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I was curious about DO friendliness ( Step 1 - 261, strong academic record, v. strong research) at JHU-Bayview, UMD. As for Cleveland - Cleveland Clinic, CWRU. As for NYC, I know Columbia, Cornell, NYU are untouchable for me, but was wondering about other University-cased programs: Sinai, Einstein, SUNY Downstate
Quite sure Bayview, UMD, CWRU, Sinai and Einstein don't take DOs.
Cleveland clinic is DO friendly and a pretty good option for a DO. Though it is essentially a fellow-run community hospital.
Stay away from SUNY downstate.
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MS3 from a mid-tier US school wanting to get a feel going forward where I may stand, and whether it is advisable to do away rotations if I am keen on a certain program.
Preclinical: mostly pass, some high pass
Step 1: 225
Clinical: HP across the board
Research: Was a research coordinator for a while
- 3 years of qualitative primary care research prior to medical school at a large academic institution
- Published three times - JAMA, Journal of Int Med
I am ideally looking at academic programs and am open to location. Leaning towards the mountain west and west coast. I know it may be a stretch but do you think I have a reasonable chance at Colorado, USC, UCLA-Harbor?
That was decidedly less helpful than what I was hoping. I am trying to think about how many programs I should apply to. Also, everyone says the top programs are a crapshoot for everyone, but I'm wondering do I have a 25% chance of an interview? 50%? 75%? higher?
Obviously no one can tell me for sure, but I imagine someone who has seen other student through this process can provide a better estimate than I can.
Getting an IM residency? Pretty good.I'm a non-US IMG with
Step 1: 267
Step 2 CK: 265
Step 2 CS: passed
YOG: 2016 (Applying for Match' 17)
Top 1% of my medical class
1 month clinical elective; 1 month clinical observership; 6 months of research electives in the US
6 pubmed indexed publications (2 from the US, the rest from my home country).
What are my realistic chances of getting an IM residency in one of the Top 10-20 programs?
Hello!
I am a rising 4th year from north east. I have 589 Comlex Level 1 , 222 in USMLE step 1.
I would like to get into a internal medicine program in north east.
Any suggestions about what programs are great and where would I be competitive?
Thanks!!
First time poster, don't be too tough.
It's not only WAMC, since i would like some advice about programs.
A little background: I'm a South American IMG currently in med school (5th year/6). I gave step one this year and got 265. I do not have a major research background. At the moment i'm doing my first clinical research in critical care, probably co-author, maybe 1st author, but it's a research that will take some time and i won't have time to many more researches or papers till application. Maybe one more. Lets assume that i won't make major mistakes on step 2 CK and CS. I'm not a visa holder. I'm a pulm/cc hopeful, and i'm not planning to go to the academic route. I would like to have a good trainning at a medium-large city.
Edit: i'm planning to do 2 months of clerkships- UT houston and Mayo and 2 observeships- UTSW and Upitts ( they dont take imgs for clerkships, unfortunetely).
Given all that, what do you guys think are my chances at two programs i like a lot: UPMC and UTSW? Heard U Colorado hardly takes IMGs, but i'd like to know if someone has any insights about it.
Additionaly, for family reasons, Texas is a specially desirable place for me. How good and WAMC in the other programs in there? UT-Houston, UT San Antonio etc. Any other programs that you guys think, outside of Texas, that would be desirable and realistic for me? Should i aim for what sort of tier?
Thanks in advance.
Those observerships are going to be worthless. Try to swap them for clerkships, even if it means doing them somewhere else.Edit: i'm planning to do 2 months of clerkships- UT houston and Mayo and 2 observeships- UTSW and Upitts ( they dont take imgs for clerkships, unfortunetely).
Thanks for the honest answers
Animalcules: My problem with mayo isnt rochester per se, its actually a geographical limitation of cities that have programs for diploma revalidation for internationally trained dentists ( girlfriend). I do understand that will make my life a lot harder. 1st rule of IMG matching: apply broadly and dont be overconfident. Unfortunately, i cannot apply as broadly as i wish.
Gutonc: im a little confused about clerk x observ. Since network is very important, at least thats what i heard, i thought doing observ in the places i hope to match would be better than doing clerkships in places that i cannot match. I have a contact at UPMC and he told me my chances there would increase greatly if i go there for an observeship. Ofc i could do 3m cleks and the observ there after. Please correct me if you think my thoughts are wrong about USCE.
