Are there really only four FM residencies around the SE Oklahoma area?

[northnorthtexan]

Spouse of an MS4 here, seeking advice so that I can understand how the residency matching process works for all the aspiring family medicine physicians out there. To start things off, I am a recent bar-passer and will begin my law career this coming January as an attorney for the Army. I will spend the first ~3 years of my career at Lawton, Oklahoma because that's where I have been ordered.

This is the complex part I need you help with. My spouse has wanted to do FM since high school, and they go into a top 10 med school and FM program to make that possible. They graduate December 2023, so they have not applied for any residencies yet because they are still studying for Step1 I think. It already is going to take a toll on our marriage because we will be separated for the better part of a year next year while she finished up school. What I'm really worried about is how we can still be together while also ensuring she matches into a good program. They've talked about wanting to start a family next year, which I fully support. Trouble is, I've only been able to find exactly four FM residencies within a 1.5 hour commute of my workplace. For example, it would be feasible for me to drive about an hour one way to Lawton, OK and her to drive another hour one way to OKC by living somewhere in the middle. What I don't think would work out is a situation where, say, she applies to the DFW area (where they are originally from) and matches in Fort Worth, TX which is nearly four hours from Lawton, OK.

Are there FM residencies that are not listed on the AAFP website? I don't know a lot about the medical student world, but I know enough to know that four residency applications only is high-risk, at best. So, what are the odds of an MD+MPH student with average grades from top 10 school matching into FM if there are only four viable options? How bad would it look for them to apply to residencies in different but similar fields, such as internal or peds? Finally, in a worst case scenario, how detrimental would it be for her to fail to match at all and just use the gap year to have a baby? I really wish medicine was as simple as law where y'all could just choose where to apply and work at like any other job.

Thanks in advance for any and all helpful insight.

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[VA Hopeful Dr]

Spouse of an MS4 here, seeking advice so that I can understand how the residency matching process works for all the aspiring family medicine physicians out there. To start things off, I am a recent bar-passer and will begin my law career this coming January as an attorney for the Army. I will spend the first ~3 years of my career at Lawton, Oklahoma because that's where I have been ordered.

This is the complex part I need you help with. My spouse has wanted to do FM since high school, and they go into a top 10 med school and FM program to make that possible. They graduate December 2023, so they have not applied for any residencies yet because they are still studying for Step1 I think. It already is going to take a toll on our marriage because we will be separated for the better part of a year next year while she finished up school. What I'm really worried about is how we can still be together while also ensuring she matches into a good program. They've talked about wanting to start a family next year, which I fully support. Trouble is, I've only been able to find exactly four FM residencies within a 1.5 hour commute of my workplace. For example, it would be feasible for me to drive about an hour one way to Lawton, OK and her to drive another hour one way to OKC by living somewhere in the middle. What I don't think would work out is a situation where, say, she applies to the DFW area (where they are originally from) and matches in Fort Worth, TX which is nearly four hours from Lawton, OK.

Are there FM residencies that are not listed on the AAFP website? I don't know a lot about the medical student world, but I know enough to know that four residency applications only is high-risk, at best. So, what are the odds of an MD+MPH student with average grades from top 10 school matching into FM if there are only four viable options? How bad would it look for them to apply to residencies in different but similar fields, such as internal or peds? Finally, in a worst case scenario, how detrimental would it be for her to fail to match at all and just use the gap year to have a baby? I really wish medicine was as simple as law where y'all could just choose where to apply and work at like any other job.

Thanks in advance for any and all helpful insight.

So there's a bunch to unpack here.

First, FM residencies are the easiest to get into. As long as she has good grades and isn't a just awful interviewer, there will be no issue getting an FM spot. For a specific region, it will help having a connection to the area or potential reason to stay there. You starting a job in that area is a decent reason, especially since its military.

Second, why the December graduation? That's off-cycle and she'll need to explain why that is.

