How should I approach SOAP?

[GatorBaitor52]

---

Members don't see this ad.

Hi everyone, I recently graduated American University of the Caribbean in August 2014. Since graduating, I have been doing research in neuro-oncology at the University of Miami SOM Neuro Department. I've achieved 1 publication so far and possible 2nd abstract in a month or so. I've applied to a 100 family medicine programs this year, and to my surprise, have not received any interview offers yet. My scores are Step 1-205 (1st attempt), Step 2 CK- 210 (1st attempt), and Step 2 CS- Pass (2nd attempt). My LOR's, MSPE, and Personal statement were all as good as can be so don't have much to improve there.I understand my scores aren't high, and I have an attempt on CS, but I'm still dumbfounded on how I haven't even got one offer yet, while I know many people who applied last year with similar scores (and even failures) that received 4-6 interviews.

My question is how can I best prepare for the upcoming SOAP? I've already asked my surgery preceptor for an LOR (got an 'A' in the rotation with great remarks) so I can look into preliminary surgery. I'm also debating if I should add a LOR from my psychiatry preceptor incase Psychiatry has a lot of open spots. I know one can only apply to 45 programs max in SOAP so I was wondering what does everyone think is the best field for me to apply in? Considering I got no interviews in Family, I'm not sure if I should apply to FM in SOAP. Psychiatry? Prelim Surgery? I don't think I'm competitive enough for IM or anything else.

Please let me know what you think. Thanks.

 

[rokshana]

did you call those programs that you haven't heard from yet? see if there are any last minute cancellations?
if you are doing research at the university of Miami, have you talked to the FM program there? or had someone in the neuro dept call for you? what about neuro? why are you doing research in a field that you are not applying for?

you needed to have been more proactive at the beginning of the season to get more interviews...but you still can try with what is left of the season...

IMG and a fail on CS...its a big red flag...and its just getting harder every year...what people were able to do last year doesn't mean anything this year.

 

[GatorBaitor52]

did you call those programs that you haven't heard from yet? see if there are any last minute cancellations?
if you are doing research at the university of Miami, have you talked to the FM program there? or had someone in the neuro dept call for you? what about neuro? why are you doing research in a field that you are not applying for?

you needed to have been more proactive at the beginning of the season to get more interviews...but you still can try with what is left of the season...

IMG and a fail on CS...its a big red flag...and its just getting harder every year...what people were able to do last year doesn't mean anything this year.

I was advised to be patient throughout October and November cause of my CS failure so I started sending out emails to programs in December. I even called multiple programs but got nothing better than "your application is on hold right now". So far I have 14 rejections . I'm continuing to send out emails incase anything happens. I talked to UM and they also have my app on hold. I'm doing neuro research because I have the intention of applying for neuro after FM. I know its a longer route than the usual 4 year categorical, but considering I'm not competitive enough for it, this is the best route.

So what you suggest incase I have to SOAP....prelim surgery or IM? FM? Psych? I want the best possible shot at being a PGY-1 next year so I'm open to any of these.

 

[drk]

I haven't matched yet but I would assume it would be a waste of your 20(?) applications you get for SOAP to try for FM again. FM is comparably competitive to IM considering far fewer positions and the new trend towards more PCP/Outpatient medicine. Considering your research and possibly a letter from that field I would say go for Psych/IM. Make sure to check any Miami/Florida unfilled spots in any specialty and ask any contacts you may have at Miami SoM to help you with those - though I believe officially, you or anyone on your behalf is not allowed to contact any programs until they have contacted you.

 

[rokshana]

I haven't matched yet but I would assume it would be a waste of your 20(?) applications you get for SOAP to try for FM again. FM is comparably competitive to IM considering far fewer positions and the new trend towards more PCP/Outpatient medicine. Considering your research and possibly a letter from that field I would say go for Psych/IM. Make sure to check any Miami/Florida unfilled spots in any specialty and ask any contacts you may have at Miami SoM to help you with those - though I believe officially, you or anyone on your behalf is not allowed to contact any programs until they have contacted you.

good lord...who on earth told you FM is as competitive as IM?
and PLEASE tell me the source for the new trend is for PCP output medicine? the trend is hospitalist medicine ...

as to the OP...i'm sorry someone told you to be quiet during oct and nov...worst piece of advice you could have ever gotten...

the SOAP is not advantageous to IMGs...while you should certainly participate, but you really need to think about how you are going to reapply for next year.

you should talk to the Neuro PD at Miami...make an appt not just a casual can i talk to you...and have them review your application and ask what you can do to improve it for euro next year and suggestions about the type of programs you should be applying to...I don't know where you got the idea that euro was ever so competitive for IMGs...its not and there are many programs out there that are I/FMG friendly.

there is no reason to waste your time doing FM then going for neuro...if neuro is what you want, work on that.

ideally you should shoot for a prelim IM spot in the SOAP...you will then be able to look for unexpected PGY2 neuro spots for the following year....but it will be difficult.... you could think about peds and then look to do peds neuro ...prelim surgery will not help you with anything...

why does your own program have your application on hold?

