Setting up 4th year

[Misery to Okay]

It's time for me to set up my 4th year rotations. At my school we have the freedom to set up the entirety of our 4th year rotations. I am currently a 3rd year DO student who has decided that if all I did for the rest of my life was well child visits and look into kids ears I would be satisfied. I love working with kids.

I am sure that I want to pursue pediatrics but I am also aware that my board scores are not competitive. I got a 15 percentile score in both my level 1 and step 1. I have passed my shelf exams so far. I did not honors pediatrics. The counselor at my school has told me that pediatrics is quite competitive these days and that I should be realistic and look into family medicine or do a research or transitional year. If all else failed, I would be okay with family medicine because I love procedures and I would still have a chance to work with kids, also I would have a chance to get paid more I suppose.

Since I was adamant about pediatrics, I was also given a suggestion to try to do as many audition rotations as I could to a residency that I would have a good chance at getting into. I have a bit of a handicap in the fact that I cannot move due to having pets and no family in the country. I might be able to squeeze 1 month in an away rotation with putting my pets in a pet hotel but that would the limit to my budget.

I would be happy to do any random rotation to fill the rest of my time in 4th year. Looking at the 2018 match, some people with my scores did in fact match into pediatrics. I have 3 letters so far (1 anesthesia, 2 pediatrics) and most likely a few more coming with my upcoming 3rd year rotations.

My main problem is I am so lost in searching for residencies and swimming through the available data. It isn't like medical school where there was an MSAR. I've been running into this issue where I will try to sort residencies by "Pediatrics" but there are things like pediatric-anesthesia, or other subtypes that make things confusing as to whether they are also general pediatric rotations or not.

I do know the pediatric program in Tulsa, OK at OSU is a DO program. But I have no idea how to find out whether I would have a chance or not because I cant find much data beyond that. I did notice a lot of MD residencies had cutoffs for interviews like 220 Step 1, or USMLE only (I thought that wasn't allowed with the merger happening?)

All in all, I am very lost at what to do and where to look. I have tried using FRIEDA, Careers in Medicine but just am having a difficult time navigating through them. Thank you for your help!

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[Oso]

Barring red flags that would prevent someone from matching in general, pretty much anyone can match into a pediatrics program. Absolutely no need to look into a research or transitional year (also get a new advisor, find someone who actually knows stuff).

Away rotations are in no way required for peds and could potentially hurt you if you don't make a great first impression. If you really wanted to do one then that's fine, and I know a few people who did, but do not feel pressured to do so especially if it's really inconvenient. Again, find a new advisor.

Finding programs isn't really that difficult, though judging if you're competitive or not is more so. This is what I did: I looked at a map and chose regions of the country I was interested in, then just googled to see what programs were there. Found more specific info (like score cutoffs, etc.) on the actual websites. Doesn't ERAS have a list of all the peds programs listed by state? I definitely looked at that list. To see who is DO friendly, you can look at the list of current and past residents and see if there are a decent number of DO's.

Find a new advisor.

EDIT: I googled "list of pediatric residencies" and found this list of ACGME peds categorical programs

ERAS 2019 Participating Specialties & Programs

It seems they also have one for osteopathic programs.

 

[GoSpursGo]

Everyone is a little lost when it comes to selecting residency programs to apply to, because as you say there just isn't any centralized list of how competitive individual programs are.

When putting together my list for residency applications, the most helpful resource I had was the program director at my home school. Does your school have a pediatrics residency, or is there a residency associated with where they send you to do your peds rotation? If so, I would reach out and see if it's possible to set up a meeting or see if they plan to do some sort of preparation for residency applications meeting for people in your class interested in peds at some point in the spring.

If there isn't a PD that you can speak with, then the next best thing to do is skim the list of current residents at programs that you are geographically interested and make note of ones that include DOs. Then of those, see if they have any level 1/step 1 cutoffs that you meet. That would be a good start at least to give you an idea of places that you could consider.

I agree with the general advice that audition rotations are not required. However, depending on how unknown your school is, it could be beneficial for you to go and get a letter of recommendation from a better-known program. If you have an opportunity to speak with a PD, that would be another question I would have for them.

Above all, I still would not classify pediatrics as "competitive." If you apply broadly and aren't super picky about where you live during residency, I think that most American DO grads are still capable of matching.

 

[Ladholyman]

Your adviser is insane. Unless something drastically changed within the last 3 years Pediatrics is not at all competitive. If you have no red flags (passed all your rotations, passed all your Steps/Comlex on the first try, have attendings that can vouch for you), then you will definitely match. If you are risk averse and have no geographical ties then apply to 50+ programs.

Look at it this way: I got a 203 and 209 on Steps I and II (209 is the passing score in Step II) and I still went on 21 interviews, 5 of them in California.

