GI Competitiveness

[painballer27]

Hi everyone. I'm a current US MD student trying to decide what field I want to go into. I have been considering GI pretty extensively, but I was wondering about its competitiveness out of IM. I know it is the most competitive fellowship, but how competitive? Is it similar in difficulty to landing a derm or ortho residency out of med school? GI is the top field I am interested in, but I am hesitant to choose IM and risk not getting a spot and being stuck doing IM or another subspecialty that I am not super interested in. Thanks

---

Members don't see this ad.

 

[GastriqueGraffin]

No if you’re a US MD and have no red flags, go to halfway decent residency and do at least some research in residency, you will get in. It’s probably more like landing gen surgery residency than derm.

 

[Nespresso]

Hi everyone. I'm a current US MD student trying to decide what field I want to go into. I have been considering GI pretty extensively, but I was wondering about its competitiveness out of IM. I know it is the most competitive fellowship, but how competitive? Is it similar in difficulty to landing a derm or ortho residency out of med school? GI is the top field I am interested in, but I am hesitant to choose IM and risk not getting a spot and being stuck doing IM or another subspecialty that I am not super interested in. Thanks

This is important to consider. If you cannot stand IM Or the other IM subspecialties, then I personally wouldn’t pursue it. It’s just too big a risk to be miserable. That being said, if you are a good candidate for university IM programs with good step scores and feel you can be successful as an IM resident at the darkest times (admitting the social patients, dealing with dying patients sitting on vents with daily family meetings in the MICU until 9-10pM, or even just the rounding late with mental exercising over a sodium of 125 with an attending who has zero desire to do procedures) then it is worth going for it if GI is the only way you will be the happiest in medicine.

 

[SOCalXtine]

Hi I have a question sorry to hijack the thread. If I get into a program that has its own GI fellowship it’s a community program and I have a 226 step 2, no step 1 do you think I would be ok or should I study now for step 1 before match (I’m a DO student)

 

[Nespresso]

Hi I have a question sorry to hijack the thread. If I get into a program that has its own GI fellowship it’s a community program and I have a 226 step 2, no step 1 do you think I would be ok or should I study now for step 1 before match (I’m a DO student)

You better hope that you're the only person in your class that wants a spot at that in-house fellowship, and that there is no Chief from your program hoping to get GI as well. It is pretty risky, which is why the consensus is to just go with the prestigious and Academic/University programs instead of affiliated/community programs for IM if you are interested in GI.

 

[Prehealth1011]

Hi I have a question sorry to hijack the thread. If I get into a program that has its own GI fellowship it’s a community program and I have a 226 step 2, no step 1 do you think I would be ok or should I study now for step 1 before match (I’m a DO student)

Don't these usually have like 2 spots max? I can't imagine how much of a hunger games it will be with the other residents.

 

[cabergoline2]

No if you’re a US MD and have no red flags, go to halfway decent residency and do at least some research in residency, you will get in. It’s probably more like landing gen surgery residency than derm.

I'd say it's close to ophto or ent than gen surg.. it is certainly lot more competitive than gen surg (which these days is not all that hard)... but less than derm ,ortho or rad onc. (dynamics are changing).

 

[Nespresso]

I'd say it's close to ophto or ent than gen surg.. it is certainly lot more competitive than gen surg (which these days is not all that hard)... but less than derm ,ortho or rad onc. (dynamics are changing).

agreed. Probably more like ophtho/ENT. When all said and done, the applicant pool to GI is also very impressive. 80% of AMGs then match from there.

 

[Dwan]

I'd say it's close to ophto or ent than gen surg.. it is certainly lot more competitive than gen surg (which these days is not all that hard)... but less than derm ,ortho or rad onc. (dynamics are changing).

Match rate for Gsurg for USMD is 85% which is around that of GI. Average scores, % AOA for matched applicants are pretty similar, but GI people do have more research (also had extra yrs to do it). I think the fellowship match rates are somewhat deflated though because some of these unmatched applicants did stuff like apply 1-3 local places (given the consequences of not matching are much smaller, and an increasing commitment to couples/family etc further in the path). Even for less competitive fields like palliative with plenty of spots for USMDs, the match rate is only 85%. From my experience, the high majority of GI applicants from good IM institutions/no flags/broad application will match. Definitely nowhere as bad as derm/ortho.

