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Try to match Urology, or go straight for OB/GYN? Advice on how to apply two specialties

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throwaway12dk

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Wondering if 4th years on the interview trail or residents can give some input in regards to chances and if I should give a shot at urology. Below are some stats and info:
-3rd year male osteopathic student, Step1 235, COMLEX1 520-530, 3.0 GPA, Step2 and COMLEX2 in May TBD.
-3 Poster presentations, 2 publication first author pending, no major leadership in medical school, no major awards, Non-traditional with lots of work experience, no urology experience, no proximity to urology residency at my clinical core site, decided late I wanted to do something semi-surgical, not worried about application costs and willing to apply to all ob and urology residencies (I know it'll cost me 8k but I don't care).

I know chances are on the lower end for urology, so I'm looking for some advice on how I should approach letters or recs, away rotations and applications (I know the obvious like applying to former AOA, multiple away rotations ect). I don't think I would care where I go for Urology training and matching would be good in and of itself. So here are my questions:
1) Given my stats and info, is it even worth trying to match urology with OBGYN as backup or should I only apply OB?
2) How do people manage gunning for two different specialties that are different in competitiveness? Any advice on how to go about this in regards to getting letters and away rotations if I apply to both?
3) How does applying for urology affect the possibility of matching at a "better" OB/Gyn program?
4)What are the downsides of applying to two different specialties?
 
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AnatomyGrey12

1. Your scores are pretty low for urology, especially combined with the rest of your app. You could probably get away with dual applying if you could make the letters work out, but you would need to apply very broadly to OB because many programs will see your urology auditions and ding you for it. You could likely match a solid OB program if you went all in on it, but you would need to go all in.

2. You audition like crazy for the more competitive one and then apply super broadly to the other one. OB has increased in competitiveness and is a tough field to apply to as a back up. You need to get separate letters for both. Some fields require all their LORs be in their field, others don't. You will need to do some research to see what are the expectations.

3. Yes if you are dual applying you will lose out on opportunities to match at better OB programs.

4. Your back up programs figure out they are your back up so don't give you interviews or rank you really low, and then you don't match your primary field of interest. So.... you don't match at all are are completely SOL. People do apply to back up specialties successfully but this is always a risk when doing so. It's easier to dual apply to something like IM than it is to something like OB that is still decently competitive.
 
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FutureDoctor5000

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with a 235 ACGME urology will be hard, i would only apply to former AOA Urology programs but I don't even know how competitive you would be there with a 520-530 COMLEX. I would apply to 50-80 OBGYN programs, you are much more likely to match OBGYN, maybe even to a mid tier residency if you have good letter of recs.
 
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BorntobeDO?

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1. Your scores are pretty low for urology, especially combined with the rest of your app. You could probably get away with dual applying if you could make the letters work out, but you would need to apply very broadly to OB because many programs will see your urology auditions and ding you for it. You could likely match a solid OB program if you went all in on it, but you would need to go all in.

2. You audition like crazy for the more competitive one and then apply super broadly to the other one. OB has increased in competitiveness and is a tough field to apply to as a back up. You need to get separate letters for both. Some fields require all their LORs be in their field, others don't. You will need to do some research to see what are the expectations.

3. Yes if you are dual applying you will lose out on opportunities to match at better OB programs.

4. Your back up programs figure out they are your back up so don't give you interviews or rank you really low, and then you don't match your primary field of interest. So.... you don't match at all are are completely SOL. People do apply to back up specialties successfully but this is always a risk when doing so. It's easier to dual apply to something like IM than it is to something like OB that is still decently competitive.
If he submits his transcript with only 3rd year rotations the OB won't see where he auditioned. I think he could make 2 apps if he only releases 3rd year grades. Although if his school lists aways on MSPE this won't work, so he needs to find that out first. My school only did 3rd year stuff on deans letter.
 
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AnatomyGrey12

If he submits his transcript with only 3rd year rotations the OB won't see where he auditioned. I think he could make 2 good apps if he only release 3rd year grades. Although if his school lists aways on MSPE this won't work, so he needs to find that out first. My school only did 3rd year stuff on deans letter.

