Applying to Multiple Specialties - Error? Path and IM

[Brunette1981]

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Hi folks, I'm an MD/PhD student from a top 5 school who's done reasonably well in medical school but not AOA material (228 Step 1, half/half honors/HPs in clerkships, 2 papers out)... and recently my SO who's not in medicine got a job in Boston.

So I have to be in Boston. And I want to go to a good residency program because I've been working hard for years! I'm interested in academic medicine and I like the more cerebral specialities so I'm attracted to both IM and pathology (and possibly to IM/Peds as an alternative way to do an IM speciality). I think I could be happy in both IM and in path but I wouldn't be happy spending 4 years away from my SO.

So, sorry to bore you all with those details, but my question is does it look bad to apply in more than one speciality? Do I have a shot in he** of getting into a residency at BWH or MGH?

 

[docbiohazard]

The way ERAS is set up, you can apply to two specialities without one ever knowing about the other - unless someone from one speciality sees you interviewing at the other speciality at the same hospital later on in the year. You can have totally separate letters of rec, personal statements, etc.

The good news is there are a bunch of path programs in Boston beyond what you mention. Given your geographical constraints I'd apply to all of them. I have a buddy with a similar profile to yours (except mid-tier MD/PhD program) and he got interviews at those places you mentioned.

I would say the much much bigger decision you have to make relates to the big difference between IM vs. Path in terms of lifestyle personally and professionally. I'd also recommend you think highly about why you're interested in Med/Peds? As MD/PhDs we're prone to want to "overtrain" I think - hell just wanting to do AP/CP has got me lectured quite a bit on the interview trail. A lot of it will relate to how much research you see yourself doing in the future and what sort of career you want to have.

I'm done with my interview season and still struggling with that question. So good luck.

BH

 

[mlw03]

yes, you have a shot at MGH, BWH, and BID with those numbers and experiences.

 

[Brunette1981]

Thanks so much for the feedback! I guess as an MD/PhD student I am prone to overtraining and as a med student I am prone to overthinking and freaking out about these kinds of things.

I didn't know you could do separate apps - that was my concern, that neither field would regard me as "serious." I understand the big differences in lifestyle/environment so I go back and forth about which one I would like better. I'm hoping 4th year electives will clarify things a bit!

Although, for me, having more than one interest might be better at this point in time. Med/peds is definitely overtraining but an additional year of residency in Boston might be a good trainoff than living far away from my fiance during all of residency...

Thanks again! If anyone else wants to chime in, that'd be wonderful. 🙂

 

[WiseMentor]

Rather than getting advice from two anonymous members of a discussion group who have yet to match in a training program, I would suggest that you turn for advice and guidance to faculty and deans at your school. There are bound to be people there who care about you and your career, as how you do reflects on what they have done for your education.

If you were to apply in two disciplines, your match list would end up looking something like this:
1. Institution A, Discipline A
2. Institution B, Discipline A
3. Institution A, Discipline B
and so on. The upshot of this would be that you would be allowing the match software to make your decision for you. Come on, you would seem to be approaching adulthood -- you should be able to do this for yourself (granted with guidance).

While it might be reasonable to start the season looking at two fields as divergent as IM and pathology, you should be able to figure out which is going to make the most sense for you career as you see it. You have spent a significant time in school, being trained and accumulating knowledge, and presumably have also developed a concept of what you want to do with all of this. Take the time to meet with faculty and the administrators. Explain your constraints, discuss your interests and plans, explore your options. You may well find that one of them has a friend who is in the field you want & works in Boston & sits on a selection committee who ...

While it may seem to students that those in medical school administration spend their lives sitting in committees, arguing about budgets and buildings, dancing with donors and arguing with faculty, the focus for many of us is to HELP STUDENTS. We have experience, we have connections and we all have opinions -- draw on those you trust and who have a reason to be truly accountable to you.

