Failed to match a advance spot. Not sure what to do. Need advice

[Itsarainbow]

Hi guys

DO grad here who applied VERY broadly to gas and received no interviews. I luckily ended up at a brand new TY program next year and I'm unsure of where my career is headed. I have opened the possibilities to a new career and was wondering how I should set up my TY year? I will have 2 elective months and I'm deciding between radiology, pmr, neurology, and psych. How competitive will I be for these specialties? Will I be able to find a pgy2 spot for next year? I just don't want to go through this experience again

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[Redpancreas]

Hi guys

DO grad here who applied VERY broadly to gas (step1:226 step2:224 comlex1:501 comlex2: 548) and received no interviews. I luckily ended up at a brand new TY program next year and I'm unsure of where my career is headed. I have opened the possibilities to a new career and was wondering how I should set up my TY year? I will have 2 elective months and I'm deciding between radiology, pmr, neurology, and psych. How competitive will I be for these specialties? Will I be able to find a pgy2 spot for next year? I just don't want to go through this experience again

Your numbers are fair/below average, but not terrible. Step 2CK + DO probably held you back. I suspect that with no interviews to gas you either did not apply broadly enough OR there is more to the story. Regardless, in order of competitiveness: Psych/Rads>=Any Neuro>PM&R.

PM&R will be the least competitive, but there are limited programs. Psych/Rads would be even more competitive than Gas which you didn't get and it's going to tougher now that you're considered a US graduate.

Pick one field you like (I think Rads may be tough, maybe Psych too). I don't know why you're ruling out Gas. If you can do an elective in Gas that's important. Additionally, get letters of recommendation from your IM rotations and apply IM as well. Don't tell anyone about your intents or else that letters won't be as strong.

You need to maximize your chances of matching after your TY year because each year you wait you lose competitiveness. Apply to Gas, XYZ, and IM.

 

[Itsarainbow]

Your numbers are fair/below average, but not terrible. Step 2CK + DO probably held you back. I suspect that with no interviews to gas you either did not apply broadly enough OR there is more to the story. Regardless, in order of competitiveness: Psych/Rads>=Any Neuro>PM&R.

PM&R will be the least competitive, but there are limited programs. Psych/Rads would be even more competitive than Gas which you didn't get and it's going to tougher now that you're considered a US graduate.

Pick one field you like (I think Rads may be tough, maybe Psych too). I don't know why you're ruling out Gas. If you can do an elective in Gas that's important. Additionally, get letters of recommendation from your IM rotations and apply IM as well. Don't tell anyone about your intents or else that letters won't be as strong.

You need to maximize your chances of matching after your TY year because each year you wait you lose competitiveness. Apply to Gas, XYZ, and IM.

Thanks for the reply. My TY year is offering electives and I do plan on using one for Rads and the other one on Neuro or PMR. I also plan on applying to Gas again (my personal statement did not mention my reasoning for choosing gas and instead focused on family deaths that occurred in the past few years and how it changed my outlook on medicine). My TY year seems medicine heavy thus I also plan on getting a few IM letters in order to also apply to IM programs also. Will a strong Step 3 help my cause?

 

[Redpancreas]

Thanks for the reply. My TY year is offering electives and I do plan on using one for Rads and the other one on Neuro or PMR. I also plan on applying to Gas again (my personal statement did not mention my reasoning for choosing gas and instead focused on family deaths that occurred in the past few years and how it changed my outlook on medicine). My TY year seems medicine heavy thus I also plan on getting a few IM letters in order to also apply to IM programs also. Will a strong Step 3 help my cause?

Yes but I don’t you to focus on Step 3. Past Step 1/2 performance is the strongest indicator (although maybe @ciestar found a way to break the cycle) so don’t hold yourself to hitting Step 3 out of the park. That said, not having Step 3 on your application will make you look inconsistent. You’re going all in to match this time around but then you don’t have Step 3. Take Step 3 and aim for 220+. 230+ will most certainly help a bit, but get the Step done just so you have it and residencies won’t have to worry about it. It also makes you seem more productive and motivated.

