I'm not worried but..

[IveGotTwins]

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A little background on my situation:

2010 Grad of a US Allopathic Med School

240+ USMLE Step 1 and 2

Currently a PostDoc Research Fellow at my home institution (read: job) involved with several projects related to anesthesiology (blood transfusions and thromboelastography).

4 letters total, two from full prefessors of anesthesiology, 1 from the chair of trauma surgery who also happens to be the PI of the lab I'm working in and one from the medicine doc from my AI.

I didn't enter the match last year for Anesthesiology because I originally thought about doing ortho but after several rotations it became clear I didn't and since it was already October it was too late to go backwards. Unfortunately at my school at the time there was no opportunity to actually do ortho during surgery rotations, anesthesiology is not a required 3rd year rotation and there is not alloted time for electives so picking a specialty was really just a shot in the dark and I missed the target. My last rotation for med school was critical care which was a breakthrough for me personally and set me on the path I've found myself on today.

I applied to 30 programs received 9 interviews and went to them all.

I have not received that many rejections, maybe 5 or 6.

I have not interviewed at a couple of the programs in my home state.

After stalking this website for years especially recently due to interviews and such I decided to finally join and post. I'm just curious why I'm getting what seems to me a low number of interviews. I say this after meeting people on the trail who received invitations to every program they applied and reading the same here on various threads.

I have my own theories: 1) a 240 on step 1 really isn't that great these days; 2) nobody looks past 2010 graduate; 3) I don't have a formal anesthesiology elective rotation on my application; 4) the specialty is becoming more competitive; 5) the specialty isn't becoming more competitive but applicants are applying more widely than needed.

Also, is there truly any utility in contacting PDs from programs that I haven't received a rejection from asking for an interview? It seems to be a lost cause at this point. My opinion is that they would have sent a rejection if they were going to bother with them at all.

Any thoughts would be appreciated.

 

[gman33]

You stated that you didn't do an Anesthesiology elective.

Just wondering what your exposure to the field entails.
I would see that as a problem from a PDs standpoint.

 

[IveGotTwins]

My last rotation in med school was Critical Care in a unit that was run exclusively by anesthesiologists. One of these attendings who I spent a fair amount of time with as well as got along well with wrote one of my letters of recommendation.

Also, during this past summer while I was working I shadowed one of the full professors from my home program for countless hours up until September. He also wrote one of my letters of rec.

 

[NOLA RISING]

Did you submit your ERAS late?

 

[IveGotTwins]

Sept 2nd.

All documents were available by my first interview in late October.

 

[shopsteward]

A strike rate of one interview in three for a competitive posting doesn't seem bad to me. You only need to match at one of the 9.

From a recruiter's point of view, it is nice to be in the position of having more good candidates than available slots for interview. But it does mean that candidates who are clearly good enough on paper to do the job might get turned away without even an interview, because all the interview slots get filled by candidates who on paper look even better.

In your case, your application may not have shown the strength and length of commitment to anesthesiology that the applications of other candidates did. If admissions people were looking for reasons to limit the numbers of interviews, they could latch on to that. But you seem to have done a lot, in the short time since your last med school rotation, to deal with the issue as best you can.

Also, I'm not entirely sure that I understand your reasons for not having submitted an application to ERAs in September (for Ortho) or October (for a back-up option) last year. But in principle there should be nothing wrong with being a 2010 grad, as long as you've explained your choices in a coherent and consistent manner and can now show a strong path towards your current choice.

Also, also, and I hate saying this, but if there is anything in your app which emphasises your family life to the same extent as your username here, that might also, unfairly and unlawfully, be an issue.

What would you have to lose by contacting the programs you haven't heard from, emphasizing both your interest in anesthesiology and in their program?

 

[IveGotTwins]

In regard to why I didn't submit to ortho last time around is a long story but the highlights are:

1) I didn't really like it after actually doing it.

2) I have a service obligation for the IHS (Indian Health Service) and the guidelines for which specialties they allow scholarship recipients to match into changed in the middle of interview season so it was a mute point for me to submit an application since my scholarship would not allow me to matriculate into ortho. It didn't matter much since I didn't enjoy it anyway. I realize it seems strange to find out something like that so late but apparently the policy for IHS states that I must receive a hardcopy of guideline changes and my address had changed. I did not receive an email notification stating that a hardcopy was on its way or anything of the sort. I thought I had notified them via the proper channels of my new address but apparently not. So when the notice ended up at my school's registrar's office because it never made its way to me it was a little too late.

Regarding the family situation (identical 3.5 yr old boys), I never in my entire application make any statements that my family life was hard, distracting or takes significant amounts of my time. However I haven't been through a single interview without the person on the other side of the desk asking about it, so I know it's noticeable even if I don't make it obvious by writing about it in my personal statement, etc. I never even considered this for a possibility though.

 

[WholeLottaGame7]

In regard to why I didn't submit to ortho last time around is a long story but the highlights are:

1) I didn't really like it after actually doing it.