Third, I think you don't quite understand how lucky you are to have 4 residency programs of her chosen specialty within 90 minutes drive of almost anywhere. There are very few other specialties that can claim that sort of thing outside of major cities. Assuming everything I said in point 1 is true, and that there's a good reason for point 2, she should have no issues matching at one of those 4. I don't remember the exact figures, but a US MD student apply to FM without any major red flags still has a very good chance of getting one of their top 3-4 choices.

 

[Rapsidy]

As far as the family goes and the idea of being pregnant, many residents get pregnant in their residencies. It’s a much better outcome for her to match into a residency and then plan the pregnancy while in residency than to defer the match for a year.

Also it may be helpful to have the timeline better understood so we know when she is looking to match. I think you have the graduation date from med school confused so it might be more helpful to tell us when she started medical school. Most students take step one around 2 years into medical school, and graduate after 4 years total.

 

[DOVinciRobot]

As someone with direct knowledge of those programs, a handful of them were originally osteopathic and converted with the merger and are heavily affiliated with OSUCOM. None of them are particularly competitive, but they do get quite a few applicants from Ok State whose students often rotate their as 3rd years and then again as a 4th year sub I. If your spouse wishes to go to one of those programs they should rotate there and make it VERY clear what their interest level is. Particularly Lawton or Durant, but honestly even the OU affiliated one in OKC. An MD applicant from a top school will otherwise be ignored because they will assume there isn’t true interest.

Also that area of the state isn’t densely populated, so yes there are only 4 FM programs in the region.

 

[mrbreakfast]

By far the simplest solution is for your spouse to match wherever she wishes for residency and for you to move there when you can. The quality of training defines the career, and it is a big ask for her to pick a residency in rural Oklahoma - I admittedly don't know much about FM programs, but I am going to guess that isn't the ideal place to train in residency.

This might actually be possible, because as others noted, you sentence

They graduate December 2023, so they have not applied for any residencies yet because they are still studying for Step1 I think.

seems to not be correct, because people apply for residency in the fall (i.e. the current class of 2023 applied this September) and will not have matched yet by December. Also, it would be pretty unusual for a fourth-year medical student to have not yet taken step 1. I would say a medical student who hasn't taken step 1 yet is probably looking at a graduation in the summer of 2024 at the earliest; even if she were graduating off-cycle (say, in December 2023) she likely would have already taken step 1 and applied to residency in order for that to happen. Some clarification might be helpful.

 

[Obnoxious Dad]

Spouse of an MS4 here, seeking advice so that I can understand how the residency matching process works for all the aspiring family medicine physicians out there. To start things off, I am a recent bar-passer and will begin my law career this coming January as an attorney for the Army. I will spend the first ~3 years of my career at Lawton, Oklahoma because that's where I have been ordered.

This is the complex part I need you help with. My spouse has wanted to do FM since high school, and they go into a top 10 med school and FM program to make that possible. They graduate December 2023, so they have not applied for any residencies yet because they are still studying for Step1 I think. It already is going to take a toll on our marriage because we will be separated for the better part of a year next year while she finished up school. What I'm really worried about is how we can still be together while also ensuring she matches into a good program. They've talked about wanting to start a family next year, which I fully support. Trouble is, I've only been able to find exactly four FM residencies within a 1.5 hour commute of my workplace. For example, it would be feasible for me to drive about an hour one way to Lawton, OK and her to drive another hour one way to OKC by living somewhere in the middle. What I don't think would work out is a situation where, say, she applies to the DFW area (where they are originally from) and matches in Fort Worth, TX which is nearly four hours from Lawton, OK.

Are there FM residencies that are not listed on the AAFP website? I don't know a lot about the medical student world, but I know enough to know that four residency applications only is high-risk, at best. So, what are the odds of an MD+MPH student with average grades from top 10 school matching into FM if there are only four viable options? How bad would it look for them to apply to residencies in different but similar fields, such as internal or peds? Finally, in a worst case scenario, how detrimental would it be for her to fail to match at all and just use the gap year to have a baby? I really wish medicine was as simple as law where y'all could just choose where to apply and work at like any other job.

Thanks in advance for any and all helpful insight.