Damn. My school reports the aways in the deans letter. I have considered dual applying myself but the fact that programs would see it make me hesitant and that was the basis of my advice. I didn’t even realize other places might not do that.

OP you need to find out what your school reports.
 
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BorntobeDO?

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Wondering if 4th years on the interview trail or residents can give some input in regards to chances and if I should give a shot at urology. Below are some stats and info:
-3rd year male osteopathic student, Step1 235, COMLEX1 520-530, 3.0 GPA, Step2 and COMLEX2 in May TBD.
-3 Poster presentations, 2 publication first author pending, no major leadership in medical school, no major awards, Non-traditional with lots of work experience, no urology experience, no proximity to urology residency at my clinical core site, decided late I wanted to do something semi-surgical, not worried about application costs and willing to apply to all ob and urology residencies (I know it'll cost me 8k but I don't care).

I know chances are on the lower end for urology, so I'm looking for some advice on how I should approach letters or recs, away rotations and applications (I know the obvious like applying to former AOA, multiple away rotations ect). I don't think I would care where I go for Urology training and matching would be good in and of itself. So here are my questions:
1) Given my stats and info, is it even worth trying to match urology with OBGYN as backup or should I only apply OB?
2) How do people manage gunning for two different specialties that are different in competitiveness? Any advice on how to go about this in regards to getting letters and away rotations if I apply to both?
3) How does applying for urology affect the possibility of matching at a "better" OB/Gyn program?
4)What are the downsides of applying to two different specialties?
I'll be honest. You are not competitive for Urology with your scores on either the AOA or ACGME front. You can do the two app thing, but I doubt you will get any interviews beyond courtesy ones from places you audition unless your step II goes way up (250+ or 650+, you have to make up for level 1 and step 1). Even if you kill Step 2, I think the relatively low step 1 combined with being a DO will make you DOA for MD programs. The only real shot is AOA and you really need to kill level II to have it.

On the other hand, you are kind of well set up for a OB-GYN app with a clear focus on a surgery fellowship. I think you should absolutely go all in on OB if you think you can live with the longer route to the surgery fellowships. You will match a better program, and I think you will get alot more love. I personally think you might even be competative for some of the 'high tier' OB if your Step 2 rises accordingly (240+). With the pubs, if you can relate them to gyn at all, I think you would look pretty nice to a lot of PD's out there in mid-to upper mid academic centers.
 
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AnatomyGrey12

I'll be honest. You are not competitive for Urology with your scores on either the AOA or ACGME front. You can do the two app thing, but I doubt you will get any interviews beyond courtesy ones from places you audition unless your step II goes way up (250+ or 650+, you have to make up for level 1 and step 1). Even if you kill Step 2, I think the relatively low step 1 combined with being a DO will make you DOA for MD programs. The only real shot is AOA and you really need to kill level II to have it.

It's not just the scores but it's just kind of the whole app to be honest. I do know MD Uro (and other surgical subs) matches that had 230s, but they had 1. better GPAs/ranks, and 2. Multiple first author field specific publications that had allowed them to rub shoulders with some important people in Uro or X subspecialty.

OP personally I would heavily consider just going all in on OB unless you absolutely LOVE Uro and would regret it forever if you didn't try, and in that case go for it but have a very detailed back up plan for what happens if you don't match.
 
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Sardonix

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Not competitive for urology. Go all in for OB instead of risking 10% chance success throwing a Hail Mary for uro.
 
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Dr.Bruh

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Urology is an early match. Id have an OB and Uro app ready to go like you are all in. So if you don't match Uro you are ready for the regular match with OB letters etc.
 

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As a DO, you are not competitive for ACGME Urology from the start. With scores and research below the average for Urology as a whole, along with zero connections in that specialty, I think it is a safe guarantee that you will go unmatched in Urology. Don't waste your time or your money. Just apply Ob/Gyn and do a fellowship in Female Pelvic Medicine and Reconstructive Surgery (Urogynecology) if you really enjoy the urogenital system. It's a challenging surgical field with some of the most difficult surgeries.
 