 

[1Cor1557]

Match rate for Gsurg for USMD is 85% which is around that of GI. Average scores, % AOA for matched applicants are pretty similar, but GI people do have more research (also had extra yrs to do it). I think the fellowship match rates are somewhat deflated though because some of these unmatched applicants did stuff like apply 1-3 local places (given the consequences of not matching are much smaller, and an increasing commitment to couples/family etc further in the path). Even for less competitive fields like palliative with plenty of spots for USMDs, the match rate is only 85%. From my experience, the high majority of GI applicants from good IM institutions/no flags/broad application will match. Definitely nowhere as bad as derm/ortho.

For us md yes, gen surg does not have the dramatic drop off for non us md like gi does where most do not match and drags down overall match rate to 2/3 overall or some years like last, worse

 

[painballer27]

Thank you all for your responses. So if I were to start GI research now while in med school, go to a decent academic IM program, and continue research then, I should have a decent shot at landing a fellowship?

 

[ChessMaster3000]

Thank you all for your responses. So if I were to start GI research now while in med school, go to a decent academic IM program, and continue research then, I should have a decent shot at landing a fellowship?

Duh. Do you really need this forum to say yes to that question?

 

[painballer27]

Duh. Do you really need this forum to say yes to that question?

Well originally I was wondering if IM--> GI was competitive like med school-->derm, ortho etc where you can have solid scores, grades, research etc and still run a substantial risk of not matching. This thread has served its purpose and I think my question has been answered. Thanks for the help guys.

 

[ChessMaster3000]

Well originally I was wondering if IM--> GI was competitive like med school-->derm, ortho etc where you can have solid scores, grades, research etc and still run a substantial risk of not matching. This thread has served its purpose and I think my question has been answered. Thanks for the help guys.

When you phrase the question like that , it is a more valid question. Yes, there is still a risk of not matching but I would not call it substantial. US medical grads who do everything they are ‘supposed to’ generally get into GI. Strength of residency does matter but only to a degree. Do not sacrifice your life to go to a better residency, when the alternative is still a solid or even moderate residency but for which y have a much better social /personal situation.

 

[goldenpill]

I'm pretty late to this thread but also a med student looking for some help here. I have a pretty bad step 1 score (21x), okay step 2 (24x), currently on a research year in GI hopefully can put out some pubs. Are pubs the main way I can make up for my step score? Also what are the match stats specially for USMDs especially those who have reapplied -- can't seem to find anything

 

[Elixir6]

I'm pretty late to this thread but also a med student looking for some help here. I have a pretty bad step 1 score (21x), okay step 2 (24x), currently on a research year in GI hopefully can put out some pubs. Are pubs the main way I can make up for my step score? Also what are the match stats specially for USMDs especially those who have reapplied -- can't seem to find anything

You can search NRMP for match statics for various specialties including GI. You could make up for low Step scores with reputation of medical school or residency more easily, , but research also works. A large proportion of applicants match at their home institution, so your best bet is to show influential GI faculty in your residency your enthusiasm, hardwork, good clinical skills and research dependability.

As for the others in this thread saying GI is only as competitive as surgery residency are smoking something. GI is extremely competitive. Using match rates has issues because applicants self select, and most only competitive applicants apply at the fellowship stage of they think they have a good shot and only apply to one fellowship specialty (e.g. residency reputation, good LOR, research). Residency applicants apply even if it's a long shot, typically apply more broadly, and apply to back up specialties (e.g. Ortho people apply to Gen Surg etc....).

Granted I don't have all the statistics to prove this, but you can't control for applicant self selection anyways and there is no numerical value you can reduce overall competitiveness down to, but anecdotally only a minority of US grads go unmatched in residency but looking at the threads I find many don't match into fellowship.

 

[Thebestofus]

Match rate for Gsurg for USMD is 85% which is around that of GI. Average scores, % AOA for matched applicants are pretty similar, but GI people do have more research (also had extra yrs to do it). I think the fellowship match rates are somewhat deflated though because some of these unmatched applicants did stuff like apply 1-3 local places (given the consequences of not matching are much smaller, and an increasing commitment to couples/family etc further in the path). Even for less competitive fields like palliative with plenty of spots for USMDs, the match rate is only 85%. From my experience, the high majority of GI applicants from good IM institutions/no flags/broad application will match. Definitely nowhere as bad as derm/ortho.

