competitive specialties

[sleep_addict]

Can anyone give me a ranking of your perception of what specialties are most competitive to get into? I've heard people talk about derm, etc, but I'd really like a better sense of this, since I feel like I'm interested in almost everything.

Thanks!

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[DarksideAllstar]

Derm and plastics are probably the two most coveted. Just do well on boards and during your rotations regardless of what you think you will end up in.

 

[Droopy Snoopy]

Plastics, dermatology, ophthalmology, orthopedics, urology, neurosurg, radonc, and ENT. I guess the next tier would include EM, rads, anesthesia, and maybe path.

 

[Wizard of Oz]

Plastics, dermatology, ophthalmology, orthopedics, urology, neurosurg, radonc, and ENT. I guess the next tier would include EM, rads, anesthesia, and maybe path.

I agree if you take out pathology--that's about as easy to match as internal med at most places. One of my friends in the midwest went unmatched in rads but got into a pretty prestigious New England slot for path.

Surgery and obgyn used to be tougher to match, but lifestyle and malpractice insurance have pushed their appeal down, not to mention other docs fixing people before they actually need surgeries (i.e. invasive cardiologists).

For family medicine, neurology, psych, and pediatrics, you will probably get a good match regardless of where you apply. Ditto for internal med and rehab.

Within internal med, tough fellowships are hemonc, GI, and cardiology, the latter two because of the ability to bill out mucho for procedures.

In some of the cases, the reason for competativeness is a lack of residency slots (doctors controlling the amount of future competition). In others, it's all about lifestyle. For derm, it's both. If you look at urology, optho, and ORL, they get to do both ambulatory med and surgery as part of their practice, so there is both a personal component and a heavily technical one to the job. Plus optho has pretty high patient satisfaction. Plastics, neurosurg, orthopod--cha ching.

 

[Mr. McDuck]

I thought surgery was getting MORE competitive. There was only 1 slot unfilled after the match this year, out of like 1034 or something.

 

[ddmo]

NRMP Match Outcomes is the best objective measure of how competive certain residencies are.

 

[Wizard of Oz]

I'm not saying that nobody out there wants to be a general surgeon (you'd still be hard-pressed to beat the salary), I'm just saying that it's not as appealing as it once was.

Of the handful of general surgery residents who started at my hospital two years ago, one of them nearly had to repeat a year of medical school because her grades were so poor.

These things wax and wane, but of the folks I know out there in general surgery residencies, relatively few are actually taking fellowships and are displeased that internal med specialists are mopping up procedures that deny them cases and income.

Plus surgery has a very military-like reputation with tons of call and a terrible lifestyle. People are instead moving toward interventional rads or anesthesiology where they can still make some bank without having to be on call 120 hours a week.

 

[Bertelman]

Derm and plastics are probably the two most coveted. Just do well on boards and during your rotations regardless of what you think you will end up in.

I'd like to add my two cents. For the really coveted spots like Plastics, Derm, Ophtho, etc. I think it typically takes more than just "doing well" on boards. Sometimes you gotta smoke 'em, like one S.D. above the mean. I guess in my eyes, "doing well" means you're a little above national average. You need much better if you want to keep all options open.

I'm not saying you won't get in with average scores, but you will be sweating match day.

 

[Wizard of Oz]

Does anybody else find it strange that we have been getting a lot of people who describe themselves as pre-medical worrying a great deal about specialties?

 

[Law2Doc]

Does anybody else find it strange that we have been getting a lot of people who describe themselves as pre-medical worrying a great deal about specialties?

They don't seem to realize that to get to that light at the end of the tunnel, you need to get past a few trains.

 

[Rockhouse]

They don't seem to realize that to get to that light at the end of the tunnel, you need to get past a few trains.

It is a little jumpy isn't it. Getting into medical school isn't a forgone conclusion regardless of your "stats," and having great stats doesn't always mean you will breeze through medschool, as I have a buddy with a 38 MCAT doing just about passing in anatomy, and some of these "pre-med" cats are already thinking about all the bank they are going to make working 50hrs a week in rads. Crazy talk. Step 1: get into medical school. I think we all (as pre-meds) forget that most of us aren't going to be top of the class anymore, and should get realistic about that before assuming we are going to kick everyone's ass and get into derm.

