Applying to Rads with backup?

[spottydotty]

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I was wondering how many people are applying to Rads with a back up specialty, and more specifically, how is such a thing done?

I consider myself a fairly competitive Rads applicant- Step>240, several clinical honors, hopefully decent LORs. However, for personal reasons, it is very important to me that I stay in my hometown, and it is considered a moderately competitive city to be in (but not as extreme as either of the coasts). That said, I am probably going to apply to Peds as a back up. Yes, I know they are vastly different specialties, but I know that I can be happy in both and in the end, location will be far more important to me.

That said, how is this typically done? I plan to use at least one letter for both specialties. Should I tell the letter writer I'm applying to both? - he is a medicine doc and therefore not from either specialty I'm applying to. Should I just ask him to leave it open?

As far as the rank list goes, where will peds fall relative to prelim/TYs? My greatest concern is ending up matching ONLY in a prelim/TY position, is this possible?

And lastly, I realize this kind of thing is frowned open, but if I apply to both programs at the same place, is it possible to match in one and not the other? There will probably only be overlap in a few places and these hospitals both have stand alone children's hospitals so I'm not really worried about bumping into the Rads PD while interviewing for Peds and vice versa. Barring the Peds PD being married to the Rads PD and such, what are the chance they'll find out and what kind of impact will that have on my chances?

I'd be grateful for any feedback.

 

[sestamibi]

I plan to use at least one letter for both specialties. Should I tell the letter writer I'm applying to both? - he is a medicine doc and therefore not from either specialty I'm applying to. Should I just ask him to leave it open?

You can ask the letter writer to keep it generic. Or you can ask your letter writer for two letters. It really depends on the vibe your attending gives off. I've had some indicate that they've written multiple letters before. And there are others that are so swamped that asking for two is a good way to get zero.

As far as the rank list goes, where will peds fall relative to prelim/TYs? My greatest concern is ending up matching ONLY in a prelim/TY position, is this possible?

You can put prelim/TYs on a supplemental ROL which only applies if you match into an advanced radiology position.

And lastly, I realize this kind of thing is frowned open, but if I apply to both programs at the same place, is it possible to match in one and not the other? There will probably only be overlap in a few places and these hospitals both have stand alone children's hospitals so I'm not really worried about bumping into the Rads PD while interviewing for Peds and vice versa. Barring the Peds PD being married to the Rads PD and such, what are the chance they'll find out and what kind of impact will that have on my chances?

I wouldn't risk it. They might not run into each other but if you interview or rotate there, someone is going to recognize you.

 

[rox]

You can put prelim/TYs on a supplemental ROL which only applies if you match into an advanced radiology position.

You mean there's such an option where you match into Prelim/TY's ONLY if you match into an advanced position? In case you don't match into advanced position then you match into Peds instead of Prelim/TY?

 

[sestamibi]

You mean there's such an option where you match into Prelim/TY's ONLY if you match into an advanced position? In case you don't match into advanced position then you match into Peds instead of Prelim/TY?

I believe that's how it works.

You can also place the prelim/TY on your normal ROL but below a pediatrics position.

 

[rox]

I believe that's how it works.

I wasn't aware of this point. Great news 🙂

You can also place the prelim/TY on your normal ROL but below a pediatrics position.

Yeah, this one is understandable. However, in this particular order your odds of matching into Peds are excellent so you might end up in Peds as a PGY-1 and probably an advanced position as PGY-2. What would one do in such a case? Do one year Peds, quit and start the advanced position?

 

[f_w]

you might end up in Peds as a PGY-1 and probably an advanced position as PGY-2.

I don't think that would happen. You either match into a categorical program or into a prelim/advanced combo.

(btw. there are prelim peds positions available. Those would be fully credited towards either continuing as categorical peds or as internship for rads)

 

[rox]

What will happen if you apply for categorical Peds(PGY-1) and Rads(PGY-2) ? Is it possible to match into both positions?

