Soaped into bad fit

[Soothsayer Dusk]

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Long story short, I applied for an entirely different specialty this year. Didn't match because of being late getting letters and difficulty getting time to interview. I have since then during my 4th year experienced internal medicine subspecialties and I became really in love with Hem/Onc. This would have been nice to know earlier, but such is life. However due to matching situation I ended up in a small community program without a Hematology/Oncology program internally and I don't know if there are oncologists I can really work with to build connections with.

So my question is how do I go forward? Can I transfer to a bigger program or can I re-enter the match and attempt to match at a bigger program? I really don't care about a lost year or redoing pgy1. My board scores are very strong: 25x/25x and I would have almost certainly matched a better program in IM had I directly applied. Or should I suck it up and try to make it work at my program? I just don't want to end up disappointed again.

 

[chessknt]

Long story short, I applied for an entirely different specialty this year. Didn't match because of being late getting letters and difficulty getting time to interview. I have since then during my 4th year experienced internal medicine subspecialties and I became really in love with Hem/Onc. This would have been nice to know earlier, but such is life. However due to matching situation I ended up in a small community program without a Hematology/Oncology program internally and I don't know if there are oncologists I can really work with to build connections with.

So my question is how do I go forward? Can I transfer to a bigger program or can I re-enter the match and attempt to match at a bigger program? I really don't care about a lost year or redoing pgy1. My board scores are very strong: 25x/25x and I would have almost certainly matched a better program in IM had I directly applied. Or should I suck it up and try to make it work at my program? I just don't want to end up disappointed again.

Your future PD now owns your destiny instead of you. If you go into the program acting like you're too good for it or you don't want to be there, there is a good chance you will be unable to match or transfer at all regardless of your board scores because you will be labeled as a problem.

Go into the program expecting to stay there all 3 years and be awesome. Once you have time to get to talk to upper levels and figure out who has matched into a fellowship from there and talk to these people to get some perspective. If you decide after talking to them that you want to transfer come up with a reason better than 'your program sucks, ' tell your PD and make sure he/she is supportive and start looking right after the match closes next year.

 

[deleted480308]

There is a heme/onc doctor somewhere around there. Make the best of the situation you are in

 

[lulu09]

Agree with all of the above. People match heme-onc from community programs. Even programs without heme-onc fellowships usually have some kind of university affiliate nearby, and the private heme-onc docs that come to see consults will have regional academic connections even if they don't do research themselves. Also you haven't done your intern year yet so you might even find something else you're interested in. I certainly had no idea about my fellowship choice until late intern year.

Re-entering the match simply because you think the program you soaped into is not prestigious enough is a very bad reason and for that reason alone you might end up with no offers even if you were to get interviews the second time around based on the merits of your step scores. That being said, there are often PGY-2 openings that pop-up in medicine that you could think about transferring to, but you need be on the good side with your current PD, and you can only do that if you become a rockstar at your intern year program and do everything with a great attitude. Since your IM program is supposedly less prestigious than the specialty program you aimed for, shouldn't everything now be possible including being intern of the year, the best scoring resident for in-services...etc. including chief?

Good luck! It sucks be on this position...anecdotally I have a friend who soaped into medicine after failing to match ortho but now is in one of the top cardiology fellowship programs - if you work hard and make the best of your situation, nothing is impossible.

 

[GastriqueGraffin]

You have great scores and I assume you went to a good school. There is almost nothing stopping you from matching, unless you act the way you are right now and have professionalism red flags. Humble yourself and work hard. You’ll have have no problems if you do

 

[Lccjblu]

You should really try to establish ties with the heme/onc department at your current institution. Start some research, sit down with the PD to discuss what to do for the next few years to make yourself competitive. If you play your cards right it may just open the door to returning for fellowship

 

[jdh71]

Long story short, I applied for an entirely different specialty this year. Didn't match because of being late getting letters and difficulty getting time to interview. I have since then during my 4th year experienced internal medicine subspecialties and I became really in love with Hem/Onc. This would have been nice to know earlier, but such is life. However due to matching situation I ended up in a small community program without a Hematology/Oncology program internally and I don't know if there are oncologists I can really work with to build connections with.

So my question is how do I go forward? Can I transfer to a bigger program or can I re-enter the match and attempt to match at a bigger program? I really don't care about a lost year or redoing pgy1. My board scores are very strong: 25x/25x and I would have almost certainly matched a better program in IM had I directly applied. Or should I suck it up and try to make it work at my program? I just don't want to end up disappointed again.

You have to show up to your residency or you face a match violation. Which means sitting out the next cycle. Plus trying to explain that will be easily worse than being an excellent resident from a community IM program. You will need to work closely with the local oncologists. Play the hand you are dealt.

Plan to do a chief year

 

[TimmyH]

Stay there and make best of your situation.
Get lots of paper submitted and go to as many conferences as you can.

If you leave, you will be screwed pretty much.

 

[Drrrrrr. Celty]

not to hijack the thread. But generally is this more or a hop onto attending and senior residents projects or like start your own type of thing?

Stay there and make best of your situation.
Get lots of paper submitted and go to as many conferences as you can.

If you leave, you will be screwed pretty much.

 

[HoldTheCoffee]

not to hijack the thread. But generally is this more or a hop onto attending and senior residents projects or like start your own type of thing?

It would make the most sense to join an attending's project. Hopping along with a senior resident or fellow all but guarantees you will not be first author on said manuscript/poster.

Also with respect to the OP, I agree with everyone else. Your best hope is to try to do well at your current place and try to be a CMR while finding an oncologist to collaborate with nearby. Even if you're set on leaving, the first step to not burning bridges and getting screwed on transferring programs is to be an excellent intern with a good attitude.

 

[Drrrrrr. Celty]

is it important to be first author or is it quantity of third and second authors that will do the job?

It would make the most sense to join an attending's project. Hopping along with a senior resident or fellow all but guarantees you will not be first author on said manuscript/poster.

Also with respect to the OP, I agree with everyone else. Your best hope is to try to do well at your current place and try to be a CMR while finding an oncologist to collaborate with nearby. Even if you're set on leaving, the first step to not burning bridges and getting screwed on transferring programs is to be an excellent intern with a good attitude.

 

[lulu09]

is it important to be first author or is it quantity of third and second authors that will do the job?

The most important thing is to be able to talk about the projects coherently and show that you put in dedicated effort in the projects and/or led them. People could care less if you were on 5 different third-author papers where your name was just added by default by the PI. Obviously having more second-third-fourth authors will make your CV look longer, but in the long run especially at the interview people will catch on to the fact that your role was minuscule. That also being said, having some publications is better than no publications, regardless of author position.