 

[ChihuahuaFarm]

Pediatrics has gotten a bit more competitive in recent years, but it’s still by no means competitive relative to most other specialties as long as you aren’t set on a popular location or one of the prestigious big children’s hospitals. From what I remember the trends being when I was going through the process, the Midwest and South were more DO-friendly than the East coast (caveat: I’m an MD grad and didn’t apply out west, so I’m not as familiar with programs out there). Audition rotations can help you get your foot in the door if there’s a specific program you’re really interested in, but are not at all required and honestly were hugely more expensive than I had anticipated.

Probably the best way to look for programs would be to determine what (if any) geographic preferences you have, then investigate programs in that area and how competitive and DO-friendly those programs are. If you’re not geographically restricted, take a look at the match reports for previous years to give you an idea of what programs do and don’t fill fully in the match to get an idea of competitiveness and apply as broadly as you’re able to. I would aim to apply at a mix of programs that are not competitive “safety” programs (usually small programs in rural areas or small cities at community hospitals, especially those that have historically gone unfilled in the match), solid academic programs that are not big name, and programs that you think are probably a reach. Any pediatric program in the US will prepare you adequately to be a general pediatrician. If you’re not planning on going into fellowship or academia where name recognition is a factor, I would actually argue that you might get a better gen peds education at Random Small Town Medical Center than at the big peds programs, where you’ll spend a lot of time taking care of the complex rare sub specialty cases that you may never see again. Good luck!

 

[Misery to Okay]

EDIT: I googled "list of pediatric residencies" and found this list of ACGME peds categorical programs

ERAS 2019 Participating Specialties & Programs

Thanks for your reply! Actually on that link I have a few questions. For the AOA it lists 3 participating programs. But on the ACGME it also lists some osteopathic recognition sites. Are the AOA ones the ones which haven't transitioned yet?
Also what are the Pediatrics/Anesthesia, dermatology, EM, Medical Genetics etc for? Are they fellowships listed under residency. Or a dual residency like IM/Peds?

I suppose I might need a more supportive adviser. Looking at the 2018 stats using my board scores: 91 out of 105 matched with my COMLEX score and 22/25 matched with my USMLE score. Obviously if it was better I would have a better chance but I cant change that now.

 

[Misery to Okay]

Everyone is a little lost when it comes to selecting residency programs to apply to, because as you say there just isn't any centralized list of how competitive individual programs are.

When putting together my list for residency applications, the most helpful resource I had was the program director at my home school. Does your school have a pediatrics residency, or is there a residency associated with where they send you to do your peds rotation? If so, I would reach out and see if it's possible to set up a meeting or see if they plan to do some sort of preparation for residency applications meeting for people in your class interested in peds at some point in the spring.

If there isn't a PD that you can speak with, then the next best thing to do is skim the list of current residents at programs that you are geographically interested and make note of ones that include DOs. Then of those, see if they have any level 1/step 1 cutoffs that you meet. That would be a good start at least to give you an idea of places that you could consider.

I agree with the general advice that audition rotations are not required. However, depending on how unknown your school is, it could be beneficial for you to go and get a letter of recommendation from a better-known program. If you have an opportunity to speak with a PD, that would be another question I would have for them.

Above all, I still would not classify pediatrics as "competitive." If you apply broadly and aren't super picky about where you live during residency, I think that most American DO grads are still capable of matching.

Unfortunately I do not have a residency or hospital attached to my school. I am doing a core rotation for a year at an off campus hospital. They only have a family medicine residency here.

So from the looks of it Tulsa, OK has 2 programs and Columbus, OH has 1 program that are very DO friendly. With my inability to move more than once for 4th year would you still not recommend trying to rotate there a few months and do my best to make a good impression? I am obviously biased but I've been doing well in the current hospital at. I am very punctual, quick and eager learner, and have gotten along with everyone so far. Of course I have also gotten comfortable with the fact that I am used to this hospital by now.

 

[Misery to Okay]

Your adviser is insane. Unless something drastically changed within the last 3 years Pediatrics is not at all competitive. If you have no red flags (passed all your rotations, passed all your Steps/Comlex on the first try, have attendings that can vouch for you), then you will definitely match. If you are risk averse and have no geographical ties then apply to 50+ programs.

Look at it this way: I got a 203 and 209 on Steps I and II (209 is the passing score in Step II) and I still went on 21 interviews, 5 of them in California.

So far I passed all my boards and shelves. I have many more shelves coming up though.

Could you tell me or PM me the programs that you focused on. Whether or not you wrote early love letters or send them after interviews. Did you have any other part of your application that stood out? Excellent letters, extracurricular activities, publications. Are you MD?

