1 month from Match and regretting my specialty. What do I do...?

[whatsthepoint]

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[Dr. Anonymouss]

M4 here, applied Ortho and did 4 away rotations and probably will match if I rank. However I got burnt out after 1-2 aways and hated pretty much everything after that. I regret applying Ortho.
What do I do? If I start Ortho residency and 2 months in already want to switch, will my PD even support this switch so early?

I applied and interviewed at 5 TYs, do I rank them higher?
I know I'd be so much happier in ophthalmology or DR, I should have applied to one of those. I would just do a TY but I know it's so hard to get into ophtho as an MD graduate. What would you do?
Any advice helps this lost 4th year med student. :/

Luckily I figured out I didn’t want this life earlier on. I wanted ortho since day 1. Busted my ass to get pubs, honors, and high step scores. Decided late into 3rd year that this was exhausting and not worth it. It’s not the life I wanted.

It sucks that you are just now figuring this out, but also realize that some people realize this into their 1st, 2nd, or 3rd year of surgical residency. I think what’s important is that you ask yourself are you 100% certain this isn’t what you want? You are so close to the finish line, so don’t throw in the towel unless you’ve fully contemplated and accepted this decision.

I’m not quite sure if it would be better to start out in ortho and switch later or if it would be better to delay your graduation and apply next year into a different specialty.

 

[ACSurgeon]

M4 here, applied Ortho and did 4 away rotations and probably will match if I rank. However I got burnt out after 1-2 aways and hated pretty much everything after that. I regret applying Ortho.
What do I do? If I start Ortho residency and 2 months in already want to switch, will my PD even support this switch so early?

I applied and interviewed at 5 TYs, do I rank them higher?
I know I'd be so much happier in ophthalmology or DR, I should have applied to one of those. I would just do a TY but I know it's so hard to get into ophtho as an MD graduate. What would you do?
Any advice helps this lost 4th year med student. :/

I think you should rank and try to match. There’s a reason you pursued ortho and wanted it at some point. Being a student sucks. You have no real responsibility. You’re not really part of the team. You’re the lowest on the totem pole. The floor and OR staff treat you poorly. You’re not building by significant surgical or patient management skills.

The hours as a sub-I or resident can suck. However, the nature of how that time is spent makes a difference. As a resident, the sense of comradery and the satisfaction from learning and growing makes the experience more palatable. As a student, you’re constantly being judged and you’re not even sure if this sub-I you’re experiencing will be your future specialty because you haven’t matched yet.

You can always switch to DR after a year or two if you truly hate it.

 

[mrbreakfast]

The #1 goal is to match somewhere. You will have better chances of changing specialties down the road if you match ortho over TY.

You should give ortho a good few months before truly deciding if you are going to try to switch.

If you matched ortho and have been performing well and still want to switch, another specialty will take you. Just be aware it may not be ophtho or DR.

Regretting a surgical subspecialty isn't too uncommon. I know a few people who got out of ortho or NSGY and had no issues going into non-surgical fields.

 

[whatsthepoint]

I think you should rank and try to match. There’s a reason you pursued ortho and wanted it at some point. Being a student sucks. You have no real responsibility. You’re not really part of the team. You’re the lowest on the totem pole. The floor and OR staff treat you poorly. You’re not building by significant surgical or patient management skills.

The hours as a sub-I or resident can suck. However, the nature of how that time is spent makes a difference. As a resident, the sense of comradery and the satisfaction from learning and growing makes the experience more palatable. As a student, you’re constantly being judged and you’re not even sure if this sub-I you’re experiencing will be your future specialty because you haven’t matched yet.

You can always switch to DR after a year or two if you truly hate it.

This is soooo true! Preach, doc. Being a med student away rotator on ortho rotations was one of the worst experiences of my life (hence why I'm reconsidering). I'm such a doer and love using my hands, I couldn't handle all the shadowing. Hoping it gets better on the other side. Thank you for your reply

 

[GotToGetThatGPAUp]

As someone who applied IM (and got great IVs to boot) I've recently fallen in love with cardiothoracic anesthesiology on a recent rotation.

Part of me chalks it up to the grass is greener, perhaps doing all my IM based rotations recently just made me crave something new.

