I need help please

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hello Medstudentquest. In your earlier post around last year you said the following
"My step 1 score is slightly below average. I passed the first time though. Clinical rotation grades have been mostly outstandings clinically but again with the issue with standarized testing, have dropped down to advanced. I have not done research. How hard is it to get into a descent IM or psych program or possibly a combined one?"

derm???
 
Medstudentquest said:
Hey a question-can I offer to work for free for the program at all? Would they allow me to do that if it came down to it?
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Interesting question. I would assume no because I'm sure you wouldn't be the first or last to make that offer.

The tricky thing would be actually proposing that without coming off as completely desperate to the program.

Anyone with a surefire answer?
 
you tell them the truth. explain your situation- and say you are ready to move on. why, what did you have in mind of telling them?
 
Definitely speak with the prelim PDs who "promised" you a spot. Be sure to explain how your rank list was set up so they don't think you were playing them.

If you were even an average derm applicant, I'm sure someone out there will take you back. I was shocked at the speed with which my prelim PD replied when I stated my intent to rank them #1.
 
how will you explain how you didn't match a prelim? - you either tell them the truth (that you f'd up in making your rank list) or tell them you decided not to rank prelim programs and to do a year of research. the second option is not entirely truthful, but it is not a lie either b/c you didn't rank prelim programs individually.

i would imagine that spots can only be created if a program has extra funding and wants to create an extra spot. if there is no money, then there is no way a spot can be opened up.
 
kralwok said:
how will you explain how you didn't match a prelim? - you either tell them the truth (that you f'd up in making your rank list) or tell them you decided not to rank prelim programs and to do a year of research. the second option is not entirely truthful, but it is not a lie either b/c you didn't rank prelim programs individually.

i would imagine that spots can only be created if a program has extra funding and wants to create an extra spot. if there is no money, then there is no way a spot can be opened up.
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I was curious how spots open up but at all the prelim programs I went to, it seemed like there was some flexibility to retain prelims as potential categoricals should they change their mind or are unable to match into their original advanced field. (Obviously, this is dependent on outstanding performance as a prelim too)

I'm sure there's some way to retain an applicant if they were truly that outstanding. (All that being said, I tended to target smaller community hospitals for prelims. I'm not sure how flexible the larger university IM programs are with their prelim spots)
 
Medstudentquest said:
Can i work for free?
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I doubt it but don't know for certain. You would still have to be covered by the hospital for malpractice, etc... Also, this would kind of set a bad precedent b/c only med students who could afford to be unpaid would be able to go this route.

Many categorical IM programs will keep you on if you are a prelim that didn't match to your specialty. However, they must have funding. My home program offered to keep me because they had funding for 2 more spots (not sure if people dropped out or if they somehow got extra funding for more spots). After a year of internal medicine there, I knew that it wasn't for me so passed on it.
 
kralwok said:
I doubt it but don't know for certain. You would still have to be covered by the hospital for malpractice, etc... Also, this would kind of set a bad precedent b/c only med students who could afford to be unpaid would be able to go this route.

Many categorical IM programs will keep you on if you are a prelim that didn't match to your specialty. However, they must have funding. My home program offered to keep me because they had funding for 2 more spots (not sure if people dropped out or if they somehow got extra funding for more spots). After a year of internal medicine there, I knew that it wasn't for me so passed on it.
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What field are you currently in now?
 
asmallchild said:
What field are you currently in now?
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I am currently taking some time off from clinical medicine and doing research (err... have not been very productive today). I plan to reapply for dermatology next year through the match with a backup in some other field. As a medical student I thought IM would be an ok backup, but I really didn't enjoy my intern year.
 
OP,

Why have you made 30 posts on this thread spanning the last 14 hours?
 
I agree with the poster above- this is just psychotic
 
let me take remake this topic into the following:
Woould you take a program spot if you were in the original posters situation but under one condition- you had to sleep with the program director who you think is abolutely hideous, and that too you had to sleep with him/her whenever you are on call..and say you are doing a prelim surg position
 
graduated from med school, did pgy-1 IM, now doing derm research. plan to reapply through the match next year for derm as well as a backup. if i don't get derm, then i will match in the backup and that will be that (of course i will be extremely disappointed but truly believe that things happen for a reason and life will be just as good in another specialty). i would have reapplied sooner but initially couples matched so am sticking it out here with my spouse since we agreed that whatever happened we were not willing to be apart. it is not feasible to only apply locally.

if you don't get in the first time for derm, it is difficult to match the next time around. however, if there is no good reason you didn't match the first time, then trying again is not unreasonable if you have the means and the dedication. what i think is unreasonable is to keep trying and trying and trying and not having a backup plan. you have to decide what your stopping point is and go with it.
 
