Application process

[physicsMD]

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Hi all,
I was wondering what the process is. Let's say you want to do Rad Onc but are program selective, there is always a chance you won't match. But you don't want to be stuck in a scramble. I don't think Rad Onc is an early match right? So can you apply to say both medicine and rad onc at the same time and see where you get interviews? When do you have to decide to do one or the other?

 

[pikachu]

From what I understand (and I'm just starting the apps process now as well) nothing will stop you from applying to both Rad Onc and IM. For that matter if you have enough money you could apply to every field that's offered (theoretically). Correct me if I'm wrong, but in the end your match list and ultimately the match itself will decide for you. For example if all your top 6 programs are Rad Onc, but you don't match into any one of them, and spots 6-12 on your match list are IM programs that you match into, you will match to the IM program. The thing is, though, you are locked in to that IM program at least for the next year once you match there.

There's always prelim/transitional programs and you can reapply for PGY-2 once those are completed, right?

 

[Thaiger75]

Yes, you can apply to as many programs as you want, to as many fields as you want. Keep in mind, however, that at least for some Rad Onc interviews, you may be asked if Rad Onc is the only field you are applying to (speaking from personal experience). I suppose they want to see how serious you are about the field.

In the scenario in the above post, if you don't match in Rad Onc, you will match down your list, such as IM, and yes, you will be locked in that program for 3 years (assuming it's a general IM program, not prelim/trans). If you are very serious about Rad Onc and would be willing re-apply if you don't match, then you should not rank any general IM programs after Rad Onc in your primary rank list. Rank only prelim/trans IM or surg programs after Rad Onc (assuming you want to do an intern year after you graduate).

 

[Adawaal]

In the scenario in the above post, if you don't match in Rad Onc, you will match down your list, such as IM, and yes, you will be locked in that program for 3 years (assuming it's a general IM program, not prelim/trans).

Actually, that's not quite true. According to NRMP rules, by successfully matching at a program, you are locked into one year of service to that program. Whether it's one year (TY or prelim) or 7 years (neurosurgery or whatever), the commitment is the same. Besides, residents all get only one-year renewable contracts when they're hired anyway....

 

[stephew]

Actually, that's not quite true. According to NRMP rules, by successfully matching at a program, you are locked into one year of service to that program. Whether it's one year (TY or prelim) or 7 years (neurosurgery or whatever), the commitment is the same. Besides, residents all get only one-year renewable contracts when they're hired anyway....

People can switchout; in fact two current hopkins residents are ex- IM and psyc residents. now, signing with a program in bad faith, that is knowing youre going to leave, is not only, well, bad faith, but illegal. However if you are unhappy, chances are the program will let you out of the contract. But be aware that one year renewable contract isn't to keep your options open; its to keep the program's options open.
Steph.

 

[radonc]

and from what i understand if you leave, the host (original) program has the choice on whether or not to give you your GME funding (ie salary). sometimes the program may keep it for itself, or may give it to you when you switch programs. if it doesnt give it to you, then the new program may have to pay for you out of the dept pocket. this was told to me during an interview 2 years back from a PD, so double check this info....

 

[stoleyerscrubz]

When people go this route do they generally choose different RadOnc programs to match into the second time around?

Does having your intern year completed help out in the matching process?

If you are very serious about Rad Onc and would be willing re-apply if you don't match, then you should not rank any general IM programs after Rad Onc in your primary rank list. Rank only prelim/trans IM or surg programs after Rad Onc (assuming you want to do an intern year after you graduate).

 

[Thaiger75]

When people go this route do they generally choose different RadOnc programs to match into the second time around?

Does having your intern year completed help out in the matching process?

Hard to say what other people have done, but I can tell you my experience. I applied to ALOT more programs the 2nd time around for cushion. I don't know why, but the trend seems to be that you won't get offered interviews from programs that you've interviewed with the 1st time. I've talked some other people and it seemed to be generally the same with them (with a couple exceptions of course).

Having an intern under your belt certainly doesn't hurt. As far as to whether it is a huge asset...people will differ. I tend to think that it probably doesn't make program directors wiggle in their pants with glee. If you re-apply during your intern year, you'll essentially only have a few months of medicine completed at most, and that doesn't sound all that. What programs may like is the fact that you have enough commitment to the field to be re-applying.

 

[physicsMD]

Hmm,
I think it is silly for Rad Onc programs to look unfavorably on people who list medicine in addition to Rad onc on their list. I want a residency at a major academic center, by nature those are more competitive to get. So I am supposed to only list Rad Onc or transitional, if I match in transitional re-apply to Rad Onc the next year with close to the same chance of not matching in Rad Onc again in any of the places I want to go since they didn't take me the first time, and just keep doing that year after year? Of course not! That makes no sense, and I can't believe that it will hurt your chances of matching to Rad Onc just because you are smart enough to have a back up plan. I don't think that the attitude of Rad Onc or bust will help you in the process if you are say, someone like me who wants to do academics. Doing a Rad Onc residency in a place with not much academic opportunity just plain would not make sense, so there is no way I could justify only listing Rad Onc and Transitional on my match list to myself. If i couldn't get into an academic Rad Onc residency I would rather get a great IM residency and go the academic Heme/Onc route. Besides, they can ask in interviews what your plans are for your list, but until you turn it in only YOU know what is on your list, and as far as I am concerned it is none of their business what I do with my list.