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throwaway12dk

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Let me preface this by saying thank you all very much for all your input!!! Ya'll are awesome for sure!!!!

If he submits his transcript with only 3rd year rotations the OB won't see where he auditioned. I think he could make 2 apps if he only releases 3rd year grades. Although if his school lists aways on MSPE this won't work, so he needs to find that out first. My school only did 3rd year stuff on deans letter.
OP you need to find out what your school reports.
So just to be clear and understand correctly. One downside is if my school shows me doing a lot of SUB-I's in my 4th year (I'm assuming 1 in my 3rd year would be okay since uro is related to gyn) that OB programs will pick up on this and start ranking me lower? So IF my school does not submit I'll be in the clear on this right?

On the other hand, you are kind of well set up for a OB-GYN app with a clear focus on a surgery fellowship
Completely understand where you're coming from on this. I guess the next question is "How am I harming my chances of matching into a OB program that leads into a surgical fellowship by dual applying?" I understand that ranking wise I only have one list so if I rank a OB place lower in place of a Uro then I lose out on the opportunity of that. But other than that is there anything else that I'm missing?

Not competitive for urology. Go all in for OB instead of risking 10% chance success throwing a Hail Mary for uro
Don't waste your time or your money.
I 100% agree with both of you on this that I'm like at a 10% (at best) chance of even matching urology. But aside from time and money for applications and getting letters, how else am I harming my chances is what I'm wondering because if it's just those things why not?
 
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AnatomyGrey12

I guess the next question is "How am I harming my chances of matching into a OB program that leads into a surgical fellowship by dual applying?" I understand that ranking wise I only have one list so if I rank a OB place lower in place of a Uro then I lose out on the opportunity of that. But other than that is there anything else that I'm missing?

Programs don't like being second fiddle, and OB is competitive enough they don't have to consider applicants who aren't "all in" so to speak. If your app even smells like a dual apply app then the better programs, I.e. the university places that can lead to fellowship, just won't interview you.
 
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BorntobeDO?

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Let me preface this by saying thank you all very much for all your input!!! Ya'll are awesome for sure!!!!



So just to be clear and understand correctly. One downside is if my school shows me doing a lot of SUB-I's in my 4th year (I'm assuming 1 in my 3rd year would be okay since uro is related to gyn) that OB programs will pick up on this and start ranking me lower? So IF my school does not submit I'll be in the clear on this right?


Completely understand where you're coming from on this. I guess the next question is "How am I harming my chances of matching into a OB program that leads into a surgical fellowship by dual applying?" I understand that ranking wise I only have one list so if I rank a OB place lower in place of a Uro then I lose out on the opportunity of that. But other than that is there anything else that I'm missing?



I 100% agree with both of you on this that I'm like at a 10% (at best) chance of even matching urology. But aside from time and money for applications and getting letters, how else am I harming my chances is what I'm wondering because if it's just those things why not?
You could do aways in OB at the places with the fellowship you want. Those are relatively gaurenteed interviews if you do well and would give you a leg up if you liked a specific program.
If your dual applying uro, you have to pretty much do aways to have any chance.

Now if you school includes 4th year comments in its MSPE and you only do Uro aways in 4th you have pretty much shafted your ob app at most good places.

And even if your school doesn't tell, you will only have your chair and a community physician letter (unless you are at a DO pprogram with a home residency in OB you can do in 3rd). That away letter is a way to show what kind of program you are looking for by implication, and if its good and from an good place it will hold a lot more weight than community OB.

TLDR: you will weaken your OB app multiple ways if you go for Uro. You could still match, but it probably won't be as good.
 
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On the other hand, you are kind of well set up for a OB-GYN app with a clear focus on a surgery fellowship. I think you should absolutely go all in on OB if you think you can live with the longer route to the surgery fellowships. You will match a better program, and I think you will get alot more love. I personally think you might even be competative for some of the 'high tier' OB if your Step 2 rises accordingly (240+). With the pubs, if you can relate them to gyn at all, I think you would look pretty nice to a lot of PD's out there in mid-to upper mid academic centers.
Not sure that the case to be honest... ACGME OB has become competitive lately. OP will match into OB for sure but it will be at low-to-mid tier programs.
 