2) I have a service obligation for the IHS (Indian Health Service) and the guidelines for which specialties they allow scholarship recipients to match into changed in the middle of interview season so it was a mute point for me to submit an application since my scholarship would not allow me to matriculate into ortho. It didn't matter much since I didn't enjoy it anyway. I realize it seems strange to find out something like that so late but apparently the policy for IHS states that I must receive a hardcopy of guideline changes and my address had changed. I did not receive an email notification stating that a hardcopy was on its way or anything of the sort. I thought I had notified them via the proper channels of my new address but apparently not. So when the notice ended up at my school's registrar's office because it never made its way to me it was a little too late.

Regarding the family situation (identical 3.5 yr old boys), I never in my entire application make any statements that my family life was hard, distracting or takes significant amounts of my time. However I haven't been through a single interview without the person on the other side of the desk asking about it, so I know it's noticeable even if I don't make it obvious by writing about it in my personal statement, etc. I never even considered this for a possibility though.

Clinical grades? If not that, I'd say it's the year "off." A 240 on Step 1/2 is not holding you back anywhere. If anything the 240 on Step 2 is slightly worse because the average is higher.

With 9 interviews and the track record you listed, I think you'll be fine.

 

[IveGotTwins]

I must be a glutton for punishment. I scanned the 2009 NRMP match statistics report and found some interesting information that doesn't really give me any confidence at all.

According to the report the NRMP categorizes applicants two ways: 1) US Allopathic Seniors and 2) everyone else or Independent Applicants. Even though I'm a US Allopathic grad who is doing research this year I'm considered an Independent Applicant.

Based on Step 1 score (240) and contiguous ranks (12) an independent applicant has a 60% and 80% chance of matching based solely on those parameters, respectively. Compare this to a US Senior and it becomes 98% and 98%, respectively.

Holy **** do I wish I had chosen Anesthesia for my electives 4th year instead of Ortho to avoid such wheel spinning.

Like I said, glutton for punishment.

 

[Arch Guillotti]

I wouldn't put too much stock in that stat. Foreign grads are at a distinct disadvantage and you probably have a leg up on DO's. There are probably some other oddballs in the mix as well. I think the lack of formal rotation is hurting you some but hopefully the good LOR's will make up for it. Sell yourself hard and I'll bet you will match.

I must be a glutton for punishment. I scanned the 2009 NRMP match statistics report and found some interesting information that doesn't really give me any confidence at all.

According to the report the NRMP categorizes applicants two ways: 1) US Allopathic Seniors and 2) everyone else or Independent Applicants. Even though I'm a US Allopathic grad who is doing research this year I'm considered an Independent Applicant.

Based on Step 1 score (240) and contiguous ranks (12) an independent applicant has a 60% and 80% chance of matching based solely on those parameters, respectively. Compare this to a US Senior and it becomes 98% and 98%, respectively.

Holy **** do I wish I had chosen Anesthesia for my electives 4th year instead of Ortho to avoid such wheel spinning.

Like I said, glutton for punishment.

 

[IveGotTwins]

Yeah, only 1,200 of the 13,000 in the Independent group are US Allopathic grads.

I've tried to play the game so to speak as best I can. I've sent the thank you notes, sent out emails to express my interest in programs that I haven't heard from yet and plan on "keeping in touch" via email or otherwise with the PDs and chairmen from my top choices.

Any other suggestions for selling myself?

 

[whydowork]

Yeah, only 1,200 of the 13,000 in the Independent group are US Allopathic grads.

I've tried to play the game so to speak as best I can. I've sent the thank you notes, sent out emails to express my interest in programs that I haven't heard from yet and plan on "keeping in touch" via email or otherwise with the PDs and chairmen from my top choices.

Any other suggestions for selling myself?

It sounds like you are doing pretty much everything that you can do. The only other option I see would be to see if any of your Anesthesiology letter writers have connections at your top places and would be willing to call on your behalf.

 

[IlDestriero]

What expoure do you have to routine OR anesthesia other than looking over the drapes during your surgical rotations? If the answer is none, I wouldn't be surprised if you don't match at all. The PDs need to know that you understand what you are getting into, even if anesthesia is just a stepping stone to an ICU fellowship. Losing someone is much more painful than passing over a couple of marginally "better" applicants. We lost a resident from my class and the position was left open. It produced some scheduling conflicts and extra call for all the senior residents. We lost 2 fellows last year right before the year started. It also caused potentially avoidable problems for both the faculty and fellows. It was too late to replace them.

 

[IveGotTwins]

This is directly quoted from above:

My last rotation in med school was Critical Care in a unit that was run exclusively by anesthesiologists. One of these attendings who I spent a fair amount of time with as well as got along well with wrote one of my letters of recommendation.

Also, during this past summer while I was working I shadowed one of the full professors from my home program for countless hours up until September. He also wrote one of my letters of rec.

Also, I haven't explained what I'm actually doing during my "research fellowship". My research project that I just finished data collection for involved blood products given during initial resuscitation in the ER and then in the OR and ICU if necessary. It was an 18 month project that I worked on for 7 months. Now the dept of anesthesiology and the dept of trauma surgery are wokring in conjuction with one another on a thromboelastography study which I'm involved with as well.

In summary, my life since April 2010 has been all anesthesiology, all the time. I