Doing the unthinkable-yay or nay?

Discussion in 'ERAS, SOAP, and NRMP Match' started by USMELL, Jan 7, 2009.

  1. USMELL

    USMELL FIRE
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    I have a friend who applied for ERAS and the NRMP for this year, but after sending applications in decided she wanted to do something completely different. She had above average Stats but was worried she couldn't get a competitive residency so she applied for a primary care position.

    She has cancelled several of her interviews but still has about 4 left in late January, she is considering not going for any of the interviews but since she already paid for NRMP see what opens up in the scramble, my question is:

    1. Is it possible to not go on interviews and still try and match through the scramble?
    2. If all her LOR are in for example Peds, can she use those during the scramble to apply for a Prelim/Transitional Spot and Radiology?
    3. Or is the chance of being able to match into a Prelim spot and radiology so far out there, she shouldn't even bother and reapply next year?
    4. If she chooses to reapply next year, will she be considered a re-applicant even if she decides not to go through the Match? Or is just having filled an ERAS application constitutes being a reapllicant
    5. if she chooses to wait a year, what would you reccomend she do during that year?

    thanks, sorry for the long post
     
  2. USMELL

    USMELL FIRE
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  3. dragonfly99

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    This doesn't make any sense. Trying to get a spot in the scramble should be a last resort...less good spots left and it is VERY stressful trying to get a spot this way.

    What specialty or specialties does she WANT to do?

    She needs to talk to her medical school's career advising office ASAP. They should be able to help her judge how competitive she is for the specialties she is thinking of doing.

    She shouldn't do primary care unless she might enjoy it...otherwise she WILL be miserable.

    If she's just totally unsure of what she wants to do, then a medicine prelim year might be a good thing (NOT if she is thinking of peds, though). It would then allow her to look for a spot in something like radiology or neurology later. There might be such a thing as a peds prelim year (not sure...but I think I know of an anesthesia resident who did the intern year @our peds university hospital).

    Another option would be to do a research year (either after graduating, or taking a leave of absence to do it now, then return for the last few months of 4th year a year from now). If she's a marginal candidate for something like radiology, that might help...but it is a bit of a gamble.
     
  4. aProgDirector

    aProgDirector Pastafarians Unite!
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    1. Sure, but it's not a very smart way to do it. Her options will be very limited, and she won't actually get to see the program she is scrambling into. At best, she'll talk to the PD on the phone for 15-30 minutes.

    2. No

    3. Yes. Prelim will be no problem, but perhaps not at a great place. Rad spots in the scramble are far and few between, and will be close to impossible to get. There's not no chance, but it's really unlikely. Without letters from rads, it's impossible.

    4. There's no such thing as a "re-applicant" like there is for med school. She will be an independent applicant next year -- able to sign a contract outside the match. This might allow her to fill an offcycle spot. Depending on the answer to #5, she would likely do just as well next year as this year.

    5. She should do something that forwards her career. If she wants Rads, then she needs to do something Rads. research, some clinical experience (will be difficult), volunteer, something.
     
  5. USMELL

    USMELL FIRE
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    thanks for the excellent post.
     
  6. USMELL

    USMELL FIRE
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    thanks again just some more quick questions:

    1. So can she go through the NRMP this year, and see if a Transitional year spot opens up, can she use her Peds LOR to get one of those spots?
    2. Then during the transitional year, see if she can get an out of match Rads spot, or are the chances of a PGY2 spot in radiology very slim?
    3. If she decides to take a year off to get an MBA or MPH will that help her chances, or should she focus on Rads research and externships (ps. are there rads externships for non 4th year students)
    4. I am worried that she might end up without any residency, should she just bite the bullet and go ahead with her Peds interviews and match?

    thanks again
     
  7. aProgDirector

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    1. Huh? It's probably too late to actually apply for TY's. If you're asking if she should hope for one in the scramble, the answer is no. They rarely end up in the scramble, and most TY's are decidedly non-academic and will not strengthen her application.

