Transitioning from IM to Anesthesia residency (non-trad US IMG)

[JtMD3]

! Advice needed !

Background:

Hello everyone, Currently a Pgy-2 IM resident at an HCA program. I am fully committed to completing my current training, however, continued thoughts of a career in anesthesia continue to be debilitating, despite my daily efforts to enjoy medicine.

Unfortunately, my knowledge of the process was less than ideal during my match. Among several anesthesia programs, I also ranked 1 back-up IM program (my current program), which I strongly believe affected the outcome. At this time, I am highly regarded in my program with a significant resident award, as well as a likely nomination for chief. 3-4 case reports.

Goal:

Following completion of my current program, I will be reapplying to anesthesia.

If anyone has a similar situation/experience, I would be grateful for any advice regarding the most effective pathway for this transition.

Questions:

Optimal approach for a candidate in my situation?

R positions (most desirable)… Few, but IYO would a candidate like myself be competitive?

Advanced Positions… potential gap year(working) worth it?

Categorical Program… repeat base year vs gap year?

Any additional recommendations which I can begin to accomplish now?

Lastly, I will never accept “no” for an answer, it comes down to how efficiently I can receive a “yes”, hence why I am asking for assistance in this process. If I am required to repeat an intern year, I will to do so without hesitation. My commitment is absolute.

Looking forward to your insights or personal experiences to help. Thank you!

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[CopaceticOne]

Just to clarify - Was the IM program at in the bottom position of your original match list?

 

[UscGhost]

! Advice needed !

Background:

Hello everyone, Currently a Pgy-2 IM resident at an HCA program. I am fully committed to completing my current training, however, continued thoughts of a career in anesthesia continue to be debilitating, despite my daily efforts to enjoy medicine.

Unfortunately, my knowledge of the process was less than ideal during my match. Among several anesthesia programs, I also ranked 1 back-up IM program (my current program), which I strongly believe affected the outcome. At this time, I am highly regarded in my program with a significant resident award, as well as a likely nomination for chief. 3-4 case reports.

Goal:

Following completion of my current program, I will be reapplying to anesthesia.

If anyone has a similar situation/experience, I would be grateful for any advice regarding the most effective pathway for this transition.

Questions:

Optimal approach for a candidate in my situation?

R positions (most desirable)… Few, but IYO would a candidate like myself be competitive?

Advanced Positions… potential gap year(working) worth it?

Categorical Program… repeat base year vs gap year?

Any additional recommendations which I can begin to accomplish now?

Lastly, I will never accept “no” for an answer, it comes down to how efficiently I can receive a “yes”, hence why I am asking for assistance in this process. If I am required to repeat an intern year, I will to do so without hesitation. My commitment is absolute.

Looking forward to your insights or personal experiences to help. Thank you!

I imagine that any route that minimizes any wasted years is vital, even if that means leaving your IM program early.

Competing your IM residency won't help you in your future career in anesthesia

 

[abolt18]

I imagine that any route that minimizes any wasted years is vital, even if that means leaving your IM program early.

Competing your IM residency won't help you in your future career in anesthesia

It won't make them more money but it will undoubtedly make them into a better doctor overall.

Nevertheless, if you can get into anesthesia before finishing medicine, all the better. If you can't, make the best of it and learn medicine the best you can.

 

[pgg]

I imagine that any route that minimizes any wasted years is vital, even if that means leaving your IM program early.

Competing your IM residency won't help you in your future career in anesthesia

An applicant who completed a residency is more attractive than an applicant who left early.

I certainly wouldn't leave early unless I already had an assured spot lined up.

 

[caligas]

Why would ranking an IM residency have hurt you? Match was different when I did it 22 years ago

 

[abolt18]

Why would ranking an IM residency have hurt you? Match was different when I did it 22 years ago

If it was ranked higher than any of the anesthesia programs, it could have prevented the match into those.

If IM was ranked very last in the list, then it would have zero effect.

 

[JtMD3]

Why would ranking an IM residency have hurt you? Match was different when I did it 22 years ago

This is

Just to clarify - Was the IM program at in the bottom position of your original match list?

Bottom of the list. This is only a theory, but today with the competition for specialty positions, it only makes sense for the NRMP to strongly focus on filling ALL positions including the IM/FM (common backups) programs who persistently fail to fill their positions. So, following several promising anesthesia interviews where the PDs personally stated they were ranking me highly, I matched at my sole backup IM program who fills >50% of their positions each year by soap. Im aware this cant be proved, its ultimately my fault, and I should have ranked a prelim or TY as a backup, but just wanted to clarify that thought lol.

 

[JtMD3]

I imagine that any route that minimizes any wasted years is vital, even if that means leaving your IM program early.

Competing your IM residency won't help you in your future career in anesthesia

I absolutely agree. The issue I am running into regarding transferring or re-entering the match at this time is funding. Due to IM being a 3y residency, my funding is only available for 3 years. I reapplied to the match during my intern year, however at that point I technically had only 2y of remaining funding. From the interviews I did receive during that match (unsure why I was even interviewed), at least half of the PDs made a strong effort to state; If this doesn't work out, I should definitely reapply after I finish my current program. If given the transfer opportunity, I would pack my bags this evening.

