Urology Backup for DO applicant

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biggiesmall

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I am planning on applying broadly to both AOA and ACGME Uro programs but knowing the numbers game and competitiveness of matching Uro, the possibility of not matching is real. What have other D.O. Applicants done as a backup in case not matching Uro? The consensus I get is that you apply to ACGME surgery prelim positions or AOA Internship year and then reapply. Is this the best bet? Just looking for some thoughts from others as the application cycle gets ready to start again.

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What are your stats?

If you PM a user named cpants he has some really great advice for the AUA match. He's always very candid and to the point without being mean or shooting someone down.

Just anecdotally: I've heard there is a rather robust DO bias in the AUA match. For urology, AOA just seems the way to go. I was talking to a urology intern the other day and she said she applied AOA urology with ACGME general surgery as backup. I think the general consensus around here is to stay away from preliminary surgery positions. An AOA TRI sounds like a good idea but maybe only if you could be productive and maybe get some research out of it. And also ideally if it were at a program with a urology department.
 
Gen Surg is probably your best backup. I would say it is closest to urology and completing an internship in that may even be transferable to a uro residency should you find a spot. I would say you would probably enjoy specialties like ENT too but these obviously cannot be used as a backup.

Survivor DO
 
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What are your stats?

If you PM a user named cpants he has some really great advice for the AUA match. He's always very candid and to the point without being mean or shooting someone down.

Just anecdotally: I've heard there is a rather robust DO bias in the AUA match. For urology, AOA just seems the way to go. I was talking to a urology intern the other day and she said she applied AOA urology with ACGME general surgery as backup. I think the general consensus around here is to stay away from preliminary surgery positions. An AOA TRI sounds like a good idea but maybe only if you could be productive and maybe get some research out of it. And also ideally if it were at a program with a urology department.

I am primarily applying AOA. I have a few connections to some ACGME programs in my area that I am applying to (done a bit of research and gotten to know the attendings there very well), but I am not holding my breath on them (They have never accepted a D.O. and their PD is somewhat openly expressed an anti D.O. bias).

As far as stats:
Step I: 548, taking step two next month
Clinical grades: All "honors" (school uses A,B,C, F), nothing below 90%
Preclinical grades: Very good
Research:One non Uro publication, 3 Uro publications pending
Other experience: Strong letters from nationally well known faculty at large academic center (M.D.).
 
I know that the two soon-to-be urology interns who just matched into the program at my hospital both have COMLEX Level 1 of 700+ and I'm not sure about their Level 2. As for ACGME urology I just don't see a 548 carrying you anywhere, although I could be wrong.

It sounds as if your best shot is through the AOA match especially considering that you've got some solid urology research and can get some great letters. From what I've heard it seems as if you'll get more bites on the AOA side (understandably) as well as have more of a chance to show off your skills and offset your [possibly] lower Level 1 score.
 
Have no idea about COMLEX scores with regard to competitiveness. MD programs will care only about USMLE scores. AOA is your best, possibly only shot, at urology. I would focus your energy there. Research and grades will help you. Unfortunately, urology is supercompetitive and right or wrong, the DO degree is going to close a lot of doors for you. Some MD progs have taken DO's in the past. Find out where they are and apply. Worth taking a shot at brand new programs and crappier programs. Brookdale has gone unmatched a few times in the past 5 years, for example. If I were you, I'd rather match at a decent DO place than an MD program with issues.
 
I am primarily applying AOA. I have a few connections to some ACGME programs in my area that I am applying to (done a bit of research and gotten to know the attendings there very well), but I am not holding my breath on them (They have never accepted a D.O. and their PD is somewhat openly expressed an anti D.O. bias).

As far as stats:
Step I: 548, taking step two next month
Clinical grades: All "honors" (school uses A,B,C, F), nothing below 90%
Preclinical grades: Very good
Research:One non Uro publication, 3 Uro publications pending
Other experience: Strong letters from nationally well known faculty at large academic center (M.D.).

Your Comlex score is a little low, but I honestly do not think it will hurt your application. Rotate at the programs you feel you would like to go to. Work really hard and just be yourself. It is going to be a tremendous journey. I know 2-3 DOs matched into the allopathic world. From what I have been told by friends, those students were stellar and top of their class. Its not impossible to get into the AUA but I think AOA is your best shot. I highly highly recommend West Virginia, UMDNJ, PCOM, DMC etc. I am sure you know all the big players. PM if you have any other questions.
 
I appreciate he feedback and advice from all, now I am hoping on getting a little more thought on the main purpose of this thread which was to discuss options for a backup plan for a DO student applying urology. I know the competition is stiff and I am not a lock for a spot so very interested in hearing what other applicants did/are planning on doing. Thanks in advance
 
Ah yes, "The Backup Plan". The demoralizing question you will be asked by almost every resident as you make your way through the audition process. Before considering TBUP (?), carefully consider your approach this season and understand that your odds of obtaining a spot are much better on your first swing at bat. Also, DO Uro seems to favor the "completeness" of an application (scores + letters + research + rotation performance). Give this all you've got and try to do away rotations to gain exposure to a good number of the available spots.

I applied to Gen Surg and pursued the possibility of doing a research year if I did not match.

Gen Surg: For me, I originally thought GS would be a good TBUP. I enjoyed GS and really like the big open procedures in Uro (RPLND, open partial Nephro). I did a solid GS Sub-I and went on a bunch of GS interviews. In the end, I was completely honest with myself and admitted that while I may enjoy the GS training, I did not want to spend my life as a GS. I ended up ranking only uro programs after getting good feedback, going on many uro interviews, and having a strong feeling I would match DO Uro. You need to also realize the risk of not ranking a backup speciality needs to be very personal and calculated. Don't take this risk just bc it worked out for someone on SDN.

Also, be careful of using other specialities, esp surgical/competitive, as back-ups. The residents and PDs will be offended if they discover such. I was honest on my GS Sub-I, but do not advertise TBUP to anyone.

Research: Uro programs are quite receptive to applicants with robust research backgrounds. I felt if I took a year off to do some meaningful Uro research and published first author, that I would bring some unique qualities to the table if a re-app was necessary. But, beware that some programs may not particularly seek out a re-app with non-clinical experience in the gap year (ie Lansing). Again, this is a personal decision.

TRI: I think TRIs can be beneficial under the right circumstances. IMO, I think TRIs at institutions which have a home DO Uro program seem optimal. In this year, I would try to get face time with the programs residents and PDs, assist on cases after-hours/weekends, and try to latch on to a research project with the residents. I think the main idea is to be at a Uro institution. There are a lot of TRIs that will promise people who failed to match competitive residencies (Uro, derm, optho, ortho) outcomes, but I think they are largely trying to obtain cheap labor from people who are very well-qualified.

Pre-lim Surg at an MD GS Program: I'm not a big fan of this option. Mainly bc the time spent here does not count as a DO intern year- unless I am missing something. I suppose if you were gunning for an MD uro spot it could make sense. But, if you were a DO who was competitive for an MD Uro spot I doubt you would be giving things a second shot.

The theme: it has to be a personal decision tailored to your personal goals. Be honest with yourself regarding your career and your strength as an applicant.

Don't overthink things, give this all you've got, and, most importantly, have faith in your abilities. You will have many long days, may find yourself driving across the country for an away thinking "This is nuts", and you will certainly have TBUP conversation many times over- but I promise you it is worth it.

Good luck and I hope to see you on the wards.
 
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