I'm starting to get really scared

[superoxide]

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Hi there,

Need some advice on what to do.

I'm a student at a caribbean school applying for the 2009 match. My stats are as follows:

Step 1: 203/83 (second attempt)
Step 2: 188/77 (first attempt)
Step 2 CS: FAILED (Retook it in 10/14. Will get results on 12/03)

Canadian citizen (need J1 visa for residency)

So far I've applied to 21 Pediatrics programs ( I know that's a low number, but I didn't have any money to apply to any more). I've only had one interview and that was at a hospital where I did elective rotations. Otherwise it's been one rejection after the other (14 rejections so far, haven't heard from 6 of them yet) I got *excellent* evaluations/letters from all my attendings there. During the interview, the PD and the director of Medical education said that my letters were "some of the strongest" they had ever seen and they "couldn't ask for better letters". I also think I have a really nice/funny PS. The interview went really well.

It's now almost the end of October and I am getting really scared. I am currently doing my FM rotation. This is the first FM elective rotation for me, since FM is not a core at my school. So far I've enjoyed it, and I'm thinking of applying to FM programs as well, but my first choice is pediatrics. I've always wanted to do peds and can't imagine doing anything else. I'm not even sure I'm going to get any FM interviews if I apply. I spoke with my preceptor here who said he will write me a strong letter at the end of the rotation, but that hasn't helped me with my peds applications, so I'm not banking my hopes on that. Looks like my USMLE scores are going to filter my application early on in the process.

This is not a 'what are my chances" thread. I know my chances are bad and I knew that all along, but I never thought it would be this bad. I'm now 2 months away from graduation (I complete all my requirements on Nov 28th), I'm broke, over $150,000 in debt and there is a very good chance that I'm not going to match anywhere (in Peds or FM) and it's only going to get harder in the years to come.

I was looking at the unfilled FM list from last year and went to visit their sites. Almost all of them had requirements like "must have passed step 1 on first attempt" or "must have >80 on USMLE". And these are programs who didn't fill almost 1/2 their slots. Should I even bother applying to these programs? I mean since they have these strict requirements, I would assume that they are a fairly good program, so how come they are not filling in the match??

I'm confused. I really don't know what to do. I'm scared. Can't sleep, can't think straight. Seems like despite my best efforts, I'm not getting anywhere. I am beginning to lose hope.

Any advice on what to do? Anyone who has gone through this have any advice to give me?

Please, no cheap shots or comments. Just looking for some guidance on what I can do, or what kinds of programs I can apply for so that I match in March.

You can reply here or PM me.

Thank You.

 

[Blade28]

The rest of your app looked good? MSPE, letters, evals, grades, etc.?

Failing Step 1 the first time is certainly a red flag to program directors - you said you applied to 21 Peds programs. Did you apply to a good range and variety, i.e. not all super-competitive ivory tower programs?

If you don't match, know that many FP/Peds spots remain open during the subsequent Scramble as well.

How much more can you afford (for additional applications)? Bear in mind I took a loan out during my MS-IV year for applications, residency interview travelling, etc. I was already $140k in debt from med school loans - unfortunately, these additional private loans can often take a few weeks to process.

 

[superoxide]

Hi Blade,

Here are some of the comments from professors/preceptors from my MSPE:

-"A pleasure to have in class; Interesting and likable; Honest, straightforward and kind; He is a caring person"
-“An excellent student, very interested in pediatrics, did extra presentations above and beyond the call of duty. Very reliable and dependable.”
-“A solid student with a good knowledge base. Good rapport with patients and staff. Caring and dedicated. He will be a fine physician.”
-“Very enthusiastic, did a good job as acting intern. He seems mature and caring. It was a pleasure to work with him.”
-“Excellent performance – this elective rotation. Superoxide shows genuine interest and aptitude for psychiatry.”
-“Outstanding knowledge of pathophysiology. Well organized thinking. Excellent physical diagnosis skills, eager to learn. Excellent data gathering and presentation. Great team work. Outstanding rapport with patients and staff. Very responsible. Leadership quality.

Although I have not seen my letters, the PD and the Director of Med. Ed at my peds interview mentioned that they were some of the strongest letters they had ever seen. The Director of Med. Ed joked that my letters were so strong, that he wondered whether or not I stole the hospital letterhead and wrote them myself.

I've gotten excellent evals/grades throughout rotations. I'll be honest that most of my third year cores were done at hospitals where almost everyone got a A or B. (I did most of my cores at a hospital in Brooklyn where there were literally hundreds of students) So I didn't put too much weight on that. But I did my electives at a great stand alone childrens hospital, where they only took one student/elective and I was the only IMG student there. All my letters from attendings there were outstanding (as mentioned above). I got A's in all my rotations there. My basic science grades are average.

I knew my step 1 failure was going to be a HUGE red flag. I know a 203/83 is not a good score either, but considering that there is a 60% chance that I'm going to fail it again (according to the stats on usmle.org), I think I did quite well. I scored 171/72 on my first attempt. I also thought that a failure would be less of a problem when it comes to Pediatrics programs. I was under the impression that peds programs look at the whole application, letters, PS etc and don't place as much weight as other programs on board scores. I guess things have changed with increasing number of applicants.

I only applied to mid to low tier community based programs. Didn't apply to any university programs. I didn't even bother with the "ivory tower" programs. I had a limited amount of money and I used it to apply to programs where I atleast have a chance of getting an interview.

I might be able to apply for 15-20 more programs, but that's about it. When i say I'm broke, I mean BROKE! It's a good thing that I am being provided free room and board for my last two rotations. I wouldn't even have money to pay for rent and food.

I thought about the scramble, but I'm not sure how much luck I'm going to have with it. Being an IMG with visa issues and usmle failures doesn't help.

The rest of your app looked good? MSPE, letters, evals, grades, etc.?

Failing Step 1 the first time is certainly a red flag to program directors - you said you applied to 21 Peds programs. Did you apply to a good range and variety, i.e. not all super-competitive ivory tower programs?

If you don't match, know that many FP/Peds spots remain open during the subsequent Scramble as well.

How much more can you afford (for additional applications)? Bear in mind I took a loan out during my MS-IV year for applications, residency interview travelling, etc. I was already $140k in debt from med school loans - unfortunately, these additional private loans can often take a few weeks to process.

 

[Blade28]

Can you take out a private loan? I was broke too (lived off financial aid throughout med school but that wasn't enough given the high cost of living) and relied on additional private loans to get me through med school and into residency (including relocation).

It sounds like you're in a very tight spot - I'm very sorry to hear that.

 

[PalmOlive]

Hi there,

Need some advice on what to do.

My stats are as follows:

Step 1: 203/83 (second attempt)
Step 2: 188/77 (first attempt)
Step 2 CS: FAILED (Retook it in 10/14. Will get results on 12/03)

Canadian citizen (need J1 visa for residency)

So far I've applied to 21 Pediatrics programs. I've only had one interview (14 rejections so far, haven't heard from 6 of them yet).

I'm broke, over $150,000 in debt and there is a very good chance that I'm not going to match anywhere (in Peds or FM) and it's only going to get harder in the years to come.

I was looking at the unfilled FM list from last year and went to visit their sites. Almost all of them had requirements like "must have passed step 1 on first attempt" or "must have >80 on USMLE". And these are programs who didn't fill almost 1/2 their slots. Should I even bother applying to these programs?

Thank You.

It is hard to pinpoint what is going wrong with getting peds interviews for you. (On the other hand the interview you got seemed very positive in that they liked your LORs). Pediatrics is more competitive for IMGs and fills about 72% with US grads, as compared to Family Practice which is closer to 50%, even IM is less competitive than Peds currently.

