SOAP 2020 Thread

[NotAProgDirector]

With average scores, minimal research, and needing a visa your chances of getting a vasc surgery spot in the US is zero.

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[shelf exam 1959]

@ aprogdirector.
step 1 -213, step 2 -229, CS - Pass and step 3 222, ( all in the first attempt ) Canadian, any advice on how to prepare me for the next match. thanks,I did not match this year. Caribbean medical school, 2 years of rotations in the US, Any advice will be appreciated.

 

[Heeach]

With average scores, minimal research, and needing a visa your chances of getting a vasc surgery spot in the US is zero.

Thank you so much for the advice

Does it make any difference if I am Canadian graduating from a Canadian medical school with a clinical vascular surgery experience in Canada?

 

[NotAProgDirector]

Thank you so much for the advice

Does it make any difference if I am Canadian graduating from a Canadian medical school with a clinical vascular surgery experience in Canada?

No. Unless "clinical vasc surgery experience" = residency. And even then, probably not.

 

[NotAProgDirector]

@ aprogdirector.
step 1 -213, step 2 -229, CS - Pass and step 3 222, ( all in the first attempt ) Canadian, any advice on how to prepare me for the next match. thanks,I did not match this year. Caribbean medical school, 2 years of rotations in the US, Any advice will be appreciated.

If you've already taken and passed S3, it means you've already graduated, perhaps quite awhile ago. How many times have you tried to match? What field(s)? How many applications did you send out, and get?

 

[shelf exam 1959]

If you've already taken and passed S3, it means you've already graduated, perhaps quite awhile ago. How many times have you tried to match? What field(s)? How many applications did you send out, and get?

2019 graduate, just this match, passed step 3 I took recently got the results only last week.

 

[shelf exam 1959]

2019 graduate, just this match, passed step 3 I took recently got the results only last week.

I applied to IM and Family
and around 125 applications

 

[NotAProgDirector]

You've got weak-ish USMLE scores, and need a visa, so that's going to limit your options. But if you apply to reasonable programs, you should usually get more interviews than that.

Why did you grad in 2019 and not apply for the 2019 match? I feel like there's still part of the story you're not including.

 

[shelf exam 1959]

You've got weak-ish USMLE scores, and need a visa, so that's going to limit your options. But if you apply to reasonable programs, you should usually get more interviews than that.

Why did you grad in 2019 and not apply for the 2019 match? I feel like there's still part of the story you're not including.

I graduated only Sep in 2019. This is first match after my grad. there nothing to hide let me know

When you say Reasonable program can you plez explain a little bit more so that I can follow that

 

[NotAProgDirector]

I graduated only Sep in 2019. This is first match after my grad. there nothing to hide let me know

When you say Reasonable program can you plez explain a little bit more so that I can follow that

Why did you graduate in Sept? Most people would graduate in May.

Reasonable programs = programs that are in non-competitive areas of the country where students from your school have placed before.

 

[shelf exam 1959]

okay thanks for the explanation, will do in the next match. I graduated on Sep 6th, 2019 that is when my school graduation date after finishing all the required steps.

 

[NotAProgDirector]

Not trying to torture you, but something sounds wrong. You should have taken your steps in a timeline that allowed you to graduate on cycle. If you required extra time for the step exams, if you didn't schedule your exams in a timely fashion, or if you failed some and had to retake -- all of those could be problems.

 

[GoSpursGo]

okay thanks for the explanation, will do in the next match. I graduated on Sep 6th, 2019 that is when my school graduation date after finishing all the required steps.

To echo @aProgDirector , it seems like either your school failed to impress upon you the importance of taking the USMLEs in an appropriate timeline, or you decided to take extra time to study which resulted in you graduating off-cycle.

In any event, that can't be changed now, but what you have been doing since graduation is hugely important. If you've been doing some sort of medically-related work in Canada or near your med school, then you potentially could just cast an even wider net next year and hope that step 3 helps. If you've been sitting at home hoping that this year's match would work out... then you're a re-applicant with a time gap in your CV, and that would be a problem. Given the current state of affairs in the world, I'm not even sure how you would go about trying to find a meaningful job between now and the next match cycle.