Don’t worry about reasoning for PS. If you wanted you could write a PS for anesthesia saying X and internal medicine saying Y. Just try to be as real as possible. PDs see applicants from beginning to end and probably can see through BS. This is one reason I have to tells FM applicants to stop writing that they want to practice in underserved areas. Everyone knows they have a psych PS they’re sending elsewhere.

I think if you’re reapplying Gas get an elective in gas too (unless you already have one). Then pick the strongest of your interests between Neuro/Rad/PMR. Otherwise you’re applying to too many fields. It’s possible, I just think your gonna burnout if you try applying to four fields but I understand the hustle.

 

[ciestar]

Yes but I don’t you to focus on Step 3. Past Step 1/2 performance is the strongest indicator (although maybe @ciestar found a way to break the cycle) so don’t hold yourself to hitting Step 3 out of the park. That said, not having Step 3 on your application will make you look inconsistent. You’re going all in to match this time around but then you don’t have Step 3. Take Step 3 and aim for 220+. 230+ will most certainly help a bit, but get the Step done just so you have it and residencies won’t have to worry about it. It also makes you seem more productive and motivated.

Don’t worry about reasoning for PS. If you wanted you could write a PS for anesthesia saying X and internal medicine saying Y. Just try to be as real as possible. PDs see applicants from beginning to end and probably can see through BS. This is one reason I have to tells FM applicants to stop writing that they want to practice in underserved areas. Everyone knows they have a psych PS they’re sending elsewhere.

I think if you’re reapplying Gas get an elective in gas too (unless you already have one). Then pick the strongest of your interests between Neuro/Rad/PMR. Otherwise you’re applying to too many fields. It’s possible, I just think your gonna burnout if you try applying to four fields but I understand the hustle.

Hah, you remember that?
Yes, i did trash on step 1. I actually got it together for step 2 though. I used Anki, did my qbanks, did well on my shelf exams. My step 1 was embarrassing. Now, I haven’t taken step 3 yet, so I cannot comment on how i well I did there.

 

[Itsarainbow]

Yes but I don’t you to focus on Step 3. Past Step 1/2 performance is the strongest indicator (although maybe @ciestar found a way to break the cycle) so don’t hold yourself to hitting Step 3 out of the park. That said, not having Step 3 on your application will make you look inconsistent. You’re going all in to match this time around but then you don’t have Step 3. Take Step 3 and aim for 220+. 230+ will most certainly help a bit, but get the Step done just so you have it and residencies won’t have to worry about it. It also makes you seem more productive and motivated.

Don’t worry about reasoning for PS. If you wanted you could write a PS for anesthesia saying X and internal medicine saying Y. Just try to be as real as possible. PDs see applicants from beginning to end and probably can see through BS. This is one reason I have to tells FM applicants to stop writing that they want to practice in underserved areas. Everyone knows they have a psych PS they’re sending elsewhere.

I think if you’re reapplying Gas get an elective in gas too (unless you already have one). Then pick the strongest of your interests between Neuro/Rad/PMR. Otherwise you’re applying to too many fields. It’s possible, I just think your gonna burnout if you try applying to four fields but I understand the hustle.

Will a Gas elective be necessary? I did a couple this past year (4th year) and have 2 LORs from anesthesiologists. I was really hoping to explore other fields because my TY year seems medicine-heavy. I want to do Gas but I'm scared after what happened this year and start looking into other fields if Gas isn't in the cards. I applied very broadly this past cycle as in over a 100+ programs and still didn't receive an interview.

 

[Itsarainbow]

Hah, you remember that?
Yes, i did trash on step 1. I actually got it together for step 2 though. I used Anki, did my qbanks, did well on my shelf exams. My step 1 was embarrassing. Now, I haven’t taken step 3 yet, so I cannot comment on how i well I did there.

Congrats man! I also hope to be on that side of my career soon

 

[Redpancreas]

Will a Gas elective be necessary? I did a couple this past year (4th year) and have 2 LORs from anesthesiologists. I was really hoping to explore other fields because my TY year seems medicine-heavy. I want to do Gas but I'm scared after what happened this year and start looking into other fields if Gas isn't in the cards. I applied very broadly this past cycle as in over a 100+ programs and still didn't receive an interview.