There are loans available for setting up interviews and realize that $150,000 in loans is low compared to what some other med students have. The only decision left to make in your case is how many programs to apply to, and the deadline is fast approaching.

If a program has a requirement that all IMGs must have passed Step 1 on the first attempt, then ERAS applications are discarded if triggered by such a filter without somebody looking at them. Most likely you would be wasting your money applying to these programs. You have to do some leg work findings IMG friendly programs that don't automatically filter out based on the step score. Your dean's letter may be great, but so are most dean's letters. (My dean's letter said Palmolive will be a great physician and leader in medicine).

The scramble is brutal from what I hear, and ALL peds residency programs filled after the first month of the scramble, meaning they can find applicants that meet their requirements. Also, such programs may be in states that require that IMGs pass their step on the first attempt, or perhaps only allow applicants for licensure to fail one step, . . . you have failed two steps, i.e. step 1 and CS, so there are some states out there where you will not be allowed to practice after residency. A residency program in such a state wouldn't want to train somebody who wouldn't be able to practice there in the future as most states are short on doctors currently. It is up to you not to apply to such states/programs that you have already struck out at because of failing licensing exams.

This may be your problem if the majority of your applications went to states that don't touch people who failed the steps. I would apply to more peds programs if you can afford it as right now you may not match with just 1-2 interviews. Also, you may have to ask yourself if you would be able to be a family practice doctor, then not being a doctor at all. I feel bad that pediatrics may not work for you, but realize that it is competitive for IMGs.

Honestly, if I were you I would apply to 10 more peds programs and to 10 less than stellar family practice programs and hope that I pass CS the second time. Also, I would get together a good plan B if you have to apply for the match again next year, maybe go for a second degree or do research to buff up your academic street cred.

 

[superoxide]

Thanks for your replies (both palmolive and Blade)

My problem is that I have bad credit, and so I have had difficulty obtaining any more loans. So any new expense will have to be self financed. I wish I had $3000 to apply to >100 programs.

I didn't apply to a single program where I didn't meet all their requirements. If they required a first time pass, I didn't apply. If they required ECFMG certification at the time of application, I didn't apply.

I agree with you about the scramble. It's brutal. I'm hoping to get something...anything! before that.

I'm not sure I agree with you about the state licensure requirements. Most of the states allow upto 3 failures before you become ineligible for licensure.

I'd rather do FM than do nothing at all. Not bashing FM or anything. I'll be fortunate and extremely thankful to get into ANY residency, but I'm still hoping to match into a peds program. Not doing anything is not an option and going back to school is definitely not an option. I did 4 years of undergrad, worked for a year, did a year of premed, then 4 years of med school. I'll be 31 years old in a few short months. I'm exhausted.

It is hard to pinpoint what is going wrong with getting peds interviews for you. (On the other hand the interview you got seemed very positive in that they liked your LORs). Pediatrics is more competitive for IMGs and fills about 72% with US grads, as compared to Family Practice which is closer to 50%, even IM is less competitive than Peds currently.

There are loans available for setting up interviews and realize that $150,000 in loans is low compared to what some other med students have. The only decision left to make in your case is how many programs to apply to, and the deadline is fast approaching.

If a program has a requirement that all IMGs must have passed Step 1 on the first attempt, then ERAS applications are discarded if triggered by such a filter without somebody looking at them. Most likely you would be wasting your money applying to these programs. You have to do some leg work findings IMG friendly programs that don't automatically filter out based on the step score. Your dean's letter may be great, but so are most dean's letters. (My dean's letter said Palmolive will be a great physician and leader in medicine).

The scramble is brutal from what I hear, and ALL peds residency programs filled after the first month of the scramble, meaning they can find applicants that meet their requirements. Also, such programs may be in states that require that IMGs pass their step on the first attempt, or perhaps only allow applicants for licensure to fail one step, . . . you have failed two steps, i.e. step 1 and CS, so there are some states out there where you will not be allowed to practice after residency. A residency program in such a state wouldn't want to train somebody who wouldn't be able to practice there in the future as most states are short on doctors currently. It is up to you not to apply to such states/programs that you have already struck out at because of failing licensing exams.

This may be your problem if the majority of your applications went to states that don't touch people who failed the steps. I would apply to more peds programs if you can afford it as right now you may not match with just 1-2 interviews. Also, you may have to ask yourself if you would be able to be a family practice doctor, then not being a doctor at all. I feel bad that pediatrics may not work for you, but realize that it is competitive for IMGs.

Honestly, if I were you I would apply to 10 more peds programs and to 10 less than stellar family practice programs and hope that I pass CS the second time. Also, I would get together a good plan B if you have to apply for the match again next year, maybe go for a second degree or do research to buff up your academic street cred.

 

[buckley]

This is a shot in the dark but i had a friend who actually applied to programs the old fashioned way--- by calling them up and asking for positions/vacancies. Of course this is applicable mostly to smaller programs, but from what I hear form you, you're not really that choosy. If you are in the US with unlimited landline calls, this could be a good option.

As for actually earning money, I had another friend who bartended, another one who worked as a caregiver, and another who worked in medical transcriptions to earn a few extra moolah. In this hard times, we have to do what we have to do.

For the professional advice, I think you also need to work on your priorities. If I were in your shoes, I would worry about passing CS now more than applying to programs.

Good luck!

 

[earmuff]

My advice would be to apply to FM programs...as many as possible. Then rank any peds programs at the top of your list, followed by any FM programs where you may get interviews. You have little choice at this point. Your odds of matching (with one interview) are low. You need to get that number up...

Cold calling programs works as well. I got an extra interview this way (although I called 40+ programs).

Donate blood, sperm, eggs, whatever, find the money. Call Warren Buffett. Get it done. Do you have any rich uncles? Sugar daddy/mama? Predatory lenders?

Good luck, and I do hope you win the lottery.

 

[Miami_med]

If the guy really wants peds, there are a LOT of community peds programs of low competative nature that he should apply to before FM. Some peds are more difficult than some FM, but this is certainly NOT true on an individual basis.

 

[BlondeDocteur]

Superoxide, one question-- did the person who wrote you such a strong LOR from the US stand-alone children's hospital *not* affiliated with your Caribbean school know about your past difficulties? If so, it's absolutely essential for you to call them up and explain how you're getting so few interviews... but you're really interested in programs X, Y and Z (in addition to their own program as well).. in short, say what you have to so that person will make a few phone calls for you. You absolutely need to work your connections.

Otherwise, apply to FP programs using your same realistic criteria. After all, it's better to have a job than not.. and who knows? If you match into FP you might be able to transfer out to a peds program the next year.

 

[mig26x]

By all means possible try to get your application number to 40 programs at least and send to community programs in the middle of nowhere if you really want to do Peds, but this has to be done this week, alot of programs use nov as their deadline for applications to be received.

You need to make a desicion this weekend on what to do, if to apply to more peds program or apply to FM, talk to family about money etc.

IMPORTANT: DECIDE by this weekend!!!

 

[thinktank]

1st step: Borrow money from parents, siblings, friends, old classmates/roomates, neighbors, whoever you know. I am very sure you could get few hundreds of dollars from them. This is for your future.
If you failed this year, and would like to try again next year.. it might be more difficult since you won't be fresh graduates, etc.
I personally know a person (a foreign grad with just barely passing USMLE scores) who has been trying for the past 3 years (he has done lots of research and published in a few journals and every year he gets fewer interviews)! I would give/lend you money if I know you.

2nd: Apply to more programs: FM and peds (your aim was right: low to mid-tiers).

