Matched to prelim only, would love anyones thoughts on reapplying to residency during prelim year

[yellgirls]

Hi everyone. Unfortunately I learned today that I did not match into neurology, only a prelim program. While good, it leaves me with 3 advanced programs to try to SOAP into. I really don't want to go to any of these and was wondering if anyone could speak on re applying to residency during a prelim year. Is it doable logistically to interview while also working as an intern? Have people had success in reapplying?
I thought that I was a competitive applicant, I got a 254 on Step 1, 267 on Step 2, got Honors in my Sub-I, all other grades honors or high satisfactory, I have a publication, etc. I feel very sad, and confused by this process. I can't believe I am in this situation and would love some advice. Thanks!

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[Osminog]

Are you an IMG?

 

[FutureDoctor5000]

Hi everyone. Unfortunately I learned today that I did not match into neurology, only a prelim program. While good, it leaves me with 3 advanced programs to try to SOAP into. I really don't want to go to any of these and was wondering if anyone could speak on re applying to residency during a prelim year. Is it doable logistically to interview while also working as an intern? Have people had success in reapplying?
I thought that I was a competitive applicant, I got a 254 on Step 1, 267 on Step 2, got Honors in my Sub-I, all other grades honors or high satisfactory, I have a publication, etc. I feel very sad, and confused by this process. I can't believe I am in this situation and would love some advice. Thanks!

WOW... are you a USMD/DO or IMG?.. I cant imagine ANY way you cant match neurology with those stats...

 

[Deecee2DO]

Hi everyone. Unfortunately I learned today that I did not match into neurology, only a prelim program. While good, it leaves me with 3 advanced programs to try to SOAP into. I really don't want to go to any of these and was wondering if anyone could speak on re applying to residency during a prelim year. Is it doable logistically to interview while also working as an intern? Have people had success in reapplying?
I thought that I was a competitive applicant, I got a 254 on Step 1, 267 on Step 2, got Honors in my Sub-I, all other grades honors or high satisfactory, I have a publication, etc. I feel very sad, and confused by this process. I can't believe I am in this situation and would love some advice. Thanks!

Youre kidding me with those stats. You cant be a US medical graduate. Impossible to not match a single neuro program with 250s-260s and honors in clerkships with pubs as an USMD or DO

 

[yellgirls]

Are you an IMG?

no...I'm so confused and sad. Went to drexel

 

[yellgirls]

WOW... are you a USMD/DO or IMG?.. I cant imagine ANY way you cant match neurology with those stats...

Unfortunately I'm MD and from Drexel...I thought I was a complete shoe in

 

[yellgirls]

Youre kidding me with those stats. You cant be a US medical graduate. Impossible to not match a single neuro program with 250s-260s and honors in clerkships with pubs as an USMD or DO

Nope, US grad. I did only apply to about 15 programs because I thought I was a shoe in. I ranked 8 and got 0 apparently

 

[Deecee2DO]

Nope, US grad. I did only apply to about 15 programs because I thought I was a shoe in. I ranked 8 and got 0 apparently

Im insanely sorry to hear this. Im officially terrified to match now if you didnt match. Nd yes you were basically a shoe-in. wow. I truly believe youll be fine whatever happens especially with an app like that. I cant imagine and I am sending you lots of positive vibes my friend

 

[yellgirls]

Are you an IMG?

No

 

[yellgirls]

Im insanely sorry to hear this. Im officially terrified to match now if you didnt match. Nd yes you were basically a shoe-in. wow. I truly believe youll be fine whatever happens especially with an app like that. I cant imagine and I am sending you lots of positive vibes my friend

Aw thanks, you'll be fine. This year was very weird with virtual, maybe I'm horrible on zoom!

 

[To be MD]

Hi everyone. Unfortunately I learned today that I did not match into neurology, only a prelim program. While good, it leaves me with 3 advanced programs to try to SOAP into. I really don't want to go to any of these and was wondering if anyone could speak on re applying to residency during a prelim year. Is it doable logistically to interview while also working as an intern? Have people had success in reapplying?
I thought that I was a competitive applicant, I got a 254 on Step 1, 267 on Step 2, got Honors in my Sub-I, all other grades honors or high satisfactory, I have a publication, etc. I feel very sad, and confused by this process. I can't believe I am in this situation and would love some advice. Thanks!

That totally sucks, and I’m very sorry. Unfortunately, Neuro doesn’t weigh “stats” as heavily as other fields and instead relies more heavily on interview and resident interactions

I believe you should try SOAPing to all 3 neuro positions—even if they’re in places you don’t want to live

otherwise, you can reapply to neuro while you’re an intern... but you’re going to get in trouble taking time off. Maybe you can use all of your vacation time for interviews?

for next year I would focus on going to all the social events, smiling like crazy, and practicing interview questions

you can do this!

