Need help on where to do aways/Sub-I's?

[lol226]

third year DO student interested in neurology. Located in the New York-New Jersey Tristate area and would prefer to do a neuro residency the east coast. Not too familiar with what good residency programs are as of yet (and which are more DO friendly), but I'm looking to apply to aways. Any recommendations on where to apply if I'm looking to stay on the east coast? Or where to do aways in general?

For more info, I'm not necessarily the strongest applicant. Low USMLE of 201, but aiming to get much higher on Step 2.

Thanks for any help and insight you can share!

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[lol226]

would appreciate any help!!

 

[Postictal Raiden]

I'm not familiar with east coast programs. However, given your low step1 score, I'd make sure to rotate at places where you have a reasonable shot at. Don't waste on addition at places that you have no chance at (Cornell, Columbia, Partners, Duke, etc..). Pick a couple programs that are DO-friendly (have taken several DO's in the past and have DO's on their resident roster).

Suggestions:
Buffalo, Westchester, Albany, UConn, RWJMS, and Cooper

If PA is another place you'd consider, I'd add Geisinger, UPMC Erie, and Lehigh

 

[lol226]

I'm not familiar with east coast programs. However, given your low step1 score, I'd make sure to rotate at places where you have a reasonable shot at. Don't waste on addition at places that you have no chance at (Cornell, Columbia, Partners, Duke, etc..). Pick a couple programs that are DO-friendly (have taken several DO's in the past and have DO's on their resident roster).

Suggestions:
Buffalo, Westchester, Albany, UConn, RWJMS, and Cooper

If PA is another place you'd consider, I'd add Geisinger, UPMC Erie, and Lehigh

Thanks. Do you think NYU's program is out of reach for me? What about Jefferson in PA or NJ programs like in Hackensack or Englewood?

Also, with my step score, what are my chances of matching at all if I apply broadly?? I'm pretty set on neurology so is there a chance I might not match at all?

 

[Postictal Raiden]

Thanks. Do you think NYU's program is out of reach for me? What about Jefferson in PA or NJ programs like in Hackensack or Englewood?

Also, with my step score, what are my chances of matching at all if I apply broadly?? I'm pretty set on neurology so is there a chance I might not match at all?

NYU and Jefferson are definitely out of reach. No clue about the others.

With your step1, I'd try to apply very broadly. Focus on low-tier, community or formally DO residencies. Not to be harsh, but you are in no position to be choosey. Neurology is not competitive, but it's not walk in the park either. It can be an uphill battle for a DO with below average stats. Doing auditions can overcome these adversities, but only at the places where you audition, so make sure to choose your auditions wise.

 

[Thama]

You'll probably match but to be confident you should apply pretty much everywhere. Limiting yourself to the urban NE in your situation is the height of folly.

 

[lol226]

NYU and Jefferson are definitely out of reach. No clue about the others.

With your step1, I'd try to apply very broadly. Focus on low-tier, community or formally DO residencies. Not to be harsh, but you are in no position to be choosey. Neurology is not competitive, but it's not walk in the park either. It can be an uphill battle for a DO with below average stats. Doing auditions can overcome these adversities, but only at the places where you audition, so make sure to choose your auditions wise.

I'm also interested in pursuing a residency which will make it possible for me to have fellowship opportunities in the future (interested in EEG, epilepsy, or vascular neuro). Should I rule those out as well if I plan to do lower-tier/community?

 

[Telamir]

To be honest first step is getting into residency. If your institution already has a fellowship in vascular/eeg/epilepsy you're golden. Fellowships in neurology are not very competitive. I'd say the exception is maybe research heavy fields (neuro-onc?). Once you get into a program you can make a plan on how to get to fellowship.

With the creation of the epilepsy board I think EEG fellowships will go the way of the dinosaur eventually. Someone correct me if I'm wrong.

 

[Postictal Raiden]

I'm also interested in pursuing a residency which will make it possible for me to have fellowship opportunities in the future (interested in EEG, epilepsy, or vascular neuro). Should I rule those out as well if I plan to do lower-tier/community?

At the risk of sounding like an ass, I’m gonna say it again. With a usmle score of 200 + being a DO, you have no leverage. You can’t afford to be selective. You need to apply broadly and, maybe, pray to get enough interviews to match somewhere.

 

[Postictal Raiden]

Hi, sorry to hijack, but I have a similar question. I am a third year DO too with USMLE step 1 23x. I want to match back to the west coast. Should I go ahead and do auditions?

PM me. I applied and matched in the west region.

 

[Thama]

I'm also interested in pursuing a residency which will make it possible for me to have fellowship opportunities in the future (interested in EEG, epilepsy, or vascular neuro). Should I rule those out as well if I plan to do lower-tier/community?

A low tier program doesn't rule any of those things out. All but the most competitive neurology subspecialties tend to have more spots than applicants nationwide. You need to buckle down and plan to apply and interview in the South and Midwest, though, if you want to be sure that you match.

