Big Problem

[amakhosidlo]

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I have one.


So, I went into my Peds rotation thinking it was going to be my chance to relax and recover between medicine and surgery. Did NOT think I wanted to do peds at all, and for the majority of the rotation, that sentiment stayed the same. Then I got to inpatient and heme onc. I don't think I've ever felt as strongly about going into something as I do about peds heme/onc. I'd been considering heme/onc via medicine, but the patients, the atmosphere, everything just clicks so much better here. I'd been losing steam and burning out, and the past two weeks basically reminded me daily why I went into medicine. 👍

The problem: I basically coasted through half the rotation and am guaranteed nothing higher than a 'pass', and have really no shot at a letter from anyone here. We only really work with residents, the attendings hardly know what we look like. My attending the first couple of weeks would've been a good choice, but there's no way he would be able to honestly write me a strong letter.I'd do an elective to get it, but we have required clerkships, basically into mid-august.

So. A pass in peds, and no shot at a letter before my application needs to go out.

I'd already had a path carved out in Rad. Onc (letters, research, everything), and starting over I really don't know how to procede. Obviously going for a fellowship I'd have to go with a strong, academic program.

Stats:
Step 1: 243
Clinicals: Honors in everything so far (everything being family and medicine)
Research: Two publications, one in rad onc and the other in a random student-specific journal.
Volunteering/leadership/etc: Nada. Was told for the things I was considering it was a waste of time

So I need a game plan. Any suggestions?

 

[mercaptovizadeh]

I have one.


So, I went into my Peds rotation thinking it was going to be my chance to relax and recover between medicine and surgery. Did NOT think I wanted to do peds at all, and for the majority of the rotation, that sentiment stayed the same. Then I got to inpatient and heme onc. I don't think I've ever felt as strongly about going into something as I do about peds heme/onc. I'd been considering heme/onc via medicine, but the patients, the atmosphere, everything just clicks so much better here. I'd been losing steam and burning out, and the past two weeks basically reminded me daily why I went into medicine. 👍

The problem: I basically coasted through half the rotation and am guaranteed nothing higher than a 'pass', and have really no shot at a letter from anyone here. We only really work with residents, the attendings hardly know what we look like. My attending the first couple of weeks would've been a good choice, but there's no way he would be able to honestly write me a strong letter.I'd do an elective to get it, but we have required clerkships, basically into mid-august.

So. A pass in peds, and no shot at a letter before my application needs to go out.

I'd already had a path carved out in Rad. Onc (letters, research, everything), and starting over I really don't know how to procede. Obviously going for a fellowship I'd have to go with a strong, academic program.

Stats:
Step 1: 243
Clinicals: Honors in everything so far (everything being family and medicine)
Research: Two publications, one in rad onc and the other in a random student-specific journal.
Volunteering/leadership/etc: Nada. Was told for the things I was considering it was a waste of time

So I need a game plan. Any suggestions?

I think trying to rearrange your schedule to throw in two peds electives and an AI would be a good idea. You probably have to do at least one elective/AI before you apply so you can get a peds letter from someone who knows you.

 

[michigangirl]

You need one peds letter. Just one. So do an elective, bust your butt and kick its a#s, and get a great letter. You'll be fine-- particularly if you are competitive for rad onc, chances are you are very competitive for a strong peds program. Make sure your other letters are excellent as well-- you'll be set!

If you loved heme-onc, are you sure you didn't impress any heme-onc attendings in the process?

 

[Jessipeds]

Try to do some Peds electives this fall. Even if you got a Pass in your core Peds, if you do really well on your away rotations, you can get some great Peds LOR's that will make you stand out.

 

[amakhosidlo]

If you loved heme-onc, are you sure you didn't impress any heme-onc attendings in the process?

I thought of that. They seem great, but honestly I'm not very confident in the writing skills of the person covering heme-onc here. Also, they've made themselves very scarce, like i said we dont really get much face time. If I have only one letter, I feel like they need to be able to write intelligibly about me

Another issue I just realized, is that our applications to do peds. Electives were due last month, essentially a week into my peds rotation, when the thought of doing peds hadn't yet crossed my mind. Would doing a sub-I or H/O away (deadline not yet passed) work? Doing the away and then applying to my home program with that letter- Would that look ridiculous? As in : "You would've gotten a letter from us if you wanted to stay here"

 

[michigangirl]

Talk to someone and see if there's any way around the deadline to get an elective. If not, do the away elective and kick a#s. Explain to your home institution exactly what you told us regarding the timing of your decision and love of the peds rotation.

 

[Nibby]

Most schools will work with you as many students switch up into june. If you need to do an away to get a letter I don't think anyone will mind. From being on the trail this year and talking to some of the residents that matched into heme/onc it sounds like heme/onc isn't the most competitive fellowship. I went down a similar route, originally thought rad/onc, switched into peds around march, only ended up doing a subi in peds heme onc and got most of the interviews i wanted. Your app sounds better than mine so you should have even better luck.

 

[pooh86]

If you have to pick between a sub I at home institution vs an away for the purpose of getting a letter, I'd recommend a sub-I. Having been on Aways myself, it's not always easy to get letters simply because you are not sure what kind of interactions you will have with the attendings. You might end up working under a new hospitalist who's letter wouldn't carry as much weight as the program director of your home institution.

 

[MonkeyRalph]

From my experience being on a residency selection committee, we all found it to be a very big red flag if an applicant had honors in everything else but just a pass in peds. Do you think you can try to really study hard and bring your pass to a high-pass by aceing your shelf? I think we also found lack of leadership and/or extracurriculars to indicate someone who is not really that well-rounded. Unfortunately for you, it's too late to make up for these downfalls, but the rest of your application so far seems like it will be pretty strong for most academic peds programs. (and there's some programs out there that care more about your scores and research than your other stuff). So my advice would be to really try and work hard for the rest of your peds rotation. Talk to you academic affairs office to see if you can switch around your elective and get a peds subI in as soon as you can. You can probably get a decent research letter and a strong letter from someone that you impressed on your medicine rotation, then all you need is a peds letter from your subI and you're set to go. Good luck.

 

[JMMH]

Just be honest and talk to the director of the peds rotation and residency program and explain your change of heart and how best to go from there. They will be the best people to help you with the application process.

Plus if you were competitive in rad/onc you'll be fine in peds as long as you interview well. Although it sounded like outpatient peds didn't do much for you the first part of your rotation, just be aware you still have to do three years of general peds before you get to heme onc fellowship (I know you do but you get my point)!

Can already tell you will love continuity clinic--otherwise known as the reason I went into fellowship in the first place 😉.

 

[chemta2006]

In arranging early 4th year rotations, also consider doing a PICU or NICU sub-I if they're available at your institution. I know that at my school, some people did not get the Peds sub-I's they wanted in July - Sept, so they opted to do a PICU sub-I. This is generally considered hardcore (and has a certain amount of risk) but if you do well on it, that would look great for your application.

Good luck on your plan!