 

[ACSurgeon]

The real mistake was only ranking eight programs. There’s enough randomness in the process to never be that confident

if the SOAP spots are open I’d try to get one of them. Your high stats are puke probably help in the soap process

 

[Test Boy]

You should’ve applied to neurosurgery as a backup, LOL.

 

[SurfingDoctor]

Hi everyone. Unfortunately I learned today that I did not match into neurology, only a prelim program. While good, it leaves me with 3 advanced programs to try to SOAP into. I really don't want to go to any of these and was wondering if anyone could speak on re applying to residency during a prelim year. Is it doable logistically to interview while also working as an intern? Have people had success in reapplying?
I thought that I was a competitive applicant, I got a 254 on Step 1, 267 on Step 2, got Honors in my Sub-I, all other grades honors or high satisfactory, I have a publication, etc. I feel very sad, and confused by this process. I can't believe I am in this situation and would love some advice. Thanks!

Forgive my ignorance, but are these programs not in Neurology? Why don't you want to go to them?

 

[Lost in Translation]

Hi everyone. Unfortunately I learned today that I did not match into neurology, only a prelim program. While good, it leaves me with 3 advanced programs to try to SOAP into. I really don't want to go to any of these and was wondering if anyone could speak on re applying to residency during a prelim year. Is it doable logistically to interview while also working as an intern? Have people had success in reapplying?

Yes, you can re-apply to the Match during prelim year. Hundreds of unmatched residents do that every year. Another thing to consider is attrition: programs have dropouts and you can have your PD at your prelim year keep an ear open to see which programs will be looking for a resident to replace a dropout, either during your intern year (in which case you transfer in the middle of the academic year) or starting as a PGY-2. There's also a website that tracks residency spots (I don't know of it off the top of my head but it exists) and PDs looking to fill holes will post what is basically a job ad on that site.

 

[husky_doc16]

Try to stay positive about matching into a prelim program. It may open the door for you to match into the neuro program at that institution. I agree with the above that you should apply to those 3 advanced positions because job security for 4 years outweighs going through the whole process again. However, I have a friend who matched prelim and not advanced anesthesia. He was able to interview for residency this past year without too much difficulty.

 

[yellgirls]

Try to stay positive about matching into a prelim program. It may open the door for you to match into the neuro program at that institution. I agree with the above that you should apply to those 3 advanced positions because job security for 4 years outweighs going through the whole process again. However, I have a friend who matched prelim and not advanced anesthesia. He was able to interview for residency this past year without too much difficulty.

Sorry to be weird but do you think you friend would contact me? My advisor made me a little nervous because they said I would be put into a different category, no longer a US senior, but put in with IMG/DO/Graduates, which might limit me more geographically so I was hoping to get insight with that.

 

[yellgirls]

Forgive my ignorance, but are these programs not in Neurology? Why don't you want to go to them?

Geographic reasons for my family and fiance

 

[SurfingDoctor]

Geographic reasons for my family and fiance

I mean, while I get that, the time is finite, plane flights are cheap and eventually you'll be done and be able to move on. Alternatively, you could not, have 1 year of lost income (which is most important when you're young from an investment standpoint) and potentially have the same thing happen next year. The trade off though isn't without a disincentive. But only you know what's best for you.

 

[order66.exe]

Consider delaying graduation OP, I went unmatched in a competitive specialty and have no regrets about this path. You have a very easy and explainable reason why you didn't match. Next time you need to apply very broadly though including places outside of you geographic area but that you can tolerate living in.

 

[Splenda88]

I always tell people it's always better to spend a couple of hundred more $$$ than having the horror of going unmatched. I remember my school told me to apply to 40 IM programs (50/50 community ad low tier university). Well, I applied close to 80 and did not regret it.

Anyway, OP will SOAP into a program with these stats

 

[calivianya]

Realistically, you should try to soap into one of those neuro programs.

You will have a red flag next year - that you didn’t match this year. So, odds are you might end up in the same spot next year, and have to move somewhere undesirable anyway. Might as well go ahead and move this year instead of paying your school an extra year of tuition for potentially no reason.

Have you considered looking to see what other specialties in your area have positions in soap, and trying to soap into one of those? At least you could keep your geographical preference that way without having the stigma of having to reapply next year.

 

[Redpancreas]

Hi everyone. Unfortunately I learned today that I did not match into neurology, only a prelim program. While good, it leaves me with 3 advanced programs to try to SOAP into. I really don't want to go to any of these and was wondering if anyone could speak on re applying to residency during a prelim year. Is it doable logistically to interview while also working as an intern? Have people had success in reapplying?
I thought that I was a competitive applicant, I got a 254 on Step 1, 267 on Step 2, got Honors in my Sub-I, all other grades honors or high satisfactory, I have a publication, etc. I feel very sad, and confused by this process. I can't believe I am in this situation and would love some advice. Thanks!

I’m sorry this happened. You say you applied to 15 places and I presume you interviewed and ranked 8.

