In a pickle

[Mx300]

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Hi guys,

AMG (MD) here and I was wondering if someone has any idea how likely it is to match to path with a CS failure, and how would I find out without emailing the PD? Long story short, dont have a pass in time for rank list (I am forking over the cash and am taking a course, hoping to pass before graduation). I interviewed at one place who outright said they wont rank with a fail. I have 6 more places that are mid-low tier programs that did not give me this information during the interview.

My school thinks I am going to match. I am a bit more skeptical, and I am wanting to prepare for SOAP. I am also uncomfortable with the possibility of SOAPing into a path spot, so I am considering FM. Maybe my assumptions are unfounded, if someone can give their perspective that would be great. After interviewing at path programs I noticed how intimate the programs were, the difference in the teaching quality and the culture of the residents. With it being such a long residency and the reputation of the program affecting job placement I feel uncomfortable with accepting a position during SOAP (if it is possible). I really do enjoy path and I think I would be happy in it, but I also think I would be happy in FM (recent revelation).

thanks, any advise or info would be appreciated.

 

[SpaghettiMeatballs]

Stick with path, SOAP-in if you have to, it will be well worth it. Look up previous years' unfilled positions, sometimes big names go unfilled. More than the program its also what you are willing to put in. You'd be surprised how many small name trainees end up in big name fellowships.
FM has a whole set of problems--you are a glorified NP, and maybe not even glorified down the road.

 

[Unty]

I didn't bother to read your post. I just read that you're an AMG with a CS failure and chances to match.

You will get in somewhere. Apply to mid tier programs with some upper tier programs sprinkled in there and you will get in somewhere. It's not very hard to get in. Aim high and if you can't get in the program of your dreams so be it and move on with your life.

If I was a Path PD, I would care less about a CS failure unless the failure was because you can't speak English, you touched patients inappropriately during the exam (you're a weirdo or a psychopath).

Good luck.

Edit: OK I just saw that you are interested in FM (family medicine?) as well. I never understood how someone could be truly interested in both FM or Pathology. Completely different fields obviously. Either you like rounding and clinically managing patients or you like sitting at a scope all day, grossing specimens or looking at frozens. You really need to find out what you are truly interested in because I don't see how someone can be passionate about managing diabetes and hypertension and at the same time be interested at looking GI and prostate biopsies all day.

You will be having to do this for the rest of your life and deal with all the **** that comes with it. I don't know any Path residents who would ever be happy switching to clinical medicine.

I would think long and hard about your career decision first.

 

[Mx300]

I didn't bother to read your post. I just read that you're an AMG with a CS failure and chances to match.

You will get in somewhere. Apply to mid tier programs with some upper tier programs sprinkled in there and you will get in somewhere. It's not very hard to get in. Aim high and if you can't get in the program of your dreams so be it and move on with your life.

If I was a Path PD, I would care less about a CS failure unless the failure was because you can't speak English, you touched patients inappropriately during the exam (you're a weirdo or a psychopath).

Good luck.

Edit: OK I just saw that you are interested in FM (family medicine?) as well. I never understood how someone could be truly interested in both FM or Pathology. Completely different fields obviously. Either you like rounding and clinically managing patients or you like sitting at a scope all day, grossing specimens or looking at frozens. You really need to find out what you are truly interested in because I don't see how someone can be passionate about managing diabetes and hypertension and at the same time be interested at looking GI and prostate biopsies all day.

You will be having to do this for the rest of your life and deal with all the **** that comes with it. I don't know any Path residents who would ever be happy switching to clinical medicine.

I would think long and hard about your career decision first.

So my real question is whether I can match with a fail when rank list are due. I will have to retake in Jan and wont have it back til march. I already applied and received 7 interviews at mostly mid-tiers a couple of low-tiers. Im someone who has had alot of issues picking a specialty in med school. I have a wide variety of interests, both in medicine and in life. I think there are pros and cons to both path and FM in drastically different areas but both appeal to me.

Also your correct, Im not really passionate about anything in medicine. This has been a recent realization. I find certain things pretty interesting but I have been able to find things interesting in a variety of specialties. Which leads me to consider FM if I cant match path, and my gut is telling me not to SOAP path.

 

[Apollyon]

When I was at Duke (for EM), I ran into a guy that was 3 years ahead of me in military college. He started out in Path, did 2 years I think, then went into FM, and didn't look back.

 

[Euchromatin]

I'm not sure if you'll get a position in the match or not. The program I was in didn't automatically exclude candidates who had failed CS, but it is a red flag. I think we did rank one person who had failed CS one year I was involved, but I will admit they were quite far down our list (although largely for other reasons not directly related to the CS fail, and we ended up matching with candidates that were all higher). If you interview well and have good scores and LORS, etc. otherwise, you very well may match at one of the mid/lower tier places.

If you don't match, I would seriously consider doing pathology SOAP. I looked up the 2018 match data and there were 28 slots from 20 path programs in the SOAP (and even more in 2017 - there were 54 positions from 31 programs). I'm not sure how to look up exactly which programs they were for those years; you might need to be a current participant to get the data organized in that fashion. I do recall seeing unfilled slots from some of the bigger name academic places come up in the SOAP more often than one would expect.

 

[terriermed]

The question is whether the CS failure is due to poor communication skills, or truly a lack of clinical skills. Program directors may not be able to tell, and may take this as a red flag (probably program dependent), but will probably be more forgiving in pathology than any other field. If due to communication skills, this may be an issue for you going forward regardless of what field you choose.

The irony, of course, is that failing the clinical skills portion is making you think about ditching pathology - a field where your clinical skills have an negligible impact on your job performance - for family med - a field where clinical skills are your most necessary asset. Sounds like FM might not be a good fit for you anyways. If path is what you WANT to do, then just go for it.

 

[Mx300]

The question is whether the CS failure is due to poor communication skills, or truly a lack of clinical skills. Program directors may not be able to tell, and may take this as a red flag (probably program dependent), but will probably be more forgiving in pathology than any other field. If due to communication skills, this may be an issue for you going forward regardless of what field you choose.

The irony, of course, is that failing the clinical skills portion is making you think about ditching pathology - a field where your clinical skills have an negligible impact on your job performance - for family med - a field where clinical skills are your most necessary asset. Sounds like FM might not be a good fit for you anyways. If path is what you WANT to do, then just go for it.

My communication skills are not the issue. And I think we all know that CS is not testing what it claims to be testing. I had my first fail when I applied so all the programs that interviewed me knew about it. They were very shocked when they met me and commented about how it didnt make sense (assuming this test is testing what it claims to). I had a PD say to my face that CS was the stupidest test she ever took. The issue is that I obviously dont know how they are grading and what they are looking for. Which is why Im taking a course, and after going through some of the material the course sent me ahead of time I can see ares where I went wrong. This test is incredibly algorithmic and my approach was to individualize each patient encounter which was obviously the wrong strategy. I think my downfall was being to confident in my clinical skills. I never failed an OSCE and I received pretty good feedback in 3rd year. I was able to develop strong rapports with patients especially adolescents and the elderly. Because of my overconfidence I felt like I was prepared and I didnt study first aid or use any outside resources.

I also had family issues throughout medical school that culminated during third year so I think my judgement was clouded when it came time to choosing a specialty. I dont think path is a wrong choice but I find aspects of both specialties appealing and I find it surprising that people are so black and white about the issue.