 

[chessknt]

Just to point out the obvious but every medical subspecialty is a no-go for you? Would be a lot easier and almost undoubtedly more financially wise to continue along that path then to start over again.

 

[Drägerman]

This is

Bottom of the list. This is only a theory, but today with the competition for specialty positions, it only makes sense for the NRMP to strongly focus on filling ALL positions including the IM/FM (common backups) programs who persistently fail to fill their positions. So, following several promising anesthesia interviews where the PDs personally stated they were ranking me highly, I matched at my sole backup IM program who fills >50% of their positions each year by soap. Im aware this cant be proved, its ultimately my fault, and I should have ranked a prelim or TY as a backup, but just wanted to clarify that thought lol.

Wat. Are you saying there is a conspiracy to just fill spots and ignore match lists? Isn’t NRMP is an independent entity?
‘It only makes sense’ seems contradictory to the self reflecting tone of your final sentence.

 

[caligas]

I’d do a pain medicine fellowship

 

[CopaceticOne]

This is

Bottom of the list. This is only a theory, but today with the competition for specialty positions, it only makes sense for the NRMP to strongly focus on filling ALL positions including the IM/FM (common backups) programs who persistently fail to fill their positions. So, following several promising anesthesia interviews where the PDs personally stated they were ranking me highly, I matched at my sole backup IM program who fills >50% of their positions each year by soap. Im aware this cant be proved, its ultimately my fault, and I should have ranked a prelim or TY as a backup, but just wanted to clarify that thought lol.

You need to take responsibility for your successful matching into a program on your match list. There was no collusion. The match algorithm actually gives slight preference to the INDIVIDUAL.

So you need to reflect on why you did not match to all your possible anesthesia programs the first time around. This will help you on your attempt this time around.

Lastly, I will never accept “no” for an answer, it comes down to how efficiently I can receive a “yes”,

And just a warning - I know the above could be misconstrued, but it is a troubling statement for a applicant to anesthesiology. If residents aren't open to following direction, even when they disagree, then they will be a problem for the program. Is it possible that you had expressed / demonstrated that sort personality during interviews?

 

[kidthor]

And just a warning - I know the above could be misconstrued, but it is a troubling statement for a applicant to anesthesiology. If residents aren't open to following direction, even when they disagree, then they will be a problem for the program. Is it possible that you had expressed / demonstrated that sort personality during interviews?

Yeah I second this thought. OPs story and attitude come off as odd. My advice to OP is to be more realistic about speciality/subspecialty choice because it seems like a grass-is-greener mindset that won’t be met with reality.

Most anesthesiologists I know would probably be plenty happy in several other specialities, many of which are sub specialties of IM.

 

[JtMD3]

You need to take responsibility for your successful matching into a program on your match list. There was no collusion. The match algorithm actually gives slight preference to the INDIVIDUAL.

So you need to reflect on why you did not match to all your possible anesthesia programs the first time around. This will help you on your attempt this time around.


And just a warning - I know the above could be misconstrued, but it is a troubling statement for a applicant to anesthesiology. If residents aren't open to following direction, even when they disagree, then they will be a problem for the program. Is it possible that you had expressed / demonstrated that sort personality during interviews?

Thank you for taking the time to respond to my post. However, I believe there may be some misunderstanding or misinterpretation of my original question and intent.

I was simply sharing my thoughts on the NRMP process and the challenges I faced in my match experience, particularly regarding backup programs and the dynamics that can affect applicants. The question I posed was not intended to open the door for judgment on my character or interpersonal skills. I would appreciate it if responses could focus on providing constructive insight based on the topic at hand, rather than making assumptions about my behavior or attitude during interviews.

While I value diverse perspectives, I must clarify that no part of my post suggested an unwillingness to follow direction or work collaboratively. In fact, I am aware of how crucial adaptability and team collaboration are in any medical field, which is why I have always strived to maintain a professional and cooperative demeanor in all of my interactions.

It’s important to remember that feedback, even if well-meaning, should be both respectful and relevant to the discussion. I would prefer if future exchanges focus on constructive dialogue, rather than veering into baseless assumptions about applicants’ personalities or behaviors, which, in this case, I find unwarranted.

Thanks again for your time, and I wish you the best in your endeavor!

 

[cchoukal]

You need to take responsibility for your successful matching into a program on your match list. There was no collusion. The match algorithm actually gives slight preference to the INDIVIDUAL.

So you need to reflect on why you did not match to all your possible anesthesia programs the first time around. This will help you on your attempt this time around.


And just a warning - I know the above could be misconstrued, but it is a troubling statement for an applicant to anesthesiology. If residents aren't open to following direction, even when they disagree, then they will be a problem for the program. Is it possible that you had expressed / demonstrated that sort personality during interviews?

It’s funny, I didn’t read this into his OP, but now that I’ve seen the response, you’re spot on!

 

[secretasianman]

Yikes. Bold move doubling down.

