Switch from Prelim Surgery to Urology

[FireRad]

So I am a current prelim General Surgery resident. I matched into Diagnostic Radiology at UCLA and I am completing my intern year in General Surgery.

As a medical student, I was torn between Urology and Radiology and I choose Radiology because of the lifestyle. However, I am absolutely LOVING my intern year in Surgery.

I want to ask how feasible it is to reapply for the match to pursue Urology for coming fall.

I am doing a great job during my intern year and I am confident that I could have several strong letters from the attendings I work with currently. Also, I have 5 publications in urology with several more posters and abstracts related to Urology.

Would it at all be possible to make this switch? I'm not sure how my application would be viewed compared to a fourth year medical student applying to Urology, but I imagine I would be far less competitive and desirable since I would have letters from General Surgery attendings and not urologists.

What do you think?

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[cpants]

Your best bet is trying to find an advanced urology spot where someone has dropped out. There are usually a few each year. People used to post them on urologymatch.com, but I'm not sure if that site still exists. You should be relatively competitive for these spots with urology research and probably a decent academic record.

I'd say your first step is to set a meeting with the urology PD at your site and discuss your options and chances at finding a spot. Your second best chance is probably to match at whatever site you are at now. I would also try to meet with your PD from your medical school. Talk also to your surgery PD. He may be willing to let you spend some time on urology and help you along, since you are a rads resident anyway.

You will need some luck and a lot of networking for this to work out.

Chances in the match are not great. I would not walk away from your radiology gig unless you have a spot locked up somewhere.

 

[FireRad]

Thanks for the advice! I have an extremely good relationship with the Chairman of my Urology department at my school. He is very well known as my Urology program is top 10 in the country.

I did research with him for 4 years with numerous publications resulting. I spoke to him and he is willing to write me a very strong letter of recommendation.

Do you think it woukd really be close to impossible to match into Urology via ERAS and reapplying?

My stats arent great for Urology. I had 240s for Step 1 and 2. And I just missed being ranked in the top half of my class, due to preclinical grades. But i honored 5 out of 7 rotations 3rd year.

 

[cpants]

A letter helps but your stats aren't amazing for urology. It is very hard to match while working as an intern. You won't be able to do any away rotations. It will be tough to get time to interview. You have already burned a year of government residency funding which is a strike against you. May or may not be able to get out of your radiology gig.

The match is just so competitive, and I don't think you will get that much interest with the baggage you are carrying. Talk to the chairman and ask him to be real with you about chances.

My advice -- try to get into IR. Very procedural, much better lifestyle, some overlap with urology.

 

[Frogger27]

A letter helps but your stats aren't amazing for urology. It is very hard to match while working as an intern. You won't be able to do any away rotations. It will be tough to get time to interview. You have already burned a year of government residency funding which is a strike against you. May or may not be able to get out of your radiology gig.

The match is just so competitive, and I don't think you will get that much interest with the baggage you are carrying. Talk to the chairman and ask him to be real with you about chances.

My advice -- try to get into IR. Very procedural, much better lifestyle, some overlap with urology.

IR better lifestyle than Urology? I was under the impression IR can be a pretty brutal lifestyle

 

[cpants]

IR better lifestyle than Urology? I was under the impression IR can be a pretty brutal lifestyle

I guess it all depends on how much call you take and how busy the hospital it is in either situation.

 

[FireRad]

A letter helps but your stats aren't amazing for urology. It is very hard to match while working as an intern. You won't be able to do any away rotations. It will be tough to get time to interview. You have already burned a year of government residency funding which is a strike against you. May or may not be able to get out of your radiology gig.

The match is just so competitive, and I don't think you will get that much interest with the baggage you are carrying. Talk to the chairman and ask him to be real with you about chances.

My advice -- try to get into IR. Very procedural, much better lifestyle, some overlap with urology.

I firmly decided I do not want to Radiology, so I already obtained a waiver from the NRMP. Also, I already met with the PD of my Gen Surgery prelim, and arranged to have time off to interview. He was very supportive of my decision.

I won't be able to do any away rotations, true. But I have been doing an excellent job as an intern and I can think of attendings at my current program who would be willing to write me a strong letter of recommendations. Granted, they are General Surgeons, but I think a letter stating you are a strong resident couldn't hurt.

I guess I can't help that I wasted a year of government funding, but it is what it is.

 

[cpants]

Yea, a good letter from your internship won't hurt, but what you really need are urology connections. It's great that the urology chair is willing to write you a letter, but letters are pretty meaningless unless they are negative. Is he willing to select you in the match? Is he willing to make some phone calls for you? Did you ask him to comment on your chances in light of your nontraditional situation? I'm sure you are a great person and a great resident, but this is definitely an uphill battle. You are competing against a fantastic applicant pool, all of whom have chosen urology as their first choice and done multiple away rotations. You need to be thinking worst case scenario (which is not unlikely) -- you don't match and you are doing another GS prelim next year and trying to find a spot as a general surgeon or something else. That radiology gig might not look so unattractive then!

