When is it too late during 3rd/4th year to decide on a specialty?

[steaksauce]

Hey Guys,

I'm a long time reader/new poster to the site. I would really appreciate some advice on the situation I am going through right now. I just started my 4th year and am having some doubts about my specialty choice. I was planning on applying for a certain specialty but after starting my 4th year rotation in the field, I am having serious doubts that it is the right fit for me. I had shadowed in field here and there but I never really got a good sense of the work process/structure until being in the actual rotation and have started to have a gut feeling that the field may not be right for me personally.

What I am trying to get a good understanding about is when is it too late to switch the specialty you are applying for during school? I have an away rotation scheduled at what is considered a very strong program after my current home rotation in the specialty. Most people have told me to try and see what it is like over there before making any decisions, but that rotation would not finish up until the end of September.

In all honesty, there hasn't been a specialty I came across during rotations that I felt I just could not live without, but at the same time I never had the strong feelings of being in the wrong place that I am having now and I want to start making a back up plan should I decide to switch.

I've seen many threads on people wishing to switch fields after intern year or at other points during residency, but does anybody have some insight on how late people can realistically make the decision on what field to apply for during 4th year without shooting themselves in the foot? Getting field specific LORs in time/at all is one big challenge I feel I would face should I make a switch.

Thanks in advance for your help.

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[qmcat]

I have several classmates in your position. If you're really not sure what specialty you want, one option is to see if you can delay graduation and do another year of elective rotations in fields you think you might like. You'll probably have to work it out with your dean, but generally it is better than graduating and then applying for the match after intern year or a prelim since you'll still look "fresh out of med school" on paper. The other option that I see some people do is apply for a transitional year, and then apply again for a PGY-2 spot in the specialty you want later.

Good luck

 

[Bartelby]

I think changing your mind after September at the beginning of fourth year would put you at a disadvantage. Have rec letter writers in mind and ask them as far in advance as possible if you are seriously entertaining the idea of a last minute switch. It's a tough situation to be in, I recommend being as decisive as you can be right now.

 

[mmmcdowe]

I know people who didn't choose until a couple days before their final match lists were due.

 

[flash14]

Is it at all common for someone to interview in more then one specialty if they cannot decide? Say I like IM and EM but can't decide, I go to several interviews for each then try to decide before setting up my match list? I understand this would cost more.

 

[beyondbethany]

I'm in the same boat. By the end of my sub-I, I had a gut feeling that this just wasn't it for me. I agree that if you want to change sooner is better, especially for making contacts and getting letters. This is my decisive week when I have to go tell the departments and my letter writers I am making a change.

Good luck, it's a crappy position to be in, lots of anxiety.

 

[duckie99]

I've known people to change as late as October. If you truly are undecided just apply to both specialities though granted I don't know the process since I'm only applying to one field. Well the process is the same (ERAS) but how you go about getting letters expressing your interest in field x while also secretly pursing field y? I guess the best thing to do is to be honest. Also you will need separate personal statements (or just tweaked). It's not impossible is the point. However if one of your interests is a field with early match like uro or optho that could be an issue.

And if it is too late a few options still exist. 1. Pull out of the match and scramble into a prelim spot (med or surg depending on the area) and then apply again next year. 2. Match and change after intern year. 3. Match and finish residency then switch. 4. Pull out of match and do a research year or pursue another degree then apply again. People do 2 and 3 all the time. I've heard that 20% of residents change fields. I personally know of some people doing 4 for various reasons.

I think most people are set on a field after third year. However as the finality of the decision approaches it gets harder and harder to accept it. It is my opinion that no one field is perfect. You just gotta pick something that is most tolerable. Work is work and at the end of the day all you end up really caring about is going home to your family or hanging out with friends.

 

[Pharmacol90]

Options 2 and 4 appear to be most used.

 

[steaksauce]

Thanks for the input everyone

 

[VenusinFurs]

Sometimes I think a rotation can turn you off a specialty because of things that are specific to being a rotating med student rather than the specialty itself. But yeah, idk, maybe if you really have no clue what to do, match into something like medicine, and then switch if you hate it? I've heard that you should do medicine if you don't know what you want to do, but I'm pretty sure that was mainly a joke.

 

[tco]

It's not really that much of a joke. Doing IM opens up doors for people who are thinkers clear through those that like to do procedures. If you're *really* stuck at the most fundamental of career intersections, IM isn't a bad way to go.

 

[NYCMS2]

I know people who didn't choose until a couple days before their final match lists were due.

Can you give us some examples? Were these closely related residencies (like different areas of surgery)?

How would someone write the PS if they are interviewing in different specialties? Do they get extra LORs, and then like with med school apps, pick and choose which letters get sent?

Any detail appreciated.

 

[mmmcdowe]

Can you give us some examples? Were these closely related residencies (like different areas of surgery)?

How would someone write the PS if they are interviewing in different specialties? Do they get extra LORs, and then like with med school apps, pick and choose which letters get sent?

Any detail appreciated.

Radiology and gas @@

Meds and Peds

Neuro and Peds and Peds Neuro

They kept their PS vague in terms and person oriented rather than goals, as far as I know. I didn't read any of them. They got extra LORs, yeah. I believe you do have control on where they are sent, but having not gone through the cycle I am note entirely clear.

 

[Raryn]

Radiology and gas @@

Meds and Peds

Neuro and Peds and Peds Neuro

They kept their PS vague in terms and person oriented rather than goals, as far as I know. I didn't read any of them. They got extra LORs, yeah. I believe you do have control on where they are sent, but having not gone through the cycle I am note entirely clear.

You could send a different PS to every program if you wanted, so that isn't any sort of barrier.

Ditto with LoR. You can submit a max of 4 per program, but they could be a different subset of 4 to every one.

 

[NYCMS2]

You could send a different PS to every program if you wanted, so that isn't any sort of barrier.

Good to know, although I don't anticipate needing to do this.