What to do if you re not 100% sure what to apply to?

[NRAI2001]

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I will be applying this coming September (5months from now); I m currently a third year and haven't done any real electives yet and I won't be able to do any electives untill basically September. I m very worried bc I don't know what I want to apply for just yet. I ve narrowed my interests down to anesthesia vs internal medicine->subspecialty .. What do you reccommend to a student like me who is unsure of what to apply to?
A) wait a year and apply next year?
B) apply to both and interview at both and decide what to rank later?
C) do a prelim or traditional year and apply during that time?

Thanks

 

[Impromptu]

There is no one right answer. No one ever knows 100%. You get to exercise your agency and choose a career that has no right or wrong answer. Likely you get to choose from amongst many good options. So, make a choice.

When making up your schedule, put these rotations as soon as possible. You have the option of sending in your applications on the first day they can be sent in, but you can also post-pone it for a few weeks with minimal consequences so that you can get things squared away in your mind.

 

[Law2Doc]

I will be applying this coming September (5months from now); I m currently a third year and haven't done any real electives yet and I won't be able to do any electives untill basically September. I m very worried bc I don't know what I want to apply for just yet. I ve narrowed my interests down to anesthesia vs internal medicine->subspecialty .. What do you reccommend to a student like me who is unsure of what to apply to?
A) wait a year and apply next year?
B) apply to both and interview at both and decide what to rank later?
C) do a prelim or traditional year and apply during that time?

Thanks

Well, in both cases a prelim year in medicine keeps you on the right path, so that's not an unreasonable fallback. And IM leaves more choices open to you in terms of subspecializing -- if you decide you don't like cards, there's always GI, hematology, rheum, endo, etc. I would probably try to interview for both specialties -- there's a chance you won't get love from both fields anyhow and the decision might become easy for you. And if you get plenty of interviews for each, you might find that the programs themselves separate the fields in your mind -- you might end up getting looked at by a nice assortment of benign IM programs but a malignant subset of anesthesiology programs or vice versa, which again may make the decision easier.

If you are going to wait a year, you have to make sure you line something up that makes you a stronger applicant besides just knowing what you want to go into. Each year out of med school is going to require you to explain why and what you did in the interval. Hope that helps.

 

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[Law2Doc]

...
B) It's hard enough to apply for one specialty and/or prelim. You probably won't have time to apply to both. A busy schedule is interviewing at a total of 20-25 programs - this will take months and only if you are great at scheduling....

It's the rare caribbean student that lands 25 interviews. Plus a number of the IM places will let you interview for both prelim and categorical at their program simultaneously. I don't see much downside with applying to both fields and see which ones want to interview him.

 

[Iwy Em Hotep]

I will be applying this coming September (5months from now); I m currently a third year and haven't done any real electives yet and I won't be able to do any electives untill basically September. I m very worried bc I don't know what I want to apply for just yet. I ve narrowed my interests down to anesthesia vs internal medicine->subspecialty .. What do you reccommend to a student like me who is unsure of what to apply to?
Thanks

1) Assess how competitive you really are for anesthesiology.
2a) Do a rotation in anesthesiology.
2b) If you can't take a rotation for whatever reason, find an anesthesiologist to follow around on the weekend for a month or two. There's definitely a few.

 

[gutonc]

I will be applying this coming September (5months from now); I m currently a third year and haven't done any real electives yet and I won't be able to do any electives untill basically September. I m very worried bc I don't know what I want to apply for just yet. I ve narrowed my interests down to anesthesia vs internal medicine->subspecialty .. What do you reccommend to a student like me who is unsure of what to apply to?
A) wait a year and apply next year?

This is a bad idea for a US grad with good scores/grades and a horrible idea for a Carib grad, regardless of grades/scores.

B) apply to both and interview at both and decide what to rank later?

