MD How hard is it to match gasteroenterology?

[FreeMarketTurtles]

Hello, M1 here. I am just wondering how hard it is to match into a gasteroenterology fellowship. I understand that top programs are looking for publications, high step 1 scores and a high ranking IM residency program, but how about matching at all? (say into a mid tier or low tier program?). What would be the average Step 1 score ranges, and how much research is needed? Any help would be appreciated, thanks

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[Redpancreas]

Hello, M1 here. I am just wondering how hard it is to match into a gasteroenterology fellowship. I understand that top programs are looking for publications, high step 1 scores and a high ranking IM residency program, but how about matching at all? (say into a mid tier or low tier program?). What would be the average Step 1 score ranges, and how much research is needed? Any help would be appreciated, thanks

If you figure this out, please come back and tell all of us.

 

[JP2740]

It all depends on the rank of the IM program you get into...

So having a high step 1 score, AOA status, abstract +/- pub will get you into a great IM program. From there, it's actually easy to get into a low to mid tier program (as long as you aren't a ****ty resident). You can basically get into those level programs from a top 20 IM program with like an abstract alone.

If you go to a outside top 30 IM program or a community program, then it gets pretty difficult. You need a lot of research and some great letters of recommendations. There's no standard advice here, you just have to do as best as possible in every area if you're in this situation. If you're in the first scenario, it's pretty painless in my opinion.

What does this all mean? Work your ass off the first two years of medical school and do as well as you can on step 1. Try to get AOA. This should be your goal regardless of whatever field you go into. If you're wondering about research after first year: 1 research project outside of your choice of specialty won't make a difference. Also, in IM, it doesn't realllly matter what your research is in if you had something you got from it: abstract or pub.

 

[FreeMarketTurtles]

It all depends on the rank of the IM program you get into...

So having a high step 1 score, AOA status, abstract +/- pub will get you into a great IM program. From there, it's actually easy to get into a low to mid tier program (as long as you aren't a ****ty resident). You can basically get into those level programs from a top 20 IM program with like an abstract alone.

If you go to a outside top 30 IM program or a community program, then it gets pretty difficult. You need a lot of research and some great letters of recommendations. There's no standard advice here, you just have to do as best as possible in every area if you're in this situation. If you're in the first scenario, it's pretty painless in my opinion.

What does this all mean? Work your ass off the first two years of medical school and do as well as you can on step 1. Try to get AOA. This should be your goal regardless of whatever field you go into. If you're wondering about research after first year: 1 research project outside of your choice of specialty won't make a difference. Also, in IM, it doesn't realllly matter what your research is in if you had something you got from it: abstract or pub.

Thanks for the advice. You mentioned being part of AOA. Without this, is it significantly harder to get into a top IM program?

 

[JP2740]

Thanks for the advice. You mentioned being part of AOA. Without this, is it significantly harder to get into a top IM program?

Hard to quantitate. Too many variables. Like how highly ranked your med school is makes a difference. If you go to an unranked or very low ranked school that's a real nice touch to differentiate you. I wouldn't say impossible without it though. If you go to a mid or high rank school obviously school name adds more punch to your app.

 

[Redpancreas]

Based on what JP2740 said, to literally answer your question, I think I'd relate it to Optho difficulty. Not Derm/Ortho/Int. Plastics level, but not Gen Surg/EM level either. Somewhere in the middle if you want to be at a top program sitting pretty for GI. I don't think I'll be at a top program this July, but I'm still putting my eggs in that basket and going for it.

 

[Uncle Albert]

It all depends on the rank of the IM program you get into...

So having a high step 1 score, AOA status, abstract +/- pub will get you into a great IM program. From there, it's actually easy to get into a low to mid tier program (as long as you aren't a ****ty resident). You can basically get into those level programs from a top 20 IM program with like an abstract alone.

If you go to a outside top 30 IM program or a community program, then it gets pretty difficult. You need a lot of research and some great letters of recommendations. There's no standard advice here, you just have to do as best as possible in every area if you're in this situation. If you're in the first scenario, it's pretty painless in my opinion.

