University IM as a DO

[ReaDoc]

What should I be doing to position myself for a university IM residency spot?

I'm interested in possibly doing academic medicine and in heme/onc and Pulm/cc, but fully understand that I could just as easily not match into a fellowship and am okay with being an internist/hospitalist/etc.

Now that COMLEX level 1 and Step 1 are likely going p/f for our class (2024), what's the next best things I should be doing?

In other words, what do university IM programs look for? Now I'm mostly talking about the DO-friendly low to mid to upper mid tier IM programs, not the T15, specifically the midwest programs.

I should also mention I'm seeking research, but it's been a pain and I am currently being ghosted by a potential PI after stating that they would set up a meeting to get me on board.

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[Duck44]

I am in the same boat with these hopes so I’m just gonna reply and see what the wise people say.

 

[Lawpy]

good step 2 + good grades + good research

 

[ReaDoc]

good step 2 + good grades + good research

Pre-clinical grades, clinical grades or both?

 

[Calizboosted76]

Pre-clinical grades, clinical grades or both?

Try for both.
Being in medical school now, we should strive to make our CV the most competitive as possible no matter the specialty or program you want to go into.

 

[Lawpy]

Pre-clinical grades, clinical grades or both?

Clinical >>>>>>>>>>> preclinical grades

@Angus Avagadro however believes class rank is important so work hard to be in top rank

 

[Duck44]

good step 2 + good grades + good research

for IM would social medicine publications mean much if it’s first author?

 

[Lawpy]

for IM would social medicine publications mean much if it’s first author?

I think any peer reviewed paper counts

 

[Angus Avagadro]

Clinical >>>>>>>>>>> preclinical grades

@Angus Avagadro however believes class rank is important so work hard to be in top rank

So say two thirds of PDs in 2018 and 2020 PD survey, and give it a weight of 4 out of 5 in importance when choosing candidates. You will note that people matching competetive residencies are rarely in the bottom quartile for their class rank. But, it's free advice on an anonymous forum, so you get what you pay for. You can believe a personal communication from a PD saying it's unimportant if you like. Do so at your own risk.. Lots of people believing what PDs have hinted to them have failed to match.Sdn is replete with stories of false interest given to students by PDs who then go on to rank the program highly only not to match at all. I have heard the same thing from some of my students. So you can believe the data or not. Life is full of choices

 

[hungrydoc710]

High pass or Honors all your clerkships. Get a good Step 2. Research if you can.

At the end of the day, academic IM isn't super diffcult to get into unless you're targetting top 25 programs or specific ones out West.

Edit - also, Pulm/CC isn't terribly hard to get into, unlike GI or Cards, so even going to a community program, you can make that happen.
I say this bc I too want to do IM >> pulm/critical care. Or anesthesia >> pain, which is def more competitive.

 

[Drrrrrr. Celty]

High pass or Honors all your clerkships. Get a good Step 2. Research if you can.

At the end of the day, academic IM isn't super diffcult to get into unless you're targetting top 25 programs or specific ones out West.

Edit - also, Pulm/CC isn't terribly hard to get into, unlike GI or Cards, so even going to a community program, you can make that happen.
I say this bc I too want to do IM >> pulm/critical care. Or anesthesia >> pain, which is def more competitive.

Pulm CC is competitive. Match rate for DOs was 40% this cycle. And many matched at their programs.

 

[Duck44]

Pulm CC is competitive. Match rate for DOs was 40% this cycle. And many matched at their programs.

If you don’t mind me asking where did you find DO match rates for specific fellowships? I could only find the match rate for DOs for all fellowships combined.

 

[ReaDoc]

So say two thirds of PDs in 2018 and 2020 PD survey, and give it a weight of 4 out of 5 in importance when choosing candidates. You will note that people matching competetive residencies are rarely in the bottom quartile for their class rank. But, it's free advice on an anonymous forum, so you get what you pay for. You can believe a personal communication from a PD saying it's unimportant if you like. Do so at your own risk.. Lots of people believing what PDs have hinted to them have failed to match.Sdn is replete with stories of false interest given to students by PDs who then go on to rank the program highly only not to match at all. I have heard the same thing from some of my students. So you can believe the data or not. Life is full of choices

I appreciate the candidness, it's something I have always asked from individuals that I sought advice from. I have taken into account that surveys from PDs regularly show that they still value class rank highly.

In all honesty, I had a rough transition to medical school and am likely sitting around the 3rd quartile as I score just below the average in most of my courses during our first semester. It doesn't take much for one to make 2+2=4 if you understand what I'm saying. However, this is not a "woe is me" post, rather me being candid.

As for this semester, I've had the best showing on an exam since I've started medical school, hopefully I can get myself back into the second quartile or higher, would you say being 2nd quartile is still not good enough and to really push for the upper 25%?

