Strategy for a 4th year DO student applying to IM res, but now wants to do Pathology

[WhiteThrombus]

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Happy holiday to all,

I'm a 4th year DO student who is applying to IM (AOA match only). I've taken and passed Comlex 1 and 2 on first try with average scores and do not have "red-flags" on my record. I've had 5 IM interviews with 4 interviews to go. My focus has been on going to small to medium sized community-based hospitals. All of my audition and elective rotations have been in the IM specialty and sub-specialties. My goal was to become a hospitalist or primary care physician, but have been discouraged recently(*read below if interested as to why)

The only experience I have in pathology is during my 1st and 2nd year of medical school. I have not rotated in pathology... I do not have experience working at the lab bench or in pathology... I do not have much experience with research....

I guess, like everyone here, I'm looking for the right fit. I've always been curious about pathology, specifically forensic pathology. I'm willing to take the jump, but have only a short window to do so with the match approaching fast.

I've thought about several options late in the interview cycle:
1) Matching into IM, complete an intern year with plan to match path next year
2) Register for the NRMP and do not rank programs, but plan to SOAP/scramble into unfilled pathology
- Is this allowed? Is it seen as unethical by programs?
3) Take a research year or something, and reapply next year

Any and all advice/options/opinions are greatly appreciated.

*I've become very turned off by the day-to-day ins and outs of IM. Most of the physicians are quite cynical or seem unhappy. This is understandable given the number of unreasonable, demanding patients and cumbersome administrative/social-work tasks. Couple this with very little appreciation for the extra effort...

 

[Postictal Raiden]

Option 1 is the most painful but the safest route

Option 2 is the ideal one but very very risky as you could never anticipate how many programs go unfilled (remember, many FMGs apply to pathology because it's relatively easy to match into)

Option 3 is the middle ground but remember, your chances of matching decreases significantly by having this gap year.

 

[zero0]

I'd go with 2 personally. Every year I've seen they had plenty of programs go unfilled. This only works if you're geographically flexible and willing to go to a big program that won't help out with finding a job. Not ideal but if pathology's what you want...

 

[CherryRedDracul]

You gotta first figure out if pathology is right for you. Especially forensic pathology.

It's a cool field and I did a 1 month rotation in it during med school to experience it. However, the **** that you see can really **** you up mentally. At the the end of that rotation, my misanthropy levels reached a high score after seeing how ****ty humans can be snuffing each others lives out over petty stuff (yes, I did my rotation in a high crime rate area). That and I felt pretty depressed after days upon days of dissecting people who died from very unfortunate accidents.

Mentally, I don't think I would be able to last in such a field for too long.