Reentering the match for categorical IM

[SwapperNoSwapping]

Hello SDN! Current PGY-1 at a combined X+IM program who has found him/herself gravitating towards IM, especially pulm/crit more and more each day. Honestly a pretty unexpected development but it is at the point where I see it as a definitive career path for me.

I believe that I came into the program with a good attitude, worked extremely hard, and have received positive feedbacks, however the program is quite limited in academic and research opportunities that I think reapplying will maximize my competitiveness for a fellowship.

For background info: USMD from a decent Med school in the northeast. Step 1: 24x, Step 2: 25x, honored in medicine sub I, and one pub during Med school from undergrad research but otherwise limited in research. Should be ok with obtaining a letter of good standing and positive letter of recs from attending I’ve worked with this year.

Planning on applying very broadly if I go down this route (150+?) to any university/academic/programs with pulm-crit fellowships and not limited by geography. Do I stand a chance at all or am I out of my mind?

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[chessknt]

Do you mean you are on an em/Im or peds/Im program already but are thinking about trying to re match as a pgy2 (because you'd would be trying to match for July 24 if applying this year) in to a pgy1 spot to get better research?

Of that is the case then yes you are out of your mind. You are already in an IM program and want to leave it... For a better one? Why would your pd ever support that??

 

[SwapperNoSwapping]

Do you mean you are on an em/Im or peds/Im program already but are thinking about trying to re match as a pgy2 (because you'd would be trying to match for July 24 if applying this year) in to a pgy1 spot to get better research?

Of that is the case then yes you are out of your mind. You are already in an IM program and want to leave it... For a better one? Why would your pd ever support that??

The latter. Everything you said makes sense but I guess my post was for if I’m able to get PD support…obviously it’s all moot without that and that’ll be it

 

[MD46]

Even with being combined IM/X, you can still spend more time in Pulm/CC electives if you request and try to get good LORs for fellowship. May be able to do an away rotation as well at a place of your choice where you might be interested in doing Pulm/crit Fellowship. (specially being a USMD getting into fellowship may not be as hard as an IMG)

Where I trained IM/Psych and IM/Peds people did the same and I think most of them went into IM subspecialities later

Best of luck.

 

[collegestud2013]

Hello SDN! Current PGY-1 at a combined X+IM program who has found him/herself gravitating towards IM, especially pulm/crit more and more each day. Honestly a pretty unexpected development but it is at the point where I see it as a definitive career path for me.

I believe that I came into the program with a good attitude, worked extremely hard, and have received positive feedbacks, however the program is quite limited in academic and research opportunities that I think reapplying will maximize my competitiveness for a fellowship.

For background info: USMD from a decent Med school in the northeast. Step 1: 24x, Step 2: 25x, honored in medicine sub I, and one pub during Med school from undergrad research but otherwise limited in research. Should be ok with obtaining a letter of good standing and positive letter of recs from attending I’ve worked with this year.

Planning on applying very broadly if I go down this route (150+?) to any university/academic/programs with pulm-crit fellowships and not limited by geography. Do I stand a chance at all or am I out of my mind?

All IM spots in the Match start at PGY-1 year , so you would be repeating your PGY-1 year (and throwing away a year of attending salary for a PGY-1 salary) if you went through the Match again. You could transfer to another program that has a PGY2 IM spot open and start there in July, though this would be done outside the Match. However, generally there needs to be a more genuine and urgent personal reason for the transfer (such as having sick family members to take care of that happen to in the same city as that program), as transferring programs just to get better reputation for fellowship application or research doesn't tend to go well with PDs as a top of reason for accepting someone. The best case may be that you can switch over to your institution's IM only program as a PGY-2 if there is a spot open (so you don't waste extra years training for another specialty that you don't plan on practicing). A USMD with your Step scores should have a strong chance of matching pulm/crit if you apply broadly, have good letters, and have some research (outside big name academic places having a crazy amount of research usually won't be the limiting factor for a USMD applicant).

