Chances of matching Advanced PGY2 Radiology positions?

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Jun 25, 2021
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Hi all currently in PGY1 IM but this wasn't my desired specialty. Not so thrilled about IM, but wondering if its worth it and if I have a good chance to match into Diagnostic radiology when applying to Advanced PGY2 Radiology positions? I know Rad make more and I feel its more intune with my post residency desires, easibility to work from home, better lifestyle, etc.
I have a 230/237, low comlexes, doing well so far in residency, have good EC, research from my last 2 years of medical school. I Could get a good radiology LOR, and IM recs.
Please advise. Thanks!


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10+ Year Member
Jun 28, 2010
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Sounds pretty uncertain at this point unless you have strong connections to a specific Radiology residency program. You have several factors working against you:
-you weren't able to match into Psych (which is generally not as competitive as DR and has lower average Step scores) so your chances of DR are probably lower
-Your Step scores are below average for radiology
-I assume you're a DO since you took the COMLEX, and DR programs as a whole do have more bias against DOs than IM programs (though there are exceptions)
-These could be compensated for if you had a lot of radiology-related research and you say you did research the last 2 years of med school but it won't help much unless it's radiology related.
-You already started a Categorical IM position so your CMS funding for future residencies is more limited at some programs. Some DR programs may not get the full CMS for all 4 years if your DR training so they may have to pay out of their own budget to fund part of your training (and this is a dealbreaker for some programs).
-Not applying as a senior med student does slightly decrease your chances and will require explanation as to why you're changing specialties. And it would require strong support from your current P.D.

Finally, the starting pay for DR is somewhat higher on a per hour basis than IM right now but any benefit of the higher pay will offset by the much later start at making the radiology attending (4 years DR + 1 year of pretty much required fellowship after your intern year; and most DR positions in the Match are Advanced positions that start 1 year after the year of the Match so matching into one of those positions would lead to another gap year between your Intern year and first year of radiology residency).
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2+ Year Member
Sep 24, 2018
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I'm pretty sure very few people enjoy IM intern year including the categoricals. Why do you want to switch and what was your desired specialty? It might be a better idea to stick with IM and go for fellowship in a subspecialty that you can tolerate.


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5+ Year Member
Dec 1, 2016
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If you're looking to jump straight from internship into a PGY2 radiology spot, that's pretty unlikely. There's generally not a lot of open R2 spots to fill. Programs that do have vacancies often have their pick of people switching out of a super competitive specialty or someone internal that's made an impression the department.

If you're okay with a gap year and applying for advanced spots like current M4's are you might have a slightly higher chance. There's a not small number of low to mid-tier programs that take statically below average people. You might have better luck with a former AOA-accredited program.