Taking a year off after M4 year

[DrBB]

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I'm currently an M4 student interested in going into derm. I'm thinking about taking a year off to do research but am somewhat confused by the process.

I am scheduled to graduate med school in June, 2013, and so I would start the research year in July, 2013. However, would I apply to residencies for the following year? If so, I would apply to residencies in September 2013 and would start interviewing in November 2013. So really, I would only have 3 months of research under my belt, which isn't really impressive.

So my question is this: By taking "a year off for research" would I in reality have to take 2 years off for research? Or, could I apply for the next cycle with only 3 months of research under my belt?

Also, does taking a year off after graduating hurt my application moreso than if I took the year off while still in med school?

 

[Winged Scapula]

1) yes, you have the timeline right.

If you graduate in June 2013 and plan to start residency in July 2014, you will apply in September 2013, or after 3 months of research.

2) thus, if you feel that doing research will make you a more appealing Derm candidate, then 3 months is not much time to buff that CV

3) statistics indicate that Physicians applying for the match are less successful than MS-IVs. However, the individuals who make up that group may have other reasons than simply having graduated for being less successful.

4) if you take a year (or two) off to do research, your student loan companies will want some payment which might be more difficult to do than if you were in residency. Doing the research during medical school alleviates #3 an #4.

Here is a link to an article written on SDN a few years ago about the Derm match and successful applicant: http://studentdoctor.net/2009/10/the-successful-match-getting-into-dermatology/

As an MS-4, you're a little behind the 8 ball in getting this sorted out, but that doesn't mean you couldn't be successful.

 

[DrBB]

Thanks for your response. If I take a year or 2 year leave of absence from medical school (while in the middle of my 4th year as I am now), wouldn't the loan companies still require repayment?

 

[gasblaster]

Depends on how your school wants to handle it. If they are willing to document you as an enrolled student during your research time, then you will not have to start repaying loans until you have officially graduated, however interest will still accumulate on it your loans. Also, I don't know how medical schools and residency programs would like having students taking 2 extra years to graduate (excluding dual degree students) unless you obtain a research scholarship/fellowship. Have you talked to your dean?

 

[group_theory]

Keep in mind the longer you are away from medical school, the less desirable you become as an applicant. One year might not be a big deal, but two or three years and lots of programs will start getting concern that your clinical skills and knowledge will have faded. And it is hard to get meaningful clinical exposure if you are no longer in medical school since you will not have an organize administrative structure in place and you will not have medical malpractice insurance.

It is up to your school to determine if and when you will graduate. They may have some research program/fellowship available to you or they may not. If you fulfill graduation requirements, they may graduate you (then you are on your own).

 

[michaelrack]

If you are going to do research, you will probably need to start it during your 4th year. That way you will have more than 3 months of research under your belt when you apply.

 

[NotAProgDirector]

If you are going to do research, you will probably need to start it during your 4th year. That way you will have more than 3 months of research under your belt when you apply.

MR beat me to it. You've got the application timeline correct. You've got the research timeline incorrect. If you're going to take a year off, you stop all your application work now, and start research NOW. You hopefully get a research position at your current medical school. Thus, you can get almost 12 months of research done (minus whatever required rotations you have left) before next application season.

You may be able to split your 4th year -- many medical schools allow that, and only charge you 1 year of tuition. You'll still have living expenses.

Note that if you don't match into derm, all that research can become a "problem". If you apply to my IM residency program after taking a year off to do derm research, I'm likely to concluide that you're applying to derm with IM as a backup. I don't want to waste my interview spots on people who aren't serious about IM.

 

[DrBB]

MR beat me to it. You've got the application timeline correct. You've got the research timeline incorrect. If you're going to take a year off, you stop all your application work now, and start research NOW. You hopefully get a research position at your current medical school. Thus, you can get almost 12 months of research done (minus whatever required rotations you have left) before next application season.

