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Started by phagocytosis41
I'm going to hit you with some facts: In 2018, 30/45 students with your score range matched in to PM&R (67%); 17/18 matched to neurology (94%); 117/132 matched to IM (88%). You do NOT have to resign to FM, you have a great shot at what you're interested in! Congratulations on PASSING an insanely hard exam! A 32 percentile in maybe any other field sucks, but in medicine, it's still a huge achievement that should be celebrated. We're geniuses competing against geniuses, try to remember that and keep your head up!
I’m just an incoming OMS2, but just given your score alone I do not think you are out of the running for any of these specialties based on charting the outcomes. Chances are pretty good for matching Neuro or IM. PM&R might be a bit of a battle though, but it doesn’t seem completely out of the question if the rest of your app is good to go. http://www.nrmp.org/wp-content/uploads/2018/06/Charting-Outcomes-in-the-Match-2018-Osteo.pdf
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may not be a helpful question but how did you prepare for comlex and how did you feel after the exam?
np you can ask. UWORLD, Combank, I felt really good after the exam.
Kill level 2
bravenugget21
Full Member
498 is still a good score and more importantly, you passed so congratulations. Would be happy to get around there. If you don’t mind me asking, what were you getting on uworld, comquest/combank, and comsae? Trying to get an idea of what would be s good range to get around 500.
also wondering about comquest and comsae 🙂
CHOOOOOO CHOOOOO THE PRIMARY CARE TRAIN IS A COMIN!
J/king. You need to sort the stats by COMLEX only peoples which I do not know if the above poster did. I think your in the running for all three. Need to pick the one you like best and get an early away. That extra letter will be very important to you. Being below the magic 500 sucks cause some places might autoscreen. But since you are so close, an email can probably get you to the next level.
J/king. You need to sort the stats by COMLEX only peoples which I do not know if the above poster did. I think your in the running for all three. Need to pick the one you like best and get an early away. That extra letter will be very important to you. Being below the magic 500 sucks cause some places might autoscreen. But since you are so close, an email can probably get you to the next level.
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Can't really sort the stats out by anything else mate, Step doesn't go up to the 400s
Use the interactive charting outcomes for osteopathic/by comlex and look at the people with 'no step.' Also I said it right there in the quote that I was talking about COMLEX not step (i.e. the exam that all DO's have to pass to get licensed).
Tableau Public
Cool table.Use the interactive charting outcomes for osteopathic/by comlex and look at the people with 'no step.' Also I said it right there in the quote that I was talking about COMLEX not step (i.e. the exam that all DO's have to pass to get licensed).
Your welcome.Tableau Public
public.tableau.com
Neurology is extremely uncompetitive. IM has lots of lower tier programs that will take you, some may even have in house fellowships. PM&R is a small world, you really want to get to know the right people to push you through the door.
Use the interactive charting outcomes for osteopathic/by comlex and look at the people with 'no step.' Also I said it right there in the quote that I was talking about COMLEX not step (i.e. the exam that all DO's have to pass to get licensed).
Your welcome.Tableau Public
How the flip am I just finding out about this tool?
why is it extremely uncompetitive? it sounds like a great field, i mean to me at least
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Audition and get letters. This will greatly help you overcome scores.
Work life balance just isn't there. It's probably the worst deal in terms of the non surgical fields.
According to that chart libertyyne throws around it works less hours than family med. residency wise its the worst non surgical but I don’t see it being too horrendous past that. I’m interested in it though so maybe I’m biased. But regardless nobody should apply to it because it’s terrible and I need a spot in it
I was mainly referring to residency. Once you're done there's really nothing stopping you from being working 40 hours a week and mainly making your money from pass income.
All I'm saying is that when I see the neuro resident pushing 95-105 hours week after week I would rather be outside of medicine at that point.
What chart btw?
Search hours worked relative to family med and it should pop up. Idk he’s posted it a bunch lately
Year 1 - internal medicine prelim year - same as IM, if not better
Year 2&3 - probably not great, pretty much what you're saying
Year 4 - Can make it pretty easy with lots of outpatient rotations
So, I'm not seeing what everyone else is saying. What am I missing? Seems fairly standard, except maybe a bit worse during years 2 and 3? @Ibn Alnafis MD .
They essentially do two bad intern years and the later years are not guaranteed to be better.
Everyone has a bad intern year though (primary care anyways). So, one extra intern year? Yeah, I guess that's pretty crappy. But it beats having to do 2-3 years after residency for an IM fellowship.
Sounds about right.
