Applying to anesthesia as backup

[Honeeplz3]

Hello all,

I'm an MS3 planning on applying to EM this coming year. Throughout clerkships, I enjoyed everything, but seriously went back and forth between anesthesia and emergency. I ended up choosing em (because eventually you have to chose one to apply to away rotations). I've been a little worried about my competitiveness for EM and will be couples matching with my wife (going into peds). I'm really worried about not matching considering the competitiveness of EM the past few years. My school had a high number of EM applicants doing SOAP this year.

I'm from the east coast midtier program, step 1 in 230s, with hp in all clerkships so far.

My question is, how will residency programs view my application if I don't have a rotation in anesthesia? I believe I will be able to get a LOR from an anesthesiologist. I did research in the anesthesia department and have shadowed several times, (almost weekly throughout MS2) and know several of the faculty. Will they immediately reject my application? My transcript will obviously show my away rotations in EM in July/aug. I will not apply to EM and anesthesia at the same institution. I was hoping to apply to anesthesia at programs that have peds programs, but no EM programs. Any thoughts or suggestions would be great! I know I would be happy doing anesthesia, and hate having to chose a specialty so soon!

---

Members don't see this ad.

 

[Depakote]

Hello all,

I'm an MS3 planning on applying to EM this coming year. Throughout clerkships, I enjoyed everything, but seriously went back and forth between anesthesia and emergency. I ended up choosing em (because eventually you have to chose one to apply to away rotations). I've been a little worried about my competitiveness for EM and will be couples matching with my wife (going into peds). I'm really worried about not matching considering the competitiveness of EM the past few years. My school had a high number of EM applicants doing SOAP this year.

I'm from the east coast midtier program, step 1 in 230s, with hp in all clerkships so far.

My question is, how will residency programs view my application if I don't have a rotation in anesthesia? I believe I will be able to get a LOR from an anesthesiologist. I did research in the anesthesia department and have shadowed several times, (almost weekly throughout MS2) and know several of the faculty. Will they immediately reject my application? My transcript will obviously show my away rotations in EM in July/aug. I will not apply to EM and anesthesia at the same institution. I was hoping to apply to anesthesia at programs that have peds programs, but no EM programs. Any thoughts or suggestions would be great! I know I would be happy doing anesthesia, and hate having to chose a specialty so soon!

I can't say you'd be rejected outright... but my concerns would be the following:

-How can you convincingly answer the "why anesthesia?" question. This is probably the most important question to answer and if you can't demonstrate why you would want to spend your life doing this specialty, you're not going to convince me to offer you a spot. I'd be skeptical if you've never actually spent time on my side of the drapes.

-I'm not sure Anesthesia is a reliable "back-up" specialty. When I was applying, it was comparably as competitive as EM. If you fail to match into the specialty you're primarily applying into, I don't believe you'll be successful applying into an equivocally competitive specialty with less direct experience.

Personally, I would focus on applying broadly to EM programs and if you absolutely do need a back-up specialty, choose one where your test scores and grades place you well above the average candidate.

 

[deleted307836]

If I remember correctly, in recent years there have been no open SOAP spots for EM whereas there have been relatively plenty for anesthesia. And I remember a post from a year ago about a med student who applied to EM and anesthesia, with anesthesia as the backup, and matched anesthesia. If you search for that thread here you may find it. I think it went on for a couple pages and there was some valuable insight about the relative competitiveness of these two specialties.

 

[Honeeplz3]

I can't say you'd be rejected outright... but my concerns would be the following:

-How can you convincingly answer the "why anesthesia?" question. This is probably the most important question to answer and if you can't demonstrate why you would want to spend your life doing this specialty, you're not going to convince me to offer you a spot. I'd be skeptical if you've never actually spent time on my side of the drapes.

-I'm not sure Anesthesia is a reliable "back-up" specialty. When I was applying, it was comparably as competitive as EM. If you fail to match into the specialty you're primarily applying into, I don't believe you'll be successful applying into an equivocally competitive specialty with less direct experience.

Personally, I would focus on applying broadly to EM programs and if you absolutely do need a back-up specialty, choose one where your test scores and grades place you well above the average candidate.

Thanks for the reply! As for answering why anesthesia, I can definitely answer that, but I think you're right in that it's not much of a back up specialty considering they're about equally competitive. My reasons are that I'll be applying to places that have peds programs in the vicinity. I realize nationally they are equally competitive but if you look at the stats at my specific school, anesthesia has a much higher match rate than EM for whatever reason. (for the life of me cannot figure out why). Maybe there's just been some fluke horrible interviewers in the EM group the last few years. Who knows. It definitely makes sense to have a back up that actually serves its purpose as a back-up. It really helps having some ideas to bounce off of, so thanks for the advice.

