UCLA residency applicant - out of state

[majik1213]

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My partner and I wish to couples match at UCLA for residency. Although he's instate, I'm an out of state applicant. I want to match in orthopaedic surgery and he in general, but I'm actually quite nervous that we may not get it if my stats are too sub-par for such a competitive school. I am aware the most important part of this is an audition rotation, which I plan to do.

We intend on practicing there for life, and I think this may help our chances. Our dream is to go there as residents - it's such a nice place. I have plans on doing two electives there. One is for ortho trauma, and the other will be a general surgery elective. The general surgery elective is there because I'm scared I may not match into ortho.

Is it true you can match as general and after PGY1 switch to ortho residency at UCLA (and other hospitals, for this regard)?

I scored a 237 on step 1, and have done well in my third year core rotations so far. He scored a 246 on step 1, is instate, and did extremely well on clinical rotations so far.

Can anyone from UCLA please give me a realistic opinion about our chances and whether it's worth it? And, should I apply general or ortho? I will NOT apply to both programs because that reflects poorly.

I just want to make sure I don't completely shoot myself in the foot if I have 0 percent chance of matching or if the cutoff for interview is about 237. Please if anyone from UCLA has any advice about who to contact (I've already called the office of Dr. Gerald Finerman), I'd be very appreciative of your advice.

 

[WellWornLad]

Do you have any connection to CA/LA besides just wanting to live there?

In any case, I think you know that you're asking for a lot. Based on your step score, you've got a good shot at matching into ortho. Matching into ortho at UCLA would be tough, but possible if you've a few ortho pubs under your belt and make a strong impression on your away rotation. Matching into ortho at UCLA from outside CA is a loooong shot. Couples matching to UCLA is getting into lottery territory.

I believe you could snag a PGY-2 ortho slot IF someone dropped out. Not a great way to plan your life. That would be a terrible idea if you started in categorical surgery at UCLA anyway, as you'd be screwing general surgery by jumping from their program and then you'd have to spend your entire time dealing with a gen surgery department that hated your guts. I doubt that ortho would even consider you for that reason - why would they take you on if it meant pissing on gen surgery?

 

[majik1213]

hey thanks for the information. I have published 2 ortho articles during medical school, 3 before. I will have published another one before the years end, making a total of 3 that I would say "count." Possibly a fourth, but that's not an ortho article so I don't count it.

what about other hospitals in california such as UC davis? Are there easier programs to couple match into?

in terms of connection, he is from there and we want to live there forever. We have no connections other than that. Our viewpoint, which we'd make clear in the interview, is that although I may be an out-of-state applicant, I have every intention of serving the state of California after training there, thereby not depriving the state of a physician.

 

[TexasPhysician]

hey thanks for the information. I have published 2 ortho articles during medical school, 3 before. I will have published another one before the years end, making a total of 3 that I would say "count." Possibly a fourth, but that's not an ortho article so I don't count it.

what about other hospitals in california such as UC davis? Are there easier programs to couple match into?

in terms of connection, he is from there and we want to live there forever. We have no connections other than that. Our viewpoint, which we'd make clear in the interview, is that although I may be an out-of-state applicant, I have every intention of serving the state of California after training there, thereby not depriving the state of a physician.

Based on research studies, anyone doing a residency is highly likely to practice within 50 miles of the program. Therefore residency programs really don't care if you currently wish to practice in Cali or not (although most people would love to live in Cali).

UCLA ortho is a very competitive position. Heck, ortho in Cali period is highly competitive. When you apply, I would list EVERY publication with your name on it. 237 for step 1 in Cali is likely pretty low for ortho and many other specialties. I would not only apply to every ortho position in the state, but every program in neighboring states as well.

A couple good friends of mine applied ortho last year. Both had Step I over 245 from respectable US MD programs with research and did many "away" rotations. Both matched but at programs 8 and 11 on their rank list respectively. This with applying to programs in the south, which are less competitive than Cali and the NE.

I don't mean to bring bad news, but to match in Cali for ortho is quite the accomplishment.

I would also NOT apply general surgery anywhere if you are planning on "switching to ortho". It would be much smarter to apply to EVERY ortho program in the nation than apply general surg and try switching. Residency programs really hate to lose their residents and few ortho spots would ever open.

 

[sunset823]

Based on research studies, anyone doing a residency is highly likely to practice within 50 miles of the program. Therefore residency programs really don't care if you currently wish to practice in Cali or not (although most people would love to live in Cali).

I have absolutely no desire to live or work in California (even though, or maybe because, I have a sibling who lives there - I'd prefer to get my tax refunds instead of IOUs, personally, and also pay off some loans while I'm in residency), and don't even intend to apply to any programs in that state in whatever specialty I choose. There are plenty of people at my school who are from Cali and want to go back there, so they can fight over the positions.

