IM as a backup, categorical vs prelim year. Advice needed!

[alEXatosu]

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So I am applying to Orthopaedic surgery right now, but I am starting to think about backup plans (something I should have done much earlier). My top choice for a back up would be Internal Medicine. However, I don’t even have any IM LORs, I would need a new IM personal statement, and it is very late in the game. So I don’t know how good my chances are to get a good categorical IM spot. For these reasons I want to apply to preliminary IM spots in addition to categorical spots to increase my chances of going to a good program. I think at this point I could get a categorical IM spot—but it wouldn’t be as good as a position as I could have gotten had I planned this out earlier.

One question—how many people apply for preliminary spots that are NOT going into advanced residencies (rads, anesthesia, PMR, etc). My angle would be I want to do whatever I have to do to get into your IM program, even if that means doing a preliminary year. Could I do this?

I read some posts that say don’t apply to both categorical and preliminary spots, because then they’ll know you’re just using the categorical spot as a backup. Well that wouldn’t be the case for me. I wonder if I do apply to both categorical and preliminary, if I should email their PD to let them know my plans.

I know I have until Jan 1st for a lot of the IM programs to get everything in, but still, am I too late in the game to make this happen? It’s so late and in my mind I feel like preliminary spots might be easier to get than categorical spots. One debate I can think of is great preliminary spot vs ok categorical spot—which one would I take?? I know a lot of this program specific—i.e. how easy/tough would it be to slide into a PGY2 spot…its all very confusing

Does anyone have any advice for what I should do here to try and secure an IM spot either categorically or preliminary? I will prob won’t reapply for ortho next year if I don’t get it this year. Thanks everyone.

p.s. Do you think it is worth it to send in my application to programs with a deadline of Dec. 1 WITHOUT a personal statement or any LOR's? there is simply not enough time to get those in before dec 1..

 

[alEXatosu]

Anybody??

 

[HoboCommander]

I am also interested in knowing the answers to his questions.

 

[IMPD]

Prelim medicine by itself is not a good idea. Although there are PGY2 spots that open up, and some programs are able to "create" spots for good prelims that wish to remain in medicine, this is not a good plan.

I know that upwards of 40% (or higher) of AMGs applying in medicine are applying as backup. I don't care. I want the best residents I can get, and if that means I get someone who failed at their Ortho list, that's fine with me. As long as they presented themselves well and told a reasonable story of why they like medicine.

There are people applying for prelim spots with no plan for PGY2, but I don't like to match those people. They create work and stress for everyone.

As for getting a complete application, yes, that would be the idea. Are you seriously telling me you can't write a personal statement by December 1st? The LORs would need to be modified by the writer and this can usually be requested.

 

[HoboCommander]

Prelim medicine by itself is not a good idea. Although there are PGY2 spots that open up, and some programs are able to "create" spots for good prelims that wish to remain in medicine, this is not a good plan.

I know that upwards of 40% (or higher) of AMGs applying in medicine are applying as backup. I don't care. I want the best residents I can get, and if that means I get someone who failed at their Ortho list, that's fine with me. As long as they presented themselves well and told a reasonable story of why they like medicine.

There are people applying for prelim spots with no plan for PGY2, but I don't like to match those people. They create work and stress for everyone.

As for getting a complete application, yes, that would be the idea. Are you seriously telling me you can't write a personal statement by December 1st? The LORs would need to be modified by the writer and this can usually be requested.

What if your MPSE states that you are interested in a particular specialty that is not IM? Would that be a problem applying for categorical IM?

 

[IMPD]

What if your MPSE states that you are interested in a particular specialty that is not IM? Would that be a problem applying for categorical IM?

Then you should explain in your PS that you changed your mind/expanded your ideas/are dual applying.

 

[NotAProgDirector]

I'm going to come at this from a slightly different perspective.

Let's assume you don't match ortho. The first question is, do you plan to apply again next year? You mentioned in your post that you "probably" won't apply. But if you plan to apply, applying for a Cat IM spot is a real pain, and a real problem for you. By applying for a Cat spot you're really committing to three years of training. If you try to apply to ortho next year, you may get squeezed with PGY-2 contract renewal coming before the match results. So, if you want to apply for ortho next year, the better question is: "What can you do with this coming year to make yourself a better ortho candidate?". That might be a year of research. Honestly, I don;t know, and you'd need to speak to ortho about that. A prelim IM spot is probably useless for ortho.

Let's say you decide it's now or never, if you don't match ortho you're not applying again. Then, it's fine to go after Cat IM. However, whether PD's are going to seriously look at your application is unclear. I personally don't want to waste my time interviewing people who plan (and are likely to succeed) in matching ortho. But, I agree with my friend IMPD that the "bottom of the ortho barrel" has great candidates. I've taken people who failed to match in Rads, Derm, and surgical specialties and it's worked out just fine.

At this point, the critical issue is getting your application out NOW. Whomever told you that you have until Jan 1 is crazy. Sure, maybe deadlines are listed as Dec 1 or Dec 31, but most programs are making their decisions now. We plan to make all of our interview decisions this week and next. So if this is what you want to do, you need to get your application out ASAP. You could ask your letter writers to change everything, but that may add delays. Plus, you're not trying to hide that you're applying to ortho -- I expect your application includes a bunch of ortho rotations, research, etc. So, you might be best using your application as is, but take your personal statement and write about "I'm applying to ortho, but I'm also applying to IM. And here's why:". You need to be clear that if you match in IM, you're not coming to me in July asking how I can help you apply for ortho again. And you'll need to explain why IM is your second choice (because it's wildly different from ortho).

Even with that, you may not get much IM love. It depends on the rest of your application, and where you're applying.