M4 Away rotations and application improvement?

[allseasons]

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Hi guys, I am an M4 at the beginning of my year. We start rotations in mid June, and I wanted some feedback for what I should do next. The problem I am running into online is that most questions and interest in rad onc is pre-2019, when the field was far more competitive. I am not entirely sure how strong my application is for the current field.

I am at a T20 (between 10-20). I have 7 publications, all in the field of Surgery. I have a few leadership positions. My background is Data Science and CS. I haven't really done anything wildly impressive.

Just last month, I decided I wanted to pursue Rad Onc. I have a Rad Onc rotation scheduled in July. I'm expecting/hoping for a step score between 250-260 based on my current performance. My Rad Onc PD says there's no need for me to do away rotations, and seems to lean slightly against them. Most of the residents I talk to advise away rotations though. I have spent my entire life in a major West Coast city until med school, and I have spent med school in a major East Coast city. I hope to match to either coast.

From now through September, what should I do to match the best Rad Onc possible? And how competitive do you think I am now? Do you advise away rotations?

 

[Ray D. Ayshun]

Hi guys, I am an M4 at the beginning of my year. We start rotations in mid June, and I wanted some feedback for what I should do next. The problem I am running into online is that most questions and interest in rad onc is pre-2019, when the field was far more competitive. I am not entirely sure how strong my application is for the current field.

I am at a T20 (between 10-20). I have 6 publications, all in the field of Surgery. I created a medical product that I pitched at multiple competitions and completed the NSF i-CORPS regional program, currently in Nationals. I have a few leadership positions. My background is Data Science and CS. I haven't really done anything wildly impressive.

Just last month, I decided I wanted to pursue Rad Onc. I have a Rad Onc rotation scheduled in July. I'm expecting/hoping for a step score between 250-260 based on my current performance. My Rad Onc PD says there's no need for me to do away rotations, and seems to lean slightly against them. Most of the residents I talk to advise away rotations though. I have spent my entire life in a major East Coast city until med school, and I have spent med school in a major West Coast city. I hope to match to either coast.

From now through September, what should I do to match the best Rad Onc possible? And how competitive do you think I am now? Do you advise away rotations?

if there's a place you'd like to do residency, you should do a rotation there.

 

[udrag14]

if there's a place you'd like to do residency, you should do a rotation there.

Dual edged sword here. If you do well, you will match 100 percent. If you do okay or don't fit, you won't match.

Sometimes doing an away rotation in the region and getting good letters is more powerful.

 

[allseasons]

Dual edged sword here. If you do well, you will match 100 percent. If you do okay or don't fit, you won't match.

Sometimes doing an away rotation in the region and getting good letters is more powerful.

Is it worth doing an away rotation outside of Harvard/Sloan/Anderson that's in the region I want to match? It's a little late, so I'm not sure if I can get an away at one of those three.

 

[udrag14]

Is it worth doing an away rotation outside of Harvard/Sloan/Anderson that's in the region I want to match? It's a little late, so I'm not sure if I can get an away at one of those three.

Some of the top tier places have you with 1 attending the entire rotation so it can be hit or miss. You dont need to rotate at a top tier place.

 

[drowsy12]

Be friendly in your interviews and you’ll match well, without needing aways. You have a strong application.

 

[yesmaster]

If you’re the type of student that does well with rotations, I would do rotations. I would not bother with rotating at any programs in the middle of the country if you want to be on the east or west coast. Personally I would aim to match at a program in the location that you’d like to settle down in, if you have any interest in community/private practice. In academics I believe going to the best residency allows you to go anywhere regardless of the residency’s location.

 

[pikachu]

Hi guys, I am an M4 at the beginning of my year. We start rotations in mid June, and I wanted some feedback for what I should do next. The problem I am running into online is that most questions and interest in rad onc is pre-2019, when the field was far more competitive. I am not entirely sure how strong my application is for the current field.

I am at a T20 (between 10-20). I have 7 publications, all in the field of Surgery. I have a few leadership positions. My background is Data Science and CS. I haven't really done anything wildly impressive.

Just last month, I decided I wanted to pursue Rad Onc. I have a Rad Onc rotation scheduled in July. I'm expecting/hoping for a step score between 250-260 based on my current performance. My Rad Onc PD says there's no need for me to do away rotations, and seems to lean slightly against them. Most of the residents I talk to advise away rotations though. I have spent my entire life in a major West Coast city until med school, and I have spent med school in a major East Coast city. I hope to match to either coast.

