Unmatched, considering specialty switch

[AnonymousMedStudent94]

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Hello,

Having a bit of a dilemma and would appreciate advice. I applied for a surgical subspecialty this year and failed to match. I am now thinking about pursuing radiology instead as I took an elective in it and really enjoyed it. I have not yet matched into a prelim in the SOAP. If I am not able to get a prelim at a university program, and only have options of TY in community hospitals, would it look better to be applying for radiology as a TY in a small program or to delay graduation and re-apply as a senior?

Stats:
Step 1 and 2CK 250s
Grades: All A's on rotations, 2nd quintile rank
Research: Mostly in surgical specialty, several posters and manuscripts. Probably can get on some radiology projects before fall though.
ECs: Some volunteering and leadership, nothing out of this world.

Any input on which is better between taking a TY and delaying graduation is appreciated.

 

[The Last Ankibender]

I am pretty sure reapply as a senior is better. Having the US senior status will avoid you getting filtered out in a lot of programs

 

[Gurby]

I am pretty sure reapply as a senior is better. Having the US senior status will avoid you getting filtered out in a lot of programs

You're an M1 who thought neurosurgery had an early match - I don't think you have the perspective to be "pretty sure" about this decision.

I definitely don't know the best answer either. My instinct is to jump into the best prelim/TY spot you can find because the majority of DR programs are PGY-2 spots, and the opportunity cost of delaying graduation seems huge compared to questionable benefit of not being filtered out (but it still being obvious in your app that you took a year after M4 after not matching). You have a strong application - if you spent your prelim year building connections to radiology and working on projects and demonstrating that rads is where you want to be, I have to think you'd be a pretty competitive applicant for the 2022 DR match.

I wonder if @RadiologyPD is still lurking here, or if @NotAProgDirector could offer advice?

Also you should be reaching out to the radiology PD / Rads student advisor person at your home program ASAP. Like, call them on the phone within the next hour.

 

[ThatSerb]

I am pretty sure reapply as a senior is better. Having the US senior status will avoid you getting filtered out in a lot of programs

so if you don't end up matching, you can just delay your graduation? how does that work? you just repeat rotations and pay an extra year of tuition?

 

[Dral]

It's so hard to tell from our perspective because we can't know what is available in SOAP.

If you can get into a good reputable intern year, I'd say take it based on my personal experience (n of 1, grain of salt):

I didn't match advanced back in my day and had my intern years listed from 'most reputable to least' on my primary list after my advanced positions.

Well, I ended up matching at my #1 intern year at least. heh.

I posted this in another thread so won't go into it in depth, but I ended up scrambling into an advanced spot (derm) before intern year started (good reputable intern year). A co-intern who didn't match derm applied during our intern year and matched derm.

If you could get an intern year at a program that has a strong radiology program (or even any rads program I guess), I'd say that would be a reasonable route to take.

To speak to your specific question, I don't know for sure, but I think the stigma against TYs is overblown. While it would be BETTER to be at a top prelim, I think any intern year is ok. The hope is that people are reasonable. People will likely know you SOAPed and it's 'take what you can get' and it was somewhat out of your control. You know...nobody's gonna be all "WHAT? you didn't SOAP into a UPenn prelim spot?". As long as you can craft a good reason for going rads (I think most people know it's somewhat of a common path that people going from surgery take..rads or gas), then I think you'd be in a decent position.

PLUS if you go that route, you can be looking for open PGY2 rads spots before you start officially interviewing. I'm not sure at what point you are bound by NRMP, but up until then, you could maybe find an open PGY2 rads and just slip right into it after your intern year.

If you do go rads, you can look at it this way:

Don't graduate: lose a year of salary AND pay tuition
Go for intern year: possibly lose a year of attending salary, but can work somewhere (year after intern year while waiting for rads to start) but POSSIBLY don't miss a beat if you can get an open PGY2 spot.

However, overall, not graduating sorta keeps the clock at 'zero' so to speak so it feels a bit 'safer' in a way. It's a tough decision. Hopefully more people chime in and you can use all the information to make your final decision.

 

[husky_doc16]

Is there any particular reason why your home program didn't keep you as a resident? I think it would be helpful to stay at your school and make stronger connections at your school, or go to a TY with a radiology program that you're interested in.

 

[AnonymousMedStudent94]

Ended up getting a pretty good TY and took it since I was under the gun time wise. Gonna be tough but I think I can make it work.

 

[Dral]

Ended up getting a pretty good TY and took it since I was under the gun time wise. Gonna be tough but I think I can make it work.

Congratulations! That is something to celebrate.

Speak to your TY year sooner rather than later to get early rads electives set up and to hopefully get a plan together for interview season. You should hopefully still have all or at least some Zoom interviews on your side this year.

Hopefully the TY is connected to some type of Rads program.

Also touch base with your home Rads department to see if someone may be able to help with networking with the goal of finding an open PGY2 rads spot this year at some point (and maybe even come back there to train!).

It can be excruciating having to go into intern year not having the rest of your career quite mapped out, but just try to forget about what is 'supposed' to happen (being matched fully) and just stay focused on YOUR path.