If you dont match, is it better to begin the prelim year and either hope a spot opens up/apply again for next year...or to take a year off at that point and do research to try and better your application? My concern with going forth with a prelim year is that it hasn't really changed my application for the next match, unless I am able to find research or do something else at the same time. Are there any other options about what to do, if you're still hoping to go into radonc? I havent gone through the match yet, but Im just trying to figure out a game plan. Thanks a lot!
If you dont match..
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I believe if you match into a prelim spot... you are bound by contact to go. If you don't show up, you will be banned from the match.
However, having said that... I am also curious on what is the best course of action to take if you fail to match into PGY-2 (radonc) but successfully match into PGY-1 (prelim/TY)
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Best strategy would be to continue forward because no matter what, you need to do a pre-lim year anyway. Once you have that done you can find a position that opens up anytime. Sometimes outside positions need you to fill immediately.
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It depends on what your app looks like. If you made a sincere effort rotating at programs, doing research and getting LORs, it's possible that you just had bad luck. It happens.
By doing your prelim year, you are eligible for any spots that open up at programs during the year, as you would essentially be able to start there that coming July. Many people get rad onc spots this way when they are unsuccessful during their initial fourth-year match.
On the other hand, if you did no research at all, and just took a blind shot at rad onc, that year might be more helpful
This is true but you can choose to not rank any prelim years separate from advanced programs.
I think medgator's assessment is pretty accurate. Another thing to consider is finding a research job. I don't know how easy that is (maybe it is easier than I think). If you don't have that much research experience, are there a lot of opportunities where someone is going to pay you to do research that will be useful on your application? As I said I honestly don't know, but it would be worth finding out before deciding you want to do a research year because you will have bills to pay.
You can also work on buffing up your research forth year. Even after applications have gone out you can update your application and if you don't match if you have been working on research then you stand a better chance next time or if a position opens up outside the match. Additionally, some internships will allow you to do a month of research and some internships have elective months that are light enough to allow research in addition to clinical duties.
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Dont rank a prelim year indepdently from a RadOnc match unless it is linked to a path to something else you want to do.
Repeat interviews during intern year would be impossible if not ridiculous.
If you rank a prelim year and then dont match, and something opens up (good research opportunity, etc) then you are bound to that contract and have to proceed.
The only advantage I can see is going ahead and getting intern year done so you can take step 3 and have it over with.
Your application will not look any better after completing a prelim year, but it may look better if you find a good opportunity for that year between not matching and reapplying.
Repeat interviews during intern year would be impossible if not ridiculous.
If you rank a prelim year and then dont match, and something opens up (good research opportunity, etc) then you are bound to that contract and have to proceed.
The only advantage I can see is going ahead and getting intern year done so you can take step 3 and have it over with.
Your application will not look any better after completing a prelim year, but it may look better if you find a good opportunity for that year between not matching and reapplying.
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I would disagree with the advice below. If you don't match in Rad Onc the first time around, then your LAST resort should be going through the Match a second time. If you are successful in matching the 2nd time, then you will have one year of "dead time" before your PGY-2 starts. Therefore, you will have to do another preliminary year (!) or otherwise earn some money (e.g. post-doc, clinical research).
Instead of relying on the Match the second time, you should keep a sharp eye out for available PGY-2 slots. These open up for many reasons, such as (1) a program is expanding or (2) a program has a resident unexpectedly leave. If you are successful, then you can "slide" straight into a PGY-2 after you complete your internship and you will not have wasted one year.
The key to doing this is being diligent about looking for openings. You can use ARRO, the ASTRO career center, SDN, and word of mouth. I know several residents who became Radiation Oncologists through this route.
Instead of relying on the Match the second time, you should keep a sharp eye out for available PGY-2 slots. These open up for many reasons, such as (1) a program is expanding or (2) a program has a resident unexpectedly leave. If you are successful, then you can "slide" straight into a PGY-2 after you complete your internship and you will not have wasted one year.
The key to doing this is being diligent about looking for openings. You can use ARRO, the ASTRO career center, SDN, and word of mouth. I know several residents who became Radiation Oncologists through this route.