I don't have any good advice for you here just support in knowing you're not alone

 

[fdgjfg]

Plenty of people do switch, so it is possible. There's a long history of surgical residents transitioning to DR, gas, and path during training, while still being able to interview and match at top programs. There are also typically at least a handful of PGY2 positions open in gas/DR each year, so you might not even delay your training if you were able to match one of those. You'd let your PD know, since a letter from them would be expected - most PDs are fine with it. The only difficulty is the relative increase in the level of competition in gas/DR lately, which may inhibit switchers a bit especially at competitive coastal programs (but probably not shut them out). Ophtho is probably out unfortunately (unless you either delay graduation or decide to do research post-graduation instead of matching) given the challenging margins and high level of competition - would be too hard to accrue the research, letters, and rotations required unless you've already built those. It would make sense to start some conversations with potential mentors in the alternate specialty this spring, since you'll need letters and exposure. You'd also want to leverage any medical school connections you could build, since matching at your medical school's program would likely be one of the most accessible in the event of a switch.

If you were absolutely certain that you didn't want to do ortho, you could consider withdrawing from the match and delaying graduation. This would allow you to accumulate extra research, letters, and rotations while hiding yourself within the "MD senior" category (preventing you from being filtered out as a grad). This would open up ophtho if you're productive enough. You'd also likely have more time to create a better app, rather than trying to check all those boxes while working 80 hours a week as a surgical intern. This would of course have it's own cons - delaying your salary clock, and potentially having to take an additional semester's worth of tuition or work a research job temporarily. This route makes the most sense if you highly value being able to access "top" or competitive programs in the new specialty, and don't mind taking some additional setup time. It'd be important to talk to your school deans/admin to learn more about how you'd actually go about this and what they can offer you (e.g. some places can offer a tuition free year).

Of the three options you mentioned (match and switch, delay grad, match TY) matching at a TY seems like the least preferable. Has the cons of graduating/not being protected by "MD senior categorization" and needing to work a fair bit/no way to get new rotations/research, without the pro of being able to actually see whether you do like ortho and want to continue after all. It wouldn't be the worst since it could be chill enough to prep a good app and allow you to enter a PGY-2 spot, but that just seems like a narrower route (would really need to match the PGY-2 to make it worth it, or figure out something unique - e.g., could do a TY, then a nuclear medicine fellowship, then match a DR spot on the normal cycle).

Fourth potential option is graduate and do research (withdraw from match). Pro is a lot of time to improve app, and no need to pay any tuition/figure that out. Negative is you may be filtered, but it'd probably be ok. Could be used to set up an ophtho app.

Before deciding how to proceed, I'd echo the above recommendations to closely examine your thoughts/feelings, and potentially push through and match. You may just be burned out from the audition process. Needing to always be "on" and impress those around you may have provided a more negative experience than you'd have as an actual resident, where feelings of improvement/confidence might buoy your opinion of the specialty. You also chose ortho for a reason - do you feel like like something fundamentally changed (pros became neutrals, or even cons), or are you just tired? Also, what made you miserable on the aways - was it the OR/what attendings do, or the drudgery of consults and running around the hospitals with the juniors? If it's the latter, that stuff improves after PGY-2; while it's tough, it's not forever.

I also wouldn't underestimate the stress/cost involved in taking an alternate or "weird" path. Whether you switched after PGY-1 or delayed graduation, the next 12 ish months might be pretty stressful. Your friends and classmates graduate and move on, and it's a lot of pressure to be outside of the stream of normalcy and having to justify to yourself and others. As mentioned above, while ortho residency is never a cake-walk, it should improve after PGY2 - 2 hard/stressful years. If you switch, it might be 1 hard/stressful year while you get yourself situated. Is 2 years to 1 really that much of a difference in the end? This certainly isn't to discourage you if this is the path that's best - only you can know that. But I would make sure to be super certain that you just would not be happy as an ortho attending at all, since it might be a bumpy ride for a little bit and that needs to be worth it.

 

[operaman]

Without a doubt I would try and match ortho. Worst case scenario, you apply for a new field while you have a steady job and are getting training. Your PD should be supportive if you decide to switch and are liked; they’ll have no trouble filling your slot with one of the many unmatched ortho hopefulls who did a prelim.

And then there’s always the chance you may end up liking ortho more than you think. Residency is a lot better than med school and you’re actually doing things and learning to be a doctor. There’s less bs - someone on a gen Surg rotation tried to pimp you on post op colectomy complications and you can just laugh. It’s really a whole different world when your program is really invested in you and your growth, versus being a faceless rotator they may never see again. Definitely worth giving it a shot and switching later.

