M4 - Switching after applying to another specialty

[whatsthepoint]

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[Gonio5]

The problem with some medical schools is that they hide exposure to good specialties from med students.

Don't delay graduation because then you will have to explain for the rest of your life that you are not a med school flunky that had to repeat the year.

You can apply while you are in your PGY-1 year or you can do ophthalmology research (or a pre-residency fellowship).

One problem is that ophthalmology residencies are now integrated as a 4 year residency while as little as 3 years ago, ophthalmology residencies started at the PGY-2 level. There may or may not be trouble to get into the PGY-2 year if one does a transitional year because they likely lack 3 months of ophthalmology rotations as a PGY-1. Currently (ACGME requirement effective 2021), all ophthalmology residencies have a PGY-1 year of 9 months of non-ophthalmology rotations and 3 months of ophthalmology.

 

[m1redsox]

Disagree with the above as med school graduate applicants have a much lower match rate than med school seniors. If you want to do ophtho, you should withdraw from ortho now, begin your “ophtho research year” (do NOT graduate this Spring), try to get something published in ophtho before August, and apply ophtho this upcoming cycle. Doing an intern year does nothing for you.

I couldn’t disagree more with the sentiment that you’ll have to explain why you’re not a med school flunky. Lol. Nobody cares.

 

[Gonio5]

Disagree with the above as med school graduate applicants have a much lower match rate than med school seniors. If you want to do ophtho, you should withdraw from ortho now, begin your “ophtho research year” (do NOT graduate this Spring), try to get something published in ophtho before August, and apply ophtho this upcoming cycle. Doing an intern year does nothing for you.

I couldn’t disagree more with the sentiment that you’ll have to explain why you’re not a med school flunky. Lol. Nobody cares.

This may or may not be true. The data is skewed by med school graduate applicants tend to be those who couldn't match. The applicant who is a med school graduate but did well and could have matched but decided to do a pre-residency fellowship might do better.

If one graduates from med school a year later, will their status be 5 years of medical school? If so, is there more tuition? Or the med student takes a leave of absence. If they take a leave of absence, will the school take away their badge, hindering doing research?

 

[m1redsox]

This may or may not be true. The data is skewed by med school graduate applicants tend to be those who couldn't match. The applicant who is a med school graduate but did well and could have matched but decided to do a pre-residency fellowship might do better.

If one graduates from med school a year later, will their status be 5 years of medical school? If so, is there more tuition? Or the med student takes a leave of absence. If they take a leave of absence, will the school take away their badge, hindering doing research?

Agreed that there are some confounding variables there, but how you're labeled to a program does make a difference. In a PD's weeding out process, USMD senior vs USMD graduate is an easy box to check in/out. Not saying that you couldn't match, but I think it is easier to be in the USMD senior category. A research year is technically a leave of absence, so there is no tuition charged. A research year is very common for a medical school to accommodate, so things like badge access are not typically a problem. I agree that a pre-residency fellowship could be better for education, especially since you can be an ocular pathologist with an ocular pathology pre-residency fellowship, however, I still think it puts you in the unfavorable USMD graduate category where you will have to explain to programs why you graduated and didn't match or withdrew from the match. Additionally, there are a limited number of spots for these pre-residency fellowships, and since there will be hundreds of unmatched ophtho applicants this year, they will likely be very competitive.

Thanks. I agree.. Is it foolish though to drop all these opportunities ahead of me just to do a research year which will pay much less than a residency salary? I regret choosing ortho over ophtho but I am having such anxiety about this decision.

In many cases, research years do not pay anything, but this is all your decision to make based on your perceived happiness. Is ophtho worth one year of resident salary to you? If you believe you will be happier as an ophthalmologist, I think that answer is an easy "yes", especially considering that ortho is an extra year of residency anyways, so you aren't missing out on that much money (~$60k). I will also say that ortho is a very grueling residency training process, so doing something really hard that you don't really enjoy could definitely affect your mood/job satisfaction.

 

[m1redsox]

To clarify, you do not have to delay graduation, but there is some evidence to suggest that you will have an easier time matching if you apply as a USMD senior, but as stated above, there are some confounding variables there.

 

[Slide]

It's a red flag more if you don't match the first time. Whether you graduate or not isn't that important. I wholeheartedly endorse either taking a "gap year" to do a pre-residency fellowship or research, or delaying a year. Whatever you do, don't try to two-time it by doing an intern year and applying at the same time. What matters most is putting your best foot forward the first time you apply.

 

[Slide]

For ophtho, would you recommend applying during my research year or gap year? Or applying after? The latter ends up being a 2 year delay which is pretty rough, but that's what some suggested.

Depends on how much you think you can get done before you start applications. Some of these research years get you going sooner than later because they know how important time is in all of this. Safer option is during gap year but obviously this isn’t ideal for lots of reasons.

 

[m1redsox]

Anyone know how doable it is to get into an ophtho residency as an ortho resident? I know PGY-2 spots never open up, I would be fine re-doing intern year if I have to for ophthalmology.

I heard from my school they're willing to make an exception for me to delay graduation for this potential switch, which is amazing because I could do away rotations and maintain MD senior status. However, I'm hesitant to drop all the work I put in for ortho, was wondering if being an ortho resident would boost my application because of the competitiveness of ortho.

I would delay graduation. Dropping out of ortho residency would not boost your ophtho application. If anything, selection committees will look at it and think, "so how do we know he won't switch out of ophtho when it gets hard?" And continuing to match ortho knowing that you are planning to pursue ophtho is just actively screwing the ortho program you match at.