Anyway, I am signing off.
I wish you the best, Medstudentquest. Have faith that things will work out, because even though things seem desperate right now and it's easy to panic, things may be clearer to you in the future.
Try to get off SDN and enjoy yourself a little. Tomorrow is match day, right? Go celebrate with your friends. If you don't feel up to that, go out with your husband. Scramble day was actually one of my best days in med school -- there were no spots availalbe, the pressure was off, I ditched class and went shopping with my husband. There is more to life than this.
 
kralwok said:
Scramble day was actually one of my best days in med school -- there were no spots available, the pressure was off, I ditched class and went shopping with my husband. There is more to life than this.
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This is the best advice I've ever seen on SDN...well done :thumbup:
 
Medstudentquest said:
How do I end up from going on a multitude of interviews, having excellent grades, letters, an additional grad degree, and being a great student, to having to struggle to even find a remote spot in a remote area?
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No offense, but please take responsibility for your actions. You didn't fill out your rank list appropriately it's as easy as that. According to your stats I doubt you would of had any problem getting into a prelim program. You had plenty of time to ask all the questions about filling out a ROL for the NRMP. There are plenty of students out there with multitudes of interviews, an additional grad degree, and are great student that got positions because they asked for help when submitting their ROL.

I'm just a little surprised that someone would fail to double check everything with something so important in their life.
 
Medstudentquest said:
I am unable to find a half decent prelim/categorical/FM position. What now? I called programs that I interviewed at, they all tell me they are full and cant open up new spots.

There is apparently one open FM spot at a decent program, but they say that since I did not apply for FM in the first place, it's unlikely they'll give me the position.

How do I end up from going on a multitude of interviews, having excellent grades, letters, an additional grad degree, and being a great student, to having to struggle to even find a remote spot in a remote area?

what now? Is it really to my benefit to just take a FM position even if i can find one, in the middle of nowhere?

Or do I sit this year out, and apply again starting Aug/Sept?
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1. I think it would be impossible for a residency program to open up a new categorical spot, and in terms of opening up a prelim spot, this could decrease the quality of the education that the other residents have if there are limited patients and attendings, as there likely is.

2. It seems that you do know how this happened, it was an error that you made when making your ROL, you didn't list prelims after categoricals for dermatology which is hard to get and plenty of well qualified medical students don't get it. We don't know exactly what the nrmp said, but in the end this was the mistake, and will be a learning experience.

3. It makes sense that you would not get a FM position if you didn't apply for it in the first place, i.e. they want medical students who started out wanting to do family practice. You are ambivalent about family practice want to know if it will "benefit" you? What does this mean? If you see FP as a viable career option then do it, but it seems that you haven't put a lot of thought into what it would be like to be an FP . . .

4. You may not be able to scramble into anything, i.e. FP or IM this year, but have a good chance at these specialties next year and you could interview at Derm programs and rank these as backup professions. We can't answer what you will want to do! You may not have a choice and need to apply again next year.
 
I hate to say this but i am doubting the credibility of the OP in its entirety. This person seems like a total mess asking important life questions on this forum without any thought. This is just psychotic.

Advice- learn the NRMP rules, and move on
 
I guess you are right- what I am trying to say is this is a mess. Maybe you should number out your problems

1) Research this year?
2) Scramble FM/IM as a substitute for prelim

have we narrowed it down to that?
 
Based on your prior posts, its seems you are passionate about Derm. If you say that it is difficult to scramble into them now ( which you are probably right as match results come out in 50 minutes) then i would do derm research if i were you and study for step 2 and step 3 and crush them. You will get it next year!
 
Medstudentquest said:
You are correct, I love derm and have a passion for it. While there are some spots open, they are in far out locations and they already have local people who will be intervieweing today. It's not like I can book a flight to NJ today and get on a plane to be there in 15 mins.

I will probably just finish the project I'm working on in derm, graduate, study hard for step 2, try to get a research position, and then see if i can make more connections and apply again in Aug/Sept.