 

[f_w]

What will happen if you apply for categorical Peds(PGY-1) and Rads(PGY-2) ? Is it possible to match into both positions?

No.

 

[rox]

Ok.

 

[Ratchet]

It will be complicated, but the ROL actually works very well. I did the couples match, and, with advanced rads, categorical rads, and prelims (had to be in same city as rads) in my ROL, we had around a total of 40 possibilities. This part will not a problem for you.

You will obviously need two separate personal statements and I would definitely not use the exact same 4 letters for both rads and peds. Maybe 2 generic, 2 rads, 2 peds, or something like that.

Your biggest problem is whether to interview for both at the same program. Personally, I wouldn't risk not matching in radiology to interview for peds at a certain hospital (I would never have done peds though). I'm not sure how programs look at this, but I don't think it would be too difficult to sneak in a peds interview or two. Doubtful that PDs in different departments talk to each other all that much about candidates.

 

[DOCTORSAIB]

OP, on one hand you're applying for a specialty where you'll probably never see another patient again (save IR) and on the other you're applying as a back up to a field where you'll be seeing TONS of screaming, crying, yelling little ankle biters.

One would think that you'd almost have to love patient contact to want to do Peds. If so, then don't you think you'd hate Rads?

I mean I'm just sayin...

 

[rox]

Of course Peds wasn't my idea. What I would do as a noncompetitive applicant applying to Rads is to have a back up plan. Sestamibi mentioned that there's such a thing where you only match into Prelim if you match into the advanced position. Assuming this is true(feel free to confirm/decline it), here's the hypothetical scenario:

Apply to Rads, Prelim Peds and Categorical Peds. Now If you match into Rads then you match into Prelim Peds. However, if you don't match into Rads, you won't match into the Prelim. Therefore, you still have the chance to match into the categorical Peds.

I know it sounds complicated, but I was wondering of it is possible. f_w at least said it is not.

 

[f_w]

Apply to Rads, Prelim Peds and Categorical Peds. Now If you match into Rads then you match into Prelim Peds. However, if you don't match into Rads, you won't match into the Prelim. Therefore, you still have the chance to match into the categorical Peds.

These are the possible matches:

1. prelim-peds/im/TY + advanced rads
2. advanced rads only
3. categorical peds only

There is no possibility of ending up with the advanced rads AND categorical peds position in the same match cycle.

 

[rox]

Thanks. Having only those three possibilities, it seems to me one can never have a back up plan when applying to an advanced position. I wonder what would OP do.

 

[gonogo]

The OP can just rank all the rads places higher on the list, then put the categorical peds places on the bottom.

The more difficult part will be to apply for both prelim and categorical peds at the same place. I don't think you can do that. So that's a big a problem assuming you're limited geographically.

 

[rox]

The OP can just rank all the rads places higher on the list, then put the categorical peds places on the bottom.

Say he/she matches into Rads, where would he/she get a Prelim from? Scramble?

 

[gonogo]

Say he/she matches into Rads, where would he/she get a Prelim from? Scramble?

You should rank the prelim spots too. The thing with peds as backup is that you can't apply to prelim and categorical peds at the same place. So an easier backup would be another advanced position (i.e. anesthesia, ophto, etc...). That way you can apply to all prelim and advanced positions possible.

In any case, if you're sure it's either peds or rads, prelim peds is in fact some sort of backup. Assuming you don't match in rads, you can just reapply next year or talk to your peds PD and see if you can stay for the categorical.

Take this with a grain of salt. I'm myself debating on what to do. I'm in a very similar situation in that I'm geographically limited and I'm applying to rads and IM prelim. I'm still thinking if I should have a backup.

 

[rox]

So an easier backup would be another advanced position (i.e. anesthesia, ophto, etc...). That way you can apply to all prelim and advanced positions possible.

Sure, it'd be less complicated.