3rd: Ask whoever wrote your stellar LORs to make phone calls for you to get you some interviews and prematch if possible.

Best of luck to you.

 

[dragonfly99]

You have received some excellent advice above.
You really need to do three things - first one is make sure you pass the Step 2 CS, and the 2nd one is apply to more programs (would suggest fp and peds both). Are there no relatives or friends you could borrow a few hundred dollars from (for the applications)? What about your parents or siblings? This is really important b/c it will be easier to get in this year vs. next. The 3rd things is you need to work your connections. You need to talk with some of those folks who wrote you great recommendations (particularly the one(s) at the well known peds hospital); just tell them you haven't been getting many interviews, and could they call someone (hopefully at one or two of the places you've already applied). You can do this by telephone (better) or even email. I'll bet they are willing to help you out.

One thing that nobody has said here that I think is important. It's important not to panic. $150k is really not that much student loan debt, and you'll be able to pay that back pretty easily, eventually, once you get a residency. You need a plan for what you are going to do after graduation, for the next few months. Can you go live with a family member and then get some sort of job, any job, just so you'll have a little money?

I would suggest that you should sign up for FindAResident (at the NRMP web site). This is a place where they post open residency spots. I think it costs less than $100 to sign up for a year (it's either $35 or $70) if you are signed up for ERAS already. I have seen lots of open spots on there for family practice and IM and neuro, peds I have't looked but I suspect they come up.

I agree with peds being more competitive than fp. I'll bet you could get an fp spot, even if a peds one doesn't turn up. Also, if you want to treat kids and adolescents in the future and you do a fp residency, then you can do that. It's hard to find anyone practicing the full spectrum of fp any more...what ends up happening is people tailor their practices to do more of what they like most. Also, as posted above, if you ended up not liking fp, you could potentially transfer to peds later.

You could consider psychiatry too, and then later do a peds psych fellowship. My friend is an FMG from India, who did psych and then 1 or 2 years peds psych fellowship, and he got many job offers, even as a FMG.

 

[Hova2005]

Some great advice so far. You definitely need to
- increase your number of applications (no time to be humble, borrow from whoever will lend it to you)
- apply to FP programs as well
- network/contact the people who have worked with you and given you great recs, explain your situation, and see if they can help you out, make some phone calls on your behalf, etc.

Good luck.

 

[plainfacts]

I hope it works out for you superoxide. I think you should go for the safe route and apply to safe programs to make sure you get into residency.

It really is a disgrace for a modern society to bait people into going through 8 years of gruel studying and debt only the be stopped at residency and maybe never get a job as a doctor. Absolutely preposterous.

 

[dragonfly99]

I don't know that people are being baited. Maybe they are being baited by Caribbean medical schools, but I think the "buyer beware" caution definitely applies to those. The problem is that people are young and idealistic when they make these decisions. Some would be better served by picking a different profession, such as being totally out of health care, of being a physicial therapist, NP or PA, rather than getting into mongo debt and going to some med school out of the country.

But I still think the OP can get a residency. He needs to work his connections, apply to more programs, etc. He is just now graduating soon, so his goose isn't cooked...even for the next application cycle, if necessary, though it would be better to get in ASAP.

 

[superoxide]

This is a shot in the dark but i had a friend who actually applied to programs the old fashioned way--- by calling them up and asking for positions/vacancies. Of course this is applicable mostly to smaller programs, but from what I hear form you, you're not really that choosy. If you are in the US with unlimited landline calls, this could be a good option.

As for actually earning money, I had another friend who bartended, another one who worked as a caregiver, and another who worked in medical transcriptions to earn a few extra moolah. In this hard times, we have to do what we have to do.

For the professional advice, I think you also need to work on your priorities. If I were in your shoes, I would worry about passing CS now more than applying to programs.

Good luck!

Hi buckley,

You're right. I'm not choosy at all. It might be a little late in the game to start calling programs, since most of them have rejected me already. There are still 6 programs I haven't heard anything from, which might mean that I'm rejected adn they haven't told me or they are waiting for my MSPE and my CS score to decide whether or not to give me an interview. Someone else PM'ed me and offered me similar advice. I might just have to do that.

As for getting a job, I can't work in the U.S. I'm a Canadian citizen here in the U.S on a B1 visa, which doesn't allow me to work. Working under the table is an option, but I'm a little scared of getting caught and getting deported and never be allowed to return to this country. That would really be the end.

I've already retaken my CS. I took it on October 14th in Houston. Now I just have to sit and wait for the score, which will be released on December 3rd. I am confident that overall I did better than my first attempt, but I'm not going to say I passed thing for sure. One never knows.

Thanks for the reply.

 

[superoxide]

My advice would be to apply to FM programs...as many as possible. Then rank any peds programs at the top of your list, followed by any FM programs where you may get interviews. You have little choice at this point. Your odds of matching (with one interview) are low. You need to get that number up...

Cold calling programs works as well. I got an extra interview this way (although I called 40+ programs).

Donate blood, sperm, eggs, whatever, find the money. Call Warren Buffett. Get it done. Do you have any rich uncles? Sugar daddy/mama? Predatory lenders?

Good luck, and I do hope you win the lottery.

You're right. My options are limited. I'm hoping I get atleast 2-3 more peds interviews and hopdefully 3-4 FM interviews. That would give me a chance to actually match. As someone else suggested, I'm going to make some calls to programs next week.

I set aside ~$150 to apply to more programs. That should be about 20 programs. I've already applied to most of the low tier peds programs, so I'm going to use most of the $150 to apply to FM programs.

Thanks for the reply.

 

[superoxide]

If the guy really wants peds, there are a LOT of community peds programs of low competative nature that he should apply to before FM. Some peds are more difficult than some FM, but this is certainly NOT true on an individual basis.

Hi Miami_med

Yup, I *really* want to do peds. I'm on my FM rotation right now. It's nice, but I'd pick Peds anyday!

I've already applied to most of the low tier, IMG friendly community based programs and already been rejected by most of them. The only thing missing from my application is my CS score and my MSPE (which is in the ERAS post office, but won't be available till Nov 1st) Otherwise I have 4 great peds letters, Step 1 and CK done, transcripts etc.

Some cold calling next week might help.

Thanks for the reply.

 

[superoxide]

Superoxide, one question-- did the person who wrote you such a strong LOR from the US stand-alone children's hospital *not* affiliated with your Caribbean school know about your past difficulties? If so, it's absolutely essential for you to call them up and explain how you're getting so few interviews... but you're really interested in programs X, Y and Z (in addition to their own program as well).. in short, say what you have to so that person will make a few phone calls for you. You absolutely need to work your connections.

Otherwise, apply to FP programs using your same realistic criteria. After all, it's better to have a job than not.. and who knows? If you match into FP you might be able to transfer out to a peds program the next year.

I got 3 letters from faculty at the children's hospital. Two of the three didn't know about my past difficulties (i.e: Step 1 retake). The third faculty knew that I failed my CS. That's because I was on that rotation the day my CS score was released. I was really upset when I found out my failing score and they told me to take the rest of the day off, which I did. They didn't know about my Step 1 failure. I thought no need to bring that up. They wrote me the letter at the end of my rotation, knowing that I had already failed my CS.

I'm going to make some phonecalls and write some emails to see if they can help in any way. They went out of their way touting me at that hospital. I even had the chaplain rooting for me!

I'm going to start applying to FM programs. I'm working on my FM personal statement. I'm worried about one thing though: All my letters are from Pediatricians and all of them are Pediatrics focused. My FM rotation ends on Oct 31st. By the time my letter is up on ERAS it might be mid-late November. I wonder what FM programs will think of that (i.e: How come this applicant is applying to FM, but has no FM letters. How *all* his letters are for Peds?)🙄

Thanks for the reply.

