Radiology Faculty--Answering Questions/"AMA"

[Doctor_Strange]

When you say "next year's R1 class", I'm not clear as to whether you mean they have an open spot for an R1 position starting July 2022 or July 2023.

If July 2022, then the PD can fill with whomever he can find outside the Match. This is because there is no possible way to use the NRMP's Match to fill this spot, the Match for this year is done. If this is the case, you have a legit shot at "switching". This is a rare scenario.

If July 2023, then the PD has to fill through NRMP's Match which runs in March 2023, by having an "R" position. This is the agreement that programs make with the Match when they sign up. Of course, if the program does not use the Match then this is moot. However, I'm not aware of any programs that don't use the Match (there were rare programs who went this route a while back). If this is the case, you still might be a successful candidate but it doesn't involve a "switch", it requires you to sign up for the Match, then interview for this position (and others), then wait until next March to find out. This would mean a gap year in which you'd have to figure out what you do.

Here's the rub. You might think you can make this "get out of IM" decision after July 1, 2022 and plan to stay on as an IM resident for a 2nd year to keep salary/benefits/etc-- but doing so could impact your funding. The program that takes you cannot rely exclusively on federal funding, otherwise they would not take you as you won't have full federal funding anymore having used up 2 years for IM. Many but not all programs have a supplemental funding source that makes this moot. Many programs do not.

In scenario 1, you are quitting your IM residency at the end of June 2022 and filling an open position outside the Match. In scenario 2, you might need to quit your IM residency at the end of June 2022 and match to an R position in the next Match. In either case, once you've decided on this route, you need to tell your IM PD. The IM residency has a hole either way, and the IM PD probably has a better chance to fill the hole the sooner you tell him/her.

If you've decided you are going for rads, you should tell your IM PD. If you aren't sure, you should discuss with your IM PD. After discussing, if you decide you are staying for IM, I don't think the discussion is going to hurt you.

Just to follow up:

I met with the Rads PD at my institution last week. They have a spot open and are looking for applicants outside the match. I was the only one interviewed in person, and the rest will be via Zoom. I am already a categorical IM and he said the fact that I am already a resident there would make it easier for me to be switched into the program as he said. He obviously will be interviewing other applicants. Per residency explorer, my Steps 243/237 fall within the 50% of their average for their matched residents. I have a few pubs as an intern, otherwise not much in the way of Radiology research. My interview was laid back and engaging. Fingers crossed it works out. I am sure I am going up against some pretty stiff competition. The position, however, is not being advertised so hopefully there is not a sea of applications he has to sift through lol

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[Hippocrates II]

Just to follow up:

I met with the Rads PD at my institution last week. They have a spot open and are looking for applicants outside the match. I was the only one interviewed in person, and the rest will be via Zoom. I am already a categorical IM and he said the fact that I am already a resident there would make it easier for me to be switched into the program as he said. He obviously will be interviewing other applicants. Per residency explorer, my Steps 243/237 fall within the 50% of their average for their matched residents. I have a few pubs as an intern, otherwise not much in the way of Radiology research. My interview was laid back and engaging. Fingers crossed it works out. I am sure I am going up against some pretty stiff competition. The position, however, is not being advertised so hopefully there is not a sea of applications he has to sift through lol

I think you've found yourself in just about the most ideal situation you could. You have an in and probably quite a bit less competition than you would have had in the traditional match. I had a few classmates (DO) fail to match with 240s-250s this year. I had 260s/260s and I matched the specialty I ranked ahead of rads, but I really don't know if I would have matched rads because none of the programs (that I can see who announced their matches) took a single DO. Seems like it was a total toss-up of a year if you didn't have an immaculate app. Good luck!

 

[RageQuitter34]

I think you've found yourself in just about the most ideal situation you could. You have an in and probably quite a bit less competition than you would have had in the traditional match. I had a few classmates (DO) fail to match with 240s-250s this year. I had 260s/260s and I matched the specialty I ranked ahead of rads, but I really don't know if I would have matched rads because none of the programs (that I can see who announced their matches) took a single DO. Seems like it was a total toss-up of a year if you didn't have an immaculate app. Good luck!

