ogp

Mar 23, 2010
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I am a 4th year US medical student. I applied for orthopaedic surgery this year and didn't match. At first I was devastated and then eventually felt somewhat relieved. Don't get me wrong, I like orthopaedics but it is a tuff road and I am a young family guy. I scrambled into a general surgery preliminary spot, first to get a job, and second to leave several options open to me, including PM&R. I scrambled into CMC because I really liked their ortho program, know their surgery program and I know they have a PM&R program. I have always had interest in PM&R but didn't pursue it because of many pressures towards orthopaedic surgery. If I had to choose something outside of surgery it would definately be PM&R. I am most interested in disability and would enjoy the opportunity to help treat disability even from a non-surgical standpoint. I have a little exposure to PM&R here at my home school and really enjoyed a 1 week rotation in peds PM&R. I am pretty sure I want to get to know the specialty better and try to match next year. I am new at this and would appreciate any advice to help me increase my chances of matching. Boards are HUGE in ortho and probably what kept me from matching despite 12 interviews. Step 1 220, Step 2 (embarrassing) 195. I understand I obviously need to somehow get some good LORs from PM&R attendings for the upcoming match application. Any suggestions? It will be hard to get much exposure while in a gen surg preliminary year. Any other advice for the upcoming application year? Best scenario would be to find a PGY2 year spot open, but I figure those chances are pretty slim to none. Thanks for your time.
 

DistantMets

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We have recently had 2 residents here at VCU that transferred from ortho to our program (completed 1 and 2 years of ortho). You will fit right in with PM&R. I think those guys were way ahead on anatomy and procedural confidence. One is a current pain fellow and the other will start in July. We have also had a few resident do a surgery prelim...there are pro's and cons to medicine vs surgery prelim for each. For example surgery people might manage wounds and nutrition better, medicine people might manage DM and BP better. Either way you take care of lots of sick people and learn to make decisions.

I would recommend letting your prelim program know early what you're interested in and see if they can get you into a PM&R elective early to get your LOR and help you make your decision. There might still be some open PM&R programs too, not sure.
 

topwise

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It sounds like some good programs went unmatched this year. Rather than entering the match again, you can go outside the match to find a PGY2 PM&R spot for after your internship. If you're flexible about where you're willing to go, there are almost always open spots.
 

Ludicolo

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I am a 4th year US medical student. I applied for orthopaedic surgery this year and didn't match. At first I was devastated and then eventually felt somewhat relieved. Don't get me wrong, I like orthopaedics but it is a tuff road and I am a young family guy. I scrambled into a general surgery preliminary spot, first to get a job, and second to leave several options open to me, including PM&R. I scrambled into CMC because I really liked their ortho program, know their surgery program and I know they have a PM&R program. I have always had interest in PM&R but didn't pursue it because of many pressures towards orthopaedic surgery. If I had to choose something outside of surgery it would definately be PM&R. I am most interested in disability and would enjoy the opportunity to help treat disability even from a non-surgical standpoint. I have a little exposure to PM&R here at my home school and really enjoyed a 1 week rotation in peds PM&R. I am pretty sure I want to get to know the specialty better and try to match next year. I am new at this and would appreciate any advice to help me increase my chances of matching. Boards are HUGE in ortho and probably what kept me from matching despite 12 interviews. Step 1 220, Step 2 (embarrassing) 195. I understand I obviously need to somehow get some good LORs from PM&R attendings for the upcoming match application. Any suggestions? It will be hard to get much exposure while in a gen surg preliminary year. Any other advice for the upcoming application year? Best scenario would be to find a PGY2 year spot open, but I figure those chances are pretty slim to none. Thanks for your time.
Your path into PM&R has been trodden before. You are correct, getting any elective time during a PGY-1 surgery year will be near impossible, but you should try anyway. You will need to talk to your surgery PD early about your plans. Maybe some early PM&R exposure can be arranged, maybe not. Other potentially valuable pre-PM&R surgical experience (with subsequent LORs) may be rotations in neurosurgery or urology. Again, don’t know if these are options with your prelim program. In any case, you’ll need an LOR from your PD emphasizing your clinical performance and work ethic. That letter will likely carry more weight than any future PM&R letter you get.

Come the next match cycle, apply broadly. But understand that it will be challenging to schedule many interviews during a busy surgical internship. Consider taking Step 3 early and rebounding from your Step 2 score. Obviously revamp your personal statement to reflect your newfound interest in PM&R. Be honest about why you are no longer pursuing ortho, and be ready to answer “why not [insert general surgery or surgical subspecialty here] instead of PM&R?”

Did you try scrambling for any advanced positions in addition to your prelim surgery spot? I would certainly apply again through the match, but as topwise said you should definitely keep your eyes/ears open for any PGY-2 PM&R openings. PM&R residents, as in every other specialty, have been known to leave programs or have changes of heart during internship. Since you’re an independent applicant you’ll be able to sign outside of the match.
 

ogp

Mar 23, 2010
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I appreciate all of you helping and giving advice. It is good to hear many perspectives. I do have some MS4 year left but at my school we are required to take 3 classes (Ethics, US health, and Public Medicine) which take up most of our time for the next 8 weeks before graduation. I do have 1 week available which I plan on at the very least shadowing an attending in PM&R. Then I have a week or so at Carolinas I hope to be able to work a little with their program before I start my internship.

I have a question about research. How important is it that I do specific PM&R research? I have done research throughout medical school in ortho. I have one publication in SPINE that won an international award for basic science at the Scoliosis Research Society, as well as an abstract and multi media presentation at the American Acadamey of Orthopedic Surgery involving a total knee arthroplasty survivorship analysis that will be submitted for publication this summer. If doing PM&R research would better my chances of matching I am obviously willing.

Thanks again,
ogp
 

Ludicolo

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I have a question about research. How important is it that I do specific PM&R research? I have done research throughout medical school in ortho. I have one publication in SPINE that won an international award for basic science at the Scoliosis Research Society, as well as an abstract and multi media presentation at the American Acadamey of Orthopedic Surgery involving a total knee arthroplasty survivorship analysis that will be submitted for publication this summer. If doing PM&R research would better my chances of matching I am obviously willing.
Your research chops are solid. I wouldn't stress too much about PM&R specific research.
 

MSKalltheway

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On my interviews they didnt care so much about PM&R specific research, they just cared that I did it at all.

Do you have any time between graduation and internship? I'll have ~4 weeks, which even a portion of this would be a good amt of time to spend with someone and maybe even attempt getting a letter. I dont know if you need that time to move or travel, but you could try that out if at all available.