Help with choosing a specialty/elective

[Ronin786]

Hey guys,

I've got a bit of a dilemma on my hands and any help or advice would be much appreciated.

I recently got my Step 1 score (23x) and now I'm trying to figure out what the best game plan is moving forward. Knowing the importance of clinical experience and LOR I'm trying to decide what to do. I'll hopefully be matching in 2015 after I graduate.

I'm very interested in Neurosurgery as well as Anesthesiology, with a tiny edge to Neurosurgery. I know given that I'm an IMG its going to be tough especially with a good but not stellar Step 1 score.

Now since I have to schedule my electives for my final year, I'm not sure if I should pick one of Anesthesia/NS or split time between the two. How detrimental would it be to apply to both NS and Anesthesiology for the match?

Basically given the following choices what would you guys recommend:
1) Pursue electives in only Anesthesia since I have a better chance in matching there than NS.

2) Pursue electives and go all in on Neurosurgery since thats my first choice, even though I run a much greater risk of not matching. (based on charting outcomes, my Step 1 score gives me a greater than 50% chance at matching into Anesthesia, but only a 25% or so for NS)

3) Take a couple months of electives in each specialty and try to apply to both. I have no problem applying very broadly, and this would be my preferred route since if I don't get any NS interviews I'd still have a shot at Anesthesia. Problem with this way is that I don't want to be seen as lacking interest in Anesthesia and only using it as a backup plan.

Thanks for any help guys!

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[CuttingCorneas]

Being an IMG has already put you at a disadvantage; a lower-than-average Step I score (for NSGY) has only added to that. The Step I statistics sound like they are weighted heavily toward US grads anyway, meaning your chances are even lower than 25%.

I say anesthesia all the way. Maybe one or two neurosurgery programs, but I wouldn't get my hopes up.

 

[Ronin786]

Being an IMG has already put you at a disadvantage; a lower-than-average Step I score (for NSGY) has only added to that. The Step I statistics sound like they are weighted heavily toward US grads anyway, meaning your chances are even lower than 25%.

I say anesthesia all the way. Maybe one or two neurosurgery programs, but I wouldn't get my hopes up.

So you don't think anesthesia programs will be scared if I'm applying to both specialties? With further thinking, I'm probably overestimating the amount of interviews I'd get in NSGY in the first place, so it would be tough to assume that they'd be the same Anesthesia programs.

I guess I can do a month elective in NSGY, apply broadly and see what happens. If I get a few interviews fine, if not I hopefully won't be left out in the lurch.

 

[Raryn]

So you don't think anesthesia programs will be scared if I'm applying to both specialties? With further thinking, I'm probably overestimating the amount of interviews I'd get in NSGY in the first place, so it would be tough to assume that they'd be the same Anesthesia programs.

I guess I can do a month elective in NSGY, apply broadly and see what happens. If I get a few interviews fine, if not I hopefully won't be left out in the lurch.

Even if you get 20 interviews within NSGY (which is highly unlikely as an independent applicant with a below the NSGY average step score unless you somehow get some bomb-ass NSGY research in before you graduate, with multiple first-author publications) your chances of matching it never get above 60%. So you'll have to apply a backup specialty anyway.

Programs closely related to each other might chat, but I can guarantee you the anesthesia PD doesn't cross-reference his list against the neurosurgery PD. You'll just need to get 2 sets of letters if you try to apply both.

 

[Ronin786]

Thanks for the reply. That last bit was my biggest worry. I know the stigma associated with applying to multiple specialties, but I guess that is probably more associated with programs that are closer to each other and those which have a tendency to be usual backup options (Psych, IM, etc...).

I have around 3 months of electives next year, and I'm going to try fitting something between graduation and applications. As such, I guess doing 2 months in anesthesia and one in NSGY to just get the letters and maybe some research if I'm lucky. I really just don't want to live my life regretting that I didn't even attempt to match, and if all I'm losing is some effort and the couple thousand bucks it'll take to apply to all the non-elite NSGY programs then I think its worth it.

 

[ArcGurren]

Thanks for the reply. That last bit was my biggest worry. I know the stigma associated with applying to multiple specialties, but I guess that is probably more associated with programs that are closer to each other and those which have a tendency to be usual backup options (Psych, IM, etc...).

I have around 3 months of electives next year, and I'm going to try fitting something between graduation and applications. As such, I guess doing 2 months in anesthesia and one in NSGY to just get the letters and maybe some research if I'm lucky. I really just don't want to live my life regretting that I didn't even attempt to match, and if all I'm losing is some effort and the couple thousand bucks it'll take to apply to all the non-elite NSGY programs then I think its worth it.

No offense, but regretting not applying is a stupid reason to apply. If you don't match one go around it doesn't look all that great trying to apply again; IMGs routinely run into that difficulty.

 

[Ronin786]

No offense, but regretting not applying is a stupid reason to apply. If you don't match one go around it doesn't look all that great trying to apply again; IMGs routinely run into that difficulty.

What I meant was applying to both during the same go.