What specialty did you end up matching in if you don't mind sharing?

 

[tinzleton]

Quick question: applying rads. have two rads letters (one by a DC and one by a PD) . I've seen the DC letter, its personal. the PD letter I have not seen. Now, I also have to strong other specialty letters. Can I send four? most programs say they want three but dont specify if its min or max

 

[Noemata]

I believe I sent four back when I applied. Should not be an issue.

 

[tinzleton]

I believe I sent four back when I applied. Should not be an issue.

thank you!

 

[tinzleton]

Hello!

How long is a letter of interest supposed to be? right now im at 3 paragraphs with a total of 413 words plus my eras pic

thank you!

 

[Noemata]

Half a page to a page max, keep it pertinent. No picture needed.

 

[tinzleton]

I've been told to call programs in addition to LOI's. What is the etiquette with calling and is it recommended? Especially for programs I signaled.

 

[guytakingboards]

I've been told to call programs in addition to LOI's. What is the etiquette with calling and is it recommended? Especially for programs I signaled.

An applicant calling doesn't mean that much, IMHO. I don't know anything about the signaling stuff but calling is just one more random communication that the program has to deal with, burning more of their time.

If you can get important people to make calls on your behalf, that means a lot more.

 

[tinzleton]

An applicant calling doesn't mean that much, IMHO. I don't know anything about the signaling stuff but calling is just one more random communication that the program has to deal with, burning more of their time.

If you can get important people to make calls on your behalf, that means a lot more.

I wish I knew important people. As a US IMG, i'm beginning to panic at just 6 interviews.

I mean an attending at UCLA is a family friend, but there's no way the PD will ruin his prestigious roster with a Caribbean bloke

 

[Steve_Zissou]

I wish I knew important people. As a US IMG, i'm beginning to panic at just 6 interviews.

I mean an attending at UCLA is a family friend, but there's no way the PD will ruin his prestigious roster with a Caribbean bloke

6 is pretty solid for an IMG. Puts you at 60-70% of match per 2022 charting the outcomes for IMGs, and I imagine there are probably one or two more coming your way.

 

[iceman55]

Hi quick question for @RadiologyPD ; Do program directors get early preliminary results of our annual DXIT exams?

 

[MouseChair]

Hi quick question for @RadiologyPD ; Do program directors get early preliminary results of our annual DXIT exams?

Not who you asked but my PD had our tests with what we got right and wrong.

 

[RadiologyPD]

Hi quick question for @RadiologyPD ; Do program directors get early preliminary results of our annual DXIT exams?

I didn't receive results "early" (I don't think--tbh, not sure when the residents got the results).

I also did not receive specific test questions or which ones were answered correctly. Only received the "scaled score" and the "percentile rank".

 

[MisterMukwa]

What is the general consensus on DO students doing aways for Rads? I know that they are generally not recommended for MD students, but does that hold true for DO students as well? Also given that the competitiveness has skyrocketed recently.

 

[vm26]

What is the general consensus on DO students doing aways for Rads? I know that they are generally not recommended for MD students, but does that hold true for DO students as well? Also given that the competitiveness has skyrocketed recently.

I graduated from residency in 2012 so things are likely very different these days. With this said, why would away rotations not be recommended for any med student? When I was a med student these were encouraged since one can make personal connections at certain outside programs which would increase their chances of matching. I graduated from a mid-tier Manhattan program (which made it a pseudo-upper tier program based on location) and the one DO student that ever matched there (to my knowledge) did an away rotation with us (our PD apparently had a good impression)...Retrospectively a significant reason why I matched at this program was likely due to the fact that I did an away rotation at a different institution which entailed performing "soft" research with a radiologist that did a lot of publishing but more importantly for me, did a lot of conferences/board review at the program where I ultimately matched.