Internship is same as IM internship.
PGY2 is very inpatient heavy. Tons of nights. Very steep learning curve. Lots of note writing. I'm now busier than I was last year. Hours aren't much different but my down time is significantly less. In internship, you start at 6am, pre-round, write notes, round with the attending, lunch, then pretty much down time until sign out unless you get new admissions. Right now I'm constantly working. My pre-rounds are more energy and time consuming. Can't half ass chart reviewing anymore. Can't BS physical exam anymore. Can't rely on specialists to do the workup and give rec's anymore. Also, there's no shortage of stroke alerts. These can happen at very inconvenient times (e.g. just after receiving sign out in the morning and just before giving sign out in the evening). Moreover, there's no shortage of BS consults; my favorite, encephalopathy, can be caused by literally anything. 90 year old patient who's been in the hospital for 3 months and have undergone tens of procedures and is on a million meds, and now he's noted to be "altered". No ****.
PGY3 busy but much more manageable than PGY2. Less inpatient wards and more elective/EMU/outpatient. Less nights.
PGY4 Same as PGY3 except that most programs don't have you do nights anymore. Some programs have you do 2-4 weeks of nights "only".
I have ZERO regrets for choosing neurology. It's the most fascinating field.
This is not entirely true. Yeah basically anyone without major red flags can match into the field, but if you want to end up at a decent program in a decent location, at a hospital where they actually care about residents and their well being, then you need to be an average applicant.
really! Worse than inpatient IM?
From my experience, it is not competitive. It's probably a little bit more competitive than IM given that there are so many IM spots in the country. 210+/220+ will get MD students into a university program
But this is not what this thread is about. The OP is a DO without usmle scores and subpar comlex. Telling them that matching neurology, or any field, is a cake walk is not a constructive advice.
Should they give up on neurology? Of course not, but they need to realize (and I’m sure they do) that they have serious shortcomings in their application and there are ways to compensate for that (aka auditioning).
A 498 is not bad
You’ll be fine. Work hard, do well on your rotations, get letters and so on. PMR is very DO friendly and if you’re not looking for top 20 IM you’ll do fine. I don’t know a whole lot about Neurology, but from the admittedly small sample of the one classmate I had that went into it it’s not that competitive. Good Luck! Also stop beating yourself up about the test. Enjoy that you passed!
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@Ibn Alnafis MD didn't say 498 was bad, he said it was "subpar", which is true.
I think the best thing is to look at data from the match. Doing well on auditions, getting good letters are a must for everyone regardless of score. Just bc someone gets over 600 doesn’t need they can slack off. Also sdn is always doom and gloom so take advice with a gain of salt here. A 498 is not horrible. It is below average. Subpar has many meanings to many ppl. I don’t think this is a subpar score. It can still get you in many places
Neurology is not difficult to match into. Even with subpar scores and being a DO applicant there is ~ 84% match. Being >500 is greater than 90% match with an Average of 95% matching.
My home neurology program director literally said, that being an American grad with just passing scores will almost guarantee a match at a decent program. This was an MD school though.
Neurologists tend to work a little less then IM docs ~200 hours or so, however it is not a statistically significant difference. The more ambitious bunch end up going into vascular intervention, but who knows how long that party is going to last since a massive number of fellowships are open with barely any oversight. Here is the chart chibucks is referring to.
My home neurology program director literally said, that being an American grad with just passing scores will almost guarantee a match at a decent program. This was an MD school though.
Neurologists tend to work a little less then IM docs ~200 hours or so, however it is not a statistically significant difference. The more ambitious bunch end up going into vascular intervention, but who knows how long that party is going to last since a massive number of fellowships are open with barely any oversight. Here is the chart chibucks is referring to.
I enjoy this graphic very much. I am thinking that it needs to adjusted for pay as well though. Occ med and peds ER, the real lifestyle champions.
Hours aren't everything. I hate working the ED. I'd gladly take 50 hrs in clinic over 36 in the ED any day. At least after a day of clinic you don't feel completely drained.
Occ med probably isn't bad in terms of burnout though.
I agree on both counts, occ med is interesting, but I think the job market is weak tho.
On the job market topic tho, what do you think of all the new psych residencies opening? Is it heading for a letdown.
I wouldn't be worried about Psych quite yet. There's a huge demand for it. Cash only, worried well practices might expload, but run of the mill mixed payer stuff will be good for a while. Plus a number of the new residencies or residency spots are struggling with funding. If you're really worried you could always do Child and then you'd have a lot more options in terms of job market. But then you'd have to deal with parents...
