Extern App

[amint32]

Hello SDN friends! It is hard to believe that in about a little more than a month our applications for externships will be completed and our programs will be selected. I know this question is highly subjective based on each individual as I’m sure people value certain things in programs more than others but for those current 4th years, residents, or attendings how did you narrow down where to extern. I am having a hard time as I have a list of about 15-20 programs where I could see myself going but obviously can’t go to them all! Any advice on how you narrowed it down would be appreciated!

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[CutsWithFury]

Hello SDN friends! It is hard to believe that in about a little more than a month our applications for externships will be completed and our programs will be selected. I know this question is highly subjective based on each individual as I’m sure people value certain things in programs more than others but for those current 4th years, residents, or attendings how did you narrow down where to extern. I am having a hard time as I have a list of about 15-20 programs where I could see myself going but obviously can’t go to them all! Any advice on how you narrowed it down would be appreciated!

You are clearly not being honest enough with what you want out of your training or residency experience. Number one focus should be attaining the best training possible. Geography shouldn't matter. Whether it is in a major city or the midwest should not matter.

If you go simply based on that I guarantee you could cut your list down in half.

Another thing to consider is that you should pick your externships based on how competitive you are as an applicant. If you are a top student you should be applying to the top tier programs. Any program that "seems good" but is you don't know for sure shouldn't be on your list. You should be going for the historically strong programs that pump out residents getting hospital jobs or going to top tier fellowships.

If you are a middle in the road applicant or bottom 25% then you should be thinking more broadly

 

[Weirdy]

What Cuts said.

Don't lock yourself down to geographical area too much.
Aim for the best training. If you have high stats, you won't have to worry about what places will take you. Pick the ones with strong training and what you like.

If you are middle or bottom, be realistic with your stats and figure out what places you can get into that have the next best training. Then go kill your externship.

 

[deleted1138023]

GPA doesn't matter as much as people think. it really comes down to how hard you work and if you're normal/likable.

 

[FutureDPM123]

GPA doesn't matter as much as people think. it really comes down to how hard you work and if you're normal/likable.

That’s only true for places that aren’t a top 20 program

 

[deleted1138023]

That’s only true for places that aren’t a top 20 program

some of the "top 20 programs" that are sought after aren't even that great. so many hidden gem residencies. I'd recommend for everyone to get as high of a GPA as you can, but at the end of the day I pick residents on work ethic, personality, and common sense. rarely did I even know an externs gpa until interviews and at that point I never even cared. unless it was way off what I figured.

 

[CutsWithFury]

some of the "top 20 programs" that are sought after aren't even that great. so many hidden gem residencies. I'd recommend for everyone to get as high of a GPA as you can, but at the end of the day I pick residents on work ethic, personality, and common sense. rarely did I even know an externs gpa until interviews and at that point I never even cared. unless it was way off what I figured.

I concur some of the historically strong programs are pretty terrible and dumb for no reason. Such as PSL and Dekalb. These programs "training" replicates nothing in reality and they like to burn out their residents for the sake of being "tough". In reality MD/DO in Colorado and Atlanta do not care much about the podiatrists at these programs.

 

[DexterMorganSK]

@Feli posted about several strong programs in the past. Highly suggest students find that post and give it a read. High GPAs are good, but working with patients, residents, and attendings is vital as an extern. You are there for three years; you better like the people in that program and vice-versa.

 

[Feli]

GPA doesn't matter as much as people think. it really comes down to how hard you work and if you're normal/likable.

It depends. As @FutureDPM123 mentioned, you won't even get approved for clerkship at most good programs if you aren't top half/third of the class. Heck, there are probably a few programs where I wouldn't have been given my first choice month (and therefore would've had a hard time making my clerkships schedule work in the way I wanted it to) even with my pretty good but not elite rank/grades. So GPA matters.

No clerkship = snowball's chance of residency interview/match at most top programs. That student is basically ruled out there unless possibly program spot goes to scramble.
This especially true with likely upcoming residency shortage in a few years if new UTRGV school doesn't create spots (crystal ball = they won't).
After getting clerkship, then no, GPA is not too important... unless perhaps interviewing for programs one didn't clerk/visit.

There is nothing wrong with trying to get some of the more "sleeper" programs that are newer or less popular yet have good volume... but a student sure won't be approved to clerk (therefore won't ever match) at Grant or Inova or Kaiser Oakland or UPMC, etc if they are bottom half of the class.

...for OP, there is nothing wrong with visiting other programs while you're in a city (especially if one of yours is a total dud once you start).
You can try to do that... but as said, also limit it down as much as you can. Pick good clerkships and focus mainly on them. There are just not that many truly good ones in most states/areas.
While in Atlanta, there is no point to see the VA (which is the only other program besides PI, at least back when I did the clerkship). While I was in Detroit, I clerked months at both DMC and StJohn Ascension main a month each but visited Oakwood (Beaumont) and StMary Livonia and Henry Ford Macomb and StJohn Providence in that span too (I was just straight up with the clerkships, I was a pretty strong student and just told the clerkship on arrival I'd be taking X day off to visit another program... since I had found out the day I could meet visit program's director or see director's surgery at the other area programs). I also clerked West Penn but visited UPMC for a half day of director's clinic. In Phila, I clerked Penn Presby month but had planned to see another hospital on one day (it was actually my last clerkship, I knew where I'd match 99%, and I think I just went downtown that day). So, I had 5 clerkships... but I visited 10 (could've been 11) total programs. It didn't matter for me in the end since I'd basically made up my mind where I was going before clerkships even ended, but it was still good to have options and a couple known backups just in case. My interviews at my backups were better received since I'd visited and met the director, although I hadn't done the full month there. So, that's an option too.