You may be able to split your 4th year -- many medical schools allow that, and only charge you 1 year of tuition. You'll still have living expenses.

Note that if you don't match into derm, all that research can become a "problem". If you apply to my IM residency program after taking a year off to do derm research, I'm likely to concluide that you're applying to derm with IM as a backup. I don't want to waste my interview spots on people who aren't serious about IM.

You don't think that the 3 months + a full year commitment to a derm research fellowship would help my application to derm? I dont really want to split my 4th year....I want to finish as scheduled and then do the research the following year. I know it's not ideal, but at this point, I'm not willing to stop my 4th year studies.

 

[gutonc]

You don't think that the 3 months + a full year commitment to a derm research fellowship would help my application to derm? I dont really want to split my 4th year....I want to finish as scheduled and then do the research the following year. I know it's not ideal, but at this point, I'm not willing to stop my 4th year studies.

This is short-sighted. You're going to ne a more competitive candidate as a "4th" year" than as a graduate.

Also...LOL at "4th year studies."

 

[DrBB]

This is short-sighted. You're going to ne a more competitive candidate as a "4th" year" than as a graduate.

Also...LOL at "4th year studies."

Ha, ya it was meant to be funny. I don't see how the dedication to a year of research wouldnt make me a better applicant though.

 

[Smurfette]

This is short-sighted. You're going to ne a more competitive candidate as a "4th" year" than as a graduate.

Also...LOL at "4th year studies."

I agree with gutonc. You want a highly competitive field...so graduate at the same time as the others who are applying. They may screen you out as an applicant if they see your graduation date was a year prior (because they may assume---albeit incorrectly---that you failed to match the first time around).

 

[K31]

You don't think that the 3 months + a full year commitment to a derm research fellowship would help my application to derm? I dont really want to split my 4th year....I want to finish as scheduled and then do the research the following year. I know it's not ideal, but at this point, I'm not willing to stop my 4th year studies.

I agree with what the others have said. You'll be in a far better spot to apply if you take time off starting now versus waiting until after you graduate.

You'll have a full year of research under your belt (more to talk about, some posters/talks and potentially publications), plus you can apply as a US senior rather than an independent applicant--you'll get more support from your school and have a better likelihood of matching per all the statistics.

That's versus applying with a new project that hasn't gotten off the ground and trying to get a letter from a PI who barely knows you.

 

[DrAwsome]

I'm currently an M4 student interested in going into derm. I'm thinking about taking a year off to do research but am somewhat confused by the process.

I am scheduled to graduate med school in June, 2013, and so I would start the research year in July, 2013. However, would I apply to residencies for the following year? If so, I would apply to residencies in September 2013 and would start interviewing in November 2013. So really, I would only have 3 months of research under my belt, which isn't really impressive.

So my question is this: By taking "a year off for research" would I in reality have to take 2 years off for research? Or, could I apply for the next cycle with only 3 months of research under my belt?

Also, does taking a year off after graduating hurt my application moreso than if I took the year off while still in med school?

So this is my take on this given that I was in your position in the past. I did what you are thinking/planning and did both derm research and an MPH as well which I in some ways tied to the derm research for a number of reasons. I was finished with the MD stuff though. However I did not graduate and took the year to do both the research and finish the MPH which I had started a bit before. I graduated with all of the above at the same time a year later, even though I was done officialy with MD stuff. For derm it was not an issue, and given that I was not officially graduated, I was not responsible for loan payments. This past match when I applied to rad onc, I had all sorts of question regarding the research however. So you may want to consider doing something like that but like others have mentioned make sure that you have likelihood of matching into derm. This way you can do both-the research which may or may not help for derm depending on your stats, and also graduate as a 4th year which may help. I do know of people who have however graduated, done a fellowship in derm and then applied.

As others have said though, if you don't match into derm, you may not have the opportunity for a fellowship because fellowship programs may be like well this person did research already and it did not help. If I were you I'd finish your MD and try to get in as much of the research in as you can now and see how it goes. It may be best to have any additional research if you have to as a fellow if you don't match.