I have no ties to anywhere so I am open to move anywhere. Also it seems that any peds program would be in a decently sized city anyways. I plan to practice rural with the hopes of having a city nearby.

 

[Misery to Okay]

Pediatrics has gotten a bit more competitive in recent years, but it’s still by no means competitive relative to most other specialties as long as you aren’t set on a popular location or one of the prestigious big children’s hospitals. From what I remember the trends being when I was going through the process, the Midwest and South were more DO-friendly than the East coast (caveat: I’m an MD grad and didn’t apply out west, so I’m not as familiar with programs out there). Audition rotations can help you get your foot in the door if there’s a specific program you’re really interested in, but are not at all required and honestly were hugely more expensive than I had anticipated.

Probably the best way to look for programs would be to determine what (if any) geographic preferences you have, then investigate programs in that area and how competitive and DO-friendly those programs are. If you’re not geographically restricted, take a look at the match reports for previous years to give you an idea of what programs do and don’t fill fully in the match to get an idea of competitiveness and apply as broadly as you’re able to. I would aim to apply at a mix of programs that are not competitive “safety” programs (usually small programs in rural areas or small cities at community hospitals, especially those that have historically gone unfilled in the match), solid academic programs that are not big name, and programs that you think are probably a reach. Any pediatric program in the US will prepare you adequately to be a general pediatrician. If you’re not planning on going into fellowship or academia where name recognition is a factor, I would actually argue that you might get a better gen peds education at Random Small Town Medical Center than at the big peds programs, where you’ll spend a lot of time taking care of the complex rare sub specialty cases that you may never see again. Good luck!

Now that you mention it what does it mean when a peds program doesnt fully fill? I noticed that in 2018 there were some programs with a few openings. But there were also quite a few students who applied for peds but didnt get into peds. Did those students settle for a different specialty (if 1 person applies fm and peds does the statistic count them for both such that it would say 1/1 for fm but 0/1 for ped if they chose fm?) Or does it mean that the programs were so picky that when it came to scramble they denied any other students? I am not too picky where I live as long as the place I live at isn't dangerous or ghetto to the point where I hear gunshots every night.

 

[SurfingDoctor]

Now that you mention it what does it mean when a peds program doesnt fully fill? I noticed that in 2018 there were some programs with a few openings. But there were also quite a few students who applied for peds but didnt get into peds. Did those students settle for a different specialty (if 1 person applies fm and peds does the statistic count them for both such that it would say 1/1 for fm but 0/1 for ped if they chose fm?) Or does it mean that the programs were so picky that when it came to scramble they denied any other students? I am not too picky where I live as long as the place I live at isn't dangerous or ghetto to the point where I hear gunshots every night.

It can be from applicants being too choosey and not wanting to go to smaller programs or it can be from programs being too choosey and not wanting certain applicants. Every year at match time, we have debates about whether it would be better to go unfilled than have an applicant that was considered not to be a good fit.

The more common reason for unfilled spots though is more spots than applicants and applicants not choosing to go there, usually based on perceived prestige... which doesn’t mean a whole lot in the long run.

 

[GoSpursGo]

Unfortunately I do not have a residency or hospital attached to my school. I am doing a core rotation for a year at an off campus hospital. They only have a family medicine residency here.

So from the looks of it Tulsa, OK has 2 programs and Columbus, OH has 1 program that are very DO friendly. With my inability to move more than once for 4th year would you still not recommend trying to rotate there a few months and do my best to make a good impression? I am obviously biased but I've been doing well in the current hospital at. I am very punctual, quick and eager learner, and have gotten along with everyone so far. Of course I have also gotten comfortable with the fact that I am used to this hospital by now.

If they don't have the ability to do a pediatrics sub-I at your home institution or any other peds electives, then I would probably see if you could do an away to get some letters of recommendation.

 

[Ladholyman]

So far I passed all my boards and shelves. I have many more shelves coming up though.

Could you tell me or PM me the programs that you focused on. Whether or not you wrote early love letters or send them after interviews. Did you have any other part of your application that stood out? Excellent letters, extracurricular activities, publications. Are you MD?

I have no ties to anywhere so I am open to move anywhere. Also it seems that any peds program would be in a decently sized city anyways. I plan to practice rural with the hopes of having a city nearby.

I applied to 102 programs (probably overkill). I applied to programs where snow is not an issue (anywhere south of the Mason Dixon line basically). I had 1 abstract, high pass in Peds, and otherwise an unremarkable application.

 

[DO2015CA]

Your school advisor is a *****. You passed step 1. There are many DOs that took comlex only and still match every year. Do better on level 2. You will be fine.