In any case, if you're sure it's either peds or rads, prelim peds is in fact some sort of backup. Assuming you don't match in rads, you can just reapply next year or talk to your peds PD and see if you can stay for the categorical.

makes sense.


I'm a bit confused now. So when you apply for Rads and IM Prelim, you simply rank Rads first then IM Prelim or what?

 

[f_w]

Thanks. Having only those three possibilities, it seems to me one can never have a back up plan when applying to an advanced position. I wonder what would OP do.

Of course, the peds categorical is the backup. If you don't get rads, you get the categorical backup.

 

[Ratchet]

error

 

[rox]

Of course, the peds categorical is the backup.

Ok, so you mean rank Rads first then categorical Peds.

Where does Prelim fit now in this plan? Where will you rank it?

 

[f_w]

Ok, so you mean rank Rads first then categorical Peds.

Where does Prelim fit now in this plan? Where will you rank it?

If I remember correctly, the ROL is not a linear list but rather a 'tree'. You rank lists of prelims along with their respective advanced programs (to increase the chances of doing internship and rads in the same city/state).

 

[rox]

Alright, this makes sense now. I probably need to familiarize myself more with the process of applying.

 

[gonogo]

But again, the problem with prelim and categorical peds if you're applying in a limited geographical area is that you can't apply to both prelim and categorical peds in the same program. So I guess you'd need to divide the programs in those where you'll apply for prelim and those for categorical.

 

[rox]

Yeah, that would be a real problem. You might consider applying only to 1 or 2 Prelim's since, I assume, they are quite easier to match into. I don't know how wise that would be 🙂

 

[PeepshowJohnny]

One more thing to give advice on, since you're applying in a limited geographical area, be very careful about applying for pediatrics and radiology at the same hospital.

While I personally can't find anything wrong with what you're doing, rads and peds (and pretty much every field in medicine) want only applicants who are very dedicated to their field. I don't think PD's in either would find it very complimentary that you put a higher value on your location over what specialty you will pursue.

Honestly, 9/10 it won't matter, but I have heard of stories of people applying for, say, Ortho and Gen Surgery in the same hospital and people finding out and ranking the candidate much lower because of their lack of dedication.

 

[spottydotty]

One would think that you'd almost have to love patient contact to want to do Peds. If so, then don't you think you'd hate Rads?

Does everybody in Rads do it because they HATE patient contact? From talking to the people at my school who matched last year and those who are applying this year, this doesn't seem to be the case. I don't love patient contact but I don't hate it either. Somtimes, it's nice to talk to people! In the end, it is not necessarily ESSENTIAL for me to have patient contact as long as I know my work is helping them in some way. I do love procedures and like seeing the immediate impact of my work, which is why I was thinking about IR- meaningful patient interaction, but I don't have to manage all the chronic/preventative stuff. I wouldn't mind seeing patients in clinic once a week for f/u...


I like Peds because kids are fun and so much better than adults to treat, but don't know if Peds medicine is something I can do for the rest of my life. What do you guys think of peds radiology? How often are IR and diagnostic procedures used on the little buggers?

 

[f_w]

I did peds before I went into rads.

What drove me away where the pediatricians and the parents, loved the kids.

You don't have much patient contact in general diagnostic rads, you have lots of 'people contact' as you interact with your staff and referring docs all day long.

Yes, there is a subset of IRs and pediatric rads who do IR with kids. Most of it is bread and butter stuff like central venous access and biopsies. The 'fun' stuff like treating AVMs, venous malformations or lymphangiomas is quite rare and fairly centralized.

 

[gonogo]

The 'fun' stuff like treating AVMs, venous malformations or lymphangiomas is quite rare and fairly centralized.

You mean neurosurgeons/vascular surgeons get to do them?

 

[f_w]

You mean neurosurgeons/vascular surgeons get to do them?

Nah, they are just so rare that there are maybe 3 people around the country that to most of them.