This true, but training is longer so you you give up a year of attending salary as well.
IF you have a real dataset for salaries i could. I attempted to do something like that incorporating hourly pay and training time / lost income for extended training. The problem at the end of the day is that personal perception of hours worked / continuously changing reimbursement and practice patterns and flexibility make it useless , since 8 hours of outpatient peds is torture to me vs 16 hours of neurosurgery which seems to fly by. So it doesnt matter at the end of the day the adage of doing what you enjoy and love holds true.
Was Anesthesiology just so far below the average they didn't bother listing it?
Could probably pull it off payscale?
Seems like the vast majority of figures I’ve seen under report. I mean docs already get a bad rap for “making too much money” so why would you invite more scrutiny by reporting anything more than your base pay (when the benefits, raises, etc make it a ton more)Was Anesthesiology just so far below the average they didn't bother listing it?
Could probably pull it off payscale?
Sure, but it should work fine if we're just trying to compare specialties to one another.
Oh yeah the base will for sure. Certain specialties have more bonuses, RVUs are higher, etc, so it’s toygh to get the actual value.
Regardless though, you really aren’t gonna be in financial trouble unless you choose some terrible paying academic job or you’re extremely careless with money
I would rather set myself on fire than do Occ Med. Seems like such a rough place to be in: fighting with workers comp on what they will pay for while fighting the patient on what the are willing to do while fighting the employer on what they want the patient to do. It's got the same low-lying level of stress the ER does (not including codes obviously), but way more bureaucracy and you're always assumed to be working for the other side of whatever person you're talking to.
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People are too focused on hours and money. Nothing wrong with that. I did the same thing when I was a premed and in my early years of med school.
Now that I'm on the other side of the equation, I have a different prospective. I still care about money and lifestyle, ofc, but now I'm more concerned with the "fit" factor. People, please remember that you'll be spending most of your walking hours doing this job, so you'd better off doing something you enjoy/tolerate even for a lower $/hr than going to work miserable everyday.
I spent most of my last year in IM, and although I liked most of it, I am so glad I'm in neurology now. Even though I am now working more hours and, sometimes, do more stressful work, I am much happier than I was last year. I'd much rather do the H&P and the workup for a seizure (even if it's pseudogenic) than dealing with CHF, COPD, or GI bleed. I enjoy and feel much more motivated reading and learning neurology than any other field. Therefore, despite of the financial consequences of my decision, I am content with my field.
Now that I'm on the other side of the equation, I have a different prospective. I still care about money and lifestyle, ofc, but now I'm more concerned with the "fit" factor. People, please remember that you'll be spending most of your walking hours doing this job, so you'd better off doing something you enjoy/tolerate even for a lower $/hr than going to work miserable everyday.
I spent most of my last year in IM, and although I liked most of it, I am so glad I'm in neurology now. Even though I am now working more hours and, sometimes, do more stressful work, I am much happier than I was last year. I'd much rather do the H&P and the workup for a seizure (even if it's pseudogenic) than dealing with CHF, COPD, or GI bleed. I enjoy and feel much more motivated reading and learning neurology than any other field. Therefore, despite of the financial consequences of my decision, I am content with my field.
They'll all get there. Its tough for 90%+ of people to really make a decision before at least halfway into 3rd year. Before that all you really can definitively talk about is compensation and hours.
Best spell I saw was a patient mimicking a tonic-clonic, but then look at me and saying "see it happening right now".
Also, you'll be fine. My brother-in-law is a neurologist in socal. Even with the debt, he's doing OK.
What financial consequences! You will be making 50k-100k/yr more than IM docs working close to the same # of hrs
A
AnatomyGrey12
That’s amazing. I had two patients this week tell me they have pseudo-seizures when discussing their PMH lol.
I could’ve been in radiology now (almost applied but changed my mind last second). They make 1.5x the salary neurologists make without having to tell people their loved one will never be able to use language again.
IM hospitalist is one of the best financial decisions in medicine. Short training, good job market, solid salary (250+), and tons of time off. In fact, it’s becoming increasingly unmotivating to pursue a fellowship nowadays. Why endure 5 extra years of hard labor and low compensation to be become an International Cardiologist, only to limit yourself geographically and more work hours than your counterpart hospitalist? The financial loss during the extra years of training exceed 1M and can be much more if you pick up extra shifts as a hospitalists and work near the same hours a cardiology fellow does. It would take a decade for the IC, in the perfect setting, to financially catch up on the opportunity loss.
