Greetings WallStreet:
My guess is that you have had a discouraging and disillusioning experience of med ed. I worked like crazy to get in to med school, and once in to a top-50 med school, I was appalled at the nuclear cynicism, compulsive competitiveness and deep-seated entitlement among classmates and residents, not to mention the benign neglect of attendings there in the House of God. I got clinically depressed and nearly quit a couple of times, but had racked up an astonishing amount student-loan debt, and so I trudged forward.
Deciding on a specialty is probably the most consequential decision I ever made on such an woefully inadequate data set. As a diagnosis of exclusion, I started training in EM, and it turned out to be unsustainable for me, even though it looks like an easy life on paper. In desperation I turned to PM&R (which I had almost applied to the first time out, but PM&R was like a mysterious, disembodied voice at my med school, versus EM which was a definite, bright, shiny object with a required rotation).
The last week of November of my PGY2 year, I cold emailed every PM&R residency program director with my story, basic stats along with Steps scores.
http://www.physiatry.org/Education_Program_Directors_List.cfm I was encouraged to submit an ERAS application, which I did by the first week of December.
I interviewed at 4 programs. In the end, I landed a PM&R PGY2 position outside of the Match at a program I interviewed at via my ERAS application. I withdrew from the Match and at the end of that academic year, I waltzed over from my EM program, and started my training in Physiatry.
The cost, I wound up repeating PGY2, and so lost a year. The reward, I'm happy, still married, and I am glad that I'm a physician now, and look forward to a great fellowship position upon residency graduation.
I don't know how it's all going to turn out with Match exclusivity. Here's some info on that:
http://www.nrmp.org/all-in.pdf
To me, it looks like advanced (PGY2) residency positions, among several other special cases, are likely to be exempted from this "air-tight" sounding rule. So much for hermetical seals.
In any case, you have my best wishes for the very best outcome you can craft.
Cheers!
