appropriate number of LOR's. 2) you could go through with IM match and then once you start if you decide you are truly more interested in neuro you could try to scramble into a PGY-2 neuro position. You'd be amazed at how many people give up on neuro after their prelim year - there is guaranteed to be at least a few spots open across the U.S., some at reputable programs.

Hmmm Ok, thank you very much for your valuable input. I need to think about all these options!