From now through September, what should I do to match the best Rad Onc possible? And how competitive do you think I am now? Do you advise away rotations?

If you are able to do it and interested, I think it's a good idea to experience clinic/culture in another department, especially since so many interview days are now online. I don't think it has to be one of the 'big three'. Some PDs may also see it as a sign of interest in the field which can help your application and distinguish you from the legions of students who are applying as a back up to rads or derm or what have you. But in the current climate, you will probably match regardless.

 

[ivybme]

Recent grad and current resident. I did a total of 3 away rotations, 2 on one coast and 1 on the other. This really helped unlock interviews on both coasts for me, as I didn't have many geographic ties. The most important thing is to take a hard look at yourself and figure out whether you think an away rotation is going to help you or hurt you (aka, are you a people person? did you get stellar reviews on your core rotations?). I think you miss 100% of the shots you don't take, so if you really want to be at a place, you should do an away there if you think you can prove to them that you're a stellar applicant. I think if you're aiming for the big 3 or top 10 program on either coast you should definitely try to do a rotation there. If you're okay with a mid top tier and geography is more important, then doing a rotation in the geographic region takes priority.

 

[medgator]

Can we be honest here.... US MD student with a Step 1/2 pass and a pulse? You're probably going to match somewhere, amirite?

 

[allseasons]

If you are able to do it and interested, I think it's a good idea to experience clinic/culture in another department, especially since so many interview days are now online. I don't think it has to be one of the 'big three'. Some PDs may also see it as a sign of interest in the field which can help your application and distinguish you from the legions of students who are applying as a back up to rads or derm or what have you. But in the current climate, you will probably match regardless.

...is that a common occurrence?? I'm not aware of people applying rad onc as a backup to rads or especially derm.

 

[pikachu]

...is that a common occurrence?? I'm not aware of people applying rad onc as a backup to rads or especially derm.

Perhaps "legions" is an exaggeration but it certainly happens. From the 2024 NRMP data, 106 US seniors are included in the "rad onc as preferred specialty" group. 103 matched and 3 did not. There were 127 US senior MD applicants to rad onc that year. I interpret this to mean that about 17% of applications were backup for another specialty. In 2022, the corresponding numbers were 80 and 111 (28% backup). The "charting outcomes" reports that provide details about preferred specialties in the Match are only released every other year, so we don't have 2023 or 2025 data points.

 

[pikachu]

Perhaps "legions" is an exaggeration but it certainly happens. From the 2024 NRMP data, 106 US seniors are included in the "rad onc as preferred specialty" group. 103 matched and 3 did not. There were 127 US senior MD applicants to rad onc that year. I interpret this to mean that about 17% of applications were backup for another specialty. In 2022, the corresponding numbers were 80 and 111 (28% backup). The "charting outcomes" reports that provide details about preferred specialties in the Match are only released every other year, so we don't have 2023 or 2025 data points.

It's a very interesting comparison with other fields like IM, gen-surg, and peds where <1% of applicants applied to another specialty.

 

[allseasons]

It's a very interesting comparison with other fields like IM, gen-surg, and peds where <1% of applicants applied to another specialty.

What are the numbers for IM or gen-surg? That's really surprising to me because so many people I know that are applying to a competitive medical or surgical specialties are applying to IM a or gen surg as a backup. I would have thought that IM, gen-surg, and FM were the most back-up specialties there are.

 

[pikachu]

What are the numbers for IM or gen-surg? That's really surprising to me because so many people I know that are applying to a competitive medical or surgical specialties are applying to IM a or gen surg as a backup. I would have thought that IM, gen-surg, and FM were the most back-up specialties there are.

You are correct, I looked only at numbers of people who selected IM as their preferred specialty who also applied to some other field. That percentage is very low. RO numbers correct.

 

[evilbooyaa]

I just want to say, what a refreshing throwback to the 2010s... A "What Are My Chances" thread, if not in letter, then at least in spirit.

OP, the answer to your question is "it depends".

You will, with near certainty, match into Rad Onc *somewhere* just being a US MD without a felony and passing Step 1/2 ideally on first attempts. However, you want more than this, and this is certainly very reasonable.

