DO That Wants to Match Chicago Internal Med w/ Possible Fellowship: How to Handle Away Rotations

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Feb 10, 2020
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Just as the title says, what are some of the places that would best improve my chances of matching in metropolitan Chicago. Some background
- I have taken step 1 / level 1 but am still waiting to take step 2 / level 2 and get a score.
- I have done the majority of my clinical rotations at a level 1 trauma center hospital and really enjoy the ED to medicine admissions that these facilities receive.
- I love urban medicine
- I'm out of state, but my fiance (also a med student, different year) is currently in Chicago and she wants to stay.
- I am able to do 16 weeks of out of state rotations through my school.

All of the above is pointing to Cook County, which by all accounts seems to be a program I really love (are there any things wrong with the program?). Also, I'm trying to figure out what hospitals / programs I should do a sub-i at for the the remaining 3 rotations. Any suggestions will be helpful!

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As a follow-up, is there any reason why there's so many IMGs in the program and will that be a problem for a DO matching in?
Are you an MS-3? For Cook County, they do have very competitive scores so try to do as best you can on Step 2. I had an interview there this year but I also rotated there multiple times and had two LORs from the attendings there. It may be one of those sites that you have to at least do one rotation at to be noticed by the IM program as they recruit mostly IMGs as you can see. I actually find that the IMGs are not only very smart but are for the most part extremely nice and easy to work with. Many of the Attendings are from all over the world too so its a very diverse program. However, you are competing for those same IM positions as the IMGs, who usually have like ridiculously high Step scores. If you can beg and plead for a Sub-I rotation or a subspecialty IM rotation and make an impression, and express your interest in the program, I think you will have a chance.

I am a DO, my Step 1 was below average, but I went up almost 30 points in my Step 2. I did my 3rd year IM rotation at county, nephrology I used as an audition in the fall, and I talked to several attendings about my interest in the program. I got 2 LORs from IM attendings, and got an interview. I am also going back for ICU and Heme/Onc there (because I can- honestly best training I can get from the sites I have through my schools). I have no research experience but a crap ton of work experience/customer service experience. If I can get an interview there I am sure you can.

If county does not work out, definitely apply to the other programs here too like UIC, Rush, Northwestern- although I feel most of them are in favor of MD students, if you have an impressive resume I think you have a chance. I did not get interviews to any of those I believe because of my lack of research experience.
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And as for your second question: I do not exactly understand the motivation for hiring mostly IMGs at certain programs but my only thought is there has to be some sort of monetary gain or something for a program to take many IMGs- otherwise it doesn't make sense at least to me. County is a safety net hospital with state government(?) funding I believe so that may play a role in recruiting IMGs? I'm sure someone who knows more about this lurks on these pages from time to time and maybe could explain it to us. But like I said above, 95% of the IMGs I've worked with are genuinely nice and hardworking/team players. I'd say even more so than some American residents (dare I say). All the resident friends I still talk to that I've made throughout the past year are IMGs, most of them at county.
Cons to county (sorry I keep forgetting to answer questions):
-No transplant service
-From my understanding, the longest shift now can be up to 18 hours(?) I was a little confused during the resident Q&A on that: I think its the night float residents getting there at 5 PM or so then having to stay until rounds end the next day which can be up to 10-11 AM which is pretty brutal compared to other programs
-Some of the sub-specialty coordinators to put it nicely are not the most organized/helpful which can really affect a rotation: for example, on one subspecialty service, there was me a brand new MS-4 and two freshly minted interns running a 30+ inpatient load. lol. That rotation usually has 5 residents, at least two being seniors. I didn't have any reporting instructions either as the coordinator to this day never responded to any of my emails. Don't think this is common practice but it happens there.
-Drip admit system now which people love or hate
-Most attendings are approachable and teach well, but there are a couple I've heard that can be intimidating or down right mean. I have not witnessed myself but I have heard stories so idk
1.) First off, stop narrowing your focus to one academic center. There are tons of programs. I'll exclude NW/UChicago since they are probably out of your scope. There's:

-Rosalind Franklin
-Cook County
-Several others

2.) Trauma 1 Center designation has little to do with IM training.
3.) "I love Urban Medicine" is super vague. All these programs will give you exposure to what you may perceive as an M2-3 as Urban Medicine.
4.) I'm out of state, but my fiance (also a med student, different year) is currently in Chicago and she wants to stay. <-Probably the most meaningful thing in your post.

My advice is to to do 1-2 rotations at these centers in Chicago, but do your research online and from others as to what the rotations are like and if you'll be given support/letters. Example, if you hear that one place offers an away but it takes forever to get EMR access and you look like an idiot to faculty, avoid the place. I don't think having multiple rotations in Chicago (i.e. demonstrating commitment to the region) is very meaningful because Chicago is a very popular place to apply to and doesn't suffer from the same fate as a majority of other places in the midwest. The aim to doing the rotation is either 1) Get a good letter 2) Make a good impression at that program 3.) Learn. The good letter can be used at any program. The impression can be a bit of a risk because you're neutral and maybe a bit of an unknown on you really want to go somewhere and have people scrutinize you? It's a risk/reward scenario which is why you should look into personal experiences people have had at the aways offered at each of these programs before you dive in expecting your experience to be a fair audition. Learning is always great and carries long term benefits but the immediate goal is to advance your candidacy
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To follow up on a very old post:

This was all for IM rotations.

I ended up rotating at Advocate Christ and UIC. The options to get a sub-I at any of the programs were very limited in terms of outside students. In terms of programs I applied to:
-UIC: Ended up doing hepatology and endo, but no interview (which could be from step 2 test scores alone)
-ACMC: Did cardiology rotation, was a pretty solid program and high on my rank list
-ALGH: Very limited rotation options, first come first serve via email, and all rotations are off cycle
-Loyola: applied to 4 different rotations with many dates day 1 that they opened, heard nothing back. Wrote essays for them all too.
-Cook County: Reaching out to their PC was nearly impossible. It seems to change very frequently and the person initially responded and ignored my next three emails over 4 months (duing the time in which they told me to reach out).
-Northshore: doesn't take non-affiliated DO students. Still high on my rank list, but not as high as expected because they don't pull any DO residents into their cardiology fellowship in house. Also their cards fellowship takes 1 external, 1 IMG, and 1 internal candidate (but that is split between UChicago Northshore and Uchicago Main).
-Rosalind Franklin: VA program, can probably squeeze a rotation in by directly emailing the PC, but you have to get VA approval with a VA identity card which will complicate things. Program is eh. Know that it is 50 minutes outside of Chicago.
-Swedish: Also did not take outside students
-Advocate Illinois Masonic: IMG heavy and has not taken DO's
-Ascension Chicago: Same thing as Advocate Illinois Masonic.

Rush, NWU, Loyola, and UChicago have all taken exceeding few DO's into their internal medicine programs. Think <10%. UIC is the only one that has 11% DO's in their resident class. Cook county also has exceedingly few DO's in their program as they are a very IMG heavy program.

By urban medicine, I meant in general densely populated areas where its more about finding ways to get access to resources versus no resources being available in the first place. Also, I was intending to mention urban underserved populations.

Overall, ALGH, Northshore, and ACMC are highly ranked on my list, the rest I either did not get interviews to, or fell far down on my list.

Hopefully this helps someone in the future.