For context I'm really only looking for advice about gaining a spot within the academic centers in the Midwest, the likes of UIowa, KU, UMKC, UNMC, SLU, etc.

 

[hungrydoc710]

Pulm CC is competitive. Match rate for DOs was 40% this cycle. And many matched at their programs.

I'll take those odds

Going academic or community is less important than going to a program with in house fellowships

 

[Angus Avagadro]

I appreciate the candidness, it's something I have always asked from individuals that I sought advice from. I have taken into account that surveys from PDs regularly show that they still value class rank highly.

In all honesty, I had a rough transition to medical school and am likely sitting around the 3rd quartile as I score just below the average in most of my courses during our first semester. It doesn't take much for one to make 2+2=4 if you understand what I'm saying. However, this is not a "woe is me" post, rather me being candid.

As for this semester, I've had the best showing on an exam since I've started medical school, hopefully I can get myself back into the second quartile or higher, would you say being 2nd quartile is still not good enough and to really push for the upper 25%?

For context I'm really only looking for advice about gaining a spot within the academic centers in the Midwest, the likes of UIowa, KU, UMKC, UNMC, SLU, etc.

First, let me say class rank is only one element of your app. I always mention it in any LOR I write when it might be helpful. We would consider other aspects along with rank, LORs, Boards, clinical evals, ECs, research,, time spent auditioning, and the personal interview, not necessarily in that order. Being in the top half with a very good remainder of your app would not be lethal Imo. This I'm sure is very program dependent due to the number and quality of their applicants. I can't comment on the programs you mentioned as I know nothing about them individually. Hopefully others on SDN can offer better insight than I can. I always considered matching to getting elected to office and others above have given solid advice on what you need for university IM. You need to sell yourself to your top choices and give them a reason to accept you. That means having all the boxes checked to be a competetive candidate for their program.. Good luck and best wishes!

 

[Drrrrrr. Celty]

If you don’t mind me asking where did you find DO match rates for specific fellowships? I could only find the match rate for DOs for all fellowships combined.

It's on the IM forum.

 

[Drrrrrr. Celty]

I'll take those odds

Going academic or community is less important than going to a program with in house fellowships

Oh no doubt. My program has a Pulm/Crit fellowship and largely everyone matches here. However it's a competitive and difficult ride getting into the top tier fellowships like Pulm/CC, GI, and Cards. The other ones, less so.

 

[AnatomyGrey12]

So say two thirds of PDs in 2018 and 2020 PD survey, and give it a weight of 4 out of 5 in importance when choosing candidates. You will note that people matching competetive residencies are rarely in the bottom quartile for their class rank. But, it's free advice on an anonymous forum, so you get what you pay for. You can believe a personal communication from a PD saying it's unimportant if you like. Do so at your own risk.. Lots of people believing what PDs have hinted to them have failed to match.Sdn is replete with stories of false interest given to students by PDs who then go on to rank the program highly only not to match at all. I have heard the same thing from some of my students. So you can believe the data or not. Life is full of choices

I think the biggest issue with the “is class rank important” debate is that people are usually using a different benchmark for what a low class rank is. I actually agree with you that people matching strong residencies don’t come from the bottom quartile. Most of us that say class rank doesn’t matter are approaching it from a “you don’t have to be top 10 to match strongly.”

For example I completely blew off class to study for boards and do research. But my rank is still right in the middle. So not bottom quartile by any means, and I would say my approach paid off based on the way my rank list looks. I think a lot of people see me say that class rank isn’t important and assume I mean bottom of the class, when what I really mean is that it will be more beneficial to your app to sacrifice a few rank spots to have a higher board score, do research, etc and have a more well rounded app.

I know a number of people who gunned class, got that shiny rank, and then did only slightly above average on boards and don’t have research and really struggled to get interviews.

Reality is that it all matters to varying degrees, and everyone should try and build the best app that they can.

 

[Angus Avagadro]

Oh no doubt. My program has a Pulm/Crit fellowship and largely everyone matches here. However it's a competitive and difficult ride getting into the top tier fellowships like Pulm/CC, GI, and Cards. The other ones, less so.

I think Pulm CC.is the way to go if you want CC. You are more attractive as a candidate who can also cover Pulm clinic. Anesthesia CC doesn't appear as competetive for jobs.

 

[MDMechEngr]

Clinical >>>>>>>>>>> preclinical grades

@Angus Avagadro however believes class rank is important so work hard to be in top rank

I am curious to know if there is any corrilation between being top rank in preclinical and clinical grades?

 

[Lawpy]

I am curious to know if there is any corrilation between being top rank in preclinical and clinical grades?

They should both be correlated because good rank --> good knowledge base --> attendings happy

But i'm not sure because it varies and being personable and hard working matters more

 

[Drrrrrr. Celty]

I think Pulm CC.is the way to go if you want CC. You are more attractive as a candidate who can also cover Pulm clinic. Anesthesia CC doesn't appear as competetive for jobs.

