match into anesthesia after a pre-lim year?

[AKMD_1984]

hello...

ok, so i am gunning for anesthesia this match...but havent gotten as many interviews as i would have liked.

my next option is to do a pre-lim year in medicine and then re-apply...do you think that i have a better chance of matching into anesthesia as a CA-1 from prelim medicine year?

is that common to do? i.e. do a pre-lim year and re-apply for CA-1?

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[AKMD_1984]

thank you.

for pre-lim spots, i know that its better if i do it where they offer anesthesia residency. but lets say that doesnt happen either...

do you think that programs look down upon someone who is applying as a pre-lim med year vs a med school grad?
i know some programs dont even offer direct CA-1.

 

[lord_jeebus]

Believe it or not, it's still not too late to apply to more programs. The prelim year does not make you a stronger candidate and you have more options applying during this cycle. If you really think you're in trouble, apply to 50 more programs or so.

 

[bubalus]

You can reapply as an intern. Interviewing as an intern sucks because they usually aren't very accommodating on vacation and leave. However, if you do reapply as an intern, you're free to go outside the match.

My concern is that if you're not getting invitations now, how will you be different and get more next year as an intern, i.e., if you're a sucky applicant now, what will make you a better applicant next year, or will you just suck as bad but be a year older?

 

[AKMD_1984]

see, the reason i am not getting my interviews right now, is multifactorial:

a) i havent taken my step 2 ck yet OR CS - i havent finished my 3rd yet (this is my last core rotation) - im taking my cs and ck in december...but i WILL have my results when i go for interviews.
b) i am a carib student (from top 4). i am however, a U.S. citizen...
c) i started my rotations in january of this year, and i have been doing them back to back and i will finish everything on jun 4th...thats IF i dont take any time of at all. i will barely get my ecfmg certificate before residency starts. maybe a week INTO residency.


i got 2 interviews so far, i applied to 40 programs...

my step 1 isnt bad...i mean its not like a 260...but its decent enough...234/98.

i was strongly DISCOURAGED by my clinical co-ordinator to even apply this year, but then i realized what exactly am i gonna do between 2010 and 2011? thats one year...and i need to work and pay off my loans...even if its 10 k...its fine. so even if i do a pre-lim year, its better than sitting on my a** and doing nothing. those 2 ivs ive gotten for anesthesia far exceeded my expectations as my initial plan was just to scramble. however, i had to apply through ERAS because most programs wont even consider you for scramble if you dont atleast apply through ERAS.

mine is a complicated case, and thats why i was trying to get some feedback on what i should do.

 

[AKMD_1984]

Believe it or not, it's still not too late to apply to more programs. The prelim year does not make you a stronger candidate and you have more options applying during this cycle. If you really think you're in trouble, apply to 50 more programs or so.

ill take your advice, and apply to some more programs just in case.

 

[bigdan]

Right.

You're in a pickle. I concur with applying to more programs now. I also concur that there's no great reason to think that you'd match with greater success after an intern year than you would now.

Also, what is your level of commitment to anesthesiology? There are routine programs that don't fill, and interviewing there & ranking them highly would likely increase your chances...but there are reasons these programs don't fill. As you likely already realize, you probably cannot afford to be overly particular about where you're applying (in a geographic or prestige sense). If you're "super-committed", you could do the standard carpet-bomb and apply to every program. You could also try to sneak in an away rotation to try to impress, but you'd be cutting things very close. Can anyone make a phone call for you to help get your foot in the door?

I'd do a search here; there are a few threads about Carib-friendly programs. I would make sure you've sent your ERAS app to all those places. You might want to give the program coordinators a jingle to say hello, and certainly call them with any updates (like those Step 2 scores) to keep your name fresh in their minds. Remind them you're willing to fly in at a moment's notice to interview if there's a cancellation, etc. Planning on the scramble is a risky bet; while open programs will indeed be looking to fill, don't forget that the 260-Step-1-AOA-folks that didn't get into Plastics are also gonna be looking for work, and anesthesia is somewhat attractive to scrambling applicants.

Lastly, maybe get those Step 2s done. And do really well. You're really, really far behind the eight-ball, and while I'm impressed with your Step 1, it's not a difference-maker type score.

Whatever you decide to do, good luck, and keep us posted.

Best,

dc

 

[RussianJoo]

i tihink you rushed things a bit. you should be applying for next years match just like your coordinator is telling you. I am also in the jan class and am not applying early. you should take your time and study for step2 so you can do at least just as well, also you should do electives in anesthesia and get LORs before applying. Not taking any breaks might come back and bit you on your butt. to be successful in the match especially as an IMG i think you need to have all your ducks in a row sort of say and early in the game, trying to rush things will hurt you. why did you want to match/graduate earlier? there have been thousands of people in the Jan term a head of you who didn't rush, honestly after being $300K in debt waiting a little longer and making sure you're 100% ready and that anesthesia is what you want is well worth the wait. i think the match is definitely something that shouldn't be rushed.