1. Does you list look more like A or B or a mix?

A) NYU, Penn, Sinai, Columbia, Duke
Or
B) Temple, Jefferson, Rutgers, etc.

If your answer is A, I’m sure you realize that you had a lack of safeties. In fact, even with a list of mid tiers, I still consider 15 quite scant. Your yield was good, but if these were all competitive places I can see how you slipped through the cracks.

Its difficult to advise because on one hand my SDN wisdom is telling me to tell you to SOAP into Neuro, but on the other hand I can see you’re picky and had you just applied like most with adequate safeties (unless there’s something we are just missing), you certainly would have matched and it’s hard to tell you not to take another shot at the Neuro match.

I’d say defer the SOAP, take the prelim, and apply BROADLY for Neuro this year. I’m talking at least 100 programs. While at your prelim, if you like it see if you can match there. Talk to your significant other. You two need to compromise on location. Your application despite the lack of a red flag will now be considered a US Medical Graduate as opposed to a US Medical Senior and that might knock off a few programs but most program directors are not stupid and can see a good candidate when one is in front of them and I suspect you will get several interviews.

I wouldn’t suggest a research year because this is Neuro, not NSG and the truth about what happened is going to come out. You’re best off not taking a gap year and to keep going.

The recommendation to defer SOAP may go against SDN conventional wisdom but I think in this unique case it’s what I’d do.

 

[NotAProgDirector]

You can apply for a new spot next year as a prelim IM intern. As already mentioned, one option is to try to get a spot wherever your prelim is. However, I assume you actually applied for neuro there and didn't match, so that suggests there might have been a problem in your interview or something else in your application, so I wouldn't count on this. You can also apply in the match the next year, applying to both A positions (which would start July 2023) and R positions (which would start July 2022). With those stats you'd be pretty competitive for those R positions, but there aren't many of them to get so your options may be limited.

You mentioned that someone suggested you'd be "lumped in with IMG/DO". That's not quite true. Assuming you graduate this year, in the statistics the match publishes you'd be considered a "prior grad". Prior grads do worse in the match than new grads -- but they have already not matched once, so one might expect they might have more trouble. Still, your stats are good, you come from a US school, and you (probably) don't need a visa so I would expect your chances in the match again to be good.

All that said, I agree with others here that you're probably better off focusing on the three spots that are out there. Getting one of those gets your career on track. I know it's not what you planned, but it is what it is. Also, interviewing at lots of programs as a prelim isn't easy. If it's all virtual, then not that big of a deal. But a prelim IM spot is a JOB, you can't just take multiple days off.

 

[Redpancreas]

I always tell people it's always better to spend a couple of hundred more $$$ than having the horror of going unmatched. I remember my school told me to apply to 40 IM programs (50/50 community ad low tier university). Well, I applied close to 80 and did not regret it.

Anyway, OP will SOAP into a program with these stats

#Thisiswhywehoard

 

[Redpancreas]

You mentioned that someone suggested you'd be "lumped in with IMG/DO". That's not quite true. Assuming you graduate this year, in the statistics the match publishes you'd be considered a "prior grad". Prior grads do worse in the match than new grads -- but they have already not matched once, so one might expect they might have more trouble. Still, your stats are good, you come from a US school, and you (probably) don't need a visa so I would expect your chances in the match again to be good.

This OP. I would have to agree with NAPD about the prelim place probably not being thrilled about you taking off so many days to interview. Here’s to hoping this year is virtual as well. Unfortunately I don’t think we may know anytime soon to ease your tension. Gosh, now that I think about this you may want to consider SOAPing for those three spots. Kinda indecisive today.

 

[yellgirls]

Consider delaying graduation OP, I went unmatched in a competitive specialty and have no regrets about this path. You have a very easy and explainable reason why you didn't match. Next time you need to apply very broadly though including places outside of you geographic area but that you can tolerate living in.

unfortunately i'm not allowed to delay graduation since I got a prelim or I totally would I feel like if I get the interviews I'll be able to explain it and make a better impression I guess I'm just worried about not getting interviews

 

[Ho0v-man]

The only thing you should take away here is that none of us are special. This system is merciless and doesn’t owe you anything. SOAP!

 

[Redpancreas]

unfortunately i'm not allowed to delay graduation since I got a prelim or I totally would I feel like if I get the interviews I'll be able to explain it and make a better impression I guess I'm just worried about not getting interviews

You’ll get interviews. Reapply broadly (100 programs), repeat in a few places of your reapp that you applied to only a few programs because of your significant other. Don’t mention your deferral of SOAP (Delete this thread soon). If it was me, I would go for SOAP but based on your application to 15 schools and what you’ve said on here (like the fact that you’re willing to defer graduation for this), I know you’re not going to SOAP for those 3 Neuro spot no matter how much sense @SurfingDoctor makes. Let’s hope for your sake and the IM PD at your prelim that there’s a virtual interview option this year so your prelim IM program director doesn’t have a fit when you’re traveling for interviews. You’re going to have to try to schedule vacation during peak interview season. You’ll have 4 weeks. I would send an email on match day informing them of this news. Be like unfortunately I didn’t match my advanced, I need some support making time interviews for this upcoming year. Network with your prelims’s Neuro department and ask to do some Neuro rotation early on and maybe get a letter if you think it is strong.