 

[Mr. McDuck]

I don't know if that includes me, but I'm not "worrying a great deal about specialties". I was just replying because I thought you made it sound like general surgery wasn't as competitive as I had heard, and I wanted to clarify--just curiosity.

 

[Wizard of Oz]

I don't know if that includes me, but I'm not "worrying a great deal about specialties". I was just replying because I thought you made it sound like general surgery wasn't as competitive as I had heard, and I wanted to clarify--just curiosity.

Naw--I was referring to the OP. Just looked at your profile--22-year-old practicing PA? You must be a wunderkind or know of a darn fast track.

Thanks up there for posting a link to the match outcomes. I didn't know that was on the Internet these days. That said, that document confuses me more than anything else. I'm not sure how to correlate most of those stats with what the OP calls "perception." The first graph, for instance, has transitional year on one end and derm near the end of the other. Almost everybody who matches prelim transitional gets a competative PGY-2.

 

[sleep_addict]

Naw--I was referring to the OP. Just looked at your profile--22-year-old practicing PA? You must be a wunderkind or know of a darn fast track.

Thanks up there for posting a link to the match outcomes. I didn't know that was on the Internet these days. That said, that document confuses me more than anything else. I'm not sure how to correlate most of those stats with what the OP calls "perception." The first graph, for instance, has transitional year on one end and derm near the end of the other. Almost everybody who matches prelim transitional gets a competative PGY-2.

I obviously don't know enough about these public profiles. Just updated my status from pre-med to medical student.

It is early to make career decisions. I just like fantasizing about doing different things.

Thanks for the info guys!

 

[Pinkertinkle]

It's never too early to start working on matching in derm.

 

[DarksideAllstar]

I'd like to add my two cents. For the really coveted spots like Plastics, Derm, Ophtho, etc. I think it typically takes more than just "doing well" on boards. Sometimes you gotta smoke 'em, like one S.D. above the mean. I guess in my eyes, "doing well" means you're a little above national average. You need much better if you want to keep all options open.

I'm not saying you won't get in with average scores, but you will be sweating match day.

Anyone who equates "doing well" with the mean has been deluding themselves for a long time . Scores will help get you the interview, the rest of your app (AOA, research, ECs, LORs) will land you the spot.

 

[Bertelman]

Glad I could make you laugh with my low expectations. I guess when you are in med school it's not enough to know you work harder and are more intelligent than 99% of the folks roaming the earth. When I typically see people boast of their board scores, like 240+, they say "I did VERY well".

When I walk into a patient's room in the morning, I ask, "Are you doing well?" I'm happy if they're not in any pain, aren't constipated, and slept at least a couple hours overnight. I know they're not really "doing well", but compared to the prosepcts of another day with diverticulosis or whatever, it ain't bad!

 

[8744]

Glad I could make you laugh with my low expectations. I guess when you are in med school it's not enough to know you work harder and are more intelligent than 99% of the folks roaming the earth. When I typically see people boast of their board scores, like 240+, they say "I did VERY well".

When I walk into a patient's room in the morning, I ask, "Are you doing well?" I'm happy if they're not in any pain, aren't constipated, and slept at least a couple hours overnight. I know they're not really "doing well", but compared to the prosepcts of another day with diverticulosis or whatever, it ain't bad!

Oh yeah. I was probably the dumbest resident at Duke last year but I am probably a lot smarter than the average man-on-the-street.

 

[Wizard of Oz]

It's never too early to start working on matching in derm.

Trudat--we have some MS 1's who have only taken one exam, and six weeks into medical school, they are already mathematically eliminated from AOA contention.

 

[psipsina]

Trudat--we have some MS 1's who have only taken one exam, and six weeks into medical school, they are already mathematically eliminated from AOA contention.

Hey just curious as I still haven't really grasped the whole AOA concept, how much would you have to screw up the first test to be out of the running? Are we talking about seriously failing the test, being only average, or not honoring it?

