Failed SOAP and new application

[ordersol7]

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Hello everyone. I am in need of some advice.
I am an AMG at a mid tier school with below average stats. 209 on step 1 and 209 on step 2. P's in all clerkships (no negative evals i'm just not good with exams). Was told I had very strong LORs. I initially applied EM and only got 3/70 interviews which i think is most likely d/t my scores since multiple people commented on how great my ER letters were. Midway through the interview cycle I applied to prelim IMs so as not to go unmatched, but then on reflecting decided i'd be happier continuing with categorical IM so i called around and changed my interviews to categorical ones. Managed to get 6 categorical IM interviews despite not applying til mid November. Thought I was safe to match. Now hear I am SOAPing and haven't gotten a single call or email from programs. There's still 3 more rounds of SOAP for tomorrow but I'm planning for the worst. I applied to all the categorical IM spots and several prelim IM. for my next 10 i applied to the remaining prelim IM, some transitional, and some family medicine. If tomorrow goes by and I still get nothing i'm not sure what to do. I have never failed or been in danger of failing anything in med school. I have no professionalism issues, never took a LOA, and have no other red flags that I'm aware of. I felt like my interviews went well. I was even told by some interviewers that I displayed more maturity and insight (their words) compared to my peers and that I would be a good fit.
My deans suggested delaying my graduation and applying again after doing some aways to get some new letters if I still couldn't find anything after SOAP or if nothing opened up. I am at such a loss. I am more depressed than I have ever been in my life. Any advice people would have is much appreciated. I'd still prefer to do categorical IM if possible.

 

[Beacopp665]

You have a great opportunity here actually in that your dean is giving you the option of delaying your graduation. I think that you should take him/her up on that if you fail to secure any positions today. That is by far your best option if you are unsuccessful in the SOAP and the best way to network and improve your app for the next cycle.

 

[ArkansasMed]

Honestly, the best thing we can all say is that we are really sorry. It must be hard and hopefully we can give you some encouraging words if things do not work out.

I would 100% take your dean up on his offer. I had a few friends who did this over the years and all ended up matching next round. It is not ideal, but it is great that he/she cares enough about his students to give you that option.

Keep your head up.

 

[ordersol7]

Thanks. Still nothing after 2 rounds today. I should note I did some research and presented a poster between 1st and 2nd year and also i passed step 2 cs without problems. I have felt throughout med school that I've had to struggle to stay afloat but thought that being a USMD that passed everything 1st attempt with no red flags would at least let me be able to SOAP in something. When I reapply will programs know about my delayed graduation and failure to match? If so how can I approach it? Also would be more beneficial to do some away rotations to get some new LORs or try to find a research job. I plan on meeting with my IM clerkship director and home PD to talk about what I should do.

 

[NYDO2014]

Try to do couple of electives to show you are committed to your specialties. The major draw-back is that you try to apply to IM as a "backup" during Oct/Nov. I would definitely meet with your home PD and see whether he can make you a prelim IM spot.

you need to convince the IM/FM PDs that you are not trying to backup into their specialties.

 

[ordersol7]

Thanks for the advice. I talked with my deans today and they seemed as puzzled as I am that I haven't gotten ANYTHING and are willing to work with me to find a spot. If not, then delaying graduation is an option and I get up to 3 away electives.

 

[anonperson]

Sorry to hear about this. Just know that this is just a temporary roadblock and ten years down the line, this won't be anything more than a dumb story to remember.

Main issue was applying to EM with borderline stats. It has gotten more competitive unfortunately and your academic advisors should have recommended you apply to more programs. I know, 70 seems like a lot, but with the intense amount of competition in general, anyone with borderline stats should be applying as widely as possible. If you get a ton of interviews, fantastic and decline the ones you don't want. It is not expensive to apply to residency in the grand scheme of things. Applying late to IM is a tough go as well.