Overall I’m sure you’ll match and be on track. Don’t buy into this notion that being a MD Grad (non US MD senior) automatically puts you into the IMG pile. Yes there’s a filter but I suspect people will find you and you’ll get solid university tier places. Perhaps not as good as you wanted/had this time around but probably better than SOAP Neuro.

 

[SurfingDoctor]

One of the things that unfortunately gets missed in the SOAP-ing discussion is that when you go to look for a future job way down the road, your future boss (ie Division or Department Chair or private practice group) could care less that you matched at your number one or scrambled into whatever. If you go to an ACGME accredited program, your clinical credentials are just as good as every other warm body applicant. The requirements aren’t where you matched, but can you bill and bill often. That’s about it. I mean, there are nuances (again not dependent on where you matched) but that’s basically the bottom line.

So, theoretically by delaying your career start, you are really only hurting yourself and reaping zero rewards from a career perspective. Again, there is a personal choice in there, but the expectation that there will be some pay off down the road is not realistic at all.

 

[yellgirls]

You’ll get interviews. Reapply broadly (100 programs), repeat in a few places of your reapp that you applied to only a few programs because of your significant other. Don’t mention your deferral of SOAP (Delete this thread soon). If it was me, I would go for SOAP but based on your application to 15 schools and what you’ve said on here (like the fact that you’re willing to defer graduation for this), I know you’re not going to SOAP for those 3 Neuro spot no matter how much sense @SurfingDoctor makes. Let’s hope for your sake and the IM PD at your prelim that there’s a virtual interview option this year so your prelim IM program director doesn’t have a fit when you’re traveling for interviews. You’re going to have to try to schedule vacation during peak interview season. You’ll have 4 weeks. I would send an email on match day informing them of this news. Be like unfortunately I didn’t match my advanced, I need some support making time interviews for this upcoming year. Network with your prelims’s Neuro department and ask to do some Neuro rotation early on and maybe get a letter if you think it is strong.

Overall I’m sure you’ll match and be on track. Don’t buy into this notion that being a MD Grad (non US MD senior) automatically puts you into the IMG pile. Yes there’s a filter but I suspect people will find you and you’ll get solid university tier places. Perhaps not as good as you wanted/had this time around but probably better than SOAP Neuro.

That was the pep talk that I needed haha thank you seriously. I feel like my school has been pressuring me so much to just take an offer if I get one and I don't have an advisor that is unbiased. Unfortunately the program that the prelim is at doesn't have a neuro program at their own hospital. They have a sister hospital which is reputable (they did reject me this year), but I can do an elective there, and can try to get a letter from them (which hopefully would make the sister main hospital want to interview me)

 

[Dral]

I’d try for one of the three spots if it was me. However, I’ll give you my experience.

Back in my day, I ranked 15 Derm programs and didn’t match Derm but matched prelim. I contacted my prelim on Thursday of match week. I explained my situation to them and they planned a Derm rotation early and helped me plan vacation time around interview season.

Luckily I scrambled into the last Derm spot just after match and found out the week before Memorial Day. When I got to my intern year in June, I found out one of my co-interns didn’t match Derm. I traded electives with her and gave her my early Derm rotation. She applied and interviewed during intern year and matched Derm. We both ended up being chiefs at our programs down the line.

It can be done...especially if you’re lucky enough to be at an intern year with people/PD who are willing to work with you.

 

[yellgirls]

I’d try for one of the three spots if it was me. However, I’ll give you my experience.

Back in my day, I ranked 15 Derm programs and didn’t match Derm but matched prelim. I contacted my prelim on Thursday of match week. I explained my situation to them and they planned a Derm rotation early and helped me plan vacation time around interview season.

Luckily I scrambled into the last Derm spot just after match and found out the week before Memorial Day. When I got to my intern year in June, I found out one of my co-interns didn’t match Derm. I traded electives with her and gave her my early Derm rotation. She applied and interviewed during intern year and matched Derm. We both ended up being chiefs at our programs down the line.

It can be done...especially if you’re lucky enough to be at an intern year with people/PD who are willing to work with you.

Thank you that is an encouraging story! Especially because derm is more competitive than neuro. I think I would be able to get an early neuro elective and that the PD will be nice.

