Switching from IM -> DR; how would 2-3 gap years look?

[swamip]

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I'm a categorical IM resident at a strong academic program, starting my PGY-2 year. Step 2CK and Step 3 27x, coming from T20 med school, 3-4 pubs in IM/pulmonology but no new research/extracurriculars in the past 2 years basically. I really loved my DR rotations in med school and was debating DR vs. IM, but decided on IM when initially applying.

After a year of IM, I've found I really don't enjoy the day-to-day of IM. I'm planning to apply via ERAS to DR this upcoming cycle (R1 starting July 2027) while also trying to find a position outside of the match, if possible.

My PD is generally supportive, and I'm currently on a leave while I try to figure this out. We are a very big program so she is open to releasing me from the program mid-year if I decide to not stay in IM. I really don't want to continue on in IM, so I'm looking for a rads research position to transition into ASAP. But if I do this, and apply via the Match, my DR spot would start in July 2027, meaning I would basically have 2 gap/research years out of clinical medicine. Would DR programs view this gap from medicine as a red flag?

I'm debating whether I should just stick it out and finish IM residency (which I really don't want to) vs. taking a rads research position for the next 2 years.

If I don't match this year, then I would re-apply next year in DR (hopefully then with a year of DR research to bolster my app), but then my gap would be even longer (i.e. 3 years).

 

[NotAProgDirector]

Apply to an R position in the match, will start July 2026. You've already completed a PGY-1

 

[swamip]

Apply to an R position in the match, will start July 2026. You've already completed a PGY-1

Thanks so much for the quick response. My understanding is that there are very few R positions available. I'm not sure how to find out where they are posted. Could I see available R positions in the AAMC residency explorer? I am still waiting for my med school to give me an eras token so I don't have access to ERAS yet.

Nonetheless, even if I try for an R position, since there are so few, I just kind of accepted I would probably match into a normal advanced position starting July 2027.

 

[NotAProgDirector]

The only way to know about open R positions is going to be in ERAS, as far as I know. SInce the process will be needed for both A and R positions, that's your next step.

DR programs are unlikely to care about a 1.5 - 2 year gap for research, I would think. With one year completed, you may be able to get a license in many states and then you could continue to have some clinical experience, even if it's just peripheral to your research.

 

[mistafab]

Regardless what you decide to do, and I know you didn't ask, but I would apply for an unrestricted license in your state if you are able to.

Maybe you already have, or maybe you cant - just do it now if you're eligible. Really important.

 

[guytakingboards]

Radiology has gotten a lot more competitive in the last 10 years. There's not nearly as many open slots and available R positions as there once was. (I managed to get an open slot in a decent academic program post SOAP week and go straight from unmatched prelim intern into radiology once upon a time)

At least back then, no one really cared about that kind of gap in your resume. It's not like research is a big must do during radiology training. Some of my program's best residents were people who either switched from or didn't match to more competitive specialties.

I think as long as you apply broadly, you'll match somewhere. One of my co-residents back in the day switched from a top 20 IM program to my program. He finished two years of IM, decided to switch and had that 2 year gap before starting radiology. He rode the barium bus for two years (i.e. worked for a company that drove around to nursing homes doing mobile barium swallows. his medical license was basically used just to step on the fluoro pedal for Speech path).

All that is to say is that you're likely going to be fine assuming your letters and PD are supportive.

If you're interested, you could try posting your bio to the Residents Seeking Positions on the APDR website: Residents Seeking Positions

 

[flowers]

to answer your question I don't think DR will care about the gap.

HOWEVER, I think you should stay in IM residency until you actually start for the following reasons:
- pay, benefits, and job security. Research funding is VERY tight now, I bet you'll make more in as a PGY2 and PGY3 than as a research position. Plus many medical centers are still in the midst of Reductions-in-Force/lay-offs. It would be terrible to give up a path to a well paying job only to be un-employed.
- you'll learn more medicine. Seeing the pathology of diseases and the corresponding imaging is going to be very useful in your career decades from now.
- optionality - IM is SO VERSITILE and if something falls through, you'll be in better position having completed more years of training.

internship is HARD and there are more electives later on so I think the IM residency should be tolerable for the above benefits.
Good luck!

 

[dozitgetchahi]

to answer your question I don't think DR will care about the gap.

HOWEVER, I think you should stay in IM residency until you actually start for the following reasons:
- pay, benefits, and job security. Research funding is VERY tight now, I bet you'll make more in as a PGY2 and PGY3 than as a research position. Plus many medical centers are still in the midst of Reductions-in-Force/lay-offs. It would be terrible to give up a path to a well paying job only to be un-employed.
- you'll learn more medicine. Seeing the pathology of diseases and the corresponding imaging is going to be very useful in your career decades from now.
- optionality - IM is SO VERSITILE and if something falls through, you'll be in better position having completed more years of training.

internship is HARD and there are more electives later on so I think the IM residency should be tolerable for the above benefits.
Good luck!

I agree with this. It’s not a good time to gamble on research positions etc. A bird in the hand is worth a million in the bush at this point. OP, never underestimate how much life will suck if all your big plans come to naught, and you have to try to make your way in the world with one year of IM training and no board eligibility.