Difficult Ranking Question-please advice!

[Iluvpassingas]

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Hey guys,

So I interviewed this season for anesthesia and categorical internal medicine as back-up.

I was offered a pre-match at a program for medicine, and decided to take it. They asked me to withdraw from the NRMP match, which I haven't done yet. The contract is for one year, and then renewed come the following year pending satisfactory evals, yada yada, and of course, if I agree to sign for the subsequest year.

Now my question:

I interviewed at my number 1 anesthesia program, which offers advanced positions. This is the only program that always makes me wonder if I could have matched, or if they ranked me. Could I possibly just rank them for an advanced position as my number 1 rank. I wouldn't rank any program, but that advanced anesthesia position. No prelims or nothing, because I technically have a first year position (even though it is categorical).

If I matched in the advanced position, I would start in 2011 and it wouldn't really break the original contract, right? I mean people change fields after a year from medicine to anesthesia and vice versa if they get a spot.

Is this risky? Is this unethical? Or would you say I have nothing to lose? Do I run the risk of losing the guaranteed medicine spot?

I tried to search all the forums, but I think this is a unique question and I'm hoping someone who has been or knows someone who has been in a similar situation can just give me some insight.

Thanks and best of luck to all!

 

[deleted50478]

It's risky and unethical. BTW:

www.merriam-webster.com/dictionary

ad·vise : Pronunciation: \əd-ˈvīz\ transitive verb
1 a : to give advice to : counsel <advise her to try a drier climate> b : caution, warn <advise them of the consequences> c : recommend <advise prudence>
2 : to give information or notice to : inform <advise them of their rights>

ad·vice : Pronunciation: \&#601;d-&#712;v&#299;s\ Function: noun
1 : recommendation regarding a decision or course of conduct : counsel <he shall have power, by and with the advice and consent of the Senate, to make treaties &#8212; United States Constitution>
2 : information or notice given &#8212;usually used in plural
3 : an official notice concerning a business transaction

 

[aredoubleyou]

If medicine is a back-up, why did you take the pre-match categorical medicine spot?

Yea, Im the last person round here that likes to stir stuff up but that sounds like a really, really, really dumb idea. If you want to go into anesthesia, then you should match into the specialty you want, not take some crap position that they obviously cant fill by normal means. Sorry for being a d ck but hopefully im doing you a facvor

 

[EternalMD]

The program you accepted is expecting a categorical resident that will be there for 3 years regardless of the institution offering a one year contract (almost all programs do this). If word of this type of behavior then got to your #1 anesthesia program, I wouldn't be surprised that they rescind the acceptance because you violated the match rules.

If your REALLY want to do anesthesia, like others suggested already --> Go through the regular match and decline the categorical medicine spot.

 

[lushmd]

As EternalMD indicated, most if not all programs operate on the basis of annual contracts subject to renewal based on performance etc... but a categorical medicine position is a three year commitment. As such, without committing a match violation, you're options boil down to:

(1) Accept the categorical medicine position. Either complete IM residency or you can always re-apply to anesthesiology as an IM resident with your PD's knowledge.

(2) Drop the IM spot (somewhat questionable given that you already gave a commitment to the IM program; may have to get permission from the IM program) and proceed with the match for anesthesiology residency.

The course you take will likely depend on your perceived likelihood of matching, which I'm assuming isn't all that great if you accepted the IM pre-match. As far as objectively assessing your probability of matching, take a look at the charting outcomes in the match document and see where you fall.

 

[Iluvpassingas]

Thanks guys for all the answers. I withdrew, and content with medicine...was just a burning thought.

I'll consider reapplying after 3 years is over.

Thanks

 

[EternalMD]

well I was hoping to write this before you did anything like that but keep in mind that medicare will only fund you for the original length of time for the specialty that you started training in. i.e. medicine gets you 3 years (if you decide to switch to say radiology after 2 years, you only get one more year of funding and then have to get a program to support you partially for the rest 4 years). If you're really dead set on anesthesia, going through the regular match might have been better than trying to go through it later on