Anyway, I did talk to my student affairs dean recently, though (as I am very interested in living long-term in New England, and the same problem arises since I don't really have roots there, though I lived there for a couple of years, and my school doesn't match that many people in the NE), and she indicated that to match in California (or the NE), they expect you to have some reason to be there, most likely having roots from there. However, having an SO there should be a good reason. It sounds like your partner is very competitive for gensurg in Cali, because his numbers are good and he is from there originally, but I'd agree with TexasPhysician that your chances are probably marginal.

I personally think applying in a specialty you enjoy is much much more important than location, so if I were in your shoes I'd apply ortho all over the country and see how it pans out. Maybe there are opportunities in AZ, OR, or other nearby states. Applying to a specialty that is not your first choice (gen surg) just to be in a certain location sounds like a recipe for lifelong misery.

 

[majik1213]

Thanks so much for this info it is very helpful. Quick follow up question .. I actually have a great shot at ortho at one place in pa (my instate) .. And I'm OK with general as well .. My question is if I apply ortho at site A and general at site B, will site A and B know this? Obviously, I wouldn't dare apply to both at same site. And of course, if asked during interview I'd say no.

Also, does it look bad if you apply to ortho and transitional at same site?

 

[TexasPhysician]

Thanks so much for this info it is very helpful. Quick follow up question .. I actually have a great shot at ortho at one place in pa (my instate) .. And I'm OK with general as well .. My question is if I apply ortho at site A and general at site B, will site A and B know this? Obviously, I wouldn't dare apply to both at same site. And of course, if asked during interview I'd say no.

Also, does it look bad if you apply to ortho and transitional at same site?

Applying to ortho at location A and gensurg at location B is fine. It would be VERY difficult for any faculty to put that information together. Program directors in different specialties at different programs don't normally compare applicants and there is no database for them to look this up.

Why ortho and transitional? What would you do with that transitional year if you got it?

 

[majik1213]

Sometimes during interview they will say "look. We want you, but we are full is year, but can guarantee you a spot next year.". I guess i wanted to make sure it didn't look bad that I applied to transitional and ortho at same place.

So, transitional would be to help get into ortho. If spots are full this year, i may get in next year, and I'm ok with doing that.

 

[TexasPhysician]

Sometimes during interview they will say "look. We want you, but we are full is year, but can guarantee you a spot next year.". I guess i wanted to make sure it didn't look bad that I applied to transitional and ortho at same place.

So, transitional would be to help get into ortho. If spots are full this year, i may get in next year, and I'm ok with doing that.

If anyone tells you that they are full this year with maybe some spots next year, tell them to suck it and walk out. No program can KNOW if they are full that year, so telling you to try another specialty means they don't want you. If you aren't competitive enough the first year you apply, you likely won't ever be competitive enough. The farther out you get from medical school, the less competitive you are in general.

A friend of mine applied ortho to only about 20 programs. He didn't match, but did a prelim year (almost same as transitional year for reapplying purposes) in medicine. He reapplied broadly and received even fewer interviews than the first time. He again didn't match so he is doing a 2nd prelim year! I'm a year younger in a full residency program. He is again applying. Maybe he is lucky and matches into a 2nd year spot in his third attempt. If he even gets into a beginning 1st year spot, he will be doing a third PGY-1 year, and I will outrank him. Worse case scenario, he doesn't match for the 3rd time - I can't even imagine the pain.

I would apply very broadly if ortho is your dream. Ortho in Wyoming is better than no ortho period in my opinion. Just rank all the Cali programs first. Apply general surgery as a back-up. If you end up in general surgery, go through the program and do a fellowship in something you enjoy. Unless you are willing to risk spending years of your life in a holding pattern, don't match into a transitional or prelim year alone.

 

[2012mdc]

Sometimes during interview they will say "look. We want you, but we are full is year, but can guarantee you a spot next year.". I guess i wanted to make sure it didn't look bad that I applied to transitional and ortho at same place.

So, transitional would be to help get into ortho. If spots are full this year, i may get in next year, and I'm ok with doing that.

Since Ortho isn't an advanced residency are you even allowed to go from a TY into a PGY-2? I assumed you would have to do PGY-1 over again. Wouldn't it be better to do research? (Not sure of this at all, just what I thought)

BTW, how do programs verify that you're in-state?

 

[TexasPhysician]

Since Ortho isn't an advanced residency are you even allowed to go from a TY into a PGY-2? I assumed you would have to do PGY-1 over again. Wouldn't it be better to do research? (Not sure of this at all, just what I thought)

BTW, how do programs verify that you're in-state?

I'm not 100% on this, but I think it depends on what rotations you do as a transitional. Some rotations you could probably get credit for. Others, maybe not. Either way, you have to hope an ortho resident drops out because magically decided they hated ortho. Pretty rare from what I've seen. Ortho residents love their job for the most part. Or you could pray that an ortho PGY-1 kicks a patient and punches a second patient or something else to get fired.