 

[shelf exam 1959]

Thanks gospursgo. Can you also explain where to find the research position and how to go about it .

 

[ThoracicGuy]

okay thanks for the explanation, will do in the next match. I graduated on Sep 6th, 2019 that is when my school graduation date after finishing all the required steps.

Also of importance is probably the school you are from as well. Places like St. George and Ross will place people better than some of the other schools in the Caribbean. Finding places were your school's grads have matched is probably the best thing to search for to help guide your chances, second being places that take caribbean grads in general.

 

[washboardEarth]

i just want to say to those who didn't match/soap this year that my heart really goes out for you. the SOAP thread here and on reddit were really helpful. i feel guilty in a way because . this process is messed up, not you. it is ridiculous that we have 2000+ U.S. citizens going unmatched and 4000+ FMGs entering . no hate to FMGs, i am a US citizen today because my parent was one. but to cast out the US citizens who have mortgage-level of debt is more signs that this is a failure of a country. just like veterans living homeless on the street. i am so sorry. it could have been you in the SOAP spot and me posting about post-match scramble. there is no coherence to this process unless you are a completely brainwashed med student who gets 230+ on steps (with the aid of stimulant prescriptions, if wanted) and kisses butt on rotations. i wish you all the best.

 

[GoSpursGo]

Thanks gospursgo. Can you also explain where to find the research position and how to go about it .

Wish I could tell you. Regular job posting websites like Indeed or LinkedIn may have some leads, but a lot of times these kinds of positions are word of mouth. If there are any recent grads from your school at university programs who can ask around for you, you might get lucky there.

Realistically, it's about using every connection you have, not getting discouraged by getting told "no" a lot, and ultimately getting lucky that one slim-chance lead pays off in the end. You also need to be willing to cold-email and cold-call places that you have only a tangential connection to. And therein lies the problem--if you don't have one of these jobs NOW, it would be very hard to find one and get any meaningful experience by 9/15 even in a normal environment.

What *have* you been doing since graduation?

 

[rokshana]

Amazed it took this long for someone to bring up the inevitable US vs FMG post...smh...

 

[shelf exam 1959]

Wish I could tell you. Regular job posting websites like Indeed or LinkedIn may have some leads, but a lot of times these kinds of positions are word of mouth. If there are any recent grads from your school at university programs who can ask around for you, you might get lucky there.

Realistically, it's about using every connection you have, not getting discouraged by getting told "no" a lot, and ultimately getting lucky that one slim-chance lead pays off in the end. You also need to be willing to cold-email and cold-call places that you have only a tangential connection to. And therein lies the problem--if you don't have one of these jobs NOW, it would be very hard to find one and get any meaningful experience by 9/15 even in a normal environment.

What *have* you been doing since graduation?

I have been tutoring for step 1 and step 2 and step 3 students on skype. that is the only option I have for now

 

[GoSpursGo]

I have been tutoring for step 1 and step 2 and step 3 students on skype. that is the only option I have for now

Start reaching out to alumni from your school at programs across the country now. Honestly not sure what you can hope to get at this time, but you need to find something that is going to improve your application from when you were unsuccessful this year. Having step 3 will help, and you can apply more broadly, so that's something... but ideally you would have something more meaningful on your CV for this time period.

Of course, nobody knows how PDs will view a gap in the CV during this time period given how crazy the world is with COVID right now. You certainly wouldn't be the only one.

 

[shelf exam 1959]

Start reaching out to alumni from your school at programs across the country now. Honestly not sure what you can hope to get at this time, but you need to find something that is going to improve your application from when you were unsuccessful this year. Having step 3 will help, and you can apply more broadly, so that's something... but ideally you would have something more meaningful on your CV for this time period.

Of course, nobody knows how PDs will view a gap in the CV during this time period given how crazy the world is with COVID right now. You certainly wouldn't be the only one.