 

[SwapperNoSwapping]

Even with being combined IM/X, you can still spend more time in Pulm/CC electives if you request and try to get good LORs for fellowship. May be able to do an away rotation as well at a place of your choice where you might be interested in doing Pulm/crit Fellowship. (specially being a USMD getting into fellowship may not be as hard as an IMG)

Where I trained IM/Psych and IM/Peds people did the same and I think most of them went into IM subspecialities later

Best of luck.

Thank you

 

[SwapperNoSwapping]

All IM spots in the Match start at PGY-1 year , so you would be repeating your PGY-1 year (and throwing away a year of attending salary for a PGY-1 salary) if you went through the Match again. You could transfer to another program that has a PGY2 IM spot open and start there in July, though this would be done outside the Match. However, generally there needs to be a more genuine and urgent personal reason for the transfer (such as having sick family members to take care of that happen to in the same city as that program), as transferring programs just to get better reputation for fellowship application or research doesn't tend to go well with PDs as a top of reason for accepting someone. The best case may be that you can switch over to your institution's IM only program as a PGY-2 if there is a spot open (so you don't waste extra years training for another specialty that you don't plan on practicing). A USMD with your Step scores should have a strong chance of matching pulm/crit if you apply broadly, have good letters, and have some research (outside big name academic places having a crazy amount of research usually won't be the limiting factor for a USMD applicant).

Thank you for the thoughtful reply. Just to clarify yes I was willing to restart as PGY1 although in total residency + fellowship it’d be about the same number of years staying in a combined residency + fellowship. I fully did not expect to be able to transfer directly to an open PGY2 spot as my understanding from talking to people who’ve gone through this process is that IM vacancies are generally not advertised but more so word of mouth between PDs.

One thing I do want to gauge on the forum is that if I were dumb enough to reenter the match for a PGY1 spot would I even be competitive for some programs at all?

 

[NotAProgDirector]

Most combined programs are 5 years long, with IM/Peds being 4. if you try to drop out at the end of this year, you'll likely only get 6 months of IM credit (although that will depend upon how your intern year was structured). if you start as a PGY-1 again, then you'll finish in a total of 4 years - so you'll save one year.

Problem is, it's certainly too late to consider this year's match. Most programs are finishing their interviews shortly. No one is looking at applications now. So applying this year is almost impossible.

Your best option is to go talk to your IM PD. They may be able to just move you over to the IM program. if they do that, you might finish in 3.5 years, less if they can give you more credit for your internship.

 

[gutonc]

Most combined programs are 5 years long, with IM/Peds being 4. if you try to drop out at the end of this year, you'll likely only get 6 months of IM credit (although that will depend upon how your intern year was structured). if you start as a PGY-1 again, then you'll finish in a total of 4 years - so you'll save one year.

Problem is, it's certainly too late to consider this year's match. Most programs are finishing their interviews shortly. No one is looking at applications now. So applying this year is almost impossible.

Your best option is to go talk to your IM PD. They may be able to just move you over to the IM program. if they do that, you might finish in 3.5 years, less if they can give you more credit for your internship.

 

[SwapperNoSwapping]

Most combined programs are 5 years long, with IM/Peds being 4. if you try to drop out at the end of this year, you'll likely only get 6 months of IM credit (although that will depend upon how your intern year was structured). if you start as a PGY-1 again, then you'll finish in a total of 4 years - so you'll save one year.

Problem is, it's certainly too late to consider this year's match. Most programs are finishing their interviews shortly. No one is looking at applications now. So applying this year is almost impossible.

Your best option is to go talk to your IM PD. They may be able to just move you over to the IM program. if they do that, you might finish in 3.5 years, less if they can give you more credit for your internship.