It's not that simple. GI is more competitive than what the surface levels show. Firstly, people applying for GI are already extremely motivated and competitive by self selection. You're not gonna find the average resident applying for GI. It's usually chiefs, people from top tier schools or have tons of research or something to brag about. Now you take this already highly selected group and try and fit them into ~450 GI spots in the country. It is brutal for non us folks. For us mds if you're a top student at a top residency.. Yes you're safe. But that's what....~200 applicants??

 

[Dwan]

It's not that simple. GI is more competitive than what the surface levels show. Firstly, people applying for GI are already extremely motivated and competitive by self selection. You're not gonna find the average resident applying for GI. It's usually chiefs, people from top tier schools or have tons of research or something to brag about. Now you take this already highly selected group and try and fit them into ~450 GI spots in the country. It is brutal for non us folks. For us mds if you're a top student at a top residency.. Yes you're safe. But that's what....~200 applicants??

Not really the top residents from my institution. I do know all the people who wanted GI and not all got their #1, but all matched fine. Few things stop you from applying GI unlike other competitive fields (AOA, step). And the fellowship charting outcomes show that matched GI applicants are at exactly the average stats for IM 235/248 with 15% AOA, except for research, while the unmatched have far lower stats. (You also have more time to do "research", usually spamming quick BS, with the extra residency yrs vs. coming out of med school) If you look up the lower tier GI programs, most of them actually come from non-competitive IM programs and don't have much research, but most US-MDs don't bother applying to these. It is definitely a lot harder for those who are not US-MD, however.

 

[1Cor1557]

Not really the top residents from my institution. I do know all the people who wanted GI and not all got their #1, but all matched fine. Few things stop you from applying GI unlike other competitive fields (AOA, step). And the fellowship charting outcomes show that matched GI applicants are at exactly the average stats for IM 235/248 with 15% AOA, except for research, while the unmatched have far lower stats. (You also have more time to do "research", usually spamming quick BS, with the extra residency yrs vs. coming out of med school) If you look up the lower tier GI programs, most of them actually come from non-competitive IM programs and don't have much research, but most US-MDs don't bother applying to these. It is definitely a lot harder for those who are not US-MD, however.

"Lower tier" gi programs, may have non us or non traditional medicine grads, but with overall CVs incl. research and board scores and achievements that runs circles around US MDs, and this is precisely because these applicants have to make up for for being non US MDs and do so by factors they can control like scholarly activities

 

[Nespresso]

"Lower tier" gi programs, may have non us or non traditional medicine grads, but with overall CVs incl. research and board scores and achievements that runs circles around US MDs, and this is precisely because these applicants have to make up for for being non US MDs and do so by factors they can control like scholarly activities

Even higher tier GI programs get God-like IMGs with more publications than one knows what to do with.
I think GI is hard to gauge because of the low number of spots in general and essentially if your top choices have “ins” for other residents then their 2-3 spots are filled essentially pre-interview and you can fall fairly low on the rank list. I know solid AMGs from mid tier places this year who didn’t match because they weren’t A) rockstars, B) knew someone to call for them, or C) didn’t apply broadly enough. It happens every year. What I can say are the match for IM and the match for GI seem like completely different leagues entirely. My rank list for IM was a whole tier or two better than my rank list for GI.

 

[SeldingerTechneek]

Hi everyone. I'm a current US MD student trying to decide what field I want to go into. I have been considering GI pretty extensively, but I was wondering about its competitiveness out of IM. I know it is the most competitive fellowship, but how competitive? Is it similar in difficulty to landing a derm or ortho residency out of med school? GI is the top field I am interested in, but I am hesitant to choose IM and risk not getting a spot and being stuck doing IM or another subspecialty that I am not super interested in. Thanks

Everyone's mileage is going to vary. GI is more competitive than an IM residency. There are tiers of fellowships, just like tiers of residency so depends on what you want and what your ERAS is going to look like in the Summer before your PGY3. You have to work hard, be honest with yourself, and be comfortable in your own skin if you don't match. If you are interested in GI, you'll find a way to match. It is meaningless to compare it to Derm/Ortho, as those are residencies and not subspecialty IM fellowships. This year, PCCM was the most competitive IM fellowship but that may not be the case all years looking forward and certainly hasn't been the case historically.