Will do already did with no positive response so far, will keep doing contacting the all the contacts made during my rotations. thanks for all the right advice.

 

[shelf exam 1959]

Contact all universities, especially the Ontario one's because they're more familiar with IMGs.

thanks, will do

 

[NotAProgDirector]

You still have not explained why you graduated in Sept when medical schools almost always graduate in May. Some of the Carib schools have a winter start, but then you graduate in Jan.

Tutoring for the steps isn't going to get you much value in the application process. In fact, if I was interviewing you I'd ask how you became a tutor if your scores were all below average -- I would expect that most people would want to be tutored by someone who did well. You should be prepared for that question.

You should try to get clinical experience. It's not easy. Being a paramedic is sometimes an option, especially if you live in a more rural environment -- sometimes the fire department will train you for free. Volunteer clinical work, if you can find it, can be helpful. As already mentioned, research experience is a plus. Just calling around and saying "do you have any research" is unlikely to be helpful -- you need to figure out what you're interested in, find out what local people are working on, and find a way to convince them that you'd be helpful. There's a good chance that any research would be unpaid. Unfortunately, if you want a residency in the US all of this (clinical experience, research, volunteer) would be better in the US, but if you need a visa that will be impossible, and COVID is going to make all of this very difficult.

From your discussion on this thread, I still get the sense that there's part of the story you're not telling us.

 

[LovelyNutella]

I have a few research project available. Message me if you can help (authorship credit will be given, unpaid)

 

[shelf exam 1959]

I have a few research project available. Message me if you can help (authorship credit will be given, unpaid)

Yes, interested let me know how to take this forward.

 

[shelf exam 1959]

You still have not explained why you graduated in Sept when medical schools almost always graduate in May. Some of the Carib schools have a winter start, but then you graduate in Jan.

Tutoring for the steps isn't going to get you much value in the application process. In fact, if I was interviewing you I'd ask how you became a tutor if your scores were all below average -- I would expect that most people would want to be tutored by someone who did well. You should be prepared for that question.

You should try to get clinical experience. It's not easy. Being a paramedic is sometimes an option, especially if you live in a more rural environment -- sometimes the fire department will train you for free. Volunteer clinical work, if you can find it, can be helpful. As already mentioned, research experience is a plus. Just calling around and saying "do you have any research" is unlikely to be helpful -- you need to figure out what you're interested in, find out what local people are working on, and find a way to convince them that you'd be helpful. There's a good chance that any research would be unpaid. Unfortunately, if you want a residency in the US all of this (clinical experience, research, volunteer) would be better in the US, but if you need a visa that will be impossible, and COVID is going to make all of this very difficult.

From your discussion on this thread, I still get the sense that there's part of the story you're not telling us.

This is my school calander for your review ,
Fall 2019
First Day of Enrollment September 2, 2019

Orientation and Registration September 2, 2019

First Day of Classes September 3, 2019

Graduation - no ceremony September 6, 2019

Tuition Due for Next Semester December 1, 2019

Last Day of Classes December 11, 2019

Basic Science Awards Ceremony December 12, 2019

Reading Day and Final Exams December 11–13, 2019

 

[NVO]

This is my school calander for your review ,
Fall 2019
First Day of Enrollment September 2, 2019

Orientation and Registration September 2, 2019

First Day of Classes September 3, 2019

Graduation - no ceremony September 6, 2019

Tuition Due for Next Semester December 1, 2019

Last Day of Classes December 11, 2019

Basic Science Awards Ceremony December 12, 2019

Reading Day and Final Exams December 11–13, 2019

What

 

[NotAProgDirector]

Very interesting. This is highly atypical. My apologies if my posts came across negatively.

Looks like your school has graduation options in Sept, Jan, March, and May (which appears to be the "main" graduation date)

So now much depends on whether you ended up with a Sept graduation because you started off cycle, or if you took more than the usual 4 years to get to graduation.

 

[shelf exam 1959]

Very interesting. This is highly atypical. My apologies if my posts came across negatively.