 

[DrBB]

So this is my take on this given that I was in your position in the past. I did what you are thinking/planning and did both derm research and an MPH as well which I in some ways tied to the derm research for a number of reasons. I was finished with the MD stuff though. However I did not graduate and took the year to do both the research and finish the MPH which I had started a bit before. I graduated with all of the above at the same time a year later, even though I was done officialy with MD stuff. For derm it was not an issue, and given that I was not officially graduated, I was not responsible for loan payments. This past match when I applied to rad onc, I had all sorts of question regarding the research however. So you may want to consider doing something like that but like others have mentioned make sure that you have likelihood of matching into derm. This way you can do both-the research which may or may not help for derm depending on your stats, and also graduate as a 4th year which may help. I do know of people who have however graduated, done a fellowship in derm and then applied.

As others have said though, if you don't match into derm, you may not have the opportunity for a fellowship because fellowship programs may be like well this person did research already and it did not help. If I were you I'd finish your MD and try to get in as much of the research in as you can now and see how it goes. It may be best to have any additional research if you have to as a fellow if you don't match.

How did you finish MD stuff but postpone graduation?

 

[DrAwsome]

How did you finish MD stuff but postpone graduation?

It's complicated but doable, especially if you are doing something else like another degree/research.

 

[Law2Doc]

I agree with gutonc. You want a highly competitive field...so graduate at the same time as the others who are applying...).

I don't think that's really what gutonc said, unless I misread. He said make sure to still be an enrolled med student when applying, not graduate at a specific time. Which is why he put quotes around "4th year". I agree with that, and disagree with your version. I know a number of people who extended their med school by a year of targeted research and got their shot at certain specialties that wouldn't have considered them a competitive applicant otherwise. Graduating on time is not as meaningful as still being a med student when applying to residency. So do what you need to do before graduation, even if you have to artificially extend graduation somehow.

 

[gutonc]

I don't think that's really what gutonc said, unless I misread. He said make sure to still be an enrolled med student when applying, not graduate at a specific time. Which is why he put quotes around "4th year". I agree with that, and disagree with your version. I know a number of people who extended their med school by a year of targeted research and got their shot at certain specialties that wouldn't have considered them a competitive applicant otherwise. Graduating on time is not as meaningful as still being a med student when applying to residency. So do what you need to do before graduation, even if you have to artificially extend graduation somehow.

I think you misinterpreted what Smurfette said. I read it as saying the same thing I meant...which is the same thing that you're saying...which is the right thing to do.

 

[DrAwsome]

I don't think that's really what gutonc said, unless I misread. He said make sure to still be an enrolled med student when applying, not graduate at a specific time. Which is why he put quotes around "4th year". I agree with that, and disagree with your version. I know a number of people who extended their med school by a year of targeted research and got their shot at certain specialties that wouldn't have considered them a competitive applicant otherwise. Graduating on time is not as meaningful as still being a med student when applying to residency. So do what you need to do before graduation, even if you have to artificially extend graduation somehow.

Yes, exactly. No one really cares if you graduate in 5 years or whatever if you got a good productive year out of it.

 

[Winged Scapula]

Yes, exactly. No one really cares if you graduate in 5 years or whatever if you got a good productive year out of it.

Exactly… Darn M.D. PhDs taking seven years to graduate!

I want to expound on something Smurfette mentioned in her post above. Although not a dermatologist, if I were reviewing your residency application and saw that you applied after graduation, I would assume two things:

1) that you applied last year and failed to match which, while unfair and perhaps untrue in your case, would already predisposition me against you;

2) that you did not apply for the match last year because you failed to get your **** together or to think about things early enough to be competitive for a term residency.