 

[nycnyc]

100% agree with RJ, wait until 2011 match; this way ... you would take your step-3 around July2010 and before your new 2011 application.... and NOW your application is different - anesthesia PDs would love to see any IMG applicant with Step1-98 +Step2 even if its 91-92 and Step3 >74 ( - not your case anyway ) with well done electives and LRs. Plan your 2010-11 transition for a low paying research position.

Good luck.

i tihink you rushed things a bit. you should be applying for next years match just like your coordinator is telling you. I am also in the jan class and am not applying early. you should take your time and study for step2 so you can do at least just as well, also you should do electives in anesthesia and get LORs before applying. Not taking any breaks might come back and bit you on your butt. to be successful in the match especially as an IMG i think you need to have all your ducks in a row sort of say and early in the game, trying to rush things will hurt you. why did you want to match/graduate earlier? there have been thousands of people in the Jan term a head of you who didn't rush, honestly after being $300K in debt waiting a little longer and making sure you're 100% ready and that anesthesia is what you want is well worth the wait. i think the match is definitely something that shouldn't be rushed.

 

[AKMD_1984]

^thank you for the sincere advice bigdan, RJ, nyc...

i will go anywhere. i dont care. thats the fate of a carib student, moving from state to state over a weekend for these rotations. i will look at some of the img friendly programs again - i do remember applying to them.
i just want to finish ASAP because im internally VERY fatigued from school - i just want stability in my life and work.
yah, my step 2 is in december, and the reason it is that late is because i am not taking ANY time off to study for it. and i realized that core rotations are extremely important for step 2 prep - i cannot imagine taking ck without internal medicine and surgery rotation. i am currently in my 3rd week of obs/gyn and then i have 28 weeks of rotations left to graduate.
i started seriously studying for it early october, and have been doing 2 blocks of uworld qns a day - im getting 65-70% avg. so that is comforting to some degree, i guess.
i managed to do squeeze in a rotation in anesthesia and got three letters that i sent with my application - however, that rotation was done at a hospital that does not offer anesthesia residency.

my clinical co-ordinator is correct, but the reason i applied is because first year is a pre-lim medicine anyways. i have known people who had other commitments and did not start exactly on july 1. i was hoping that they would make that exception for me esp. for phy 1 pre lim medicine year and that will be my lead in for anesthesia CA-1 in 2011

i mean i just honestly do not see myself sitting around for 1 year and doing absolutely nothing. i could do research, but i have tried it - its not for me.

 

[nycnyc]

my point is - try it out this year but do not rank prelim only option (use it as a secondary option for Anesthesia ). If no match this year, next year you are still going to be IMG who finished his rotations after July 2010 (after March 20 ask your advisor to move it some time after July), this way on a paper you would be 2011 graduate, not 2010. Other option to take your Step3 in Aug-September 2010 during your prelim medicine elective month (you can ask for it).

Just FYI: UW 65-70% avr. first time random = at min 235-240 on Step2.

^thank you for the sincere advice bigdan, RJ, nyc...

i will go anywhere. i dont care. thats the fate of a carib student, moving from state to state over a weekend for these rotations. i will look at some of the img friendly programs again - i do remember applying to them.
i just want to finish ASAP because im internally VERY fatigued from school - i just want stability in my life and work.
yah, my step 2 is in december, and the reason it is that late is because i am not taking ANY time off to study for it. and i realized that core rotations are extremely important for step 2 prep - i cannot imagine taking ck without internal medicine and surgery rotation. i am currently in my 3rd week of obs/gyn and then i have 28 weeks of rotations left to graduate.
i started seriously studying for it early october, and have been doing 2 blocks of uworld qns a day - im getting 65-70% avg. so that is comforting to some degree, i guess.
i managed to do squeeze in a rotation in anesthesia and got three letters that i sent with my application - however, that rotation was done at a hospital that does not offer anesthesia residency.

my clinical co-ordinator is correct, but the reason i applied is because first year is a pre-lim medicine anyways. i have known people who had other commitments and did not start exactly on july 1. i was hoping that they would make that exception for me esp. for phy 1 pre lim medicine year and that will be my lead in for anesthesia CA-1 in 2011

i mean i just honestly do not see myself sitting around for 1 year and doing absolutely nothing. i could do research, but i have tried it - its not for me.

