How to get into a specific school, even if changing specialties to do so?

[doctor15]

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If someone like Joe Smith said “I want to be in XYZ city first and my specialty can change accordingly,” how could they do it?

For example, for someone, it’s more important they attend a residency like Utah (to be close to a specific mountain range) or go to Penn to be close to a specific Philadelphia option.

The point is, suspending incredulity and whether it’s advisable or not, what should this person do if they have chosen to go to residency at a specific school first and foremost, even if it means changing their specialty? Reach out to specific attendings? Go to the school?

 

[FalconSlice]

If someone like Joe Smith said “I want to be in XYZ city first and my specialty can change accordingly,” how could they do it?

For example, for someone, it’s more important they attend a residency like Utah (to be close to a specific mountain range) or go to Penn to be close to a specific Philadelphia option.

The point is, suspending incredulity and whether it’s advisable or not, what should this person do if they have chosen to go to residency at a specific school first and foremost, even if it means changing their specialty? Reach out to specific attendings? Go to the school?

I don’t understand. You choose a specialty first to apply to and rank (assuming you get interviews etc.) places and nothing is guaranteed. Idk what you mean by choose to go a specific “school” (these are hospital programs not “schools”).

Also if being close to a specific mountain range is the most important thing for this “person” his/her priorities are seriously messed up.

 

[operaman]

Sure is a lot of strategy for what is basically a temp job.

Hopefully the desired area would have multiple hospitals so you aren’t tied to one institution.

Beyond that, you could probably make a convincing dual application in semi related non competitive specialties, so maybe apply IM, EM, FM, Peds. Your issue there would be programs talking and dropping you because they think you’re weird.

If one of those 4 traditionally has spots in SOAP at that hospital then you could tee up an app but not apply unless you don’t match. Might be a way to hedge just a bit.

 

[obiwan]

Yeah not really sure what you are asking but you don't just randomly switch specialities. If you want to be in a specific location, apply to all the programs in the vicinity in whatever specialty that you choose. Switching specialties isn't like the NIL

 

[doctor15]

Well, the point is to do something like go to a New York city school to do something with the UN. That's not exactly a 1:1 comparison but the point is, the school in question offers unique access to a specific opportunity, even professionally. It would be like going to Stanford for Silicon Valley connections but not exactly. So what would someone trying to match into Stanford and go into Silicon Valley do? Or trying to match into Penn to do something in Philly.

These are not exactly 1:1 because there's multiple residencies in Philadelphia that would mean you aren't so restricted but the idea is:

1 location/town that is geographically far from other elite schools
1 unique connection to a high priority professional opportunity

As such, it would be like going to a school in Alaska to do something professionally there. Let's say someone wanted to match into a hypothetical Harvard-level competitive residency in a city like Juneau?

 

[obiwan]

Well, the point is to do something like go to a New York city school to do something with the UN. That's not exactly a 1:1 comparison but the point is, the school in question offers unique access to a specific opportunity, even professionally. It would be like going to Stanford for Silicon Valley connections but not exactly. So what would someone trying to match into Stanford and go into Silicon Valley do? Or trying to match into Penn to do something in Philly.

These are not exactly 1:1 because there's multiple residencies in Philadelphia that would mean you aren't so restricted but the idea is:

1 location/town that is geographically far from other elite schools
1 unique connection to a high priority professional opportunity

As such, it would be like going to a school in Alaska to do something professionally there. Let's say someone wanted to match into a hypothetical Harvard-level competitive residency in a city like Juneau?

Not trying to sound harsh here or anything but this is where I'm going to need you to be as specific as possible because I'm not quite sure you even know what you are trying to say. For instance, Harvard level competitive residency in Juneau is a scenario that does not exist. But lets say your life's mission is to be an field officer for the CDC, then certainly you can try to match into the internal medicine residency at Emory to take advantage of a rotation at the CDC if that is what you are trying to get at. Also, you do not have to do residency after medical school. There are kids from some of the coastal ivory tower programs that graduate and go into non-clinical ventures like some VC-startup or consulting with McKinsey/Bain since your post makes it seem like residency is the means to an end whether it be some mountain range or whatever

 

[NotAProgDirector]

You can't just apply to all specialties at one site. I mean, you can -- but it won't be successful. Your application is going to be tailored to one field, perhaps two if you're applying to a backup. And that's really the practical maximum.

But let's redefine your question -- if you MUST match to a specific city, you have no flexibility at all, then what are your options?

If you must be in a specific city - let's say NYC or PHL both of which have been mentioned -- then there are multiple programs in those cities. You'll apply to all of them, hopefully interview at a bunch of them, and then match in that city. You would not apply to programs outside that city if ir was truly impossible for you to live elsewhere. if you didn't match, you'd end up in the SOAP process and see what spots were open in that city -- often prelim GS spots would be there -- and you'd then apply for those in SOAP. Alternatively, you could apply for those in the main match and rank them at the bottom of your list.