Thank you for the reply. Will definitely be talking to my PD one way or another. As far as the match goes I was looking at the upcoming 2023-24 Match not the current one - where I theoretically would be applying during my PGY2 vs gap year

 

[chessknt]

Thank you for the reply. Will definitely be talking to my PD one way or another. As far as the match goes I was looking at the upcoming 2023-24 Match not the current one - where I theoretically would be applying during my PGY2 vs gap year

What? A gap year? How are you planning to navigate that conversation without nuking your future?

I think this is one of the worst ideas I've read in a long time. You are already matched in the specialty you want, you can only screw yourself up at this point, you're not going to get something better. It wouldn't hurt to talk to your pd to try to get out of the X specialty if you don't want it any more but telling them you're just going to drop out next year to reapply to IM only is a nonstarter.

 

[Gastrapathy]

Stick with med/peds, do allergy, profit

 

[NotAProgDirector]

Thank you for the reply. Will definitely be talking to my PD one way or another. As far as the match goes I was looking at the upcoming 2023-24 Match not the current one - where I theoretically would be applying during my PGY2 vs gap year

If you look to transfer after your PGY-2, you should be able to get 12 months of IM credit. You could look for a PGY-2 spot instead -- no match for that, you would just need to look for a spot. If you were to try to match to a PGY-1, you'll finish in the same amount of time.

Go talk to your IM PD. You're not the first person who has wanted to drop out of a combined training pathway.

 

[dozitgetchahi]

What? A gap year? How are you planning to navigate that conversation without nuking your future?

I think this is one of the worst ideas I've read in a long time. You are already matched in the specialty you want, you can only screw yourself up at this point, you're not going to get something better. It wouldn't hurt to talk to your pd to try to get out of the X specialty if you don't want it any more but telling them you're just going to drop out next year to reapply to IM only is a nonstarter.

Totally agree. Rematching IM again sounds like a complete waste of time and a terrible idea.

There were med/peds people at my program that dropped out of one part of it (some people dropped IM and went peds only) - if you can do this, perhaps that makes some sense. But restarting IM only is just a really, really bad idea.

 

[mszzeta]

Hello SDN! Current PGY-1 at a combined X+IM program who has found him/herself gravitating towards IM, especially pulm/crit more and more each day. Honestly a pretty unexpected development but it is at the point where I see it as a definitive career path for me.

I believe that I came into the program with a good attitude, worked extremely hard, and have received positive feedbacks, however the program is quite limited in academic and research opportunities that I think reapplying will maximize my competitiveness for a fellowship.

For background info: USMD from a decent Med school in the northeast. Step 1: 24x, Step 2: 25x, honored in medicine sub I, and one pub during Med school from undergrad research but otherwise limited in research. Should be ok with obtaining a letter of good standing and positive letter of recs from attending I’ve worked with this year.

Planning on applying very broadly if I go down this route (150+?) to any university/academic/programs with pulm-crit fellowships and not limited by geography. Do I stand a chance at all or am I out of my mind?

You are a USMD and now in a university program I assume. You should have a very decent chance of matching into an adult pulm/ccm fellowship. Don't waste your time of re-matching.

One million step back. Even if you did end up with a far more prestigious residency with the best research powerhouse, your own research may still not work out simply because of the inherent uncertainty in research, or your mentors happen to not like you for whatever reason.......

 

[SwapperNoSwapping]

You are a USMD and now in a university program I assume. You should have a very decent chance of matching into an adult pulm/ccm fellowship. Don't waste your time of re-matching.

One million step back. Even if you did end up with a far more prestigious residency with the best research powerhouse, your own research may still not work out simply because of the inherent uncertainty in research, or your mentors happen to not like you for whatever reason.......

I am currently at a community program/university affiliated with not the best track record at pulm/crit match looking at past years’ lists - hindsight is 20/20 as I prioritized other factors making my rank list as fellowship did not seem AT ALL what I wanted to pursue…regardless I think the consensus from this thread is clear at this point. Think I’ve just been disappointed at putting myself in disadvantages with some short-sighted decisions so I’ve been way fixated on reversing that without looking at the big picture.