 

[yellgirls]

You’ll get interviews. Reapply broadly (100 programs), repeat in a few places of your reapp that you applied to only a few programs because of your significant other. Don’t mention your deferral of SOAP (Delete this thread soon). If it was me, I would go for SOAP but based on your application to 15 schools and what you’ve said on here (like the fact that you’re willing to defer graduation for this), I know you’re not going to SOAP for those 3 Neuro spot no matter how much sense @SurfingDoctor makes. Let’s hope for your sake and the IM PD at your prelim that there’s a virtual interview option this year so your prelim IM program director doesn’t have a fit when you’re traveling for interviews. You’re going to have to try to schedule vacation during peak interview season. You’ll have 4 weeks. I would send an email on match day informing them of this news. Be like unfortunately I didn’t match my advanced, I need some support making time interviews for this upcoming year. Network with your prelims’s Neuro department and ask to do some Neuro rotation early on and maybe get a letter if you think it is strong.

Overall I’m sure you’ll match and be on track. Don’t buy into this notion that being a MD Grad (non US MD senior) automatically puts you into the IMG pile. Yes there’s a filter but I suspect people will find you and you’ll get solid university tier places. Perhaps not as good as you wanted/had this time around but probably better than SOAP Neuro.

Thank you so much that was an encouraging pep talk! I have been feeling a lot of pressure from my current school to take an offer if I got one so I appreciate someone saying there’s a chance. Unfortunately my prelim program doesn’t have their own neuro department, but I can do electives at their sister hospital (who did originally reject me), but maybe if I rotate there and get a letter they will interview me again after meeting in person.

 

[singkwon]

Hi everyone. Unfortunately I learned today that I did not match into neurology, only a prelim program. While good, it leaves me with 3 advanced programs to try to SOAP into. I really don't want to go to any of these and was wondering if anyone could speak on re applying to residency during a prelim year. Is it doable logistically to interview while also working as an intern? Have people had success in reapplying?
I thought that I was a competitive applicant, I got a 254 on Step 1, 267 on Step 2, got Honors in my Sub-I, all other grades honors or high satisfactory, I have a publication, etc. I feel very sad, and confused by this process. I can't believe I am in this situation and would love some advice. Thanks!

Not sure if my story from many years ago applies to your situation since you’ve already matched into a Prelim year. But I’ll share it.

I went unmatched for a competitive specialty (Ophthalmology) which is an early match. (So I got my unmatched results through SFMatch around January and had to decide what to with my Prelim year through NRMP). I met with my dean who said my application was fine and I somehow fell through the cracks. She suggested that I go through with the match for internship and then reapply for my specialty. Thus the three options were to: (1) Go through NRMP and obtain an intern preliminary medicine position, (2) take a year off and delay graduation then reapply the following year as an “MS5”, or (3) graduate from medical school without immediate postgraduate training. After serious consideration, I opted for Option #3. As a result, I had no internship lined up. My plan was to do with research with some big wig ophthalmologists and then reapply. This option as opposed to a straight internship would allow me opportunities to make more connections and also allow me time off to interview for both preliminary intern positions and Ophthalmology positions.

I ended up matching my second time around. It was a scary path as it was deemed very non traditional as most medical students want to have something aligned right away after graduation. Bear in mind this research position was unofficial and unpaid. (I simply shared my situation with these ophthalmologists and asked If I could do some clinical work and research and publish with them. In a small field like ours, a strong letter / phone call from someone well known can go a long way). Now given it was unpaid, I took out an extra 20K in Stafford loans right before graduation to help with living and interview costs. It was an investment and today I am nearly finished paying off my medical school student loans. Currently I am a board certified ophthalmologist in private practice. Looking back it was a tough decision, but I have no regrets. Hope my story inspires others that the challenges and decisions you face help make you a stronger person. If you are committed and passionate about something, don’t be afraid to go for it even if you don’t get it in your first try!

 

[Redpancreas]

Thank you so much that was an encouraging pep talk! I have been feeling a lot of pressure from my current school to take an offer if I got one so I appreciate someone saying there’s a chance. Unfortunately my prelim program doesn’t have their own neuro department, but I can do electives at their sister hospital (who did originally reject me), but maybe if I rotate there and get a letter they will interview me again after meeting in person.

The only thing that you haven't clarified (not trying to be nosy, it may change my advice) is were your 15 applications to top places? If so, I can definitely see how you went unmatched but if you applied to primarily local programs in your area in mid tiers this would be a bit puzzling. I would have understood if they hadn't given you interviews but if you had at least 8 interviews at midtier places, I would expect (with your profile) you'd be at the top of their rank lists. Even if neuro places emphasize on fit, Steps/Clinical Performance still carries a large weight. The next step if it was midtiers you interviewed at would be to ensure one of your letters wasn't bad by asking a trusted advisor to review your letters and double check with fam about your interview habits.

Keep on the look out for openings in PGY-2 advanced neuro positions opening up for 2022 as this year goes by. You may be able to find a place that had a prelim quit medicine or something and is looking for a PGY-2 in Neuro next year.