BorntobeDO?

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Not sure that the case to be honest... ACGME OB has become competitive lately. OP will match into OB for sure but it will be at low-to-mid tier programs.
With auditions and a single focus I think he could hit the upper side of mid tier. Maybe saying high was a bit much, but the point was I feel that he can get a solid university program with a fellowship with his scores if he goes all in. If he goes all out for uro, especially if his school shows his aways to start 4th year, community OB with no fellowship becomes much more likely if he matches at all.
 
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BorntobeDO?

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I think the fundamental problem with OB is that its not a good backup specialty with a 235. Thats a above average score for OB but not by enough that they will go crazy even tho his mspe/app screams uro. And remember they see the same app when you dual apply. So when your trying to relate your research to urology, OB will see that too. You get different personal statements, but the app is the same. By default your app will either show a bias or be weaker for either speciality by being more generic when you dual apply.

I don't think OP will get the kind of OB program he really wants unless he goes all in.
 
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Splenda88

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With auditions and a single focus I think he could hit the upper side of mid tier. Maybe saying high was a bit much, but the point was I feel that he can get a solid university program with a fellowship with his scores if he goes all in. If he goes all out for uro, especially if his school shows his aways to start 4th year, community OB with no fellowship becomes much more likely if he matches at all.
Maybe but OB was a rough match from what I saw in my class of 2018 and the one after me. A couple people with 210s/230s had two scramble for a spot in FM/IM/OB.
 
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AnatomyGrey12

Maybe but OB was a rough match from what I saw in my class of 2018 and the one after me. A couple people with 210s/230s had two scramble for a spot in FM/IM/OB.

I know people with 240s getting high tier OB interviews. A mid-230s should receive some solid interviews to places where a fellowship is possible.
 
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samac

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Maybe but OB was a rough match from what I saw in my class of 2018 and the one after me. A couple people with 210s/230s had two scramble for a spot in FM/IM/OB.
I got a doximity article and it was like 5% more of US MDs didn’t match OB last year due to increase in competitiveness, it tried to blame it on DOs snagging more spots but didn’t talk about the DO OB match rate.
 

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I help out with both urology and OB recruitment and unfortunately I think Uro will be a real reach for you unless you have some sort of personal connection. OB is fairy competitive lately, but if you do sub-Is and have LORs you should be in decent shape, and frankly being a guy will help you. The real question is why is OB the backup? They are extremely different fields at least in residency and generalist practice. The only real way to have a busy surgical practice in obgyn is to do gyn onc or urogyn; MIGS will get you there eventually but for now most people who do MIGS only with no OB are in academics. If you’re interested in surgery why not try for gen surgery at a solid community program. You won’t get crushed by the residency, will get plenty of surgical training (arguably more than at ivory tower populated by super specialists and fellows) and can get a solid job with reasonable hours
 
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DNC127

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I know people with 240s getting high tier OB interviews. A mid-230s should receive some solid interviews to places where a fellowship is possible.

you forgot to mention that bro 1. was a dude and 2. has 10 pubs lol

OP, your comlex and lack of good research (yours is about par for an MD student right now, above average if those 1st authors land) was the real nail in the coffin, not your usmle because now even the AOA programs are far gone. I would go OB and not look back.

Apply to a lot. The bro Anatomy grey is talking about applied to 90 and has around 22 invites, but is a better applicant on paper. I would apply to 100-120 to hope for 10-15 interviews. Especially considering you were already willing to spend 8k on both.

The only people hurting in my class are those with a bad plan, which mostly resulted from 1. not enough aways or ill advised and 2. not applying to enough places. Over apply >> worrying about interviews
 
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AnatomyGrey12

you forgot to mention that bro 1. was a dude and 2. has 10 pubs lol


True. I wasn’t really clear but I don’t think OP will get the same high tier interviews, but more just university places in general.
 

