Medical SOAP Preparation

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Goro

Goro

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Previous IM PGY-2 resident (graduated US MD from low/mid tier US MD) performed 2 years of IM residency, given credit for 1 year, decent board scores. My USMLE Step 3 report should also come out mid-SOAP too which could be an asset? Issue for leaving was concern I was not at PGY-3 level after a year of PIP remediation, but no professionalism, etc. issues. Resigned this past October 2020 and applied to IM for the match. I have 15 IM programs (not including tracks) ranked but am still fearing SOAP because:

1.) Funding was brought up at some places. At one place, I interviewed with the PD and got the vibe he interviewed me just to see what was going on but wasn't serious about my application.
2.) While I have a home program ranked, I didn't have any advisers to fall back on to go to bat for me
3.) COVID shenanigans

If I do not match this Monday, I will obvious apply to open IM categoricals in the SOAP but at this point if I didnt match, I need to realize that I have to apply to other fields. I have a separate PS written for FM already with an additional two letters. What other fields would you all suggest I choose. I went straight from UG to med school to residency and things were on track until this happened and essentially threw me 3 years behind. If I SOAP I have to be judicious with my choices and not shoot too high. Besides IM and FM, what other specialties do you think I have a shot at? I don't really have any references for any other fields outside of my deans letter talking about my rotations (strong deans letter, middle of the class, honored IM, commendations in FM). At least I know some of my letters now could apply to FM.

1.) Anesthesia?
2.) Radiology?
3.) Gen Surgery?
4.) OB/GYN
---

Would it be worth it wasting one of my 45 spots on EM? any competitive programs (Derm, IR, etc.) that are unmatched?
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I will leave the bulk of the answers to the experts here, but isn't it a red flag if there is an unfilled spot in a competitive specialty? Like a sign is a malignant program?
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Goro said:
I will leave the bulk of the answers to the experts here, but isn't it a red flag if there is an unfilled spot in a competitive specialty? Like a sign is a malignant program?
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Not always. I know there were a few open ortho spots this year due to programs only ranking 10 people.

Anesthesia and peds maybe an option. Probably not the rest you mentioned.
 
Goro said:
I will leave the bulk of the answers to the experts here, but isn't it a red flag if there is an unfilled spot in a competitive specialty? Like a sign is a malignant program?
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It can be, but beggars can’t be choosers.

I agree with @TheBoneDoctah , wouldn’t bother applying for anything other than IM/FM. The competitive spots like EM will likely go to all stars who don’t match derm/ortho/etc.
 
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I'm trilled you got 15 interviews. Honestly, I was worried you wouldn't get that many. With 15 ranks you should be in good shape for the match, but I agree that everyone should be ready for SOAP, and perhaps you're at higher risk.

I assume that if you match into a PGY-1 spot, you expect to complete all 12 months of it? On your prior threads (with a prior username!) we were discussing starting in a new program at the PGY-1 level for 4-6 months. But if you're getting a spot in the match, I assume most programs will expect you to complete all 12 months. That may be the best option for you anyway -- more time to get prepped for a more successful PGY-2.

With the issues you've discussed previously, I would highly recommend you not apply to EM, GS, or OB. I don't think you'll get any interest from those programs, but even if you did, I am very worried they would not play to your strengths.

The spots you could theoretically apply to would be a Reserved spots -- these would be for someone in 7/2021 whom already has a PGY-1 completed. Rads would be a possibility, but without any prior interest in Rads, no letters, etc, I think this is a bad idea. Neuro is also possible -- much less competitive, people whom have done prelim GS can't apply for them. Similar to IM, more narrow focus. PGY-2 in Neuro is much like a repeat of PGY-1, just focusing on Neuro. If you were to apply to anything outside of IM/FM, that's what I'd pick.
 
Def work on FM if you need to since that is where you can get the strongest letters both from your current program and previous school for rotations.

EM, rads, gen Surg, ob gyn are probably not worth trying to fill SOAP slots with unless you have a really unique experience (like an opening in your hospital or nearby in which you have some sort of connections).
 
AlteredScale said:
Def work on FM if you need to since that is where you can get the strongest letters both from your current program and previous school for rotations.

EM, rads, gen Surg, ob gyn are probably not worth trying to fill SOAP slots with unless you have a really unique experience (like an opening in your hospital or nearby in which you have some sort of connections).
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Agree. Sometimes there are PGY-1 in surgery programs who quit after year 1, so there's a PGY-2 opening that you may be able to slip into, but this is not something to rely on.
 
Thanks! Another piece of good news came today as I found out I cleared Step 3 by 1 entire standard deviation above average. I wish I had this before the ROL deadline but unfortunately I didn't. I do have PGY-1 IM credit already and plan on applying for a full license in the state I match in. When I restart intern year, do you think they will allow me to moonlight?
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Congrats on Step 3! Not to be overly negative, but given your previous struggles in residency, I think it would be wise to just focus on performing extremely well and not moonlighting yet, at least for intern year and perhaps PGY-2. Second chances are rare enough, especially in the same specialty and you want to make absolutely sure that you succeed at this one.
 
Most places do not allow PGY-1's to moonlight. And I agree -- you've got a second chance here. Make sure you maximize it. I wouldn't take your focus off your training by arranging moonlighting.
 
Point taken. I have been extremely restless after I finished Step 3. I can’t find a job because most states require PGY-2 before offering basic supervised clinical work with insurance companies. I haven’t been able to find any alternative jobs worth the effort. I want to be able to do something to get myself ready for restarting residency. I’ve been doing MKSAP and should be done by June but there’s nothing else really else to do. Do you think a residency program would allow me to move and train (even without pay) for a few months. I really don’t have much else to do besides taking up other people’s space.
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Unlikely. Programs were doing this last year when they needed more COVID cannon fodder, but not really now.
 
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