I am planning to go into pediatric neurology via the fast track. This means I will apply to a general peds residency (but only for 2 years) and a fellowship position for 3 years down the road. I was wondering if you have to keep quiet about your intentions to specialize while you are on general peds interviews in order to secure PG1 and PG2 positions before going into fellowship? Or can you let them know your intentions, but at the risk of being denied because you are leaving the residency early?
Pediatric Neurology
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Unlike most other pediatric specialties, peds neuro is not a fellowship, it is a residency. The standard method of training is to apply as a fourth year medical student to both a general peds residency (to begin following med school graduation) and a peds neuro residency to begin two years later (via SFMatch). There is already a thread on this board about the peds neuro application process. As to whether you tell the peds interviewers that you are doing neuro, it is not a matter of failing to state your intention to do neuro, you would actually have to avoid mentioning that you are actively pursuing a peds neuro residency, and from my experiences in the app process, I can say that many interviewers directly ask about it.
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Addendum: My mistake... I forgot which board I was reading. The thread on the peds-neuro application process is located on the neurology residency board. Technically speaking, peds-neuro is considered a specialty of neurology, and not a specialty of pediatrics. While 85+ percent of peds-neurologists are also fully boarded in pediatrics, they are not required to be.
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(Future peds-neurologist starting residency in 11 days.)
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(Future peds-neurologist starting residency in 11 days.)
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No, and yes. But I suppose the answer depends on how strongly you are attached to personal integrity. One of my friends matched into peds neuro, and he was asked about whether he was applying to peds neuro at every single peds interview he went to. He didn't want to lie about it, so he told them straight up that he was intending to leave after 2 years for peds neuro. Come Match Day, big surprise, he didn't match (after all, why would a peds PD want to take a resident for just two years and then have to go through the hassle of locating a new PGY3 transfer who is probably going to be of lower quality than the rest of its applicant pool?). When he started calling around for scramble spots, he decided to not mention that he was going to leave for peds neuro (but then again, he was never asked -- so it was more a sin of omission rather than comission), and he did land a spot. But when he mentioned to his PD in his PGY2 year that he was going to peds neuro, boy did the PD get angry. Loaded him up with PICU/NICU months and all that.
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It's really a matter of knowing which programs routinely accept peds-neuro-bound residents. Generally larger programs are okay with it (I know CHOP routinely takes all four of their own peds-neuro folks into their peds class, and occasionally will even take people who will be doing the neuro component elsewhere). Children's National in DC (where I am doing both peds and peds-neuro) is the same way. It is the smaller programs that cannot afford to lose the peds residents after their second year. There are also a few programs that formally combine the peds and peds-neuro into a five year program. You match into the peds-neuro during the SFMatch in January, and you are guarenteed the two prelimary years of pediatrics within their program. Programs that are formally set up this way are listed as such in the SFMatch database.
I did the following: in my NRMP application, there was no indication that I was doing peds-neuro, because I wanted to maximize my chances of getting interviews. I also was careful to pick programs that I heard were at least not openly hostile to peds-neuro applicants. Then, during interviews, I made sure each program knew what my plans were. I had a pretty strong application, and I wanted the chance to sit down and try to convince them that I was a worthwhile investment, even if for just two years. You definitely don't want to show up in your peds residency and then let them know you have already committed to leaving after your second year, because you will be known as the resident who is screwing over his/her colleagues for the rest of your time there.
Anyways, there were a small number of programs that flat out told me they would not be ranking me because of the peds-neuro commitment, but I still got my top choice. It's really a matter of doing your research when you make your application list.
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I did the following: in my NRMP application, there was no indication that I was doing peds-neuro, because I wanted to maximize my chances of getting interviews. I also was careful to pick programs that I heard were at least not openly hostile to peds-neuro applicants. Then, during interviews, I made sure each program knew what my plans were. I had a pretty strong application, and I wanted the chance to sit down and try to convince them that I was a worthwhile investment, even if for just two years. You definitely don't want to show up in your peds residency and then let them know you have already committed to leaving after your second year, because you will be known as the resident who is screwing over his/her colleagues for the rest of your time there.
Anyways, there were a small number of programs that flat out told me they would not be ranking me because of the peds-neuro commitment, but I still got my top choice. It's really a matter of doing your research when you make your application list.
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guess I really didn't answer your question... good luck for the coming year! If all else fails you could complete a peds residency and then do a child neuro fellowship. Granted, an extra year, but still possible.
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(I apologize if this has been addressed elsewhere; I did do a search but could have missed the appropriate post)
In a couple of weeks, I'll be starting my peds residency. I've recently become interested in doing peds neuro, but did not decide in time to go through the SF match last fall. Are there any options for me now to try to secure a child neuro position to commence after my PGY2? In other words, is it possible to find a child neuro program with open spots for 2009, outside of the SF match?
Again, I'm sorry if this has previously been asked/answered. I feel a bit at a loss for where to begin now that I have "missed" the SF match opportunity. My child neuro mentor is a great physician, but seems to have no clue about the actual residency process.
Thanks so much for any input! I appreciate the help!
In a couple of weeks, I'll be starting my peds residency. I've recently become interested in doing peds neuro, but did not decide in time to go through the SF match last fall. Are there any options for me now to try to secure a child neuro position to commence after my PGY2? In other words, is it possible to find a child neuro program with open spots for 2009, outside of the SF match?
Again, I'm sorry if this has previously been asked/answered. I feel a bit at a loss for where to begin now that I have "missed" the SF match opportunity. My child neuro mentor is a great physician, but seems to have no clue about the actual residency process.
Thanks so much for any input! I appreciate the help!
