What makes a competitive Cardio, GI, or Nephrology applicant

[Serendipity100]

---

Members don't see this ad.

Greetings fellow MDs and med students,

Current 3rd year med student here

Having just taken Step1 (with a disappointing 198 Pass), I was wondering what makes one a competitive applicant for GI, Cardio, or Nephro?

Obviously, I am intrested in getting into IM and further subspecializing in either Cardio, GI, or Nephrology. What I don't know is what makes a competitive applicant for an IM subspecialty. Is it the quality of the program you graduate from (IM) and are there other factors? Is there anything that I can do as a third year to ensure getting into GI, Cardio, or Nephro? Lastly, I'm a US grad and a US citizen, so no issues there.

Any input on either or all of the above mentioned sub-specialties are highly appreciated.

 

[dragonfly99]

GI = the most competitive IM specialty (along with allergy/immunology)
cards = also competitive
nephro = less competitive

The 198 may hurt you a little, but not a killer. I would try to do better on the next steps (even like 215 or 220 would help a lot). In my experience I was not asked about USMLE scores at any fellowship interview, although mine were pretty good (220 #1, 240 #2 and 3). I would not fixate on the 198...you passed, you did fine and the test is supposed to be pass/fail anyway.

If you know which of the 3 fellowships you might want, try to go to an IM residency that has a good, well known faculty in that particular area. For example, Emory has a well known cardiology department, etc. etc.
Other than that, try to go to a generally well know medicine program at a major teaching hospital where you might want to do a fellowship. GETTING TO KNOW FACULTY IS KEY. The fellowship programs will often take someone with average board scores with a letter of recommendation from a faculty member they know, vs. someone with good board scores and grades with letters from some faculty person they don't know. Do a research project, it doesn't matter how small, with one of the faculty. When you go for medicine residency interviews, find out from the current residents (NOT the program director) how many elective months and/or research months you'll get in the first 2 years of residency, because that will determine in large part if you have any time to do research.

Be careful when you are an intern to not make anyone mad at you ever. This includes nurses, other interns, other residents, and attendings and your program director. It's more than "being nice" and "working hard". You must learn how the political games are played.

In answer to your original question, I would guess the vast majority of grads from US medical schools would get into nephrology. For GI and cards, it's definitely >60%. Start trying your 2nd year of residency, if you don't get in try again the next year.

Look at the listing of where current medicine residents in a particular program are in terms of fellowship (vs. not). If the program director won't give you a comprehensive list, that's a bad sign. This info is often hard to come by though...prog. director will show you a list of where people matched, and what they matched into, but won't tell you how many didn't match.