Aiming too high? (Competitive specialty too competitive)

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Apr 21, 2016
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Hey friends, I’m an MS1 trying to figure out my interests. Let me just start off saying I find IM, rads, & ophtho interesting. However, I’m worried that I’m aiming a bit too high since I realized just how competitive ophthalmology & radiology are...

I’m by no means at the top of my class (or ever will be given the genuises in my class). I’m about right in the middle and getting B’s.

So now I’m thinking of just sticking with IM.
I’m going to be starting a research project soon and would like to do something interesting but also applicable to my future career (so I dont know if I should continue aiming high or sticking with less competitive residencies).

What are your thoughts? Do you have to be at the top of your class in order to match into radiology or ophtho?

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I’m not sure but I think the answer is no and yes to rads and optho, respectively.

Here’s the thing: ask yourself which is worse? “Settling” for internal medicine and forever wondering if you would have been able to match into one of those two, or going all in, not matching, and having to scramble? I mean we’re talking about your career ie the thing you’re going to be doing for the next thirty years of your life.

And Keep in mind you’re an MS1 in November. You have a lot of time to build an application.
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Rads? No.
Even so, worry about your board scores more than your class rank.
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Why not just bust your but for ophtho and then if you fall short then you 1. know you gave it all you had and 2. will still be very well positioned for a whole host of other specialties

Oh and rads isn't that competitive.
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Without an actual STEP1 score, hard to really say what your chances are. IM definitely doable regardless, rads is definitely within reach but optho depends on your score.
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Keep aiming high. There is a lot more that goes into the decision to interview/rank than grades alone, even for the most competitive specialties . It's not perfect, but the NRMP compiles data from program directors from each specialty regarding on what they think is most important (step scores most of time). It's worth a glance.
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Kill step 1 and pass your preclinicals and nearly every door will be open to you as a US MD going into third year. Any research between first and second year is a plus especially if you can contribute to published work.
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Agree with above. Most important thing is to do your best in classwork, study hard for step 1, and then once you get your score you'll know which doors are open to you.

If you think you might be interested in ophtho, do some research in the field. You're going to need every single duck in a row if you are going to match in that field, including building contacts now and doing relevant research. If you get your step 1 score back later and find out that ophtho isn't going to be in the cards, then the fact that you did any research at all will still be a plus when applying to IM or rads.
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Having recently matched into ophtho this year and having a handful of friends applying into rads, I might be able to answer your question.

Ophtho is extremely competitive but by no means do you have to be at the top of your class in order to match. If you have decent board scores and clinical grades but demonstrate a strong passion in ophtho by doing research and publishing ophtho related papers and/or have good volunteer activities related to ophtho, I think you have a fair shot at matching. You may not match at the absolute best programs in the country for ophtho (I.e. Bascom, Iowa, Wills, etc) but you have a good chance to match somewhere. I’ve seen plenty of candidates with strong board scores (250 and 260+) have only 5 to 6 interviews or not match at all this year primarily because they lacked research/publications. And I’ve seen plenty of candidates with lesser board scores (235/240) who matched well because they had numerous publications. Usually if you have numerous publications, that PI/mentor will also write you a stronger LOR so you get 2 for the price of 1! Thus, if you’re interested in ophtho, you can do it, despite not being a superstar student! Just find a good mentor who publishes a lot!

With regards to rads, I would say there are plenty of spots and I know several of my classmates with decent board scores who garnered enough interviews to likely successfully match this upcoming year. IR is a different story but DR is certainly doable with 230s, decent clinical grades, and no research/pubs. If you’re interested in DR, go for it! Don’t be scared to apply!

My advice is first figure out what you truly want and then go all in! You can do these specialties. Feel free to let me know if you have any questions:)
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One of my classmates matched into DR with 215 in step1 last year... Don't know what his step2 was. I think IM and DR are doable. Don't know too much about ophtho