No interviews yet, what to do...

[FIREitUP]

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The school suggested that deferring graduation would be an option, but they're heavily discouraging that. They are really pushing the prelim surgery thing. I don't know if that's a good idea for me. My advisor told me that my best bet was to either take the prelim surgery spot at our program, or graduate, get some sort of research job, and then either find a spot outside of the match or apply again next season. Any thoughts on this plan?

prelim surg is hell from what i've seen. i would go the research job route, i think you could find a spot outside of the match. did you take step 2 yet?

 

[Wordead]

The school suggested that deferring graduation would be an option, but they're heavily discouraging that. They are really pushing the prelim surgery thing. I don't know if that's a good idea for me. My advisor told me that my best bet was to either take the prelim surgery spot at our program, or graduate, get some sort of research job, and then either find a spot outside of the match or apply again next season. Any thoughts on this plan?

What I know about prelim programs is largely hearsay, so take it with a grain of salt, but I really don't think it's a good idea for you. You are guaranteed nothing after your year is up (which will be BRUTAL). Given your lack of interest, do you think you'll work hard enough during your prelim year to secure a categorical position? My impression is no....

 

[BrooklynBulls]

The school suggested that deferring graduation would be an option, but they're heavily discouraging that. They are really pushing the prelim surgery thing. I don't know if that's a good idea for me. My advisor told me that my best bet was to either take the prelim surgery spot at our program, or graduate, get some sort of research job, and then either find a spot outside of the match or apply again next season. Any thoughts on this plan?

I'd refuse prelim surgery at all costs. That's just me, but that's what I think.

The school suggested that deferring graduation would be an option, but they're heavily discouraging that. They are really pushing the prelim surgery thing. I don't know if that's a good idea for me. My advisor told me that my best bet was to either take the prelim surgery spot at our program, or graduate, get some sort of research job, and then either find a spot outside of the match or apply again next season. Any thoughts on this plan?

I'd go for the research job, try to SOAP, if that fails, then look for residency programs out of the match (which usually suck, but hell, I'd rather do that than not have a residency), then reapply for the match if necessary, sending out a truly massive wave of applications in multiple non-competitive specialties. I'd spend the remainder of your 4th year taking challenging electives or if you have core rotations left, doing EVERYTHING I can to get honors and impress attendings. If you do well (and you'd better), get letters from them.

 

[ACSurgeon]

What I know about prelim programs is largely hearsay, so take it with a grain of salt, but I really don't think it's a good idea for you. You are guaranteed nothing after your year is up (which will be BRUTAL). Given your lack of interest, do you think you'll work hard enough during your prelim year to secure a categorical position? My impression is no....

After a prelim year of anything, at least you're eligible to apply for an unrestricted license after passing step 3. This actually makes the MD meaningful in terms of clinical and non-clinical opportunities. Also might make him more attractive for the following match.

I'd refuse prelim surgery at all costs. That's just me, but that's what I think.

It's not universally bad. It's worse for those wanting to do surgery who bust their balls with no real guarantee for a categorical position. For someone who is faced with the option of surgical prelim (or any prelim) or get out of clinical medicine all together, I'd take the prelim year, get my license, and then look into opportunities (moonlighting type jobs, work for a company, reapply to the match, etc).

Granted, some surgery programs are "malignant", and for those programs the prelims are treated that much worse. For programs with mostly normal people (faculty and residents), a prelim will work just as hard as categorical interns, but won't be treated differently and it's not a bad experience. I know we work harder than non-surgical residencies, but it's not as bad as people make it out to be. Finally, our prelims are treated similar to our categorical interns. As a matter of fact, last year, both prelims were favored by senior residents/staff over most categorical interns.

 

[BrooklynBulls]

It's not universally bad. It's worse for those wanting to do surgery who bust their balls with no real guarantee for a categorical position. For someone who is faced with the option of surgical prelim (or any prelim) or get out of clinical medicine all together, I'd take the prelim year, get my license, and then look into opportunities (moonlighting type jobs, work for a company, reapply to the match, etc).

I think a surgery prelim is a great way to limit options. In the next match, if this guy gets interviews, will the prelim allow him to go to all of them? All over the country? Hard to know, hard to plan for. Several friends of mine had to refuse interviews in remote locations, and ended up not matching. They are bitter about that. Similarly, signing that contract means you can't get out of it, a lot of the time. My perspective is that if you don't match once, do a research year (and do it hard), or extend graduation (and still do a bunch of research). The nice part about that is that you'll be able to go on all your interviews, you will buff your CV for your future, and you'll hopefully make connections in the field you want to go into.

