What would you do??

[tewbad]

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My dilemma: I'm currently doing a transitional year, but don't have an advanced position for July 2009. This year I've interviewed for Radiology (only given 2 Interviews despite pan applying) and this is what I would like to do. Because I got so few interviews I also applied to Internal Medicine and went on 4 interviews for IM. The radiology programs were both desirable to me, and both in generally unattractive locations geographically (hopefully boosting my chances).

My question is this: Should I rank the IM programs and therefore give up the chance to possibly scramble into Rads (assuming I match IM) or fill a PGY2 opening for July 2009 or should I only rank Rads, keeping the option for the scramble.

My stats: Step 1 - 222/90, Step 2 249/99, GPA 3.75, minimal research exp. no pubs.

(Yes I realize I will have to repeat PGY-1 if I get IM, Yes I realize that I will have a gap year If I match rads)

 

[CaMD]

I think if you really want to do radiology then you should try to scramble. And if you aren't able to, then spend the next year making your application stronger. An extra year or two in order to not spend the rest of your life in a "back-up" specialty seems worth it.

My dilemma: I'm currently doing a transitional year, but don't have an advanced position for July 2009. This year I've interviewed for Radiology (only given 2 Interviews despite pan applying) and this is what I would like to do. Because I got so few interviews I also applied to Internal Medicine and went on 4 interviews for IM. The radiology programs were both desirable to me, and both in generally unattractive locations geographically (hopefully boosting my chances).

My question is this: Should I rank the IM programs and therefore give up the chance to possibly scramble into Rads (assuming I match IM) or fill a PGY2 opening for July 2009 or should I only rank Rads, keeping the option for the scramble.

My stats: Step 1 - 222/90, Step 2 249/99, GPA 3.75, minimal research exp. no pubs.

(Yes I realize I will have to repeat PGY-1 if I get IM, Yes I realize that I will have a gap year If I match rads)

 

[Law2Doc]

I think if you really want to do radiology then you should try to scramble. And if you aren't able to, then spend the next year making your application stronger. An extra year or two in order to not spend the rest of your life in a "back-up" specialty seems worth it.

I would suggest that very very few rads slots are likely to fall to the scramble this year (rads popularity seems to be on an upswing after positive press in USA today and the like), and those that do will be well fought over slots. So odds are good that if you don't rank IM programs and end up scrambling, you will be having that next year off. If you have a game plan for improving your credentials in time for the next match, that's fine -- if not, then think hard about this.

 

[PeepshowJohnny]

I would suggest that very very few rads slots are likely to fall to the scramble this year (rads popularity seems to be on an upswing after positive press in USA today and the like), and those that do will be well fought over slots. So odds are good that if you don't rank IM programs and end up scrambling, you will be having that next year off. If you have a game plan for improving your credentials in time for the next match, that's fine -- if not, then think hard about this.

I actually agree with Law2Doc, I think it's going to be hard to scramble to a radiology position. But there are some out there who would argue that this year they may actually be some more scramble slots for radiology. Their logic is this: A lot of the high number of applications is more and more radiology applicants pan-applying and a lot of programs are interviewing the same small pool of qualified applicants and ranking them, they may end up with a few open slots this year.

It'll be interesting to see how it pans out. Anyway, if you're absolutely dead set on radiology, you need to work on improving your application in a gap year: try to find a research position.

 

[SaintFrances]

Tough situation...Why so few interviews? Did you apply to a ton of programs? Your step I score is not all that low and step II is very good. Are research and pubs really that important for Rads? I don't see how you could improve your app all that much in one year's time though.

Regarding the scramble - there is always a chance you could get a spot. Couldn't you also potentially scramble into IM if you can't scramble into Rads? At least with IM you would have a job for the next year and could still try to reapply once more. Again though, I don't see how next year will be much different in terms of your chances of getting more interviews.

 

[Samoa]

You could also call up your medicine programs and ask them if they'd be willing to rank you as a prelim instead of categorical (this is assuming you decide to go the rads-only route). That way you have a job next year no matter what, and can still look for rads PGY-2s in the scramble and throughout the year. If you don't find one, and your prospects look dismal for future matches, off-cycle categorical spots in medicine come up all the time. Your prelim program might even offer you a spot.

 

[Law2Doc]

... I don't see how you could improve your app all that much in one year's time though. ...

Not even a year -- ERAS opens in September and interviews start in late October. So we are really only talking 7-9 months before he'd have to have something to show in an interview.

 

[Doctor Bob]

You could also call up your medicine programs and ask them if they'd be willing to rank you as a prelim instead of categorical (this is assuming you decide to go the rads-only route).

Correct me if I'm wrong (a common occurence), but I don't think he/she can do that from a funding standpoint. Since he/she's already doing a transitional year, a preliminary year would be counted as the same thing from a federal funding standpoint so the hospital would have to pay his/her salary outright. And programs are pretty hesitant to take someone for whom they can't get reimbursement.

 

[Samoa]

As I understand it, prelim years continue to be funded, even if you've done several. Where the funding problem arises is in the last years of your categorical residency. But even then, it's not an absence of funding, it's just reduced funding. Whether programs are hesitant to take someone depends on the program, and also the quality of applicant. There are multiple threads on this topic.

 

[dragonfly99]

Tough situation.
I think you are at a fork in the road.
I think the chances to get a rads spot in the scramble are not too good.
What is the chance of matching for a rads applicant who has had only 2 interviews? I don't know.
Without having publications and/or being "well connected" in radiology circles, I think you are likely to do poorly in the scramble for radiology spots. You may get a spot from one of your 2 interviews, though.

Could you accept IM? If so, may want to go do that, but it's going to suck repeating an intern year and IM intern year is likely to be harder than a TY, though will be less hard for you than other interns. I think if you weren't sure about IM, it would have been better to apply to IM prelim years, but I understand why you did what you did. Is IM your real 2nd choice or did you just do it as a random backup, hoping that you wouldn't really need the spot?

If radiology is really what you want, the best plan might be to assume you aren't going to match, and push hard to get a radiology research spot somewhere for next year. You'd have to start looking ASAP though, as well as asking around with your med school's radiology dept. chair, etc. I think if worse comes to worse, you could still to IM or some other specialty later, but if you launch yourself into IM now, I'd do so only with the thought of staying in IM...you don't want to bail after a year or two and end up back where you are now.

 

[toomuch]

hmmm......interesting


dragonfly

what if this person was a prelim surg resident, do you think redoing intern year as a medicine intern would be easier or harder?

 

[dragonfly99]

It's always going to suck doing two intern years, b/c it just sucks being an intern twice. I think anyone who has done either a TY or a surgical intern year would have an easier time doing a medicine prelim year than someone fresh out of med school...I mean unless he/she was really lazy and dumb, he/she has definitely learned a lot during the first prelim year. I think doing a surg. prelim year is generally a lot harder than a TY and involves doing more call and managing more patients on the floor, vs. a lot of TY's that have a lot of elective time, so I think that having done a surg. prelim, vs. a TY, would make the medicine intern year easier, yes.