 

[MisterMukwa]

I graduated from residency in 2012 so things are likely very different these days. With this said, why would away rotations not be recommended for any med student? When I was a med student these were encouraged since one can make personal connections at certain outside programs which would increase their chances of matching. I graduated from a mid-tier Manhattan program (which made it a pseudo-upper tier program based on location) and the one DO student that ever matched there (to my knowledge) did an away rotation with us (our PD apparently had a good impression)...Retrospectively a significant reason why I matched at this program was likely due to the fact that I did an away rotation at a different institution which entailed performing "soft" research with a radiologist that did a lot of publishing but more importantly for me, did a lot of conferences/board review at the program where I ultimately matched.

Maybe not necessary would be a better way to phrase it, but I have heard both “not necessary” and “not recommended”. From what I gather, the recommendation to not do an away is because it can be hard to make an impact in the reading room in a busy environment and that a lot of applicants shoot themselves in the foot by being too eager. The AMSER guide recommended not doing an away unless there’s one specific location you want to go. https://www.aur.org/assets/Affinity...idency-Guide/07.05.2023- AMSER Guide V.12.pdf

It seems like there a lot of differing opinions in terms of the utility of away rotations.

 

[SeisK]

It’s a politics game. I don’t think it’d necessarily shoot you in the foot, unless people expect you to be memorable during an away. But for it to be useful you have to leave a good impression with someone who has influence with the review committee, which is difficult. It’s variable from program to program and it’s impossible to glean this information most of the time, but the single most likely person to have the greatest influence over the adcom is the program director of the residency. If you’re able to work with them somehow on a research or QI project during your time there, or you’re able to establish a meaningful mentorship relationship with them, that would be best. The alternative is working on another project closely with someone who will meaningfully go to bat for you with the adcom (the formal way to do this is to ask for a recommendation letter from them).

Most diagnostic radiologists, including in academics, are increasingly indifferent to trainees so it’s becoming especially difficult to leave an impression. With med students it’s doubly challenging because there is no radiologic performance to assess on a rotation. It’s essentially a month-long shadowing experience where you’re looking over someone’s shoulder. I don’t see any way to leave an impression other than through some kind of project. If your’e not doing a project, the juice probably isn’t worth the squeeze.

The way to go about doing this is, once you’ve established you’re doing an away, well in advance of your away ask the contact person if they know of anyone looking for people to help with research, or better yet peruse the faculty page to find faculty engaged in research. Then simply reach out to that faculty and start the ball rolling. You’ll want to be squared away with your IRB and research ethics stuff before you get there. Then outside of your time on service, go gungho on that project, enough to make an impression to ask for a strong LOR. That strong LOR will go a long away for that adcom.

 

[RadiologyPD]

SeisK hit this one out of the park with the reply.

In addition to that advice, here is another strategy for an away: Do an away at a place that you are seriously thinking of ranking high but don't know much about AND which is within reach of your metrics (consider your scores, honors, activities, leadership, personality--the whole package).

There are two reasons for this:

1. You do this away FOR YOU--gives you a much better chance to know the culture of the program, observe the existing residents, and help you decide if this is really the place you want to rank highly and be at for 4 or more years. With metrics that are "in the range", the PD will want to meet you, so take the opportunity to do that. It may still feel like faculty are blowing you off, especially those not involved in selection, but don't feel bad about that--keep your eyes and ears open to the residents and how they interact with faculty and each other.

2. Since this program is not a "reach", your presence should help increase the likelihood of moving up the rank list if you are seriously considering it, because the program realizes you are a "known quantity"--but do consider how well you come off in these situations. Do you converse easily with people? Do you have good EQ? If you are too shy (little shy is ok), awkward, too much of a "bro", or tend to be cocky, the away can only hurt you.

Doing an away at a "reach" program may be the only way you can get in, but it often doesn't work.