I think there's a lot of critical care routes you can go. It's just an issue about how you make it work with your skill set. Like there's a ridiculous amount of X + Critical Care right now like Nephro Critical Care.

But off the bat Pulm CC is the most logical thing. A lot of critical care fundamentally is pulmonary disease and being able to do consults for Pulm on the floor on your off month and cover pulm clinic is a lot more of a good sell than someone without that skill set.

 

[Drrrrrr. Celty]

I am curious to know if there is any corrilation between being top rank in preclinical and clinical grades?

Most high class ranked folks are going to be smart thus they're going to do well in their clinicals. Although I personally went from being middle of the class to being top in clinicals because I found clinical medicine to be far more stimulating and pleasant than lecture based studies.

 

[Natremia]

At the end of the day, academic IM isn't super diffcult to get into unless you're targetting top 25 programs or specific ones out West.

Edit - also, Pulm/CC isn't terribly hard to get into, unlike GI or Cards, so even going to a community program, you can make that happen.
I say this bc I too want to do IM >> pulm/critical care. Or anesthesia >> pain, which is def more competitive.

Pulm crit had the lowest match rate this past cycle

lower than gi and cards... so, yes, it has definitely become terribly hard to get into

 

[DrJackRyan]

Agree with doing well on Step 2 and Level 2. Class rank doesn’t really matter unless you’re at the bottom 25th or top 25th percentile. Research is gonna be the biggest factor that separates good candidates from great candidates. See my post on getting research as a DO student. Finding research as a DO student

 

[Drrrrrr. Celty]

Pulm crit had the lowest match rate this past cycle

lower than gi and cards... so, yes, it has definitely become terribly hard to get into

It's weird honestly because I feel like with all the extra critical care i've done because of COVID I've been turned off from Pulm/CC while everyone seems to be more interested in it now.

 

[hungrydoc710]

Most high class ranked folks are going to be smart thus they're going to do well in their clinicals. Although I personally went from being middle of the class to being top in clinicals because I found clinical medicine to be far more stimulating and pleasant than lecture based studies.

Idk I know a lot of wicked smart students that are awkward with patients and can't get an honors or high pass 4 rotations deep.
It's quite sad really.

 

[hungrydoc710]

Pulm crit had the lowest match rate this past cycle

lower than gi and cards... so, yes, it has definitely become terribly hard to get into

Damn that's not amazing news to me haha

 

[Drrrrrr. Celty]

Damn that's not amazing news to me haha

COVID has made Pulm/CC a lot more competitive. But it always was one of the most competitive subspecialties. People have a very strange infatuation with putting tubes into people.

 

[CocoMelon0531]

Gen IM sucks considering the amount of nonsense that comes along with that.

Bless your souls if you want to practice hospital medicine.

 

[hungrydoc710]

Gen IM sucks considering the amount of nonsense that comes along with that.

Bless your souls if you want to practice hospital medicine.

Nahh

 

[Drrrrrr. Celty]

Gen IM sucks considering the amount of nonsense that comes along with that.

Bless your souls if you want to practice hospital medicine.

7 days on 7 days off isn't terrible. It just isn't for everyone.

 

[Goro]

What should I be doing to position myself for a university IM residency spot?

I'm interested in possibly doing academic medicine and in heme/onc and Pulm/cc, but fully understand that I could just as easily not match into a fellowship and am okay with being an internist/hospitalist/etc.

Now that COMLEX level 1 and Step 1 are likely going p/f for our class (2024), what's the next best things I should be doing?

In other words, what do university IM programs look for? Now I'm mostly talking about the DO-friendly low to mid to upper mid tier IM programs, not the T15, specifically the midwest programs.

I should also mention I'm seeking research, but it's been a pain and I am currently being ghosted by a potential PI after stating that they would set up a meeting to get me on board.

Network, network, network!

Get letters from people in the field. Even if you can't do that, seek their advice.

Shine on audition rotations.

I'll let other chime on on the importance of research (esp in the field), but after all these years on SDN, my take is that it can never hurt.

Wise @NotAProgDirector, any sage counsel to add?

 

[NotAProgDirector]

DO schools have very variable curricula. It's often very difficult for me to assess what happens on clerkships -- there's little description, and the comments are often very brief and not helpful. An IM rotation at a university with an LOR makes an application stand out. Not easy to get, esp with COVID. But a supportive letter stating that you performed well in a known program is worth it's weight in gold IMHO.

 

[Chads2]

I would advocate for Auditions and try to get a letter from someone who is faculty at that Audition. Sounds basic but it 1.) helped me personally as a D.O. and 2.) has helped several D.O.’s in years after me match at my program.