I think so! You didn't match it so you need something and you did choose it for a reason. You need something else to add to your application if you're going to reapply gas. I would imagine this would be your top choice out of anything, no? Also, radiology while nice as an elective would be more competitive than gas, but if your heart is set on it I wouldn't discourage you from trying for it.

 

[NotAProgDirector]

Will a Gas elective be necessary? I did a couple this past year (4th year) and have 2 LORs from anesthesiologists. I was really hoping to explore other fields because my TY year seems medicine-heavy. I want to do Gas but I'm scared after what happened this year and start looking into other fields if Gas isn't in the cards. I applied very broadly this past cycle as in over a 100+ programs and still didn't receive an interview.

I think this is complicated. You'll be applying in September, so the only electives that will "count" for your application are those you do in July-Sept. That doesn't leave you much room. I agree that doing a Gas elective might help your Gas application, but that didn't go so well last time and I think you're probably better off focusing on other fields with your electives, apply Gas and see what happens, but hedge your bets for other fields.

 

[Redpancreas]

I think this is complicated. You'll be applying in September, so the only electives that will "count" for your application are those you do in July-Sept. That doesn't leave you much room. I agree that doing a Gas elective might help your Gas application, but that didn't go so well last time and I think you're probably better off focusing on other fields with your electives, apply Gas and see what happens, but hedge your bets for other fields.

Definitely start Step 3 studying now OP. You have a little under two months before work starts. Aim to take it in September.

 

[Itsarainbow]

I think this is complicated. You'll be applying in September, so the only electives that will "count" for your application are those you do in July-Sept. That doesn't leave you much room. I agree that doing a Gas elective might help your Gas application, but that didn't go so well last time and I think you're probably better off focusing on other fields with your electives, apply Gas and see what happens, but hedge your bets for other fields.

My 1st elective will start in September and the following one in October. So I will have exposure and hopefully new LOR in those fields. My program director seems very supportive and I'm hoping to have him back me up also. Can I send out new applications at the of the October? Is that a disadvantage for pgy1 residents? From what I have read it seems like more physcian reserved spots open up later in the cycle. I also plan on applying broadly to IM programs including my own program. I just don't want to risk matching into a speciality again.

 

[Itsarainbow]

Definitely start Step 3 studying now OP. You have a little under two months before work starts. Aim to take it in September.

I'm buying step 3 today and hoping to take it by September. Will a strong score mean much? Or do programs only care if you pass the step 3?

 

[Redpancreas]

I'm buying step 3 today and hoping to take it by September. Will a strong score mean much? Or do programs only care if you pass the step 3?

<200 or no score: Net negative.
20X-21X: Meh...well at least it's done. You met our expectations by taking the exam. Neutral. We knew you weren't a strong test taker.
21X-22X: Good for you to get it done and it's something we won't have to worry about in residency. Slight positive.
230+: Positive.

That said, Step 1/2 are strong predictors so don't go into it with any ultimatums. I recommend you look at the USMLE Step 3 Official thread I started for some resources and keep in mind it's going to be especially tough for you below average test-taking and no residency experience. Just do your best.

 

[Redpancreas]

My 1st elective will start in September and the following one in October. So I will have exposure and hopefully new LOR in those fields. My program director seems very supportive and I'm hoping to have him back me up also. Can I send out new applications at the of the October? Is that a disadvantage for pgy1 residents? From what I have read it seems like more physcian reserved spots open up later in the cycle. I also plan on applying broadly to IM programs including my own program. I just don't want to risk matching into a speciality again.

All your stuff needs to be ready by September 29th, 2021.

1.) Step 3 studying starts now. It will put you ahead of the game on some knowledge aspects for IM when you start training. When you exactly take it needs to be based on your elective rotations, but keep in mind you'll be being evaluated on these electives so you'll have competing time sinks. Regardless, your day 2 of Step 3 needs to be done by early September.
2.) Secure the LOR from the September elective.
3.) Secure an IM/FM LOR from July-August rotations.
4.) That October elective should be something IM/FM/Anesthesia. It can't be PM&R/Rads/Psych as a new experience. You can do the elective and submit a letter late and most people won't read it. That's why that elective should just reinforce something else.

