PSTP/ABIM short track selection

[somemd]

For those applying to short track programs or currently in one, what factors did you take into account when choosing a program? Obviously, research options and location are a big part. But, I feel like I have limited knowledge beyond that on how to choose a fellowship program. The interviews are often combined with the categorical program, and you rarely get to talk to many of the fellows and even if you did, most of them won't be around by the time you start. So, it's even more difficult to get a good sense of the fellowship programs than it is for the categorical spot.

I'm interested in heme/onc, but I know very little about how to judge the strength of clinical training beyond reputation and the vague opinions of a few faculty at my home institution, which seem to correspond mostly with USNews rankings.

It seems that career mentorship is quite important, but every program I've been to claims they have great mentoring and help trainees transition from fellowship to faculty. And, many of these programs haven't been around for that long and so don't have a long track record of successful graduates.

Anyhow, I'd appreciate it if other people have suggestions or could share the approach they've taken in the process.

---

Members don't see this ad.

 

[Orange Man]

For those applying to short track programs or currently in one, what factors did you take into account when choosing a program? Obviously, research options and location are a big part. But, I feel like I have limited knowledge beyond that on how to choose a fellowship program. The interviews are often combined with the categorical program, and you rarely get to talk to many of the fellows and even if you did, most of them won't be around by the time you start. So, it's even more difficult to get a good sense of the fellowship programs than it is for the categorical spot.

I'm interested in heme/onc, but I know very little about how to judge the strength of clinical training beyond reputation and the vague opinions of a few faculty at my home institution, which seem to correspond mostly with USNews rankings.

It seems that career mentorship is quite important, but every program I've been to claims they have great mentoring and help trainees transition from fellowship to faculty. And, many of these programs haven't been around for that long and so don't have a long track record of successful graduates.

Anyhow, I'd appreciate it if other people have suggestions or could share the approach they've taken in the process.

A concern I had is a mutually exclusive match between IM and fellowship training. Some places had great fellowship training, but not great IM training (Yale in my case back then), or they had both, but the location was bad (Vanderbilt, Dartmouth in my case). For others, location, IM, and fellowship were great (BID, MGH), but the fellowship was not guaranteed so you have to interview as an intern. Interviewing at these places is all about compromise.

Just keep in mind that the ABIM research commitment is three years after your basic IM training and hem/onc fellowship. This is longer than each of those two afore-mentioned clinical components (separately), so you need a lab and mentor you'll be happy with to launch your academic career.

 

[nomogram3]

For those applying to short track programs or currently in one, what factors did you take into account when choosing a program? Obviously, research options and location are a big part. But, I feel like I have limited knowledge beyond that on how to choose a fellowship program. The interviews are often combined with the categorical program, and you rarely get to talk to many of the fellows and even if you did, most of them won't be around by the time you start. So, it's even more difficult to get a good sense of the fellowship programs than it is for the categorical spot.

I'm interested in heme/onc, but I know very little about how to judge the strength of clinical training beyond reputation and the vague opinions of a few faculty at my home institution, which seem to correspond mostly with USNews rankings.

It seems that career mentorship is quite important, but every program I've been to claims they have great mentoring and help trainees transition from fellowship to faculty. And, many of these programs haven't been around for that long and so don't have a long track record of successful graduates.

Anyhow, I'd appreciate it if other people have suggestions or could share the approach they've taken in the process.

The most important element in selecting a physician scientist program, bar none, is mentorship. The goal at completion of the ABIM Research track is that you will have secured some independent funding and be able to become an independent investigator.

I agree, it is difficult to measure various programs in their ability to prepare you for a career as a medical student. I looked at it this way, there are three things you are looking for. Can this program provide excellent residency (for me, IM) training? Realistically, if an institution provides the research track, the answer is probably yes. (Ignore US News rankings, there are largely irrelevant other that looking to see who the big earners of NIH dollars are, its also pointless to look at the threads about best IM residencies on this forum, if you want a Research Track spot you are playing a different ballgame than most anyone else). Does the institution provide good fellowship training? Here it helps to talk to fellows, does your program have NIH Cancer Center status, number of BMTs done per year if this is your interest, etc.

But the most important factor is does the institution offer the research that I want. Here, you have to have an idea of the names at the institution, and you need to have a good idea of what you want to do. I am in immunologist with a pretty good focus on what I want to do, this eliminated a good number of US News top 10 programs in cancer, they just didn't have the names or funding in my area of interest for me to find a mentor. I matched at what I feel was the best fit for me, and I have a short list of mentors that I will consider working with. The worst thing that can happen is that you finish residency in two years, do fellowship (Onc or Heme would be 12 months, picking one or the other is a different discussion) start doing research and realize that your mentor is unable or unwilling to provide you with the tools you need to succeed, or find out that what you want to do isn't available at the institution you short-tracked into.

