Recently switched into medicine with intention of pursuing GI

[VinnytheMeatball]

I am a prelim who was initially pursuing rads and fell in love with GI on an elective rotation early in intern year. I asked to be released from my rads program and am in the process of obtaining a PGY-2 position. I have been offered a position by the same institution as my prelim year and its a mid-tier university program. I have already made connections with the GI faculty and started a research project. The GI fellowship here though is notorious for not taking their own medicine residents.

However I have been offered a PGY-2 position at a bigger name program which has a more impressive match list particularly in GI and the GI program there tends to take their own. Does brand name of my residency program matter that much for matching into GI? Is it worth going to another program because of the better reputation and historically better match list?

I am a fairly competitive applicant. I am an American grad and scored 250+ on Steps. I have research prior to medical school (first author pubs) but haven't published in the field of GI. Already started on a GI research project during intern year but will likely be third author on paper/poster/abstract.

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[DreamDoc305]

I would say to increase your chances of matching GI to go to the Program that recruits internally. Congrat's on your choice. With GI being so competitive it is best to take any and all advantages you can get.

 

[VinnytheMeatball]

Also, my concern is that I will be coming as a PGY-2 and it will be harder to make an impression and make connections with the GI faculty only 1 year before fellowship apps are due. Should this be a major concern? I would prefer not to have to take time in between residency and fellowship to bolster my application.

 

[GastriqueGraffin]

Great decision! Depends on how close you are with the current GI people (are you already involved in research and are you on very good terms?) and how much you like or dislike your current residency. You may go to the bigger name place and find it’s not a good match for you, which may hurt you. You will have no problems with matching regardless of your choice.

 

[VinnytheMeatball]

Thanks for the responses. I like certain aspects of my program in that they have a good balance of inpatient and consult/ambulatory rotations during intern year so it was easier to have a decent life outside of work. The big drawback is that we spend about 50% of our time at the VA which I do not enjoy as it's too light on terms of patient load and I feel I am not getting adequate training. I am already involved in research at the VA but haven't had an opportunity to meet the faculty at the main hospital and GI rotations are not available until PGY-3 however I may ask for special permission to have a GI rotation sooner in PGY-2.

 

[ShiShiMD]

Thanks for the responses. I like certain aspects of my program in that they have a good balance of inpatient and consult/ambulatory rotations during intern year so it was easier to have a decent life outside of work. The big drawback is that we spend about 50% of our time at the VA which I do not enjoy as it's too light on terms of patient load and I feel I am not getting adequate training. I am already involved in research at the VA but haven't had an opportunity to meet the faculty at the main hospital and GI rotations are not available until PGY-3 however I may ask for special permission to have a GI rotation sooner in PGY-2.

Many of GI programs have strong ties with GI faculties at VA. I am not saying all but many do.
It is always a plus to have a GI letter from the VA-GI attending, in my opinion, a huge decision maker for who to interview. Some might disagree, but this is how I do it.

 

[Gastrapathy]

I’d stay where you are since you know you’ll succeed there. You’ll be highly competitive for fellowship. You’ve already had a GI rotation. You don’t need another one

 

[hemosuccus]

Pedigree AND takes internals? This is easy, go elsewhere, it will open doors. Your best chance is matching internally. As a US grad with good scores you will match regardless. Get GI experiences and do research, you should be fine.

One point I'd stress, do not lose focus on being an excellent IM resident first. I've had the distinct displeasure of working with many Cards/ GI/ HemOnc gunners who are stellar on their cards/ GI/ insert future specialty rotation who are disinterested on ICU/ Hospitalist/ clinic rotations and are a pain to work with and awful team players. Do not be that guy. With that said, these folks still match, but internally can lower your chances if this climbs up the chain of command.

 

[ChessMaster3000]

Are you ABSOLUTELY SURE program a doesn’t take their own and program B does? Are you reading into that too much? It Would be dangerous to make decisions based on rumors.

is moving to new program a big life hassle for you?

 

[VinnytheMeatball]

They do take their own (though max 1 per year) but going by the match list from the other program, they take more (2 per year) however their program only has 3 spots and my current program has 6 spots per year.

The other thing is that this other program's fellowship is much more research heavy (60% research and 75% in PGY-5 and 6) which isn't exactly what I want. I am interested in research but I would prefer to have more clinical training as I intend to do advanced endoscopy.

Moving would be a big hassle as I won't get time off between finishing internship and PGY-2. It's certainly doable.

I have already started making connections at my home programs and started working on an existing research project and in the process of getting my own research project started.

 

[Gastrapathy]

75% research for F2 and F3? I can’t imagine a worse fate. You are an AMG with good scores. Youll match GI. Look at the charting outcomes for the fellowship match.

 

[ChessMaster3000]

They do take their own (though max 1 per year) but going by the match list from the other program, they take more (2 per year) however their program only has 3 spots and my current program has 6 spots per year.

The other thing is that this other program's fellowship is much more research heavy (60% research and 75% in PGY-5 and 6) which isn't exactly what I want. I am interested in research but I would prefer to have more clinical training as I intend to do advanced endoscopy.

Moving would be a big hassle as I won't get time off between finishing internship and PGY-2. It's certainly doable.

I have already started making connections at my home programs and started working on an existing research project and in the process of getting my own research project started.

I would stay at current program

don’t jump ship for the hope of only one more internal spot available per year.

If your program has six spots every year I am hard pressed to believe they Would notbe willing to take more than one internal. Doesn’t make sense.
Don’t move

 

[wrkndply]

am i wrong about usmle scores not being looked at when applying to fellowship?

my board scores are not great so this is of interest and would appreciate any clarification on how usmle scores affect GI fellowship chances

 

[Gastrapathy]

Why would you think they aren’t looked at?

 

[ChessMaster3000]

am i wrong about usmle scores not being looked at when applying to fellowship?

my board scores are not great so this is of interest and would appreciate any clarification on how usmle scores affect GI fellowship chances

yes, you are wrong

 

[1Cor1557]

am i wrong about usmle scores not being looked at when applying to fellowship?

my board scores are not great so this is of interest and would appreciate any clarification on how usmle scores affect GI fellowship chances

They are used for screening hard out applicants program directors don't have time to look through every single application so they'll set up filter different programs have different filters some are 250 steps others are 215 or 220 it's quite variable according to the application pool and location, the way to bypass that is the directly reach out and directly Network or have contacts or faculty on your behalf or letter-writers on your behalf directly reach out to a respective program you have targeted, steps are to get interviews only and if you have contacts you could work around them
Although ideal scenario is they would be high enough you don't have to worry about getting filtered out

 

[Ehegi]

75% research for F2 and F3? I can’t imagine a worse fate. You are an AMG with good scores. Youll match GI. Look at the charting outcomes for the fellowship match.

Depends on how the program lets fellows define their “research” time. OP stated that they were interested in pursuing an advanced endoscopy fellowship. Some research fellowships are fairly flexible and fellows with interest in endoscopy elect to do a ton more scopes with their unstructured time. For instance, our advanced-endo bound fellows spend a ton of time scoping including doing bariatric endoscopy with our bariatric endo group. Lastly, depending on what type of advanced endo fellowship you are looking for, the most competitive applicants for the top programs tend to be very productive in research during GI fellowship, with numerous DDW abstracts and publications.

Advice for OP: When you consider different GI fellowships, talk to the current fellows and get a sense of what they’re actually doing with their unstructured research time and whether their graduates end up going to the type of advanced fellowships you are interested in. You may be surprised by what the “best” fit may actually be.