WAMC:
very broadly applying upcoming cycle. GI hopeful, region doesn't matter, preference: academic (w/ fellowship) > community.
med school: low-tier MD in south
m1/m2 grades: mix of H/HP
step1: 236
step2cs/ck: pending
m3 grades: 1 H in peds, rest P, last rotation pending
LOR: 1 colorectal surgeon, 1 IM clerkship director, 1 IM associate PD of home prgm, 1 from IM chair at home prgm, hopefully 1 letter pending from each away
research: 2 1st author pubs in surgical subspecialty. multiple conference posters/oral presentations in same surgical subspecialty. 2-3 ongoing GI projects pending journal submission soon. undergrad national level presentations in obesity and metabolic syndrome.
aways: 1 rotation (GI) in Sept lined up, 1 hopefully pending for Aug
extracurriculars: specialty interest group leadership, school chapter for state medical board officer, free clinic
WAMC:
School: mid-tier MD on west coast
Step 1: 252
Step2cs/ck: 272
m3 grades: H in peds, IM and surg. rest P (no HP at my school)
LOR: ok, 1 peds doc, 1 IM doc and 1 from IM assistant director
research: minimal, 1 poster, 1 pending pub in neuro.
extracurriculars: work at free clinic, tutoring
Hoping to apply to north-east for family reasons, wondering if minimal research and extracurriculars will hurt me.
Thanks!
Trying to see what my chances are for I.M. (and what kind of programs are realistic for me):
Background -
Started med school in 2011 but took one year leave of absence for health reasons after just a couple days of class (didn't take any exams or anything).
Returned as part-time student the following year (did the part-time tract offered at our school due to on-going health and family reasons). Basically the way it works is your M1 year is taken over 2 years.
Did fine the Fall semester of M1 year 1.
I Failed anatomy class and histology class in Spring semester of M1 (year 1). Passed the make-up histology exam over summer. Failed the make-up anatomy exam.
Because I was part-time M1 anyway, I retook Anatomy during my M1 (year 2) (with the other classes I hadn't taken yet) and passed.
Would say my academic troubles end of first year highly related to medical and family issues on-going at the time. Which is why the school allowed me to simply retake anatomy with the second half of my outstanding M1 classes the next year (but technically counted as "repeat year" - though as explained, because it is a part-time program, I was already scheduled to take all of the other M1 courses in the upcoming year anyway).
Subsequently finished M1 and M2 with no academic problems after this. I have completed all M3 rotations thus far except Psychiatry.
M3 grades are: High Pass in Surgery (2nd highest grade below honors) and an Honors grade in my I.M. rotation. Still waiting on F.M., pediatrics, and OB/GYN grades (though I have completed these rotations).
M4 year starts in about 6 weeks.
USMLE Step I 225.
U.S. M.D. student at state M.D. school. Not a top 20 school or anything.
Very well-liked/personable and hard-working.
Medical/family issues previously stated have been resolved for the past 3.0 years.
Thanks in advance for your opinion.
WAMC:
School: lower-tier MD on east coast. Top quartile of class, 3.8 GPA. AOA unsure but let's say no just in case.
Step 1: 224
Step2cs/ck: Haven't taken yet
m3 grades: H in IM
LOR: Haven't decided who to pick yet
research: 2-3 case reports, 2-3 retrospective cohort studies, 1-2 abstracts. Most are in trauma/surgical fields. I mostly just did whatever research I found. Currently in the process of doing a cardiology case report.
I am hoping to stay in the southeast if possible. Emory is my dream school so I can stay near my family since they live in Atlanta. Is this even possible with my step 1 score? Hopefully I can score 240+ on step 2ck. Should I do an away rotation at emory or is it a lost cause? what types of schools should I be focusing on? I would like to end up in cardiology.