 

[RxnMan]

Hey just curious as I still haven't really grasped the whole AOA concept, how much would you have to screw up the first test to be out of the running? Are we talking about seriously failing the test, being only average, or not honoring it?

It's probably a function of not doing well enough and a low frequency of testing.

 

[psipsina]

It's probably a function of not doing well enough and a low frequency of testing.

Well yeah, but I was wondering what constitued "not well enuf". Like can you still make a comeback from just passing, or are you screwed. What about almost passing? Did you have to honor your first test to have a shot at AOA?

 

[Bertelman]

What about almost passing? Did you have to honor your first test to have a shot at AOA?

At my school at least, you can pass the test and still be in contention for AOA. We elect like 30 or so, and believe me, they don't all have a 4.0, i.e. all A's, or all honors, or whatever. I would argue that, depending on the class and number of tests, failing one exam may not even put you out of the running. With 4 tests, bonus material and a shelf final, I imagine you could fail your first Gross test and still manage a B with some hard work. If you bust A, you may even scratch by with an A.

 

[DarksideAllstar]

At my school at least, you can pass the test and still be in contention for AOA. We elect like 30 or so, and believe me, they don't all have a 4.0, i.e. all A's, or all honors, or whatever. I would argue that, depending on the class and number of tests, failing one exam may not even put you out of the running. With 4 tests, bonus material and a shelf final, I imagine you could fail your first Gross test and still manage a B with some hard work. If you bust A, you may even scratch by with an A.

My situation...
First semester, first year, first test (gross anatomy): 70.2%. I had a nice meeting with the GA instructor, a little letter sent to me reminding me I needed to do better. Ended up with a B in the class. I went on to honor half of my classes 1st semester and get B's in the other half. Throughout the rest of 1st year, 2nd year, and 3rd year I honored everything with the exception of my psych rotation (pass). Bottom line: you could probably pass a couple of your classes and still be elected.

 

[Izabelle]

What's the big deal with AOA anyway? I've heard it's just a popularity contest. Is that true?

And do things like that (or anything) look at just one test grade? Wouldn't they just look at your overall standing? Wouldn't anyone just care about your overall standing?

I'm just asking because I really don't know.

 

[colbgw02]

What's the big deal with AOA anyway? I've heard it's just a popularity contest. Is that true?

And do things like that (or anything) look at just one test grade? Wouldn't they just look at your overall standing? Wouldn't anyone just care about your overall standing?

I'm just asking because I really don't know.

i wouldn't call AOA a popularity contest. i don't know how other places do it, but at my school junior AOA members were selected based purely on their academic performance. then anyone in the top 15% of the class was eligible for senior AOA election, and the junior members voted for those who were eligible based on their overall performance - to include ECs, research, etc.

 

[Izabelle]

Gotcha. Shows how much I know. Guess I shouldn't always believe what I hear.
Thanks for filling me in.

 

[psipsina]

My situation...
First semester, first year, first test (gross anatomy): 70.2%. I had a nice meeting with the GA instructor, a little letter sent to me reminding me I needed to do better. Ended up with a B in the class. I went on to honor half of my classes 1st semester and get B's in the other half. Throughout the rest of 1st year, 2nd year, and 3rd year I honored everything with the exception of my psych rotation (pass). Bottom line: you could probably pass a couple of your classes and still be elected.

Thanks! I passed but I missed the high pass mark by a few points and was worried I may have screwed myself this early in the game. I know AOA isn't everything but I am striving for it if its within my capabilities. I figure the loftier the goal the better I'll do.

 

[Brown429]

What about schools that do not have AOA? There are several school, IE BrownMed, that do not have AOA. Do you guys think this is an advantage or disadvatage?

 

[Wizard of Oz]

Hey just curious as I still haven't really grasped the whole AOA concept, how much would you have to screw up the first test to be out of the running? Are we talking about seriously failing the test, being only average, or not honoring it?