If you're set on IM now, I think delaying graduation is a good option as it allows you to do electives and get more letters of recommendation. If you apply early and widely, you should be able to get into a categorical university IM residency. As far as reasoning, you can always word it as a change of heart regarding specialty interest. Programs will know your graduation is delayed just by looking at your start and expected end dates of medical school.

 

[jdh71]

Thanks for the advice. I talked with my deans today and they seemed as puzzled as I am that I haven't gotten ANYTHING and are willing to work with me to find a spot. If not, then delaying graduation is an option and I get up to 3 away electives.

I'd suggest delay and reaply as a super senior 4th year student. Too bad your home program can't open a spot for you.

 

[ordersol7]

Thanks for everyone's advice. I'm meeting with my home IM PD next week to talk about next steps and ask him about any red flags on my app I didn't know about. Maybe see if I can get a prelim IM spot here but not holding my breath. Looking back I think on paper I was competitive enough for IM based on the interviews I got late but maybe I didn't do a good enough job convincing them I wasn't just trying to back-up with IM.

 

[ordersol7]

Hello again. I met with my home PD and he was very helpful. He was blunt with me (which I appreciated) and told me that my boards were very below average for his program but said that with IM-specific LORs (which i didn't have before save my home department chair letter) and getting everything in as early as possible that I should be able to match into a university program or high end community program in the midwest where I want to stay. He thought delaying my graduation was a good idea and gave me some tips on how to explain what happened in the personal statement and interviews.

I also called around to some of the other IM programs I interviewed at. Some were concerned about the borderline step 2, others didn't care. A common theme was that they weren't convinced I was legitimate about wanting to switch to IM especially since I was late.

My question is that he suggested that i should do my aways at places where i would be marginally competitive and where a good performance could "push me over the edge" into matching there when i might not have otherwise. He also said I should check that I'll be working continuously with 1/2 attendings over the month instead of multiple so that I could get a good detailed letter. Is there anything else I should be thinking about when trying to set up aways? Does it matter if they're wards vs icu vs a subspecialty month or anything like that? I've looked on vsas and some hospitals in my area for options but haven't sent applications yet. Thank you.

 

[efex101]

Despite your low board scores, me thinks you did not match IM well because you initially did not apply to IM and chose EM which is very competitive. Now that you know, lesson learned. Apply EARLY, apply broadly and you should be fine. I would absolutely do away rotations at programs where you may be accepted and be willing to TRAVEL far and away. I would choose wards as that will be more contact with IM folks whereas ICU would be more critical care type attending. Do not let this get you down, you passed all your boards congrats! and you should be fine the second go round.

 

[ordersol7]

Hello everyone. I wanted to thank everyone who responded for your advice and support, and to also ask for advice again.
By now I've completed 2 additional away medicine sub-I's. Both went very well. I received honors on both rotations and a LOR from each place.. One of the letters is from one of the PDs at that program who informed me I was in the top 15% of students he has worked with. Both programs were mid tier IM programs in the midwest, 1 community and 1 university. I have nothing lined up this month but I have another medicine sub-I in September at another university IM program. I will also be meeting with my advisor this week to talk about getting started on a research project to continue throughout this semester and next. My IM department has already promised a Chair letter for this coming cycle.
I was hoping I could get feedback on my initial list of programs. I want to stay in the midwest. Ideally a university program or community program with in-house fellowships. I'm aware some of these would be serious reaches for me (UMich, NW, UChicago). Both places I did aways are also on this list. Any advice on programs I should add/drop from this list or if this is a good amount of programs would be very much appreciated.

