Starting Residency Off Cycle in September

[FutureDO2016]

Will any residency program take me if I finish rotations in August and cannot start residency until September 1st? I know most programs start late June/July 1st but I finish my rotations later. I applied to 30 family medicine programs and in early August and got 0 interviews and am anticipating not matching and possibly scrambling. I know there are usually 300+ family med positions left open usually after the AOA Match but still extremely nervous.

I know some residents get pregnant and take some months off and finish residency a few months after their peers but I am starting later due to finishing 4th year rotations later due to extra time spent studying to retake/pass Level 1. I had no choice as it was the school's policy to mandate time off to pass, which I did. I was depressed and it was one of the worst times in my life and when I did pass, I was just relieved I could continue but now the consequences of my test taking abilities are giving me sleepless nights. I'm very worried, stressed, and scared. Will I be able get residency? It's kind of scary going through medical school and then not ending up with a residency program and essentially having a useless DO degree since you can't practice I feel like I spent the last 8 years of my life after high school working towards this goal and now don't know what will happen.

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[FutureDO2016]

Not sure what will be the outcome...

A) Match or Scramble and start Sept. 1
B) Do research and and apply following year
C) Do a Masters in public health or health administration and apply following year
D) Do a mission trip abroad, volunteering internationally, work with a nonprofit?

I'm sure plenty of people have been in this situation, any advice or suggestions? Obviously Outcome A is the preferred outcome but who knows what will happen?

 

[yanks26dmb]

Worst case scenario, you dont match this year. Go do something awesome, work for some nonprofit, travel somewhere on the cheap, come back with more experience, etc. and match. In the grand scheme, i.e. 30 years from now, 1 extra year is not going to make a big difference...I assure you.

 

[NurWollen]

Not sure what will be the outcome...

A) Match or Scramble and start Sept. 1
B) Do research and and apply following year
C) Do a Masters in public health or health administration and apply following year
D) Do a mission trip abroad, volunteering internationally, work with a nonprofit?

I'm sure plenty of people have been in this situation, any advice or suggestions? Obviously Outcome A is the preferred outcome but who knows what will happen?

I wouldn't worry too much. You may not be able to be super picky, but there are tons of DO residency spots that go unfilled every year, even after the scramble. Mostly in FM and IM. I know SDN tends to emphasize the differences in quality between different programs and makes these AOA residencies out to be the worst of the worst, but honestly they'll more than give you what you need to be a competent physician. The whole issue is a bit overblown on SDN, IMHO.

 

[yanks26dmb]

I wouldn't worry too much. You may not be able to be super picky, but there are tons of DO residency spots that go unfilled every year, even after the scramble. Mostly in FM and IM. I know SDN tends to emphasize the differences in quality between different programs and makes these AOA residencies out to be the worst of the worst, but honestly they'll more than give you what you need to be a competent physician. The whole issue is a bit overblown on SDN, IMHO.

Out of curiosity...what happens to a person who ends up in one of these FM/IM residencies...if they REALLY dont want to go into that field, is it easy to switch to a different residency the following year? And does that first year count towards residency if its in a field that requires an intern year?

 

[NurWollen]

Out of curiosity...what happens to a person who ends up in one of these FM/IM residencies...if they REALLY dont want to go into that field, is it easy to switch to a different residency the following year? And does that first year count towards residency if its in a field that requires an intern year?

IM probably would count... but I don't think it's easy to switch from one residency to another after a year. Not impossible, but rare. Unless the first year is a preliminary spot or transitional year. That's obviously a bit different.

 

[hallowmann]

Not sure what will be the outcome...

A) Match or Scramble and start Sept. 1
B) Do research and and apply following year
C) Do a Masters in public health or health administration and apply following year
D) Do a mission trip abroad, volunteering internationally, work with a nonprofit?

I'm sure plenty of people have been in this situation, any advice or suggestions? Obviously Outcome A is the preferred outcome but who knows what will happen?

Normally, I would recommend talking to your school about an LOA so that you can enter the match, but in your case rather than delaying yourself from the start, you'd probably be better off trying to find a place willing to take you off schedule. Not being able to start July 1st is a big issue when applying for the match (in many cases you can't apply for the match if you aren't starting on July 1st).

This is going to be tough, and you really won't be able to rely on the same methods used by most of your class to secure a residency (i.e. the normal match process). You are really going to have to cold-call/email programs. 30 isn't going to cut it, it should be more like 100. You basically need to contact them and ask first, do they accept residents off-schedule and second do they accept residents that have a previous board failure. Then you'll have to apply to the appropriate programs, and make it clear that you're interested in securing a position to start in Sept, even if it means signing a contract before the match.

For programs you're in close proximity to, I'd ask to set up a meeting with the PDs, explain your situation, ask if they have any advice, or if there is something you can do to improve your chances, etc. They may just give you good advice, or if they don't offer to consider you, they may at least be able to point you to programs/PDs that would.

Now all of this is time-consuming and honestly not going to be easy, but it's what you need to do to get out ahead of this. If you just sit back and hope you can scramble, your chances will be lower of actually finding a program.

That all said, I know of multiple people who have secured spots off schedule. They couldn't do it in the match, but were able to do it by contacting programs directly or scrambling (which more or less is the same thing). I even know one person who's starting at an FM program in Sept. this year, because they are graduating off schedule. It's possible, and if you put in the work, you should be able to find something. Aim for new programs and ones that have historically not filled their spots.

Out of curiosity...what happens to a person who ends up in one of these FM/IM residencies...if they REALLY dont want to go into that field, is it easy to switch to a different residency the following year? And does that first year count towards residency if its in a field that requires an intern year?

1) They live with it and find parts of the job they like (or they do a fellowship in something more tolerable to them). I honestly like FM (and apparently IM), but I guess if I didn't like patient contact or something, the job would drive me crazy.

2) I wouldn't call it easy, nor would they really have many options or could they be particularly picky, but it is possible (in some fields 10-15% of residents might change programs, with a smaller number changing field completely). The real issue you have is funding when you start at a new program that is longer and/or that might not accept your first year as training credit. In that case the program might only get 2/3 of the money to train you as they would someone else for those extra years.

3) This is very program and field specific. Some programs would accept say a first year in IM as a pre-lim medicine year for Gas/Rads/Neuro/PM&R for example, while others might only accept part of it. For FM, it really depends on the makeup of your PGY1. Other programs might offer you only some credit, whereas others will expect you to start completely over again.