Doing a prelim surgical year for somebody not interested in an advanced position in surgery, or even in programs that are advanced and require a separate internship, is a waste of time and an incredible waste of effort, misdirected into a grueling year rather than their actual goal; securing a residency. If all else fails, it's very likely this guy can get a prelim surgical year in NEXT years match, so he can still practice medicine in some capacity in his future.

 

[ACSurgeon]

I think a surgery prelim is a great way to limit options. In the next match, if this guy gets interviews, will the prelim allow him to go to all of them? All over the country? Hard to know, hard to plan for. Several friends of mine had to refuse interviews in remote locations, and ended up not matching. They are bitter about that. Similarly, signing that contract means you can't get out of it, a lot of the time. My perspective is that if you don't match once, do a research year (and do it hard), or extend graduation (and still do a bunch of research). The nice part about that is that you'll be able to go on all your interviews, you will buff your CV for your future, and you'll hopefully make connections in the field you want to go into.

Doing a prelim surgical year for somebody not interested in an advanced position in surgery, or even in programs that are advanced and require a separate internship, is a waste of time and an incredible waste of effort, misdirected into a grueling year rather than their actual goal; securing a residency. If all else fails, it's very likely this guy can get a prelim surgical year in NEXT years match, so he can still practice medicine in some capacity in his future.

Pros and cons I guess… Keep in mind that the further you are from clinical rotations, the less desirable you are as an applicant. Delaying graduation and doing research with a few rotations is an option. There is no perfect answer here.

 

[tpn89]

Thanks,

Sounds like taking a prelim spot is a terrible idea, and I don't think I'll be doing it.

So right now my dilemma is whether I should pull out of the match now and postpone graduation, or I should stay in the match and see what happens, including SOAP. Does it make a difference if I have a failed match? Would I be better off pulling out?

 

[tpn89]

Why would you pull out?

The whole delaying graduation thing should be contingent upon whether or not you match.

My advisor thinks it will be easier for me to match if I don't have "failure to match" on my record. If I pull out, he can just write in my dean's letter that I was on "extended curriculum". He thinks that would be safer. Do you agree?

However, he doesn't want to postpone graduation for me at all. The school wants me to take a prelim spot, and if I can't do that, they just want me to graduate and figure it out on my own. They already told me that they are strongly discouraging postponing graduation as they think I have a very very low chance of matching if I do. They hinted that they will give me a hard time if I want to exercise that option, instead of taking the prelim spot.

 

[ACSurgeon]

My advisor thinks it will be easier for me to match if I don't have "failure to match" on my record. If I pull out, he can just write in my dean's letter that I was on "extended curriculum". He thinks that would be safer. Do you agree?

However, he doesn't want to postpone graduation for me at all. The school wants me to take a prelim spot, and if I can't do that, they just want me to graduate and figure it out on my own. They already told me that they are strongly discouraging postponing graduation as they think I have a very very low chance of matching if I do. They hinted that they will give me a hard time if I want to exercise that option, instead of taking the prelim spot.

My advice would be to
1 stay in the match
2 soap if you fail to match
3 take a prelim spot or whatever you can get

Your priority should be continuity of clinical experience especially in light of your school not supporting the option of delaying graduation. Your priorities should be to secure the degree followed by securing a license. This will keep some doors open to be a physician

 

[a runner]

My advice would be to
1 stay in the match
2 soap if you fail to match
3 take a prelim spot or whatever you can get

Your priority should be continuity of clinical experience especially in light of your school not supporting the option of delaying graduation. Your priorities should be to secure the degree followed by securing a license. This will keep some doors open to be a physician

I agree with this. Wasting time on a research year will not help you or make you any more competitive, especially if you have already graduated and are applying as a "US Grad" instead of a "US Senior" as it seems like your school is forcing you into. The programs and positions that you will be competing for will be uncompetitive community programs and not likely care at all about research.

There are some benefits to this though. You will have passing step 2 scores on the books. You will be able to apply at the beginning of the cycle. And you will be able to go on all your interviews. All of this is true (except possibly the going on all your interviews part) if you are doing a prelim year too, though.

Also, a prelim position is not a dead end road. There were 274 positions available in the match last year that were only for physicians who will have completed a PGY1 spot by the end of the year, and out of those only 211 filled. The specialties included: Neurology (23 spots), Psychiatry (50), Radiology (31), Radiation Oncology (7), Dermatology (14), Anesthesiology (98), and a few others. In addition, there are other spots that open up in various specialties outside of the match that you could try to get. Even if all that fails, you are at least eligible to sit for Step 3 and get your medical license at the end of a prelim.

