Beware: IM-Prelim Lessons learned from 2014 Match

[thinkenergy]

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IM - prelim this year was EXTREMELY & BRUTALLY competitive, and it will only get worse. IM-prelim is the feeder program for the ROAD specialties (Rad, Rad-Onc, Opth, Anes, Derm).

Applied to 14 - mostly in my home state, got 7 interviews, ranked all of them, did not match. Matched to PGY-2 in Radiology, how crazy is that???!!! It seems that many IM programs are very picky about whom they interview/rank. My home program didn't even take me. How disappointing is that???!!!

Only got 1 offer even though 5 programs called me during SOAP. Accepted the offer at a small university program, just happy NOT losing my PGY-2 spot.

My Stats:
Step 1/2 both in 250s, 3H's/3HP's in clinical year, 2 researches, excellent LOR's, still have to go through SOAP!!!

 

[dyspareunia]

IM - prelim this year was EXTREMELY & BRUTALLY competitive, and it will only get worse. IM-prelim is the feeder program for the ROAD specialties (Rad, Rad-Onc, Opth, Anes, Derm).

Applied to 14 - mostly in my home state, got 7 interviews, ranked all of them, did not match. Matched to PGY-2 in Radiology, how crazy is that???!!! It seems that many IM programs are very picky about whom they interview/rank. My home program didn't even take me. How disappointing is that???!!!

Only got 1 offer even though 5 programs called me during SOAP. Accepted the offer at a small university program, just happy NOT losing my PGY-2 spot.

My Stats:
Step 1/2 both in 250s, 3H's/3HP's in clinical year, 2 researches, excellent LOR's, still have to go through SOAP!!!

Rough life bro.

 

[sazerac]

According to the SOAP2014 thread in the residency sub forum (link), even FM is competitive this year. I guess all that recent effort to increase the number and size of medical school classes is finally starting to pay off.

 

[badnewstime1]

I was the other way around. Matched only prelim IM but not advanced in very competitive specialty. My step scores were below average. I will agree that prelim IM is brutally competitive in terms of getting interviews as I struggled to even get a handful. TYs, forget about it, didn't even get an interview. OP, you didn't get ranked at your home program? Guess what, not only did I not get an interview at my home program, I got a flat out rejection letter early in the season.

Any way, point is I would rather be in your shoes. M3s -- focus on your advanced program first. To get prelim IM interviews you MUST email programs you get advanced interviews at. They will usually accommodate you on the same day. Shotgunning applications through ERAS is not the way to get prelim and TY interviews. You must be aggressive and demonstrate interest -- the best way of which is to have an interview invitation from an advanced program at the same institution.

 

[Daodejing]

Any way, point is I would rather be in your shoes. M3s -- focus on your advanced program first. To get prelim IM interviews you MUST email programs you get advanced interviews at. They will usually accommodate you on the same day. Shotgunning applications through ERAS is not the way to get prelim and TY interviews. You must be aggressive and demonstrate interest -- the best way of which is to have an interview invitation from an advanced program at the same institution.

this sounds like some sage advice. thanks.

 

[SouthernSurgeon]

IM - prelim this year was EXTREMELY & BRUTALLY competitive, and it will only get worse. IM-prelim is the feeder program for the ROAD specialties (Rad, Rad-Onc, Opth, Anes, Derm).

I'm glad you got a spot, but I'd point out that IM/TY are not the ONLY feeders for advanced programs (at least not rads, ophtho, and anesthesia). Applicants would be wise to at least look into a prelim surgery spot at their home program (assuming it's not horribly malignant). Even if they rank it at the bottom of their list it would prevent going unmatched.

 

[Psai]

According to the SOAP2014 thread in the residency sub forum (link), even FM is competitive this year. I guess all that recent effort to increase the number and size of medical school classes is finally starting to pay off.

So basically not only is it getting harder for us to match into something we want to do, but if we're unsuccessful, it will be harder to match something we don't want to do? Fantastic. Good thing the payoff is only increasing oh wait

 

[badnewstime1]

I'm glad you got a spot, but I'd point out that IM/TY are not the ONLY feeders for advanced programs (at least not rads, ophtho, and anesthesia). Applicants would be wise to at least look into a prelim surgery spot at their home program (assuming it's not horribly malignant). Even if they rank it at the bottom of their list it would prevent going unmatched.

^^^ This guy is spot on. I know a few rads applicants who only applied prelim surgery. TY competition is insane and a good surgery prelim is arguably more useful to rads than prelim med. Plus you don't have the drama involved with trying to land TY and IM interviews. I can't imagine losing an advanced spot because you couldn't get a prelim surgery position in the SOAP.

 

[badnewstime1]

So basically not only is it getting harder for us to match into something we want to do, but if we're unsuccessful, it will be harder to match something we don't want to do? Fantastic. Good thing the payoff is only increasing oh wait

Yes, virtually everything is competitive now. Failing to match makes everything even more competitive. I partially blame the NRMP and the publication of match statistics. It encourages applicants to either self-select in or out of certain specialties solely based on their step 1 score. And it does so using old data. And that's why the average step 1 scores keep climbing without end. It's so stupid and bad for the system it's almost unbelievable.

 

[MedStud!]

^^^ This guy is spot on. I know a few rads applicants who only applied prelim surgery. TY competition is insane and a good surgery prelim is arguably more useful to rads than prelim med. Plus you don't have the drama involved with trying to land TY and IM interviews. I can't imagine losing an advanced spot because you couldn't get a prelim surgery position in the SOAP.