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you forgot to mention that bro 1. was a dude and 2. has 10 pubs lol

OP, your comlex and lack of good research (yours is about par for an MD student right now, above average if those 1st authors land) was the real nail in the coffin, not your usmle because now even the AOA programs are far gone. I would go OB and not look back.

Apply to a lot. The bro Anatomy grey is talking about applied to 90 and has around 22 invites, but is a better applicant on paper. I would apply to 100-120 to hope for 10-15 interviews. Especially considering you were already willing to spend 8k on both.

The only people hurting in my class are those with a bad plan, which mostly resulted from 1. not enough aways or ill advised and 2. not applying to enough places. Over apply >> worrying about interviews
I gotta say though one thing I realized this season was that applying to more does not necessarily equal higher outcome. I applied to over 100 psych programs, I’m sitting at 8 interviews, and none of them are from my wide net. All of them are programs I would have applied to if I applied to 30, which would have been regional + Florida. Smart applications can be just as effective as a wide net.
 
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I gotta say though one thing I realized this season was that applying to more does not necessarily equal higher outcome. I applied to over 100 psych programs, I’m sitting at 8 interviews, and none of them are from my wide net. All of them are programs I would have applied to if I applied to 30, which would have been regional + Florida. Smart applications can be just as effective as a wide net.

I have yet to apply to I'm pretty ignorant to the inner workings of ERAS and all of that. But I'm fascinated by this question of how many programs to apply to. In your case, you can identify that a wider net and a shot gun approach didn't necessary help you but if you applied to 30 and got 1 interview, wouldn't you be wishing you applied to more? This is strictly out of curiousity on my end because I'm currently trying to get a better idea how many programs I will apply to next year.

I feel like from a probability stand point. And putting finances aside. You can't get an interview unless you apply so more apps at least gives you a shot.

Obviously one needs to apply smart and that probably trumps it all. But from the outside looking in, I think I'm going to have a really hard time only applying to 30 places like most of my classmates.
 

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I have yet to apply to I'm pretty ignorant to the inner workings of ERAS and all of that. But I'm fascinated by this question of how many programs to apply to. In your case, you can identify that a wider net and a shot gun approach didn't necessary help you but if you applied to 30 and got 1 interview, wouldn't you be wishing you applied to more? This is strictly out of curiousity on my end because I'm currently trying to get a better idea how many programs I will apply to next year.

I feel like from a probability stand point. And putting finances aside. You can't get an interview unless you apply so more apps at least gives you a shot.

Obviously one needs to apply smart and that probably trumps it all. But from the outside looking in, I think I'm going to have a really hard time only applying to 30 places like most of my classmates.
For me I had a red flag so I looked through all the programs, eliminated any who had a first time board pass requirement, and I’m a DO so I went through and culled programs that had no DO’s. It left me with 112 (without looking at any Cali programs).
my point is that you should have a pretty good idea on what/where you’re competitive for. I understand your point of applying at 30 and sitting at 1 interview, but the 30 I would have applied to would have included all the interviews I got. I was just freaked out in the beginning, but I wasted $2000. I mean I realize people say it isn’t about money right now, but that could have been put toward interviews or moving expenses. I wish I didn’t do that and would have just applied more strategically than splattering applications out everywhere. If I get any from my splattering I’ll update you, but it’s not looking that way.
 
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You should do what you want. Doing Urology aways won’t hurt you THAT much as long as you also do an OBGYN subI as well. If your heart is set on urology then you may as well apply so you’re not left wondering “what if”. I agree with everyone that your chances aren’t the best, but right now you need to focus on doing much better on Step 2.

For me I had a red flag so I looked through all the programs, eliminated any who had a first time board pass requirement, and I’m a DO so I went through and culled programs that had no DO’s. It left me with 112 (without looking at any Cali programs).
my point is that you should have a pretty good idea on what/where you’re competitive for. I understand your point of applying at 30 and sitting at 1 interview, but the 30 I would have applied to would have included all the interviews I got. I was just freaked out in the beginning, but I wasted $2000. I mean I realize people say it isn’t about money right now, but that could have been put toward interviews or moving expenses. I wish I didn’t do that and would have just applied more strategically than splattering applications out everywhere. If I get any from my splattering I’ll update you, but it’s not looking that way.