 

[Honeeplz3]

If I remember correctly, in recent years there have been no open SOAP spots for EM whereas there have been relatively plenty for anesthesia. And I remember a post from a year ago about a med student who applied to EM and anesthesia, with anesthesia as the backup, and matched anesthesia. If you search for that thread here you may find it. I think it went on for a couple pages and there was some valuable insight about the relative competitiveness of these two specialties.

I have really searched and searched and can't seem to find this thread! It would be super helpful though, so if anyone knows where to find it, send me the link!

 

[DrZzZz]

Thanks for the reply! As for answering why anesthesia, I can definitely answer that, but I think you're right in that it's not much of a back up specialty considering they're about equally competitive. My reasons are that I'll be applying to places that have peds programs in the vicinity. I realize nationally they are equally competitive but if you look at the stats at my specific school, anesthesia has a much higher match rate than EM for whatever reason. (for the life of me cannot figure out why). Maybe there's just been some fluke horrible interviewers in the EM group the last few years. Who knows. It definitely makes sense to have a back up that actually serves its purpose as a back-up. It really helps having some ideas to bounce off of, so thanks for the advice.

The past couple of years, EM has become slightly more competitive than Anesthesia. In this year's match, there were about 700 more PGY-1 EM spots than Anesthesia, yet fewer programs filled Anesthesia than EM. 25 unfilled Anesthesia spots to 14 EM. If you throw another 500 PGY-2 Anesthesia spots into the mix, the gap of unfilled programs grows more significant (another 33 unfilled spots). All unfilled EM spots filled in SOAP, whereas 1 PGY-1 and 3 PGY-2 Anesthesia spots were unfilled after SOAP. Avg number of applicants to fill each spot for 2014: 7 for Anesthesia, 6.3 for EM. In another thread, people were comparing the two fields and how many of their fellow classmates applied and IRC, most schools seemed to range from 2:1 to 3:1 for EM:Anesthesia applicants. There's another document on NRMP somewhere that breaks down by specialty the avg scores (and other info) of matched applicants. I had it bookmarked, but it looks like they moved or removed it. If you can find it, it'd help you compare the difficulty of getting into each.

Here's the match data from this year - http://www.nrmp.org/wp-content/uploads/2014/04/Main-Match-Results-and-Data-2014.pdf

All that being said, I still agree that there's at best a slight difference between EM and Anesthesia in terms of competitiveness. So, Anesthesia may not be that good of a backup option for you, especially considering you'll have 0 Anesthesia rotations on your resume and will have a more difficult time proving your interest in the field. Best of luck, whatever you choose!

 

[imfrankie]

My suggestion is decide what specialty you'd most like to practice.

 

[deleted307836]

I have really searched and searched and can't seem to find this thread! It would be super helpful though, so if anyone knows where to find it, send me the link!

This thread might have been it: http://forums.studentdoctor.net/threads/convince-me-of-anesthesia.992698/

I was thinking there was one where someone applied to both instead of SOAPing but I could be mistaken.

 

[BLADEMDA]

Consider the bottom 1/3 of anesthesia programs as backup. You have a very good shot at those if you don't match EM. Alternatively, go for EM in the match and use SOAP to get anesthesia if nobody accepts you into EM.

Your primary focus should be EM. Perhaps, interview at 5 of the weaker anesthesia programs (at most) as backup.

 

[docblue]

Applying as a US med student coming from a US allopathic school with the scores and grades you posted to EM residency should not be too challenging. Even if you are couples matching with your wife, it will still be very achievable. Focus on doing well in your clerkships as who you are in person, how well you get along with others and your fit for a program, as well as how you perform clinically all have a lot of influence on your application. Don't stress too far ahead to the match and neglect on doing your best in clerkships. Rest assured you will match.

 

[womp]

2% US seniors unmatched in anesthesiology.
3.4% US seniors unmatched in EM.

Of the 1662 total anesthesiology spots, 1081 were filled by US grads
Of the 1786 total EM spots, 1388 were filled by US grads

 

[womp]

I think some of the people above are overstating the competitiveness of anesthesia in recent years. It's dropping precipitously with more CRNA and AMC awareness among medical students. Many of my classmates who didn't match in other specialties (uro, PMR, ortho) SOAPed into anesthesia programs (mid and top tier) this year. None of them had a rotation or prior interest. I don't know of anyone who SOAPed into EM from my school. I also know many strong EM applicants who dropped well down their rank list in BFE this year, while almost all the anesthesia applicants are at large academic programs and Ivies.

The only thing limiting the OP is the lack of anesthesia rotation; if he were able to schedule an anesthesia rotation even for two weeks, he would have no trouble matching to a decent anesthesia program with his scores. The OP also has research in anesthesia which puts him well above many other anesthesia applicants. There's absolutely no need for him to only target the bottom 1/3rd of anesthesia programs, he should aim for every tier.