 

[drk]

Right, I guess I meant there is more need for PCP/Outpatient.

As far as FM/IM competitiveness I guess the point I was trying to make (possibly am wrong) was that there are far fewer positions fir FM and still a high number of applicants. Solid advice though. Best of luck OP.

 

[Law2Doc]

good lord...who on earth told you FM is as competitive as IM?...

While IM is more competitive than FM as a specialty, to be fair some of the community hospitals in IM that have to resort to SOAP are going to be signing up IMGs and the differential in competitiveness once you get to that stage isn't really that great.

I do think an IMG with low steps and a failure is a tough spot to be in. I also have to wonder if the lower end FM programs which primarily train people for primary care might have been put off by all the neuro research, especially if that goal was echoed in the essays -- they have a mission and an identity and you might have missed the mark. I see no downside to casting a wide net in SOAP, some low end IM, some FM you didn't already try, some psych, some prelims. Focus on community programs in less popular cities/suburbs with multiple spots to fill -- you won't compete usefully at a university program in a hopping city, but you might find love at a community hospital in an underserved part of the state/country.

As for whether to snag a surgery prelim... I think you'll probably be more likely to get one of these than IM -- it will be rough but you'll survive -- but the question is where that puts you. You'll be back in the match next year for sure -- these are dead end paths. Imho You will have slightly better pedigree than a guy coming straight from an island. And you may have more steps under your belt. You won't have a ton of time to interview, but can probably finagle things. And you will get a year closer to a medical license. Not ideal but at least you'd be moving forward.

 

[Nivens]

Two pieces of advice from a UMiami MS4:

1) I just finished my Neuro rotation. The Jackson Neuro program is FULL of IMGs- I would definitely speak to the program director.
2) Have a look at the UM regional campus IM program in Boca Raton. It's a categorical program that's almost 100% IMG.

Best of luck.

 

[ACoordinator]

Forgive me if you mentioned this and I missed it, but do you have your ECFMG certificate yet? That could be a reason why you aren't getting interviews. Many programs, mine included, will automatically screen out applicants without their ECFMG. if you do have it, then I agree: Go to the neuro PD and ask him/her to review your application to see what you can do to improve it.

 

[rokshana]

Forgive me if you mentioned this and I missed it, but do you have your ECFMG certificate yet? That could be a reason why you aren't getting interviews. Many programs, mine included, will automatically screen out applicants without their ECFMG. if you do have it, then I agree: Go to the neuro PD and ask him/her to review your application to see what you can do to improve it.

actually you just have to be ECFMG verified (Steps I, CK, CS passed), not certified(diploma in hand) for most programs...those that state they want ECFMG certified either really want verified and mix it up with certified, or aren't really all that IMG friendly since becoming certified means that you have already graduates and no 4th yr will be eligible....but the OP has already graduated so presumably is ECFMG certified.

and i have a friend that matched at UM neuro (albeit many years ago) and they required verified by ROL but not for interview...

 

[OldPsychDoc]

And don't look to Psych--open positions in the SOAP have been slim-to-none the past 3 years.

 

[AlwaysSunny96]

Forgive me if you mentioned this and I missed it, but do you have your ECFMG certificate yet? That could be a reason why you aren't getting interviews. Many programs, mine included, will automatically screen out applicants without their ECFMG. if you do have it, then I agree: Go to the neuro PD and ask him/her to review your application to see what you can do to improve it.

ACoordinator, if you don't mind me asking, which program are you at?

 

[Winged Scapula]

ACoordinator, if you don't mind me asking, which program are you at?

SDN respects the privacy of its users and appreciates the input of program directors and coordinators. Please do not ask them to divulge their identity or program as this will discourage others from participating.

 

[drkristy85]

Hi everyone, I recently graduated American University of the Caribbean in August 2014. Since graduating, I have been doing research in neuro-oncology at the University of Miami SOM Neuro Department. I've achieved 1 publication so far and possible 2nd abstract in a month or so. I've applied to a 100 family medicine programs this year, and to my surprise, have not received any interview offers yet. My scores are Step 1-205 (1st attempt), Step 2 CK- 210 (1st attempt), and Step 2 CS- Pass (2nd attempt). My LOR's, MSPE, and Personal statement were all as good as can be so don't have much to improve there.I understand my scores aren't high, and I have an attempt on CS, but I'm still dumbfounded on how I haven't even got one offer yet, while I know many people who applied last year with similar scores (and even failures) that received 4-6 interviews.

