Unmatched Surg Sub to IM?

[order66.exe]

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Hi all, I'm unfortunately an M4 who went unmatched in a competitive surgical subspecialty and am delaying graduation. I'm thinking about possibly switching to medicine as I had a strong interest in Heme/Onc coming into medical school and am also curious about the more procedural subspecialties.

Step 1 : 250-255
Step 2CK: 255-260
Step 2CS: Pass (First attempt)
AOA

3rd year Grades: Honors in most clerkships including medicine

Research:
-Several middle author bench work Oncology stuff
-Some oncology clinical research in progress
-Some papers from my competitive subspecialty that will likely be published this year

I have a medicine sub-I scheduled for this summer and am looking for more research stuff to do. Just wondering about any general advice going forward as well as how being unmatched this year might affect me.

 

[PugsAndHugs]

How did you not match?!?!?!

 

[IMGASMD]

How did you not match?!?!?!

And/or why didn’t you soap into something rather wait for a year?

 

[order66.exe]

How did you not match?!?!?!

Combination of particularly competitive year, picking aways at smaller programs without as many positions, maybe I’m a quieter person when interviewing and didn’t sell myself well. Didn’t have a ton of specialty specific research either so that probably hurt.

Other than that, no red flags in my performance per the feedback from my home program and aways. Honored all of my Sub-Is and was told I had good letters while interviewing

And/or why didn’t you soap into something rather wait for a year?

Thought about reapplying and was told the most benefit would be derived from a research year and delaying graduation to maintain US senior status rather than a prelim. After talking a lot with my heme/onc mentors, I’m now having second thoughts and I felt I should give IM a fair shake via a Sub-I

 

[MyTachyBradyHeart]

Hi all, I'm unfortunately an M4 who went unmatched in a competitive surgical subspecialty and am delaying graduation. I'm thinking about possibly switching to medicine as I had a strong interest in Heme/Onc coming into medical school and am also curious about the more procedural subspecialties.

Step 1 : 250-255
Step 2CK: 255-260
Step 2CS: Pass (First attempt)
AOA

3rd year Grades: Honors in most clerkships including medicine

Research:
-Several middle author bench work Oncology stuff
-Some oncology clinical research in progress
-Some papers from my competitive subspecialty that will likely be published this year

I have a medicine sub-I scheduled for this summer and am looking for more research stuff to do. Just wondering about any general advice going forward as well as how being unmatched this year might affect me.

You should be fine matching into IM. Just do well on your sub-I and make sure you're ready to explain why you want to go into IM on interviews (if that question ever comes up). Otherwise, I would suggest reaching out to your letter writers to make sure they strongly recommend you for IM and perhaps do practice interviews if you feel that may be a weak aspect of your application. No need for more research (unless you're interested). You have enough.

 

[Gastrapathy]

Talk to your home IM program. See if you can avoid delaying a year. Also, do GI.

 

[order66.exe]

Talk to your home IM program. See if you can avoid delaying a year. Also, do GI.

Unfortunately, they don’t have the cash to create a spot for me. Will definitely consider GI

 

[NotAProgDirector]

The question is whether next year you'll dual apply to your surgical sub and IM, or just IM. It's too early to know now, do a SubI and figure out what you want to do. if you choose IM and decide to not apply to your surgical sub, see if you can get an LOR from your surgical sub mentor and have them state in it that you are NOT applying to the sub anymore and only applying to IM. You will def get an IM spot even without that, but with a letter like that you'll probably get top IM invites. Talk about it in your PS also, originally interested in XYZ, didn't match, re-evaluated and decided my heart wasn't in it and I really wanted Heme/onc (or IM) (or GI) for ABC reason, not matching was actually just what I needed.

 

[order66.exe]

The question is whether next year you'll dual apply to your surgical sub and IM, or just IM. It's too early to know now, do a SubI and figure out what you want to do. if you choose IM and decide to not apply to your surgical sub, see if you can get an LOR from your surgical sub mentor and have them state in it that you are NOT applying to the sub anymore and only applying to IM. You will def get an IM spot even without that, but with a letter like that you'll probably get top IM invites. Talk about it in your PS also, originally interested in XYZ, didn't match, re-evaluated and decided my heart wasn't in it and I really wanted Heme/onc (or IM) (or GI) for ABC reason, not matching was actually just what I needed.

I’ll definitely keep this in mind. I admit that being so forthright scares me a bit but this definitely seems like the best way to approach it.

 

[NotAProgDirector]

There's nothing to be scared of. IM programs love when someone defects from a surgical sub. It stokes our egos. We also know that your sub mentor won't write a letter saying you're only applying to IM if it wasn't true.

 

[tomballunger]

Surgical subs were just a serious bloodbath to apply to this year in general since they have an excellent job market, high income coupled with relatively short training (exception of 7 yr neurosurg) and not having to compete/impress for fellowship- academic gen surg tends to be 5 years + 2 years research before applying to fellowships that can often take 2 more years = 9 years, and fellowship can be extremely competitive. The moment people posted that radonc had a job market issue + legitimate data backing up their claims, it went from being a field saturated with md phd aoa 260s (min 250) with many publications +away rotations requiring top interview skills+dismal match rates to having almost no US MD apply, leaving ~30 radonc seats in the SOAP for 2 years straight- heard lots of ortho ent's derms surgical subs with supposedly great CVs but "weaker interview skills" etc even the ones who went unmatched in gen surg due to weak applications were getting those spots in the SOAP. FYI plenty of radonc attendings/residents in the radonc forum talking of how up and coming heme/onc is with immunotherapy + huge shortage of hemeoncs+ unspeakably high starting hemeonc salaries and the ability to always practice primary care after having done an IM residency in case heme/onc ever goes bust.

I've been seeing an abnormally high number of posts+people with these types of great CVs and scores not matching. Obviously, one can make it easy and blame it on interview skills (sometimes the issue but not always) but anecdotally talking to people applying to less competitive things, I notice this is not as much an issue. SOAP is not always a good option for someone who worked hard and brought in good results over 4 years of med school, now having to take a spot without any real knowledge of the program/ field compared to having formal rotations /interviews in the normal cycle. Sometimes these soap programs have legitimate issues and some of these high achievers deserve better (a hopkins program director even recommended the rare surgical sub JHU student who went unmatched with a great CV to defer and apply to something less competittive over SOAP or taking a prelim (very hard to find time to interview as a prelim + the exhaustion from being a prelim while simultaneously interviewing is risky)/. I know of those who were rejected from surgical subs 1st time around, deferred graduation, and are planning to do IM, different field etc and looks like they will have much more opportunities in their new field.

Whether the increase in the number of posts of students with great CVs not matching in their unintended field is a temporary change or the sign of a permanent trend of too many medical schools in the US opening recklessly+expansion of current schools, both MD and DO without a similar expansion in the number of surgical subspecialty+ quality residency spots ( plenty of low quality programs have opened up), this is definitely concerning.