 

[DocMcCoy]

So I had to SOAP this year (failed ortho applicant) and I am telling you to avoid SOAP at all cost. I consider myself very fortunate to have wound up with a categorical anesthesia spot, but the process was gruelling and I hav many other classmates that were not as fortunate.

You sound like you have a solid interest in both specialties with research in anesthesia. You can assign which letters go to which program as well as having multiple personal statements. Set yourself up for success. Write a personal statement and get letters for both specialties. You will get interviews. Like others said as long as you can defend your choice during the interview you will be fine.

I can't speak to the competitiveness between the two, but I know the anesthesia slots in the SOAP outnumberedthe EM spots about 4 to 1. That being said, there were unfilled positions in both specialties. If you have the money apply to as many programs as possible and for God's sake man avoid the risk of not matching.

 

[Sublimazing]

So I had to SOAP this year (failed ortho applicant) and I am telling you to avoid SOAP at all cost. I consider myself very fortunate to have wound up with a categorical anesthesia spot, but the process was gruelling and I hav many other classmates that were not as fortunate.

You sound like you have a solid interest in both specialties with research in anesthesia. You can assign which letters go to which program as well as having multiple personal statements. Set yourself up for success. Write a personal statement and get letters for both specialties. You will get interviews. Like others said as long as you can defend your choice during the interview you will be fine.

I can't speak to the competitiveness between the two, but I know the anesthesia slots in the SOAP outnumberedthe EM spots about 4 to 1. That being said, there were unfilled positions in both specialties. If you have the money apply to as many programs as possible and for God's sake man avoid the risk of not matching.

As an outsider, it seems so crazy to me that physicians spend so much time training, become set on a specialty...but if they don't match they just take whatever is available? Even if it's completely different?

In the dental world the match rate is a lot lower, and it's very common for someone not to match. When this happens most people will wait a year and reapply after an intership,general residency, or working.

 

[ScarfTheVerb]

I say go for it. More specifically I would apply to the anesthesia programs in the cities you and your wife most want to be in. I know a lot of people that were between EM and anesthesia--myself included. They're both hospital based, procedural, and tend to have decent pay and quality of life. I thought they were both a lot of fun. Those were my priorities

Don't let people give you crap for not being "faithful" to one specialty. As a med student you often don't have a whole lot to go on when picking a specialty, and it is always a leap of faith in some sense that you'll be satisfied doing whatever you pick.

I didn't get many questions about my fourth year rotations during anes interviews, and I think with an anesthesia letter, anesthesia research, and a decent answer to "why anesthesia?" you'll be just fine. Be open about having a hard time choosing between anes and EM if they ask, but maybe not so open about applying to both. And don't feel guilty about that--the PDs are playing the same game you are and are likely withholding from you as well. As long as you'll be a hard working resident if you match there you aren't hurting anyone.

Good luck.

 

[B-Bone]

As an outsider, it seems so crazy to me that physicians spend so much time training, become set on a specialty...but if they don't match they just take whatever is available? Even if it's completely different?

In the dental world the match rate is a lot lower, and it's very common for someone not to match. When this happens most people will wait a year and reapply after an intership,general residency, or working.

The difference being, of course, that a new dental grad can get a job and make a good living whereas a medical degree without a residency is merely an ornate paperweight.

 

[DocMcCoy]

Not to derail the thread further. But yes, other options do exist for those that don't match. Unpaid/paid research year, postponing graduation, transitional year through soap, etc.

If a med school does it's job an applicant will be exposed to most of the specialties and have an idea of where they fit in and where they won't.

It's a personal cost benefit analysis of what you want to do when you don't match. In my case, with mouths to feed and being maxed out on loans with private loans that go into repayment this year, I needed a job with some security. A categorical position is a specialty I enjoyed but just happened to not be my first choice made a lot more sense than taking a year to figure things out with a slim chance of reapplying successfully.

In the OPs case, I'm saying avoid the situation entirely. In hindsight I wish I would have applied to anesthesia as well as ortho. I don't consider any specialty to be a backup, but it is something else I enjoyed and could have bettered my odds in the match. OP is qualified for both specialities and should apply to both if he is interested.

 

[BLADEMDA]

Going for interviews in both specialties? Does anyone have the time and money for 60+ interviews? I'd say go for choice 1 with gusto and choice 2 stick with mid tier programs so when you don't match into EM the odds of matching into Anesthesia are very high. This way you can go on just 5-10 anesthesia interviews and 20+ EM interviews.

Some examples would be Pittsburgh, Emory or UT Southwestern. There are many more fine mid tier programs which train Residents to become outstanding Anesthesiologists.