 

[Dral]

The only thing that you haven't clarified (not trying to be nosy, it may change my advice) is were your 15 applications to top places? If so, I can definitely see how you went unmatched but if you applied to primarily local programs in your area in mid tiers this would be a bit puzzling. I would have understood if they hadn't given you interviews but if you had at least 8 interviews at midtier places, I would expect (with your profile) you'd be at the top of their rank lists. Even if neuro places emphasize on fit, Steps/Clinical Performance still carries a large weight. The next step if it was midtiers you interviewed at would be to ensure one of your letters wasn't bad by asking a trusted advisor to review your letters and double check with fam about your interview habits.

Keep on the look out for openings in PGY-2 advanced neuro positions opening up for 2022 as this year goes by. You may be able to find a place that had a prelim quit medicine or something and is looking for a PGY-2 in Neuro next year.

I agree that this has potential to be a useful critique.

I think part of my issue with not matching was that I interviewed at a bunch of upper tier places because of my strong research background. However, I didn't intend to apply that research background much to my specialty. So I think I was probably a let down to a lot of places where I interviewed. I don't think I tended to get invites from mid to lower tier programs because they assumed I would be invited by the upper tier places (which I was).

 

[SurfingDoctor]

I agree that this has potential to be a useful critique.

I think part of my issue with not matching was that I interviewed at a bunch of upper tier places because of my strong research background. However, I didn't intend to apply that research background much to my specialty. So I think I was probably a let down to a lot of places where I interviewed. I don't think I tended to get invites from mid to lower tier programs because they assumed I would be invited by the upper tier places (which I was).

Speaking from experience, this is most likely the case. I will often see candidates who did all this stuff and when you ask them on the interview why they did it and and what they learned, if the answer is "I learned I didn't like it very much", its usually a huge let down and can also be a yellow flag (not a red one), that they don't have a real passion or that they can't make up their mind and thus will float around aimlessly. That's not to say that is absolutely going to be the outcome, but I have seen it enough times that when you can't make up your mind about what you are truly interested in, you more often than not end up doing nothing. Interviews are all about selling yourself and why you deserve that spot more than the next applicant.

As for the latter, that's just bad luck (or an unfortunate product of the system).

 

[yellgirls]

The only thing that you haven't clarified (not trying to be nosy, it may change my advice) is were your 15 applications to top places? If so, I can definitely see how you went unmatched but if you applied to primarily local programs in your area in mid tiers this would be a bit puzzling. I would have understood if they hadn't given you interviews but if you had at least 8 interviews at midtier places, I would expect (with your profile) you'd be at the top of their rank lists. Even if neuro places emphasize on fit, Steps/Clinical Performance still carries a large weight. The next step if it was midtiers you interviewed at would be to ensure one of your letters wasn't bad by asking a trusted advisor to review your letters and double check with fam about your interview habits.

Keep on the look out for openings in PGY-2 advanced neuro positions opening up for 2022 as this year goes by. You may be able to find a place that had a prelim quit medicine or something and is looking for a PGY-2 in Neuro next year.

Sorry, my tops were Upenn, Jeff, UPMC, NYU, Cornell, Mount Sinai and then Cleveland Clinic. so I guess all but Jeff were definitely top tier. was surprised i didn't get jeff, but I didn't reach out to them again or anything to say i was very interested. I think my interview habbits may not have been the best as far as my resting face (can look sad, maybe annoyed), will definitely work on that. I did have nice responses to my thank you emails though from my top 3. UPMC said we think you are a great fit and the email was very personal so i didn't think the interview could have gone that badly...but yeah that's a good point about the letters. Hopefully I will be able to get some new ones early on in intern year. And I will be looking on the residency swap pages

 

[Redpancreas]

Sorry, my tops were Upenn, Jeff, UPMC, NYU, Cornell, Mount Sinai and then Cleveland Clinic. so I guess all but Jeff were definitely top tier. was surprised i didn't get jeff, but I didn't reach out to them again or anything to say i was very interested. I think my interview habbits may not have been the best as far as my resting face (can look sad, maybe annoyed), will definitely work on that. I did have nice responses to my thank you emails though from my top 3. UPMC said we think you are a great fit and the email was very personal so i didn't think the interview could have gone that badly...but yeah that's a good point about the letters. Hopefully I will be able to get some new ones early on in intern year. And I will be looking on the residency swap pages

Definitely mostly top tier and 1-2 mid tiers there. I think this more happens to do with the way you applied. You likely got bumped out at these places and had bad luck. You need to emphasize this in your reapplication. You also don’t seem THAT geographically restricted as CLE to NYC is a 10 hr drive. Anyhow, I would get an app together with 100+ or so of these top tier, mid tier, and a few lower tier places. It’s so ironic because in a another thread I’m discussing application caps but then telling you to do this but it’s what’s required.