Location is a different ballgame. It didn't really factor into the final discussion for me, if you need to be in Boston, you need to be in Boston, regardless of anything else mentioned.

 

[coarctation]

The most important element in selecting a physician scientist program, bar none, is mentorship. The goal at completion of the ABIM Research track is that you will have secured some independent funding and be able to become an independent investigator.

I agree, it is difficult to measure various programs in their ability to prepare you for a career as a medical student. I looked at it this way, there are three things you are looking for. Can this program provide excellent residency (for me, IM) training? Realistically, if an institution provides the research track, the answer is probably yes. (Ignore US News rankings, there are largely irrelevant other that looking to see who the big earners of NIH dollars are, its also pointless to look at the threads about best IM residencies on this forum, if you want a Research Track spot you are playing a different ballgame than most anyone else). Does the institution provide good fellowship training? Here it helps to talk to fellows, does your program have NIH Cancer Center status, number of BMTs done per year if this is your interest, etc.

But the most important factor is does the institution offer the research that I want. Here, you have to have an idea of the names at the institution, and you need to have a good idea of what you want to do. I am in immunologist with a pretty good focus on what I want to do, this eliminated a good number of US News top 10 programs in cancer, they just didn't have the names or funding in my area of interest for me to find a mentor. I matched at what I feel was the best fit for me, and I have a short list of mentors that I will consider working with. The worst thing that can happen is that you finish residency in two years, do fellowship (Onc or Heme would be 12 months, picking one or the other is a different discussion) start doing research and realize that your mentor is unable or unwilling to provide you with the tools you need to succeed, or find out that what you want to do isn't available at the institution you short-tracked into.

Location is a different ballgame. It didn't really factor into the final discussion for me, if you need to be in Boston, you need to be in Boston, regardless of anything else mentioned.

Some good advice here, but I wanted to ask a couple of more:

For programs that don't guarantee fellowship application as an M4, what are they looking for? Do they think student who come in wanting to do the PSTP/ABIM pathway change their mind after their first year? Is there such a glut of applicants they can choose from even as interns? I am trying to figure out the rational behind not accepting students upfront.

I want to do clinical research, and I've been told the sooner you find a mentor and get started on a project, the better off you are because often times you need 5-10 years for some outcome and survival data to mature. Maybe it is a bit different from the bench/basic science world, I honestly don't know. It just seems that the more time I spend trying to audition and apply for programs as a PGY1/PGY2, the less time I have to get my protocol through the IRB to accrue data.

 

[Friendly]

Some good advice here, but I wanted to ask a couple of more:

For programs that don't guarantee fellowship application as an M4, what are they looking for? Do they think student who come in wanting to do the PSTP/ABIM pathway change their mind after their first year? Is there such a glut of applicants they can choose from even as interns? I am trying to figure out the rational behind not accepting students upfront.

I want to do clinical research, and I've been told the sooner you find a mentor and get started on a project, the better off you are because often times you need 5-10 years for some outcome and survival data to mature. Maybe it is a bit different from the bench/basic science world, I honestly don't know. It just seems that the more time I spend trying to audition and apply for programs as a PGY1/PGY2, the less time I have to get my protocol through the IRB to accrue data.

I mentioned this when you posted the same question on another thread, but the most competitive IM programs I interviewed at (MGH, BIDMC, Hopkins) make it clear that they do endorse the ABIM track, but they will not guarantee the fellowship. Now that said, those that do a good job tend not to have an issue, but this situation does force you to apply for fellowship as an an intern to multiple places. This is a logistic nightmare. It's hard to get good letters in the first two months of internship because you don't know very much. Also, intern schedules are very unforgiving and few upperclassmen are willing to cover an intern shift for you (BIDMC residents made that clear to me when I interviewed).

The system is set up so that even institutions which offer a guarantee of fellowship permit you to interview elsewhere as an intern if you want.

As an MS4, programs are looking for you to commit the majority of your time to a research career. The best way you prove this is by publications and showing an interest in and a capability to conduct research. You'll find that it's the same select few residents interviewing at all the same programs. I had slightly above average board scores and good grades in medical school, but I had around 15 publications. I was lucky to have interviewed at every place that I applied to for ABIM. People with higher board scores and grades than me were not always being offered categorical interviews at the places where I was offered ABIM interviews, so I think the research commitment means most to them.

Again, keep in mind that you cannot apply as a PGY-2 if you are applying for medicine sub-specialty fellowship. You need to have that paperwork started two years before you begin fellowship. If you plan to do ABIM without a sub-specialty (i.e. three years of clinical research after two years of IM; rare, but it happens), you may be able to sneak in as a PGY-2. If you choose to leave the ABIM track, you are responsible for a third year of medicine residency or you will not be board-certified.