 

[superoxide]

By all means possible try to get your application number to 40 programs at least and send to community programs in the middle of nowhere if you really want to do Peds, but this has to be done this week, alot of programs use nov as their deadline for applications to be received.

You need to make a desicion this weekend on what to do, if to apply to more peds program or apply to FM, talk to family about money etc.

IMPORTANT: DECIDE by this weekend!!!

I'm going to apply to 20 FM programs. That will bring my total applications to about 40 (21 peds and ~ 20 FM)

I'm working on my FM personal statement. I should have it done by early next week. I'll upload it onto ERAS and let's see what happens.

Thanks for the reply.

 

[superoxide]

1st step: Borrow money from parents, siblings, friends, old classmates/roomates, neighbors, whoever you know. I am very sure you could get few hundreds of dollars from them. This is for your future.
If you failed this year, and would like to try again next year.. it might be more difficult since you won't be fresh graduates, etc.
I personally know a person (a foreign grad with just barely passing USMLE scores) who has been trying for the past 3 years (he has done lots of research and published in a few journals and every year he gets fewer interviews)! I would give/lend you money if I know you.

2nd: Apply to more programs: FM and peds (your aim was right: low to mid-tiers).

3rd: Ask whoever wrote your stellar LORs to make phone calls for you to get you some interviews and prematch if possible.

Best of luck to you.

I have about $150 to apply to more programs, but not much more than that. I really want to match this year. I was supposed to match last year. What I mean is if I had passed Step 1 on my first try I would have been done by now and in a program already. Because of my Step 1 failure I didn't finish in time to match for 2008. So I'm already a year behind and don't want to fall any more behind than I already am. As you mentioned, it is getting tougher every year, which is not good at all for someone like me.

If someone offers me a prematch I'm most likely going to take it! I'm not expecting a prematch from a peds program, although the peds program I interviewed at hs offered prematches in the past. That possibility was discussed at the interview and they said that it depends from year to year and the number and quality of the applicants. I'm going to take that as a "No", but they did say that I should stay in touch with them about that possibility once I have a passing CS score.

Thanks for the reply.

 

[futuredo32]

I don't have any advice to offer, but I just wanted to wish you good luck, Superoxide.🙂

 

[superoxide]

You have received some excellent advice above.
You really need to do three things - first one is make sure you pass the Step 2 CS, and the 2nd one is apply to more programs (would suggest fp and peds both). Are there no relatives or friends you could borrow a few hundred dollars from (for the applications)? What about your parents or siblings? This is really important b/c it will be easier to get in this year vs. next. The 3rd things is you need to work your connections. You need to talk with some of those folks who wrote you great recommendations (particularly the one(s) at the well known peds hospital); just tell them you haven't been getting many interviews, and could they call someone (hopefully at one or two of the places you've already applied). You can do this by telephone (better) or even email. I'll bet they are willing to help you out.

One thing that nobody has said here that I think is important. It's important not to panic. $150k is really not that much student loan debt, and you'll be able to pay that back pretty easily, eventually, once you get a residency. You need a plan for what you are going to do after graduation, for the next few months. Can you go live with a family member and then get some sort of job, any job, just so you'll have a little money?

I would suggest that you should sign up for FindAResident (at the NRMP web site). This is a place where they post open residency spots. I think it costs less than $100 to sign up for a year (it's either $35 or $70) if you are signed up for ERAS already. I have seen lots of open spots on there for family practice and IM and neuro, peds I have't looked but I suspect they come up.

I agree with peds being more competitive than fp. I'll bet you could get an fp spot, even if a peds one doesn't turn up. Also, if you want to treat kids and adolescents in the future and you do a fp residency, then you can do that. It's hard to find anyone practicing the full spectrum of fp any more...what ends up happening is people tailor their practices to do more of what they like most. Also, as posted above, if you ended up not liking fp, you could potentially transfer to peds later.

You could consider psychiatry too, and then later do a peds psych fellowship. My friend is an FMG from India, who did psych and then 1 or 2 years peds psych fellowship, and he got many job offers, even as a FMG.

Hi dragonfly,

I had my CS retake on October 14th. Just waiting for my score, which will be released on December 3rd.

I'm going to apply to 20 FM programs this week. Let's see how that goes.

I'm also going to make some calls next week and see if some of the faculty can help me out with getting interviews.

You're right. $150,000 of debt isn't as high as many other students. But it is a lot of debt if you have graduated med school and have been unable to get a residency. That's what i'm worried about - getting a residency.

The scramble is an option, but it's brutal for IMGs, especially if you're not even an american citizen/PR....but it is option.

You're right about the flexibility of FM. One of the residents at the program I'm doing my FM rotation told me about one FM doc who just does OB and once the baby is born he takes over their care as their pediatrician and he is doing quite well.

I considered doing Child psych at one time. I did an elective in it as well. Although I enjoyed working with the kids, I thought a significant part of it was "social work" (placements, parental issues, legal issues, court dates etc etc) I think Child psych is a great field and there is a lot of need, but i don't think I can handle all the social stuff which goes with it. But I'm not in a position to be picky.🙁

Thanks for the reply.

 

[superoxide]

Some great advice so far. You definitely need to
- increase your number of applications (no time to be humble, borrow from whoever will lend it to you)
- apply to FP programs as well
- network/contact the people who have worked with you and given you great recs, explain your situation, and see if they can help you out, make some phone calls on your behalf, etc.

Good luck.

I'm going to apply to 20 FM programs this week. I'm hoping to get 3-4 FM interviews and maybe 1-2 more peds interviews once my hopefully passing CS score and MSPE are in.

Thanks for the reply.

 

[superoxide]

I hope it works out for you superoxide. I think you should go for the safe route and apply to safe programs to make sure you get into residency.

It really is a disgrace for a modern society to bait people into going through 8 years of gruel studying and debt only the be stopped at residency and maybe never get a job as a doctor. Absolutely preposterous.

I'm sticking to the safe route and applying to low tier FM programs. So far that hasn't worked for Peds. Let's see if FM is any different.

I started my med school journey back in May 2003. I did 8 months of premed courses, followed by 4 years of the MD program. When I started premed, things were very different. The number of applicants was *much* lower in 2003 than in 2008. I didn't think I would fail Step 1 or CS. So I don't blame my school at all. Did I know it would be an uphill battle getting a residency coming from a caribbean school? Absolutely. Did I expect that I would have all these problems along the way? Yes. Was I under the impression that I would be without a residency after all of this? NO!!! People kept saying, "Hey, you want to do Peds? You'll get it. There are so many spots. If not Peds, you can always do FM"

But things have changed since 2003. Neither Peds nor Fm is "easy" to get into anymore.

So I'm not blaming anyone but myself for my problems. I shouldn't have panicked the day before I took Step 1. I should have realized "Hey, i'm not ready. Maybe I need more time". But I didn't. I panicked. I was sick of stuyding and I decided I had had enough. But all that's done. Now I have to work with what I have. Hopefully this thing will have a happy ending.🙂

Thanks for replying

 

[superoxide]

I don't have any advice to offer, but I just wanted to wish you good luck, Superoxide.🙂

Thank you 🙂

 

[superoxide]

Hi Doowai,

Tried PM'ing you but it didn't go through, because your mailbox is full. Just wanted to say thanks for the great PM.

~ superoxide

 

[dragonfly99]

Another thing to consider if you just want a job for next year is to apply to medicine prelim years...but for that you would at least need a letter from a medicine doc. You probably don't want to go that route as it really sounds like you want to do peds.