 

[lol226]

At the risk of sounding like an ass, I’m gonna say it again. With a usmle score of 200 + being a DO, you have no leverage. You can’t afford to be selective. You need to apply broadly and, maybe, pray to get enough interviews to match somewhere.

yeah I understand that. Some residency spots have written on their sites that most applicants have scores above 220 (though there's no specific cut-off). I wonder, how much can an audition actually improve my chances at places like Westchester or RWJS, or Stony Brook. Should I not even audition at these spots because an audition won't make up for my low score?

I understand I can't be picky, but I also don't want to end up in the middle of nowhere. Should I be applying to IM programs as well in the chance I don't match into neuro at all?

Edit: For what it's worth, I also have some neuro research that I've presented and is in the process of publishing..

 

[jd1031]

yeah I understand that. Some residency spots have written on their sites that most applicants have scores above 220 (though there's no specific cut-off). I wonder, how much can an audition actually improve my chances at places like Westchester or RWJS, or Stony Brook. Should I not even audition at these spots because an audition won't make up for my low score?

I understand I can't be picky, but I also don't want to end up in the middle of nowhere. Should I be applying to IM programs as well in the chance I don't match into neuro at all?

Edit: For what it's worth, I also have some neuro research that I've presented and is in the process of publishing..

The reality is, a 201 USMLE step 1 score is pretty low. If you want to match into neurology, be prepared to apply to and match into programs in the middle of no where and in “less desirable” programs.

It’s still worth it to do an audition rotation, ideally at as many places as you can the beginning of your MS4 year at places you have a realistic shot of matching in. Make sure to get great LORs from attendings at those places, as that can increase your chances of matching quite a bit.

 

[Postictal Raiden]

yeah I understand that. Some residency spots have written on their sites that most applicants have scores above 220 (though there's no specific cut-off). I wonder, how much can an audition actually improve my chances at places like Westchester or RWJS, or Stony Brook. Should I not even audition at these spots because an audition won't make up for my low score?

I understand I can't be picky, but I also don't want to end up in the middle of nowhere. Should I be applying to IM programs as well in the chance I don't match into neuro at all?

Edit: For what it's worth, I also have some neuro research that I've presented and is in the process of publishing..

If geography is more important than specialty, then yes, apply to back up specialties (IM or FM).

Research experience in neurology can be very helpful. However, it probably won't overcome step1 of 201.

If neurology is what you want to do, then audition at 2-3 programs (that are DO-friendly and considered low-tier academic) and apply broadly.

 

[lol226]

Thanks for all the advice. I know I'm just being repetitive at this point by asking questions.

I know I'm risking sounding desperate, but would applying to child neurology also broaden my chances?? And adding to that, would I need to do specific child-neuro sub-I's or would general neuro auditions apply? I don't know if child-neuro programs are more or less competitive but I guess in the end I wouldn't be opposed to them.

Also, let's say I do tremendously better on step2 than step1-- how much weight would this hold?? (working my butt off to make sure this happens)

I really am set on neuro to be honest, and have kinda come to terms with the fact that I'll have to travel South or Midwest. I wouldn't mind programs anywhere near Chicago, Atlanta, New Orleans, Seattle, etc etc though I will still rank NY/NJ the highest if possible

 

[Postictal Raiden]

Don't spread yourself thin by applying to other specialties (unless you are applying to FM or IM as backup). Applying to child neuro means you do at least one child neuro rotation and then you have to secure one peds LOR and one child neuro LOR. You also need to write a second personal statement. That's a lot of work. Also you will have to avoid applying to both adult neuro and child neuro at the same hospital, which will decrease your pool of programs you apply to in each specialty. Besides, child neuro isn't exactly less competitive. Most of these programs are at big academic centers in desirable cities.

If you want neuro, just focus on that. Do the following:

1) Do your best on step2.
2) Don't fail anything
3) Set up 2-3 auditions (as I mentioned above)
4) Get letters from attendings at places you do auditions, preferably from PDs
5) Try to do neuro research, write up a cool case, attend AAN, or anything that shows your commitment
5) APPLY BROADLY. There are enough low tier academic and community programs on East coast to feel confident about matching. However, you still need to be sincerely open to match ANYWHERE.

 

[lol226]

Don't spread yourself thin by applying to other specialties (unless you are applying to FM or IM as backup). Applying to child neuro means you do at least one child neuro rotation and then you have to secure one peds LOR and one child neuro LOR. You also need to write a second personal statement. That's a lot of work. Also you will have to avoid applying to both adult neuro and child neuro at the same hospital, which will decrease your pool of programs you apply to in each specialty. Besides, child neuro isn't exactly less competitive. Most of these programs are at big academic centers in desirable cities.

If you want neuro, just focus on that. Do the following:

1) Do your best on step2.
2) Don't fail anything
3) Set up 2-3 auditions (as I mentioned above)
4) Get letters from attendings at places you do auditions, preferably from PDs
5) Try to do neuro research, write up a cool case, attend AAN, or anything that shows your commitment
5) APPLY BROADLY. There are enough low tier academic and community programs on East coast to feel confident about matching. However, you still need to be sincerely open to match ANYWHERE.

