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Plz plz need advice! (want to change specialty now!)

Discussion in 'General Residency Issues' started by whorubigman, Dec 14, 2005.

  1. whorubigman

    whorubigman Member
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    I'm typing this for a friend of mine.
    She's a 4th yr med student wanting to change her specialty to EM from geriatrics at this late a stage in application. Is it too late? What can she do?
     
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  3. BKN

    BKN Senior Member
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    It's very late. I'm not sure, but i believe that the ERAS post office closes Dec 15 for new apps. I've already completed my interview offers and I suppose that most others have as well.

    A change from geriatrics to EM is a major one. Is she really serious?

    It might be possible to get interviews this late, but I suspect she'll have to scramble or go for a Transitional or preliminary year.
     
  4. lilycat

    Moderator Emeritus 10+ Year Member

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    I made a switch on Nov. 4th, and I found that that date was "too late," for most programs. Technically they were still accepting applications, but most of them had completed their interview offers by early November, so I just got added to the waitlist for interview slots.

    What your "friend" should do is:
    1) Talk to her Dean immediately. If she hasn't really sat down and assessed her reasons for making this change, if the Dean is "good," he/she will help her do this and come up with some sort of gameplan for what she wants to do and how to proceed at this point in time.

    2) Talk to her home PD of Emergency Medicine (if her school has one). If she already has an application on ERAS, she might be able to at least send it to her home program, and they might give her an interview, at least out of courtesy. Also, the PD (in my case) is usually invaluable in strategizing and assisting with the late application, whether its emails to other PDs asking if they will consider a late application, or discussing possible options for a scramble in March.

    For what it's worth, as someone who switched at a late date, I'm considering trying to match in my new chosen field (difficult prospect with only 2 interviews right now) vs. matching in a TY or prelim program and reapplying next year (likely scenario with several such interviews, but the thought of doing two intern years is not very appealing) vs. scrambling for a PGY-1 spot in my chosen field (midly scary to me since it can be such a crapshoot in terms of quality of program and location) vs. taking another year of medical school and reapplying next year (seems extremely safe option, major drawback is extra year of tuition, not sure how my Dean will feel about it).

    Hope this helps and good luck to your friend.
     
  5. MM9

    MM9 Member
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    I misunderstood the question, sorry about that. I edited my post to correct the mistake.

    I don't now if the door is closed on matching into EM this year or not. I would advise her, like the above poster said, to talk to her Dean’s office and the Residency Director of EM at your school.

    If indeed ERAS/NRMP is not an option for this year (or even if it is and it doesn't work out) going forward she has these (and maybe more I don't know about) options:

    1. Scramble into Em.....obviously pretty tough to do.

    2. Scramble into a preliminary or transitional year, assuming it is too late to match into one. She could then apply for the match again.

    3. Go forward and match into IM. She can always switch if she wants. Bear in mind, however, that under the Medicare rules you are 'locked' into how many years of Direct funding the government will give your program to train you. If you run out of years the amount the program will receive for you is decreased somewhat (despite you might hear, they still receive $ for you, the decrease is usually much less than half) This would apply if she matched into a 3 year IM program and, after one year, switched to EM. Since she would still have to do 3 years of EM, she'd run out of the Direct funding in her last year of EM. Would this stop an IM residency from taking her? That's the big question…..
    Check out:
    https://services.aamc.org/Publications/showfile.cfmfile=version19.pdf&prd_id=88&prv_id=110&pdf_id=19 for more information about this.

    4. Take a year ‘off’ and do something else (research, MPH, ?), then reapply.

    Obviously, this is a big change. Tell her to talk to friends, family, professor’s, her dog, anyone, to discuss her reasons for the switch.

    Good Luck
     
  6. Orange Julius

    Orange Julius Senior Member
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    What's wrong? She got no fingers or something? :confused:
     
  7. needsadvice

    needsadvice Junior Member
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    MM9 is right.
     
  8. carminosa

    carminosa Junior Member
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    I think that some people have the OPs comment twisted...the person wants to go FROM geriatrics TO Emergency Medicine. IM is not her final destination or goal.

    Anyway, I can only tell you about my experience of "switching at the last minute" in my 4th year of med school, 3 years ago. I was going down the road of a really nice specialty from about Jan-August of 3rd/4th year. I made a snap decision to apply for another field (happens to be EM :eek: ) because I though it was cool and interesting and had a good lifestyle, and did not research it to the same extent as the first field (which was an early match BTW)...since time was running out (or so I felt) I JUST HAD to make a decision. I took about 6 weeks of elective and SWORE that I loved it and went for it. I matched into my #1 spots for both prelim med and EM (this particular program was a PGY2 EM program). I did my internship year...tough but hey that's how it goes. I got to my "chosen field" and guess what...I HATED IT..more than anything I ever hated in my life..more than being post call in the ICU at my IVY league, quartenary referral hospital during my internship. I was there for a few months and resigned because I could not see myself as an attending in that field at all much less 10, 20 years from now..So I sat out for 9 months, and now I am doing a year of public health research ( I had an MPH before med school, thank GOD) and while my collegues are PGY3s and about to graduate from residency this year or next or going into fellowship, I am trying to figure out what is next for me.

    All this to say not to make a decision unless you feel totally ready. It is MUCH harder to "just switch" once you are in residency. Just take a look at all the posts of people (including myself) who are looking for "open PGY2 spots" at decent programs. Also, not everyone is in love with the fact that a resident left their program, how does the new PD know that you won't do it again? Looking back, it would have made more sense to stay in school an extra year to continue weighing my options, graduate take a year off and go into the match the following year. Your connections with your school will still be fresh and you will have the time to go on all the interviews you want (vs while you already an intern). You can even explore other fields during this time since you still have a closer link to your med school. Now, not only am I in another state, but even if was still there they would be like "who? you graduated when?" Ooh...okay.

    Tell your friend and anyone else to be careful when making such a last minute decision..It can go either way.
     

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