It's much more problematic if you want to be somewhere there is only a single program. Dartmouth would be an example -- if that's where you need to be, you only have one choice. That's not a tenable application strategy. Also this strategy is much more complicated if the field you're applying to is competitive and/or small.

It's important to review WHY you're doing this. It's common to feel that you must be in some location, when in fact you might be perfectly fine elsewhere. As already mentioned/hinted by others, once you complete your residency you'd be free to move and practice for the rest of your life wherever you might want.

 

[doctor15]

Yes, that’s much closer to a fitting example.

The school I am trying to match at is akin to Dartmouth: in a small college town with no other nearby programs. But, it offers unique access to a hotspot for professional development in another field that can be used in conjunction with my medical degree. I plan to be a doctor and I also hope to use the opportunities of a nearby hotspot.

For example, if I were trying to match into a Dallas-based program (let’s just call it Dallas U but if there were only one program in Dallas) because I thought there was big opportunity in medical/petrochemical intersections, then what would my strategy be to get into the Dallas U? Find the least competitive residency they have? Reach out to Dallas U attendings?

This is another hypothetical but let’s say Rochester MN happened to be the global hub for engineering and I wanted to go to Mayo to do something with medicine and engineering (ignore the possibilities in BME for this thought experiment), what would be the strategy to make this happen?

 

[doctor15]

And the other thing is, yes during residency I plan to be a resident but this specific location offers a unique opportunity that I want to jump into immediately as opposed to waiting 7+ years for.

 

[AJS59]

I don't understand what your endgame is here. You, as a resident, are unlikely to have the time to meaningfully engage with a field entirely separate from medicine. Opportunities definitely increase as an attending, but with maybe the exceptions of bioengineering/computing (so like Boston or SF or Seattle), medical consulting or finance (take your pick of big cities), or policymaking (DC), I don't really see why you need to anchor yourself to a specific residency program in a specific area.

Another question: If it is so specifically important to you that you go to this ONE town without given specific family or cultural ties for vague professional development connections, to the point where you don't really care about specialty, then why medicine at all? I struggle to think of any medicine adjacent fields other than the ones listed above where you would meaningfully benefit living in 1 town.

PS: As someone who went to Dartmouth for undergrad, I ain't going to lie, there's no special connections in Hanover or the Upper Valley that you would get versus going to residency elsewhere. It's certainly good if you're interested in Rural Medicine or Wilderness Medicine, but I don't think that's what you're reaching at here.

 

[wysdoc]

And the other thing is, yes during residency I plan to be a resident but this specific location offers a unique opportunity that I want to jump into immediately as opposed to waiting 7+ years for.

Are you already in med school or are you still in college or HS?
Your questions are unusual and unusually vague

 

[operaman]

The time in residency thing is definitely going to bite you if you aren’t careful. Maybe worth focusing on EM then as you would probably have more free days during the week than any other field. It’s also a fairly easy match these days overall.

As you’re planning, do be mindful of what your resident schedule may look like. It could very easily be 5am - 6pm M-F plus a weekend day on average. Some of those may have nights peppered in as well. EM is more shift based with X number of shifts per month except for off service rotations that will follow that service’s schedule.

 

[doctor15]

I’m an M2.

Why medicine? Because it relates to this field. Think something like going to Stanford to do Neuralink. Obviously you can’t have a full time job at Neuralink as a resident but you start to build an infrastructure/network of colleagues, even if by just hanging out with nearby people at the library etc.

And again the point isn’t to go to Dartmouth for EM. I was just using Dartmouth as an example because it’s a good program in a city with no other nearby programs.

So some other examples:

Stanford-Silicon Valley
Dartmouth-Connection to rural medicine
Mayo-Connection to 3M
Seattle-Connection to BC

The point is, what would someone do if they were flexible with their specialty and prioritized location.

And why?
Well, it is a long explanation but I don’t think it’s relevant to the q.

 

[MateoGM416]

I’m an M2.

Why medicine? Because it relates to this field. Think something like going to Stanford to do Neuralink. Obviously you can’t have a full time job at Neuralink as a resident but you start to build an infrastructure/network of colleagues, even if by just hanging out with nearby people at the library etc.

And again the point isn’t to go to Dartmouth for EM. I was just using Dartmouth as an example because it’s a good program in a city with no other nearby programs.

So some other examples:

Stanford-Silicon Valley
Dartmouth-Connection to rural medicine
Mayo-Connection to 3M
Seattle-Connection to BC

The point is, what would someone do if they were flexible with their specialty and prioritized location.

And why?
Well, it is a long explanation but I don’t think it’s relevant to the q.

I think why the other posters are trying to cue in on this vague goal of yours is because it seems your expectations of what residency is like and opportunities for professional development outside of your emotionally and physically exhausting 60-80 hour a week job are unrealistic.

