Reapplying

[rad_hopeful]

I didn't match this cycle ... the field seemed very competitive this year. I applied to 30 programs and interviewed/ranked 10 programs. On the bright side, I've matched into a prelim medicine position in a large midwest city that also has a radiology program.

Stats: Top 25 US grad, 232 Step 1, 250 Step 2, third quartile (low preclinical grades including 1 C, 3 honors, 4 near honors clerkship grades), letters were good, 4 abstracts/posters all radiology, fifth abstract recently won an award at national radiology meeting. I thought interviews went very well, no red flags.

I know I'm not stellar but I thought I'd be atleast acceptable. I plan to reapply during intern year for physician positions, advanced positions and likely IM as a backup. I'm wondering what the chances that a spot would open up outside the match? I know reapplying puts me at a disadvantage, but if I apply to a ton of programs and go on more interviews I feel hopeful?



I'd appreciate some advice about how to proceed with everything... I don't want to give up my dreams.

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[Doctor D]

Random PGY2 spots do open up. I would ask the radiology PD at your program for advice if there is one. Sometimes these spots are posted on AuntMinnie forums. Don’t beat yourself up, not matching happens to good candidates every year.

 

[sunnymist321]

Rad hopeful,

You should 100% reapply. First off, your résumé is actually better than you're giving yourself credit for. I switched into radiology from another specialty with an application almost considerably less polished than yours. Granted, I did not have a ton of places knocking down my door for interviews(~8) but I believe I had enough in order to feel comfortable about matching. Second, roughly 12-15 R1 radiology positions open up every year it seems(you can look this up on NRMP website), which have a significantly smaller applicant pool. I believe someone told me a few cycles ago there were more R1 positions available in radiology than applicants and that all physicians applying radiology ended up matching. I would definitely make sure to apply as broadly as you can and be sure to include community programs as well should you apply for advanced positions a second time. Given your grades/scores/research you have worked too hard to settle for anything less than something you love without at least giving it a second chance, especially considering the fact you already received 10 interviews which clearly shows you're worthy and most likely just a victim of a numbers game. There is a website for which I have posted the link below, which posts open radiology spots as well provides a forum for people looking for positions. Your persistence I feel will also look favorable on your next application considering lots of people who rank radiology also rank other specialties as back-ups because they are not willing to reapply again due to debt, family obligations, etc.

Hope this helps,

- Sunny


APDR website ====> trainees tab ====> "residency information"

 

[rad_hopeful]

Thanks for the resources! Does anyone have experience with residentswap? Is it worth the subscription?

 

[TCOM12]

Residency swap probably works for other subspecialties like IM. I would keep an open eye on auntminnie. A few spots open every year

 

[ortholegoo]

Residency swap probably works for other subspecialties like IM. I would keep an open eye on auntminnie. A few spots open every year

If you SOAPed into a categorical IM spot and a PGY2 Rads spot opened up could you potentially transfer into it?

 

[rad_hopeful]

There’s something you’re not telling us.

Unless you only ranked top 25 programs with no safeties, there’s a red flag somewhere in your application or you came across badly in interviews. Your step 1 is below average and you have some mediocre grades, but radiology hasn’t gotten as competitive as it once was unless you were only looking at IR.

I would consider reaching out to a few programs and ask if they have any advice on how you can improve your application, especially if you have a home program. You need honest feedback, because unless you had a ton of hubris, you should have matched.

Thanks for the feedback. I ranked diversely, including all my in-state schools and a few community programs. The PD at my home program said my interviews went well, told me I'd usually match and concluded this year was exceptionally competitive. Hopefully the other programs will respond to my request for honest feedback...

 

[rad_hopeful]

If you SOAPed into a categorical IM spot and a PGY2 Rads spot opened up could you potentially transfer into it?

I matched into a prelim medicine year, so I was ineligible for SOAPing into categorical programs. I was advised by my deans to rank all my intern year programs below my Radiology spots... although I'm glad I have an intern year, I'm not sure if this is the best since I could have done exactly what you said... I'd recommend any future applicants reading to consider this because there were very very few advanced spots this year.

 

[collegestud2013]

I didn't match this cycle ... the field seemed very competitive this year. I applied to 30 programs and interviewed/ranked 10 programs. On the bright side, I've matched into a prelim medicine position in a large midwest city that also has a radiology program.

Stats: Top 25 US grad, 232 Step 1, 250 Step 2, third quartile (low preclinical grades including 1 C, 3 honors, 4 near honors clerkship grades), letters were good, 4 abstracts/posters all radiology, fifth abstract recently won an award at national radiology meeting. I thought interviews went very well, no red flags.

I know I'm not stellar but I thought I'd be atleast acceptable. I plan to reapply during intern year for physician positions, advanced positions and likely IM as a backup. I'm wondering what the chances that a spot would open up outside the match? I know reapplying puts me at a disadvantage, but if I apply to a ton of programs and go on more interviews I feel hopeful?



I'd appreciate some advice about how to proceed with everything... I don't want to give up my dreams.