Mentor (from the Greek)

 

[mlw03]

what is this sanctimonious stuff? s/he asked a question, we answered. no one said to avoid advice from people at their school. i'm a little offended by the implication that because we're not accountable to the poster we're going to give inferior advice to someone in the student affairs office at their school who may or not be familiar with what it takes to be a successful pathologist. for a first post, the below is painfully obvious. the implication also that everyone in school administration make their decisions with only the best interest of students in mind is a silly one as well - administrators are people with their own agendas and ambitions. while i have gotten much excellent advice from people in my school's administration, i've also gotten some poor advice. all advice, this included, should be taken with an inquisitive mind.

to the original poster: path and IM do share some similarities with respect to the mindset needed to do either, but there are also major differences. you should be thinking about a few major questions, such as do you want to deal with patients regularly? do you enjoy instituting therapeutic plans? do you enjoy procedures? can you sit at a microscope for 6 hours without developing a headache or nausea? i think the patients or no patients issue is the biggest question for people considering pathology versus IM - i have a few classmates who had that choice to make and one picked IM and the other picked pathology, and knowing these girls i think both made the right choice for them. neither is intrinsically better or worse, but it is a major difference that needs to be seriously considered.

wisementor: that kind of specific advice is what many of us who have been posting here for years get when we ask questions, not just vague motivational-speech style material that sounds like it came from a tony robbins convention. so please don't insult our motives and knowledge of the decision process that goes into choosing a pathology career (which is something we have recently done).

Rather than getting advice from two anonymous members of a discussion group who have yet to match in a training program, I would suggest that you turn for advice and guidance to faculty and deans at your school. There are bound to be people there who care about you and your career, as how you do reflects on what they have done for your education.

If you were to apply in two disciplines, your match list would end up looking something like this:
1. Institution A, Discipline A
2. Institution B, Discipline A
3. Institution A, Discipline B
and so on. The upshot of this would be that you would be allowing the match software to make your decision for you. Come on, you would seem to be approaching adulthood -- you should be able to do this for yourself (granted with guidance).

While it might be reasonable to start the season looking at two fields as divergent as IM and pathology, you should be able to figure out which is going to make the most sense for you career as you see it. You have spent a significant time in school, being trained and accumulating knowledge, and presumably have also developed a concept of what you want to do with all of this. Take the time to meet with faculty and the administrators. Explain your constraints, discuss your interests and plans, explore your options. You may well find that one of them has a friend who is in the field you want & works in Boston & sits on a selection committee who ...

While it may seem to students that those in medical school administration spend their lives sitting in committees, arguing about budgets and buildings, dancing with donors and arguing with faculty, the focus for many of us is to HELP STUDENTS. We have experience, we have connections and we all have opinions -- draw on those you trust and who have a reason to be truly accountable to you.

Mentor (from the Greek)

 

[yaah]

We have had numerous threads on these forums (although not really in the path forum) about this topic in the past. I would suggest a search in the general residency or ERAS forums - like for "multiple specialties" or something like that. A lot of people ask this question, often it is for people applying to radiology + Medicine or derm + something. The situation is often like yours, where the applicant wants to be limited to one city or even a specific hospital in rare occurences.

There are enough programs in Boston and surrounding areas (Worcester) that you shouldn't have too much trouble. BWH and MGH are highly competitive programs and while your numbers and stats shouldn't torpedo your chances, you are certainly not guaranteed a favorable reception, bearing in mind also that candidates who are successful in matching in these programs often have in common that they really LOVE pathology and want to excel in it - their stats are often of peripheral importance because they are generally also good. BIDMC is a good program also. BU and Tufts are also in Boston, BU is a growing program with a lot to offer, Tufts has seen better days but likely would still provide you solid training. I would suspect you would not have trouble matching at these latter three programs, but with the caveat that you have only provided a step I score and the fact that you like pathology. Internal medicine might be "safer" if only because there are more programs and there are more spots in these programs.

There are different opinions on whether it is a bad thing to apply to multiple specialties within a single institution. Some argue that it is bad because if these program directors find out (sometimes by accident) they will question your dedication to the specialty. And therefore, some candidates likely go about this in a sneaky fashion without divulging their intentions. Some would therefore recommend transparency and being honest, but then you would have to deal with numerous questions about your sincerity and dedication (are you going to switch specialties if you don't get your first choice? Do you really like pathology or do you just think it's an easier match?). I sense that your goals of an academic career will be a favorable part of your application though.

The advice above is reasonable - it is never a bad thing to talk to your med school dean or other advisors about this problem. They have extensive experience in these areas and how things would be looked upon.