 

[Thaiger75]

You're right, programs really don't have any business asking about your rankings or what fields you are applying to...some may say that it is unethical or rude for them to ask applicants that. But the fact remains that you may still be asked that question. I don't think they would have a problem with one having IM as a backup. (They may even ask what you will do if you happen to not match.) I think the reason why they do ask that question if rad onc is the only one you're applying to is to see how serious of a rad onc applicant you are. Cuz there are people who apply to multiple fields, such as rad onc or rads...

Perhaps a safe answer, if asked, would be that you are applying to IM or another field as a backup to rad onc, and if unmatched, would reapply for rad onc during IM residency or after...or go the Heme/Onc route. But who knows, depending on the person you're interviewing with...maybe they're looking for someone who is persistent and willing to do whatever it took to get in rad onc.....

 

[Gfunk6]

Doing a Rad Onc residency in a place with not much academic opportunity just plain would not make sense, so there is no way I could justify only listing Rad Onc and Transitional on my match list to myself.

Although what you are saying makes perfect sense, I think don't think it is pragmatic. RadOnc, I think, has gone the way of Diagnostic Radiology, Plastic Surgery, and Dermatology in terms of competitiveness. With the match rate hovering around ~33% you are certainly not guaranteed admission in any program, let alone in the institution of your choosing.

Since the academic RadOnc programs are almost by definition, ultra-competitive, I fear that you might be setting yourself up for a fall. But that's just one man's opinion.

 

[uxbridge]

I agree with GFunk, Rad Onc is amazingly competitive. But if an academic career in Oncology (regardless Med or Rad) is your goal, an IM backup sounds reasonable.

To all our treasured mentors...what sort of unethical/rude interview questions have you encountered and how did you deal with it? 🙂 (guess I shoulda put it in the interview thread, eh?)

 

[Thaiger75]

To all our treasured mentors...what sort of unethical/rude interview questions have you encountered and how did you deal with it? 🙂 (guess I shoulda put it in the interview thread, eh?)

I think there was a thread about this particular topic that was put up during last year's interview season....not sure whether it's still up or not.

 

[Thaiger75]

RadOnc, I think, has gone the way of Diagnostic Radiology, Plastic Surgery, and Dermatology in terms of competitiveness.

It has surpassed Diag Rads by leaps and bounds in competitiveness. Diag Rads actually has some unfilled spots some years. Rad Onc up there with Plastics and Derm.

 

[pikachu]

Although what you are saying makes perfect sense, I think don't think it is pragmatic. RadOnc, I think, has gone the way of Diagnostic Radiology, Plastic Surgery, and Dermatology in terms of competitiveness. With the match rate hovering around ~33% you are certainly not guaranteed admission in any program, let alone in the institution of your choosing.

33%???!!!!
I thought it was closer to 50% at least?

 

[Thaiger75]

33%???!!!!
I thought it was closer to 50% at least?

Depends on the year. Last year, probably closer to 35-40%, 2 years ago, closer to 30%, but probably not anywhere close to 50%...ever again.

 

[Mutterkuchen]

What do students who don't match do? IM? Reapply? Reapply then IM?

 

[Gfunk6]

Well if you read through some of the threads in this forum, you'll notice there were a few people who reapplied after an IM preliminary year. I suppose if you were really persistent you could do IM THEN re-apply. Quite a few RadOnc PDs and attendings are board certified in IM and RadOnc.

 

[phd2b]

OK, now I'm a little confused.

Let's say, for example, that you were unfortunate and did not match to a Rad/Onc spot (which is really for PGY2 after one year of IM, etc, right?). You were successful, however, in matching to a transitional IM spot, which is PGY1.

So, you re-apply for a rad-onc position during your PGY1 IM year, but most programs are actually looking to fill positions that are two years out (b/c most positions are combined with the PGY1 IM year?).

If you are fortunate and do match, what on earth would you do for the one year that you'd have to wait (after your have completed PGY1) until your PGY2 position is available????

Please lay this out so that slow folks like me can understand. 🙂

 

[Gfunk6]

Basically, I think they would let you enter immediately as a PGY-2 since you already completed your Transitional/Preliminary Year. Then, they would either offer one less spot at the PGY-1 level or someone would have to drop out.

 

[Thaiger75]

Basically, I think they would let you enter immediately as a PGY-2 since you already completed your Transitional/Preliminary Year. Then, they would either offer one less spot at the PGY-1 level or someone would have to drop out.