My question is how can I best prepare for the upcoming SOAP? I've already asked my surgery preceptor for an LOR (got an 'A' in the rotation with great remarks) so I can look into preliminary surgery. I'm also debating if I should add a LOR from my psychiatry preceptor incase Psychiatry has a lot of open spots. I know one can only apply to 45 programs max in SOAP so I was wondering what does everyone think is the best field for me to apply in? Considering I got no interviews in Family, I'm not sure if I should apply to FM in SOAP. Psychiatry? Prelim Surgery? I don't think I'm competitive enough for IM or anything else.

Please let me know what you think. Thanks.

easy to answer. everything depends on the year you apply. My year, 2013, was the hardest, most competitive match in history. 2009, 4 yrs earlier, is when US allopathic med schools started opening up and expanding their classes. As a result, there were too many US applicants and not enough spots. Lowest match rate for US seniors. Lots of inquiries/complaints were fielded that year about the need for residency spot expansion. Some of my classmates did not match, even though they had great scores. I was lucky to match, though lower on my rank list than I would have liked.

2014, following year, many more residency spots were created to accommodate what was thought would be a rise in applicants. To everyone's surprise, there were fewer US seniors in 2014 than in previous yrs. No one knew why. Big f**king mystery. Mona Signer, president of NRMP herself, was baffled. Press release: http://www.prweb.com/releases/2014/03/prweb11682006.htm

"Although the total number of registrants increased in 2014, the number of U.S. seniors declined. “Eighty-nine fewer seniors registered for the Match and 113 fewer submitted rank order lists of programs. That’s a surprise,” said Signer. " (3rd paragraph)

Therefore, 2014 match was an easier one for applicants (worse for programs b/c they got worse applicants). Your Caribbean classmates got lucky last year. In my residency program, my year we had mostly US grads, all very high-level with top board scores. Our program was super happy with our batch. The current intern class, 2014 batch, is great, but most of them are IMG's. I was close to the chief resident last year, who went to ranking meetings, and she said our program had never gone down so low on our rank order list as they had in 2014. It was a big surprise..

If I had graduated a year later and been in 2014 match, I would probably have matched to the program of my choice....anyways, that's in the past now

2015 is another story from 2014. Competitive year. Sorry for you, but it is what it is

 

[drkristy85]

good lord...who on earth told you FM is as competitive as IM?
and PLEASE tell me the source for the new trend is for PCP output medicine? the trend is hospitalist medicine ...

as to the OP...i'm sorry someone told you to be quiet during oct and nov...worst piece of advice you could have ever gotten...

the SOAP is not advantageous to IMGs...while you should certainly participate, but you really need to think about how you are going to reapply for next year.

you should talk to the Neuro PD at Miami...make an appt not just a casual can i talk to you...and have them review your application and ask what you can do to improve it for euro next year and suggestions about the type of programs you should be applying to...I don't know where you got the idea that euro was ever so competitive for IMGs...its not and there are many programs out there that are I/FMG friendly.

there is no reason to waste your time doing FM then going for neuro...if neuro is what you want, work on that.

ideally you should shoot for a prelim IM spot in the SOAP...you will then be able to look for unexpected PGY2 neuro spots for the following year....but it will be difficult.... you could think about peds and then look to do peds neuro ...prelim surgery will not help you with anything...

why does your own program have your application on hold?

Regarding peds, Peds is very competitive. Much more competitive than FM and IM. Peds fills almost every single spot every year. Despite crappy salary, a lot of people want to do Peds because they quite simply enjoy it (at least that is the case for me). And unlike IM and FM, Peds fills with > 70% US American graduates, because it is much more competitive.

Peds Neuro, on the other hand, is not competitive. OP can certainly apply for Peds Neuro. You will need a Peds prelim year, which is more competitive than Child Neuro, but not as competitive as Peds categorical, so within your reach. If you do become a Peds Neurologist, you will be in very high demand. You will have multiple job offers in multiple cities. You will have sign-on bonuses and relocation expenses paid for.

 

[candbgirl]

A few years ago.

 

[Law2Doc]

When did this start getting called the SOAP? When I was in school, it was the scramble.

It's very different than the scramble now. No more racing to phone or fax people. Now it's a series of mini-matches. Basically screws the non US grads who used to have a decent shot of getting spots just because they got their CV in first before the fax jammed.

 

[Raryn]

Not to mention a "decrease" in 89 fewer seniors registered for the match is a tiny blip on the total. Easily explained by there being a handful of extra people who dropped out that year, went for urology, went for ophthalmology, took an extra year for research, took a year longer to do their MD/PhD, whatever. It's a discrepancy of <1 person per school.