What does this all mean? Work your ass off the first two years of medical school and do as well as you can on step 1. Try to get AOA. This should be your goal regardless of whatever field you go into. If you're wondering about research after first year: 1 research project outside of your choice of specialty won't make a difference. Also, in IM, it doesn't realllly matter what your research is in if you had something you got from it: abstract or pub.

Do you think this matters as much if I'm going for a middle-of-the-pack GI fellowship program? If just getting into any GI fellowship is my goal, does it matter if I go to "top 20" IM residency vs. mid-tier IM residency (anywhere from 20-70)

 

[JP2740]

Do you think this matters as much if I'm going for a middle-of-the-pack GI fellowship program? If just getting into any GI fellowship is my goal, does it matter if I go to "top 20" IM residency vs. mid-tier IM residency (anywhere from 20-70)

Lol I addressed this exactly in my post, read it again. I used the actual words mid tier program

 

[JP2740]

Based on what JP2740 said, to literally answer your question, I think I'd relate it to Optho difficulty. Not Derm/Ortho/Int. Plastics level, but not Gen Surg/EM level either. Somewhere in the middle if you want to be at a top program sitting pretty for GI. I don't think I'll be at a top program this July, but I'm still putting my eggs in that basket and going for it.

I forgot to mention that being an AMG makes a difference too. You’ll be fine:
1. Identify GI as your interest from day 1, be a good resident (should always be your goal).
2. Find a mentor early on (preferably someone with some name recognition if you can; is he or she both a research and career mentor? If not good at both get another one to fill the other role).
3. Every GI experience is an opportunity for a letter of rec so treat it that way even if you’re rounding with junior faculty you don’t get many opportunities for LOR. Don’t bother getting LOR from a non GI unless that person ends up knowing you like your father or mother.
4. Not sure how good your program is but let’s say in terms of prestige, it’s as low as a community program. Your best shot is getting in at your home program so you want every GI you meet to have a good experience with you and know you want to go into GI. The more of them that know you the better.

If you do this and hopefully have a pub and abstract before you apply as an AMG with some good letters of rec you’ll probably be fine even from a non top 20 program. It’s not an exact science. I mean plenty of people match even from programs completely off the radar.

 

[Redpancreas]

I forgot to mention that being an AMG makes a difference too. You’ll be fine:
1. Identify GI as your interest from day 1, be a good resident (should always be your goal).
2. Find a mentor early on (preferably someone with some name recognition if you can; is he or she both a research and career mentor? If not good at both get another one to fill the other role).
3. Every GI experience is an opportunity for a letter of rec so treat it that way even if you’re rounding with junior faculty you don’t get many opportunities for LOR. Don’t bother getting LOR from a non GI unless that person ends up knowing you like your father or mother.
4. Not sure how good your program is but let’s say in terms of prestige, it’s as low as a community program. Your best shot is getting in at your home program so you want every GI you meet to have a good experience with you and know you want to go into GI. The more of them that know you the better.

If you do this and hopefully have a pub and abstract before you apply as an AMG with some good letters of rec you’ll probably be fine even from a non top 20 program. It’s not an exact science. I mean plenty of people match even from programs completely off the radar.

 

[Osteoth]

I forgot to mention that being an AMG makes a difference too. You’ll be fine:
1. Identify GI as your interest from day 1, be a good resident (should always be your goal).
2. Find a mentor early on (preferably someone with some name recognition if you can; is he or she both a research and career mentor? If not good at both get another one to fill the other role).
3. Every GI experience is an opportunity for a letter of rec so treat it that way even if you’re rounding with junior faculty you don’t get many opportunities for LOR. Don’t bother getting LOR from a non GI unless that person ends up knowing you like your father or mother.
4. Not sure how good your program is but let’s say in terms of prestige, it’s as low as a community program. Your best shot is getting in at your home program so you want every GI you meet to have a good experience with you and know you want to go into GI. The more of them that know you the better.