The spots they have for the year you're applying for are for that year only. So if you are applying for a PGY-2 spot in 2006, they would only consider you for a spot that year. At any given year, however, there are programs that, for whatever reason, have an opening right away for a PGY-2 that you could enter immediately after you finish your intern year (if you were to apply during the winter of your intern year). How do you find out about which programs have an opening for the next coming year instead of 2 years in advance the normal way? Good question. Most of the time you hear about it thru the grapevine, but another tedious way would be to contact each program you applying to and ask them directly.

As far as what you would do if you did match, you have several choices. You can do another year of medicine or whatever you're in...find a research position for a year...or do nothing.

 

[humble99]

People can switchout; in fact two current hopkins residents are ex- IM and psyc residents. now, signing with a program in bad faith, that is knowing youre going to leave, is not only, well, bad faith, but illegal. However if you are unhappy, chances are the program will let you out of the contract. But be aware that one year renewable contract isn't to keep your options open; its to keep the program's options open.
Steph.

Is it really illegal? If so how did people get around that ?
humble

 

[stephew]

you basically have to have a chat with your pd and tell them you aren't happy in the field and are thinking of other things and hope they're nice about it. most are since they dont want unhappy residents.

 

[OnMyWayThere]

If you don't match Rad Onc the first time around and do IM, and then match the second time around... are you then 1 year behind that if you had been accepted the first time around? 😕 Is it the same for other fields?

 

[Thaiger75]

If you don't match Rad Onc the first time around and do IM, and then match the second time around... are you then 1 year behind that if you had been accepted the first time around? 😕 Is it the same for other fields?

If you do an entire IM residency (3 yrs), then you will be 2-3 years behind everyone else (2 if you were able to slip into a rad onc residency right away, 3 if you had to wait a year to get in). If you do just an intern year, then you will only be 1-2 years behind (1 if you were able to slip into a rad onc residency right away, 2 if you had to wait a year to get in).

That make sense?

 

[music710]

I applied last year, and also thought about doing IM as back-up. Similar to the thoughts of many here, if I couldn't become a rad onc (i.e. don't match), perhaps I would enjoy being a med onc (which I believe would be true for me).

The reason I ultimately dropped the IM back-up plan was that I wanted to do an IM prelim year (as opposed to transitional year). So I did the "math." If I applied to rad onc (and thus, IM prelim programs) as well as categorical IM (as back-up), what do I tell "top" IM programs where I'm applying for both categorical and prelim spots? So I would have to split my list of IM programs into the ones where I would apply for a prelim spot, and the other ones where I would apply for a categorical spot. That was too much math for me to handle.

The other reason -- which has been mentioned by others -- is that I didn't want to feel like I'm lying to programs by telling rad onc interviewers that I love rad onc, and by telling IM programs that I love IM. I guess both statements would be true (for me), but I still felt weird about it. After some serious thinking, I realized that I really wanted to become a rad onc, so took the risk of not applying to IM for back-up.

I guess it's an individual decision. It worked out for me, but having no back-up meant I was taking a risk of not matching at all.

 

[stephew]

If you don't match Rad Onc the first time around and do IM, and then match the second time around... are you then 1 year behind that if you had been accepted the first time around? 😕 Is it the same for other fields?

either that or like two folks currently in the hopkins program, get lucky when an extra slot opens up (and no, noone left the hopkins program; extra slots were made availabel when 1) a military guy didnt wind up coming and 2) we expanded the program).

 

[ijokergirl]

Along these lines of transitional year etc. What if you apply to a transitional year and match, but you also match into the RAd onc program at Emory which requires that you do you PGY-1 with them in IM. It is my understanding that your transitional year match is a binding contract, so what would you do?

 

[Thaiger75]

Along these lines of transitional year etc. What if you apply to a transitional year and match, but you also match into the RAd onc program at Emory which requires that you do you PGY-1 with them in IM. It is my understanding that your transitional year match is a binding contract, so what would you do?

When you actually fill out your rank list next year, you'll understand how it works. But essentially, you have 2 rank lists. Your primary one (rad onc) and secondary one (prelim). If you match in your primary list, then your secondary list goes into effect. If you don't, then your secondary means zilch. That is why you have to rank a prelim program after your rad onc programs in your primary rank if you plan to do a prelim year regardless of whether you match or not. And to answer your question, if you match in an integrated program such as Emory, your secondary list automatically becomes void.

 

[fettucine]

Thaiger: Could you rank the same prelim program in both primary and secondary list? For example on the primary list as a backup.

 

[Thaiger75]

Thaiger: Could you rank the same prelim program in both primary and secondary list? For example on the primary list as a backup.

Yes. Each rad onc program on your primary list will be linked to a list of secondary prelim programs, so you could basically assign a different secondary list to each primary rad onc program.

An example of a primary list would be:

1. MDA
2. MGH
3. Jefferson
etc. down the list for rad onc

Then as a backup:


10. Prelim year at wherever
might wanna add a couple in case the prelims you are applying to are competitive

Having said that, there are plenty of open prelim spots every year that you can get through the scramble. So, you could get away with not ranking a backup, but your choices would be limited.