With this, apply:

1.) IM
2.) FM
3.) PM&R/Rads/Psych (pick one-September).
4.) Anesthesia (I guess you'll have Step 3 +/- an October LOR).

 

[Itsarainbow]

All your stuff needs to be ready by September 29th, 2021.

1.) Step 3 studying starts now. It will put you ahead of the game on some knowledge aspects for IM when you start training. When you exactly take it needs to be based on your elective rotations, but keep in mind you'll be being evaluated on these electives so you'll have competing time sinks. Regardless, your day 2 of Step 3 needs to be done by early September.
2.) Secure the LOR from the September elective.
3.) Secure an IM/FM LOR from July-August rotations.
4.) That October elective should be something IM/FM/Anesthesia. It can't be PM&R/Rads/Psych as a new experience. You can do the elective and submit a letter late and most people won't read it. That's why that elective should just reinforce something else.

With this, apply:

1.) IM
2.) FM
3.) PM&R/Rads/Psych (pick one-September).
4.) Anesthesia (I guess you'll have Step 3 +/- an October LOR).

Okay thanks for all this info!

Are you saying I apply to all those specialities or are you ranking them based on how competitive my application is? I applied to 100+ gas programs and still didn't recieve an interview (not mentioning anesthsia in my PS + below average scores but I am surprised that I didn't recieve a single one). I really don't want to do FM as I found it boring and would be really unhappy. I feel kind of stuck in a crappy situation and I'm not sure where my career is going to go. Sometimes I wish I had stuck to my biomed eng degree and called it a day...

 

[Redpancreas]

Okay thanks for all this info!

Are you saying I apply to all those specialities or are you ranking them based on how competitive my application is? I applied to 100+ gas programs and still didn't recieve an interview (not mentioning anesthsia in my PS + below average scores but I am surprised that I didn't recieve a single one). I really don't want to do FM as I found it boring and would be really unhappy. I feel kind of stuck in a crappy situation and I'm not sure where my career is going to go. Sometimes I wish I had stuck to my biomed engineering degree and called it a day...

Not ranking them at all just listing. The bolded's a pretty big slip up, what happened there my friend? If you don't want to do FM, do you want to do IM? What's your plan there? There's a lot of options, but many don't find any appealing or many less competitive applicants think they'll get XYZ fellowship and end up settling for ABC. I have felt what you are feeling... in that I wish my life turnt out differently, but you only get this one life and these are the terms of it right now. A couple low effort things you do now could help in the future when you're feeling better which will leave you kicking yourself. For now, getting that residency slot should be most important. Despite finding FM/IM unappealing, you need to still apply to them as back ups because at the end of the day they'll let you practice and making a very good living after 3 years of training.

 

[Itsarainbow]

Not ranking them at all just listing. The bolded's a pretty big slip up, what happened there my friend? If you don't want to do FM, do you want to do IM? What's your plan there? There's a lot of options, but many don't find any appealing or many less competitive applicants think they'll get XYZ fellowship and end up settling for ABC. I have felt what you are feeling... in that I wish my life turnt out differently, but you only get this one life and these are the terms of it right now. A couple low effort things you do now could help in the future when you're feeling better which will leave you kicking yourself. For now, getting that residency slot should be most important. Despite finding FM/IM unappealing, you need to still apply to them as back ups because at the end of the day they'll let you practice and making a very good living after 3 years of training.

I wasn't thinking straight and received some poor advice. I have dealt with 4 family deaths since the beginning medical school (including my father's just before med school started) and it's been a tough go since. Around my PS statement time I was dealing with my grandma's (also a reason for my poor Step 2 score while I was averaging close to a 235-240 on practice exams). These past few years have been hell for me and I'm finally feeling like my old self again. As altruistic as medicine seems, the path to becoming a physician is the complete opposite. I have found that no one is willing to listen to a sob story and that's totally fine. I should have known better. I'll try to make the best of this situation and I plan to work my butt off this year. You're right; better to have a career than no career at all.