Looks like your school has graduation options in Sept, Jan, March, and May (which appears to be the "main" graduation date)

So now much depends on whether you ended up with a Sept graduation because you started off cycle, or if you took more than the usual 4 years to get to graduation.

I took 4 years and 2 months

 

[shelf exam 1959]

I took 4 years and 2 months

Also, I have to wait for graduation ( 3 months ) after finishing all the required steps and rotations due to my graduation date.

 

[GoSpursGo]

What are your thoughts on this matter?

How about let's not? That discussion never ends well, and really isn't the point of this thread.

 

[icykelp]

It's called a DISCUSSION FORUM. To discuss and debate. Not to regurgitate the same opinions of the collective. Oh wait, this is a for profit website that aims to be the most advertiser friendly space for those looking to market to aspiring healthcare workers. No wrong think or harassment allowed - unless you are a vetted member with thousands of posts.. in which case shake your head in every post

That topic has been discussed and debated plenty of times.

Other - Allow doctors in the the US not in residency to help fill the gap in the COVID pandemic

The US State Department has stopped processing J1 visas as of 03/20/20. If IMGs living abroad cannot start on July 1st, we will be down 4,200 doctors in the middle of the most deadly pandemic of our lifetime. Please sign my petition urging the ACGME, NRMP, and CMS to allow unmatched American...

forums.studentdoctor.net

Why are so many non US IMG filling residency spots?

Ok so I am currently a rising 4th year medical student currently getting ready to apply to the upcoming match cycle and I have noticed something very upsetting over the past year since I started clinical rotations. I am at a Caribbean medical school, and at the city hospital I have been rotating...

forums.studentdoctor.net

Take a look at those dumpster fires if you were curious.

 

[ThoracicGuy]

It's called a DISCUSSION FORUM. To discuss and debate. Not to regurgitate the same opinions of the collective. Oh wait, this is a for profit website that aims to be the most advertiser friendly space for those looking to market to aspiring healthcare workers. No wrong think or harassment allowed - unless you are a vetted member with thousands of posts.. in which case shake your head in every post

 

[ThoracicGuy]

I talked with my dean and unfortunately I can't extend graduation because I already completed my M4 requirements. I started studying for Step 3 but can't take it until after I graduate per FSMB rules. I have tried contacting some hospitals for externships but haven't heard back. I've been checking websites to find open positions everyday but there haven't been any openings. Anything else you think I should do?

Are you US based md or do or something offshore? Most MD schools seem to not have to big of and issue with delaying.

Keep watching, there can always be spots that open up with some people not being able to start.

 

[ThoracicGuy]

I'm at a US based MD. I talked with my dean and she said I can't delay because I finished my M4 requirements. Not sure what I can say to convince her otherwise?

It seems unusual that they wouldn't want to do everything possible to help you match. By staying in, you can continue to do rotations, get experience, and more LOR. Did your dean give any other reasoning other than just finishing requirements?

 

[NotAProgDirector]

In other posts, you mentioned that you failed at least 2 of the steps, and the wording makes me think it might be several times. Your dean is correct that a year of research is unlikely to help. Taking S3 might, but I worry that you've struggled with other steps and S3 covers material best learned in internship, taking it without an internship is risky. Fail it and you'll have zero chance in the upcoming match. Seems like you applied for psych, which you're very unlikely to get with that type of performance unfortunately.

 

[ThoracicGuy]

Unfortunately, my school isn't very helpful. It's a low ranked MD and they didn't really help advocate for us during SOAP. Even now the most they say for me to do is keep looking on those websites for positions. My school even has a psych program which I interviewed at but they didn't take me.. She said I can't just continue to do more rotations and pay more tuition indefinitely. Once I complete requirements then I must graduate. She said some students take a LOA to do research but that's only for people applying for Orthopedics/Neurosurgery and she doesn't think that would be the best in my case.. The main reason I didn't match likely is because I have multiple Step attempts from previous failures. If I have to graduate, I was going to try to take Step 3 and pass but then I'm not sure how to continue clinical involvement and improve my app?

