Jul 28, 2016
Medical Student
I'll be applying to a surgical sub-specialty this year and have all my rotations/aways lined up this fall. However, I am not that competitive and want to make sure I have my alternative options planned out. I go to a "top tier" institution and have a national average step 1 and mostly HP clinical grades, with research in a surgical subspecialty (couple pubs), with one radiology-related experience. My priority is to try to get into a residency as soon as possible without taking gap years/research years if they aren't necessary.

I was initially thinking about also applying to prelim gen surg and then deciding if I want to "give up" and go into general surgery or radiology if my first choice doesn't work out. I have an interest in anatomy and was drawn to radiology and IR early on in med school but did not pursue much in terms of research, rotations, etc. beyond shadowing early in med school. I do enjoy the OR, but general surgery doesn't seem like something I would be happy in (vs. other surgical fields I've been exposed to). Speaking to people in radiology and the shadowing experience I've had...I feel that I could be happy doing rads if not my first-choice. I basically have been "all in" on this surgical field but understand the reality of how competitive everything is these days. That being said...here are a few questions I have:

1) What kind of letters do radiology programs require? So far, I only have a couple from a surgical specialty and 1 gen surg. Potentially can get one from a radiologist (see #2)
2) Would it be appropriate to reach out to a radiologist that I've briefly worked with and ask for a letter while telling him this is a backup?
2) Should I be applying to my first-choice specialty + prelim programs + radiology programs? Just first choice + radiology?
3) Are most radiology programs categorical or do most radiology applicants also apply to prelim/TY programs? Confused on how to approach this without having to apply to well over 100 programs.
5) Thoughts on just applying to pgy-1 prelim/TY years and then hoping to SOAP into radiology if my first-choice specialty doesn't work out? It seems that this is a route people took last year as there were many open spots. If it comes to that will I need a radiology letter/radiology rotation to apply via SOAP?
#6) How do I "set myself up for success" in the case that I'm not seeing many interviews for my first-choice during the winter and I want to SOAP into radiology in March?

I apologize if many of these questions have been asked before or if this sounds totally spastic. I've tried to do research late in the game but often find conflicting or non-pertinent info. Thanks!


5+ Year Member
Apr 30, 2014
Medical Student
Just get a letter from a radiologist if you can and send it to a few rad programs that you apply to. There are a lot of community programs that would be slam dunks for you if you are a half decent applicant that speaks English. Is it ortho you are applying to?


There are a lot of Radiology Residencies that don't fill in the US and they LOVE taking rejected surgical subspecialty applicants. By and large you're better than the vast majority of the applicants seen at the less desirable residencies. If it gets to the point that you SOAP, I imaging you'll end up in a Radiology Residency somewhere (who knows where though). This is all assuming you have a nice normal personality. You can apply to a preliminary surgery program if you want but there will be plenty of openings in the SOAP. Also, wherever you land for Radiology Residency can likely make room for you as an intern in medicine/surgery. If you truly go to a top tier institution then they should have no problems creating a position for you intern year if your match doesn't go well.

I was in your exact situation, I obviously didn't make it and I'll be going into IR soon. Overall it turned out really well for me. Good luck with it all. Also I sent you a PM with a few extra details.