 

[Redpancreas]

I wasn't thinking straight and received some poor advice. I have dealt with 4 family deaths since the beginning medical school (including my father's just before med school started) and it's been a tough go since. Around my PS statement time I was dealing with my grandma's (also a reason for my poor Step 2 score while I was averaging close to a 235-240 on practice exams). These past few years have been hell for me and I'm finally feeling like my old self again. As altruistic as medicine seems, the path to becoming a physician is the complete opposite. I have found that no one is willing to listen to a sob story and that's totally fine. I should have known better. I'll try to make the best of this situation and I plan to work my butt off this year. You're right; better to have a career than no career at all.

That's OK. You made a mistake. As heartless as it sounds, your PS should focus more on your passion for XYZ field. You can mention the deaths, but make it apparent you made it work in spite of these setbacks and how you want to be XYZ doctor. In re: to medicine's heartless nature, that may be true but do you need someone to sit and listen to your story? You have what's left of your support system and you don't need crocodile tears from anyone. All your goals are still in front of you. Keep us updated!

 

[Itsarainbow]

That's OK. You made a mistake. As heartless as it sounds, your PS should focus more on your passion for XYZ field. You can mention the deaths, but make it apparent you made it work in spite of these setbacks and how you want to be XYZ doctor. In re: to medicine's heartless nature, that may be true but do you need someone to sit and listen to your story? You have what's left of your support system and you don't need crocodile tears from anyone. All your goals are still in front of you. Keep us updated!

Will do! Thanks for all your advice!

 

[Splenda88]

I would not apply to gas again if I were you. I would concentrate in IM, FM or Neurology. If you fail to match again, you will have tough time convincing ANY PD to give you a chance the 3r time around. Time to move on!

 

[Redpancreas]

I would not apply to gas again if I were you. I would concentrate in IM, FM or Neurology. If you fail to match again, you will have tough time convincing ANY PD to give you a chance the 3r time around. Time to move on!

OP didn't mention anything about Gas in his Personal Statement. I don't think any problems OP has with his profile are specific problems for Gas. If anything, I would think Rads (and who knows even Psych based on what people are saying) are more competitive than Gas.

I do agree that OP would be wise to focus on IM/FM. The limiting factor here is elective rotations OP can do. OP has realistically one elective month. Let's assume he gets general hospital IM/FM experience before that. That checks off his IM/FM letter. Then, OP's September elective is either PM&R, Rads, Psych, Neuro, or Gas. I think Rads is competitive. I think Psych may work...not sure, the field takes Caribbean grads but then US MD/DOs are left with rejections and seems like it's kind of getting competitive. PM&R is a solid option if OP likes it. Another discussion yesterday outlined a few reasons why PM&R is a good field for DOs.

143 Gas residencies. OP said they applied to 100. Some may filter his application out if they have already rejecting him (no one knows the specifics on that). The class size is probably in the 10s-20s
91 PM&R programs with a small class size.
165 Rads residencies, anticipate lower class size.
148 Neuro residencies, medium class sizes like Gas.

Ultimately, if we're strictly talking competition OP should do PMR/IM/FM. They have expressed their lack of desire for IM/FM though already. Rads is competitive, but OP can give that a shot. Psych is also mildly competitive, but OP can give it a shot.

 

[Splenda88]

OP didn't mention anything about Gas in his Personal Statement. I don't think any problems OP has with his profile are specific problems for Gas. If anything, I would think Rads (and who knows even Psych based on what people are saying) are more competitive than Gas.

I understand that and as a DO, OP stats are not competitive for gas and there has been a renewed interests in gas by US students (not sure why). Therefore, gas is getting more and more competitive. I would be more careful if I was OP.

 

[GoSpursGo]

I think this is complicated. You'll be applying in September, so the only electives that will "count" for your application are those you do in July-Sept. That doesn't leave you much room. I agree that doing a Gas elective might help your Gas application, but that didn't go so well last time and I think you're probably better off focusing on other fields with your electives, apply Gas and see what happens, but hedge your bets for other fields.

I would not apply to gas again if I were you. I would concentrate in IM, FM or Neurology. If you fail to match again, you will have tough time convincing ANY PD to give you a chance the 3r time around. Time to move on!

