Gap Year after not Matching - What can I Do to be/remain Competitive Next year?

[EastCoastEMApplicant17]

Hi all, thank you in advance for any advice.

I didn't match into EM this year (went on 17 interviews, this was not expected). Long story short, during my surgery rotations I spent half the day each day in the OR with the anesthesiologists, and I hold clout with the anesthesiologists at my institution because of this. They are offering me an advanced position in scramble (and I am humbled by it, and ready to join the anesthesiology field), but I am preparing for all eventualities, including the possible eventuality that I do not find a prelim position and am forced to give up the spot.

If that is the case, I would like to know what advice you might have for gap year activities to be a competitive applicant next year for anesthesiology, as I would like to re-apply broadly to anesthesiology next year. I am a US MD student with all high pass and honors rotations with 220/210/pass boards, and tons of EM research. I am doing a formal anesthesiology rotation next month in which I believe hard work will lead to an honors grade and good anesthesiology letters.

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[BLADEMDA]

Hi all, thank you in advance for any advice.

I didn't match into EM this year (went on 17 interviews, this was not expected). Long story short, during my surgery rotations I spent half the day each day in the OR with the anesthesiologists, and I hold clout with the anesthesiologists at my institution because of this. They are offering me an advanced position in scramble (and I am humbled by it, and ready to join the anesthesiology field), but I am preparing for all eventualities, including the possible eventuality that I do not find a prelim position and am forced to give up the spot.

If that is the case, I would like to know what advice you might have for gap year activities to be a competitive applicant next year for anesthesiology, as I would like to re-apply broadly to anesthesiology next year. I am a US MD student with all high pass and honors rotations with 220/210/pass boards, and tons of EM research. I am doing a formal anesthesiology rotation next month in which I believe hard work will lead to an honors grade and good anesthesiology letters.

There has to be a PGY-1 year in IM or GS in detroit or BFE somewhere for you. Keep looking. IMHO, keep your GAS spot and find that PGY-1 position no mater where it is.

 

[Planktonmd]

Hi all, thank you in advance for any advice.

I didn't match into EM this year (went on 17 interviews, this was not expected). Long story short, during my surgery rotations I spent half the day each day in the OR with the anesthesiologists, and I hold clout with the anesthesiologists at my institution because of this. They are offering me an advanced position in scramble (and I am humbled by it, and ready to join the anesthesiology field), but I am preparing for all eventualities, including the possible eventuality that I do not find a prelim position and am forced to give up the spot.

If that is the case, I would like to know what advice you might have for gap year activities to be a competitive applicant next year for anesthesiology, as I would like to re-apply broadly to anesthesiology next year. I am a US MD student with all high pass and honors rotations with 220/210/pass boards, and tons of EM research. I am doing a formal anesthesiology rotation next month in which I believe hard work will lead to an honors grade and good anesthesiology letters.

You sound pretty competitive to me with your scores and research experience, what do you think caused you not matching?

 

[Twiggidy]

like Blade said, Surgery and IM PGY 1 positions are literally on every corner in every major city. just apply to one in your favorite city, bite you lip, and get through the year.

although not trying to be the jerk of the board, but you resume just from your post sounds pretty decent, so is there another reason you don't think you matched? especially saying you didn't expect to match

 

[Scotty_G]

What state are you in EM? You should be able to find a pgy1 yr . Also I am not sure who is advising you but the chances of you not grabbing a pgy-1 spot are very low. Sure you may not get one very close to where you are now, but that is a different story.

 

[EastCoastEMApplicant17]

Thank you guys for your responses. It is 5 days since match week ended; it looks like there are only possibly 3 prelim spots open in the country - I applied to Baylor Scott and White and Wake Forest, while East Tennessee State said they had 700 applicants for 1 spot and were not taking further applications.

I don't like my 700:1 odds, despite presumably a lot of foreign doctors and people without advanced spots in the running. The question then becomes whether I can find a spot that opens up between now and July 1 (or even later). Presumably I wait for some foreign person to have Visa issues or someone to quit their job?

 

[WholeLottaGame7]

220 on Step 1 is low-average, 210 on Step 2 is fairly poor, that probably has something to do with it. Still, I would have thought ranking 17 programs would have given you a pretty good shot at matching somewhere.

 

[Twiggidy]

who knows....not matching could be a blessing in disguise, depending on your school debt situation. not even joking

 

[AdmiralChz]

Reading your post it looks like you SOAP'ed the advanced spot at your home institution (awesome, congratulations!) - your first thing you need to do is to head straight to your home PD and your student affairs office (or whomever handles match-related issues) and let them know about your situation. They will have direct access to preliminary spots at your home institution and might be able to make some calls and see if anything is or may become available during the next few months. They might also know of some surrounding programs and may be able to make some calls for you.