A few things to consider:
1) Any spots that open outside the match (regardless what website it's posted on) usually want someone who can start R1 this year (July 2018) after already completing PGY-1 year. Some are looking for R2 or R3 transfers. So you would be ineligible for any of those. The Advanced spots that are filled now that open up down the line (eg someone dies or decides to switch specialties) will be converted to R spots and placed in the next Match cycle, as there is enough time for another match cycle before that position starts in July 2019. Thus, you will almost certainly need to go through the Match again to have a chance. However, note that it will probably continue to be just as competitive next year as there are many in your position who are unmatched (just based on the ratio of applicants to spots available) and many who are already residents in other specialties are also trying to switch to radiology (eg Surgery to Radiology for some reason seems to be a common switch).

2) If you weren't able to match with 10 interviews, you would likely have to do many more next cycle. Finding the time to schedule that many interviews as a PGY-1 internal medicine intern is very difficult at most programs, as you are no longer a medical student and considered essential to patient care. Not to mention it will be expensive to re-apply.

3) You probably won't have time to do IM categorical interviews next cycle on top of radiology. Besides, since IM spots in the Match all start at PGY-1, you would be repeating intern year anyways. If you want to switch to IM down the line your best bet would be transferring from your current prelim PGY-1 IM to a PGY-2 categorical spot that opens up.

4) You can also consider nuclear medicine residency as an alternative career pathway, which is much easier to get in at the moment than radiology. It's 3 years (so shorter than the 4 years radiology residency + 1 year of fellowship), and you essentially start sub-specializing early without going through radiology. Many nuclear medicine programs have rolling admissions and not through the match. Not to mention that nuclear medicine residencies are probably much more chill and less work than radiology (probably a lot less emergency nuclear med studies ordered during the night).

 

[collegestud2013]

If you SOAPed into a categorical IM spot and a PGY2 Rads spot opened up could you potentially transfer into it?

In theory, yes. But trying to transfer out of a categorical IM program will likely piss off the PD (as they will need to find another PGY-2 to replace you, which isn't always easy to find). The PD might not be supportive of this and try to screw you over (eg not giving time off for interviews, giving you a poor LOR and most programs will be more interested in how you do as a resident than medical student)

 

[collegestud2013]

Rad hopeful,

You should 100% reapply. First off, your résumé is actually better than you're giving yourself credit for. I switched into radiology from another specialty with an application almost considerably less polished than yours. Granted, I did not have a ton of places knocking down my door for interviews(~8) but I believe I had enough in order to feel comfortable about matching. Second, roughly 12-15 R1 radiology positions open up every year it seems(you can look this up on NRMP website), which have a significantly smaller applicant pool. I believe someone told me a few cycles ago there were more R1 positions available in radiology than applicants and that all physicians applying radiology ended up matching. I would definitely make sure to apply as broadly as you can and be sure to include community programs as well should you apply for advanced positions a second time. Given your grades/scores/research you have worked too hard to settle for anything less than something you love without at least giving it a second chance, especially considering the fact you already received 10 interviews which clearly shows you're worthy and most likely just a victim of a numbers game. There is a website for which I have posted the link below, which posts open radiology spots as well provides a forum for people looking for positions. Your persistence I feel will also look favorable on your next application considering lots of people who rank radiology also rank other specialties as back-ups because they are not willing to reapply again due to debt, family obligations, etc.

Hope this helps,

- Sunny


APDR website ====> trainees tab ====> "residency information"

Radiology became a lot more competitive again since 2017. A lot of applicants who didn't match the first time are going for the R spots the following year, so there are WAY more applicants than spots right now.

 

[JoshSt]

4) You can also consider nuclear medicine residency as an alternative career pathway, which is much easier to get in at the moment than radiology.

Above advice is solid but I disagree with this point. If you’re dead set on radiology, this could be considered as a way to eventually get into a rads residency but would not do it as a sole career without radiology training. The number of jobs available for nucs only training is low and largely limited to academics. I think a few places offer NM integrated into the 1+4+year radiology residency, otherwise you can subspecialize in NM with an extra year after rads 1+4+1. If you started with NM, it would add a year to this if you went into radiology 1+2+4 (but might be your only way to get into radiology residency). In most cases, you’ll be very comfortable reading bread and butter NM through rotations in a rad residency.

 

[rad_hopeful]

Above advice is solid but I disagree with this point. If you’re dead set on radiology, this could be considered as a way to eventually get into a rads residency but would not do it as a sole career without radiology training. The number of jobs available for nucs only training is low and largely limited to academics. I think a few places offer NM integrated into the 1+4+year radiology residency, otherwise you can subspecialize in NM with an extra year after rads 1+4+1. If you started with NM, it would add a year to this if you went into radiology 1+2+4 (but might be your only way to get into radiology residency). In most cases, you’ll be very comfortable reading bread and butter NM through rotations in a rad residency.

Thanks for the advice. Just to clarify, in addition to the initial clinical year, I thought a nucs residency would be 3 years if I didn't complete a residency and 2 years if I did. When you say 1+2+4, does that imply I can opt out of my final year of nucs to enter a DR residency? Also if I go down this route, can I obtain additional fellowship afterwards, say if I want to do something other than nucs?