 

[whatsthepoint]

Plenty of people do switch, so it is possible. There's a long history of surgical residents transitioning to DR, gas, and path during training, while still being able to interview and match at top programs. There are also typically at least a handful of PGY2 positions open in gas/DR each year, so you might not even delay your training if you were able to match one of those. You'd let your PD know, since a letter from them would be expected - most PDs are fine with it. The only difficulty is the relative increase in the level of competition in gas/DR lately, which may inhibit switchers a bit especially at competitive coastal programs (but probably not shut them out). Ophtho is probably out unfortunately (unless you either delay graduation or decide to do research post-graduation instead of matching) given the challenging margins and high level of competition - would be too hard to accrue the research, letters, and rotations required unless you've already built those. It would make sense to start some conversations with potential mentors in the alternate specialty this spring, since you'll need letters and exposure. You'd also want to leverage any medical school connections you could build, since matching at your medical school's program would likely be one of the most accessible in the event of a switch.

If you were absolutely certain that you didn't want to do ortho, you could consider withdrawing from the match and delaying graduation. This would allow you to accumulate extra research, letters, and rotations while hiding yourself within the "MD senior" category (preventing you from being filtered out as a grad). This would open up ophtho if you're productive enough. You'd also likely have more time to create a better app, rather than trying to check all those boxes while working 80 hours a week as a surgical intern. This would of course have it's own cons - delaying your salary clock, and potentially having to take an additional semester's worth of tuition or work a research job temporarily. This route makes the most sense if you highly value being able to access "top" or competitive programs in the new specialty, and don't mind taking some additional setup time. It'd be important to talk to your school deans/admin to learn more about how you'd actually go about this and what they can offer you (e.g. some places can offer a tuition free year).

Of the three options you mentioned (match and switch, delay grad, match TY) matching at a TY seems like the least preferable. Has the cons of graduating/not being protected by "MD senior categorization" and needing to work a fair bit/no way to get new rotations/research, without the pro of being able to actually see whether you do like ortho and want to continue after all. It wouldn't be the worst since it could be chill enough to prep a good app and allow you to enter a PGY-2 spot, but that just seems like a narrower route (would really need to match the PGY-2 to make it worth it, or figure out something unique - e.g., could do a TY, then a nuclear medicine fellowship, then match a DR spot on the normal cycle).

Fourth potential option is graduate and do research (withdraw from match). Pro is a lot of time to improve app, and no need to pay any tuition/figure that out. Negative is you may be filtered, but it'd probably be ok. Could be used to set up an ophtho app.

Before deciding how to proceed, I'd echo the above recommendations to closely examine your thoughts/feelings, and potentially push through and match. You may just be burned out from the audition process. Needing to always be "on" and impress those around you may have provided a more negative experience than you'd have as an actual resident, where feelings of improvement/confidence might buoy your opinion of the specialty. You also chose ortho for a reason - do you feel like like something fundamentally changed (pros became neutrals, or even cons), or are you just tired? Also, what made you miserable on the aways - was it the OR/what attendings do, or the drudgery of consults and running around the hospitals with the juniors? If it's the latter, that stuff improves after PGY-2; while it's tough, it's not forever.

I also wouldn't underestimate the stress/cost involved in taking an alternate or "weird" path. Whether you switched after PGY-1 or delayed graduation, the next 12 ish months might be pretty stressful. Your friends and classmates graduate and move on, and it's a lot of pressure to be outside of the stream of normalcy and having to justify to yourself and others. As mentioned above, while ortho residency is never a cake-walk, it should improve after PGY2 - 2 hard/stressful years. If you switch, it might be 1 hard/stressful year while you get yourself situated. Is 2 years to 1 really that much of a difference in the end? This certainly isn't to discourage you if this is the path that's best - only you can know that. But I would make sure to be super certain that you just would not be happy as an ortho attending at all, since it might be a bumpy ride for a little bit and that needs to be worth it.

Thank you kind stranger. Really appreciate you laying out my options. This nuclear medicine fellowship you mentioned can you actually do that after a TY?

 

[mrbreakfast]

e.g., could do a TY, then a nuclear medicine fellowship, then match a DR spot on the normal cycle

I'm not sure you can do this, though I don't know anyone who actually did nuc med.

