dual application question

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MilesDavisTheDoctor

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If I am a very strong applicant (top 20 med school, almost all honors with honors in IM, lots of pubs) but I apply IM after I do a research year in a surgical sub how badly will that affect my chances of matching to a top program(lets say top 30 program)? Will they all assume I'm dual applying and rank me low?

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If I am a very strong applicant (top 20 med school, almost all honors with honors in IM, lots of pubs) but I apply IM after I do a research year in a surgical sub how badly will that affect my chances of matching to a top program(lets say top 30 program)? Will they all assume I'm dual applying and rank me low?
Short answer is yes.

Most programs will take perceived specialty interest into account when ranking applicants. Programs don't want residents who matched there as their 2nd choice back-up specialty. Though in practice this happens quite often since matching into competitive specialties can be uncertain, even for strong applicants. I'm assuming that you would be applying IM as a back-up if you took a whole research year to do research in a surgical subspecialty (in case you didn't match into that specialty). If that's the case IM programs will be able to tell and it will be difficult to hide; you'll have to explain on your app the 1 year research and you will list all your publications in that specialty, and this will go on your ERAS app that you send to both your IM programs and your surgical sub programs (unless the other specialty is something like Urology or ophtho that doesn't use ERAS). Usually PDs will assume that when an applicant is dual applying, the more competitive specialty is their preferred specialty and the less competitive one is their back-up; IM programs will likely assume this (and it's difficult to convince them otherwise). So it will definitely hurt from top IM programs than if you just applied to only IM, but usually not enough to completely get you off their rank lists just on this alone. However, if you're applying IM as a back up would throw in some mid-tier programs in there just to be sure.
 
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Thanks a lot for the response I really appreciate it. Do you think doing something like this would keep me out of a top 30-40 program? Basically, my goal if the surgical sub doesn't work out would be to do cards and I've heard matching to the best IM program you can is important for that ( I know surgical sub and cards is a very weird combo but I've done a lot of soul searching on this lol). Also do I even need a top 30-40 IM program if I want cards?(ie. would matching an even lower, but still academic, program given me being a dual app not be a problem for matching cards)
 
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Thanks a lot for the response I really appreciate it. Do you think doing something like this would keep me out of a top 30-40 program? Basically, my goal if the surgical sub doesn't work out would be to do cards and I've heard matching to the best IM program you can is important for that ( I know surgical sub and cards is a very weird combo but I've done a lot of soul searching on this lol). Also do I even need a top 30-40 IM program if I want cards?(ie. would matching an even lower, but still academic, program given me being a dual app not be a problem for matching cards)
Hard to say. The last thing programs want is someone who doesn't want to be there and there are equivalently strong IM applicants out there for the top programs who actually like IM. Be aware that matching into cards is not guaranteed from any program, and cards is a long pathway- requires a lot outside of work (networking, research) outside of a very tough residency, and fellowship is super tough/stress level of surgery. Would make sure you like general IM too as things change- maybe you decide you don't want to do 6-8 years of training after med school.
Why not apply G/S as back up?
 
If I am a very strong applicant (top 20 med school, almost all honors with honors in IM, lots of pubs) but I apply IM after I do a research year in a surgical sub how badly will that affect my chances of matching to a top program(lets say top 30 program)? Will they all assume I'm dual applying and rank me low?

Skip the research year. You've already proven yourself. Go to residency. You'll have plenty of time for more research later (especially if you do a fellowship, and then as an attending if you land an academic gig).
 
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Thanks a lot for the response I really appreciate it. Do you think doing something like this would keep me out of a top 30-40 program? Basically, my goal if the surgical sub doesn't work out would be to do cards and I've heard matching to the best IM program you can is important for that ( I know surgical sub and cards is a very weird combo but I've done a lot of soul searching on this lol). Also do I even need a top 30-40 IM program if I want cards?(ie. would matching an even lower, but still academic, program given me being a dual app not be a problem for matching cards)
Hard to say if you would be kept out of a top program for sure, as it can be a crapshoot at top programs (which get a lot more qualified applicants than spots). Though assuming you do well on Step 2 you should still be able to match into a mid-tier academic program even dual applying the way you have described. Just make sure the program has an in-house cardiology fellowship (which nearly all major academic IM programs usually do). Cardiology is one of the more competitive fellowships in IM to get into, but graduating from a mid-tier IM program as a USMD won't be main factor holding you back, as long as the program has an in-house cardiology fellowship. The rest will depend largely on how well you do in residency (eg rec letter from program director, research, networking, Step 3 scores).
 