 

[RussianJoo]

my point is - try it out this year but do not rank prelim only option (use it as a secondary option for Anesthesia ). If no match this year, next year you are still going to be IMG who finished his rotations after July 2010 (after March 20 ask your advisor to move it some time after July), this way on a paper you would be 2011 graduate, not 2010. Other option to take your Step3 in Aug-September 2010 during your prelim medicine elective month (you can ask for it).

Just FYI: UW 65-70% avr. first time random = at min 235-240 on Step2.

not anymore.. people who have taken the new format of the test are saying UW is a poor predictor of your step2 score. I know a few people that averaged that and did pretty poorly on the test, now of course that doesn't mean it will be the OP i am just saying that the test has changed and became longer/harder.


to the OP, spread stuff out take some time off to study for step2 instead of studying during your electives. Try doing an anesthesia rotation at a place that has a residency and get an LOR from someone who can comment on how you would be as a resident instead of some private practice dude who has never worked with residents as an attending. These could all be factors why you're not getting any interviews. the main one i would bet is that they're waiting for your step2 score. everyone wants a step2 score from an IMG and won't make any decisions on your applications with out it. there are literally hundreds of IMGs with the same scores as you but also have those scores on step2 and have done anesthesia rotations at places with a residency program and don't have that many more interviews than you. I am one of them. So I am sorry but to think that you'd match with just your setp1 score is very unrealistic especially as an IMG. It's very tough for us these days. I can only imagine how hard it will get in the fallowing years.
ohh and you're not the only one willing to go anywhere for an anesthesia residency.

 

[AKMD_1984]

^have YOU taken this new step 2?

the anesthesia docs i worked with varied in their experiences, and most of them did teach residents at some point in their career. the rotation WAS greenbook, and they are teaching attendings for surgical icu for surgery residents. so the legitimacy and the credentials of the authors is not an issue, and i know for a fact that those letters actually got me those two interviews (one of them was hand written and signed, and a PD called me personally to do an audition rotation).

secondly, as i said earlier, i was actually quite surprised to get interviews at all because my application is far away from being complete. good for me i guess.
to me, spending 1500 dollars applying and potentially landing a spot is WORTH every penny IF i match come march 2010.

back to the original question about landing a CA-1 position while doing a pre-lim medicine year. i guess only one person has answered that...and thats what i wanted to know. i guess there is no real disadvantage to doing that becaue i would rather do a pre-lim year, earn my 50 k, get experience, and then try to match again (even if i have to apply as a pgy1 categorical in an anesthesia program in 2011). i will take that.

thanks everyone.

 

[RussianJoo]

^have YOU taken this new step 2?

the anesthesia docs i worked with varied in their experiences, and most of them did teach residents at some point in their career. the rotation WAS greenbook, and they are teaching attendings for surgical icu for surgery residents. so the legitimacy and the credentials of the authors is not an issue, and i know for a fact that those letters actually got me those two interviews (one of them was hand written and signed, and a PD called me personally to do an audition rotation).

secondly, as i said earlier, i was actually quite surprised to get interviews at all because my application is far away from being complete. good for me i guess.
to me, spending 1500 dollars applying and potentially landing a spot is WORTH every penny IF i match come march 2010.

back to the original question about landing a CA-1 position while doing a pre-lim medicine year. i guess only one person has answered that...and thats what i wanted to know. i guess there is no real disadvantage to doing that becaue i would rather do a pre-lim year, earn my 50 k, get experience, and then try to match again (even if i have to apply as a pgy1 categorical in an anesthesia program in 2011). i will take that.

thanks everyone.

no i was lucky enough to take the old format, but a few of my good friends took the new version and were averaging in the 70's on UW and got very low scores, they averaged in the mid 60's on UW for step1 and got 230's. So the test has gotten substantially harder, also go to the Step2 forum and read some of the stories on there. As for that rotation being green booked it might have been, but not under anesthesia. the definition of green book is to have a residency in the specialty of that rotation, since that place doesn't have an anesthesia residency it's not officially green booked. Now another residency program might put down their ACGME code on your evaluation and thus make it "green booked" on paper but technically speaking that rotation is not green booked. those residents and attendings that rotate through there are only doing electives to learn how to intubate or get their number of required intubations so that they can be certified, that's all.

 

[AKMD_1984]

^i will let you know on match day whether it matters that the letters be from green book hospitals or not.

there isnt any concrete evidence that usmle step 2 has gotten harder. couple of my friends wrote the exam recently and did way better than their expectations. so anecdotal evidence of isolated experiences cannot be used to guage the difficulty of an exam.