Yup... I thought I was a shoe-in for the local TY or prelim medicine. We had a not-so-awful prelim surgery program in the area that usually has a spot or two open in the SOAP. I figured I might as well interview there during the regular cycle so I don't have to fight for it in the SOAP. Turns out that was a good idea... because that is where I am going next year.

 

[Daodejing]

Yup... I thought I was a shoe-in for the local TY or prelim medicine. We had a not-so-awful prelim surgery program in the area that usually has a spot or two open in the SOAP. I figured I might as well interview there during the regular cycle so I don't have to fight for it in the SOAP. Turns out that was a good idea... because that is where I am going next year.

Congrats on radonc. Did you have a PhD/do a research year?

 

[thinkenergy]

I was the other way around. Matched only prelim IM but not advanced in very competitive specialty. My step scores were below average. I will agree that prelim IM is brutally competitive in terms of getting interviews as I struggled to even get a handful. TYs, forget about it, didn't even get an interview. OP, you didn't get ranked at your home program? Guess what, not only did I not get an interview at my home program, I got a flat out rejection letter early in the season.

Any way, point is I would rather be in your shoes. M3s -- focus on your advanced program first. To get prelim IM interviews you MUST email programs you get advanced interviews at. They will usually accommodate you on the same day. Shotgunning applications through ERAS is not the way to get prelim and TY interviews. You must be aggressive and demonstrate interest -- the best way of which is to have an interview invitation from an advanced program at the same institution.

Pretty sure ranked by my home program, just not high enough to match. There are a ton of derm and rads applicants from my school this year. Last year, out of 10 prelims spots, 5 went to derm, 1 went to optho, 1 went to radonc. I am guessing it will be a similar picture this year.

 

[thinkenergy]

Congrats on radonc. Did you have a PhD/do a research year?

Congrats on landing PGY-1 spot. For me, I would not even try to SOAP into surgery unless I absolutely have to. If I did not get any SOAP offers, I would contact PD of my advanced program to see if any strings can be pulled. There are tons of program that have spots outside the SOAP. If everything fails, I would consider prelim-surgery.

 

[SouthernSurgeon]

Congrats on landing PGY-1 spot. For me, I would not even try to SOAP into surgery unless I absolutely have to. If I did not get any SOAP offers, I would contact PD of my advanced program to see if any strings can be pulled. There are tons of program that have spots outside the SOAP. If everything fails, I would consider prelim-surgery.

That's incredibly foolish. You risk losing your entire future because of some preconceived notion that ONE year in a surgical residency is so undesirable ?

The decent prelim surgery programs are, IMO, a much better choice than whatever prelim medicine slots fall through into SOAP or, god forbid , whatever programs (med or surg) fall through both the regular match and soap.

 

[MedStud!]

Congrats on radonc. Did you have a PhD/do a research year?

Thanks! I did do a PhD in cancer research. I know that was helpful... but going back to clinic on a different schedule had a significantly negative impact on my clerkship grades because of the way my school calculates ranking and honors. I'm sure that hurt with prelim programs since they could care less about my research. Anyway, I have a job next year and matched at my second choice for advanced so I can't complain.

 

[calvnandhobbs68]

According to the SOAP2014 thread in the residency sub forum (link), even FM is competitive this year. I guess all that recent effort to increase the number and size of medical school classes is finally starting to pay off.

Yeah for DOs/IMGs trying to match into MD spots. Not terribly surprising considering they're gonna get filled with US MDs first. FM still isn't competitive by any stretch of the imagination.

 

[thinkenergy]

Just found out: of the 10 IM-prelim positions at my home program this year, 7 went to derm, 1 went to rad-onc, 2 went to rad (who are not as competitive as me). Majority of rad applicants this year matched into transitional year. There seems to be a discrimination against rad applicant by IM PD's: rads applicants were perceived to be relatively lazy and only want cush internship.

I am pretty sure the IM PD offered 2 extra positions outside the match to 2 optho applicants who did not match.

 

[DermViser]

So basically not only is it getting harder for us to match into something we want to do, but if we're unsuccessful, it will be harder to match something we don't want to do? Fantastic. Good thing the payoff is only increasing oh wait

• So more schools (both MD and DO) getting approved and graduating classes at a high rate to where eventually there will be more U.S. medical students than positions
• Obama's proposed budget cuts 14.6 Billion dollars out of GME over 10 years (a.k.a. cutting funding of a number of residency positions)
• Meanwhile the goal of healthcare reform is to insure everyone, with the next phase being to heavily rachet down reimbursement for doctors and hospitals
• with the advocacy of midlevels to infiltrate primary care (at least for now)

That NRMP Charting Outcomes the next time it comes out is going to have to be followed to the "t" for future seniors. Very scary time for seniors graduating in the next few years.

 

[DermViser]

That's incredibly foolish. You risk losing your entire future because of some preconceived notion that ONE year in a surgical residency is so undesirable ?

The decent prelim surgery programs are, IMO, a much better choice than whatever prelim medicine slots fall through into SOAP or, god forbid , whatever programs (med or surg) fall through both the regular match and soap.

There's nothing preconceived at all about it. Hardly anyone wants to deal with one year of highly abrasive surgery personalities, who know you won't be there next year. At least in IM, the personalities on average tend to be much nicer than their surgery counterparts.

 

[SouthernSurgeon]

There's nothing preconceived at all about it. Hardly anyone wants to deal with one year of highly abrasive surgery personalities, who know you won't be there next year. At least in IM, the personalities on average tend to be much nicer than their surgery counterparts.

I'm well aware of your feelings on surgeons.

But I'd suggest that trading one year of putting up with us is far preferable to the alternative - that being either (a) going unmatched and losing your coveted advanced spot or (b) having to SOAP into one of the (most likely) least desirable medicine prelims in the country.