While I get that the OP didn't have a great personal statement, I agree with these sentiments. I don't think that PS is the main reason why he didn't match--his stats were borderline. Based on COMLEX scores, only ~71% of DO seniors with his stats would be expected to match, and while it's a little better based on steps (~90%), only 13 former DO grads have even bothered applying to gas in the last 5 years. If the OP has the money and a ready-made gas application that they can churn back out with just a new PS, I guess go for it, but I wouldn't waste a precious elective on a specialty that has already said no.

I think a reapplicant in the OP's shoes should focus on neuo or PMR, as rads or psych both seem very risky.

 

[Redpancreas]

While I get that the OP didn't have a great personal statement, I agree with these sentiments. I don't think that PS is the main reason why he didn't match--his stats were borderline. Based on COMLEX scores, only ~71% of DO seniors with his stats would be expected to match, and while it's a little better based on steps (~90%), only 13 former DO grads have even bothered applying to gas in the last 5 years. If the OP has the money and a ready-made gas application that they can churn back out with just a new PS, I guess go for it, but I wouldn't waste a precious elective on a specialty that has already said no.

I think a reapplicant in the OP's shoes should focus on neuo or PMR, as rads or psych both seem very risky.

Agreed. Well reasoned.

 

[Itsarainbow]

Thank you for the replies. Out of PMR, Neuro and IM, which is the isn't to find a pgy2 spot from my Transitional year? I have been looking for statistics but haven't been able to find anything.

 

[gutonc]

Thank you for the replies. Out of PMR, Neuro and IM, which is the isn't to find a pgy2 spot from my Transitional year? I have been looking for statistics but haven't been able to find anything.

PMR and Neuro are both advanced so will be much easier to find a PGY1 spot than IM. The downside is that you'll likely have a 1 year break between finishing your TY and starting the advanced program.

If you decide to go into IM, you should apply as a PGY1 through the match since your TY will NOT allow you to move directly into an IM PGY2 position.

 

[Itsarainbow]

PMR and Neuro are both advanced so will be much easier to find a PGY1 spot than IM. The downside is that you'll likely have a 1 year break between finishing your TY and starting the advanced program.

If you decide to go into IM, you should apply as a PGY1 through the match since your TY will NOT allow you to move directly into an IM PGY2 position.

My Transitional year is really IM heavy with 2 IM subspecialty months, 2 IM months, 2 FM months, night float and the only outlier being one month of surgery. I can even use my 2 electives for even more IM. Wouldn't that technically be more like a preliminary year?

Why would I have a gap if I were to go neuro or pmr?

 

[Dral]

My Transitional year is really IM heavy with 2 IM subspecialty months, 2 IM months, 2 FM months, night float and the only outlier being one month of surgery. I can even use my 2 electives for even more IM. Wouldn't that technically be more like a preliminary year?

Why would I have a gap if I were to go neuro or pmr?

At least for Neurology you would likely come up short on the IM months.

IV.C.4. In programs offering the 48-month format, the first year of the program must provide broad clinical experience in general internal medicine and include at least one of the following: (Core)
IV.C.4.a) eight months in internal medicine with primary responsibility in patient care, or (Core)
IV.C.4.b) six months in internal medicine with primary responsibility in patient care, and a period of at least two months comprising one or more months of pediatrics, emergency medicine, internal medicine, or family medicine. (Core)


I don't think the IM subspecialty months would count technically as 'internal medicine months'. I think that requirement means literally general IM floor medicine. You could ask someone about that to be sure though.

 

[gutonc]

My Transitional year is really IM heavy with 2 IM subspecialty months, 2 IM months, 2 FM months, night float and the only outlier being one month of surgery. I can even use my 2 electives for even more IM. Wouldn't that technically be more like a preliminary year?

Nope. It's a TY. You might get partial credit on the backend if you match into an IM program, but you're not going to get hired as a PGY2. Full stop. So if IM is a/the route you choose, go into the match for a PGY1.

Why would I have a gap if I were to go neuro or pmr?

Because advanced programs start a year later.

 

[j4pac]

PM&R is not nearly as easy to get as many people seem to think. Pretty much 100% match rate...and it’s as much of a “fit specialty” as any. Programs want candidate genuinely interested in their specialty.

 

[Redpancreas]

PMR and Neuro are both advanced so will be much easier to find a PGY1 spot than IM. The downside is that you'll likely have a 1 year break between finishing your TY and starting the advanced program.