 

[fdgjfg]

Thank you kind stranger. Really appreciate you laying out my options. This nuclear medicine fellowship you mentioned can you actually do that after a TY?

I'm not sure you can do this, though I don't know anyone who actually did nuc med.

Know of someone who did it so it is theoretically possible (although after a different prelim not TY, but that might not make a difference - would depend on preferences of the nuc med program). You'd do prelim, then nuclear medicine fellowship for a year, then join a DR program as an R2.

It would be a bit tricky because it would be very individualized and institutionally dependent - would really need to be at your home institution or wherever you do your prelim, in order to ensure that they give your app a look despite doing things out of order. Whoever is running the fellowship would also need an assurance that you're high quality, reliable, smart etc. so again probably would need to be at home school or wherever you do prelim. I wouldn't count on it unless a faculty advisor tells you explicitly that it's possible and that they can help you access the opportunity.

 

[whatsthepoint]

Luckily I figured out I didn’t want this life earlier on. I wanted ortho since day 1. Busted my ass to get pubs, honors, and high step scores. Decided late into 3rd year that this was exhausting and not worth it. It’s not the life I wanted.

It sucks that you are just now figuring this out, but also realize that some people realize this into their 1st, 2nd, or 3rd year of surgical residency. I think what’s important is that you ask yourself are you 100% certain this isn’t what you want? You are so close to the finish line, so don’t throw in the towel unless you’ve fully contemplated and accepted this decision.

I’m not quite sure if it would be better to start out in ortho and switch later or if it would be better to delay your graduation and apply next year into a different specialty.

Feel this. What'd you switch into? Did you ever regret the switch?

 

[whatsthepoint]

Before deciding how to proceed, I'd echo the above recommendations to closely examine your thoughts/feelings, and potentially push through and match. You may just be burned out from the audition process. Needing to always be "on" and impress those around you may have provided a more negative experience than you'd have as an actual resident, where feelings of improvement/confidence might buoy your opinion of the specialty. You also chose ortho for a reason - do you feel like like something fundamentally changed (pros became neutrals, or even cons), or are you just tired? Also, what made you miserable on the aways - was it the OR/what attendings do, or the drudgery of consults and running around the hospitals with the juniors? If it's the latter, that stuff improves after PGY-2; while it's tough, it's not forever.

Regarding this point, I'm not tired anymore, I was exhausted the entire Fall but I figured by now these feelings would fade. I'm frustrated that that they haven't. I was miserable on aways mostly due to the shadowing and the horrid hours. I started hating most OR days (which I've never felt before), I hated cases that lasted over 90 minutes. This drove me freaking insane, standing there wearing lead doing absolutely nothing, internally having a panic attack because I'm so bored and questioning my entire career path. I reached my breaking point on my last ortho rotation, a polytrauma came in during weekend call and we had the slowest Attending in the hospital. We literally were operating on the same patient for 24 full hours on my Saturday and Sunday. Obviously as a rotator I did nothing but stand there, watching them go back and forth, inlet and outlet, for all those hours. THIS DRIVES ME NUTS. I lost my **** after this...

I liked seeing consults in the ED because I find it fun, but I found that I hate splinting and using fluoro and having to man your own C-arm (though I've never actually done it, I was just helping the residents). I love hand and sports though. Does it sound like I chose the wrong field?

 

[Dr. Anonymouss]

Feel this. What'd you switch into? Did you ever regret the switch?

Anesthesia. The best specialty 😉

 

[collegestud2013]

M4 here, applied Ortho and did 4 away rotations and probably will match if I rank. However I got burnt out after 1-2 aways and hated pretty much everything after that. I regret applying Ortho.
What do I do? If I start Ortho residency and 2 months in already want to switch, will my PD even support this switch so early?

I applied and interviewed at 5 TYs, do I rank them higher?
I know I'd be so much happier in ophthalmology or DR, I should have applied to one of those. I would just do a TY but I know it's so hard to get into ophtho as an MD graduate. What would you do?
Any advice helps this lost 4th year med student. :/

Both ophtho and radiology require a prelim year and start at the PGY-2 level. Not sure if a year of PGY-1 ortho residency would count toward this (or if you would have to repeat a PGY-1 year anyways), as the typical prelim options are usually a IM, Surgery, or TY.