 

[Bryan O’Blivion]

Free (and apparently priced) advice: a finished training program and board certification are worth something. An unfinished one and a lack of board eligibility is worthless. During your IM training You will learn a lot about disease severity and manifestation in a patient’s physiology and ability to tolerate surgery and anesthesia, which a lot of what an anesthesiologist’s job is. That’s valuable. That being said, if you are willing to devote 6 years of this finite human life to training, consider an IM subspecialty. Anesthesia seems attractive right now, frankly it is good, but these things can change in a short period of time, like the length of a training program. I’ve seen the job market change within three years. Sometimes these things work out in your favor, sometimes they don’t. I wouldn’t blow up your IM residency just to get into anesthesia more quickly. GL

 

[NukHopkins]

This guy is gonna gun for GI and be insufferable to work with.

 

[kidthor]

10 years ago it was radonc and before that er. Now those programs don’t even fill consistently.

It’s absolutely wild how the tides have turned. I remember my EM friends making absurd money while the anesthesia job market was seemingly saturated - now in merely 5 years it’s completely flipped. Rad onc also used to be a secret gold mine that only the top candidates could match into and now spots go unfilled.

 

[NicholasPavona]

Thank you for taking the time to respond to my post. However, I believe there may be some misunderstanding or misinterpretation of my original question and intent.

I was simply sharing my thoughts on the NRMP process and the challenges I faced in my match experience, particularly regarding backup programs and the dynamics that can affect applicants. The question I posed was not intended to open the door for judgment on my character or interpersonal skills. I would appreciate it if responses could focus on providing constructive insight based on the topic at hand, rather than making assumptions about my behavior or attitude during interviews.

While I value diverse perspectives, I must clarify that no part of my post suggested an unwillingness to follow direction or work collaboratively. In fact, I am aware of how crucial adaptability and team collaboration are in any medical field, which is why I have always strived to maintain a professional and cooperative demeanor in all of my interactions.

It’s important to remember that feedback, even if well-meaning, should be both respectful and relevant to the discussion. I would prefer if future exchanges focus on constructive dialogue, rather than veering into baseless assumptions about applicants’ personalities or behaviors, which, in this case, I find unwarranted.

Thanks again for your time, and I wish you the best in your endeavor!

First day on SDN?

 

[CopaceticOne]

It’s funny, I didn’t read this into his OP, but now that I’ve seen the response, you’re spot on!

Yeah... the subsequent reply was kind of what I was expecting and actually explained a lot. Oh well, no skin off my back.

 

[Maz777]

! Advice needed !

Background:

Hello everyone, Currently a Pgy-2 IM resident at an HCA program. I am fully committed to completing my current training, however, continued thoughts of a career in anesthesia continue to be debilitating, despite my daily efforts to enjoy medicine.

Unfortunately, my knowledge of the process was less than ideal during my match. Among several anesthesia programs, I also ranked 1 back-up IM program (my current program), which I strongly believe affected the outcome. At this time, I am highly regarded in my program with a significant resident award, as well as a likely nomination for chief. 3-4 case reports.

Goal:

Following completion of my current program, I will be reapplying to anesthesia.

If anyone has a similar situation/experience, I would be grateful for any advice regarding the most effective pathway for this transition.

Questions:

Optimal approach for a candidate in my situation?

R positions (most desirable)… Few, but IYO would a candidate like myself be competitive?

Advanced Positions… potential gap year(working) worth it?

Categorical Program… repeat base year vs gap year?

Any additional recommendations which I can begin to accomplish now?

Lastly, I will never accept “no” for an answer, it comes down to how efficiently I can receive a “yes”, hence why I am asking for assistance in this process. If I am required to repeat an intern year, I will to do so without hesitation. My commitment is absolute.

Looking forward to your insights or personal experiences to help. Thank you!

You matched at an HCA IM program and didn't match in anesthesia. Sorry to be blunt but I highly doubt you have a strong application/CV. It's going to be even tougher the second time around. You aren't a neurosurgery resident at UCSF looking to jump ship with a CV that includes curing cancer and two 1st author JAMA papers. It's important to be realistic.

Also, you sound like an AI bot that no one would miss if they got offed during a Squid Game.

 

[pgg]

You matched at an HCA IM program and didn't match in anesthesia. Sorry to be blunt but I highly doubt you have a strong application/CV.

OP said he's an IMG, which can mean a lot of things, they often struggle to match.

US-born Caribbean grad? Would certainly explain the match result.

Foreign-born grad, different culture, with English as a second language? Could explain the writing and tone being a little off.

 

[JtMD3]

Free (and apparently priced) advice: a finished training program and board certification are worth something. An unfinished one and a lack of board eligibility is worthless. During your IM training You will learn a lot about disease severity and manifestation in a patient’s physiology and ability to tolerate surgery and anesthesia, which a lot of what an anesthesiologist’s job is. That’s valuable. That being said, if you are willing to devote 6 years of this finite human life to training, consider an IM subspecialty. Anesthesia seems attractive right now, frankly it is good, but these things can change in a short period of time, like the length of a training program. I’ve seen the job market change within three years. Sometimes these things work out in your favor, sometimes they don’t. I wouldn’t blow up your IM residency just to get into anesthesia more quickly. GL

Thank you, I appreciate the positive feedback.