You mention wanting to match east OR west coast. Do you have additional requirements to the program you match to? If you consider states that have the eastern or western border shared with the ocean, you probably have at least 30-40% of yearly Rad Onc residency positions. I'm sure someone will double check my math. Would you consider Pennsylvania a coastal state?

If you get a 250 or higher on Step 2, you have an excellent chance at matching at one of those programs on one of those coasts. It would probably benefit you to do a research project and try to get at least a submitted abstract or paper prior to ERAS to really cement your choices and let YOU decide which program you want more so than falling wherever you may end up.

 

[allseasons]

I just want to say, what a refreshing throwback to the 2010s... A "What Are My Chances" thread, if not in letter, then at least in spirit.

OP, the answer to your question is "it depends".

You will, with near certainty, match into Rad Onc *somewhere* just being a US MD without a felony and passing Step 1/2 ideally on first attempts. However, you want more than this, and this is certainly very reasonable.

You mention wanting to match east OR west coast. Do you have additional requirements to the program you match to? If you consider states that have the eastern or western border shared with the ocean, you probably have at least 30-40% of yearly Rad Onc residency positions. I'm sure someone will double check my math. Would you consider Pennsylvania a coastal state?

If you get a 250 or higher on Step 2, you have an excellent chance at matching at one of those programs on one of those coasts. It would probably benefit you to do a research project and try to get at least a submitted abstract or paper prior to ERAS to really cement your choices and let YOU decide which program you want more so than falling wherever you may end up.

Unfortunately, although I began working on some rad onc research, I don't think I'll have much output by September. I am applying with a lot of prior research, as I was fortunately very productive in the past, especially undergrad. 10+ national conference presentations, a bunch of regionals, I think 10 ish abstracts with 6 first author and 7 pubs, 4 first author. They're just all in surgery 😭 . I guess I'll focus on maximizing Step 2.
And yes, I include Pennsylvania, but also Virginia and Maryland when I say East Coast. I really don't want to go to North Carolina through Florida though. Maybe Atlanta or Miami would be alright even then.

 

[RickyScott]

Assuming you are a us md with an average usmle, you will match at a very good program. Perhaps not mskcc, but UPenn, Hopkins, Emory etc.

 

[NotMattSpraker]

Unfortunately, although I began working on some rad onc research, I don't think I'll have much output by September. I am applying with a lot of prior research, as I was fortunately very productive in the past, especially undergrad. 10+ national conference presentations, a bunch of regionals, I think 10 ish abstracts with 6 first author and 7 pubs, 4 first author. They're just all in surgery 😭 . I guess I'll focus on maximizing Step 2.
And yes, I include Pennsylvania, but also Virginia and Maryland when I say East Coast. I really don't want to go to North Carolina through Florida though. Maybe Atlanta or Miami would be alright even then.

If I was interviewing you, Id be a lot more interested in how you discussed your prior research with me, not whether it was in radiation oncology. Did you lead the study and do you understand the context and purpose, or were you just doing data collection/processing? You decided on Rad Onc "late", PDs should not expect you to have rad onc research.

Field is small and job placement is highly dependent on networking. A genuine interest in the field and settling/working in a specific region goes a very long way with many Rad Oncs that are interviewing applicants for residency or jobs.

My guess is the value in an away rotation for you is starting to form connections in a region you want to live versus improving your application on paper.

 

[evilbooyaa]

Unfortunately, although I began working on some rad onc research, I don't think I'll have much output by September. I am applying with a lot of prior research, as I was fortunately very productive in the past, especially undergrad. 10+ national conference presentations, a bunch of regionals, I think 10 ish abstracts with 6 first author and 7 pubs, 4 first author. They're just all in surgery 😭 . I guess I'll focus on maximizing Step 2.
And yes, I include Pennsylvania, but also Virginia and Maryland when I say East Coast. I really don't want to go to North Carolina through Florida though. Maybe Atlanta or Miami would be alright even then.

With your productive background, even just an inkling of interest in Rad Onc research will be sufficient to put the rest of your work at the forefront. I can tell you we consider all research, but we favor someone who has even a little bit of Rad Onc research (even if just a submitted abstract or just a project that hasn't come to abstract/manuscript submission yet) in addition to their others, if they decided on Rad Onc late.

For example, someonw ith 7 pubs, 4 first author in Rad Onc would be 'best'.