Research is great and all, but how much can you accomplish in research in 1 year? Not much to better your application. Some people do a transitional year, and then try to transfer into any surgical position they can get. Once you go unmatched in year 1, you really NEED to broaden your horizons and take what you can. From all the classmates I've seen not match, 95% are unhappy. 1 actually matched at a program he absolutely loves in Oklahoma. The others wished they applied more broadly.

Programs can't really verify you are in-state anymore. When I interviewed at Duke (I'm from Texas), I was asked why I wanted to leave Texas. If I had family in North Carolina or some ties, I would have explained them, etc. Locals can usually tell if you are lying. Instead I expressed my interest in attending a top program, research, faculty, etc. They seemed to be ok with that explanation. In-state really becomes pretty over-rated once you get to residency. I never had anyone ask if I was in-state on a single interview. Only 2 asked why I was applying there.

 

[2012mdc]

I'm not 100% on this, but I think it depends on what rotations you do as a transitional. Some rotations you could probably get credit for. Others, maybe not. Either way, you have to hope an ortho resident drops out because magically decided they hated ortho. Pretty rare from what I've seen. Ortho residents love their job for the most part. Or you could pray that an ortho PGY-1 kicks a patient and punches a second patient or something else to get fired.

Research is great and all, but how much can you accomplish in research in 1 year? Not much to better your application. Some people do a transitional year, and then try to transfer into any surgical position they can get. Once you go unmatched in year 1, you really NEED to broaden your horizons and take what you can. From all the classmates I've seen not match, 95% are unhappy. 1 actually matched at a program he absolutely loves in Oklahoma. The others wished they applied more broadly.

Programs can't really verify you are in-state anymore. When I interviewed at Duke (I'm from Texas), I was asked why I wanted to leave Texas. If I had family in North Carolina or some ties, I would have explained them, etc. Locals can usually tell if you are lying. Instead I expressed my interest in attending a top program, research, faculty, etc. They seemed to be ok with that explanation. In-state really becomes pretty over-rated once you get to residency. I never had anyone ask if I was in-state on a single interview. Only 2 asked why I was applying there.

Did you apply anywhere in a competitive location (Cali, NY, Chicago, etc)?

I asked the original question for two reasons.
1) I'm from Cali and want to return and was wondering if having my permanent address in Cali makes any difference

2) For the OP's sake, if they changed their permanent address to in-state, would programs be able to find out how long they have been at the permanent address?

I just hear all this talk about how hard is it for outsiders to match Cali, well do they really dig deep and find out?

 

[SouthernSurgeon]

Last year UCLA told folks on their ortho interview day that they didn't INTERVIEW a single person with a sub 260 board score...

I also have to say that based on your posts in this thread I think you have several misconceptions and/or are getting bad advice. For one, residency programs care very little about "in-state"/"out-of-state" - it is not nearly the same as applying to medical school. For another, applying to general surgery with the hopes of trading up and obtaining a subspecialty slot is a very poor decision. Finally, I would be very very skeptical of any program making guarantees about slots in future years.

 

[TexasPhysician]

Last year UCLA told folks on their ortho interview day that they didn't INTERVIEW a single person with a sub 260 board score...

I also have to say that based on your posts in this thread I think you have several misconceptions and/or are getting bad advice. For one, residency programs care very little about "in-state"/"out-of-state" - it is not nearly the same as applying to medical school. For another, applying to general surgery with the hopes of trading up and obtaining a subspecialty slot is a very poor decision. Finally, I would be very very skeptical of any program making guarantees about slots in future years.

Agreed. Residency programs don't care where your permanent address is, how long you've lived there, etc. While I didn't apply to Cali, I got interviews at Duke, Vanderbilt, Emory, etc. and I've never lived outside of TX. Numerous classmates of mine have 0 ties to Cali and they matched there because of great board scores. It is more of a numbers game in Cali than it is address.

 

[2012mdc]

Agreed. Residency programs don't care where your permanent address is, how long you've lived there, etc. While I didn't apply to Cali, I got interviews at Duke, Vanderbilt, Emory, etc. and I've never lived outside of TX. Numerous classmates of mine have 0 ties to Cali and they matched there because of great board scores. It is more of a numbers game in Cali than it is address.

Which specialties? I'm wondering if what I've been told is specialty dependent or just completely in contrast to what I'm hearing now

 

[MediumDef]

Last year UCLA told folks on their ortho interview day that they didn't INTERVIEW a single person with a sub 260 board score...

I'm skeptical, the 2009 data says there were 31 260+ applicants total. No need to stress the OP out even more.

 

[mjscal]

Actually residencies may actually even prefer out of state applicants as there may be a higher chance you leave the area and not compete for the same patients when you are done. Which medical school you attend will matter in residency application but your state residence is not important.
I know nothing about couples matches but can you not both match in the same city and not necessarily at the same hospital? USC, Cedars, Wadsworth VA, Santa Monica, and Harbor are major hospitals in the area other than UCLA and possibly have some independent residencies so you could both match in the same city?