Is there no chance for you to match in Canada? Is it even harder than the US although you are a citizen there?

Another thing to consider if you can't get a US residency right away is to try the UK or Australia. I'm sure it would be a big pain, because I guess they have their own exams, etc. I heard sometimes the UK will take people if they have extra openings/spots.

I actually still think that you can match. Failing step 1 the first time definitely hurts you, particularly as an IMG, and failing the CS too, though probably less so. I think you might be underestimating the importance of personal connections...perhaps you CAN get a prematch at this peds place that you interviewed. I would definitely recontact them, perhaps through a trusted intermediary/faculty member, once you get your passing CS score. Maybe they are just waiting on that and would consider prematching you after they confirm you passed.

Agree with your reasons for not doing psych...it is a lot of social work, as you noted.

 

[BabyPsychDoc]

Another thing to consider if you can't get a US residency right away is to try the UK or Australia. I'm sure it would be a big pain, because I guess they have their own exams, etc. I heard sometimes the UK will take people if they have extra openings/spots.

The only problem is that the UK does not have extra training slots anymore; and they recently changed not only their postgraduate medical training but also immigration rules, making it virtually impossible for somebody from outside the EU to get a training post. Hence, the massive influx of FMGs from subcontinent into the US. (When I was taking both computerised Steps in London, all my fellows USMLEers in the Prometric Centre🙂 were either from India, Pakistan or Sri Lanka).

Superoxide, hang on in there. When I was job hunting in England 3 years back, I had a pretty hard time initially, as I was five years out of medical school (USSR) and three years out of medical training (doing research in Cambridge). Few people gave a damn about my clever MSc project, my excellent test scores or my existence 🙄. BUT, I persisted, and things worked out for me. After all, you only need ONE job offer to have things work out - and you may have a very good chance with that peds programme where you did an audition rotation.

Good luck.

 

[BlondeDocteur]

You absolutely need to make use of these people who seemed to take a shine to you. I'm not sure what advice to give re: disclosure of your Step I failure, though if you interviewed at the program they reviewed your ERAS and saw it already.

Cold-calling pales in comparison to having an academic pediatrician pick up the phone in your stead.

 

[superoxide]

Another thing to consider if you just want a job for next year is to apply to medicine prelim years...but for that you would at least need a letter from a medicine doc. You probably don't want to go that route as it really sounds like you want to do peds.

Is there no chance for you to match in Canada? Is it even harder than the US although you are a citizen there?

Another thing to consider if you can't get a US residency right away is to try the UK or Australia. I'm sure it would be a big pain, because I guess they have their own exams, etc. I heard sometimes the UK will take people if they have extra openings/spots.

I actually still think that you can match. Failing step 1 the first time definitely hurts you, particularly as an IMG, and failing the CS too, though probably less so. I think you might be underestimating the importance of personal connections...perhaps you CAN get a prematch at this peds place that you interviewed. I would definitely recontact them, perhaps through a trusted intermediary/faculty member, once you get your passing CS score. Maybe they are just waiting on that and would consider prematching you after they confirm you passed.

Agree with your reasons for not doing psych...it is a lot of social work, as you noted.

Definitely don't want to do prelim and I don't have a medicine letter. I didn't get to spend a lot of time with the attending to ask him for one. Most of the time the students were just ignored and told to go home after noon lecture.

In order to apply for the Canadian match, all IMGs have to pass the MCCEE (Medical College of Canada Evaluating Exam). It is similar to USMLE Step 2 CK. I haven't taken that test yet. I'll take it in February/March. I will have to take that test regardless of whether I apply in Canada or the US, because I need a passing score on the MCCEE in order to qualify for the J1 visa. There have been a few graduates from my school in the last 1-2 years who have matched into programs in Canada (FM, Psych and even Neurosurgery). So it is a possibility, but since I haven't taken the MCCEE, I'm not qualified for the 1st round of the match. In Canada there are two rounds. The second round is kind of like the scramble where the spots that didn't fill in the first round are open to applicants. But it's not like the US scramble where you call and fax your applications in a hurry and try to get through someone. The second round works the same way as the first. You apply and if you are selected then you go for an interview and then (I believe) there is a second match result when you find out whether you matched or not.

I was going to take the MCCEE right around the same time I took CK, since the content is similar, but MCCEE costs around $1000 as well and as I have mentioned in previous posts I have been in considerable financial difficulty. $1000 is like a fortune to me. So I chose to take CK.

I'm going to contact two of the faculty members who I worked with at the children's hospital and ask them if they can talk to the PD to try to persuade him to offer me a prematch. At the end of each rotation, they both asked if there is anything they can do help me match at their program, I should contact them...so I will.😀 I think I'm going to wait till I get my hopefully passing CS score and then ask them to contact the PD. That way my application will be complete and they can make some sort of decision, whatever that might be.

Thanks.

 

[superoxide]

You absolutely need to make use of these people who seemed to take a shine to you. I'm not sure what advice to give re: disclosure of your Step I failure, though if you interviewed at the program they reviewed your ERAS and saw it already.

Cold-calling pales in comparison to having an academic pediatrician pick up the phone in your stead.

I'm going to call two faculty members at the hospital. Both of them are directors of their departments and I worked with them a lot. At the beginning of the rotation I told them that I would like an LOR at the end of the rotation and asked them what their expectations were of medical students. One of them gave a whole list of expectations (one of them was to do two 45 minute presentations)...which I did. Both presentations went really well. At the exit interview the director asked me to send him a copy of my presentation so that he could use it himself.😎

None of the faculty know about my Step 1 failure. Only one knows about my CS failure. When they asked me if I had passed my Step 1, I just said "yes", but didn't say that it was on my second attempt. The people I interviewed with were obviously aware of my difficulties with the boards (both Step 1 and CS). All three interviewers subtly brought it up, but didn't grill me on it and I was not uncomfortable talking about it at all. The PD mentioned that my scores will hurt me "a little bit" (it all depends on what his definition of "a little bit" is) but I had performed really well in my rotations there and had excellent clinical skills based on my LORs, so that will be taken into consideration as well. The Director of Med. Ed also brought it up. He's an ER physician and he started talking about one of his ER colleagues who had a lot of trouble passing the boards. I think his exact words were "He couldn't pass a standardized exam to save his life!", but clinically he was the best ER physician he knew and that he would be comfortable taking his own children to see him. I briefly talked about my failures and he said "Don't worry, You're fine" (This program requires you to pass it by the second attempt, which I had). So that made me feel a little better.

I'm clutching at straws, but I have my fingers crossed!

 

[dragonfly99]

superoxide,
All this (your peds rotation) sounds very positive. And there IS a difference between a doc saying he will write you a recommendation and one telling you to "let him know anything he can do for you" and asking to keep/get a copy of a presentation you made. So while you can't hang all your hopes on getting a spot at this one place, I think these folks may be willing and able to help you, whether or not you match at their program. I think your plan (wait 'til getting passing CS score, then recontact them) is a good plan. Then, if they decide they can't prematch you, and don't think you are very highly likely to match at their program, they may still know people at other (less picky) program(s) where they can help you get in. You can bet they are aware of which peds programs in their geographic region take IMGs, or sometimes have open spots and/or prematch people. And you can bet they know faculty at other institutions.

It sounds like you have been honest with everyone from the start also. This program where you did your peds rotation already knows about your test troubles, and still it sounds like they had some interest.

 

[BlondeDocteur]

I think I'm going to wait till I get my hopefully passing CS score and then ask them to contact the PD. That way my application will be complete and they can make some sort of decision, whatever that might be.