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Thank you so much for the advice everyone. Is it reasonable to assume that going to a mid tier program and being a good resident I will have a good (>90% chance) of matching cards? The only reference point I have is my home IM program which is probably ranked like in the 20s and here my understanding is everyone gets whatever fellowship they want as long as they are normal, hardworking and not super geographically restricted.
 
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Thank you so much for the advice everyone. Is it reasonable to assume that going to a mid tier program and being a good resident I will have a good (>90% chance) of matching cards? The only reference point I have is my home IM program which is probably ranked like in the 20s and here my understanding is everyone gets whatever fellowship they want as long as they are normal, hardworking and not super geographically restricted.
Generally, and as long as the program has an in-house fellowship to fall on (though wouldn't count on an a fellowship taking an in-house resident 100% of the time, especially on the competitive specialties). Will need some research as well but as a USMD don't need a crazy number of publications either that you see with some FMG applicants.
 
Thank you so much for the advice everyone. Is it reasonable to assume that going to a mid tier program and being a good resident I will have a good (>90% chance) of matching cards? The only reference point I have is my home IM program which is probably ranked like in the 20s and here my understanding is everyone gets whatever fellowship they want as long as they are normal, hardworking and not super geographically restricted.

Any mid-tier university main program should be more than enough for matching cards.
 
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Hey guys just wanted to update this thread. Got step 2 back this week and it was in the 260s which I'm pretty happy about. I'm starting to move away from the idea of dual applying but given how competitive ortho is I still feel like I need a back up plan (also recently completed a cardiology elective rotation which helped me realize that would probably be my second choice of specialty after ortho). I will be doing a research year with my home ortho department before I apply. What do you guys think?
 
Hey guys just wanted to update this thread. Got step 2 back this week and it was in the 260s which I'm pretty happy about. I'm starting to move away from the idea of dual applying but given how competitive ortho is I still feel like I need a back up plan (also recently completed a cardiology elective rotation which helped me realize that would probably be my second choice of specialty after ortho). I will be doing a research year with my home ortho department before I apply. What do you guys think?
Perhaps I’m behind the times, but is it common at this point for otherwise seemingly strong candidates to do a research year just to match ortho? I’m inclined to agree with posters above…just get in the match and go to residency…trust me, the whole training process is already long and miserable enough without adding in random extra years of “research”. You will get to the point where you just want to be done with all of it.
 
@dozitgetchahi thanks a lot for the reply. From my upperclassmen my understanding is that ortho is becoming more like neurosurgery in plastics where the default is that everybody does do a research year unfortunately.
 
I went to a university-affiliated community IM program, and even there, you rank toward the bottom anyone that you think is dual applying
 
Hey guys just wanted to update this thread. Got step 2 back this week and it was in the 260s which I'm pretty happy about. I'm starting to move away from the idea of dual applying but given how competitive ortho is I still feel like I need a back up plan (also recently completed a cardiology elective rotation which helped me realize that would probably be my second choice of specialty after ortho). I will be doing a research year with my home ortho department before I apply. What do you guys think?
Sounds reasonable for research year. Unless your med school already gives you enough time dedicated research time built into its standard 4-year curriculum, most applicants will need that time to get the typical number of pubs/abstracts/posters that are needed to match ortho (or any of the other super competitive specialties that require a lot of research). Would still have a back up plan in this situation since matching ortho is uncertain. One option that many applicants do is to also dual apply to gen surgery if they're still interested in a surgical field. Or, I've also seen unmatched ortho applicants SOAP into a gen surgery prelim spot and re-apply the following year.

If it's still IM I would do both IM sub-I and surgery sub-I prior to ERAS application deadline so you can get rec letters from both. As mentioned above, the higher tier IM programs will likely rank you lower just by being able to tell from you app that you're likely dual applying (whether or not they actually mention it on interview day, both ortho and IM programs will see the ortho research you have on your ERAS app) and they'll assume (often without asking) that ortho is your preferred specialty over IM. But given the wide variety of IM programs out there, with your stats you would likely match somewhere for IM. You could submit apps for both IM and ortho initially, and turn down some interview at IM programs if you find yourself already getting enough ortho interviews.
 
If you can't get into a "top 30" IM program with pedigree of "top 20 med school, almost all honors with honors in IM, lots of pubs", the problem won't have been anything on the application. IM is not a competitive specialty. For instance, I had interviews at top IM programs relying essentially on scores and LORs alone. That would not have flown in ophtho, ENT, etc. IM programs salivate at the prospect of having an applicant with "lots of pubs" regardless of context.
Would agree if OP were single applying, but the problem is he/she is planning on dual applying to ortho and IM. And dual applying usually hurts your chances of matching into the best program of your "back-up" specialty compared to just single applying to that specialty.
 
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