If you do this and hopefully have a pub and abstract before you apply as an AMG with some good letters of rec you’ll probably be fine even from a non top 20 program. It’s not an exact science. I mean plenty of people match even from programs completely off the radar.

Pretty surprising that you say you can match from a top 20 IM program with just an abstract/paper to your name. Sounds kinda light when I've been hearing Cards/HemeOnc guys having to slave away pumping out stuff to match.

Why is that?

 

[TAVR4life]

No one from a top 20 program has to pump out stuff to match into cards or heme onc. As a matter of fact, my buddy had 0 abstract, 0 pubs, and got all his interviews he wanted and matched to his number 1 in cards (a different hospital). His number 3 was his home program and they said he would match if he wanted to.

Heme/onc absolutely, 100% not true.

Maybe these people are really academically driven and want to match at a top 20-30 fellowship as well. The original post was asking what it would take to match to a mid or low tier GI fellowship, not an upper tier GI fellowship.

By far the most difficult fellowships to get into are cards and GI. By numbers alone it may be more difficult to get into GI because they've limited their spots (only a couple of spots at some programs while cards is 4-6 spots at most programs and some of the bigger programs have up to 12 cards spots) so yes may have to go a bit more above and beyond to stand out and get that one spot in GI

Just check out the cards and GI fellowship threads from this year just how crazy competitive it was.

 

[W19]

@JP2740 Are you doing IM at a top 20? Are you a MD or DO?

 

[W19]

Yes, MD

School rank helps a lot in this process even if some in SDN don't want to admit it...

 

[J ROD]

I would suggest posting and reading in the IM subforums for GI. Ask the folks that are actually doing and trying this

 

[J ROD]

Lol the sub forum for GI is as dead as a forum can get. There was a thread the other day asking why it’s such a graveyard

Okay I do not go there so I do not know. Just made sense. Maybe they are working their ass off or counting their money. Either way talking to folks that are actually in the process is the best idea. Maybe try and locate a few.

 

[J ROD]

No you got this boss.

 

[TAVR4life]

I matched into GI this year, so yea I have a good idea. Like, some of you just choose to really not listen when I say the rank of your program matters a lot in terms of what you need to do to stand out. Some of those people in those threads are IMG (no hate) or from who knows what rank IM program.

****, a couple of my co residents who are even considered the weaker ones in my program got great GI fellowship spots. They did go above and beyond to stand out in a bad way often times. I think they both had 0 pubs.

I agree 100%, no doubt that prestige of your residency program plays a HUGE rule in the interviews you get--this was definitely the case for cardiology. USMLE scores seemed to play a major role as well surprisingly.

 

[Redpancreas]

I agree 100%, no doubt that prestige of your residency program plays a HUGE rule in the interviews you get--this was definitely the case for cardiology. USMLE scores seemed to play a major role as well surprisingly.

Congratulations on your match. Going through the fellowship match, could you expand on how much of a factor Step 1/CK play? I get that it's probably a threshold for interviewing similar to residency, but what cut-offs do you suspect? I was reading a book about fellowship matches that quoted PDs and some said thing like 200s others said 80th percentile (250s).

 

[TAVR4life]

Congratulations on your match. Going through the fellowship match, could you expand on how much of a factor Step 1/CK play? I get that it's probably a threshold for interviewing similar to residency, but what cut-offs do you suspect? I was reading a book about fellowship matches that quoted PDs and some said thing like 200s others said 80th percentile (250s).

No uniform cut off that's why it's hard to predict. There are some programs that do not even ask for USMLE scores while there are some top programs that use it as a filter--they need a way to filter out the 500+ applications that they get and it's one of the filters. No way they have time or patience to read all 500 applications, they probably review 100-120 at most. The better the program the higher the cutoff.

A program director told us they have an automated filter for everything and anything that is asked on your online application including geographical location, visa status, med school prestige, residency prestige etc etc. Program director determines the filter settings.

