Switching to neuro from IM

[applicant5000]

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Is it possible for me to transfer from IM to neuro with poor med school application?

I'm a PGY1 in a low-tier community IM program that is affiliated with a public university.

I went to a US MD school and performed somewhat poorly. Probably close to the bottom of my class.

I matched at my #9 ranked program on my list for Internal Medicine.

I only applied IM because it was really the only specialty I could apply for. I had zero time for elective rotations 4th year because I had to make up a 3rd year rotation at the beginning due to a prior medical leave. So I wasn't able to get even 1 neuro letter by the time ERAS opened.

So how realistic is it for me to switch? Into any specialty (I was primarily thinking of neuro and psych)? Would I have to settle for low-tier programs due to my poor med school app or would they take my residency performance into account?

Given my poor med school performance, should I risk telling my PD and applying? Or is it better not to given that I might be losing a spot at my current program for a potential spot at another? (one in the hand better than...two in the bush kind of deal? idiom doesn't work the best here)

To give some more detail on my med school app:

Step 1 score: ~240
Step 2ck score : ~220
Step 2cs: passed on first attempt
Class rank: 20th percentile
Pre-clincal grades: HP in all classes
3rd year grades: all HP but with mostly lackluster comments. One rotation I had outright bad comments (about lack of energy and so forth) which is what prompted me to take the medical leave.

Thanks!

 

[NotAProgDirector]

Doesn't sound like a weak application to me. I expect you'd get a neuro spot if you apply. You'd want to apply for "R" spots in the match -- PGY-2 positions to start July 2019. Although there won't be a ton of them, there also won't be a ton of good applicants. The big question is whether your program will hold your spot for you all the way to match day. This assumes that you're doing OK in your program. You would need to talk to your PD about doing this, as you'll need interview time, etc.

 

[NeurologyHopeful2018]

You must go to a prestigious school if all HP = bottom of your class...

 

[rokshana]

You must go to a prestigious school if all HP = bottom of your class...

Or a place with grade inflation...

 

[NeurologyHopeful2018]

Is it possible for me to transfer from IM to neuro with poor med school application?

I'm a PGY1 in a low-tier community IM program that is affiliated with a public university.

I went to a US MD school and performed somewhat poorly. Probably close to the bottom of my class.

I matched at my #9 ranked program on my list for Internal Medicine.

I only applied IM because it was really the only specialty I could apply for. I had zero time for elective rotations 4th year because I had to make up a 3rd year rotation at the beginning due to a prior medical leave. So I wasn't able to get even 1 neuro letter by the time ERAS opened.

So how realistic is it for me to switch? Into any specialty (I was primarily thinking of neuro and psych)? Would I have to settle for low-tier programs due to my poor med school app or would they take my residency performance into account?

Given my poor med school performance, should I risk telling my PD and applying? Or is it better not to given that I might be losing a spot at my current program for a potential spot at another? (one in the hand better than...two in the bush kind of deal? idiom doesn't work the best here)

To give some more detail on my med school app:

Step 1 score: ~240
Step 2ck score : ~220
Step 2cs: passed on first attempt

Pre-clincal grades: HP in all classes
3rd year grades: all HP but with mostly lackluster comments. One rotation I had outright bad comments (about lack of energy and so forth) which is what prompted me to take the medical leave.

Thanks!

Also matching to number 9 is not that bad if your list is top heavy!

My friend matched to No. 12 for IM - and it was U of Iowa. Not bad result by any means.

 

[applicant5000]

Doesn't sound like a weak application to me. I expect you'd get a neuro spot if you apply. You'd want to apply for "R" spots in the match -- PGY-2 positions to start July 2019. Although there won't be a ton of them, there also won't be a ton of good applicants. The big question is whether your program will hold your spot for you all the way to match day. This assumes that you're doing OK in your program. You would need to talk to your PD about doing this, as you'll need interview time, etc.

Thank you. I think I was a bit euphimistic about how bad my app was. Almost every 3rd year rotation save for one, had at least some sort of objectively bad comment in there. Like "uninterested" or "should read more" or something like that. One even said I seemed uncomfortable talking to patients. Our school goes by quintile, so I was in the second to last quintile.