If you decide to go into IM, you should apply as a PGY1 through the match since your TY will NOT allow you to move directly into an IM PGY2 position.

Hey! Why is this? If OP applies to 2021-22 ERAS for advanced neuro/PMR positions to start July 2022 and is working on his TY until then, where is the gap?

 

[gutonc]

Hey! Why is this? If OP applies to 2021-22 ERAS for advanced neuro/PMR positions to start July 2022 and is working on his TY until then, where is the gap?

If you apply to an advanced program in the upcoming cycle (21-22), the advanced program starts July 2023, with the (presumed) prelim program starting July 2022. It's how it works. It's not new.

 

[Redpancreas]

If you apply to an advanced program in the upcoming cycle (21-22), the advanced program starts July 2023, with the (presumed) prelim program starting July 2022. It's how it works. It's not new.

Ahhh, was being dumb and I just had to think about it for a second. Just realized the advanced positions for 2022 were already given out! Also didn't see you already clarified this. Sorry! Dumb mistake. Thanks! @Itsarainbow , you know this right?

OP I know your next thought it going to be the attrition rate and finding a PGY-2 in 2022. I'd give up on that TBH though. You can look, but you won't find much. In terms of time then, recognize IM (since you already ruled out FM) will actually be a year shorter than the advanced positions since you'd start as a PGY-1 IM intern next year as opposed to a PGY-2 (Intern in Neuro, etc.).

 

[Redpancreas]

PM&R is not nearly as easy to get as many people seem to think. Pretty much 100% match rate...and it’s as much of a “fit specialty” as any. Programs want candidate genuinely interested in their specialty.

This makes sense given the small nature of the field. DO friendly, but OP needs to demonstrate a genuine interest/commitment to it. If OP's interested, perhaps they can request 2 electives early on?

 

[j4pac]

This makes sense given the small nature of the field. DO friendly, but OP needs to demonstrate a genuine interest/commitment to it. If OP's interested, perhaps they can request 2 electives early on?

Absolutely. If he/she doesn't find a way to convince programs that he is passionate about the field and it's not just a fall back plan (which of course it is)...then he/she won't match.

 

[Itsarainbow]

Sooo.. the vibe I'm getting from this thread is that basically everything besides IM/FM is going to be tough?

 

[Splenda88]

Sooo.. the vibe I'm getting from this thread is that basically everything besides IM/FM is going to be tough?

Just have a plan B and C if you want to stick with anesthesia

 

[Itsarainbow]

Just have a plan B and C if you want to stick with anesthesia

Gotcha Thanks


Does anyone know how competitive neuro is compared to PMR?

And if I were to apply IM, what programs should I aim for?

 

[Splenda88]

Gotcha Thanks


Does anyone know how competitive neuro is compared to PMR?

And if I were to apply IM, what programs should I aim for?

You will be a shoo-in for neuro. I think it's a good choice.

 

[Redpancreas]

Gotcha Thanks


Does anyone know how competitive neuro is compared to PMR?

And if I were to apply IM, what programs should I aim for?

Competition's determined in many ways. Ultimately for you it's what is the hardest to match. If you don't demonstrate commitment to PM&R, that may be more difficult but I think both aren't fairly strict when it comes to USMLEs which is one of the major things holding you back.

Depends on whether you see yourself specializing down the line. Lower tier university programs would be ideal. Otherwise, it really doesn't matter. Apply to >100, be realistic, and rank them based on location.

 

[NotAProgDirector]

Neuro is not competitive. If you're flexible about location, and you spin a story that shows you're actually interested, you can probably get a spot.

Although advanced spots in the next match will be to start 7/2023, programs with advanced spots and openings in 7/2022 will be in the match as R positions. There won't be many of them, but you could apply to anesthesia and neuro R positions. Candidates for those positions must have completed their PGY-1 already, so although the number of spots are low, so are the candidates.

Neuro is a bit of a mess with a TY. The ABPN is relatively strct about what counts and does not. If your TY program has an IM program and if the rotations that you'll be doing are identical to what IM residents do, that will be a big plus. Even if you don't get full credit, it's possible that a Neuro program will take you and then add in some additional IM rotations to make up the difference. I wouldn't count on that, but you can def ask.