 

[Redpancreas]

I'm just going to assume it's 240/250/230 for top 20-30 and go with that, but I doubt that matters. What JP2740 says is interesting in that the chairs commend Step performance even on fellowship applications and yeah, those charting outcomes showed something in the 220s for GI applicants which I think something's wrong with. I wholeheartedly agree with ya TAVR4Life, if I had an app that could show you all the online singles in the area and I lived in a big city, I would use a filter. That's kind of how it is for these programs I'm assuming...and if they want to find more or aren't satisfied, they'll toggle the filters around and invite more people. Just going to have to work on being the best resident possible and make somehow make meaningful research contributions to an already well established field.

 

[jhamaican]

In order of importance:

1. Stellar letters of recommendation from important well connected individuals in the GI world and your program director. This can fix any sin or blemish you may have on your application.
2. Prestige of IM residency
3. Performance as a resident (has a lot to do with #1, good resident = awesome PD letter)
4. Step scores (yes Step 1, 2 and 3 still matter, a lot!) Multiple faculty on the interview trail mentioned that they especially care about a decent step 1 (predicts your ability to pass the sub specialty boards) and step 3 (did this applicant start to slack off if lower than your step 1+2)
5. Research - show some interest in the field. If you kill it in this area it has the possibility to make up for a lot of sins in #1-4. This is also how you will make connections to get those awesome letters (see #1)
6. other bull**** like extracurricular, personal statement, med school letters and grades etc. These things matter less and less as you progress in training. Although many interviews did mention things from medical school that they must have gotten from my Residency application? or Deans letter.

There are also many other variables. If you are an IMG you will be held to different and much higher standards. This is just a fact. Chief residency gives a huge leg up. Are you a minority (huge help) or female (less but still helps)?. Lots of random variables come into play.

 

[jhamaican]

I'm just going to assume it's 240/250/230 for top 20-30 and go with that, but I doubt that matters. What JP2740 says is interesting in that the chairs commend Step performance even on fellowship applications and yeah, those charting outcomes showed something in the 220s for GI applicants which I think something's wrong with. I wholeheartedly agree with ya TAVR4Life, if I had an app that could show you all the online singles in the area and I lived in a big city, I would use a filter. That's kind of how it is for these programs I'm assuming...and if they want to find more or aren't satisfied, they'll toggle the filters around and invite more people. Just going to have to work on being the best resident possible and make somehow make meaningful research contributions to an already well established field.

Your step cutoffs are a little high I think. I scored less than your quoted on some of them and will be attending what is considered by most to be a top 10 GI fellowship next year.

 

[Redpancreas]

Your step cutoffs are a little high I think. I scored less than your quoted on some of them and will be attending what is considered by most to be a top 10 GI fellowship next year.

OMG, CONGRATS!

 

[W19]

Your step cutoffs are a little high I think. I scored less than your quoted on some of them and will be attending what is considered by most to be a top 10 GI fellowship next year.

i thought you just started residency last year... maybe I am confusing you w/ another member.

 

[Redpancreas]

Agree It's high, especially step 2. I don't even think residency programs like ENT have cut offs that high but could be wrong. I did score much higher than your cut-offs though so not sure.

Lol. You’re my new favorite poster.

 

[Osteoth]

No one from a top 20 program has to pump out stuff to match into cards or heme onc. As a matter of fact, my buddy had 0 abstract, 0 pubs, and got all his interviews he wanted and matched to his number 1 in cards (a different hospital). His number 3 was his home program and they said he would match if he wanted to.

Heme/onc absolutely, 100% not true.

Maybe these people are really academically driven and want to match at a top 20-30 fellowship as well. The original post was asking what it would take to match to a mid or low tier GI fellowship, not an upper tier GI fellowship.

So the top 20 programs are basically just straight fellowship feeders then, with little by the ways of tangible proof you'll be a good fellow besides what you've shown in the medical school application cycle?

Don't mean to be so reductive but that kinda blows my mind lol.