AR:
University of Arkansas for Medical Sciences Program
IA:
University of Iowa (Des Moines) Program
University of Iowa Hospitals and Clinics Program
IL:
University of Chicago Program
Chicago Medical School at Rosalind Franklin University of Medicine and Science Program
McGaw Medical Center of Northwestern University Program
University of Illinois College of Medicine at Chicago Program
Loyola University Program
University of Illinois College of Medicine at Chicago/Advocate Christ Medical Center Program
Advocate Lutheran General Hospital Program
Southern Illinois University Program
Rush University Medical Center Program
University of Chicago (NorthShore) Program
University of Illinois College of Medicine at Peoria Program
Advocate Illinois Masonic Medical Center/North Side Health Network Program
University of Illinois College of Medicine at Urbana Program
IN:
Indiana University School of Medicine Program
St Vincent Hospital and Health Care Center Program
KS:
University of Kansas School of Medicine Program
University of Kansas (Wichita) Program
MI:
Wayne State University School of Medicine Program
William Beaumont Hospital Program
Henry Ford Hospital/Wayne State University Program
University of Michigan Program
Detroit Medical Center/Wayne State University Program
Michigan State University Program
Western Michigan University Homer Stryker MD School of Medicine Program
MN:
University of Minnesota Program
Abbott-Northwestern Hospital Program
Hennepin County Medical Center Program
MO:
University of Missouri-Columbia Program
Washington University/B-JH/SLCH Consortium Program
St Mary's Health Center Program
St Luke's Hospital Program
University of Missouri at Kansas City Program
St Louis University School of Medicine Program
Ohio:
Summa Health System/NEOMED Program
Jewish Hospital of Cincinnati Program
Ohio State University Hospital Program
University of Cincinnati Medical Center/College of Medicine Program
Case Western Reserve University/University Hospitals Case Medical Center Program
Kettering Medical Center Program
University of Toledo Program
OK:
University of Oklahoma Health Sciences Center Program
University of South Dakota Program
TN:
University of Tennessee College of Medicine at Chattanooga Program
University of Tennessee Medical Center at Knoxville Program
East Tennessee State University Program
University of Tennessee Program
University of Tennessee (Nashville) Program
WS
Gundersen Lutheran Medical Foundation Program
University of Wisconsin Program
Medical College of Wisconsin Affiliated Hospitals Program

 

[Crayola227]

I dont know if it meet your criteria about fellowship or whatever, but there's an IM categorical at Oklahoma TULSA, like program there better and city is better than OKC (some people though the PD in OKC if it's the older gentleman was gruff)
you are doing yourself a HUGE disservice to consider OKC and not Tulsa, if you can afford it apply

There's a program in Kalamazoo MI, don't know if it's on your list I can't remember Michigan program names just locations
don't know how competitive with fellowship, but they seemed like they were really working hard to sell the program but because of location middle of no where, not because I think it was bad there, it seemed laidback there, lots of golden weekends if I remember

Univ of WI is too competitive, but it can't hurt to apply if you want to put the money there
Same with Univ of MI & Washington at St. Louis, not trying to hurt your feelings, hey, miracles happen

I've heard any Chicago program that isn't UChicago or NW isn't worth visiting from a PD, but that was couple years ago
You may like/need the other programs, who am I to say?
I don't know why I'm partial to Loyola but I am, they are not the most competitive it is worth applying
I may be wrong double-check but I think Rush is too high a tier

Minneapolis a solid program people liked

Cincinnati is a good choice IMHO

Why not look at Kentucky, Louisville if you're looking at TN and OH? Not that much further but who I am to tell you your geographic priorities

You failed a match, why too proud for Nebraska? Seriously Creighton Omaha not competitive (safety) but more well regarded than other program in area

Iowa a hidden jewel for you

Some of this is experience, some of this is hearsay from a few years back
2 cents for what it's worth
PM me later when you get interview offers

 

[ordersol7]

Thanks. For what it's worth, it's not on my record anywhere that I failed to match. Only that my graduation was extended 6 months. I could point out too I did actually get an interview at Rush last cycle despite applying late without IM letters and my boards being what they are. I will definitely add the Tulsa program and those Nebraska programs and maybe some of those KY ones too. I just didn't remember them when I made up this list. Thanks for your input!

