Specialty Switch Advice

[United20]

Hello,

I'm a current 4th year medical student recently matched into IM, which I applied as backup to general surgery. I'm entering IM with an open mind and resolution to maximize the learning opportunities, but want to ultimately get back into surgery. I am weighing the risk of reapplying as an intern (potential not match, scramble etc) versus sticking out IM then reapplying for surgery as a physician. Looking for some feedback regarding anyone's experience with the process of switching specialties, especially switching into surgery. Thanks!

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[ThoracicGuy]

Hello,

I'm a current 4th year medical student recently matched into IM, which I applied as backup to general surgery. I'm entering IM with an open mind and resolution to maximize the learning opportunities, but want to ultimately get back into surgery. I am weighing the risk of reapplying as an intern (potential not match, scramble etc) versus sticking out IM then reapplying for surgery as a physician. Looking for some feedback regarding anyone's experience with the process of switching specialties, especially switching into surgery. Thanks!

What are your stats? Why do you think you didn't match surgery the first time around? What will be different this time?

 

[United20]

What are your stats? Why do you think you didn't match surgery the first time around? What will be different this time?

COMLEX I - 525
COMLEX II - 559, CS passed first time

I think a combination of step I score (which can't be changed) and not applying broadly enough, which I could do differently next time around. I'm also looking at the possibility of taking USMLE step I during intern year, as I think not having that limited me greatly. The rest of my application was well rounded with published research, case presentations at conferences, extracurriculars and strong LORs from surgeons. My hesitation with reapplying though is on par with the point you make, however. I fear that between match day 2019 and September of 2019, my application won't be significantly stronger than the first time around.

 

[GoSpursGo]

I can't fathom that you're really going to get the kind of Step 1 score that you need to become competitive for gen surg by only studying "in your free time" during intern year.

I guess it depends what you mean by "not applying broadly enough." How many programs did you apply to, and how many interviews did you get? If you applied only to 15 programs near you, then yeah maybe by casting a wider net you could get a better result. If you applied to 50+ programs and still only got 1-2 interviews, then you may need to accept that your application just isn't competitive for GS. If that's the case, well that's why you had a backup right? The safest thing you can do is chat with the GS program at the place you matched to see what they think about the feasibility of you matching, but I wouldn't go all-in on a reapplication and not sign your PGY-2 contract hoping for a different outcome in the match.

 

[ThoracicGuy]

COMLEX I - 525
COMLEX II - 559, CS passed first time

I think a combination of step I score (which can't be changed) and not applying broadly enough, which I could do differently next time around. I'm also looking at the possibility of taking USMLE step I during intern year, as I think not having that limited me greatly. The rest of my application was well rounded with published research, case presentations at conferences, extracurriculars and strong LORs from surgeons. My hesitation with reapplying though is on par with the point you make, however. I fear that between match day 2019 and September of 2019, my application won't be significantly stronger than the first time around.

I just don't see this as a likely viable path and will give you a real chance of not having any training after this upcoming year. Your IM program may look to replace you if they know you are trying to leave. I know its not the same, but there are procedural fellowships in IM. Do any of those interest you? Otherwise, you can always complete residency and try to match after that. Then if you don't match you still have IM to fall back on for practice.

I don't see you having the time to study appropriately and take USMLE Step 1 to get a good enough score.

 

[Raryn]

Hello,

I'm a current 4th year medical student recently matched into IM, which I applied as backup to general surgery. I'm entering IM with an open mind and resolution to maximize the learning opportunities, but want to ultimately get back into surgery. I am weighing the risk of reapplying as an intern (potential not match, scramble etc) versus sticking out IM then reapplying for surgery as a physician. Looking for some feedback regarding anyone's experience with the process of switching specialties, especially switching into surgery. Thanks!

Your chances only get worse after your MS4 year. Honestly, go into your residency with an open mind and try to find a niche within IM that you would feel comfortable with. It's the largest field in medicine, chances are pretty good there's something for everyone.

 

[NotAProgDirector]

Getting enough time to interview at a good number of programs while an intern is not easy.

If your future institution has a GS program, that;s your best bet. Work with them as much as possible, hope for a spot.

 

[LookForZebras]

One thing to consider (if you haven't already) is sticking it out with internal medicine and then pursuing a procedure-heavy subspecialty. Maybe gastroenterology or cardiology would be enough procedural work to fulfill your surgical desires. If so, you could avoid having to switch.

 

[Gastrapathy]

Match rates for GI/Cards for DO grads aren’t great (below 50% in a presumably self-selected group for GI, for example).

 

[collegestud2013]

If you were dead set on General Surgery, your back-up plan should have been a Surgery prelim (which is VERY easy to get into). General Surgery residencies have a very high attrition rate (close to 20%), so many places have PGY-2 spots that open up. Someone in a PGY-1 Surgery prelim can often switch to a PGY-2 categorical either in their home program, or if a position is not available in their home program they can transfer to another program after their first year.

On the other hand, it's difficult to match into GI or cardiology as a DO, especially if your home institution doesn't have an in-house fellowship. Most DOs who match from IM residency often do a Chief year (which nearly guarantees a match into any in-house fellowship of choice) or at least match into their home program.