    2. Very rare, when rads spots open they are often filled by internal candidates. So this is unlikely to work.

    3. Maybe, but she should only pursue these degrees if she really wants one. As a CV filler they are not helpful.

    4. If she's strong enough to actually get a rads spot (i.e. if she applies early enough and has the requisite letters), then she will almost certainly get something in the scramble. Problem is that spots fill very quickly, so she will have 30 minutes to make a decision. If she goes this direction, her best option is a prelim medicine year. The better the name regonition, the better for her. Then she applies to rads next year, and then has a year off when she can do research, or perhaps actually moonlight (depends on state). Matching in peds will cause funding problems if she decides to pursue rads later. But, if she does prelim medicine and then does't get a rads spot, she needs a plan B -- and if that's peds she would have to start over as a PGY1

    She could also consider extending her 4th year. Some medical schools allow you to split your 4th year over two years to do extra electives, etc. They usually only charge you tuition once, so the only cost is living expenses and "lost income" from the residency she could have had. This would probably be the most flexible way for her to retool her application
     
  8. USMELL

    USMELL FIRE
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    Thank you aPD, so which is better to scramble into a Prelim year now and apply for radiology later, so she will have a year between Prelim and Radiology or should she take a year off now to improve her stats, then apply for a Prelim spot and radiology together next year.

    If she goes this route, what should she do about her ERAS and NRMP applications, can one just leave it open, so to have access to the match or is that a violation if she has no intention of ranking any programs this year.

    Can the school keep her old LOR, dean's letter etc and can she have access to them next year when she is applying as an independant applicant. If one is an AMG and independant applicant next year, how those it work, will she have to get new LOR, since she will be responsible for mailing documents to ERAS herself next year, or will she still have to go through her dean's office.
     
  9. aProgDirector

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    Although she's almost certain to get a prelim in the scramble, remember that it may not be a GOOD prelim.

    The answer depends on how competitive she is for rads. Doing a prelim will NOT make her comeptitive for rads, esp if its in a small place. Doing a rads research project + getting some clinical experience (usually easier in rads since there is no direct patient contact) is probably the best way to go, and then try the whole match over again next year.

    She should probably alert the programs that have interviewed her that she has had a change of heart. They will be fine with that.

    She can stay in the match, and simply not submit a ranl list (or submit an empty one, same either way). This would allow her to look at the scramble list. If there happens to be a prelim IM spot at a really good place, she could consider going for it. This would require that she spend the rest of this year getting her rads credentials together. It will also require that she be interviewing for rads spots in the middle of her prelim year, so when she is talking to programs she should be clear about that. She could require quite a bit of time away for interviews, which might not be possible.

    Although her school can keep her LOR's, she's going to need new ones that are rads directed. She absolutely needs to get those now -- i.e. before 4th year is over. Do a bunch of rads rotations, a rad SubI if such a thing exists, and ask for letters now (for next year).

    All of her ERAS stuff will still go through her Dean's office next year, same as this year. If she is not in the same city, it can all be done through the mail.
     
  10. bananamed

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    why are you posting here and not your "friend"?
     
  11. USMELL

    USMELL FIRE
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    aPD I just wanted to say thank you, your help on this board is truly invaluable, thank you for taking time out of your busy schedule to help. :)
     
  12. dragonfly99

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    APD's advice is really good.
    I think she should ideally try to do a radiology research year, if she's fairly competitive for radiology an it's what she wants to do. She can always go back to peds in the future, if all else fails. I'd start doing radiology rotations now, hopefully take a research year next year, then apply next fall for prelim spots (IM) and/or transitional years, along with PGY 2 radiology spots. Scrambling for radiology won't work because there won't be many spots at al (if any) in the scramble, or random open spots throughout the year, and they usually go to internal candidates anyway, plus she doesn't have radiology LOR's right now.
     
  13. USMELL

    USMELL FIRE
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    thanks, I guess it just seems scary to take another year? Do programs look down on those who take a year off after medical school?
     

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