This is (IMHO) the best of 3 bad ideas. The problem is that you're going to need letters for Gas which it sounds like you won't get uploaded to ERAS until, best case, November which, while technically "on time" is actually late, especially for an IMG. But since applying to residency programs borders on free ($305 for the first 30 programs), you don't have much to lose by doing this. You'll very quickly get a pretty good idea of whether you're going to get enough interviews in one specialty or the other to help you decide which way to go and you can always add more programs at any time. If you don't have 10 interviews in Gas by December 15, circle the wagons around IM and go for it.

C) do a prelim or traditional year and apply during that time?

This isn't a horrible idea but it has problems such as finding time to interview during your prelim year and potentially having a year off to deal with (Gas matches 2 years out). Also, if you're not competitive enough for Gas, you'll never get a TY spot.

 

[NRAI2001]

This is a bad idea for a US grad with good scores/grades and a horrible idea for a Carib grad, regardless of grades/scores.


This is (IMHO) the best of 3 bad ideas. The problem is that you're going to need letters for Gas which it sounds like you won't get uploaded to ERAS until, best case, November which, while technically "on time" is actually late, especially for an IMG. But since applying to residency programs borders on free ($305 for the first 30 programs), you don't have much to lose by doing this. You'll very quickly get a pretty good idea of whether you're going to get enough interviews in one specialty or the other to help you decide which way to go and you can always add more programs at any time. If you don't have 10 interviews in Gas by December 15, circle the wagons around IM and go for it.



This isn't a horrible idea but it has problems such as finding time to interview during your prelim year and potentially having a year off to deal with (Gas matches 2 years out). Also, if you're not competitive enough for Gas, you'll never get a TY spot.

I was partly thinking of taking some time off after my 3rd year and possibly spend a few months doing research after doing a few electives in both medicine and anesthesia?? This would allow me to get experience in both fields and see where my interests really are. Also it could make me a better applicant in the next year? Would you guys recommend this?

The other problem I have as you mentioned was that I dont have any gas LORs yet. Our school doesnt allow us to do electives untill we ve finished all our cores. I ll finish my cores end of July and then take a month to do Step 2 (plan to take it end of August) then be able to start my electives early September.

 

[NRAI2001]

It's the rare caribbean student that lands 25 interviews. Plus a number of the IM places will let you interview for both prelim and categorical at their program simultaneously. I don't see much downside with applying to both fields and see which ones want to interview him.

I know Carrib friends and upperclassman that interviewed at 20 and some even 30+ spots in IM/PMR/Peds/anesthesiology... just from the people I know that interviewed this past year. I good friend of mine had 22 anesthesia interviews at mostly mid tiered university spots and matched at a pretty decent mid tiered spot.

Obviously going for neurosurgey, derm, ortho, optho... probably shouldnt expect so many interviews.

 

[Law2Doc]

I know Carrib friends and upperclassman that interviewed at 20 and some even 30+ spots in IM/PMR/Peds/anesthesiology... just from the people I know that interviewed this past year. I good friend of mine had 22 anesthesia interviews at mostly mid tiered university spots and matched at a pretty decent mid tiered spot.

Obviously going for neurosurgey, derm, ortho, optho... probably shouldnt expect so many interviews.

First, PM&R and Peds aren't as competitive as anesthesiology, so I wouldn't look to those as indicative. Second, I didn't say it couldn't happen, I said it was rare. Everybody is going to know someone who beat the odds, but that doesn't change the odds. Third, things are getting harder every year and we are supposedly going to start seeing the effects of increased US allo class size this coming year so the person who got 20 interviews last year might get 15 this year (remains to be seen if this is true). If it is in fact likely to get harder for offshore folks each year, then taking time off after third year for you would be a real gamble. Hard to predict, but I'd probably push forward unless you were absolutely sure you were going for something that expected you to have some research, and that you could line up something substantial in terms of research.

At any rate, I agree with gutonc and my initial post above. Apply to both fields. Where you get interviews probably will dictate what your realistic shot is. My bet is that between the two fields you probably won't get more than the 25 interviews the prior poster suggested was the maximum you would be able to go to. If you do, you just cancel some. Most of the US allo folks I know who applied to anesthesiology didn't get a crazy number of interviews, although they didn't apply as widely as someone from an offshore school might have to. And if you do get a ton of interviews, kudos -- I'm happy to be wrong here.