Post I'd made is here on some of the historically strong and higher volume programs. It changes, though... some programs gain/lose key attendings (might leave, some start a fellowship and train fellows instead of residents... big hit to residents there) or the programs sometimes might lose surgery locations (usually due to new program opening at a hospital that was formerly covered by prior program's residents). The programs that are historically strong are almost always your best bet since they have enough attendings/cases depth and enough talented people who care about the program's quality to handle losing a surgeon or two and still be very good. The lesser programs are adequate but don't have that ability, and a lot of them are a turtle on its back and will struggle to get numbers if they lose the director or key RRA surgeon or two (and then there are total crap programs that basically fake their numbers to begin with).

 

[mingle_pringle]

What if you have a high GPA/class rank - but, still didn't get your preferred clerkships? Or, you just feel like you completely messed up on your clerkship selection at this point

 

[DexterMorganSK]

What if you have a high GPA/class rank - but, still didn't get your preferred clerkships? Or, you just feel like you completely messed up on your clerkship selection at this point

There is time to switch programs; extern at programs where you can see yourself getting matched at.

 

[PTPuser]

There is time to switch programs; extern at programs where you can see yourself getting matched at.

Dexter, is it the norm for students to switch programs often and is that school base policy?

 

[DexterMorganSK]

Dexter, is it the norm for students to switch programs often and is that school base policy?

I don't think it's a policy, but yes, most students switch around after hearing about the program from friends or reading evals.
If you want to be in program B, there is nothing wrong with switching from program A to program B.

 

[mingle_pringle]

I don't think it's a policy, but yes, most students switch around after hearing about the program from friends or reading evals.
If you want to be in program B, there is nothing wrong with switching from program A to program B.

TY! How do you switch from program A to program B? Never heard of this.

 

[DexterMorganSK]

TY! How do you switch from program A to program B? Never heard of this.

If you can't change it yourself, contact your clinical dean.

 

[Weirdy]

Swaps are common. It is better to heed major red flags so you do not WASTE a month at a program you know you will not 1) want to go to 2) give you extremely poor training

 

[mingle_pringle]

Swaps are common. It is better to heed major red flags so you do not WASTE a month at a program you know you will not 1) want to go to 2) give you extremely poor training

Do I just go into round 3 apply to programs that are available and then try to swap? Some programs haven't accepted nor denied for the month I have left.

 

[heybrother]

Do I just go into round 3 apply to programs that are available and then try to swap? Some programs haven't accepted nor denied for the month I have left.

Have you picked up the phone and called anyone. A few years ago it was somewhat kind of against the rules and yet everyone did it to try and make months work.

I had pretty good grades but only hit 5 of 7 on my first round. I had some programs offer me spots in an order that didn't work for me and thankfully a program that was going to die denied me a spot (which I'm grateful for because they didn't interview that year).

Yes, there are people who get everything they want immediately in the order they want it. Our ultimately #2 who was #1 at the time hit 7/7 in a row. Other classmates who were struggling were freaking out.

Here's my thing - if you don't get what want - dig deep and keep looking. I didn't match there - but in my later rounds I asked to visit Norton in Kentucky and I had a really good time there. Good program. Good people. Saw good stuff. Expand your horizons.

I can't say it enough - there's been talk of here recently about people wanting to be close to home or limiting themselves based on geography.

Enormous mistake. Don't do it. Reach out and find good programs. Go somewhere else for a few years. Biggest mistake I ever made was fixating on Texas. Two of my months were absolute mistakes. Waste of time. Learned nothing. Didn't even rank 'em. Should have gone elsewhere.

You may not be going to a TAR program, but there are still good programs where you can learn full scope from podiatry attendings.

 

[PTPuser]

Thanks to SDN and the advice / review on here, I was able to fill everything in round 1. I'm not top of the class at all...not even close. But I made really good connections and was able to snag programs that was out of my league. Best of luck. All of this could be a blessing in disguise.

 

[de Ribas]

I don't think there is any advantage of filling as many spots as you can on 1st round. Plenty of people fill half on 1st round and still able to get great places 2nd round.

 

[iridocyclitiss]

Have you picked up the phone and called anyone. A few years ago it was somewhat kind of against the rules and yet everyone did it to try and make months work.

I had pretty good grades but only hit 5 of 7 on my first round. I had some programs offer me spots in an order that didn't work for me and thankfully a program that was going to die denied me a spot (which I'm grateful for because they didn't interview that year).

Yes, there are people who get everything they want immediately in the order they want it. Our ultimately #2 who was #1 at the time hit 7/7 in a row. Other classmates who were struggling were freaking out.

Here's my thing - if you don't get what want - dig deep and keep looking. I didn't match there - but in my later rounds I asked to visit Norton in Kentucky and I had a really good time there. Good program. Good people. Saw good stuff. Expand your horizons.

I can't say it enough - there's been talk of here recently about people wanting to be close to home or limiting themselves based on geography.

Enormous mistake. Don't do it. Reach out and find good programs. Go somewhere else for a few years. Biggest mistake I ever made was fixating on Texas. Two of my months were absolute mistakes. Waste of time. Learned nothing. Didn't even rank 'em. Should have gone elsewhere.

You may not be going to a TAR program, but there are still good programs where you can learn full scope from podiatry attendings.

I'll add my extern experiences after rankings and interviews-- but I cannot understate how awesome Norton is. It's a huge sleeper program, and I absolutely loved my month there.