Thanks!
very doable. you have a great app minus the steps which really arent that bad
Hey all - as MS-IV year comes around - I would really appreciate any help on my list
Medical School: Top 25
USMLE Step 1: 259, Step 2: Not yet taken
AOA: we only do senior AOA at my school, and I am in contention (will find out in November)
Grades: Honors in all clerkships with exception of OB/GYN (High Pass)
Research: Heavily basic science. Prestigious year out fellowship (Sarnoff), third-author basic science manuscript, manuscript currently in progress, two oral presentations, several poster presentations, 1 book chapter in cardiology
Recommendations: Strong. 1 from home IM PD with strong reputation, 1 from cardiologist/research mentor. 1 from year-out Sarnoff Preceptor (internationally known basic scientist with a lot of clout)
Extracurriculars: nothing spectacular - histopath and anatomy tutoring, cardiology specialty group leader, etc. - most of my time spent on research
Very strong interest in cardiology (shocker haha)
Programs List:
MGH
BWH
BID
JHH
UCSF
Stanford
UW
Duke
Columbia
NYU
Penn
UTSW
Vanderbilt
UMichigan
UChicago
WashU
Northwestern
Case
What Are My Chances:
School: Midwest top something school
Step 1: 254
Step2: Taking this summer
M3 grades: H in IM, Obgyn, Neurology, Family. HP in Surg, Peds, probably Psych.
AOA: Unlikely, very average student at my school.
LOR: 1 Chair's letter(composite type letter based off performance on medicine, should be strong). 1 from ONC attending(former chair, offered to write letter but good chance will be impersonal "big wig" type letter), +hopefully from MICU subI or elective this summer.
Research: minimal, 1 first author paper from undergrad work submitted will hopefully be accepted before I apply, 1 presentation at national conference in social sciences, 2 posters at local conferences from quality improvement work in medical school
Extracurriculars: Year off with masters public health related, some free clinic leadership, some minor institutional activities
Interested in primary care programs with eventual goal of primary care or ID. Hoping to go west(from California originally). Was told by advisor won't be competitive for Stanford based on previous students from our institution and UCSF is possible but big stretch. Chances at UWash, UCLA, OHSU, UCSD? Any other strong programs that way I should consider that will set me up for academic primary care or ID? Will probably also apply to east coast and a few midwest programs.
Just wanted to bump my original post to see if anyone had a response or suggestions on application strategy. I plan to apply for ~100 programs.
Original:
What Are My Chances:
School: Top 20.... but not top 10.
Step 1: 250s
Step2: Should have score before apps go in
M3 grades: HP neuro, P surgery, all others honors including Medicine core, several non-IM electives, sub-I to come
AOA: 50/50.
LOR: 1 Chair's letter (composite), 1 from junior attending who knows me well, should be very strong (he's on the residency app review committee, told me he will write something that 'stands out'), 1 from "big wig"
Research: Weak spot for sure. 3 projects, 1 presentation, 3 pending presentations, should have 3 manuscripts drafted/submitted for publication by September, but nothing accepted
Extracurriculars: Lots of activities (through school, volunteer work in the community, hobbies etc). No one thing that is going to be impressive, but should at least demonstrate I do more than study.
Interested in academic programs in larger cities, ideally with multiple teaching hospitals (county, private). Haven't sat down to do any research yet so basing my prelim list based mostly on location and a little bit on reputation amongst peers at my school with a few definitely huge reaches just for fun.
Chances for: Big 3, Stanford, BID, Penn, Vanderbilt, UPMC, UW, UTSW, Northwestern, Colorado, OHSU, Baylor, Emory, Tulane?
Anything I can do at this point to strengthen my application?
What Are My Chances:
School: Midwest top something school
Step 1: 254
Step2: Taking this summer
M3 grades: H in IM, Obgyn, Neurology, Family. HP in Surg, Peds, probably Psych.
AOA: Unlikely, very average student at my school.
LOR: 1 Chair's letter(composite type letter based off performance on medicine, should be strong). 1 from ONC attending(former chair, offered to write letter but good chance will be impersonal "big wig" type letter), +hopefully from MICU subI or elective this summer.
Research: minimal, 1 first author paper from undergrad work submitted will hopefully be accepted before I apply, 1 presentation at national conference in social sciences, 2 posters at local conferences from quality improvement work in medical school
Extracurriculars: Year off with masters public health related, some free clinic leadership, some minor institutional activities
Interested in primary care programs with eventual goal of primary care or ID. Hoping to go west(from California originally). Was told by advisor won't be competitive for Stanford based on previous students from our institution and UCSF is possible but big stretch. Chances at UWash, UCLA, OHSU, UCSD? Any other strong programs that way I should consider that will set me up for academic primary care or ID? Will probably also apply to east coast and a few midwest programs.