Isn’t that playing the result though? If you had gotten 4-5 more interviews from the “wide net”, would it have helped? Did you send any LOIs? I agree that a strategic plan is better than just applying everywhere and hoping for the best though.
 
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samac

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You should do what you want. Doing Urology aways won’t hurt you THAT much as long as you also do an OBGYN subI as well. If your heart is set on urology then you may as well apply so you’re not left wondering “what if”. I agree with everyone that your chances aren’t the best, but right now you need to focus on doing much better on Step 2.



Isn’t that playing the result though? If you had gotten 4-5 more interviews from the “wide net”, would it have helped? Did you send any LOIs? I agree that a strategic plan is better than just applying everywhere and hoping for the best though.
If I would have gotten 4-5 interviews from the wide net I wouldn't talk down about the strategy. But for myself and other people I've spoken to the interviews come from places they would have expected them to. My goal from the wide net was to get 10 in the first place. I only sent 3 LOIs and they were still to places I had ties to. Without ties an LOI is like, "Oh hey your program is cool interview me please?"
I'm sure I won't stop anyone from taking a shotgun approach, and someone may get 1-2 interviews out of it. But is that random interview worth it when you're likely to match somewhere you have a stronger tie to in the first place? I think this process has taught me alot, and if I could do it again I would have just applied to 30-40 targeted places I knew were good shots for me.
 
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AnatomyGrey12

But for myself and other people I've spoken to the interviews come from places they would have expected them to.

I get what you are saying and agree to an extent but it just depends on what the field is, what your app looks like, etc. The flip side to your anecdote I know people who are sitting on 3-4 surprise interviews to really great programs they wouldn't have otherwise gotten if they hadn't of applied to the wide range of programs that they did.
 
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If I would have gotten 4-5 interviews from the wide net I wouldn't talk down about the strategy. But for myself and other people I've spoken to the interviews come from places they would have expected them to. My goal from the wide net was to get 10 in the first place. I only sent 3 LOIs and they were still to places I had ties to. Without ties an LOI is like, "Oh hey your program is cool interview me please?"
I'm sure I won't stop anyone from taking a shotgun approach, and someone may get 1-2 interviews out of it. But is that random interview worth it when you're likely to match somewhere you have a stronger tie to in the first place? I think this process has taught me alot, and if I could do it again I would have just applied to 30-40 targeted places I knew were good shots for me.

I noticed the same. I did the shot gun approach as im 1. neurotic af 2. I didnt have my CS result back 3. have a terrible step 1.

Im applying FM, but my “wide-net” i casted (and i applied to >40 programs, which is a LOT for FM with no true red flags) but where I got my success was primarily my targeted programs, which is what I wanted in the first place.
 
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I gotta say though one thing I realized this season was that applying to more does not necessarily equal higher outcome. I applied to over 100 psych programs, I’m sitting at 8 interviews, and none of them are from my wide net. All of them are programs I would have applied to if I applied to 30, which would have been regional + Florida. Smart applications can be just as effective as a wide net.

Its a decent point, and I guess field dependent to an extent. I am sitting on some ortho invites from places I could have never dreamed I would get love from and if I would have applied "smart" I wouldn't have applied to those programs at all. Same with people in Derm, OB as mentioned above, and ENT in our class. I for one, would rather literally go all in on my app and see what happens that *hope* I applied "smart" like I thought I was.
 
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BorntobeDO?

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Its a decent point, and I guess field dependent to an extent. I am sitting on some ortho invites from places I could have never dreamed I would get love from and if I would have applied "smart" I wouldn't have applied to those programs at all. Same with people in Derm, OB as mentioned above, and ENT in our class. I for one, would rather literally go all in on my app and see what happens that *hope* I applied "smart" like I thought I was.
With field like ortho derm ent or even PMR you apply to all cause there isnt that many.
 
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