 

[Leukocyte]

Does everybody in Rads do it because they HATE patient contact? From talking to the people at my school who matched last year and those who are applying this year, this doesn't seem to be the case........ I like Peds because kids are fun and so much better than adults to treat.....

Yes, but be careful. The "patient contact" from a perspective of a medical student is VERY different from that of a resident who has the responsibility to deal with all the bulls&hit. Yes, well all love kids and babies. It is natural. But in pediatrics, you will deal with angry, ungrateful, rude, unsophisticated, loud parents. Actually many times you will be "treating" the psychotic parents instead of their kid. Let me give you a REAL LIFE example. A patient comes to my clinic (I am a Family Medicine resident) with her 10 YO daughter saying that she thinks that her daughter has "Strep Throat", along with a runny nose. I look into her month. Perfectly normal. The rest of exam is also perfectly normal, and indicates seasonal allergies that can be controlled simply with OTC anti-histamines. So I tell the mother that she is OK, and all she needs is some OTC Claritin. She gets all angry at me, and starts yelling and screaming, and DEMANDS that I give her child antibiotics. I tell her that ABX are not indicated in URI/Allergies...she says "I do not care, I came here for an antibiotic prescription, and not leaving without one". So I left the room and talked to my attending. My attending, a 20-year veteran pediatrician, laughs and says, "No problem, I will take care of this". I thought she will go in and kick some as$, but instead, she goes in, apologies to the mother, and give the child a 5 day coarse of Amoxacillin just like mom wants????!!!! I asked her what was the indication for the antibiotic, she responds, "I am treating the mother, and I want her to come back to my practice. I do not want to loose her as a patient to another practice".😱
This is VERY common among real-world PRIVATE PRACTICE pediatricians. I see this all the time. They are running a "business" and want to keep their "customer" happy. Things like this makes me want to puke.

"Patient contact" is way over-rated. I, like you, also did not mind seeing patients. But once I saw all the Bullsh$it that goes on in real life, as a resident, my eyes are now opened up. In Pediatrics, just like FM, you will have TONS upon TONS of patient contact WITH ADULTS.

By the way, those of you who are in Radiology, and "miss the patient contact", DON'T! You are not missing anything other than headaches, yellings, and screams. Radiology is one of the best fields out there.

 

[f_w]

"No problem, I will take care of this". I thought she will go in and kick some as$, but instead, she goes in, apologies to the mother, and give the child a 5 day coarse of Amoxacillin just like mom wants????!!!! I asked her what was the indication for the antibiotic, she responds, "I am treating the mother, and I want her to come back to my practice. I do not want to loose her as a patient to another practice".😱

At this very moment, I am sitting at home babysitting my kids so my wife can follow-up on a kid with Stevens Johnson in the hospital who had a course of amoxi for 'acne'.......

 

[DOCTORSAIB]

I don't love patient contact but I don't hate it either. Somtimes, it's nice to talk to people!

Which is why I asked why you're considering Peds -- a field with significant amount of patient (and parent) contact.

 

[rox]

The "patient contact" from a perspective of a medical student is VERY different from that of a resident who has the responsibility to deal with all the bulls&hit.

Don't you agree that we should base our judgment according to the lifestyle of an attending rather than a resident? I mean you spend only 5-6 years as a resident and the rest of your life as an attending.

Being a resident is probably the worst profession in life except for a few specialities, but as an attending, I suppose, you no more have to worry about the bugging parts of residency( notes, follow-up,...etc) as there are others doing those things for you.

That's at least how I look at the whole thing. I might be wrong though.

 

[f_w]

but as an attending, I suppose, you no more have to worry about the bugging parts of residency( notes, follow-up,...etc) as there are others doing those things for you.

As an attending you will have to worry MORE about documentation and follow-up. Documentation because that is how you get paid, follow-up because that is how you get sued.

Don't confuse the cushy world of academic medicine with the real world. In the real world (at least as a pediatrician) you won't have anyone to do your documentation for you.

 

[rox]

I see. Rads rules 🙂