 

[Crayola227]

be prepared to maybe talk about your test taking skills and what strategies you will use to nail Step 3

seems off the mark I know, but not to pat my own back but my boards were solid for IM but some random comment offhand from someone about a shelf yielded an interview day question
thankfully I had solid boards and a good answer to that question in stride

you're not there yet, I know, I'm alwasy too many steps ahead

in any case, whoever interviews you with your step scores will be worried about Step 3 (not to shame you, this is just what PDs use NOT just to look at your knowledge base and ability to function clinically, lots of people do great in real life clerkships intern rotations and that's probably you BUT no matter how awesome you are PDs are always worried about Step 3 passing because of licensing)

Good luck on the match! Keep us updated here these threads help other ins your shoes

 

[Crayola227]

Thanks. For what it's worth, it's not on my record anywhere that I failed to match. Only that my graduation was extended 6 months. I could point out too I did actually get an interview at Rush last cycle despite applying late without IM letters and my boards being what they are. I will definitely add the Tulsa program and those Nebraska programs and maybe some of those KY ones too. I just didn't remember them when I made up this list. Thanks for your input!

Hey, no problem, that comment about matching was sorta mean. Yes, your record is clean THANK GOD.

I meant from a practical standpoint. I want you to match match day. And like I said I had no idea about Rush but good on you. Anywhere you interviewed/had offer before is great. And go ahead apply to the longshots, just have a safety for every longshot!

Good luck and seriously when you get interviews talk to me later

 

[ordersol7]

Appreciate it. I did make an error in judgement when I took step 2. I pushed it forward due to an incident where I lost my driver's license and didn't have another ID and ended up taking it the day after an ER shift. I was tired and very anxious when taking it, but I was consistently hitting 230-240 on practice exams so I thought I'd still be ok. I never failed or was borderline on my shelf exams, just consistently below the mean.
My home PD and also the PD of the place I rotated suggested that I should run with the explanation that I decided to switch to IM very late in interview season (which is more-or-less the truth, I genuinely think now I would be happier with IM long term) and decided based on advice from my school to delay graduation and reapply to only IM after doing additional sub-is/electives both to maintain US senior status and also to avoid spending an intern year doing something I would not be happy in and then try to leave, hurting the program. I've been getting differing answers on whether or not to include this in my personal statement though. Some faculty said I should explain it up front rather than hope it goes unnoticed and then be "found out" later, others said that it would unneccessarily draw attention to a potential red flag and just have an explanation ready at interviews if it comes up. My home advisor also suggested dual applying to family medicine. Tbh, outpatient work doesn't interest me as much, but I'm willing to go there if it's necessary for me to match.

 

[ordersol7]

Hello Everyone.

Sorry to bump an old thread, but I wanted to update this thread to give hope for other students in the situation I was..
I matched this year into IM. About half my rank list were academic programs and the other half were community programs with in-house fellowships.
I ultimately received 11 invites (9 came before mid-October and then got off 2 waitlists) out of 70 IM applications total.
Almost every interview asked about my delayed graduation (though only a couple asked about my step scores), and I rolled with the explanation that I decided very late that EM wasn't a good fit for me and was advised by my school to extend graduation to do some additional sub-i's if i was serious about switching since it's easier to match as a current student than a graduate. This was a definite stretch of the truth but that's just the game, and in the end I really do think i'll be happier in IM long term. I'lll edit the post later this week when i find out how far down my rank list I ended up.
I want to thank everyone on SDN who were willing to take the time to advise me. In a lot of ways this forum has been a lot more helpful than my home school advisors. Thank you all so much.

Edit: Matched at my #6. A community program with in-house fellowships and a close affiliation with a nearby Uni program. Not gonna lie, a little bit of a letdown but I rotated here and already know it's a nice program that treats their residents well. Thanks again for everyone's help

 

[buonassezia]

Congrats!!! Very impressed that you did all the right things to pick yourself up and come back from a difficult situation--true sign of character and great problem-solving that will benefit you wherever you go. Hurray! Thanks for sharing the great news.

 

[terrypk1]

congrat man. I am very happy to hear this. A friend of mine also had similar problem and had delayed 2 years...guess what. he matched this year as well. Very very happy for him as well. I can't wait to see how well you did.