As far as FM and IM, you would likely have to repeat some or all of your 1st year if you do a surgery prelim. If you can manage to get a medicine prelim, that would count as your PGY1 of an IM residency if you could find an open PGY2 IM position afterwards, but won't count as the first year of an FM residency.

 

[evilbooyaa]

1. Try to match
2a. SOAP, going for prelim IM > Prelim surg
2b. Speak to your school and see if they will let you delay graduation. This is ideal. The whole idea of 'failed to match' is not something that shows up in ERAS per what I've been told.

Honestly, I think your best bet is to take a prelim year. It will be hard and it's definitely not a guarantee at all, but you can get more LoRs from people you work with, try to make connections at the corresponding IM/FM program at the same hospital, and see if someone will look at you a bit more favorably.

However, as SouthernIM (SouthernSurgeon? WTF man lol) said, your school wants you to graduate and match into a prelim surg spot so they can say that you 'matched' and it won't hurt their match percentage. They are looking out for their own best interests, not your best interests, in this situation.

 

[a runner]

To give them some credit, I do think it's very possible that may just be the best the OP can hope for. But I don't understand the advice to drop out of the match - he's gotten a couple of interviews so there is at least a slim slim chance.

And the OP's best chance for a categorical spot is probably going to be SOAP more than the match. By then hopefully he/she will have passing step 2 scores. If you drop out of the match, you can't SOAP. I agree - dropping out of the match just doesn't make sense.

 

[tpn89]

Thanks everyone, I'm going to stay in the match and see how things go.

I was wondering, since I have failing attempts / poor board scores, if it would make any sense for me to graduate, study hard and take Step 3, so I can at least show the PDs a good step score.

 

[ACSurgeon]

Thanks everyone, I'm going to stay in the match and see how things go.

I was wondering, since I have failing attempts / poor board scores, if it would make any sense for me to graduate, study hard and take Step 3, so I can at least show the PDs a good step score.

A good step 3 would not change much. If it was me, I would try to get any clinical year available (if categoricals are all out).

 

[tpn89]

A good step 3 would not change much. If it was me, I would try to get any clinical year available (if categoricals are all out).

Thanks. Suppose I end up not being able to find any spots in the SOAP, at that point would you think given my very low step scores that graduating and taking Step 3 would be better than delaying graduation and doing more rotations/research?

 

[Beacopp665]

Thanks. Suppose I end up not being able to find any spots in the SOAP, at that point would you think given my very low step scores that graduating and taking Step 3 would be better than delaying graduation and doing more rotations/research?

I think in the event that the SOAP doesn't work out, if delaying graduation is on the table in any capacity you should go for that over graduating just to take step 3.

Edit: is it still on the table, from previous posts it seemed like your school may not allow this?

 

[ACSurgeon]

No one really cares about Step 3 scores (unless of course you fail it). Also no one really knows what "rocking" step 3 looks like since most people study only a very minimal amount for it.

As the above poster said - if you fail to get a spot in the main match or SOAP, you should absolutely try and delay graduation if that is on the table.

And just to be clear, ANY spot is better than delaying graduation. So any prelim is better than delaying graduation in my opinion.

If you can't get a spot, and your school pushes you to graduate on time, then I'd look for research and try to get step 3 out of the way before the next match...

 

[PatsyStone]

I think in the event that the SOAP doesn't work out, if delaying graduation is on the table in any capacity you should go for that over graduating just to take step 3.

Edit: is it still on the table, from previous posts it seemed like your school may not allow this?

I don't think you can take Step 3 until you graduate (see page 4 http://www.usmle.org/pdfs/bulletin/2014bulletin.pdf)

 

[Beacopp665]

I don't think you can take Step 3 until you graduate (see page 4 http://www.usmle.org/pdfs/bulletin/2014bulletin.pdf)

I'm aware of that which is why I cautioned OP to delay graduation if possible instead of graduating in order to "rock" step 3.

 

[tpn89]

I'm aware of that which is why I cautioned OP to delay graduation if possible instead of graduating in order to "rock" step 3.

I agree, I just thought that since I have a history of failing and marginally passing both Step 1 and Step 2, passing Step 3 by a comfortable margin might help to convince the PDs that whatever was causing my bad performance on previous step exams is not an issue anymore.

 

[Beacopp665]

I agree, I just thought that since I have a history of failing and marginally passing both Step 1 and Step 2, passing Step 3 by a comfortable margin might help to convince the PDs that whatever was causing my bad performance on previous step exams is not an issue anymore.