Hey all - as MS-IV year comes around - I would really appreciate any help on my list
Medical School: Top 25
USMLE Step 1: 259, Step 2: Not yet taken
AOA: we only do senior AOA at my school, and I am in contention (will find out in November)
Grades: Honors in all clerkships with exception of OB/GYN (High Pass)
Research: Heavily basic science. Prestigious year out fellowship (Sarnoff), third-author basic science manuscript, manuscript currently in progress, two oral presentations, several poster presentations, 1 book chapter in cardiology
Recommendations: Strong. 1 from home IM PD with strong reputation, 1 from cardiologist/research mentor. 1 from year-out Sarnoff Preceptor (internationally known basic scientist with a lot of clout)
Extracurriculars: nothing spectacular - histopath and anatomy tutoring, cardiology specialty group leader, etc. - most of my time spent on research
Very strong interest in cardiology (shocker haha)
Programs List:
MGH
BWH
BID
JHH
UCSF
Stanford
UW
Duke
Columbia
NYU
Penn
UTSW
Vanderbilt
UMichigan
UChicago
WashU
Northwestern
Case
What Are My Chances:
School: Top 20.... but not top 10.
Step 1: 250s
Step2: Should have score before apps go in
M3 grades: HP neuro, P surgery, all others honors including Medicine core, several non-IM electives, sub-I to come
AOA: 50/50.
LOR: 1 Chair's letter (composite), 1 from junior attending who knows me well, should be very strong (he's on the residency app review committee, told me he will write something that 'stands out'), 1 from "big wig"
Research: Weak spot for sure. 3 projects, 1 presentation, 3 pending presentations, should have 3 manuscripts drafted/submitted for publication by September, but nothing accepted
Extracurriculars: Lots of activities (through school, volunteer work in the community, hobbies etc). No one thing that is going to be impressive, but should at least demonstrate I do more than study.
Interested in academic programs in larger cities, ideally with multiple teaching hospitals (county, private). Haven't sat down to do any research yet so basing my prelim list based mostly on location and a little bit on reputation amongst peers at my school with a few definitely huge reaches just for fun.
Chances for: Big 3, Stanford, BID, Penn, Vanderbilt, UPMC, UW, UTSW, Northwestern, Colorado, OHSU, Baylor, Emory, Tulane?
Anything I can do at this point to strengthen my application?
What Are My Chances:
School: ranked 30-40th
Step 1: not great...mid-high 230s
Step2: taking in late Aug/Sept
M3 grades: all honors
AOA: possibly...50/50
LOR: This is one thing that I'm a bit concerned about. I had planned on going into another specialty and only recently decided to switch to IM, so I have not had time to form strong relationships with the academic IM attendings at my school yet. I should have 1 good letter from one of the IM dept chairs at a large community hospital nearby. I will also have a strong letter from one of the dept. chairs of another department at my school (but not IM, so not sure if this counts for much) as well as a letter from a FM preceptor I worked with over the course of 3 years.
Research: 2 poster presentations presented at national conferences during med school, 1 poster from before med school as well as a publication in a big-name journal (but I'm #6 on the author list). My research was not specifically in IM but is very applicable to IM/cardiology.
Extracurriculars: Lots of activities (through school, volunteer work, hobbies etc).
I know that the top academic programs will probably be a reach with my mediocre Step 1 score, but I'm interested in strong academic programs, preferably near decently sized cities.
What are my chances for:
-Likely reaches? Duke, Wash U, Michigan, Mayo, NYU, Pitt, Northwestern, UChicago, UCLA, UTSW, UAB, UVA
-Others: CWRU, Ohio State, IU, Wisconsin, Colorado, Rochester, IU, Boston, Tufts, Maryland
Anything I can do at this point to strengthen my application?
What Are My Chances:
School: unranked
Step 1: 241
Step2: taking in late July/Aug
M3 grades: Honors in IM, Peds, path elective, HP neuro/psych, surgery, P in family; ob/gyn pending (upward trend in third year grades from P-->HP-->H last three rotations); honors all first and second year
AOA: lol
LOR; hopefully strong from IM attending, psych attending and peds attending. I was wondering if I should aim for a letter from my Sarnoff preceptor?