Hope that helps.

 

[coarctation]

I mentioned this when you posted the same question on another thread, but the most competitive IM programs I interviewed at (MGH, BIDMC, Hopkins) make it clear that they do endorse the ABIM track, but they will not guarantee the fellowship. Now that said, those that do a good job tend not to have an issue, but this situation does force you to apply for fellowship as an an intern to multiple places. This is a logistic nightmare. It's hard to get good letters in the first two months of internship because you don't know very much. Also, intern schedules are very unforgiving and few upperclassmen are willing to cover an intern shift for you (BIDMC residents made that clear to me when I interviewed).

The system is set up so that even institutions which offer a guarantee of fellowship permit you to interview elsewhere as an intern if you want.

As an MS4, programs are looking for you to commit the majority of your time to a research career. The best way you prove this is by publications and showing an interest in and a capability to conduct research. You'll find that it's the same select few residents interviewing at all the same programs. I had slightly above average board scores and good grades in medical school, but I had around 15 publications. I was lucky to have interviewed at every place that I applied to for ABIM. People with higher board scores and grades than me were not always being offered categorical interviews at the places where I was offered ABIM interviews, so I think the research commitment means most to them.

Again, keep in mind that you cannot apply as a PGY-2 if you are applying for medicine sub-specialty fellowship. You need to have that paperwork started two years before you begin fellowship. If you plan to do ABIM without a sub-specialty (i.e. three years of clinical research after two years of IM; rare, but it happens), you may be able to sneak in as a PGY-2. If you choose to leave the ABIM track, you are responsible for a third year of medicine residency or you will not be board-certified.

Hope that helps.

Thanks for the advice.

I've read GutOnc's/alkhkim's posts - which even though they are from 2006 were greatly helpful. But much has changed in 5 years, so I ask because it is helpful to get a fresh perspective. I posted here because I thought research questions might be better answered here than over in IM. The confusion for me occured because a coordinator at a school I am interested in e-mailed me back saying that applicants apply as a PGY1 or PGY2. I just can't imagine interviewing during your intern year - that sounds like a logistic nightmare. So it seems that you either have to take the risk if you want to aim for the upper tier programs, or go middle of the road and get the guaranteed fellowships.

I also met with someone who is doing this tract in peds. He had taken a year off in medical school to do research, was very productive, and felt that it helped him in the application process. He confirmed what you had said: it wasn't as much about great board scores and grades, but the number of pubs he had. For any of the fastrack programs(misnomer, I know), he said you should know at interview what you expect from the institution in terms of funding after fellowship. I am not sure how to answer this question as an M4 interviewing. I can see this being a pertinent question for basic researchers who need dedicated lab space/etc. I am not sure how this applies to those with clinical research goals. Any thoughts?

 

[Rumit]

Thanks for the advice.
I just can't imagine interviewing during your intern year - that sounds like a logistic nightmare. So it seems that you either have to take the risk if you want to aim for the upper tier programs, or go middle of the road and get the guaranteed fellowships.

Just a quick note that I wouldn't say you have to go middle of the road if you want a program that guarantees a fellowship spot. Among those that will guarantee one are UCSF, Stanford, Wash U, U Chicago, Michigan, Cornell, and Yale which are definitely not middle of the road. And, there are many more, I'm sure. Although, some will only guarantee all fellowships except for cards.

Also, I think that at any quality program you really won't have much time to set up any research during intern year. Even getting a protocol through IRB doesn't seem like a realistic goal for PGY1 and 2. But, maybe others know better?

As far as choosing programs go, I'd say that the thing I've looked at most closely is the strength of research and mentoring. How successful are grads from the program, and where do they go after finishing? Then, geography, because in all likelihood you'll end up staying there for at least 6 years and probably more like 8-10. Then, somewhat less important, is the quality of clinical training/reputation of the place.

Anyhow, good luck everyone. Match day is coming soon.

 

[nomogram3]

Some good advice here, but I wanted to ask a couple of more:

For programs that don't guarantee fellowship application as an M4, what are they looking for? Do they think student who come in wanting to do the PSTP/ABIM pathway change their mind after their first year? Is there such a glut of applicants they can choose from even as interns? I am trying to figure out the rational behind not accepting students upfront.

I want to do clinical research, and I've been told the sooner you find a mentor and get started on a project, the better off you are because often times you need 5-10 years for some outcome and survival data to mature. Maybe it is a bit different from the bench/basic science world, I honestly don't know. It just seems that the more time I spend trying to audition and apply for programs as a PGY1/PGY2, the less time I have to get my protocol through the IRB to accrue data.