This.

Do NOT wait until December 3, when you find out if you've passed. Your ship will have long since sailed.

I agree with Dragonfly-- such sincere encouragement of your candidacy is rare and a very encouraging sign. Get those people in your corner, pronto! People do *not* say things like "tell me what we can do to get you a spot here" to just anyone!

When you contact them, reiterate how much you love their program, that it's your dream program, that you would so happily accept a prematch their heads would spin at the thought of it, etc. Then mention that you've been having trouble getting interviews, and that just to 'cover your bases' you'd really like to interview at peds programs X, Y, and Z... do they happen to know anyone there?

And so forth.

 

[superoxide]

EGAD!! Three more rejections today. All from the same state too. Hmmm...

 

[DarthNeurology]

I'm going to call two faculty members at the hospital. Both of them are directors of their departments and I worked with them a lot. At the beginning of the rotation I told them that I would like an LOR at the end of the rotation and asked them what their expectations were of medical students. One of them gave a whole list of expectations (one of them was to do two 45 minute presentations)...which I did. Both presentations went really well. At the exit interview the director asked me to send him a copy of my presentation so that he could use it himself.😎

None of the faculty know about my Step 1 failure. Only one knows about my CS failure. When they asked me if I had passed my Step 1, I just said "yes", but didn't say that it was on my second attempt. The people I interviewed with were obviously aware of my difficulties with the boards (both Step 1 and CS). All three interviewers subtly brought it up, but didn't grill me on it and I was not uncomfortable talking about it at all. The PD mentioned that my scores will hurt me "a little bit" (it all depends on what his definition of "a little bit" is) but I had performed really well in my rotations there and had excellent clinical skills based on my LORs, so that will be taken into consideration as well. The Director of Med. Ed also brought it up. He's an ER physician and he started talking about one of his ER colleagues who had a lot of trouble passing the boards. I think his exact words were "He couldn't pass a standardized exam to save his life!", but clinically he was the best ER physician he knew and that he would be comfortable taking his own children to see him. I briefly talked about my failures and he said "Don't worry, You're fine" (This program requires you to pass it by the second attempt, which I had). So that made me feel a little better.

I'm clutching at straws, but I have my fingers crossed!

I think you would need to explain to any faculty that you call about helping you get a residency spot that you failed Step 1 as they could then say why maybe you could improve your knowledge if you are dedicated to becoming a doctor. (I am assuming you are calling faculty to have them "go to bat" for you). If they don't know your story then they can't help you out.

Personally, I think that calling faculty to call their "friends" to help you get a residency spot won't work. Not that your faculty where you did a rotation don't like you, but, in general that is not how residency application works. Most pediatric programs you apply to won't personally know your hospital or the faculty where you did Peds, and hence won't be particularly swayed by either the LOR or a phone call.

In the end, the pediatric PD has to be happy with YOU and how you will fit into their program, unless the PD owes somebody a big favor they aren't really under much pressure to accept you. Therefore, I would disagree that this is a connections problem, . . . doctor to doctor phone calls are made for favors i.e. taking call, helping residents who's program shutdown, but at the student level I don't think calling a faculty where you did a rotation to help you get a spot will help. Mostly because the help they want to give you they already have, i.e. LORs etc . . . Now if you applied to their program then that connection would help as it is not a sort of 6 degree to Kevin Bacon sort of thing.

Asking faculty to put pressure on a pediatric program in another hospital is unwelcomed pressure that most PDs don't like and seems a little unprofessional to me in a way.

 

[DarthNeurology]

I'm going to contact two of the faculty members who I worked with at the children's hospital and ask them if they can talk to the PD to try to persuade him to offer me a prematch. At the end of each rotation, they both asked if there is anything they can do help me match at their program, I should contact them...so I will.😀 I think I'm going to wait till I get my hopefully passing CS score and then ask them to contact the PD. That way my application will be complete and they can make some sort of decision, whatever that might be.

Thanks.

Again, I doubt this would work as nobody at the faculty level would put pressure on somebody else at the faculty level at the request of a student (unless you saved their first born child or helped them win a noble prize!). It could backfire and make you look bad. It is OK to have these faculty help you at their own program though. Unfortunately for applicants, the residency application process for pediatric residency has become more competitive and beggars can't be choosers.

 

[BlondeDocteur]

Darth, I'm sorry, but you're completely wrong here. Academic pediatricians at a stand-alone children's hospital *will* be decently well-known, and their opinion counts enormously. I can't tell you how many times I've seen a department chair or other academic attending make calls and voila! interview offers arrive next week.

Our differences of opinion on this matter will be entirely due to our respective medical school environments-- you carib, me snotty top 10. I'm telling you it's the way things really work.

 

[Winged Scapula]

Blonde Docteur is right.

This is the way things work.

Obviously it works best if the faculty interaction exists between two physicians who know or know of each other, but this is a VERY common factor in the residency interview process. It is also very common post-interview for faculty members to pick up the phone and talk to each other about candidates...a conversation which can make or break whatever presumed rank/standing you had at the program before the call. Hell, I'm not famous but have received a few of these phone calls myself.

It doesn't even have to be at snooty Top 10 programs either.😉

 

[DarthNeurology]

Darth, I'm sorry, but you're completely wrong here. Academic pediatricians at a stand-alone children's hospital *will* be decently well-known, and their opinion counts enormously. I can't tell you how many times I've seen a department chair or other academic attending make calls and voila! interview offers arrive next week.

Our differences of opinion on this matter will be entirely due to our respective medical school environments-- you carib, me snotty top 10. I'm telling you it's the way things really work.

I have plenty of friends inside academic medicine, people involved with the residency selection process. I have never tapped them for assistance in getting such and such an interview because it seemed unethical, unprofessional and pushy. There are plenty of PDs who feel likewise. But maybe Blonde Docteur has a point if you don't have any interview at all, that is sad and I feel for the OP.

APD said on one thread that in only one situation he/she reversed a decision not to interview . . . the case here is reversing a no-interview decision which seems to happen rarely anyhow.

Why do you think I'm a carib??

 

[DarthNeurology]

Blonde Docteur is right.

This is the way things work.

Obviously it works best if the faculty interaction exists between two physicians who know or know of each other, but this is a VERY common factor in the residency interview process. It is also very common post-interview for faculty members to pick up the phone and talk to each other about candidates...a conversation which can make or break whatever presumed rank/standing you had at the program before the call. Hell, I'm not famous but have received a few of these phone calls myself.

It doesn't even have to be at snooty Top 10 programs either.😉

Chances are your LOR writer is unknown to most. Even most "free standng children hospitals" have a ton of pediatricians nobody has ever heard of, and thus likely won't get a lot of help outside of that hospital. But if the attending is so well known then the PD should have called up their buddy after reading the LOR. Faculty members talking about candidates is nothing new, but the thread was about:

Reversing a no-interview decision by using an attending you know to do this. Even if you do get an interview, the PD may reject you anyways. I suggest that somebody ask APD if ever in her/his time as a PD that they reversed a decision to interview and accepted the candidate for residency (i.e. ranked highly.)

Winged can comment if her program ever rejected someone for interview and then a bigtime surgeon made her program interview this person and if that helped would be interesting. I bet it never happened.

I would be afraid to try something like this as you may get a worthless interview.

Actually maybe not a bad idea, I got an interview rejection that didn't sit well and I should have got an attending to order them to take me, kick the slimy PD out, and make me chief residency after PGY-1 too for good measure just for having the nerve to reject me, I'll show 'em I've got friends in high places to bail me out! Too bad I didn't know about that little residency trick.