Someone with 7 pubs, 4 first author in Surgery and 1 abstract submitted in Rad Onc would be looked at more favorably than someone with 7 pubs, 4 first author in Surgery, with ZERO Rad Onc research. It would almost seem that Rad Onc was a 'back-up' specialty for someone who is probably applying for a competitive surgical sub-specialty (less likely Gen Surg).

It's definitely not necessary to match, but in terms of matching at the 'best' spot (which is in the eye of the beholder).

I was including Virgnia and Maryland. Eliminating NC through Florida does eliminate about 7-8 programs though

 

[allseasons]

With your productive background, even just an inkling of interest in Rad Onc research will be sufficient to put the rest of your work at the forefront. I can tell you we consider all research, but we favor someone who has even a little bit of Rad Onc research (even if just a submitted abstract or just a project that hasn't come to abstract/manuscript submission yet) in addition to their others, if they decided on Rad Onc late.

For example, someonw ith 7 pubs, 4 first author in Rad Onc would be 'best'.

Someone with 7 pubs, 4 first author in Surgery and 1 abstract submitted in Rad Onc would be looked at more favorably than someone with 7 pubs, 4 first author in Surgery, with ZERO Rad Onc research. It would almost seem that Rad Onc was a 'back-up' specialty for someone who is probably applying for a competitive surgical sub-specialty (less likely Gen Surg).

It's definitely not necessary to match, but in terms of matching at the 'best' spot (which is in the eye of the beholder).

I was including Virgnia and Maryland. Eliminating NC through Florida does eliminate about 7-8 programs though

That makes sense! The funniest part of this is that I absolutely dislike surgery and never even considered doing it for residency. I just starting doing the first research I could get into in undergrad, and because of a specific skillset I had and relationships I formed, it was just easy to continue doing the same research. Plus, I wasn't sure what field I even wanted to go into, so I figured I might as well continue working the field I was the most productive in.

I have 0 electives in any surgical field though. Hopefully that will help show rad onc PDs that I am not applying as a surgery back up. Can't really apply for Surgery if I don't do any 4th year Surgery electives, right?

 

[allseasons]

With your productive background, even just an inkling of interest in Rad Onc research will be sufficient to put the rest of your work at the forefront. I can tell you we consider all research, but we favor someone who has even a little bit of Rad Onc research (even if just a submitted abstract or just a project that hasn't come to abstract/manuscript submission yet) in addition to their others, if they decided on Rad Onc late.

For example, someonw ith 7 pubs, 4 first author in Rad Onc would be 'best'.

Someone with 7 pubs, 4 first author in Surgery and 1 abstract submitted in Rad Onc would be looked at more favorably than someone with 7 pubs, 4 first author in Surgery, with ZERO Rad Onc research. It would almost seem that Rad Onc was a 'back-up' specialty for someone who is probably applying for a competitive surgical sub-specialty (less likely Gen Surg).

It's definitely not necessary to match, but in terms of matching at the 'best' spot (which is in the eye of the beholder).

I was including Virgnia and Maryland. Eliminating NC through Florida does eliminate about 7-8 programs though

Do you know of any conferences or otherwise I can submit/get accepted an abstract to in Rad Onc prior to October? The ASTRO deadline was February unfortunately.

 

[evilbooyaa]

That makes sense! The funniest part of this is that I absolutely dislike surgery and never even considered doing it for residency. I just starting doing the first research I could get into in undergrad, and because of a specific skillset I had and relationships I formed, it was just easy to continue doing the same research. Plus, I wasn't sure what field I even wanted to go into, so I figured I might as well continue working the field I was the most productive in.

I have 0 electives in any surgical field though. Hopefully that will help show rad onc PDs that I am not applying as a surgery back up. Can't really apply for Surgery if I don't do any 4th year Surgery electives, right?

I'm not sure if your research was in a surgical sub-specialty or general surgery related, but would not assume that people reading your app would think hard enough about the bolded for it to be in your favor....

Do you know of any conferences or otherwise I can submit/get accepted an abstract to in Rad Onc prior to October? The ASTRO deadline was February unfortunately.

Accepted, no. Submitted - you could do a late-breaking abstract submission for ASTRO between 6/24 - 7/10. Otherwise, would reach out to your local T10-20 department - presumably there is a Rad Onc residency at your home program? Is there someone (attending or resident) that you can work with and get some form of authorship on a paper that might be submitted in the next few months?