 

[JP2740]

So the top 20 programs are basically just straight fellowship feeders then, with little by the ways of tangible proof you'll be a good fellow besides what you've shown in the medical school application cycle?

Don't mean to be so reductive but that kinda blows my mind lol.

Yes.

Also top medical schools can be straight residency feeders, often with a lot less proof of being a good resident. And those people can still get great fellowships with no proof of being a good fellow.

 

[Lawpy]

So the top 20 programs are basically just straight fellowship feeders then, with little by the ways of tangible proof you'll be a good fellow besides what you've shown in the medical school application cycle?

Don't mean to be so reductive but that kinda blows my mind lol.

Yes.

Also top medical schools can be straight residency feeders, often with a lot less proof of being a good resident. And those people can still get great fellowships with no proof of being a good fellow.

I don’t know why people are so surprised that school name matters. It’s the same thing for med school admissions: if you go to a top undergrad (or even Harvard/Stanford/Yale/Princeton/MIT), you will have a lot easier time getting into top medical schools than someone with a comparable application but went to a no name undergrad. The fact that med school name matters for residency matching should not be of any surprise, seeing that networking and letters play a major role.

Top med schools have much higher quality students on average because admissions at these schools actively select for superstar applicants who will become leaders in medicine. The nature of competition in getting into top schools is more intense and more selective, with applicants having amazing applications.

School name matters and going to a top med school will help a lot for matching into competitive residencies and fellowships. Program directors know the high quality of students coming from top schools, and so students at top schools can match comfortably even if they have no research output. School name alone is enough to stand them out.

Unfortunately, the same does not apply to students at low tier schools, so they need to work extremely hard, get AOA, destroy Steps, destroy clinical years, get strong letters etc. in order to match into competitive residencies. It is not easy to match into a top residency program just like it’s not easy to get accepted into a top med school. But hard work does and will pay off.

 

[Lawpy]

I'm surprised?

Just agreeing with your comments in a more detailed way

I'm more surprised that many members think school name doesn't matter and are shocked by the fact it does.

On a sadder note, it does explain why AOA does matter and why preclinical grading is justified at low and mid tier schools.

 

[Osteoth]

Yes.

Also top medical schools can be straight residency feeders, often with a lot less proof of being a good resident. And those people can still get great fellowships with no proof of being a good fellow.

Yeah but going from medical school to residency you have STEP and other metrics to normalize the data. It seems like there's literally nothing going from residency to fellowship.

I don’t know why people are so surprised that school name matters. It’s the same thing for med school admissions: if you go to a top undergrad (or even Harvard/Stanford/Yale/Princeton/MIT), you will have a lot easier time getting into top medical schools than someone with a comparable application but went to a no name undergrad. The fact that med school name matters for residency matching should not be of any surprise, seeing that networking and letters play a major role.

Top med schools have much higher quality students on average because admissions at these schools actively select for superstar applicants who will become leaders in medicine. The nature of competition in getting into top schools is more intense and more selective, with applicants having amazing applications.

School name matters and going to a top med school will help a lot for matching into competitive residencies and fellowships. Program directors know the high quality of students coming from top schools, and so students at top schools can match comfortably even if they have no research output. School name alone is enough to stand them out.

Unfortunately, the same does not apply to students at low tier schools, so they need to work extremely hard, get AOA, destroy Steps, destroy clinical years, get strong letters etc. in order to match into competitive residencies. It is not easy to match into a top residency program just like it’s not easy to get accepted into a top med school. But hard work does and will pay off.

I'm not surprised that it matters, I'm just a little shocked to the degree that it influences decisions at that level.

I kind of assumed that when you move from one level of training to the next it's kind of a reset, because thats been the trend in my educational career thus far. Doesn't matter how you did in high school when you get to college, same in med school. I assumed everyone would have to bust their ass to get into a good fellowship during residency, but those that were at the top tier programs would have those PD letters and connections that would help them, but not to the point that they could literally do nothing and still land great fellowship positions.

Color me surprised.