Thank you for the honest advice. It is heartening to know that I can find a spot close to home even if it be low-tier academic or community. That being said, I will be applying to the vast majority of programs

 

[mrbreakfast]

I know I'm risking sounding desperate, but would applying to child neurology also broaden my chances?? And adding to that, would I need to do specific child-neuro sub-I's or would general neuro auditions apply? I don't know if child-neuro programs are more or less competitive but I guess in the end I wouldn't be opposed to them.

Not speaking from much experience, but I also considered applying to child neuro and talked to the people from my program who matched child. Like surgical subspecialties, they mostly dual applied and used separate letters for child vs adult, did two AIs, and all did a PICU rotation.

They told me I should secure a chair letter for both, then 3 adult neurologist letters for adult and 2 child neuro letters + either a pediatrician or an adult neurologist who trained at the specific institution they were applying to for child.

I ended up applying only to adult, but think child is more competitive than adult. I interviewed simultaneously with some child neuro applicants and from talking to them was led to believe they didn't necessarily expect to match to child.

 

[RainbowYoshi]

In general, is it worth applying to do a sub-i at a place that you otherwise wouldn't have a shot at like applying to Upenn or UCSF, or is it better to do it at a program you have a good shot at anyway.

 

[Postictal Raiden]

In general, is it worth applying to do a sub-i at a place that you otherwise wouldn't have a shot at like applying to Upenn or UCSF, or is it better to do it at a program you have a good shot at anyway.

What kind of question is this?

Of course doing a sub-I at place that you have a reasonable shot at is better than somewhere you don’t.

 

[RainbowYoshi]

What kind of question is this?

Of course doing a sub-I at place that you have a reasonable shot at is better than somewhere you don’t.

Sorry if I was unclear. It was more I was unsure if the purpose of a sub-I was to make you more likely to to be interviewed at a program vs making it more likely you’d be ranked highly by the program.

 

[Telamir]

So this depends:

If you do a Sub-I somewhere you have ZERO hope from matching you may get a courtesy interview, even if you still have no chance at matching there and this may give you some false sense of hope.

On the other hand if a program is just slightly out of reach it may work out in your favor.

Thing about Sub-Is though is that they can be double edged. If you look good on paper but are super awkward (or hard to work with) or the residents don't like you you might end up blacklisted by the residents themselves. It may also make you look good and end up matching there. I've seen it go both ways where I trained.

 

[Telamir]

Also worth noting. Sub-Is are not free. You pay for accommodations and travel, etc etc. You should be selfish about it and go with a goal. How is this best going to help you? Are you here for LORs, or are you here for an audition cause you like the program? Etc. etc.

 

[Samsungs9]

Do you think sub-Is/aways are essential to match mid/top tier neurology programs? I am a DO with the following stats. USMLE1 245+ and comlex 1 650+, 0 research. I am researching programs at the moment but with costs for accommodations and the thought of being away from my family, I'm a little hesitant. I've reached out to upperclassmen and there isn't really a consensus on whether the away/audition strengthened their application for residency.

 

[Postictal Raiden]

Do you think sub-Is/aways are essential to match mid/top tier neurology programs? I am a DO with the following stats. USMLE1 245+ and comlex 1 650+, 0 research. I am researching programs at the moment but with costs for accommodations and the thought of being away from my family, I'm a little hesitant. I've reached out to upperclassmen and there isn't really a consensus on whether the away/audition strengthened their application for residency.

As mentioned above, auditioning at a place that is a little out of reach (OHSU, Duke, CCF, Case, Mayo AZ/FL, USC, etc...) may help you match at that specific program. Auditioning at a place that is totally out of reach due to lower than average boards or lacking research (or in your case being a DO) is a waste of time. For example, I find that rotating at UCLA as a DO student is a total waste of time.

Doing an audition has also other benefits. You can obtain a letter from an ACGME residency program faculty. This tends to have a lot more weight than a letter from a PP physician. You also get exposure to residency structure and cool cases. You will often be asked on interviews to talk about your audition experiences or cool cases you encountered.

If I were you, I'd pick a local (within driving distance) ACGME neurology program and try to do an audition there. Otherwise, your scores are solid to get plenty of invites from mid-tier academic programs.

 

[typhoonegator]

Do you think sub-Is/aways are essential to match mid/top tier neurology programs? I am a DO with the following stats. USMLE1 245+ and comlex 1 650+, 0 research. I am researching programs at the moment but with costs for accommodations and the thought of being away from my family, I'm a little hesitant. I've reached out to upperclassmen and there isn't really a consensus on whether the away/audition strengthened their application for residency.

Sub-I's at a top tier neurology program are absolutely not required to match there. Pretty much everything else has already been said. They might help a little, or hurt a little (or a lot, if you're annoying or bad) at a particular institution, but overall they are certain to be expensive and time-consuming. Only do one with a clear goal in mind, and don't expect getting a sub-I at Hopkins means you just have to shine on your rotation and you're in.

 

[RainbowYoshi]

Would doing a sub-i to get a letter from an attending in a state you otherwise have no ties to help match in that state, or does it not make a difference.

 

[Telamir]

I think you're over-thinking the LOR situation.