hpsm2016

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Hey everyone,

Got my Step 1 score back and got a 239. Was hoping for better but it’s over with haha. Hopefully I can bring that up on CK. Anyways, I’m not super sure how competitive I am for academic programs on the coasts. Specifically ESIR programs.

I am a US MD student at an unranked Midwest state school. Grades were all pass the first two years, top 10%. Third year is only pass/fail, with pass so far. Not a ton of research but very strong EC’s and leadership positions. I guess my two questions are a) is it realistic for me to be looking at the coasts and b) if so, what programs should I be looking at?

Thanks for your help!
 
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harambe4ever

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  1. Medical Student
A. Yes, depending on where.
B. Honestly there are so many programs on the "coasts" it is difficult for me to recommend any. It will probably be tough to match to a MGH or UCSF without something else significant on your app (AOA or significant research or something), but honestly, the "coasts" can mean anything from UCLA to Portland, Maine to a random community program in Florida.

Also, just FYI maybe you know this but you don't apply to ESIR from med school. You apply to any DR program and if they have ESIR, you apply internally. It's not a given and may or may not be difficult to get into depending on the institution.
 

hpsm2016

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Thanks for the reply. Sorry I wasn’t more clear haha. I’m looking mostly for big coast cities (DC, NYC, Boston, SoCal). I knew that about ESIR, but if you do the independent residency at another place, would it still be two years if you went through a DR program which was ESIR?
 

irwarrior

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There are a limited number of ESIR spots designated at ESIR certified programs. There is usually some type of selection process, if there are multiple people who are interested. If you do get the ESIR spot and complete the requisite procedure volume (500) and the clinical rotations such as ICU, you are able to apply for the independent residency and are able to enter at the final year level (PGY6). Thus your total training should still only be 6 years (1+4+1). The difference with a standard DR program without ESIR certification is that you would have to go to a 2 year independent program (7 yrs/1+4+2). The integrated residency is one that you match directly from medical school and complete in 6 years with more "integration " of clinical time and IR rotations (1+5) or (6) years. The benefit of integrated is that you potentially get 6 years at one institution and learn the nuances of the EHR, the whims of the attendings, develop relationships with resident and attending colleagues in surgery/medicine and have a guaranteed spot.

The negative of the integrated residency is if you are uncertain about wanting to do IR (and the lifestyle,call demands or residency ends up being too rigorous and you realize that you would be happier reading imaging and having a more protected lifestyle), it may be tougher to exit out of the IR residency and you may end up having less diagnostic imaging training then your counterparts. There are also a limited number of integrated IR residency spots making it rather competitive.

The benefit of ESIR or DR alone are that you have more options of just going the diagnostic route, but the number of quality independent spots available may be limited and your foundational skills in clinical medicine and interventional techniques may not be at the level of the integrated trainees. So, if you are dead set on doing interventional and are leaning towards trying to develop a 100 percent IR practice the high end clinical IR integrated programs are probably a better fit.
 
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