Also note that nearly all optho and radiology residency spots start one year after the match (to give time to do the prelim year), so you will likely have a gap year (and hence a year of lost attending pay) if go down this route and apply for optho or DR while as a PGY-1. The excretion is of you get into an "R" spot that starts the same year as the Match results, but there are very few of these spots.

 

[voxveritatisetlucis]

Would be hard to craft an optho application before September

 

[jambro]

i dont know about people saying to just match ortho man. Too late to do anything this cycle of course but what about delaying graduation and applying in the match next year - maybe to rads? Plenty of people have switched from surgical subspec to rads and absolutely loved it. If you're questioning surgery before you're even doing residency thats a big red flag to me imo.

Have you done a rads rotation? Even if its boring are there parts of yourself you can see liking about rads? if you're competitive for ortho and do some basic rads stuff between now and next ERAS (even if you dont prob) i bet you'd match super well for rads.

 

[DOVinciRobot]

Regarding this point, I'm not tired anymore, I was exhausted the entire Fall but I figured by now these feelings would fade. I'm frustrated that that they haven't. I was miserable on aways mostly due to the shadowing and the horrid hours. I started hating most OR days (which I've never felt before), I hated cases that lasted over 90 minutes. This drove me freaking insane, standing there wearing lead doing absolutely nothing, internally having a panic attack because I'm so bored and questioning my entire career path. I reached my breaking point on my last ortho rotation, a polytrauma came in during weekend call and we had the slowest Attending in the hospital. We literally were operating on the same patient for 24 full hours on my Saturday and Sunday. Obviously as a rotator I did nothing but stand there, watching them go back and forth, inlet and outlet, for all those hours. THIS DRIVES ME NUTS. I lost my **** after this...

I liked seeing consults in the ED because I find it fun, but I found that I hate splinting and using fluoro and having to man your own C-arm (though I've never actually done it, I was just helping the residents). I love hand and sports though. Does it sound like I chose the wrong field?

I mean, I’m a resident and I hate standing there doing nothing in cases.

There is a significant difference when you are the one actually doing stuff, you are far more mentally engaged. If you don’t want to do surgery then do something else, but if there is even part of you that thinks you will ever miss actually operating then I heavily recommend you think before you switch fields. I’ve realized if I left surgery I’d leave medicine entirely. Every specialty has stuff you’re going to hate, the grass isn’t always as green as it may seem.

And if you don’t want to do 24hr cases on weekends then just don’t do ortho trauma…. I’ve never once seen an ortho sports guy on the weekend…

 

[Meerkatology]

I regret applying Ortho.

my question is how much can you actually "like" a job?

i've been an IM hospitalist for close to 10 years, i'd say theres maybe 5% of the time i actually enjoy it, u know when u get to help the rare patient that can walk and talk and is a nice human being. rest of it are either boring paperwork/cya stuff or ever so slightly delaying the inevitable in the chronically ill

optho is a surgical specialty too, so obviously u dont dislike surgery. is there really that big of difference between the two? if its just lifestyle and call schedule, do you not get to pick ur own schedule as an ortho attending?

i work somewhat less than the average FT hospitalist because to me working is a waste of life, i want to do it as little as possible. it is a means to enable other things i enjoy in life. i dont dislike medicine, i'd choose the same path if i had to do it again. but at the end of the day a career is still just work. ur not supposed to love it.

i dont know of any docs around me who would do their jobs for free, in fact i've come across quite a few that will go great lengths just to avoid taking a patient.

also, as a student, alot of what people end up liking is based on their experiences on those particular rotations, which isnt necessarily a good representation of attending life in their respective specialties. there is a large variation even going from job to job in the same specialty. u have the ability to match into a high paying specialty, if u end up not liking it , you could just work half as much as someone else while still making the same pay. doenst sound so bad to me.

 

[Esmolol]

Anesthesia. The best specialty 😉

Yeah! I wouldn’t worry. You can soap into anesthesia this cycle. Heard there will be plenty unfilled spots /s

 

[whatsthepoint]

Would be hard to craft an optho application before September

even if I did a research year? I have a couple offers, sounds like I could pump out a lot of case reports quickly, but obviously wouldn't have a big paper by August.