Research: M1-M2 summer--> 1 student conference presentation, one abstract, one 4th author pub in works, and one second author review article. all related to immunology. will be doing a Sarnoff research year before M4, so hopefully will have another pub before applying
Extracurriculars: none- weakest point of app
Red Flags- No academic or ethical red flags, but I'm a very shy, reserved person, and I have one or two comments in my evals which reflect this, and it's part of the reason my third year grades have been lackluster for the most part. I feel like this is going to be a problem when applying for residency.
List: thinking of staying in the OH-PA-MD region, bu not opposed to going east. I have family near Pittsburgh, and would like to be close to them. UPMC is my top choice, but I think it may be out of my reach at this point.
Penn- Penn State, Temple, Drexel, Allegheny, St Francis, Northeastern Pennsylvania Hospitals
Ohio- Ohio state, Case Western, U Cincinnati, Toledo, Cleveland Clinic, Akron, Riverside
Maryland- U Maryland, Hopkins-Bayview, GBMC, Sinai Hospital, Union Memorial
Fantasy programs: U Mich, UPMC, JHH,WashU, U Penn, MGH (I'll be doing research here next year, FWIW)
Questions:
1.) What other safety programs can I add? I know I need more.
2.) I would love to do a PSTP IM program--is this completely out of reach with my average research and lack of an MD-PhD?
3.) Since I have one year before applying, is there anything I can do about my lack of ECs at this point?
4.) What can I do about my too-quiet personality before interviewing? I feel like I may not match because of this problem.
1. I think you have plenty of "safety" programs. Why is Jefferson not on your list?
2. Not sure why you want to do this. You can do plenty of research at any academic program, which is what you should focus on if you want research to be a significant part of your career
3. research is the only EC that matters
4. IM attracts lots of people who are "too quiet". The specialty is full of "nerds" after all. It certainly won't keep you from matching and as long as your LORs are solid and you appear to be a normal person at the interview
Thanks. I wanted to do IM PSTP because it gave me an opportunity to have protected research time, and an opportunity for a guaranteed fellowship placement (at least at some programs, like U Mich, which is my number two choice after UPMC). I'll add Jefferson.
WAMC:
School: lower-tier MD on east coast. Top quartile of class, 3.8 GPA. AOA unsure but let's say no just in case.
Step 1: 224
Step2cs/ck: Haven't taken yet
m3 grades: H in IM
LOR: Haven't decided who to pick yet
research: 2-3 case reports, 2-3 retrospective cohort studies, 1-2 abstracts. Most are in trauma/surgical fields. I mostly just did whatever research I found. Currently in the process of doing a cardiology case report.
Thanks. I wanted to do IM PSTP because it gave me an opportunity to have protected research time, and an opportunity for a guaranteed fellowship placement (at least at some programs, like U Mich, which is my number two choice after UPMC). I'll add Jefferson.
Does anyone have any advice on away rotations for a step 1 in the mid 220s? Is it more harmful or helpful as an MD student. Also, could someone please help me create a list of decent places to apply to with my stats? I'm having a time figuring out what places I should apply for. Obviously the top tier places will probably screen me out. I just don't know decent programs I should be aiming for (especially since I want to do cardiology). Thank you!
You're gonna have to get this started based on geography and other program characteristics.
We're also gonna need more info like your class rank and school at the very least.
Away rotations are not recommended across the board in IM. If you're a superstar and crush a subI it may get you an interview but for the most part it makes no difference.
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Need help with school list!
Step 1: 248
Step 2 CK: 265
Step 2 CS: scheduled for September
School: unranked mid-tier MD school in the south
Rank: top 15%
Third year clerkships: H in OBGYN, IM, family, peds, psych, neuro; HP in surgery
AOA: will qualify for senior but not sure extracurriculars will make the cut
Research: none in med school
Extracurriculars: couple leadership positions and some service (nothing special)
LORs: chairman’s letter; neurology clerkship director; anticipated letter from IM residency program director at my school from sub-I in July
Potentially interested in heme/onc or ICU
Want to stay in the South (or at least somewhere warm), preferably an academic program in a large city.
Georgetown
GW
UVA
VCU
UNC
MUSC
Emory
Tulane
Ochsner (New Orleans)
LSU
UAB
Miami
USF Morsani (Tampa)
Vandy
UT Austin
UTSW
UT Houston
UT San Antonio
Baylor
UCSD
Cedars-Sinai
USC
UCLA
University of Arizona (Tucson)
I feel like this list may be top heavy. Any lower tier academic programs in the south worth considering?
Thanks!