The OP needs to apply to more programs, really. I don't think using connections to reverse a no-interview would help all that much. Obviously, the OP should try to get a residency at the hospital where the attendings who like the OP work. They could be consulted about residency applying strategies, but I don't think asking them to "make the PD at Uptown Hospital give me a prematch." will work.*



*Based on my past enduring proclivity to oppose Winged's generally amusing albeit skewed view of the world at every possible juncture . . . she may be correct in the end, but I must post my counter point!

 

[BabyPsychDoc]

I have plenty of friends inside academic medicine, people involved with the residency selection process. I have never tapped them for assistance in getting such and such an interview because it seemed unethical, unprofessional and pushy. There are plenty of PDs who feel likewise. But maybe Blonde Docteur has a point if you don't have any interview at all, that is sad and I feel for the OP.

APD said on one thread that in only one situation he/she reversed a decision not to interview . . . the case here is reversing a no-interview decision which seems to happen rarely anyhow.

Why do you think I'm a carib??

DN, you are a smart and generally well informed poster. However, some things you may not be qualified to judge and comment on; especially in such an arrogant and condescending manner.

 

[Winged Scapula]

Darth,

I'm glad that my "skewed view" provides you with some amusement. I would counter that your view is just as, if not more, skewed than my own. But I'm sure with your years of being on residency selection committees that your experience trumps that of mine.🙄

No one is suggesting that faculty members bully PDs into interviewing or ranking unacceptable candidates. You may live in a fairy tale and unicorn world where all applicants are thoroughly reviewed with attention to minute detail, but the fact is that programs have to filter applications and applicants who might not pass the filter or who look better in person than on paper will not be noticed or invited to interview.

These are the candidates for which a phone call might be helpful. "Hey Jim, we have an excellent student here who has had some trouble getting interviews and we're not sure why. I've worked with him closely during his rotation and was quite impressed. Perhaps you could look through your applications and provide us some feedback on why he was rejected or even reconsider your decision? BTW, how are the wife and kids?" There is no bullying or pressure other than a phone conversation like the one above.

I've never felt forced to rank an applicant because some bigwig surgeon called (because they would never ask that), but we have interviewed people when asked to. Sometimes its a courtesy interview and other times you realize the candidate does have something to offer that you didn't notice on initial review. The corollary is that we've also NOT invited people to interview based on phone calls where faculty felt able to speak more freely than they would in their LOR.

This is the way the real world works - in and outside of medicine. Who you know and calling in favors is rampant. What you choose to do with those requests is up to you but I'd venture most people would at least review the applicant when asked.

Please feel free to be amused at my skewed view on this topic.

 

[dragonfly99]

I respectfully disagree 100% with Darth on this.
You NEED to use your connections.
It's not a matter of being "pushy" or "forcing" anyone to interview the OP. But faculty calling other faculty happens all the time and it DOES get people interviews. I personally got a fellowship interview this way, after the place had already sent me a rejection. So it does happen, and it actually happens pretty commonly. It's not considered pushy to have faculty contact other faculty. If the OP was personally calling the program every other day, THAT would be pushy.

I agree that faculty calling other faculty/PD's at other institutions on an applicant's behalf happens commonly, esp. at "top 10 snooty" academic medical centers, one of which I attended. I didn't know this when I was going through the residency application process, but later found out that LOTS of students had had department chairs or full professors making phone calls on their behalf. I never did it for medicine residency b/c I didn't know folks did that, and also it's not that hard to match in medicine if you are a US grad. However, in terms of fellowship applications, I did have some faculty call and/or email programs - usually it was places I was invited to interview or had already interviewed, but like I mentioned above I did it with one place that I got rejected but wanted to interview, and they reversed their decision. I am sure it was because the person knew the faculty member who called on my behalf.

Also, Darth was saying they "would have called" your faculty member after reading the LOR if they knew him/her. However, I think the point is with the OP the programs probably are not even reading any of his application, including the LOR's, because he's probably getting screened out by his having failed the Step 1. However, if a PD received a phone call from a faculty member he/she knows, just asking him to consider the OP, then the application (along with the solid LOR's) might actually get read, and if he's lucky then he might get an interview.

In the applications process you have to use whatever you have. If that's research publications, an AOA rank, whatever. If it's very strong LOR's and faculty who like you, then use that.

 

[LADoc00]

I think the OP is screwed. I think heshe will have a hard time matching anywhere in anything. And I think this points to the fatal flaw in the entire US style med grad training scheme....

think about, you are out 150000USD, for what? YOU HAVE NOTHING TO SHOW FOR IT. You just got taken in a high stakes card game and lost not only 150Gs but 4+ years of your life.

Assuming you fail to match, which seems likely, you literally have no way to pay off that debt. It is completely UNSECURED assuming you arent hiding an asset horde somewhere.

Tens of thousands dare I say HUNDREDS of thousands of students are in same boat. The situation is the housing crisisx100 levels of absurdity because none of these kids had any collateral! Now their lives are wrecked, they are hopelessly broke and have no skills outside of niche areas.

Enter the "smart people"..what if we, as working physicians who know the fail boat we are seeing set sail, bet AGAINST students paying off their loans as a derivative bet on Wall Street similar to how people made billions when the housing derivative market fell apart? We'd be rich, this is a no brainer.

Back on topic, you are screwed IMHO. Your loans will begin ticking soon after you graduate, you will take some credit hits, worse case scenario you cant rent a decent apartment because of your sub 500 credit score, your wages are garnished because you are behind on your loans and you are still shelling mad $$ to a system that has essentially already enslaved you.

 

[DarthNeurology]

I respectfully disagree 100% with Darth on this.
You NEED to use your connections.
It's not a matter of being "pushy" or "forcing" anyone to interview the OP. But faculty calling other faculty happens all the time and it DOES get people interviews. I personally got a fellowship interview this way, after the place had already sent me a rejection. So it does happen, and it actually happens pretty commonly. It's not considered pushy to have faculty contact other faculty. If the OP was personally calling the program every other day, THAT would be pushy.

I agree that faculty calling other faculty/PD's at other institutions on an applicant's behalf happens commonly, esp. at "top 10 snooty" academic medical centers, one of which I attended. I didn't know this when I was going through the residency application process, but later found out that LOTS of students had had department chairs or full professors making phone calls on their behalf. I never did it for medicine residency b/c I didn't know folks did that, and also it's not that hard to match in medicine if you are a US grad. However, in terms of fellowship applications, I did have some faculty call and/or email programs - usually it was places I was invited to interview or had already interviewed, but like I mentioned above I did it with one place that I got rejected but wanted to interview, and they reversed their decision. I am sure it was because the person knew the faculty member who called on my behalf.

Also, Darth was saying they "would have called" your faculty member after reading the LOR if they knew him/her. However, I think the point is with the OP the programs probably are not even reading any of his application, including the LOR's, because he's probably getting screened out by his having failed the Step 1. However, if a PD received a phone call from a faculty member he/she knows, just asking him to consider the OP, then the application (along with the solid LOR's) might actually get read, and if he's lucky then he might get an interview.

In the applications process you have to use whatever you have. If that's research publications, an AOA rank, whatever. If it's very strong LOR's and faculty who like you, then use that.

Well, I feel that I really got "schooled" on using your connections. I know that at some schools you have to be in with say the orthopedic chairman to get a residency interview at some places, and that if you don't have his blessing you are "screwed." It all seemed sort of mafioso and godfather like to me.

 

[superoxide]

Agreed. I'm definitely going to disclose my Step 1 failure to them when calling them. The reason I didn't disclose it before is because (a) it never came up and (b) I didn't want that information to influence what they thought of me. But now I'm going to tell them the whole story so that they can present my whole case to whomever they call.

