Help-options if I don't match in advanced program

[BananaPancake]

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I am currently applying to Prelim Medicine programs for my intern year, as well as programs for my advanced specialty choice. I received very few interviews for my advanced specialty, so my chance of matching is very low. I need to evaluate my alternatives. Unfortunately, my home institution does not have very good advising resources. They always seem pressed for time, among other things. I just don't feel supported, so I am seeking advice from individuals here who may have some insight.

Right now my inclination is to NOT reapply to my advanced specialty choice. There is nothing I can do to significantly improve my application before the next application season. (A small case report and drug review will not turn many heads.) Most re-applicants I have talked to have told me that their #1 i'view question has been "What have you done to improve your application?" My own program director has flat out told me that he suspects that my board scores (although not bad, but not stellar) are what kept me from receiving many i'views. Obviously I can not change those. In light of the above reasons, I feel that attempts to reapply would be futile, not to mention very, very expensive.

The alternatives that I have come up with are:
1. Do the Prelim year and become categorical medicine
2. Do the Prelim year during which I could apply to an entirely different specialty
3. Try to find a research fellowship for next year in the field I will apply to
4. Scramble

My concerns are these:
A. If I go into categorical medicine, I am almost certain that I would want to do a fellowship (I am not enthralled with general medicine). I am fearful that I could get "stuck" and not be able to get into a fellowship. Anyone have experience switching from prelim to categorical??

B. If I go into my intern year with the intent of applying to something else, logistically is there time for i'views during the Fall? Also, if I apply to another field that doesn't require a prelim med year (i.e. OB/GYN, GenSurg, etc.), will there be issues with funding, thus creating difficulty getting into something else?

C. Are there many research positions available in various specialties? (I realize this is program-dependent.) Anyone with experience in this?

D. The scramble seems really risky. It seems like you could end up selecting a place/program/field that you really regret simply because you make a rushed/uneducated decision due to the time crunch. Anyone with comments about scrambling?

I really appreciate any help.

Thanks,
BP

 

[NotAProgDirector]

My concerns are these:
A. If I go into categorical medicine, I am almost certain that I would want to do a fellowship (I am not enthralled with general medicine). I am fearful that I could get "stuck" and not be able to get into a fellowship. Anyone have experience switching from prelim to categorical??

Switching from prelim to cat is not terribly complicated in IM. Many PGY-2 positions open, and there's always the chance that your prelim program will have an open slot. IN general, your options will be better the more prestigious your prelim program is.

As for fellowships, some are competitive and some not. Cardiology, GI, H/O are all competitive. Endo and Renal are a buyers market. Things may change, of course.

B. If I go into my intern year with the intent of applying to something else, logistically is there time for i'views during the Fall? Also, if I apply to another field that doesn't require a prelim med year (i.e. OB/GYN, GenSurg, etc.), will there be issues with funding, thus creating difficulty getting into something else?

Getting interview time during your internship year can be challenging. You will likely not have time to interview at a large number of programs. Funding may be an issue, but most programs will be able to absorb the cost (there are many threads about this)

C. Are there many research positions available in various specialties? (I realize this is program-dependent.) Anyone with experience in this?

It depends on the field, but yes there are usually many people willing to have you slave in their lab for little/nothing. The question to ask yourself is whether this will help your application. Remember that you will be applying about 4-5 months after graduating. Will you have anything to show by then?

D. The scramble seems really risky. It seems like you could end up selecting a place/program/field that you really regret simply because you make a rushed/uneducated decision due to the time crunch. Anyone with comments about scrambling?

There are many, many threads about this. The scramble is a big risk, a few good categorical programs are often open, but they fill very quickly. Most good spots are gone 15 minutes after the scramble starts. You will have very limited geographic choices. In general you're probably better off with a prelim if you have good prelim interviews.