For spots, there is ResidencySwap, ResidencyInfo, SDN has a position swap page. Talk to Jeff’s PD when you’re across the street now at your prelim.

There are people who apply to 20 places and get all 20 and have 250+x2, honors in their field, etc in IM. The key difference though between those people and you is they’re also from a top school. You’re coming from low/mid tier MD.

 

[Redpancreas]

One of the things that unfortunately gets missed in the SOAP-ing discussion is that when you go to look for a future job way down the road, your future boss (ie Division or Department Chair or private practice group) could care less that you matched at your number one or scrambled into whatever. If you go to an ACGME accredited program, your clinical credentials are just as good as every other warm body applicant. The requirements aren’t where you matched, but can you bill and bill often. That’s about it. I mean, there are nuances (again not dependent on where you matched) but that’s basically the bottom line.

So, theoretically by delaying your career start, you are really only hurting yourself and reaping zero rewards from a career perspective. Again, there is a personal choice in there, but the expectation that there will be some pay off down the road is not realistic at all.

Yeah I’m not clear why OP is so insistent on deferring SOAP Neuro for a second shot. It’s not like IM where fellowship is based on your residency and at some places fellowship is just not accessible. With Neuro, you’re going there for training and fellowships after per my understanding are not super competitive.

Anyhow, we are likely talking in past tense SOAP #1 ended and I suspect those 3 Neuro spots are gone now.

 

[SurfingDoctor]

Yeah I’m not clear why OP is so insistent on deferring SOAP Neuro for a second shot. It’s not like IM where fellowship is based on your residency and at some places fellowship is just not accessible. With Neuro, you’re going there for training and fellowships after per my understanding are not super competitive.

Anyhow, we are likely talking in past tense SOAP #1 ended and I suspect those 3 Neuro spots are gone now.

I don't know the IM world, just Pediatrics, so maybe there is a difference there, but this has not been my experience. In reality, name recognition doesn't get you very far. Other than to say, at the bigger more beautiful places, there is usually more opportunity to do other things outside of direct patient care. But it's only helpful if you utilize them. If you go to big, fancy ivory tower U, but just run through the mill, you don't have a better chance of matching to a fellowship than slightly dingy tower U if the person at dingy tower U did extra stuff. In fact, I don't even consider institutional name to be that meaningful at all other than the name is usually more of a reflection that that person is going to the extra mile on purpose, hence why they got there in the first place. The only time it may matter by name recognition only is if you are trying to MATCH to a home program. Like, we will personally set aside spots for internal applicants to play nice with the institution (unless there is some major flaw). This is especially true for fellowship training, as it would look pretty more for a residency program who has a specific fellowship to have a resident applying for the fellowship not match at all.

Of course, when you're done with training and an attending, nobody gives a crap at all. I guess, if you know person at big fancy ivory tower U and they are well regarded and are willing to call people on your behalf to get you an interview, but generally speaking, its a matter of timing (ie budgets and budget season) and how quickly you can start. The place you trained is superfluous.

 

[Redpancreas]

I don't know the IM, just Pediatrics, so maybe there is a difference there, but this has not been my experience. In reality, name recognition doesn't get you very far. Other than to say, at the bigger more beautiful places, there is usually more opportunity to do other things outside of direct patient care. But it's only helpful if you utilize them. If you go to big, fancy ivory tower U, but just run through the mill, you don't have a better chance of matching to a fellowship than slightly dingy tower U if the person at dingy tower U did extra stuff. In fact, I don't even consider institutional name to be that meaningful at all other than the name is usually more of a reflection that that person is going to the extra mile on purpose, hence why they got there in the first place. The only time it may matter by name recognition only is if you are trying to MATCH to a home program. Like, we will personally set aside spots for internal applicants to play nice with the institution (unless there is some major flaw).

Of course, when you're done with training and an attending, nobody gives a crap at all. I guess, if you know person at big fancy ivory tower U and they are well regarded and are willing to call people on your behalf to get you an interview, but generally speaking, its a matter of timing and how quickly you can start. The place you trained is superfluous.

Very different for IM. The residency name recognition means more than probably anything else they look at which is why IM M4s hardly celebrate until they figure out where they’re going. I don’t agree with it but it’s how it works since there’s no metrics like scores they look at anymore.

I’d be curious as to why OP didn’t apply for those 3 SOAP spots as Neuro is usually terminal training for most and fellowship spots aren’t competitive. I suppose it’s not relevant to the advice we give her now though.

 

[Dral]

Speaking from experience, this is most likely the case. I will often see candidates who did all this stuff and when you ask them on the interview why they did it and and what they learned, if the answer is "I learned I didn't like it very much", its usually a huge let down and can also be a yellow flag (not a red one), that they don't have a real passion or that they can't make up their mind and thus will float around aimlessly. That's not to say that is absolutely going to be the outcome, but I have seen it enough times that when you can't make up your mind about what you are truly interested in, you more often than not end up doing nothing. Interviews are all about selling yourself and why you deserve that spot more than the next applicant.