 

[ACSurgeon]

my question is how much can you actually "like" a job?

i've been an IM hospitalist for close to 10 years, i'd say theres maybe 5% of the time i actually enjoy it, u know when u get to help the rare patient that can walk and talk and is a nice human being. rest of it are either boring paperwork/cya stuff or ever so slightly delaying the inevitable in the chronically ill

optho is a surgical specialty too, so obviously u dont dislike surgery. is there really that big of difference between the two? if its just lifestyle and call schedule, do you not get to pick ur own schedule as an ortho attending?

i work somewhat less than the average FT hospitalist because to me working is a waste of life, i want to do it as little as possible. it is a means to enable other things i enjoy in life. i dont dislike medicine, i'd choose the same path if i had to do it again. but at the end of the day a career is still just work. ur not supposed to love it.

i dont know of any docs around me who would do their jobs for free, in fact i've come across quite a few that will go great lengths just to avoid taking a patient.

also, as a student, alot of what people end up liking is based on their experiences on those particular rotations, which isnt necessarily a good representation of attending life in their respective specialties. there is a large variation even going from job to job in the same specialty. u have the ability to match into a high paying specialty, if u end up not liking it , you could just work half as much as someone else while still making the same pay. doenst sound so bad to me.

I like my job a good bit. Sure, it’s stressful at times, and some aspects suck (complications, bureaucracy etc) but I spend a majority of my time doing cool things or socializing with coworkers that I like. I’m sure being paid well is a big factor in how much I like my job, but if I woke up super rich tomorrow I’d keep doing my job, just maybe fewer shifts.

Not to start a medicine vs surgery war, but when I was a medical student a senior resident pointed out how boring the interns jobs were. And he made a statement to the effect of would you rather do a 3 year residency and do that for a job (ie paperwork, rounding, no procedures etc), or would you rather suck it up for a couple of years until you’re a senior resident and spend a lot of your time operating and get to operate for the rest of your career. I’m so glad I chose the latter. Now, he was only half right because I did a cc fellowship and spend 6 days a month in the icu essentially rounding and doing paperwork, albeit with some procedures and much less social work. I don’t consider goals of care work to be social work, and actually really enjoy having family meetings and guiding patients/families towards goals that are congruent with their values.

 

[Meerkatology]

I woke up super rich tomorrow I’d keep doing my job, just maybe fewer shifts.

i'd also do it, but it would be to maintain my ability to work in case i need to again, not for enjoyment reasons

maybe its different for surgical, u guys work so much and have to do so much more to get there, if u didnt like it who would want to go through that.

i dont think any of my coworkers wake up everyday looking forward to working. i dont either, but as a job, its still better than most others. i'm pretty ok with it.

 

[jambro]

i'd also do it, but it would be to maintain my ability to work in case i need to again, not for enjoyment reasons

maybe its different for surgical, u guys work so much and have to do so much more to get there, if u didnt like it who would want to go through that.

i dont think any of my coworkers wake up everyday looking forward to working. i dont either, but as a job, its still better than most others. i'm pretty ok with it.

Considering it's 7 years of serious suck, to only like your job 5% of the time for the rest of your life sounds really depressing. Idk, just a med student here but I hope to god when im finally doing something I actually chose to do i'll enjoy it more

 

[Meerkatology]

Considering it's 7 years of serious suck, to only like your job 5% of the time for the rest of your life sounds really depressing. Idk, just a med student here but I hope to god when im finally doing something I actually chose to do i'll enjoy it more

i actually didnt mind residency at all. kinda liked it, IM residency hours werent that bad and people were nice.

id still pick this job over any other job. but id still prefer to be doing other things like hobbies if im not getting paid.

 

[eyeeye_captain]

Anyone know how doable it is to get into an ophtho residency as an ortho resident? I know PGY-2 spots never open up, I would be fine re-doing intern year if I have to for ophthalmology.

I heard from my school they're willing to make an exception for me to delay graduation for this potential switch, which is amazing because I could do away rotations and maintain MD senior status. However, I'm hesitant to drop all the work I put in for ortho, was wondering if being an ortho resident would boost my application because of the competitiveness of ortho.

It's not a thing, sorry. No matter what other field you're in, you wind up in the group of people trying to match in from the outside, and it's not very common or very successful (though it does happen). Having the ability to do aways with a possible research fellowship that you've mentioned gives you the best chance to have connections and papers, which in turn gives you the best chance to match (and senior status is not something to underestimate). If you have a home ophtho department, you should be blowing them up for advice and/or a possible in-house spot in a year.

 

[fdgjfg]

Anyone know how doable it is to get into an ophtho residency as an ortho resident? I know PGY-2 spots never open up, I would be fine re-doing intern year if I have to for ophthalmology.

