Clarification on residency

[vin5cent0]

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Just wondering if someone could explain this a little bit more to me, or perhaps point me in the right direction to a site that would go a little more in-depth about it.

I understand about the whole medical school process, and about 'the match', choosing your residency, etc etc. What I'm wondering is, what happens if you want to be, lets say, a cardiologist, and you can't get it? Are you just supposed to change your entire future around and choose something else? Wait it out and re-apply? What affects your chances of getting your chosen residency? Are some harder to get in than others?

Thanks for any help 👍

 

[GAdoc]

Just wondering if someone could explain this a little bit more to me, or perhaps point me in the right direction to a site that would go a little more in-depth about it.

I understand about the whole medical school process, and about 'the match', choosing your residency, etc etc. What I'm wondering is, what happens if you want to be, lets say, a cardiologist, and you can't get it?


You may know this, but to be a cardiologist you have to first complete a three year IM residency. Usually, cards fellows apply in year two of their IM residency. To play this particular example out, I would think it would be important to do well on Step I and your clinical rotations (especially medicine) so that you can land an IM residency at a good spot (preferably one where lots of residents go on to competitive fellowships). Usually, this means research. Reserach in med school, but especially residency will be vital to landing a cards fellowship.

If you can't get in you have options: you could enter another specialty, you could work as a general internist and wait to reapply, or you could research and build your application as you wait to reapply. But, as you may suspect, there are fewer slots for cards fellows than there are applicants. Some IM sub-specialties are easier to get into than other (i.e ID or Nephrology).

 

[Blade28]

What I'm wondering is, what happens if you want to be, lets say, a cardiologist, and you can't get it? Are you just supposed to change your entire future around and choose something else? Wait it out and re-apply? What affects your chances of getting your chosen residency? Are some harder to get in than others?

I agree with the above post by GAdoc.

Think of it like applying to med school. Not everyone gets in. What do you do next? Reapply? Take a few years off, bolster your app, and try again? Switch fields?

Same thing with residency. Not everyone that wants to be a cardiologist gets to be one.

 

[lilnoelle]

Cardiology isn't a good example because it is a fellowship done after an internal medicine residency.

There definitely are residencies that are more difficult to get into and it does happen where individuals don't get into their chosen fields.

Usually what happens is your school will help advise you about residency choice. If your scores are lower than the average individuals that get into your choice residency, then your advisor will probably advise you to look into an alternative field. Individuals applying for competitive residencies tend to apply very widely and rank as many programs as they can in order to increase their chance of matching. Individuals that don't match can try to scramble into an open position, or they can choose to take a year off for research, or do an intern year and try to match the next year.

Individuals applying for a competitive residency may choose to apply to more than one type of residency during fourth year. A good example of this is someone trying to get into plastic surgery. They may also apply for general surgery and rank general surgery below plastics - increasing their chance of matching that year. Perhaps this individual won't match into plastics, but they can complete their surgery residency and try to get into a plastics fellowship.

I have no doubt that there are individuals who don't get into their desired field, but I think it happens less often than you think because individuals will generally apply for fields that they are competitive for. Just like the highschool quarterback realizes during college that they will never be a professional athlete and chooses a different career, an individual in the bottom 1/4 of the class is probably going to give up on dermatology as their first choice and choose a different specialty.

 

[Blade28]

Just like the highschool quarterback realizes during college that they will never be a professional athlete and chooses a different career, an individual in the bottom 1/4 of the class is probably going to give up on dermatology as their first choice and choose a different specialty.

Or, as the case may be, the bottom 90% of the class will give up on Derm. 🙂

 

[vin5cent0]

Thanks folks, you're all really quite helpful. My skin is the greatest, so it'd probably be a bit odd if I was advising others on their skin Guess I don't have to worry about that one.

 

[mfrizzo3]

Sure, you can reapply.

Just remember that everyone cannot be the best, everyone cannot get what they want, everyone cannot be ENT/ORTHO/DERM/RADS etc. It probably is very hard to get a residency that you have been previously denied. Remember you will always be applying against a new crop of AOA/Honors/Super Awesome med student for those spots.

Almost everyone who gets in to med school has the capability to get a good residency, but some people would rather f-around than study so if you want to get that awesome residency, you should start bustin arse as soon as you get to med school, particularly during the ol' clinicals

 

[Law2Doc]

I have no doubt that there are individuals who don't get into their desired field, but I think it happens less often than you think because individuals will generally apply for fields that they are competitive for. Just like the highschool quarterback realizes during college that they will never be a professional athlete and chooses a different career, an individual in the bottom 1/4 of the class is probably going to give up on dermatology as their first choice and choose a different specialty.

It's not all self selection -- We also should not underemphasize the strong-armed advising many schools will do. It is not like applying to med school where folks are "allowed" to take longshots. When considering residencies your school administration will often sit folks down and shake some reality into them, if they are contemplating fields to which they have no shot. I know of several folks who have had these uncomfortable conversations. But as a result, most people (94%+ of all allo students) match.

 

[xanthomondo]

If you don't match and go on to your intern year, will you have a "gap year" in between internship and residency? Or will you have to do another intern year?

 

[PeepshowJohnny]

It's not all self selection -- We also should not underemphasize the strong-armed advising many schools will do. It is not like applying to med school where folks are "allowed" to take longshots. When considering residencies your school administration will often sit folks down and shake some reality into them, if they are contemplating fields to which they have no shot. I know of several folks who have had these uncomfortable conversations. But as a result, most people (94%+ of all allo students) match.

Agreed. My school does this almost to a fault (basically telling people they have no shots at residencies that they end up matching at). However, we have enough residency's on site, that usually you can get a good PD to help advise you.

That said, sometime's it's not over until it's over. Let's take the dermatology example. It's rare, but there are people who have failed to match into derm, completed an internship year and gotten a position in a subsequent year. However, you'll NEVER be as competitive as you will be as a graduating M4. Moral of the story: work hard in med school.