Those things may seem to be unfair. Perhaps it's because Smurfette and I are mean surgeons but I can tell you that if she and I thought it, others will as well. You are already behind the vast majority of derm applicants by thinking of this as a fourth-year. There's no reason to harm your application more than it already is. I delayed my graduation to get more rotations and research in as have many others. I think you need to talk to your school about doing that. Having you match successfully looks good for them and their future students. They should want you to succeed.

 

[gutonc]

Those things may seem to be unfair and perhaps it's because Smurfette and I are mean surgeons but I can tell you that if she and I thought it, others will as well. You are already behind the vast majority of derm applicants by thinking of this as a fourth-year. There's no reason to harm your application more than it already is. I delayed my graduation to get more rotations and research in as have many others. I think you need to talk to your school about doing that. Having you match successfully looks good for them and their future students. They should want you to succeed.

This is what I would think...and I'm a touchy-feely medical oncologist.

 

[Doctor Bagel]

Exactly… Darn M.D. PhD is taken seven years to graduate!

I want to expound on something smurfette mentioned in her post above. Although not a dermatologist, if I were reviewing your residency application and saw that you applied after graduation, I would assume two things:

1) that you applied last year and failed to match which, while unfair and perhaps untrue in your case, would already predisposition me against you;

2) that you did not apply for the match last year because you failed to get your **** together or to think about things early enough to be competitive for a term residency.

Those things may seem to be unfair and perhaps it's because Smurfette and I are mean surgeons but I can tell you that if she and I thought it, others will as well. You are already behind the vast majority of derm applicants by thinking of this as a fourth-year. There's no reason to harm your application more than it already is. I delayed my graduation to get more rotations and research in as have many others. I think you need to talk to your school about doing that. Having you match successfully looks good for them and their future students. They should want you to succeed.

I'm a psychiatry resident, and I'd think exactly the same thing. Applying after you graduate can raise all sorts of questions.

 

[DrAwsome]

This is what I would think...and I'm a touchy-feely medical oncologist.

I agree that it would seem unfair. Are you sure you are touchy-feely? I noticed the medical oncologist part, but the touchy-feely, not so much! 😀

 

[DrAwsome]

I'm a psychiatry resident, and I'd think exactly the same thing. Applying after you graduate can raise all sorts of questions.

You know, it is possible to apply for residency, not match, and simply not graduate as well. You can take up another degree, do research, take more rotations, etc. There would be no way for programs to know that you did not match previously. I've seen it done successfully too.

I think people get too hung up on graduating in 4 years, which for competitive specialties, is becoming less common.

 

[gutonc]

You know, it is possible to apply for residency, not match, and simply not graduate as well. You can take up another degree, do research, take more rotations, etc. There would be no way for programs to know that you did not match previously. I've seen it done successfully too.

I think people get too hung up on graduating in 4 years, which for competitive specialties, is becoming less common.

Nobody here is arguing for him graduating in 4 years (aside from the OP)...we're actually arguing against that. His (I'm assuming male for now...just bear with me) plan is to do 4y of med school and 1y of research and then match in Derm. That is a completely reasonable plan. The issue is whether he goes straight through, graduates, does some sort of research fellowship (which might be unpaid) and then applies to the Match, OR postpones graduation for a year while he does the same 1y of research. The eventual outcome is the same (MD + 1y of research, hopefully with pubs and maybe a little funding...everybody likes to see that you can get funding). The issue is that most PDs would rather see the latter than the former, for all the reasons people have explained above.

 

[Winged Scapula]

This is what I would think...and I'm a touchy-feely medical oncologist.

A touchy-feely medical oncologist? Is that like a unicorn?

 

[DrAwsome]

Nobody here is arguing for him graduating in 4 years (aside from the OP)...we're actually arguing against that. His (I'm assuming male for now...just bear with me) plan is to do 4y of med school and 1y of research and then match in Derm. That is a completely reasonable plan. The issue is whether he goes straight through, graduates, does some sort of research fellowship (which might be unpaid) and then applies to the Match, OR postpones graduation for a year while he does the same 1y of research. The eventual outcome is the same (MD + 1y of research, hopefully with pubs and maybe a little funding...everybody likes to see that you can get funding). The issue is that most PDs would rather see the latter than the former, for all the reasons people have explained above.

