Finishing in the bottom 1/2 of the class...

[MacGyver]

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OK so given the following facts what residency choices will I have?

1) Finishing in bottom 1/2 of class at a top 10 school
2) Average clinical recommendations
3) Average Step I score
4) MD/PhD graduate with several relevant publications

So I realize that I wont be matching at Harvard Mass General, but what specialties do I still have a shot at in a community program?

 

[anonymousEM]

OK, so you're not where you envisioned yourself at this point in your medical training. Neither was I (from a little recognized school outside of it's region). I never honored a course until my 4th year of med school (gotta love that ever-present "P"). I still had more EM interviews than I could even go to.

The key, now, is to figure out where you want to be after residency. Set up visiting electives early in the year at the places you may be interested in for residency and EXCEL in those. I "earned" an interview at a place I where I wouldn't have gotten out of the "hold" pile. It was all based on my work ethic on an off-service rotation with EM residents on my team there.

You also need to get EXCELLENT letters of recommendation from people who are known to the program directors where you'd like to go. Perhaps, if your clerkship director at your top-10 hospital can't give you this, you should consider making sure your "interview" rotations are early enough to get the letters you will need. Don't feel bad asking someone if they feel comfortable writing you a great letter...better to have them say no and find someone else than to not ask and get a luke-warm (or worse) letter. I had one friend who later found out the first line of one of her letters said "I do not know this student." Big help that was!

GOOD LUCK. Apply and see, you'll be surprised how random some interview offers seem. I got one at a place where an AOA classmate was turned down.