Seems like you've made up your mind, so I wish you luck. I'm not trying to be totally negative, but don't let people blow smoke up your bum.

Don't forget what I said -- inside or outside of the match, your only chance is networking within urology. Your application is going in the can at most places without some form of introduction.

 

[FireRad]

Yea, a good letter from your internship won't hurt, but what you really need are urology connections. It's great that the urology chair is willing to write you a letter, but letters are pretty meaningless unless they are negative. Is he willing to select you in the match? Is he willing to make some phone calls for you? Did you ask him to comment on your chances in light of your nontraditional situation? I'm sure you are a great person and a great resident, but this is definitely an uphill battle. You are competing against a fantastic applicant pool, all of whom have chosen urology as their first choice and done multiple away rotations. You need to be thinking worst case scenario (which is not unlikely) -- you don't match and you are doing another GS prelim next year and trying to find a spot as a general surgeon or something else. That radiology gig might not look so unattractive then!

Seems like you've made up your mind, so I wish you luck. I'm not trying to be totally negative, but don't let people blow smoke up your bum.

Don't forget what I said -- inside or outside of the match, your only chance is networking within urology. Your application is going in the can at most places without some form of introduction.

Thanks for the solid advice! I'll speak with my chairman directly and ask him about networking opportunities. As a direct competitor against MS4s, I'm aware I'm a **** candidate for multiple reasons. But perhaps, there will be an open PGY2 spot somewhere and my Chairman could definitely help in that regard.

I appreciate the honest advice!

 

[FireRad]

How do people find out about open PGY2 positions in urology? I want to maximize the chances of finding a spot.

Should I out of the blue contact programs directly?

 

[hung]

google "aua vacancies" and click on the first link

 

[FireRad]

I wanted to close the loop on this. When I initially posted, people were very pessimistic regarding my chances of matching into Urology. This site seems to only care about board scores and grades.

Well, in the real world, it turns out residency programs care ALOT about your performance as a resident. I crushed it as a surgery intern and got amazing letters of recommendation from my current program.

I applied to the Urology match this year and I got offered an out of match direct position with a top 20 program in NYC. I signed my contract back in early October.

To anyone reading this and thinking they might not be in the right field after match day, don't give up! Go after your dreams!

#ladyboss

 

[cpants]

Congratulations to you! Sounds like you made a calculated risk and it paid off.

I do think the advice given to you above was pretty sound though. You found a spot outside the match, presumably through networking, as advised. I'm not sure if you went into the match you would have had similar results. You also had some significant advantages that many other people in your situation lack -- good board scores, urology research, previously matched to competitive field, home program on board to help you find a spot. Many people don't have those assets.

I think "Follow your dreams" is not necessarily the best advice for a lot of people looking to move into this field, but hey, it worked for you!

 

[Frogger27]

I would be interested to hear how the match process was going for her prior to getting offered a spot outside it.. .Maybe she interviewed at a program for a PGY-1 spot that ended up having an unexpected PGY-2 opening that she ended up being a strong candidate for.

Question for everyone in here: If a student goes through the Urology match unsuccessfully, is it best to find a prelim surgery spot and actively be on the lookout for PGY-2 openings vs other options such as research year, etc??

 

[cpants]

I would be interested to hear how the match process was going for her prior to getting offered a spot outside it.. .Maybe she interviewed at a program for a PGY-1 spot that ended up having an unexpected PGY-2 opening that she ended up being a strong candidate for.

Question for everyone in here: If a student goes through the Urology match unsuccessfully, is it best to find a prelim surgery spot and actively be on the lookout for PGY-2 openings vs other options such as research year, etc??

I think it depends on your situation. It's important to do some self-examination and also seek out advice from mentors/PD at your home program. Every year there are some great head-scratcher candidates that just don't match for some reason - ie. great scores and grades, research, letters. If that's your sitatuation, it might be worth doing a prelim and trying to find an advanced position and/or reapplying. It's a crapshoot though, and most years there are only a handful of spots if any that open up.

If however, there are clear deficiencies in your portfolio -- everything was good but you only have 1-2 publications for example, it might be worth trying to get some additional experience.

I will also repeat that it is worth strongly considering other specialties for anyone who doesn't match to urology. There just aren't many spots at all, and it's very difficult to get a spot from any angle if you don't match the first time. Keep in mind that OP in this thread was not a candidate who didn't match to urology on his first attempt. It's a much different situation.