As for the latter, that's just bad luck (or an unfortunate product of the system).

Pretty much true. I was very passionate about my research but it was a stand alone PhD which didn't connect over to what I was doing in medical school. I was focused on what I wanted in med school (even was doing things to prepare for the fellowship I ended up doing during 4th year). However, I think the residency interviews I went to expected to hear this nice packaged flowing story from pre-med school to residency. Sometimes I feel like leaving the PhD stuff off altogether would have been better. heh. However, then I would need to explain that gap.

However back to med school, again, I was doing so much my 3rd and 4th year that I never was able to get one significant thing done. Now I advise folks to do what you have to do, but only take on as much as you can handle in terms of getting good meaningful results instead of a bunch of surface things (depth over breadth).

Things still worked out for me, but don't make the same mistakes I made folks.

And best of luck, OP. I feel you've gotten some good advice from others in this thread. I've been there and know the feeling. It will get better.

 

[yellgirls]

Very different for IM. The residency name recognition means more than probably anything else they look at which is why IM M4s hardly celebrate until they figure out where they’re going. I don’t agree with it but it’s how it works since there’s no metrics like scores they look at anymore.

I’d be curious as to why OP didn’t apply for those 3 SOAP spots as Neuro is usually terminal training for most and fellowship spots aren’t competitive. I suppose it’s not relevant to the advice we give her now though.

Hi again, I did apply to all 3 neuro places in the SOAP to see what would happen, I only interviewed at one and they didn't offer me the first position and whoever they offered it to first accepted. So the decision doesn't really matter now I have to reapply and just hope for the best. I appreciate the advice a lot and I will apply much more broadly and work hard this year, keep an eye out for any spots that open. That's all I can do I guess.

 

[yellgirls]

Pretty much true. I was very passionate about my research but it was a stand alone PhD which didn't connect over to what I was doing in medical school. I was focused on what I wanted in med school (even was doing things to prepare for the fellowship I ended up doing during 4th year). However, I think the residency interviews I went to expected to hear this nice packaged flowing story from pre-med school to residency. Sometimes I feel like leaving the PhD stuff off altogether would have been better. heh. However, then I would need to explain that gap.

However back to med school, again, I was doing so much my 3rd and 4th year that I never was able to get one significant thing done. Now I advise folks to do what you have to do, but only take on as much as you can handle in terms of getting good meaningful results instead of a bunch of surface things (depth over breadth).

Things still worked out for me, but don't make the same mistakes I made folks.

And best of luck, OP. I feel you've gotten some good advice from others in this thread. I've been there and know the feeling. It will get better.

I appreciate all the advice, I did try to SOAP and it didn't work out anyways so I'll reapply, which is what my heart kind of wanted anyways! Thank you for trying to help though

 

[Redpancreas]

Hi again, I did apply to all 3 neuro places in the SOAP to see what would happen, I only interviewed at one and they didn't offer me the first position and whoever they offered it to first accepted. So the decision doesn't really matter now I have to reapply and just hope for the best. I appreciate the advice a lot and I will apply much more broadly and work hard this year, keep an eye out for any spots that open. That's all I can do I guess.

Mmm...so you ate your pride and did t it. OK, well now you can honestly say you did all you possibly could and didn't match. I hope people who throw the word DNR like it’s a joke realize how miserable SOAP is.

I feel like SOAP is just a place where dreams go to die. I get OP couldn't match Neuro since there were three spots, but she seems more than qualified.

I think that there should be an official "unmatched but qualified pool" that residents should enroll in that residency directors have access to and can view when someone prematurely leaves their program. The way it's done now is through connections (i.e. who is available at the right moment).

 

[order66.exe]

OP I think at the end of the day you are going to be fine. Yes you made a mistake, but you are so so qualified. As long as you apply broadly and go on as many interviews as is logistically possible, I think you will match into a great program.

 

[Redpancreas]

Agreed. OP you will be fine.

 

[RaiImposs]

Definitely mostly top tier and 1-2 mid tiers there. I think this more happens to do with the way you applied. You likely got bumped out at these places and had bad luck. You need to emphasize this in your reapplication. You also don’t seem THAT geographically restricted as CLE to NYC is a 10 hr drive. Anyhow, I would get an app together with 100+ or so of these top tier, mid tier, and a few lower tier places. It’s so ironic because in a another thread I’m discussing application caps but then telling you to do this but it’s what’s required.

For spots, there is ResidencySwap, ResidencyInfo, SDN has a position swap page. Talk to Jeff’s PD when you’re across the street now at your prelim.

There are people who apply to 20 places and get all 20 and have 250+x2, honors in their field, etc in IM. The key difference though between those people and you is they’re also from a top school. You’re coming from low/mid tier MD.

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