There seem to be three ways institutions do this. (1) accept applicant for a specific fellowship at the time you match as an intern (2) accept applicant for dedicated "Research Pathway" (or some other name) but not to desired fellowship at the time of match, so that you are set up to do the ABIM pathway and finish IM in 2 years but have to apply for fellowship at the same institution or somewhere else or (3) admit to "Research Pathway" and give you guarantee of the fellowship of your choice with a handshake agreement but make you interview anyway.

There are risks involved in all three. Say you start out wanting to do ID, but as an intern decide you really like Onc, if you are already locked into ID then there has to be some juggling to make this happen. If fellowship is not guaranteed it protects the institution, but if you leave for fellowship the institution loses promising talent. Alternatively, the plus side is you can do IM in one spot and then move to another institution that doesn't offer residency training (I strongly considered doing IM for two years at a couple places and applying to Sloan-Kettering for Onc as an intern, but ultimately decided against it). If a program accepts applicants for fellowship right out of MS4, the crapshoot that is the match could allocate a high number of interns that want to do one specialty to one program, which also would not be ideal (I have heard this happened at a well-known Midwest program last year).

Programs want to use their Research Pathways as a "farm system" for young faculty. They want you to be successful and stay on. Obviously this isn't going to work out for everyone, but if a place has spent a lot of money training you they want to get a benefit as well. Expect a lot of "where do you see yourself in ten years..." questions.

Don't worry about doing research as a PGY1. Research is not the focus of being an intern. If you do a research pathway with a clinical research focus you will be involved in a lot of course work on how to be a clinical researcher so you can do good trials in the future.

 

[nomogram3]

I mentioned this when you posted the same question on another thread, but the most competitive IM programs I interviewed at (MGH, BIDMC, Hopkins) make it clear that they do endorse the ABIM track, but they will not guarantee the fellowship. Now that said, those that do a good job tend not to have an issue, but this situation does force you to apply for fellowship as an an intern to multiple places. This is a logistic nightmare.

Applying for fellowship as an intern is doable, but you have to know WHERE you are going to apply far in advance and apply to only a few programs. I had to apply and interview for fellowship at my institution as a requirement of my Research Pathway program even though I knew going in that a spot is mine (I assume so the program can say all of their fellowship spots are through the fellowship match).

As an aside, just because an institution is one of the "most competitive IM programs" does not mean that its the place for you for fellowship. I would have gotten great clinical training at Hopkins, but I would have had difficulty finding a research mentor for what I want to do. My take on it is if you are going to do the ABIM Research Pathway, pick someplace that has multiple possibilities for research mentors and where you can see yourself staying for a while if all the chips fall into place, or go somewhere where you will get great IM training for two years and have a short list of fellowships to apply to as an intern, keeping in mind you will need to have an impressive CV with publications and good letters.

 

[coarctation]

Just wanted to bump this thread up for those who did the IM PSTP application process and were accepted this year. Please leave any words of wisdom about the application process for those of us who are going through this process soon.

 

[texasguy]

Just wanted to bump this thread up for those who did the IM PSTP application process and were accepted this year. Please leave any words of wisdom about the application process for those of us who are going through this process soon.

Just wanted to bump this again now that we're in the application process!

Can we apply PSTP if we aren't certain on the fellowship (s/p IM residency) we would like to pursue?

I would like to continue doing obesity/metabolism research but I'm unsure whether clinically i'd rather do cards/GI/endocrine/etc...the leaders in the field are in all three fields...

Did you mention specific research interests in your personal statements?

 

[vitalamine]

bump

 

[texasguy]

Does anyone know how the match works w/ these programs? Do we still only 'match' at one institution based on our rank? And how will we know if that particular program will take us for the research pathway - ie. I've heard you can get accepted categorical but not necessarily for the ABIM/research pathway...

 

[Friendly]

Does anyone know how the match works w/ these programs? Do we still only 'match' at one institution based on our rank? And how will we know if that particular program will take us for the research pathway - ie. I've heard you can get accepted categorical but not necessarily for the ABIM/research pathway...

The research tracks often have a different match number from categorical programs. You rank them like you would any other program. Many of them will send you a very formal, detailed letter that saying "you are ranked in the matchable range". It's a gray area, but it happens. One of the residents I worked with applied and ranked the fast track first, and then the categorical number second...at the same institution. On match day, he found out he matched into the three-year categorical. Since you will be doing just two years of medicine, the programs need assurance that you're pretty good clinically. For what its worth, the Vanderbilt program director said that the fast track residents tend to be his strongest residents. Take it with a grain of salt.