I would also disagree with the advice never to rank prelim alone. In addition to what Gfunk said, you can interview during a prelim year. I know there was one applicant this cycle who was doing a prelim surgery year and still going to interviews. If you let everyone know your situation up front people are usually willing to work with you.
Doing a prelim versus a TY may be better in that if you decide to do medicine you already have a year under your belt whereas a TY likely will not count.
As discussed above it is not unreasonable to consider doing something besides a prelim year, but for most applicants I think the better choice would be to do the prelim year.
Doing a prelim versus a TY may be better in that if you decide to do medicine you already have a year under your belt whereas a TY likely will not count.
As discussed above it is not unreasonable to consider doing something besides a prelim year, but for most applicants I think the better choice would be to do the prelim year.
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How competitive are prelim surgery years? Would you apply directly to these programs if you were concerned about not matching or do you scramble into one? And do you apply while letting them know that it is an "interim" plan or do you apply as if you are planning on going into surgery?
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Prelim surgery programs are actually the easiest prelims to get into. They regularly fill through the scramble but like to fill upfront through the match if they can. And its a prelim. They are usually cool about rad onc being your ultimate goal. They love to hear that you think your prelim year in sry would give you a better understanding of anatomy and acute care and how that would be as if not more applicable to your career in rad onc as a year in medicine. There are arguments to be made either way. Of coarse, keep in mind, a surgery prelim year is more intense than a med year. But, if you like the OR, think about it.
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I'd like to throw a few caveats out there regarding prelim surgery years.
(a) there are some good ones out there but many of them turn you into a mega scut monkey with minimal OR time; they have their own categorical residents who will likely get the most OR time; a frequent complaint of prelim surgery residents is the high percentage of time spent on minimally operative rotations such as trauma
(b) if you don't match into Rad Onc the 2nd time and decide to pursue categorical surgery it is VERY difficult for you to simply go from PGY-1 to PGY-2; in the worst case scenario you may be forced to REPEAT your prelim surgery year before you are even considered for a categorical spot
Overall, I think you'd be better off doing prelim medicine instead.
(a) there are some good ones out there but many of them turn you into a mega scut monkey with minimal OR time; they have their own categorical residents who will likely get the most OR time; a frequent complaint of prelim surgery residents is the high percentage of time spent on minimally operative rotations such as trauma
(b) if you don't match into Rad Onc the 2nd time and decide to pursue categorical surgery it is VERY difficult for you to simply go from PGY-1 to PGY-2; in the worst case scenario you may be forced to REPEAT your prelim surgery year before you are even considered for a categorical spot
Overall, I think you'd be better off doing prelim medicine instead.
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My backup plan (if I didn't match into radonc) was to match into a TY (which you can do by concluding your "primary", or "advanced" rank order list with some TY programs) - and during TY look for additional open slots. I came to favor this strategy after a certain PD (from a pretty nice program) told me that they have one or two spots that ACGME had approved for them, but did so too late for the spots to be eligible for filling via Match (or SOAP). Rad Onc is a growing field with a new spots cropping up all the time, so I was hoping to secure one of these spots.
Regarding interviewing during your TY - I obviously can't speak from experience, but a TY PD assured me during the interview that they do look favorably upon TY residents interviewing for advanced positions (if they hadn't matched into one).
Regarding interviewing during your TY - I obviously can't speak from experience, but a TY PD assured me during the interview that they do look favorably upon TY residents interviewing for advanced positions (if they hadn't matched into one).
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I just went through match and gave the "back-up plan" question considerable thought. My feeling was that while radonc is my first choice by far, it is not the only field that I would be happy doing. Furthermore, with a 70% match rate there was a strong possibility I wouldn't get it. Think about what it is you like about radonc and look at specialties that offer similar qualities. That's a topic for another forum. The point is, your chances of matching are highest during your first match cycle. If you plan to re-apply to radonc the following year your chances of matching are much lower regardless of what you do with your CV be it research or away rotations. If you don't get in the second time around you have now put off the beginning of your residency until 3 years post-graduation. That's the length of a medicine or peds residency. My understanding is that the NRMP match agreement is valid only for the first year of residency meaning that if you do get into radonc the second time around, you can leave your program without incurring a violation. If you don't get in, then you are on track for your second choice career. Applying to a second residency is more work and money, but believe me, I slept much better for the past 8 months knowing that I would have a job and career either way it went on match day. Plus, it doesn't mean you can't keep applying to radonc during or after (if you think of it like a fellowship it's only 1 year longer than med-onc) your back-up residency. I was reluctant to give up my chance to scramble, but this year it turned out that there was only 1 empty spot in the entire country. I did hate having to lead a double life with the two specialties (keeping them secret from each other).