It's a fair thought but whatever benefit that would give you would be significantly outweighed by the disadvantage of applying next year as an independent applicant rather than a US senior (all assuming delayed graduation is an option). Prelim surgery spot would be worse than delaying grad IMO. Just apply on time and to a wide range of programs and with those stats in addition to what you could during your next year I think you would have better chances of matching

 

[Winged Scapula]

I agree, I just thought that since I have a history of failing and marginally passing both Step 1 and Step 2, passing Step 3 by a comfortable margin might help to convince the PDs that whatever was causing my bad performance on previous step exams is not an issue anymore.

Not really.

Most would realize that the vast majority of US students pass Step 3 on the first try and most don't try and do anything but pass (i.e., no one really looks at the actual score).

Since its widely considered to be the easiest of the steps, a pass is expected and exceeding a passing grade won't add anything to her application.

 

[tpn89]

Not really.

Most would realize that the vast majority of US students pass Step 3 on the first try and most don't try and do anything but pass (i.e., no one really looks at the actual score).

Since its widely considered to be the easiest of the steps, a pass is expected and exceeding a passing grade won't add anything to her application.

I agree, but the vast majority also pass Step 1 and 2 on the first try, and I didn't. So it wouldn't be unreasonable for the PD to assume I'd also have trouble with Step 3 and specialty board exams given my history, right? My thinking was maybe if I showed I could get through an exam on the first try, that would give the PDs more confidence in me.

 

[tpn89]

I think the bigger concern from PDs is going to be your issues clinically.

If they are willing to overlook your step failures and still consider you, they will.

If they aren't willing to overlook them, Step 3 won't change their minds.

And as has been said over and over, reapplying as an independent graduate is worse than as a current med student.

Ok, sounds good. Thanks for all the advice, I really appreciate it. Same to everyone else who helped out here.

I'm gonna stay in the match, and try to get into anything except for a prelim surg spot. If I can't get into anything, I'll work on convincing the school to let me postpone graduation. They're not very keen on doing it, but I'll have to state my case and persuade them if possible.

 

[tpn89]

Just to clarify, do you all generally agree that it would be better to take a prelim spot in this year's match, than try to grab a categorical spot in next year's match? I know a couple people had thought that was a good idea but I just wanted to get some more opinions on that. I think if I apply on time and with all my ducks in a row (this time I applied very late and didn't have my scores all in), I might get a few more interviews next year -- or will pushing back graduation be enough of a red flag that it'll cancel out any benefit from applying early with a complete application next time around.

 

[Winged Scapula]

I agree, but the vast majority also pass Step 1 and 2 on the first try, and I didn't. So it wouldn't be unreasonable for the PD to assume I'd also have trouble with Step 3 and specialty board exams given my history, right? My thinking was maybe if I showed I could get through an exam on the first try, that would give the PDs more confidence in me.

I can understand your line of thinking but as @SouthernSurgeon notes, you passing Step 3 is not going to be at the forefront of their issues with your application.

If they can overlook the other issues with the USMLE, then it shows they are willing to consider you and expect that you will pass Step 3.
If they won't overlook Step 1/2, then Step 3 is a moot point.

 

[Winged Scapula]

Just to clarify, do you all generally agree that it would be better to take a prelim spot in this year's match, than try to grab a categorical spot in next year's match? I know a couple people had thought that was a good idea but I just wanted to get some more opinions on that. I think if I apply on time and with all my ducks in a row (this time I applied very late and didn't have my scores all in), I might get a few more interviews next year -- or will pushing back graduation be enough of a red flag that it'll cancel out any benefit from applying early with a complete application next time around.

I think we (or at least some of us) are saying that its better to do a real effort at the match next year, with a delay of graduation, if you don't match or can't find a good position in the SOAP, than taking a Prelim position which will not allow you time off to interview and won't give you any credit toward further training. After all, its not as if your application doesn't already have red flags; I can imagine a PD thinking that you taking the extra year to graduate could be a good thing given your previous problems.

 

[tpn89]

I think we (or at least some of us) are saying that its better to do a real effort at the match next year, with a delay of graduation, if you don't match or can't find a good position in the SOAP, than taking a Prelim position which will not allow you time off to interview and won't give you any credit toward further training. After all, its not as if your application doesn't already have red flags; I can imagine a PD thinking that you taking the extra year to graduate could be a good thing given your previous problems.

Ok that makes sense. I think that's exactly what I'm going to propose to my school when the match arrives.

 

[tpn89]

Just thought Id' come back and post what ended up happening, since I wish more people would do that. After failing to match last year and extending graduation, I ended up matching in IM this year. Thanks everyone for your advice and support!

 

[pre med 2014]

Congrats!


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