Not sure it's smart to go out to random places to get a random spot in something.
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would it still be possible to find an "off cycle" prelim spot? but that might mess up your timeline for derm in 2 years.
I think you are right- make connections aggressively, study hard for step 2/3, and do research. The good news is once summer rolls along- its back on the application trail again. So you really dont have much time until you are back in the thick of things! goodluck!
 
yes cat- want to do GI.
are you shooting for psych if derm doesnt work out?
 
Medstudentquest said:
I realize all of these things and that ultimately it was a stupid thing that happened.

I mean, realistically, does it make sense to desperately try to get into a random program? And yes, of course I don't want to do FM. That would simply be for one year since it could be used as the PGY-1 before derm.

Also, in my understanding, FM was extremely easy to get into. Am I wrong about this? Some of the recordings when I call to ask about the availability of the program sound like they are Neurosurgery at Harvard or something.

But of course, I don't have FM letters.

Also, I don't think it would realistically make any sense to go from Derm to FP or IM. I certainly think that my credentials are to get into something better and that I would enjoy more.

As far as the scramble, why is it so hard to get into programs? It's impossible to even get through! And how do the people who get the spots even get them?

For example, I sent my info over to a FP program in my state the other day through ERAS. I called and emailed several times. The next day-gone!

I looked today and the application materials were not even downloaded!

The million dollar questions I suppose remain:
-Does it make sense to try to get into a random program at this point? If I can't ultimately get into derm, how will doing a random prelim in the middle of nowhere or a year of FP help me?

-If I can't find a residency this year, will it be the end of my career? I.e.: will admissions committees think, oh man, Medstudentquest must really suck to not get a spot, especially if I apply to the same programs.
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1. Many scramblers would be happy doing FP, and fax/email to all the programs and try very hard to scramble, but once a program finds a suitable candidate then the spot is "filled", there isn't a second match. The competitiveness of the scramble is very intense as there are thousands more applicants than spots, enough said.

2. You keep asking if it would make sense or be your worth scramble into FP or IM. You say your credentials wouldn't make sense to go into IM or FP. From a prior post you said you had a learning disability and scored below average on Step 1 ( I am guessing you are in the 210s range). There are tons of people with above average Step 1 scores who love FP and IM and do it. It is not a question of "credentials" but whether or not you would be happy and succeed, if you look down on FP and IM, then I wouldn't apply for these. Do you really want me or someone else to tell you that you shouldn't do FP or IM??? We really don't know you. You said in a prior post you liked or loved IM and then later said you don't like it.

3. No one can tell you how competitive you would be for derm or something like this if you apply again next year. You could tell PDs that you didn't fill out your ROL properly, (but this would raise questions about organization and attention to details), but you could honestly say that you applied for derm categorical and didn't match.
 
I don't think that not matching into derm on the first try will be the kiss of death for your application next year. Just go ahead and try for derm a 2nd time.

It doesn't seem you are interested in categorical IM or fp right now, so I would NOT try to scramble into some random spot. If you were to try to get a random open spot, you should only try for IM prelim year (or a TY, which there probably aren't any of anyhow) IMHO. This wouldn't be a total waste as it would give you a year of training that is potentially useful (even if you don't do IM, it would count as a 1st year for derm, neuro, anesthesiology, other specialties...). However, as you said there probably aren't many good spots left at this point, unless your med school is able to create one or keep one open for you. Besides, getting a derm publication(s) would probably help your application more than doing a medicine intern year, and also you will find it very hard to go on interviews while doing an IM intern year.

It seems like in this situation, doing a research year would help you the most. If you can publish something and get a good Step 2 score, you probably still have a shot at derm next year. Programs know that people don't match into derm, so I don't see not matching as being a big deal as far as them not liking your application. If I were you, I wouldn't necessarily volunteer the fact that you messed up your rank list (that IS what happened) and didn't really have a backup plan. They probably won't ask you about it anyway next year, but if they do, you could just finesse the question by implying that you had planned to do an extra year of research and finish your MPH if you didn't get in derm on the 1st try.

I think you need to get on it if you want to do a research year next year, though, because you, or your future PI, will need to secure funding to pay your salary.

In any case, you need to have backup plan next year for in case you don't match into derm. I don't think doing radiology counts as a backup plan, b/c it's also highly competitive. You could apply to 2 competitive specialties, but I think that would be tough to do well...I certainly wouldn't recommend applying ONLY to derm and radiology. You've got to be smart and leave yourself an out in case you don't get derm...if you don't like IM, pick psych, neurology, even anesthesia maybe.
 
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