Silas Wright

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A delayed path has led me to anesthesiology as a prospective career. However, my background is a bit untraditional and -- uncertain of how competitive of a candidate I am -- I thought that picking the minds of some SDN'ers couldn't hurt.

I'm an undersea and diving medical officer in the US Navy. After a transitional internship, I went through six months of dive school and undersea medicine training. Currently, I'm working in the operational setting as part of a service obligation and plan a residency in anesthesiology after leaving the active duty Navy.

Current Service:
-undersea medical officer
-qualified Navy deep sea diver
-Research/publications is diving, hyperbaric, and preventive medicine
-Interesting experiences aboard submarines, running a primary care clinic, managing radiation health programs, deep sea diving, handling medevacs and dive casualties, etc.

Transitional Internship:
-Competitive program among the Navy's internships
-Final eval placed me objectively in upper half of transitional class
-Especially strong evals in MICU, trauma surgery, and an anesthesiolgy elective (one month)

Medical School:
-US Allopathic
-Passing grades years 1-2
-Third Year Clerkships: Honors in medicine and surgery
-Fouth Year Clerkships: Honors in anesthesiology elective (1 month away), ER, medicine sub-I, neurology
-Gold Humanism Honor Society: some on SDN scoff at the organization, but at the very least you could call it evidence that I get along well with others

Undergraduate/Other:
-humanities major at liberal arts college
-published works of fiction
-worked for one year as an OR scrub tech

My main problem and concern -- and perhaps the point of this post -- are my boards. Although I never failed a step, all three of my USMLE's were around 200. In medical school and the first six months of internship, I wanted nothing to do with research or academic medicine and planned a career in primary care. However, the internship rotations in critical care, anesthesia, and now the undersea medicine experiences have changed my focus completely. I caught the research bug, love anesthesiology, and want an academic career in the field and thus am interested in applying to very strong programs.

Basically, I have three questions:
1) Do I have a prayer at strong academic programs? I plan to settle in the northeast and am especially interested in Yale, Dartmouth, and Rochester
2) If not, do I need to just worry about matching? Anesthesiology appears to be getting only more competitive with time -- the 200 trifecta being a significant liability I would imagine.
3) Top programs or not, would I have better luck applying as a US grad through the match or by trying to secure a spot outside the match, contacting program directors directly, sending CV's, etc.?

All honest advice is greatly appreciated!
 
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Arch Guillotti

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I would imagine that your military experience could only help you. The only thing that is POTENTIALLY concerning is the fact that you may have been out of traditional medical care for a while, sorry I have no idea what an undersea and diving medical officer in the US Navy does. I imagine that you are doing regular old primary care so I don't think this will hinder you at all.

PLENTY of people match with mediocre board scores (like me:oops:). So long as you follow the usual conventional wisdom (apply to a bunch of places including ones that are a "reach" and ones that are a backup and go on enough interviews). As long as I have been on this board there has always been talk about how competitive anesthesia is/is getting but IMHO it really hasn't changed too much over the years. There are tons of programs in the NE you shouldn't have a problem matching somewhere so long as you can tie your shoelaces and are not a psycho (at least that they figure out on interview day:p). The "moderator emeriti" of this group is OldManDave and he completed his residency at Dartmouth not too long ago, you may want to PM him for details. He hangs out at oldpremeds.org a lot and you might could catch him there as well. I can't speak as to the question of signing outside of the match, but it seems to happen a moderate amount. Some programs hold out spots for persons switching from other fields, etc.

Good luck!

edit: you board scores may hold you out of some programs that have a "cutoff". It is in your favor that you have easily passed all steps w/scores >200. You might not match at Penn/JHU but you never know - I interviewed at both those programs with a Step I of 200.
 
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RxBoy

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You seem like a very well rounded applicant and could def find a spot. It will def. stand out among others.

Unfortunately board scores are pretty important because a lot of these top programs have a cutoff. Some cut at 220, some at 200, some read each individual applicant (which would def. favor you). If your step 1 is <200 than you probably have a small chance with the prestigious institutions. Your Med School ranking could make or break you as well. I had competitve board scores and the interviews were flooding before my MSPE was submitted. After the remaining programs caught whiff of my bottom 50% ranking, the rejections started coming in and I haven't recieved an interview since.

Your best bet at matching was matching 4th year MS. Your chances of matching now are going to be hindered but it doesn't mean you won't match if you apply. If I were you I would def. ask around and see if there are any open spots for next year. If your plan is just to match w/o specific institution than your chances of matching will be pretty high. For example if you just want to match in the NE territory, there are plenty of spots. They may not be top tier but if its anesthesia you love, then you'll just have to settle. Either way it doesn't hurt to try. Best of Luck.
 
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militarymd

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Former Navy doc here.

Also former chair of education committee for the anesthesia program at Portsmouth.

I would recommend you apply to the Navy programs..ALONG with the civilian ones.

The Navy releases it's match results in December....so you may have to commit before the Civilian match results are out...the only down side...


But I do know of people who've dragged their feet with the paperwork with the Navy until the civilian results are out...then jump ship.
 

Bertelman

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OP,

With your experience, +200 bard scores should be sufficient to find a program. The diving stuff is pretty cool. Use your experience to your favor. Ever worked with anyone at Duke with your diving research? Try to get an LOR or a phone call to help you get an interview. It's a top program which would normally be closed to your board scores, but that's where experience and connections pay off.
 

bubalus

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Another thing to be aware of is that you are free to take a position outside the match because you're not a 4th year med student. This can work well to your favor. People are interviewing now for PGY2 spots starting 2010. There are a few PGY2 spots starting 2009 out there, and a program could easily divert one of its 2010 PGY2 spots from the match to outside the match. You may want to consider sending a CV and cover letter to every program you may be interested in and see what happens. Some programs also have alternate start dates, so if you left active duty in November, for example, you may be able to start January. Not as common as a July start date, but it happens.
 

CambieMD

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You will find a program. You bring different experiences to the table. That is a big strength. Residents with different life experiences balance a program.
That is no secret.

Cambie
 

militarymd

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You will find a program. You bring different experiences to the table. That is a big strength. Residents with different life experiences balance a program.
That is no secret.

Cambie


What the hell does that mean?

Everyone says it...I've heard it a million times...I've trained 5 years worth of Navy residents with backgrounds like his...and straight arrows....

I still don't know what the hell that means?


Do they interpret Miller in an existenial way that a younger person can't?

Do they intubate with a different perspective?

Perhaps it's their approach to the central line?

Or do they bond better with their old anesthetized patients during their AAA cross-clamp?

Please explain.
 
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