24thGrade

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I looked around some but didn't quite find the answer I'm looking for. I'm hoping to get people's input on this. In short, I'm hoping to do a competitive subspecialty of internal medicine ultimately for my research/short track residency. As I understand it there are two types of program I can apply to:

1. schools that guarantee subspecialty placement.
2. schools that don't guarantee subspecialty placement

Obviously the first is preferable, but I see it isn't available everywhere. The first thing I'm wondering is if there is a comprehensive list of IM research residencies and what their policy is on subspecialty placement.

Next, I'm curious what the major selection criteria are for option #1. They obviously will care about my commitment to research (to some extent) but do board score become the major player for admittance in these programs? If so, what types of scores are we talking about for the better schools? Derm/Rad onc level (240+?)? If boards are not a big deal, what is? The reason I ask is that I'm always told MD-PhDs are going to be very competitive for the best IM residencies but I'm not sure if this extends to a situation in which I'd be guaranteed a subspecialty. My school is pass/fail for preclinical, and typical grading for clinical years. Anyways, I just really want some sense for what they are looking for beyond a dedication to research.

My other question is for situation #2- if I then begin apply to subspecialties during my residency, does the focus for admittance turn to my recommendation letters and performance during my residency (in other words, do my med school record and step 1 scores begin to matter less), or are the major factors going to still be what makes people competitive for most residencies (boards, clinical grades...).

Thanks.
 
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nomogram3

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I'm a resident, and soon to be fellow in Heme/Onc, in an short-track residency program. First off, the list below is quite helpful in term of investigating programs. Secondly, just because a program is listed as guaranteeing fellowship placement, doesn't been its a done deal the moment you sign your contract. My program conditionally offers fellowship placement when you match to the medicine residency, but for most fellowships you have to apply and it is no guarantee that you will match. This simply protects the fellowship if you turn out to be a sub-par intern, and there have been residents that are short-tracking that don't actually match to the fellowship based on their performance as a PGY-1 (but this has been very rare).

So about matching to a research-track program. For me, I had a list of investigators that I had met or wanted to meet, and I really focused on institutions that were going to provide me with the best chance to be an independent PI when I finished the program. I interviewed all over the country, and I can tell you that if you want to go to a top program, you had better have 240+ board scores and a good CV with good papers. You will be interviewing against other candidates with Nature and Cell papers. The best short-track residencies take the MD/PhDs with the best records.

As it happens, I decided to go to a program that offers fellowship. I seriously considered ranking a few medicine programs that don't guarantee fellowship and applying for fellowship as an intern (which, by the way, will be easier now that the application cycle has been pushed back to the summer) but my wife would have shot me. This is done pretty commonly though, and you will meet residents that have done it on the residency trail. You don't have a lot of time to interview as an intern, so you have to have a limited number of programs in mind, and you will focus on your research record, but will need good evals from your time as an intern, but your program-director letter will spell out your particular situation.

I'll finish with my standard line on short-tracking. You need to really figure out if you want to do research for your career or not. If the answer is no, don't short-track. You will be signing on for another MD/PhD program-like commitment and you will be miserable. The total time spent training is actually longer, and the clinical time is shorter, so you won't be as well-trained to care for patients if this is your real focus. If you want to run a lab, it's a great decision.
 
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24thGrade

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Thanks a lot for the reply, I really appreciate it and the info is very helpful. I'm surprised to hear how high your perspective of the typical board scores are but understand that it may be the case.

I had one other questions, do most people applying to these apply to straight IM programs as well? It is assumed you will or is it a similar situation to people applying to MD-PhD programs and then also applying to MD-only programs as sort of a backup (somewhat frowned upon by some directors I know).

Also, when you say your program "guarantees" you the subspecialty spot "conditionally" (like I'm guessing most "guaranteed" spots are), you do NOT have to reapply for the fellowship, correct? Do you need to just not do horribly during PGY1, or do they require you to be at the very top of your class to continue on? Is there any straightforward way of determining whether you actually go on to your guaranteed spot?
 

BruinBear13

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Kind of a necro-bump, but 4th year here also thinking of applying fast-track in Internal Medicine for Hem/Onc in order to do research in cell immunotherapy.
Is Nomogram's expectations true (nature/cell paper, 240+)? I do have a total of ~18 total publications, abstracts, presentations, with hopefully 3 first-authors (not in nature or cell by any means), couple 2nd authors in Scientific Rep, Journal of Immunology, several poster presentations, but 235 step I, mid-tier med school, honored about half of my clerkships. Some ties to PI's at UC's that are writing me letters of recs. Any input is appreciated.

Thank you!
 
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