Chances of matching Internal Medicine?

[prospectivemd3]

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I am currently an MS4 at a mid to low tier US MD program. This past year I applied into ortho and did not match. I decided to pursue IM-->Cards as I had been considering this in the past. The SOAP options were terrible so after discussing with mentors and advisors, I decided to reapply this fall into the next match cycle. In the meantime, I have scheduled an IM elective rotation, a home Medicine Sub-I, and am in the process of applying for an away sub-i for an IM program preferably on the west coast (as this is where I am from). Will also be looking to get strong LORs through these rotations. I am also working to get involved with some cardiology-specific research as well. My stats and research are listed below:

MS3 Clinical: 7 High Pass, 1 Honors. Strong Clinical Evals (my program has a specific SHELF score cutoff to be considered for honors)
Step 1: PASS
Step 2: 232
Research: 8 publications, 3 Podium Presentations (2 local research conferences, 1 national research conference), 2 poster presentations; 5 studies still under review.

My biggest question is will I be competitive for decent academic internal medicine residency programs? Also, same question for California programs in particular (UCI, Kaiser LA, Kaiser SF, UCSD, USC, etc)?

Thanks for the insight/feedback.

 

[NotAProgDirector]

There are lots and lots of decent IM programs out there. Students get in their minds that if they don't match at MGH/BWH/BIDMC/Mayo/JHH/Duke/Penn etc that their careers are over. This is nonsense. Your performance is probably not going to let you compete for those spots -- although feel free to apply to UCLA and see what happens. The most important thing you can do in the next cycle is to make your application 1000% clear that you are no longer applying to ortho. You are free to talk about that in your PS -- but this is meaningless to programs, since you can send a different PS to your IM programs vs Ortho (if you were applying again). So you should 1) get an LOR from your Ortho research mentor that states that you're now applying to IM, and 2) in your ortho research description, write that after re-evaluating your career goals you've decided to apply to IM instead. Most ortho mentors won't be willing to write you two LOR's for two different specialties, and you only get one ERAS app/CV, so if you state this in the research description programs will know you're serious.

 

[typhoon1]

Is all your research ortho related

 

[prospectivemd3]

There are lots and lots of decent IM programs out there. Students get in their minds that if they don't match at MGH/BWH/BIDMC/Mayo/JHH/Duke/Penn etc that their careers are over. This is nonsense. Your performance is probably not going to let you compete for those spots -- although feel free to apply to UCLA and see what happens. The most important thing you can do in the next cycle is to make your application 1000% clear that you are no longer applying to ortho. You are free to talk about that in your PS -- but this is meaningless to programs, since you can send a different PS to your IM programs vs Ortho (if you were applying again). So you should 1) get an LOR from your Ortho research mentor that states that you're now applying to IM, and 2) in your ortho research description, write that after re-evaluating your career goals you've decided to apply to IM instead. Most ortho mentors won't be willing to write you two LOR's for two different specialties, and you only get one ERAS app/CV, so if you state this in the research description programs will know you're serious.

Thanks for that advice, thats super helpful. A big part of why, in addition to my medicine rotations, I wanted to do some IM-specific research was to really show my commitment to the field. But I think reaching out to my research mentor about a new LOR stating that specifically would go a long way.

 

[prospectivemd3]

Is all your research ortho related

Yes, at this point all of my research has been ortho. I am trying to get involved with some cards research at the moment.

 

[abc123412]

I am currently an MS4 at a mid to low tier US MD program. This past year I applied into ortho and did not match. I decided to pursue IM-->Cards as I had been considering this in the past. The SOAP options were terrible so after discussing with mentors and advisors, I decided to reapply this fall into the next match cycle. In the meantime, I have scheduled an IM elective rotation, a home Medicine Sub-I, and am in the process of applying for an away sub-i for an IM program preferably on the west coast (as this is where I am from). Will also be looking to get strong LORs through these rotations. I am also working to get involved with some cardiology-specific research as well. My stats and research are listed below:

MS3 Clinical: 7 High Pass, 1 Honors. Strong Clinical Evals (my program has a specific SHELF score cutoff to be considered for honors)
Step 1: PASS
Step 2: 232
Research: 8 publications, 3 Podium Presentations (2 local research conferences, 1 national research conference), 2 poster presentations; 5 studies still under review.

My biggest question is will I be competitive for decent academic internal medicine residency programs? Also, same question for California programs in particular (UCI, Kaiser LA, Kaiser SF, UCSD, USC, etc)?

Thanks for the insight/feedback.

Is there any scope of your scrambling into an Internal Medicine program now itself?

 

[Dr. Robb Bassett]

Hey, really appreciate you sharing your journey—takes a lot to pivot after not matching, and it sounds like you’ve done so thoughtfully and intentionally. That kind of resilience will serve you well moving forward, especially in something as demanding and nuanced as cardiology.
From what you've shared, you're absolutely setting yourself up to be a competitive candidate for solid academic IM programs. Your clinical performance, particularly the strong evals and 7 High Passes + Honors, already reflects a solid foundation, especially given the way your school handles honors based on shelf scores (which can definitely make a difference in how adcoms read your transcript). Step 2 at 232 isn't blow-the-doors-off, but it’s well within range for many academic IM programs—especially when paired with a strong application narrative and meaningful LORs.

Your research portfolio is probably one of your strongest assets—8 publications and a mix of podiums and posters shows not just productivity, but breadth. The fact that you're pivoting and already moving into cardio-specific research helps thread the needle between your past work and your current path. I might ask: what kind of story do you want your app to tell about why cardiology? How do your past ortho ambitions inform that pivot—not in terms of content, but in the underlying values or traits that drew you to both?

In terms of California programs—yeah, it’ll be competitive, but not impossible by any means. Places like UCI and Kaiser LA do tend to lean heavily on high Step scores or top-tier med schools, but strong clinicals + research + authentic interest (especially with local ties) definitely count. I’d encourage you to keep pursuing that away sub-I out west—those face-to-face connections can sometimes move the needle more than a test score can.

Are you also thinking about how to frame the reapplication year in your personal statement? That’s often where people either lose or gain a lot of ground. Program directors understand non-linear paths, especially when there's reflection, growth, and clarity on display.

You’re already asking the right questions—and it sounds like you’re doing the right things. Keep putting yourself in positions to be seen and remembered. You don’t have to be perfect—you just have to be clear on who you are and what you bring.

Happy to continue the conversation if more questions come up down the road. You're not alone in this.