In the case that I am speaking of, there are folks in my class who can no longer earn a 90% in their classes with 30-40% of the grade already in the bag. At my school, we use A-B-C with 90%=A. It is a very traditional school, and our AOA is grades only--top 20 GPA's get AOA. Over the past decade, we've never had an AOA with less than a 4.0. In fact, they usually have to go to tie break by looking at actual grade average (average percentage). There are just too many gunners who've NEVER slipped up let alone their first test block. So, six weeks into medical school with a 75% average and 40% of the grade already determined equals no AOA, have a nice day.

Probably the larger issue, though, is that if you start out in medical school scoring in the bottom quartile of your class, you are already behind because your classmates will naturally improve just like you hope to. It's not like the girl who got a 94% on the first test is planning on dropping down to an 86% so that you can catch up with her.

 

[Wizard of Oz]

What about schools that do not have AOA? There are several school, IE BrownMed, that do not have AOA. Do you guys think this is an advantage or disadvatage?

The board scores shall set you free.

 

[DarksideAllstar]

It's not like the girl who got a 94% on the first test is planning on dropping down to an 86% so that you can catch up with her.

Funny that you mention this, but I have seen it happen to a couple of people. They start off real strong during their first year and burn out 2nd year. I dont think it is all that uncommon. People end up figuring out what is important to them and adjust accordingly (ie studying less and having a life, or going out less and putting in more time). In the end, just do your best and keep your fingers crossed just like the other 95% of us who weren't "sure" they would get it.

 

[beefballs]

couple of things - i am shooting to assimilate and make connections-you know learn the stuff. Yes there is alot of memorization-no way around it, but I need to have some idea how the pieces fit. Due to this I am working hard, but my goal is neither AOA, or all honors-if it happens for me wonderful if there are more deserving folks so be it- my goal is to do my best and be able to synthesize info for step 1
second thing is trauma surgery board certified and offering fellowships? (if this sounds like a dumb question-well I aint the sharpest tool in the shed) oh and I am willing to "hug it out" with anybody whos got a problem with that

 

[Wizard of Oz]

Funny that you mention this, but I have seen it happen to a couple of people. They start off real strong during their first year and burn out 2nd year. I dont think it is all that uncommon. People end up figuring out what is important to them and adjust accordingly (ie studying less and having a life, or going out less and putting in more time). In the end, just do your best and keep your fingers crossed just like the other 95% of us who weren't "sure" they would get it.

Yeah I have seen it happen as well (though I don't know if they actually "planned" on dropping), even cases where people have had perfect grades up until their last clinical rotation and missed AOA after 3 years of gunning.

I guess I'm just not happy with my school which still uses this out-dated grading system and emphasis on grades to decide AOA membership. I know that there will be people who relax back, but still, some of my friends are completely out of the AOA race after one test since stats show that we will have at least ten percent who never ever relax back.

 

[Wizard of Oz]

couple of things - i am shooting to assimilate and make connections-you know learn the stuff. Yes there is alot of memorization-no way around it, but I need to have some idea how the pieces fit. Due to this I am working hard, but my goal is neither AOA, or all honors-if it happens for me wonderful if there are more deserving folks so be it- my goal is to do my best and be able to synthesize info for step 1

Do your best, synthesize info for step 1--excellent plan! (Sorry, no sarcasm intended, tired of being around people who only talk about grades.)

second thing is trauma surgery board certified and offering fellowships? (if this sounds like a dumb question-well I aint the sharpest tool in the shed) oh and I am willing to "hug it out" with anybody whos got a problem with that

If I understand your question, trauma is a 2-year fellowship undertaken after a five-year residency in general surgery. I'm no expert, though--surgery is already on a long list of "will-not-consider" residencies for me. Please feel free to correct me if I am wrong.

http://www.trauma.org/resources/fellowships/fellowships.html

 

[beefballs]

yup that was my question thanks for the info. I found people that are competitive internally to be around "I do the best I can" vs the "I am going to do better than you" people. We still want to do well, but not so we beat someone but because we are here to do our best. this attitude is really making me a nicer person thru no extra effort so I kinda like it.