Yes, I completely agree with you on this.

My statement re: everyone is hung up on graduating in 4 years WAS directed towards the OP, not the rest of the commentators actually. I guess it was not super clear since I posted it under someone else's comment.

 

[Winged Scapula]

There would be no way for programs to know that you did not match previously.

No way? Dermatology is a pretty small field. All it would take is for someone to remember seeing that person the year before. We always kept the file on people we interviewed the year before. Or you can simply ask the candidate, assuming they tell you the truth.

 

[DrAwsome]

No way? Dermatology is a pretty small field. All it would take is for someone to remember seeing that person the year before. We always kept the file on people we interviewed the year before. Or you can simply ask the candidate, assuming they tell you the truth.

That's assuming that someone interviewed at that program. Many applicants only get a handful of interviews. If you don't get to the interview stage no one will remember your application.

 

[Winged Scapula]

That's assuming that someone interviewed at that program. Many applicants only get a handful of interviews. If you don't get to the interview stage no one will remember your application.

True. However, I presume that anyone that was competitive applied for most programs and probably got interviewed the majority of those. thereby, increasing the chances that someone would know.

Besides I like to engage in fostering medical student paranoia about these things. 😆

 

[Law2Doc]

That's assuming that someone interviewed at that program. Many applicants only get a handful of interviews. If you don't get to the interview stage no one will remember your application.

PDs all know each other and sometimes compare notes. So in a small field even a place you didn't interview with could get the down low.

 

[DrAwsome]

True. However I presume that anybody that was competitive applied for most programs and probably got interviewed at most of those. That would increase the chances of somebody would know.

Besides I like to engage in fostering medical student paranoid about these things. LOL.

Don't do that. This whole process is very much nerve wrecking and anxiety provoking.

 

[Winged Scapula]

Don't do that. This whole process is very much nerve wrecking and anxiety provoking.

I *was* joking.

 

[gutonc]

I *was* joking.

I'm not.

But then, I'm the one who voted for an SDN t-shirt design that said "deliberately misleading pre-meds since 2002." I was pretty much the only one who thought that was a good idea though.

 

[Smurfette]

Besides I like to engage in fostering medical student paranoid about these things. LOL.

Must be the mean surgeon in you! Paranoia runs deep around here, so of course she was kidding....

But then, I'm the one who voted for an SDN t-shirt design that said "deliberately misleading pre-meds since 2002." I was pretty much the only one who thought that was a good idea though.

Sounds more mean surgeon than "unicorn". 😉


And yes, WS and gutonc interpreted the 'semantics' of my post correctly.

 

[RadOncDoc21]

Definitely do the research year prior to graduation... It will also give you time to work on your application and gain an advantage in the field you're applying for. It will also help you stand out more during interviews.

 

[NotAProgDirector]

I hate to be a hard ass, but there's something not quite right here.

In this thread, we have the OP debating how to best arrange their schooling to get a derm residency.

In this other thread, started 4 days prior, the OP is looking for advice about how they can apply for rads without ever doing a rads rotation.

But, 5 days prior to that, the OP started this thread looking for advice trying to decide between Anesthesia and IM.

To be fair, prior to this all of the OP's energy seemed to be focused on anesthesia. Then, perhaps because people in anesthesia told him not to go into it, he started looking into other fields.

So, I think the best advice for the OP is to delay graduation for a year to sort out what they want.

 

[Winged Scapula]

I hate to be a hard ass, but there's something not quite right here.

In this thread, we have the OP debating how to best arrange their schooling to get a derm residency.

In this other thread, started 4 days prior, the OP is looking for advice about how they can apply for rads without ever doing a rads rotation.

But, 5 days prior to that, the OP started this thread looking for advice trying to decide between Anesthesia and IM.