 

[collegestud2013]

Thanks for the advice. Just to clarify, in addition to the initial clinical year, I thought a nucs residency would be 3 years if I didn't complete a residency and 2 years if I did. When you say 1+2+4, does that imply I can opt out of my final year of nucs to enter a DR residency? Also if I go down this route, can I obtain additional fellowship afterwards, say if I want to do something other than nucs?

That was a typo, I meant 1+4+1 (1 prelim year + 4 years of radiology residency + 1 year of nucs fellowship). These people have advantage in the job market as they are both radiology and nucs board certification. Obviously, it requires getting into a radiology residency first.

I think they are some fellowships after nucs such as CT fellowships to make you more competitive in the job market, though not sure about the details.

 

[JoshSt]

That was a typo, I meant 1+4+1 (1 prelim year + 4 years of radiology residency + 1 year of nucs fellowship). These people have advantage in the job market as they are both radiology and nucs board certification. Obviously, it requires getting into a radiology residency first.

What field are you in? While your above posts have some good advice, this quoted post has incorrect information about NM and it’s obvious you don’t know about radiology fellowships.

To be clear, I am not advocating for NM in the least. I perceived your post, 2 posts ago as encouraging OP to go into NM residency BEFORE a DR residency. While you say you have to have prior DR, that’s incorrect.

While some places may not consider someone without DR residency, it’s not a strict requirement. The theoretical 1+2+4 would be a circumstance where you did intern year (1), a nuclear medicine residency (2), then a DR residency (4). This would be a terrible path as it extends your minimum total training time to 1+2+4=7 years.

In a normal 1+4 year normal DR residency, you will have sufficient knowledge to interpret PP NM studies. There are nuances with being able to sign off on a nuclear imaging (and certainly therapeutic) agent, but DR are cognizant of this.

Should one happen to want to specialize in NM, with DR training it’s 1+4+1=6 years. This is typically for academics although there are some NM for PP, almost always with the expectation to read normal DR studies.

There are a few places that have the number of hours needed for a NM with DR training built into their DR for residents who wish to do so for 1+4=5 years. People that do this typically do another fellowship to make themselves more marketable (so still 1+4+1=6 years).

I think they are some fellowships after nucs such as CT fellowships to make you more competitive in the job market, though not sure about the details.

There are a number of different radiology fellowships. Now, they are typically based on organ system such as abdomen, chest, MSK, neuro. OP already knows this.

NM is not one of the more popular subspeciaties people in radiology choose to go into. Notice that this forum has a nuclear medicine subforum and note how dead/inactive that sub is.

 

[deleted103644]

4) You can also consider nuclear medicine residency as an alternative career pathway, which is much easier to get in at the moment than radiology. It's 3 years (so shorter than the 4 years radiology residency + 1 year of fellowship), and you essentially start sub-specializing early without going through radiology. Many nuclear medicine programs have rolling admissions and not through the match. Not to mention that nuclear medicine residencies are probably much more chill and less work than radiology (probably a lot less emergency nuclear med studies ordered during the night).

DO NOT DO THIS

Nuclear medicine is dying as a separate specialty. The continued existence of NM residencies is quite frankly a disservice to applicants who don’t know better.

Do you know what most nuclear medicine residents do after their residencies, if they’re lucky? Go to a low tier radiology residency. The less qualified ones usually do a PET/CT fellowship to get their CT reading skills around on par with a radiology R2. There is almost 0 job market for NM trained residents, only marginally more so with a PET/CT fellowship.

Nuclear medicine as a fellowship (1 yr) after radiology is reasonable. People with this background preferentially get the rare NM jobs that are available.

If you can’t get into radiology, at least do IM before NM. It’s then only a 2 year fellowship and you’ll be employable, although probably just for your IM credentials.

Seriously. Don’t do an NM residency.

For clarification, pathways for NM credentials:

Intern (1) + rad (4) + fellowship (1, can be done 4th year as subfellowship at some programs)
IM (3) + fellowship (2)
Intern (1) + NM (3)

Last option is shortest, but essentially unemployable.

 

[JoshSt]

Seriously. Don’t do an NM residency.

Agree.

For clarification, pathways for NM credentials:

Intern (1) + rad (4) + fellowship (1, can be done 4th year as subfellowship at some programs)
IM (3) + fellowship (2)
Intern (1) + NM (3)

Last option is shortest, but essentially unemployable.

Yeah, I was wrong about 1+2. I think it’s any residency + 2, but not just a prelim intern year + 2.

 

[deleted103644]

Agree.


Yeah, I was wrong about 1+2. I think it’s any residency + 2, but not just a prelim intern year + 2.

Yeah, I’ve only seen someone do it after IM, but don’t think they’re picky.

 

[drir2023]

You have a lower than average Step 1 score but with your Step 2 score, the fact that you are from a top 25 school, and your research experiences, I feel like that you should have matched at least at a community-based or pseudo-academic program. Are you sure your letters are good? I would contact the PD at your school to see if there is any malignant letters in your file.