 

[mvenus929]

Now that you mention it what does it mean when a peds program doesnt fully fill? I noticed that in 2018 there were some programs with a few openings. But there were also quite a few students who applied for peds but didnt get into peds. Did those students settle for a different specialty (if 1 person applies fm and peds does the statistic count them for both such that it would say 1/1 for fm but 0/1 for ped if they chose fm?) Or does it mean that the programs were so picky that when it came to scramble they denied any other students? I am not too picky where I live as long as the place I live at isn't dangerous or ghetto to the point where I hear gunshots every night.

Last year was a very weird year. The number of open positions after the initial match went from like 5 to like 30. In general, the number of programs people are applying to has gone up dramatically in the past 5 years, despite the number of spots not increasing. So programs are left to figure out who to interview, knowing that some of the stronger candidates are applying to them as back-up.

And the match statistics usually look at those who applied to peds as their first choice. Those who didn't match into peds may have matched into something else as backup.

 

[Misery to Okay]

Okay from the looks of it I should Just plan my 4th year to whatever is convenient for me. I'm thinking of staying in the Dallas area for a year. I'll try to do a rotation or 2 or 3 in a children's hospital hopefully one with a residency attached but regardless those residencies' cutoff is above my own score. Ill work hard and hopefully get a better level 2 score but most likely wont take the step 2 unless my level 2 score is that amazing.

For the rest of my time I'll do some research, online, or random IM, FM, etc rotations to fill my time.

 

[settingqt31]

I don't think you are in a bad spot to match into peds if you apply broadly. I was in the 200-210's on my steps and got interviews at over 25 of the 35 places I applied including several upper level programs (I also was published and had a lot of volunteer work but grades were just average).

As far as away rotations go- I was able to bring my dogs with me to a couple of mine by renting out a corporate apartment for one and staying in a city with a family friend who welcomed my dog at another. So if you happen to have a little extra in budget for that may be something to consider. I matched at a program that I didn't do an away at (but felt like a great fit on interview and I had family in area) and ranked 1 above my favorite away location but I do think the away rotation helped and I know that program really wanted me to go there.

 

[ciestar]

If they don't have the ability to do a pediatrics sub-I at your home institution or any other peds electives, then I would probably see if you could do an away to get some letters of recommendation.

My peds pathway advisor wants me to do a home sub-i PLUS one or two aways, and an elective before apps go out. It is so intimidating.

 

[NurWollen]

My peds pathway advisor wants me to do a home sub-i PLUS one or two aways, and an elective before apps go out. It is so intimidating.

If you have a home peds residency where you can do a Sub-I and a peds subspecialty elective or two or three, I wouldn't bother with aways.

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[ciestar]

If you have a home peds residency where you can do a Sub-I and a peds subspecialty elective or two or three, I wouldn't bother with aways.

Sent from my SM-G930V using SDN mobile

Luckily, we do.

I think my Step score is what led her to this suggestion.

 

[GoSpursGo]

My peds pathway advisor wants me to do a home sub-i PLUS one or two aways, and an elective before apps go out. It is so intimidating.

Yeah I'm not so sure I agree with your advisor. Doing an away, doing well and getting a letter from a program that is better recognized than your current one probably isn't a terrible idea, but I don't think I'd say it's an absolute must.

 

[ciestar]

Yeah I'm not so sure I agree with your advisor. Doing an away, doing well and getting a letter from a program that is better recognized than your current one probably isn't a terrible idea, but I don't think I'd say it's an absolute must.

Yeah, i didn’t consider this. But DuPont is one of the aways she suggested. Our home in St. Chris

 

[Staphylococcus Aureus]

Do alway rotations do more harm than good for the average applicant in peds?

 

[GoSpursGo]

Do alway rotations do more harm than good for the average applicant in peds?

Not necessarily. I would say in general they are a plus if you do well, but there's always the risk that you could do poorly due to not being familiar with the hospital/EMR/etc and hurting yourself.

But most importantly, peds still isn't that competitive. So spending a lot of money to do an away rotation generally is a waste if you could have just applied broadly and matched anyways, unless you have a reason to target a specific program or geographic region.

 

[Misery to Okay]

Not necessarily. I would say in general they are a plus if you do well, but there's always the risk that you could do poorly due to not being familiar with the hospital/EMR/etc and hurting yourself.

But most importantly, peds still isn't that competitive. So spending a lot of money to do an away rotation generally is a waste if you could have just applied broadly and matched anyways, unless you have a reason to target a specific program or geographic region.

So it seems that since my core site does not have a pediatric residency or a children’s hospital, I should definitely do an away rotation. We don’t have a nicu or picu here. (Completely rural). I have had two pediatric outpatient + nursery rotations so far. But nothing beyond that. Maybe I will set up base and do all my fourth year rotations in Tulsa, OK or something.