According to the match results released last week for the 2012 match, there were only two non US seniors who matched this year (and there were large number of applicants). Going through match again will likely not land you a spot. If I had not matched, I would have done a prelim med year and tried to find openings outside the match. If that didn't work out, I probably would have completed a full medicine residency (each year keeping my eyes peeled for openings in rad onc programs).
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hey, where are the results posted? couldn't find anything on NRMP website...
Unfortunately, there will not be a charting outcomes (as this is only done every other year), but here are the results that were released on match day. It looks like 2/35 non-US seniors matched this year.
http://www.nrmp.org/data/datatables2012.pdf
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I saw this in the derm forum but thought it was solid advice for those in rad onc. The nice thing about derm is that they seem to have these established fellowships leading to residency tracks:
What do you do if you don't match? In recent years past, about forty percent of derm applicants have found themselves in this situation, and if you are still committed to derm, there are numerous ways to handle the aftermath.
First, however, I hope you matched into an IM prelim internship, ideally a name-brand one. Not only do you learn more medicine in an IM year, but also you want to avoid looking lazy during your second appearance on the dog-and-pony show. In my view, nothing is worse than reapplicants who have to reveal that they are in a transitional internship, and during past match cycles, that point was specifically brought up as a mark against at least one reapplicant in casual conversation amongst residents, who were coming up with their own rank lists. No matter how unfair you think that is, there are those in the derm world who still sniff at transitional years, and you'd rather avoid being on anyone's pet peeve list as soon as they look at your ERAS.
Certainly, some will argue that a transitional year will give you the downtime to pursue more derm research or to rotate through a derm department, and I can't disagree that this may be true. So, ultimately, you'll need to weigh what you need to do to buff up your resume for that second go-around, but keep in mind that you're being interviewed by people who see themselves as having jumped high hurdles to get to residency, one of which being a prelim internship.
There is no need, however, to put yourself through the wards scut of a surgical prelim, even if you want to do Mohs. You won't see the light of the OR lamp as a non-surgical intern heading towards derm. And you learn everything you need to know about Mohs surgical techniques during your Mohs fellowship; when you're applying to that, they only care about what you learned during your derm residency.
Second, you may want to consider a research fellowship in dermatology, many of which attract non-matched applicants (versus people who haven't yet entered the derm match, or derm residency graduates). Do your research wisely, because the last thing you want is a difficult mentor more interested in glory for himself and working you to the bone, instead of grooming you to successfully enter the derm match again. Although sometimes difficult to obtain, get the names of people who completed (or more tellingly, didn't complete) the fellowship you're inquiring about. People may try to stay mum because they don't want to offend, but you may be able to get the inside scoop on the fellowship, enough to make or break the deal. Research fellowships are posted here at SDN, and since there are fewer spots than applicants, move fast.
A research fellowship doesn't even have to be one of the "official" ones. You can create a spot out of whole cloth, if you approach a particular investigator and come with your own money, either funding you've won or savings from your part-time job pumping gas in college (which of course you wisely invested and made a killing from before the stock market crashed).
Third, with the possible exception of pediatrics, I would hesitate doing another residency, because that creates all sorts of residency funding issues for derm programs. The feds only give any trainee X number of years of funding for residency and if you use up most of it doing another residency, a derm program is not going to be able to fund you. Lots of info is available about that conundrum here on SDN; please don't ask me because I am still not clear on the details.
Fourth, I would not break up your medical training to obtain another degree in hopes that it will help you match into derm. The time for doing that would have been before or during medical school. After medical school, if you want to be a practicing physician, you need to work on your clinical skills, which will only rot if you delay applying again to derm residency.