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Hi Shane2150,
I think you are in a great position to do Child Neurology, as you will begin the pediatric residency years soon. I would not advertise to your program, i.e. don't talk loudly about your plans to do Child Neurology, but focus on doing well in your pediatrics training as it will help you be a better pediatric neurologist, and you will want to get letters from your pediatric residency attendings. If you are at a big program, especially on that is affiliated with a Child Neurology program then I would ask around, anonymously at first to see what the options are. Bigger programs can absorb the loss of a resident much easier than smaller programs. Alot of Child Neurology are/will open up for PGY-3 training in Child Neurology, just check out the San Francisco match page and they are always listing opening for PGY-3 child neurology positions, alot of them are at surprisingly prestigious places, so fear not, you will be able to secure a good to excellent PGY-3 Child Neurology spot somewhere at least for starting 2009.
I would guess that you willl need to get a PGY-3 child neurology spot outside the match, which you can do easily when the time comes. Basically keep your ears open as to where a spot might/is open for a PGY-3 resident. Alot of programs, for various reasons, may lose a resident who was committed to Child Neurology for PGY-3 2009. Be glad that you have secured a pediatrics residency. The sticky part for you won't be finding the PGY-3 spot, many PGY-3 Child Neurology programs will look at you favorably having completed two years of pediatrics residency. Technically, right now, there are a large number of open PGY-3 child neurology spots for 2009, and you are well within your rights to sign an outside of the match contract now with a PD of a child neurology program. Go to the San Francisco website, then you have to fax your application, plus LORS, plus usmle scores, to a PD, there are programs that would give you a contract now for the PGY-3, PGY-4, PGY-5 years, especially since you are set for pediatrics residency, the only issue is a legal one regarding whether you can sign a contract for PGY-3 child neurology when you (I would suppose) have agreed to three years of pediatrics residency training. You will need to get your current PD to modify your current contract if needed, and your current PD will need to write a letter to the child neurology program director saying that you were a competent resident, etc . . .
The hard part will be how to gracefully excuse yourself from the PGY-3 pediatrics year. I would focus on doing an excellent job on the pediatrics residency portion, at some institutions pediatric neurology residents are often the chief pediatric resident in their final year of study, so keep up a reputation for excellence. I would keep mum about your decision to pursue pediatric neurology until after PGY-1 year. The worst case scenario is that the pediatrics program could make your life very "difficult" if you decide to defect to child neurology.
I would do a good job during PGY-1, then spring the news later maybe 1/3 of the way through PGY-2, because at that point, hopefully, the attendings will have a good view of you as a resident and won't want to make your life to difficult, and it gives them a headsup that they will need to reorganize call schedule or advertise for a PGY-3 resident position. If your peds program is massive, like 50+ residents, then this is less of a problem than at other places. If they are very academic/research focused then they might help you a small amount with the transition to child neurology, but wait to let the cat out of the bag until the moment is right . . . if there a child neurologist on faculty where you are at I would talk with them to get them on your side.
I think you are in a great position to do Child Neurology, as you will begin the pediatric residency years soon. I would not advertise to your program, i.e. don't talk loudly about your plans to do Child Neurology, but focus on doing well in your pediatrics training as it will help you be a better pediatric neurologist, and you will want to get letters from your pediatric residency attendings. If you are at a big program, especially on that is affiliated with a Child Neurology program then I would ask around, anonymously at first to see what the options are. Bigger programs can absorb the loss of a resident much easier than smaller programs. Alot of Child Neurology are/will open up for PGY-3 training in Child Neurology, just check out the San Francisco match page and they are always listing opening for PGY-3 child neurology positions, alot of them are at surprisingly prestigious places, so fear not, you will be able to secure a good to excellent PGY-3 Child Neurology spot somewhere at least for starting 2009.
I would guess that you willl need to get a PGY-3 child neurology spot outside the match, which you can do easily when the time comes. Basically keep your ears open as to where a spot might/is open for a PGY-3 resident. Alot of programs, for various reasons, may lose a resident who was committed to Child Neurology for PGY-3 2009. Be glad that you have secured a pediatrics residency. The sticky part for you won't be finding the PGY-3 spot, many PGY-3 Child Neurology programs will look at you favorably having completed two years of pediatrics residency. Technically, right now, there are a large number of open PGY-3 child neurology spots for 2009, and you are well within your rights to sign an outside of the match contract now with a PD of a child neurology program. Go to the San Francisco website, then you have to fax your application, plus LORS, plus usmle scores, to a PD, there are programs that would give you a contract now for the PGY-3, PGY-4, PGY-5 years, especially since you are set for pediatrics residency, the only issue is a legal one regarding whether you can sign a contract for PGY-3 child neurology when you (I would suppose) have agreed to three years of pediatrics residency training. You will need to get your current PD to modify your current contract if needed, and your current PD will need to write a letter to the child neurology program director saying that you were a competent resident, etc . . .
The hard part will be how to gracefully excuse yourself from the PGY-3 pediatrics year. I would focus on doing an excellent job on the pediatrics residency portion, at some institutions pediatric neurology residents are often the chief pediatric resident in their final year of study, so keep up a reputation for excellence. I would keep mum about your decision to pursue pediatric neurology until after PGY-1 year. The worst case scenario is that the pediatrics program could make your life very "difficult" if you decide to defect to child neurology.
I would do a good job during PGY-1, then spring the news later maybe 1/3 of the way through PGY-2, because at that point, hopefully, the attendings will have a good view of you as a resident and won't want to make your life to difficult, and it gives them a headsup that they will need to reorganize call schedule or advertise for a PGY-3 resident position. If your peds program is massive, like 50+ residents, then this is less of a problem than at other places. If they are very academic/research focused then they might help you a small amount with the transition to child neurology, but wait to let the cat out of the bag until the moment is right . . . if there a child neurologist on faculty where you are at I would talk with them to get them on your side.