You need some research ASAP. You would probably be competitive at some of the stronger programs but many of these programs will look the other way without even making an effort to do some research. So join a lab or get involved in some clinical research, even if you don't have anything published by the time you apply it will go a long way.
Heme/onc is a very heavy research field. So, another reason to get involved now.
Thanks for the input. Unfortunately, there isn't much time before September 15 to meaningfully get involved in any research, especially with my sub-i in July. Are there any programs I should drop based on my lack of research? Lower tier programs I should add?
Hi - Thank you for your response. I had my stats quoted: School: lower-tier MD on east coast. Top quartile of class, 3.8 GPA. AOA unsure but let's say no just in case.
Step 1: 224
Step2cs/ck: Haven't taken yet
m3 grades: H in IM
LOR: Haven't decided who to pick yet. The chair of my home internal medicine program said he would be willing to write me one for sure which was nice.
research: 2-3 case reports, 2-3 retrospective cohort studies, 1-2 abstracts. Most are in trauma/surgical fields. I mostly just did whatever research I found. Currently in the process of doing a cardiology case report.
If you saw those though, unfortunately I'm not sure how to get a better class rank for you. I can email someone and find out my exact standing though (we are only told what quartile we are in if you don't ask for specifics). I go to a state MD school that isn't a top ranked school. I do have a home program that is top 20 in the south in internal medicine through the hospital attached to the school if that helps at all (but no cards fellowship here).
I would like to stay in the southeast and will apply to Emory and my home program for sure. Honestly, I would ultimately like to set myself up for the best chances of matching into cardiology though (which outweighs my desire to stay in the southeast) so I don't mind applying throughout the nation. I know I won't match at Duke/Vandy but I thought I might just apply for the heck of it (unless you all think that would be a waste of money). Any advice with my stats would be greatly appreciated. Thank you!
Need help with school list!
Step 1: 248
Step 2 CK: 265
Step 2 CS: scheduled for September
School: unranked mid-tier MD school in the south
Rank: top 15%
Third year clerkships: H in OBGYN, IM, family, peds, psych, neuro; HP in surgery
AOA: will qualify for senior but not sure extracurriculars will make the cut
Research: none in med school
Extracurriculars: couple leadership positions and some service (nothing special)
LORs: chairman’s letter; neurology clerkship director; anticipated letter from IM residency program director at my school from sub-I in July
Potentially interested in heme/onc or ICU
Want to stay in the South (or at least somewhere warm), preferably an academic program in a large city.
Georgetown
GW
UVA
VCU
UNC
MUSC
Emory
Tulane
Ochsner (New Orleans)
LSU
UAB
Miami
USF Morsani (Tampa)
Vandy
UT Austin
UTSW
UT Houston
UT San Antonio
Baylor
UCSD
Cedars-Sinai
USC
UCLA
University of Arizona (Tucson)
I feel like this list may be top heavy. Any lower tier academic programs in the south worth considering?
Thanks!
Hi all,
Was looking to get some advice on my situation. I am currently a 4th year us allopathic student who suddenly realized that I wanted to do IM all along. The problem is I thought that I really wanted to do EM and have had 2 EM away rotations already (for their letter of recommendations) and might have another one coming up. I've been trying to get a last minute medicine subi but have had no luck and all the spots I've looked into are filled before ERAS opens.
I feel like I've really set myself up to be a great em applicant which might be hard to explain during interviews. Other than that, I have great scores, clerkship grades, and some research. How should I approach this?
Are my numerous em electives red flags for solid academic IM programs?
Has anyone else been in this situation? At what length should I explain my change of heart(should I talk about it in my PS?)
Thanks for the advice!
Hi all,
Was looking to get some advice on my situation. I am currently a 4th year us allopathic student who suddenly realized that I wanted to do IM all along. The problem is I thought that I really wanted to do EM and have had 2 EM away rotations already (for their letter of recommendations) and might have another one coming up. I've been trying to get a last minute medicine subi but have had no luck and all the spots I've looked into are filled before ERAS opens. I feel like I've really set myself up to be a great em applicant which might be hard to explain during interviews. Other than that, I have great scores, clerkship grades, and some research. How should I approach this? Are my numerous em electives red flags for solid academic IM programs? Has anyone else been in this situation? At what length should I explain my change of heart(should I talk about it in my PS?) Thanks for the advice!