To be fair, prior to this all of the OP's energy seemed to be focused on anesthesia. Then, perhaps because people in anesthesia told him not to go into it, he started looking into other fields.

So, I think the best advice for the OP is to delay graduation for a year to sort out what they want.

Stellar detective work there. IMHO you're not being a hardass but just once again proving that when posters have a problem, they often don't reveal the whole story.

So the OP is clearly confused and unsure of what he wants to do.Delay seems the only option.

 

[DrBB]

Stellar detective work there. IMHO you're not being a hardass but just once again proving that when posters have a problem, they often don't reveal the whole story.

So the OP is clearly confused and unsure of what he wants to do.Delay seems the only option.

You guys are so sneaky. Big deal - yes - I am interested in multiple fields at this time and am trying to explore all avenues. Is that such a crime? I personally think the system is at fault for making us choose our careers after only brief experiences on rotations.

 

[Winged Scapula]

You guys are so sneaky. Big deal - yes - I am interested in multiple fields at this time and am trying to explore all avenues. Is that such a crime? I personally think the system is at fault for making us choose our careers after only brief experiences on rotations.

No its not a crime. I agree with you that students aren't given enough time to make such a life changing decision. There's no need to be snarky about it. Your "tone" makes me feel like you knew that you were hiding something.

The conventional wisdom is that its rather unfair to those who are trying to help you for you not to be open about that and your multiple interests. There's no crime in that - there are multiple medical students every year who go through the same thing. Why not be open (and not require someone to do a search for your previous posts) and say, "I'm having trouble trying to decide what to do, here are some of my choices, what I like about them, etc."? That might actually help others in the same situation to see they aren't alone in feeling forced into choosing before they are ready.

That you are having difficulty makes a lot more sense to me (and me more sympathetic to you) than thinking you were just a slacker who couldn't get his act together (which is what it looks like, without the back story, when you come on here and post about applying to Derm so late in the game).

And you shouldn't be so disingenuous that we would be somewhat skeptical about your interests when one week its Anesthesia, the next week its Rad and then its Derm. By hiding that, it looks sneaky and makes people less inclined to help once they find out.

 

[DrBB]

No its not a crime. I agree with you that students aren't given enough time to make such a life changing decision. There's no need to be snarky about it. Your "tone" makes me feel like you knew that you were hiding something.

The conventional wisdom is that its rather unfair to those who are trying to help you for you not to be open about that and your multiple interests. There's no crime in that - there are multiple medical students every year who go through the same thing. Why not be open (and not require someone to do a search for your previous posts) and say, "I'm having trouble trying to decide what to do, here are some of my choices, what I like about them, etc."? That might actually help others in the same situation to see they aren't alone in feeling forced into choosing before they are ready.

That you are having difficulty makes a lot more sense to me (and me more sympathetic to you) than thinking you were just a slacker who couldn't get his act together (which is what it looks like, without the back story, when you come on here and post about applying to Derm so late in the game).

And you shouldn't be so disingenuous that we would be somewhat skeptical about your interests when one week its Anesthesia, the next week its Rad and then its Derm. By hiding that, it looks sneaky and makes people less inclined to help once they find out.

Listen - this is an anonymous forum where people can post questions to receive answers, right? My question was specific regarding taking a year off to do derm research and whether or not that would be beneficial. The fact that I have other interests and considered other fields has nothing to do with my specific question. I guess next time I want to ask a specific question, I'll have to create a new username to do it.

 

[gasblaster]

For my own curiosity, what are you planning on doing? Since ERAS just went out, I'm guessing you've probably made a decision about what to do, or at least have a general idea hopefully.

 

[Winged Scapula]

Listen - this is an anonymous forum where people can post questions to receive answers, right? My question was specific regarding taking a year off to do derm research and whether or not that would be beneficial. The fact that I have other interests and considered other fields has nothing to do with my specific question. I guess next time I want to ask a specific question, I'll have to create a new username to do it.