If you match into an advanced spot for 2023, then you can still get a job for the gap year. You'll have your internship done, you can get a license in many states, and you can likely find something to do that pays reasonably well.

In IM, you likely won't get more than 6 months of credit. Usually that means matching as a PGY-1 and repeating it. However, if you're applying to IM programs there's always the chance that some program will have a current opening -- in that case, you'd resign your TY spot and move directly into IM. Would leave your TY program with a hole, but that's not really your problem.

 

[Itsarainbow]

Neuro is not competitive. If you're flexible about location, and you spin a story that shows you're actually interested, you can probably get a spot.

Although advanced spots in the next match will be to start 7/2023, programs with advanced spots and openings in 7/2022 will be in the match as R positions. There won't be many of them, but you could apply to anesthesia and neuro R positions. Candidates for those positions must have completed their PGY-1 already, so although the number of spots are low, so are the candidates.

Neuro is a bit of a mess with a TY. The ABPN is relatively strct about what counts and does not. If your TY program has an IM program and if the rotations that you'll be doing are identical to what IM residents do, that will be a big plus. Even if you don't get full credit, it's possible that a Neuro program will take you and then add in some additional IM rotations to make up the difference. I wouldn't count on that, but you can def ask.

If you match into an advanced spot for 2023, then you can still get a job for the gap year. You'll have your internship done, you can get a license in many states, and you can likely find something to do that pays reasonably well.

In IM, you likely won't get more than 6 months of credit. Usually that means matching as a PGY-1 and repeating it. However, if you're applying to IM programs there's always the chance that some program will have a current opening -- in that case, you'd resign your TY spot and move directly into IM. Would leave your TY program with a hole, but that's not really your problem.

Thanks for the great info

As of now I have 4 months of IM (2 months IM and 2 months of subspecialties (eg cards, pulmon)) and then also 2 months of night floats? Do the night floats and subspecialties count as IM?

As of now, I'm deciding between PMR and neuro for elective and kind of unsure which way to go. My ultimate dream is pain medicine but I think the general opinion is that it's probably easier to match into neuro (and then finding my way into pain)

I'm applying to anesthesia (only a few lower-tier programs), Neuro or PMR (gonna decide this week; lots of programs), IM (lots of programs)

I'm really hoping I don't have to skip a year and I'm going to be on the lookout for "R" positions and also PGY2 openings

 

[j4pac]

Thanks for the great info

As of now I have 4 months of IM (2 months IM and 2 months of subspecialties (eg cards, pulmon)) and then also 2 months of night floats? Do the night floats and subspecialties count as IM?

As of now, I'm deciding between PMR and neuro for elective and kind of unsure which way to go. My ultimate dream is pain medicine but I think the general opinion is that it's probably easier to match into neuro (and then finding my way into pain)

I'm applying to anesthesia (only a few lower-tier programs), Neuro or PMR (gonna decide this week; lots of programs), IM (lots of programs)

I'm really hoping I don't have to skip a year and I'm going to be on the lookout for "R" positions and also PGY2 openings

You can get into pain from either Neuro or PM&R. However, PM&R is more common and frankly, I think we are usually better trained to enter Pain. But as I said...you need the exposure and need to sell yourself as all in on the specialty. But yeah...you need a backup. I’ve known lots of solid applicants who have failed to match to PM&R the past two years...most of which didn’t have your concerns.

 

[NotAProgDirector]

Is there an accredited IM program at your institution?

 

[Itsarainbow]

Is there an accredited IM program at your institution?

Yes

 

[NotAProgDirector]

That's a definite plus in all circumstances. It will make it easier to get credit with the ABPN, and would also allow you to get credit should you decide to switch to IM.

Med subspecialties will count as IM.

Night float will also count, if you're covering IM patients. If this is night float for the OB floor, not so much.

 

[Itsarainbow]

That's a definite plus in all circumstances. It will make it easier to get credit with the ABPN, and would also allow you to get credit should you decide to switch to IM.

Med subspecialties will count as IM.

Night float will also count, if you're covering IM patients. If this is night float for the OB floor, not so much.

That's awesome news! Thank you!