You should try to talk to your local psych PD once things are a bit calmer and all for some feedback. It would probably be worth asking what you could do to improve your application for next year. Might also be worth taking to the local FM PD as well.

 

[GoSpursGo]

I already contacted them, we're supposed to talk sometime in the next two weeks. Our school doesn't have a FM residency unfortunately..

Honestly, you need to stop thinking that psych is going to happen. You were a longshot this year, and you got a clear answer this year that you are not competitive for that specialty. Without extending your graduation, you will only be LESS competitive next year.

Time to try and see if you can do an FM rotation (or two) in the next month before graduation and start crafting an application for that next year.

 

[GoSpursGo]

I applied to FM programs this year as well but got no interviews. I think maybe since I did mostly Psych aways and 1 FM Sub-I they didn't think I was committed enough? I'm not sure. Unfortunately, our school cancelled all clinical rotations for the rest of the year. How can I convince my school dean to allow me to extend?

Oh yeah. I forgot about COVID.

I don't know what to tell you. My only thought is to spin doing an LOA for research because you're in an unusual situation where you find yourself needing to change your specialty choice. In a normal year you would use these last couple of months to get experience in that specialty, but COVID is making that impossible. So you need to do SOMETHING to show your commitment to that specialty, and you could use that time to presumably get more clinical experience in that field.

I have no idea if that will work.

 

[GoSpursGo]

Yeah I think if I do research it would be during a LOA so I wouldn't be technically enrolled in school and able to do away rotations.. Do programs filter you out in Sept if you graduated in May of that year?

You definitely wouldn't be able to do a formal rotation, you might need to get creative in finding ways to make connections with FM physicians who could write you letters. Honestly not sure exactly how you would do that, but you'd give yourself time, and you need to find SOMETHING that will make your application stronger than it was this past year.

Programs won't automatically filter you based on year of graduation, but there are other red flags on your application that may get you filtered. Honestly, there's not much you can do about it--you just have to apply broadly and hope that you can find a program that'll take a chance on you.

 

[icykelp]

In that case I'm not sure how much a LOA would help? I'd have to do the same thing as a graduate - being creative to make connections with FM physicians. I actually had a LOA between 3rd and 4th year where I did psych related research. I was originally c/o 2019. Do you think extending again would be worth having another extension?

You should go to the AAFP national conference if it is held this year. As of right now it is scheduled to be between Jul 30 and Aug 1 in Kansas City. You'll get a chance to meet a lot of program directors in person and get to explain your situation. It'll help you show interest prior to the beginning of the match season.

It also shows commitment to FM, which a lot of programs look for. You might be able to find a few programs willing to take on observers etc.

Edit: There is also a smaller Midwest Family Medicine conference ( Family Medicine Midwest Conference ) and a Northeast fam med conference ( Exhibitors ). Like the main AAFP conference, these also have residency program booths.

 

[GoSpursGo]

In that case I'm not sure how much a LOA would help? I'd have to do the same thing as a graduate - being creative to make connections with FM physicians. I actually had a LOA between 3rd and 4th year where I did psych related research. I was originally c/o 2019. Do you think extending again would be worth having another extension?

You didn't tell us that you'd already played the LOA for research card once... I don't know what to tell you, you're in a tough situation. Taking 6 years to graduate would be a red flag in and of itself, on top of the other red flags that you already have.

There's probably no "right" answer, and it's not clear they would let you take another LOA anyways. Talk with your school and your FM clerkship director to see if you could do anything through the medical school while on an LOA or after you graduate. Keep a close eye on those websites, and apply for literally any position that becomes available.

 

[icykelp]

Thanks, I'll look into it. I went to the APA conference last year but I felt like the PDs didn't really remember me since there were so many people. Is this one different/ have you heard of it helping people?

I can't speak for others, but it helped me. I spoke with about 20 programs. I could only attend a day and a half due to prior commitments.

Instead of rushing from booth to booth, I researched the programs I was interested/qualified for and spent more time talking with the residents/PDs there. I felt this worked out better for me than had I just tried to show my face for a minute at 100 programs.