What do you do if you don't match? In recent years past, about forty percent of derm applicants have found themselves in this situation, and if you are still committed to derm, there are numerous ways to handle the aftermath.
First, however, I hope you matched into an IM prelim internship, ideally a name-brand one. Not only do you learn more medicine in an IM year, but also you want to avoid looking lazy during your second appearance on the dog-and-pony show. In my view, nothing is worse than reapplicants who have to reveal that they are in a transitional internship, and during past match cycles, that point was specifically brought up as a mark against at least one reapplicant in casual conversation amongst residents, who were coming up with their own rank lists. No matter how unfair you think that is, there are those in the derm world who still sniff at transitional years, and you'd rather avoid being on anyone's pet peeve list as soon as they look at your ERAS.
Certainly, some will argue that a transitional year will give you the downtime to pursue more derm research or to rotate through a derm department, and I can't disagree that this may be true. So, ultimately, you'll need to weigh what you need to do to buff up your resume for that second go-around, but keep in mind that you're being interviewed by people who see themselves as having jumped high hurdles to get to residency, one of which being a prelim internship.
There is no need, however, to put yourself through the wards scut of a surgical prelim, even if you want to do Mohs. You won't see the light of the OR lamp as a non-surgical intern heading towards derm. And you learn everything you need to know about Mohs surgical techniques during your Mohs fellowship; when you're applying to that, they only care about what you learned during your derm residency.
Second, you may want to consider a research fellowship in dermatology, many of which attract non-matched applicants (versus people who haven't yet entered the derm match, or derm residency graduates). Do your research wisely, because the last thing you want is a difficult mentor more interested in glory for himself and working you to the bone, instead of grooming you to successfully enter the derm match again. Although sometimes difficult to obtain, get the names of people who completed (or more tellingly, didn't complete) the fellowship you're inquiring about. People may try to stay mum because they don't want to offend, but you may be able to get the inside scoop on the fellowship, enough to make or break the deal. Research fellowships are posted here at SDN, and since there are fewer spots than applicants, move fast.
A research fellowship doesn't even have to be one of the "official" ones. You can create a spot out of whole cloth, if you approach a particular investigator and come with your own money, either funding you've won or savings from your part-time job pumping gas in college (which of course you wisely invested and made a killing from before the stock market crashed).
Third, with the possible exception of pediatrics, I would hesitate doing another residency, because that creates all sorts of residency funding issues for derm programs. The feds only give any trainee X number of years of funding for residency and if you use up most of it doing another residency, a derm program is not going to be able to fund you. Lots of info is available about that conundrum here on SDN; please don't ask me because I am still not clear on the details.
Fourth, I would not break up your medical training to obtain another degree in hopes that it will help you match into derm. The time for doing that would have been before or during medical school. After medical school, if you want to be a practicing physician, you need to work on your clinical skills, which will only rot if you delay applying again to derm residency.
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Necro bumping this thread for a friend who didn't match, and weakness is research:
I met 2 folks on the trail this year who delayed graduation rather than take a year off when they found out they had not matched. Between April and August, they had enough time to be productive, and then do some away rotations September through November. Was this just a fluke that I happened to come across this year, or is this something that is a viable option in general.
It just seems so much easier to apply as a medical student, rather than a graduate, no?
I met 2 folks on the trail this year who delayed graduation rather than take a year off when they found out they had not matched. Between April and August, they had enough time to be productive, and then do some away rotations September through November. Was this just a fluke that I happened to come across this year, or is this something that is a viable option in general.
It just seems so much easier to apply as a medical student, rather than a graduate, no?
I would think it makes more sense to do an internship and work on getting a PGY2 spot that opens up.
Do you pay additional tuition if delay graduation? Are programs going to quickly understand that you voluntarily delayed medical school or just see that you didn't graduate on time and wonder if you had a problem (besides not matching)?
I don't agree with the (old) advice a couple of posts up about doing a prelim year instead of TY if you didn't match. Could be true for derm but lots of rad oncs do TYs so I don't think that would be looked down on (I'm sure you can find an exception). I know I wouldn't hold it against someone. Some TYs will provide more opportunity for research. Naturally, if someone asks you why you are doing a TY don't say because it is easier; mention the opportunities it allows.