 

[squareknot]

why can't you start doing electives until september? It's a bit late in the year to be trying to explore and gather LORs.

 

[Mattchiavelli]

I would say B as well- if you do C you are going to have to try to interview as an intern and only for PGY2 spots that are open which will be a smaller pool than what you would have if you interviewed for PGY1 spots and residencies. If you're taking your year for research because you have a genuine interest do it and you'll be better for it, but if it's just to kick graduation back a year think twice per what Law2Doc said

You MUST get some anesthesia experience to match however. I base this on nothing but logic and reason, but gas is long periods of fairly cush practice interspersed with short bursts of extreme intensity. If you haven't experienced something like a patient coding in the PACU some other craziness I could see that making you a much weaker applicant. Do some ICU time if you can [you will rotate a decent amount through ICU as a gas resident].

 

[MJB]

First, PM&R and Peds aren't as competitive as anesthesiology, so I wouldn't look to those as indicative. Second, I didn't say it couldn't happen, I said it was rare. Everybody is going to know someone who beat the odds, but that doesn't change the odds. Third, things are getting harder every year and we are supposedly going to start seeing the effects of increased US allo class size this coming year so the person who got 20 interviews last year might get 15 this year (remains to be seen if this is true). If it is in fact likely to get harder for offshore folks each year, then taking time off after third year for you would be a real gamble. Hard to predict, but I'd probably push forward unless you were absolutely sure you were going for something that expected you to have some research, and that you could line up something substantial in terms of research.

At any rate, I agree with gutonc and my initial post above. Apply to both fields. Where you get interviews probably will dictate what your realistic shot is. My bet is that between the two fields you probably won't get more than the 25 interviews the prior poster suggested was the maximum you would be able to go to. If you do, you just cancel some. Most of the US allo folks I know who applied to anesthesiology didn't get a crazy number of interviews, although they didn't apply as widely as someone from an offshore school might have to. And if you do get a ton of interviews, kudos -- I'm happy to be wrong here.

It seems to me Gas is getting much less competitive.

For whatever reason, EM is getting more competitive.

Seems we are in a time of flux again. Rads with 41 open spots?

 

[Law2Doc]

It seems to me Gas is getting much less competitive.

For whatever reason, EM is getting more competitive.

Seems we are in a time of flux again. Rads with 41 open spots?

Anesthesiology has been an up and down roller coaster for a couple of decades now. It's not a field you can really peg two years in a row.
EM is extremely popular thanks to shift work -- although residents will end up working more nights than most other fields the total number of shift hours is such that it's being thought of as a lifestyle field, hence it's rise in popularity.
Radiology got hit hard likely because med students woke up to the fact that although it's a lucrative lifestyle field, it's a long residency, is generally thought of as requiring a fellowship, and fellows specializing in other than mammography these days are having trouble finding jobs.

But I still think that we didn't see the rise in number of US seniors that is thought to be coming down the pipeline, and once that happens (next year?) all bets are off as to what is competitive, particularly if you are coming from a non-US allo school.

 

[MJB]

Anesthesiology has been an up and down roller coaster for a couple of decades now. It's not a field you can really peg two years in a row.
EM is extremely popular thanks to shift work -- although residents will end up working more nights than most other fields the total number of shift hours is such that it's being thought of as a lifestyle field, hence it's rise in popularity.
Radiology got hit hard likely because med students woke up to the fact that although it's a lucrative lifestyle field, it's a long residency, is generally thought of as requiring a fellowship, and fellows specializing in other than mammography these days are having trouble finding jobs.

But I still think that we didn't see the rise in number of US seniors that is thought to be coming down the pipeline, and once that happens (next year?) all bets are off as to what is competitive, particularly if you are coming from a non-US allo school.

Agreed on all points...

One thing I doubt I'll ever understand is how someone could consider working night shifts, holidays, weekends, etc...as a "lifestyle". But, i'm good with it and glad there are those that wanna do that stuff.

I like my family. 🙂