I'm not sure what the PD *really* thinks of me. I have met him several times over the 4 months I was at that hospital. He has always been extremely nice to me (but he's like that to everyone). All the residents have only good things to say about him. A few residents told me that the only reason they ranked this program #1 is because of the PD.

I have sat down with the PD to two occasions (The first time was right after I found out I failed CS and the second was during my residency interview) Both time he was extremely nice to me. During the first meeting he actually felt bad for me that I failed CS. His exact words were something like "You got screwed man!" I asked him if I would still qualify to get an interview at his program and he said ofcourse. I also mentioned at that visit what the attendings I worked with thought of me and he was very impressed. The same thing during the residency interview. There was actually another applicant with me on that day. My last day of rotations at that hospital was in early October, but their first interview date was in late November. So I asked them if they would interview me before I left the city and they set up a special interview day for me and this other applicant who was in a similar situation as me (except that she had never done any electives at the hospital). During the interview day the PD was very friendly to both of us, but with me I felt that he was a little more "comfortable"....like "Hey, superoxide! (gives big pat on the pat) Probably doesn't mean anything...but I think he's comfortable with me.

The residents at the lunch also liked me. One was a senior resident and the other was an intern. I had worked with both of them over the 4 months I was there on different services. Both of them said how they wish I match there and gave me their email addresses to stay in touch with them (without me even asking for it). As I said before, the interview went really well. So the *only* thing that is going to affect my chances of matching there are my board scores. Everything else looks really, really good. What I'm basically trying to say is that I think I would be a good fit at this hospital.

Thanks for your reply.

I think you would need to explain to any faculty that you call about helping you get a residency spot that you failed Step 1 as they could then say why maybe you could improve your knowledge if you are dedicated to becoming a doctor. (I am assuming you are calling faculty to have them "go to bat" for you). If they don't know your story then they can't help you out.

Personally, I think that calling faculty to call their "friends" to help you get a residency spot won't work. Not that your faculty where you did a rotation don't like you, but, in general that is not how residency application works. Most pediatric programs you apply to won't personally know your hospital or the faculty where you did Peds, and hence won't be particularly swayed by either the LOR or a phone call.

In the end, the pediatric PD has to be happy with YOU and how you will fit into their program, unless the PD owes somebody a big favor they aren't really under much pressure to accept you. Therefore, I would disagree that this is a connections problem, . . . doctor to doctor phone calls are made for favors i.e. taking call, helping residents who's program shutdown, but at the student level I don't think calling a faculty where you did a rotation to help you get a spot will help. Mostly because the help they want to give you they already have, i.e. LORs etc . . . Now if you applied to their program then that connection would help as it is not a sort of 6 degree to Kevin Bacon sort of thing.

Asking faculty to put pressure on a pediatric program in another hospital is unwelcomed pressure that most PDs don't like and seems a little unprofessional to me in a way.

 

[superoxide]

Hi Darth,

I agree with you about me getting an interview somewhere and then get rejected by them anyway. I'm guessing it doesn't take a whole lot of time and effort to add one more interviewee to the roster on interview day. The only reason even this hospital interviewed me was because I did a rotation there. If I had been just a random applicant, there is no way I would have been selected for interview even though I meet their criteria (They require that you pass each step within 2 attempts and they accept the J1 visa) I know that because I have applied to more inferior programs than this one with a much lower "minimum requirement" threshold (eg: no minimum score, no limits on attempts, no U.S clinical experience required) and I have been rejected by all those programs as well.

Chances are your LOR writer is unknown to most. Even most "free standng children hospitals" have a ton of pediatricians nobody has ever heard of, and thus likely won't get a lot of help outside of that hospital. But if the attending is so well known then the PD should have called up their buddy after reading the LOR. Faculty members talking about candidates is nothing new, but the thread was about:

Reversing a no-interview decision by using an attending you know to do this. Even if you do get an interview, the PD may reject you anyways. I suggest that somebody ask APD if ever in her/his time as a PD that they reversed a decision to interview and accepted the candidate for residency (i.e. ranked highly.)

Winged can comment if her program ever rejected someone for interview and then a bigtime surgeon made her program interview this person and if that helped would be interesting. I bet it never happened.

I would be afraid to try something like this as you may get a worthless interview.

Actually maybe not a bad idea, I got an interview rejection that didn't sit well and I should have got an attending to order them to take me, kick the slimy PD out, and make me chief residency after PGY-1 too for good measure just for having the nerve to reject me, I'll show 'em I've got friends in high places to bail me out! Too bad I didn't know about that little residency trick.

The OP needs to apply to more programs, really. I don't think using connections to reverse a no-interview would help all that much. Obviously, the OP should try to get a residency at the hospital where the attendings who like the OP work. They could be consulted about residency applying strategies, but I don't think asking them to "make the PD at Uptown Hospital give me a prematch." will work.*



*Based on my past enduring proclivity to oppose Winged's generally amusing albeit skewed view of the world at every possible juncture . . . she may be correct in the end, but I must post my counter point!

 

[DarthNeurology]

I have sat down with the PD to two occasions (The first time was right after I found out I failed CS and the second was during my residency interview) Both time he was extremely nice to me. During the first meeting he actually felt bad for me that I failed CS. His exact words were something like "You got screwed man!" I asked him if I would still qualify to get an interview at his program and he said ofcourse. I also mentioned at that visit what the attendings I worked with thought of me and he was very impressed. The same thing during the residency interview. There was actually another applicant with me on that day. My last day of rotations at that hospital was in early October, but their first interview date was in late November. So I asked them if they would interview me before I left the city and they set up a special interview day for me and this other applicant who was in a similar situation as me (except that she had never done any electives at the hospital). During the interview day the PD was very friendly to both of us, but with me I felt that he was a little more "comfortable"....like "Hey, superoxide! (gives big pat on the pat) Probably doesn't mean anything...but I think he's comfortable with me.

The residents at the lunch also liked me. One was a senior resident and the other was an intern. I had worked with both of them over the 4 months I was there on different services. Both of them said how they wish I match there and gave me their email addresses to stay in touch with them (without me even asking for it). As I said before, the interview went really well. So the *only* thing that is going to affect my chances of matching there are my board scores. Everything else looks really, really good. What I'm basically trying to say is that I think I would be a good fit at this hospital.

Thanks for your reply.

It seems to me like you are golden with the PD who likes you, especially patting you on the shoulder and being happy to see you, also with the comments that attendings were "impressed" this is so much better than just being "solid." Honestly, if I were you I would email those residents back, they have input into the whole process and perhaps want to see if you stay in touch. PDs are looking for people who are interested and believe in their residency program and I would email the residents saying how impressed you are with the program and would like to go there. All it takes is one program to match at and this seems like a place that is comfortable with you which is what it is all about.

Residents often offer their email addresses to applicants, and if you stay in touch I think it helps, i.e. shows that you are interested in their program. Definitely stay in touch with the PD as well, and it wouldn't hurt your chances if you asked for a prematch, nicely of course like along the lines of "If I was able to even prematch at your program I would be very satisified, but will also rank your program highly going through the match." This PD would love this even if he/she doesn't give you the prematch but ranks you highly *because* the PD has already shown you a lot of "love" and this would be just reciprocating in my mind.

I think it would also be productive to perhaps ask this PD about the general competitiveness of peds residency and why you haven't gotten much interviews and then after whatever he/she says, i.e. "Don't worry superoxide you will match your great" you could ask about help getting interviews. I only mention this as I got my booty handed to me on this thread concerning using your connections and maybe this would work.