I heard from my school they're willing to make an exception for me to delay graduation for this potential switch, which is amazing because I could do away rotations and maintain MD senior status. However, I'm hesitant to drop all the work I put in for ortho, was wondering if being an ortho resident would boost my application because of the competitiveness of ortho.

Unfortunately nobody will be able to say for sure since this would be such a unique situation; I've never heard of anyone switching into opthto, but it may have happened at some point in history.

If you want ophtho, you're almost definitely going to need to withdraw + delay graduation. The margins are just so thin with the smaller surgical subs e.g. ophtho that you don't want to take a risk. Plenty of places have like two (or even one) total interview days where they interview 35-40ish people. They need to eliminate so many people from the applicant pool that an enormous amout are categorically filtered out before engaging in holistic application review; you don't want anything weird that might get you put on the "filtered out" chopping block, even if it's holistically interesting. The number one priority in surgical sub resident selection is reliability/steadfastness and the trust that this person will do their job predictably; this is secondary to the small resident pool keeping all the patients tucked in and consults seen while the attendings are in bed. Accordingly, I think any positive impressions yielded by matching ortho in a competitive environment will be outweighed by concerns regarding indecisiveness or flightiness. As ungenerous or unreasonable as it may be, PDs seem to have the thought of "why take a risk, no matter how small?" and prefer a slightly less competitive applicant who has a more straightforward story.

It could potentially be possible to match ophtho as an ortho intern, but it's unlikely and would probably need to heavily involve personal connections (e.g. you would have to try to switch to ophtho at your med school institution where theoretically people know you). This would work to avoid you getting filtered out and help with holistic review, and help assuage any risk concerns. But even if your personal connections/home program know and like you, there are only so many spots, and always a fresh crop of kids who have never wanted anything but optho and have the CVs to match without the unusual story.

I think you need to make a hard call this weekend and punch it in - all in or all out. Don't look back either. If it's ortho, you can't have one foot out, since all your peers won't, and your performance will likely suffer if you do. Maybe see if you can spend a day or two shadowing one of the attendings you've worked with (in both specialties), and just really getting a sense of what attending (NOT resident) life you prefer. From your prior message it honestly sounds like you're just tired of being in a passive role as a med student, and don't love splinting, but largely like the specialty otherwise. The tedium and length of surgical cases seems like something that would rapidly improve when you're the one doing it, and may also involve some personal style element (maybe you'd be a faster attending and the surgeon you worked with in that situation was just a bit more neurotic). I think good reasons to switch out would be that you absolutely can't tolerate a busy 3-4ish years in residency from a lifestyle perspective (although ophtho - especially pgy2 - isn't exactly a cakewalk either), or find the subject matter fundamentally uninteresting/unfulfilling. That doesn't sound like it's the case for you.

All-in-all I would just go ahead and try to match ortho if I were you.

 

[mrbreakfast]

Anyone know how doable it is to get into an ophtho residency as an ortho resident? I know PGY-2 spots never open up, I would be fine re-doing intern year if I have to for ophthalmology.

Outside of a long shot at home institution following a research year, this isn't happening. I'm sorry.

I heard from my school they're willing to make an exception for me to delay graduation for this potential switch, which is amazing because I could do away rotations and maintain MD senior status. However, I'm hesitant to drop all the work I put in for ortho, was wondering if being an ortho resident would boost my application because of the competitiveness of ortho.

Just to be crystal clear, you are aware that dropping out of a specialty and pursuing another one is, from a recruiting perspective, a red flag, correct? This isn't to say you shouldn't do this, and obviously happiness in your career comes first, but I just think you should be aware that you are going to lose some "competitiveness" by switching specialties after declaring for the match.

I do know of a single person who switched from GS -> surgical subspecialty without having to repeat a year, but this was an all-star GS intern who applied to fill a vacated spot in the same institution. It can happen, but just consider the potential outcomes if things don't happen to fall perfectly in place.

 

[jambro]

I would think about rads over ophtho just for easiness sake. Plus the grass is not always greener - i think itd be a lot easier to make more money in rads over ophtho. Do you like the idea of working from home? You'll never get that in ophtho. Ophtho doesnt make money. like they did even 15 years ago.