 

[ChessMaster3000]

Everyone's mileage is going to vary. GI is more competitive than an IM residency. There are tiers of fellowships, just like tiers of residency so depends on what you want and what your ERAS is going to look like in the Summer before your PGY3. You have to work hard, be honest with yourself, and be comfortable in your own skin if you don't match. If you are interested in GI, you'll find a way to match. It is meaningless to compare it to Derm/Ortho, as those are residencies and not subspecialty IM fellowships. This year, PCCM was the most competitive IM fellowship but that may not be the case all years looking forward and certainly hasn't been the case historically.

where did you get the data the PCCM was most competitive IM fellowship this year? can you please post a link

 

[SeldingerTechneek]

where did you get the data the PCCM was most competitive IM fellowship this year? can you please post a link

Credit to @blue.jay for integrating both ERAS and NRMP data.

The NRMP data does not show the full picture, as it only shows match statistics for candidates who registered with NRMP (ie attended interviews). There might be few candidates who applied in ERAS and never got an invite. I took ERAS application submitted data and NRMP match data to show a more clear picture.

-----------------------------------------------------------------------------------

1. Cardiology
Total Applications 1780; Total Positions 1045 (58.5%); Unfilled positions 3
USMD 689; matched 549 (79.6%)
DO 204; matched 103 (50.5%)
IMG 887; matched 389 (43.8%)


-----------------------------------------------------------------------------------

2. GI
Total Applications 1034; Total Positions 590 (57%); Unfilled positions 6
USMD 436; matched 352 (80.7%)
DO 139; matched 66 (47.5%)
IMG 459; matched 166 (36%)


-----------------------------------------------------------------------------------

3. Hematology-Oncology
Total Applications 1009; Total positions 638 (63.2%); Unfilled positions 0
USMD 412; matched 336 (81.5%)
DO 92; matched 64 (69.5%)
IMG 505; matched 237 (58.3%)


-----------------------------------------------------------------------------------

4. Pulmonary-Critical Care
Total Applications 1357; Total positions 657 (48.4%); Unfilled positions 2
USMD 461; matched 323 (70%)
DO 228; matched 92 (40.3%)
IMG 668; matched 240 (35.9%)


-----------------------------------------------------------------------------------

5. Allergy (both IM and Peds)
Total Applications 222; Total positions 146 (65.8%); Unfilled positions 1
USMD 132; matched 110 (83.3%)
DO 20; matched 9 (45%)
IMG 68; matched 26 (38%)

-----------------------------------------------------------------------------------

6. Rheumatology
Total applicants 412; Total Positions 257 (62.4%) Unfilled 7
USMD 126; matched 106 (84%)
DO 71; matched 50 (70.4%)
IMG 215; matched 94 (43.7%)

-----------------------------------------------------------------------------------

*NRMP provides separate data for US-IMG and FMG but ERAS data only has IMG, hence NRMP US-IMG and Foreign is shown together as IMG

 

[jd.711]

USMD grad here with Step 1:248, Step2: 256, step 3 244. At a community program with no GI fellowship I chose for location reasons. Having difficulty getting any research experiences. Wondering about chances without it or any advice on how to succeed.

 

[thecalccobra]

USMD grad here with Step 1:248, Step2: 256, step 3 244. At a community program with no GI fellowship I chose for location reasons. Having difficulty getting any research experiences. Wondering about chances without it or any advice on how to succeed.

Apply broadly. Try to get good LORs. You will prob match at a low tier/community program.

 

[ChessMaster3000]

USMD grad here with Step 1:248, Step2: 256, step 3 244. At a community program with no GI fellowship I chose for location reasons. Having difficulty getting any research experiences. Wondering about chances without it or any advice on how to succeed.

id be worried. ur step scores not gonna help here.

 

[GastriqueGraffin]

USMD grad here with Step 1:248, Step2: 256, step 3 244. At a community program with no GI fellowship I chose for location reasons. Having difficulty getting any research experiences. Wondering about chances without it or any advice on how to succeed.

