Need some clarification on residency and matching.

[Kape1one]

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Hello SDN,

I am still a pre-med.

I just need some clarifications on matching and residency.
Do you "choose/pick" your specialty during your clinical years (3rd/4th) of medical school?
Let me just give you a scenario.

If a students wants to specialize in Emergency Medicine or Surgery, does the student only perform rotations in those departments in medical school?
Also, I hear people talking about USLME and Step 1 Scores. Competitive specialties require high Step 1 scores and high grades, but what happens if the student does poorly on the USLME? Is the student rejected from all EM and General Surgery residency programs?


Can you apply again next year if you get rejected from your dream specialty?

Finally, can students apply to two or three different specialties?

Thanks!

I appreciate your info!

 

[Starlightembers]

Hello SDN,

I am still a pre-med.

Hello.

In the purpose of full disclosure, I will say I am a pre-med, too, so this information does not come from first-hand experience; but information I have gained via reading this board and other sources.

I just need some clarifications on matching and residency.
Do you "choose/pick" your specialty during your clinical years (3rd/4th) of medical school?

You actually send out applications to residency programs during your fourth year. When a student actually decides/realizes what specialty they want to go into, however, varies; many do choose during 3rd/4th year.

Let me just give you a scenario.

If a students wants to specialize in Emergency Medicine or Surgery, does the student only perform rotations in those departments in medical school?

No. They have to perform a set of "core" rotations that all students, no matter the specialty they plan on going into, have to complete. In addition to your core rotations, however, you can take electives to gain more exposure to a certain specialty.

Also, I hear people talking about USLME and Step 1 Scores. Competitive specialties require high Step 1 scores and high grades, but what happens if the student does poorly on the USLME? Is the student rejected from all EM and General Surgery residency programs?

It depends on how you define "poorly".

All students have to PASS the USMLE Steps. Once you pass, you cannot take it again, so you are "stuck" with your score (if you fail, most schools will allow you to retake it once or twice).

If a student gets a score that is below average for a certain specialty, they are not necessarily rejected from all programs, especially if they apply broadly enough. It will hurt them, however.

Can you apply again next year if you get rejected from your dream specialty?

It depends.

If that was the only specialty you applied to -- and, as such, the only specialty you had ranked -- you have the choice to "scramble" (try to get an unmatched spot after the match occurs) or choose to reapply the next year.

If you ranked another specialty and matched into that, then you would not be able to simply reapply.

Finally, can students apply to two or three different specialties?

You can apply to as many specialties as you want/can afford to send applications to; however, you can only match into one.

Thanks!

I appreciate your info!

Good luck.

 

[Kape1one]

Thanks! I appreciate it a lot.

Residency, matching, etc is much clearer now!

 

[organdonor]

What was said above is correct. I will however go into some further detail regarding the match.

In your 4th year of medical school you will indeed apply to different residency programs. Each program will see your grades, test scores, and the rest of your application. If the program thinks they may be interested in you they will invite you for an interview.

At the end of the interview season you will rank the programs you would like to go to. For instance, I liked program A so I ranked them #1, I liked B less so they are #2, and so on. At the same time, residency programs also rank their interviewees. They liked applicant Z so they rank them #1 but they hated applicant Y so he gets ranked #324. Everyone's rank lists, students and residency programs, gets submitted to the same place. This centralized location will match up applicants with residency positions, and it is a binding contract. To me the binding contract thing is kinda scary. Consider that there may be few residency programs of any certain specialty (IM and FM notable exceptions) in a location you may want to be. In order to apply broadly to dermatology residencies you are going to probably have to fly around the country and rank many many places. And at the end of the day do you know what decides which of these very different programs you end up at? A computer. You may apply to as many specialties as you like, but this even exaggerates the role the computer plays as it would decide the rest of your career. Also you want to apply broadly to any specialty, and you would run yourself ragged trying to apply broadly to several different specialties. However it isn't uncommon to have people apply to two different specialties. Just realize that then you are letting a computer pick your career for you!

With this setup it is possible to not match anywhere. This would occur when all the programs that you ranked highly ranked other candidates higher than you. These unmatched students have an opportunity to go into the "scramble" as it was formerly called. It has actually changed this year a little bit but not by a whole lot as I understand. At a certain time at the exact same time across the country, all unmatched students are given a list of residency programs that still have unfilled positions in their area of interest. Then you call, email, fax, plead, beg, anything you can think of to have one of these programs let you in. Alternatively you could sit out a year and try again while applying more broadly.

 

[Starlightembers]

Thanks! I appreciate it a lot.

Residency, matching, etc is much clearer now!

No problem. Glad I could be of help.

And thank you to organdonor for the elaboration and detailed information.