Unless you're confident you're done with ortho maybe take the ortho spot if you get it this year while using the year to decide if you want to stay? You can reapply rads next cycle as an intern maybe. Hell you might have an easy time finding some ortho/rad dual applier who didnt match and be able to swap with them. Of course make sure your ortho year would count as a prelim (I think it would)

Ortho spot is a very valuable currency if you think about it and you can always reapply as an intern instead of as a "M4". I would be hesitant to drop it considering you didn't already dual apply.

 

[Saturday’s Child]

Thank you all for the advice. I know no one can make this decision but me. Really struggling with this, I feel like it's a lose-lose because I've already spooked myself so much about ortho I feel like starting the residency is a bad idea. On the other hand, delaying grad to pursue ophtho sounds nice but that just adds a year of training and forces me to continue to be a med student which I obviously am so tired of.

My friends going into EM and Anesthesia laugh at my training path because Ortho is gonna be 6 years (since everyone does a fellowship now), which just makes me feel even worse. This is an awful situation not sure how I got here

Almost every path in medicine, even a lot of non-surgical ones, end up requiring at least 5+ years unless you just want to be a generalist. IM residency is only 3 years, for example, but fellowship will bring you up to 5 at least. Ortho is a tough residency, but you can end up with a very solid lifestyle as an attending. You can also work with a motivated patient population and provide generally good to excellent outcomes pretty quickly.

Transitioning to ophtho would likely require 2 more years since you wouldn’t be able to build up a competitive app and letters in time to apply this fall.

You can laugh at your EM friends who will be burnt out before you even finish your training.

 

[fdgjfg]

Thank you all for the advice. I know no one can make this decision but me. Really struggling with this, I feel like it's a lose-lose because I've already spooked myself so much about ortho I feel like starting the residency is a bad idea. On the other hand, delaying grad to pursue ophtho sounds nice but that just adds a year of training and forces me to continue to be a med student which I obviously am so tired of.

My friends going into EM and Anesthesia laugh at my training path because Ortho is gonna be 6 years (since everyone does a fellowship now), which just makes me feel even worse. This is an awful situation not sure how I got here

Tough situation certainly. I think most people could honestly be happy in both though, and you're almost to the finish line for ortho (ostensibly did well with a good # of interviews etc.). Again, maybe there's more but what you stated above doesn't really sound like you hate ortho. Bird in the hand vs. bird in the bush; it would stink to trade out of ortho and then not match ophtho. Plus, are you looking forward to a hypothetical stressful next 6 months scrambling for research, rec letters, and doing more auditions? What specifically about ophtho vs. ortho is going to make all that worth it for you?

I wouldn't worry about what EM and anaesthesia people think. A ton of training paths in medicine take ~6/7ish years so ortho isn't special. Even in gas, plenty of people will do like critical care + cardiac care fellowships and take 6 years, or pain and take 5. The length of ortho training is more than made up for by the sky-high compensation (yes, even if you divide it by hours worked) and being extremely resilient to threats of scope creep or AI-augmented midlevels.

 

[whatsthepoint]

I would think about rads over ophtho just for easiness sake. Plus the grass is not always greener - i think itd be a lot easier to make more money in rads over ophtho. Do you like the idea of working from home? You'll never get that in ophtho. Ophtho doesnt make money. like they did even 15 years ago.

Unless you're confident you're done with ortho maybe take the ortho spot if you get it this year while using the year to decide if you want to stay? You can reapply rads next cycle as an intern maybe. Hell you might have an easy time finding some ortho/rad dual applier who didnt match and be able to swap with them. Of course make sure your ortho year would count as a prelim (I think it would)

Ortho spot is a very valuable currency if you think about it and you can always reapply as an intern instead of as a "M4". I would be hesitant to drop it considering you didn't already dual apply.

Thank you all... Y'all are the voices of reason that I needed. I know Ortho intern year counts for DR, which yes is my other top 3 field. Can you apply directly to PGY-2 R1 positions like you can for Anesthesia PGY-2?

 

[fdgjfg]

Thank you all... Y'all are the voices of reason that I needed. I know Ortho intern year counts for DR, which yes is my other top 3 field. Can you apply directly to PGY-2 R1 positions like you can for Anesthesia PGY-2?

Yes that's possible. Some programs will have spots open up, and others will reserve a few PGY-2 spots automatically (e.g. BIDMC I think).

 

[mrbreakfast]

My friends going into EM and Anesthesia laugh at my training path

You may yet have the last laugh here.