I emailed each PD/PC once I got back and about 60% responded. Out of these I was able to get 3 interviews. I only had a total of 6 interviews, so half my interviews were from having been at the AAFP. I am also a non US-img with scores in the 210s/220s.

I was unable to go to the smaller regional midwest/northeast conferences, but I am quite sure they would help similarly.

 

[icykelp]

That's awesome. I'll definitely look into this, the only hesitation is that the price is kind of high. which day did you attend?

I went on Saturday and stayed till about 12pm on Sunday.

If there is only one day that you could go, I would highly recommend Saturday. The programs are usually setting up on Friday and tearing down on Sunday.

 

[NotAProgDirector]

You really need to try to reinvent your application. You have a year of psych research, mutiple psych aways. You need something that is FM focused -- whether it's volunteering with some FM's, or something.

Your school is not going to let you take an LOA, or anything. They are very clear -- you've completed your schooling, and you'll graduate.

 

[Reperfused]

So, FM is easier to get into compared to Psych?

That was not the case atleast until a few years ago, it was the other way round. What happened?

 

[GoSpursGo]

albeit not as broadly as I should have

I think this, and as you said the fact that your app was screaming that FM was your backup, was the issue rather than FM being competitive.

Psych has become increasingly competitive in the last few years as a lifestyle-friendly specialty. It’s still certainly not “competitive” like surgical sub specialties or radiology, but definitely a step up from FM—yes they get a ton of apps, but the quality of the applications is also lower. In any case, I think you did just about everything you possibly could to compensate for your otherwise weak application including taking a research year, and if you couldn’t get a psych spot this year I think it’s safe to say it’s not going to happen.

 

[GoSpursGo]

If I end up passing Step 3 on the first try, I feel like that would somewhat compensate for my attempts. You think I still shouldn't try for psych along with fm and im then either?

How many interviews did you get this cycle?

Talk with your psych PD and ask for brutally honest advice, but just passing step 3 I don't think would be enough given that you're presumably going to have a gap where you're not doing anything clinical which will be a negative. And as mentioned above, given your past performance passing step 3 on the first try is FAR from a guarantee, and a failure would absolutely crush any chance you might have for matching in any field.

 

[GoSpursGo]

4 interviews, yes I'm hoping to do post-graduate rotations in psych, family and IM in addition to step 3. I talked with my associate PD but she said she couldn't reveal my scores on application, interview, etc., whether my scores were low in a certain category, or ranking because it's confidential?? and she didn't really identify any specific reason for why I didn't match... just said to pass Step 3, clinical experience, research etc. like everybody else is telling me. I'll hopefully be able to talk with the main PD sometime this week or next but honestly don't know how helpful he will be either. I understand that Step 3 is no guarantee but I would only take it if I am comfortable passing 20-30 points higher on the practice test than the minimum passing score. I heard Step 3 is similar to Step 2 CK and I was able to score in the 220's on Step 2 CK after taking a prep course so I was planning on studying my Step 2 CK notes/lectures and doing Step 3 UWorld for theory/CCS and or course practice tests.

It honestly sounds to me like she doesn’t want to be the bad guy who has a frank conversation about you not being competitive for the specialty that you were hoping for. You clearly just want To hear that psych is still on the table, so at the end of the day you’re going to do whatever you want.

Your chance isn’t 0%, but I would wager it’s not 80-90% either even if you pass step 3. I feel like you went all out this year and were unsuccessful, and if a full year off doing psych research didn’t help I’m just not sure that step 3 and a few more rotations will really make a huge difference. The downside to failing to match a second time is so dire that I would recommend fully committing to reinventing yourself as an FM/IM applicant rather than half-hearted attempt at all 3. But that’s just me.

 

[ThoracicGuy]

Ok, thanks for the advice. I think that makes sense to focus on one specialty to show commitment and I agree failing to match a second time would be horrible more than the situation I am already in which is hard to fathom...

It's not unknown for FM or IM residents to get a spot in psych as a pgy2, so that could be a way in later. You need to go all in on FM or IM, though.