Yes, to the other posters, there was definitely grade inflation at my school. The median grade for a preclinical class probably around 88 and more than half get honors in almost every rotation. Getting a P in any rotation got you put on academic monitoring.

 

[NeurologyHopeful2018]

Thank you. I think I was a bit euphimistic about how bad my app was. Almost every 3rd year rotation save for one, had at least some sort of objectively bad comment in there. Like "uninterested" or "should read more" or something like that. One even said I seemed uncomfortable talking to patients. Our school goes by quintile, so I was in the second to last quintile.

Yes, to the other posters, there was definitely grade inflation at my school. The median grade for a preclinical class probably around 88 and more than half get honors in almost every rotation. Getting a P in any rotation got you put on academic monitoring.

So you are 3rd quartile...thats not bad and not the reason you matched low for IM. How did you explain your LoA? That could be considered a red flag. Also did you match into a university or community IM program?

 

[AdmiralChz]

Thank you. I think I was a bit euphimistic about how bad my app was. Almost every 3rd year rotation save for one, had at least some sort of objectively bad comment in there. Like "uninterested" or "should read more" or something like that. One even said I seemed uncomfortable talking to patients. Our school goes by quintile, so I was in the second to last quintile.

Yes, to the other posters, there was definitely grade inflation at my school. The median grade for a preclinical class probably around 88 and more than half get honors in almost every rotation. Getting a P in any rotation got you put on academic monitoring.

I am sorry, OP. Schools are doing no one any favors by assigning all HPs when there are consistent clinical concerns.

This is why the MSPE includes a grade distribution rubric. When I reviewed apps in residency I was shocked that some schools assign nearly 90% As/A- for some rotations - at that point, it’s badically Pass/Fail. Or Honors, Excellent, You Rock or whatever weird euphemism your school might use.

 

[applicant5000]

So you are 3rd quartile...thats not bad and not the reason you matched low for IM. How did you explain your LoA? That could be considered a red flag. Also did you match into a university or community IM program?

Well it's quintile. So I'm in the 4th bracket out of 5. The LoA was a medical LoA that I didn't go into detail on my ERAS but explained in person. It's a community program that is associated with a university (like a satellite hospital). They do have neuro and psych programs at the main hospital.

 

[IMGASMD]

I think with your steps you should have a shot. Is Neuro hot now? I remembered a few years ago, one of my senior residents after finished IM, with no possibility of fellowship, switched into Neuro.

IM to psych isn’t too difficult either, right?

 

[applicant5000]

I think with your steps you should have a shot. Is Neuro hot now? I remembered a few years ago, one of my senior residents after finished IM, with no possibility of fellowship, switched into Neuro.

IM to psych isn’t too difficult either, right?

Neuro and psych about same competitiveness as IM. I barely matched IM though, got #9 out of 10 rank.

 

[NeurologyHopeful2018]

Well it's quintile. So I'm in the 4th bracket out of 5. The LoA was a medical LoA that I didn't go into detail on my ERAS but explained in person. It's a community program that is associated with a university (like a satellite hospital). They do have neuro and psych programs at the main hospital.

For many IM programs your class rank is not important. I suspect its your LoA/poor letters/poor interview that did you in.

 

[NeurologyHopeful2018]

I think with your steps you should have a shot. Is Neuro hot now? I remembered a few years ago, one of my senior residents after finished IM, with no possibility of fellowship, switched into Neuro.

IM to psych isn’t too difficult either, right?

Many IM fellowships (ID & rheum & renal) don't even fill. How can he not have any possibility of matching fellowship?

 

[applicant5000]

yeah i'm not worried about not matching into a fellowship if I continue IM, but i'm not thinking of doing one anyways. And yes, class rank is just a proxy of the things that PDs actually care about (LORs, clinical grades, etc.)

 

[IMGASMD]

Many IM fellowships (ID & rheum & renal) don't even fill. How can he not have any possibility of matching fellowship?

Or nothing that he wanted to do? Depends where you are, ID may not easily find a job. Renal used to be semi-competitive. You’re certainly right, I should probably have qualified it as, couldn’t find a way into a competitive subspecialty.

 

[rokshana]

Many IM fellowships (ID & rheum & renal) don't even fill. How can he not have any possibility of matching fellowship?

when is the last time you looked at the rheum fill rate? They are hot right now.