Relax, counselor. Look at page 140 of the NRMP Report for match data in Oklahoma.

https://www.nrmp.org/wp-content/uploads/2022/06/Program-Results-2018-2022.pdf

You will see that the Oklahoma State program in Lawton has four slots and sometimes they don't fill. Your better half should be able to match there. Furthermore, if you look at page 8 of the report you will see that there is a 9 slot University of Arkansas program in Fort Smith, Arkansas which is just over the border from Eastern Oklahoma. There is also a new 8 slot program in Fort Smith that is affiliated with the new osteopathic med school.

I think you have your dates wrong. You need to sit down and map this out together time wise.

 

[voxveritatisetlucis]

My two cents. She’s at a top 10 medical school and probably used to working in university hospital. Trust me, there is a huge difference between UWash FM and a program that barely fills. She may resent you for a long time if she ends up feeling like you forced her to do it in Oklahoma when she probably could match at Harvard, uchicago, UNC, UWash etc.

I would let her match wherever she wants and then move to her or just do long distance.

 

[Med Ed]

What I'm really worried about is how we can still be together while also ensuring she matches into a good program.

That ship sailed with the starting premise: two careers, one in the military.

They've talked about wanting to start a family next year, which I fully support.

I'm getting the mother/father-in-law vibe here.

I really wish medicine was as simple as law where y'all could just choose where to apply and work at like any other job.

There is a reason the match came into existence, and it's not because the world before was simple and fun.

Unless one of the four FM programs in question turns out to be desirable for the aspiring doctor, something here has to give. Long distance is always difficult, but it has the benefit of being temporary (down to the day). And @mrbreakfast is right, residency training is an irreplaceable experience that will largely define the next 30-40 years of one's professional life. Since 30-40>2-3, best not to skimp.

 

[TJRock]

Furthermore, if you look at page 8 of the report you will see that there is a 9 slot University of Arkansas program in Fort Smith, Arkansas which is just over the border from Eastern Oklahoma. There is also a new 8 slot program in Fort Smith that is affiliated with the new osteopathic med school.

Ft. Smith is almost 4 hours from Lawton. Ft. Worth, Tx is an hour closer and that is where the OP's spouse is from.

 

[cj_cregg]

My two cents. She’s at a top 10 medical school and probably used to working in university hospital. Trust me, there is a huge difference between UWash FM and a program that barely fills. She may resent you for a long time if she ends up feeling like you forced her to do it in Oklahoma when she probably could match at Harvard, uchicago, UNC, UWash etc.

I would let her match wherever she wants and then move to her or just do long distance.

I don't know much about the specific OK programs being discussed here, but FM is not like other specialties with regards to the "brand name" programs. Academic centers generally tend to treat FM residents like the red headed stepchild and prepare you to do outpatient only in a specialist rich environment - which is fine if that's what you want, but many stronger candidates don't. The more competitive programs actually tend to be community programs in smaller cities with no other residencies in the hospital, because those ones offer more extensive training for inpatient, peds, OB, and often better outpatient training as well because you're used to managing sicker patients. So it's certainly possible that the programs in OK actually offer strong training.

 

[DOVinciRobot]

I don't know much about the specific OK programs being discussed here, but FM is not like other specialties with regards to the "brand name" programs. Academic centers generally tend to treat FM residents like the red headed stepchild and prepare you to do outpatient only in a specialist rich environment - which is fine if that's what you want, but many stronger candidates don't. The more competitive programs actually tend to be community programs in smaller cities with no other residencies in the hospital, because those ones offer more extensive training for inpatient, peds, OB, and often better outpatient training as well because you're used to managing sicker patients. So it's certainly possible that the programs in OK actually offer strong training.

This. The programs are actually pretty decent. They get very broad training and basically run the hospital. They don’t fill because most medical students treat rural Oklahoma as BFE, and to be fair it kind of is lol

 

[Obnoxious Dad]

Ft. Smith is almost 4 hours from Lawton. Ft. Worth, Tx is an hour closer and that is where the OP's spouse is from.

That was my goof. I thought I had read that he was looking for programs in eastern Oklahoma. However, the OP should still look at the NRMP results for Oklahoma programs.