There is no reason to be so defensive. It makes people less likely to want to help you. Every one here volunteers their time, so a little less vitriol goes a long way especially when I told you in my response above that I am now more sympathetic to your issues (went through it with my med school roommate who couldn't decide what she wanted to do).

Perhaps you think your other interests have nothing to do with your specific question but it does give users some backstory as to what's going on and ya know what? It DOES matter. Frankly, in your situation, knowing that you are having difficulty in deciding what you want to do (and that maybe it won't be Derm), means that we are even more than likely to suggest you delay graduation so you have more time to think about your future. So it IS relevant.

And, creating a new username is a violation of the SDN Terms of Service agreement you signed when you registered. So don't do that.

 

[DrBB]

For my own curiosity, what are you planning on doing? Since ERAS just went out, I'm guessing you've probably made a decision about what to do, or at least have a general idea hopefully.

I applied to IM....so will probably end up going into that, unless I do a research year. I like IM and it's a good foundation for medicine that I can build on in the future.

 

[duckie99]

I applied to IM....so will probably end up going into that, unless I do a research year. I like IM and it's a good foundation for medicine that I can build on in the future.

also if you decide to do something like rads or anesthesia later it won't be much of an issue transferring because both of those fields require a prelim year. So you can always change your mind and apply again.

 

[Law2Doc]

also if you decide to do something like rads or anesthesia later it won't be much of an issue transferring because both of those fields require a prelim year....

As does derm. But if you know for sure you want to be in an advanced program it doesn't make much sense to start in on something categorical -- you are better off with the research year, delaying graduation and figuring things out first. Its a whole lot easier finding time to interview during a research year than as an intern.

 

[duckie99]

As does derm. But if you know for sure you want to be in an advanced program it doesn't make much sense to start in on something categorical -- you are better off with the research year, delaying graduation and figuring things out first. Its a whole lot easier finding time to interview during a research year than as an intern.

agreed. OP, if you know for a fact you would much rather do something not IM then don't apply IM and switch. It's much harder to switch out mainly because you are sort of screwing over the program you match into and that won't make them very happy. Also coordinating interviews will be more difficult.

Taking a research year isn't the worst thing. If you decide now you want to do that you should be able to get some research done before you apply again (1 year from now). This also gives some time to do a couple more electives in fields you were considering.

 

[NotAProgDirector]

To the OP: I wasn't trying to be mean, or call you out.

My point was simple -- you seem very conflicted about what you want to do. In that case, your best option all around is delaying graduation by a year, and taking the next 9 months to do rotations in whatever you might be interested in.

Do not fool yourself -- applying to another field while training in IM is not easy. Your medical school may not care that you take off a bunch of days during interview season, but your new internship next year certainly will. Your internship is a job that you're being paid to do, so they will certainly care if you ask for days off (and you'll have real clinical responsibilities that will need to be covered by someone else). And, 3 months of IM training (which is all you'll have by next application season) won't really impress anyone, your letters will say "DrBB seems to have started OK as an intern, but it's too early to tell how he'll/she'll do". Last, you run into the problem of medicare funding limits.

So, bottom line is this:

1. Your first match is likely to be your best, for many reasons.
2. If you don't know what you want to do, you're probably better delaying graduation and planning to match next year
3. The best way to do that is delay graduation, if your medical school will let you split your 4th year (which most will).
4. During your split year, you can do research, rotations, or whatever you'd like.

Splitting your year lets you continue to keep your loans out of payment.
Splitting your 4th year costs you your salary next year (that's the negative).

Given what you've posted here on SDN, you should very seriously consider splitting your 4th year.

 

[DrBB]

To the OP: I wasn't trying to be mean, or call you out.

My point was simple -- you seem very conflicted about what you want to do. In that case, your best option all around is delaying graduation by a year, and taking the next 9 months to do rotations in whatever you might be interested in.