I would say if you're generally trying to match to a specific area, you can send personalized personal statements to each program in ERAS (not sure about ResidencyCAS or the uro app service) about why you want that program and area specifically, and you can talk about any sort of family/personal/historical connections you have to that area. Not that not having connections to an area you're applying to is a dealbreaker per se. You'll probably be asked why you want to live and train there regardless in your interviews. But if there was any other reason besides a personal connection to the area that could give you any sort of edge when it came to ranking or getting an interview at all, professional development outside of medicine is one that is not going to appeal at all to PD's and will probably raise a few eyebrows of why you want that specialty or to do medicine at all.

Furthermore, if professional development in this area is that important to you, it will probably be much easier to break into as a board-certified attending than a PGY-1 and I assume these opportunities wouldn't go away in the however many years you spend in residency.

 

[DOVinciRobot]

First step would be to stop being so vague and just tell us directly whatever this super specific scenario is you have in mind.

I don’t think you have a good understanding of residency or the process in general.

 

[obiwan]

I don’t think you have a good understanding of residency or the process in general.

This .......

 

[AJS59]

I’m an M2.

Why medicine? Because it relates to this field. Think something like going to Stanford to do Neuralink. Obviously you can’t have a full time job at Neuralink as a resident but you start to build an infrastructure/network of colleagues, even if by just hanging out with nearby people at the library etc.

And again the point isn’t to go to Dartmouth for EM. I was just using Dartmouth as an example because it’s a good program in a city with no other nearby programs.

So some other examples:

Stanford-Silicon Valley
Dartmouth-Connection to rural medicine
Mayo-Connection to 3M
Seattle-Connection to BC

The point is, what would someone do if they were flexible with their specialty and prioritized location.

And why?
Well, it is a long explanation but I don’t think it’s relevant to the q.

I just still don't see why residency location matters that hyper specifically. Tech isn't just Silicon Valley anymore. You can definitely do rural medicine in places that aren't New Hampshire. And frankly speaking, why would you want or need a hyper specific connection to 3M or BC or what not?

What might help us make more sense of this also would be explaining what your long term career goal is. Are you actually trying to practice medicine at some point in the future? If not, and being in this 1 hyper specific area matters, and matters so much that you cannot wait to move until after residency, then why even do residency at all (not that this is advisable)?

 

[NotAProgDirector]

The bottom line is you can't just apply to all specialties at a single location. If you tried to do that, no one would take you seriously. You'll need to pick the specialty that makes the most sense to you. You're likely to be more successful if the specialty you're looking at is less competitive, and has a larger number of spots.

If this other opportunity is more important to you than your medical career, then you should have just pursued that and forgone medicine. But that ship has sailed.

 

[Dral]

For example, if I were trying to match into a Dallas-based program (let’s just call it Dallas U but if there were only one program in Dallas) because I thought there was big opportunity in medical/petrochemical intersections, then what would my strategy be to get into the Dallas U? Find the least competitive residency they have? Reach out to Dallas U attendings?

I would say yes to both of the last two questions IF your endgame is the endeavor you speak of, not necessarily practicing a certain specialty. I know you do not want to dox yourself, but this is very difficult without specifics.

Does the medical specialty matter to the endeavor?
Do you care what sort of specialist or generalist you become?

Another strategy is to do away rotations at the institution just before interview season. Breaking into a 'region' is advisable, but it sounds like there is not much regional action going on where you want to end up. The reason that can be good is, for instance: I went to school in the mid atlantic. To break into the NYC metro area, I did an away there and got a letter from an attending. When all the NYC programs read that letter, they can say "Oh, I know Dr. X and this letter holds some weight because of that". The docs in a specialty in a geographic area might tend to know each other personally more so than two docs in say Nebraska and Massachusetts (not saying that doesn't happen though).

 

[Med Ed]

This feels like two truths and a lie.

I'm guessing OP wants to match at Stanford so they can schmooze with randos in Silicon Valley and eventually climb onto the next Pied Piper.

 

[RangerBob]

If you want to go somewhere specific do an audition rotation there. And rank it first. If it’s that critical/important, apply to IM/peds or whatever their least competitive program is.

It all sounds like a recipe for disaster. Almost no resident has meaningful time to develop an alternative career during residency. Most put any non-passive side hustles on pause. I used two vacations to do a side hustle, then decided it wasn’t worth spending my only meaningful free time that way.

If you really want to go into this other career, either cut your losses and do it now, or wait until residency is complete and you can bring more to the table. If you try during residency you’re likely to sacrifice the quality of your training and risk getting kicked out, and/or thoroughly impressing the people you want to impress at whatever company you’re trying to impress, and you’ve wrecked your chances with them. It would be better to start with a strong hand.

I agree with every other poster that more specifics would help.