There are other spots but they likely aren't advertised very well since the majority of remaining applicants aren't very competitive or desirable. Your application as an AMG with impending graduation will put you at near the top of desirable people for a preliminary year so I have no doubt you will be able to find something, somewhere especially if people decide not to proceed with residency (mostly IMGs who decide to remain in their home countries or are unable to obtain the proper visa as you allude to, I would suspect).

As for the stats, Step 1 scores have been steadily getting higher on average - 220 may have been reasonable just 10 years ago but I think now approaches average or below average. The step down in Step 2, where the average increases ~ 8-10 points, is a bit of a red flag. That is far beneath the average. It honesty doesn't matter a whole lot now as you have successfully found an advanced position - trust me your stats and AMG status are still much more competitive than the majority of applicants trying to scramble. Plus the last couple years have been very tough and competitive for EM and there are many in the SOAP thread who had similar experiences.

 

[vector2]

Surprising that you didn't match given your number of interviews, even with below average stats. I think you'll be able to get a prelim spot somewhere, but if you don't then you might need to have a come to jesus moment regarding some other more nebulous flaws before you apply again. Was there something in your personal statement that rubbed ppl the wrong way? Did you come off as too introverted or too arrogant in your interviews? Talk with your home PD and attendings and have them give you a damned honest assessment, even if it's painful.

 

[EastCoastEMApplicant17]

Hi everyone,

Thank you for the responses. It looks like my lack of having a preliminary position (I think in your established ranks there is a notion that they are easier to come by because they may have been in the past - prelim surgery positions are very scarce and are being hunted by 100's of people right now) is causing me to not get the anesthesia spot and I do have to plan for the year off. I suppose research is the only thing I can do. Any suggestions would be appreciated. To reiterate, I am a US MD MS-4 who applied to another specialty and received 17 interviews and did not match. I have a passion for airway management and am completing an anesthesiology AI before graduating in which I hope to excel. I am looking for recommendations on a gap year to remain competitive as I hope to match in anesthesiology in the 2017-2018 match cycle.

With appreciation,
Eastcoastemapplicant17

 

[nimbus]

This really reflects the changing balance between med school graduates and GME. Back when I was in training, prelim medicine and surgery spots would go begging for qualified warm bodies and many would remain vacant. Now there are 700+ applicants for 1 mediocre prelim surgery spot in a backwater Louisiana town. It's hard enough as a USMG, I'd think long and hard before becoming a USIMG or attending one of the new DO schools. It's 43000+ applicants for 31700 spots. There will be intense competition for every unmatched spot going forward. Over 10000 candidates for a few dozen spots.

 

[EastCoastEMApplicant17]

So, what does anesthesiology think about a research year? Is the practice prevalent? Would it be looked at as an academic endeavor? Or rust away from clinical duty? Any way to augment the year? (Plan on taking STEP III and doing very well)

 

[deleted171991]

A research year would serve you well, as long as you can show something (i.e. publications) for it. I would choose something clinical, and even do some sub-i's, if possible, to show continuous clinical activity. It's the internship programs that will be worried about your clinical skills, not the anesthesia residencies. The latter will wonder about why you became damaged goods, so you'd better have some good story for that.

Your Step 2 score is catastrophic for anything that requires decent medical knowledge (the passing score is 209). You really need a home run for Step 3. Plan for 240 or better (and much higher for top scores). There are tons of foreign grads who will run circles around you knowledge- and score-wise.

 

[Psai]

So, what does anesthesiology think about a research year? Is the practice prevalent? Would it be looked at as an academic endeavor? Or rust away from clinical duty? Any way to augment the year? (Plan on taking STEP III and doing very well)

You really want to waste a year of your life with research?

 

[EastCoastEMApplicant17]

A research year would serve you well, as long as you can show something (i.e. publications) for it. I would choose something clinical, and even do some sub-i's, if possible, to show continuous clinical activity. It's the internship programs that will be worried about your clinical skills, not the anesthesia residencies. The latter will wonder about why you became damaged goods, so you'd better have some good story for that.

Your Step 2 score is catastrophic for anything that requires decent medical knowledge (the passing score is 209). You really need a home run for Step 3. Plan for 240 or better (and much higher for top scores). There are tons of foreign grads who will run circles around you knowledge- and score-wise.

Thank you. Time to aim for that number and keep moving forward with the plan.

You really want to waste a year of your life with research?

I don't see alternatives right now

 

[dragonark]

Thank you. Time to aim for that number and keep moving forward with the plan.



I don't see alternatives right now

*New* Anesthesiology Residency Program - Kaweah Delta Health Care District

Buyer beware for any such new endeavors, but another year of your life is a lot of wasted earning potential...

 

[deleted547631]

Bumping to get an update from OP.

 

[Mehd School]

Bumping to get an update from OP.

Post history indicates he was able to find an open EM spot.

 

[deleted547631]

Post history indicates he was able to find an open EM spot.

Happy it all worked out for this guy!

 

[Psai]

Post history indicates he was able to find an open EM spot.

It's always nice when these things work out. The match is stressful enough as it is and it's a little ridiculous to come so far but not achieve your goal.