Do not fool yourself -- applying to another field while training in IM is not easy. Your medical school may not care that you take off a bunch of days during interview season, but your new internship next year certainly will. Your internship is a job that you're being paid to do, so they will certainly care if you ask for days off (and you'll have real clinical responsibilities that will need to be covered by someone else). And, 3 months of IM training (which is all you'll have by next application season) won't really impress anyone, your letters will say "DrBB seems to have started OK as an intern, but it's too early to tell how he'll/she'll do". Last, you run into the problem of medicare funding limits.

So, bottom line is this:

1. Your first match is likely to be your best, for many reasons.
2. If you don't know what you want to do, you're probably better delaying graduation and planning to match next year
3. The best way to do that is delay graduation, if your medical school will let you split your 4th year (which most will).
4. During your split year, you can do research, rotations, or whatever you'd like.

Splitting your year lets you continue to keep your loans out of payment.
Splitting your 4th year costs you your salary next year (that's the negative).

Given what you've posted here on SDN, you should very seriously consider splitting your 4th year.

The thing is - I have liked something about every rotation I've done. However, there has not been a single rotation where I've been like "Oh wow! This is what I would really love to do for the rest of my life!" There have been rotations where I have said "Ok, I cannot see myself doing this for my entire life," i.e. surgery. In general, I like inpatient IM, clinic, and doing certain procedures. However, I feel like I am a fairly competitive applicant, and should go into something that I like enough, that also pays well. IM (unless I specialize) is not really a competitive/high reimbursement field. That's why I was thinking derm: it has some medicine, some procedures, and clinic. However, at this point I haven't done a rotation in it, don't have any derm letters, and probably am not the most competitive applicant.

As of now, I don't know of any research PI's or fellowships that will take me. Most of the programs are a year long and start in June/July. That's why I was considering graduating med school, and then starting the program in June/July of next year.

 

[NotAProgDirector]

Choosing derm because it's lucrative and you are competitive enough to get it is not a great idea. You'd want to make sure that you really like it, and there's no guarantee that it will remain lucrative.

Given your story, I still stand behind my advice to delay graduation for a year. You'd stop the ERAS madness now. You'd do 2 derm rotations, and maybe rads rotations, and maybe some additional anesthesia rotations. You could also set up a research project in derm, rads, or anything else you want.

What happens if you graduate this year, start a derm fellowship, and really dislike it? What we're trying to tell you is that you're going to find it difficult (but not impossible) to switch to another field. For me to interview you in IM, you'd have to convince me that you really have decided to abandon derm, not just applying as a backup. How do you plan to do that? (That's a rhetorical question for you to ponder. Note that writing about it in your PS is BS -- I've read too many that state that they have given up on derm, yet then go on to match in derm anyway. I understand why people lie -- if they match in derm, it won't really come back to haunt them, and they feel they have no real choice.)

 

[DrBB]

Choosing derm because it's lucrative and you are competitive enough to get it is not a great idea. You'd want to make sure that you really like it, and there's no guarantee that it will remain lucrative.

Given your story, I still stand behind my advice to delay graduation for a year. You'd stop the ERAS madness now. You'd do 2 derm rotations, and maybe rads rotations, and maybe some additional anesthesia rotations. You could also set up a research project in derm, rads, or anything else you want.

What happens if you graduate this year, start a derm fellowship, and really dislike it? What we're trying to tell you is that you're going to find it difficult (but not impossible) to switch to another field. For me to interview you in IM, you'd have to convince me that you really have decided to abandon derm, not just applying as a backup. How do you plan to do that? (That's a rhetorical question for you to ponder. Note that writing about it in your PS is BS -- I've read too many that state that they have given up on derm, yet then go on to match in derm anyway. I understand why people lie -- if they match in derm, it won't really come back to haunt them, and they feel they have no real choice.)

Honestly, I have spent some time doing rads - it's too boring for me I realize. I think the best option for me is to just go for IM. I actually enjoy it, and there are lots of options to subspecialize afterwards.