Stories like yours are what upset me about our fellowship process. You are a USMD with obviously scores high enough to have gotten into great university research residency. But you had genuine reason not to and I’m sure you’d make a great clinician. Unfortunately your application will be reviewed by academic physicians at universities. Some may not have even done well in their school/residency, some may not even be great clinician or don’t practice outside their little scope. They value research because it’s what they care about. So yes, I’d be somewhat worried if I were you with 0 research from a community program. Just play their game and get in so you can move on with your career.

 

[jd.711]

Thanks for the input. Yea, hard not to regret my decision to go to the program I did when I could have gotten into a much higher ranking program. But I'll do my best to play the game. I'd be happy with a community program.

 

[Nespresso]

Thanks for the input. Yea, hard not to regret my decision to go to the program I did when I could have gotten into a much higher ranking program. But I'll do my best to play the game. I'd be happy with a community program.

I ranked 3 community programs above the program I matched at. They turn out to be more selective because of the 1) small number of fellow spots, 2) they usually already know who they are ranking to match (their home IM program chiefs or applicant) prior to ROL. When they don’t have interest from in house, they still will prioritize applicants from university IM programs to build their name and reputation. Your safest bet is to just pump some research out and have some people call some programs for you if they have a good relationship with GI faculty at nearby programs. Are there a lot of GI programs in the area of your IM program?

 

[jd.711]

I ranked 3 community programs above the program I matched at. They turn out to be more selective because of the 1) small number of fellow spots, 2) they usually already know who they are ranking to match (their home IM program chiefs or applicant) prior to ROL. When they don’t have interest from in house, they still will prioritize applicants from university IM programs to build their name and reputation. Your safest bet is to just pump some research out and have some people call some programs for you if they have a good relationship with GI faculty at nearby programs. Are there a lot of GI programs in the area of your IM program?

Good to know, not many GI programs in my vicinity however.
I have an away elective. Should I try to go to a university program and get involved in research or go to a community program where I might have a higher chance at matching?

 

[deleted980918]

Just do cardio

 

[jd.711]

Think I'd have that much more chance of getting into cardio?

 

[Nespresso]

Think I'd have that much more chance of getting into cardio?

I thought cards is rough too. But then again some co residents of mine matched cardiology with ZERO, yes ZERO research. Albeit they were community/affiliated uni programs, but I don’t think I’ve ever heard an applicant match GI without at least a couple research projects.

 

[realdocs]

I thought cards is rough too. But then again some co residents of mine matched cardiology with ZERO, yes ZERO research. Albeit they were community/affiliated uni programs, but I don’t think I’ve ever heard an applicant match GI without at least a couple research projects.

I’ve seen some Match with maybe 1 ACG poster abstract... but that is of course a US MD at a university program, that may or may not keep half of its spot to internal IM ppl

 

[ChessMaster3000]

I’ve seen some Match with maybe 1 ACG poster abstract... but that is of course a US MD at a university program, that may or may not keep half of its spot to internal IM ppl

this is a misinterpretation of what programs do. you aren't even in the field of Gi yet.

I do not believe that programs set aside a set number of internal spots. they may prefer internal candidates but they DO NOT say we will take 1 internal candidate no matter what. maybe a small handful of program do this.

as an example: if an internal candidate was the only person in their year applying to GI, and they had 1 ACG poster abstract, compared to other outside candidates who came from reasonable program and had much more research, that program is NOT going to take the internal candidate.

 

[deleted980918]

When my parents applied to college in another country, their chance of making it in anywhere and change their life was less than 5%. All they did was study, do what they can control and hope for the best. I’m not even in GI 😂, but I think the best advice anyone can give you is do your best and the rest will take care of itself. Best of luck and don’t forget to get vaccinated!

 

[realdocs]

this is a misinterpretation of what programs do. you aren't even in the field of Gi yet.

I do not believe that programs set aside a set number of internal spots. they may prefer internal candidates but they DO NOT say we will take 1 internal candidate no matter what. maybe a small handful of program do this.

as an example: if an internal candidate was the only person in their year applying to GI, and they had 1 ACG poster abstract, compared to other outside candidates who came from reasonable program and had much more research, that program is NOT going to take the internal candidate.

Thankful to have matched this year! But you’d know more than me. And yeah I’d agree with the small number of programs doing that..