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iobu

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If you finished one IM year you can apply for PGY2 radiology positions without repeating intern year. Network with your local rads department and explore if this is a possibility, maybe the PD can give you some input. You will need a good reason as to why you are picking radiology now instead of IM. As an IMG you will be at a disadvantage despite decent scores but it's not insurmountable with appropriate networking. You will likely need a letter of good standing from your current PD and probably some rads letters from someone connected.

You will need to sit down and be honest with yourself about your app and see if there is a reason you did not match radiology outside of the IMG stigma. Especially in the world of virtual interviews you will face some issues as an IMG, but if you have good letters/mentors and maybe people who are willing to call on your behalf you may have some luck. If you can market the skills you've learned as a medicine intern this could help. Good luck.
 
I think you need to really convince yourself this is what you want to do. Having been through intern year not too long ago, this would be the time when most people including categoricals feel burnt out and want to switch out of IM. Make sure you want to do radiology because you love it and not because you're tired of IM. I have many IM friends who wanted to leave it at some point but most stayed.

If you apply next cycle regardless of the outcome you'll lose a year. Ask yourself why radiology and think hard on it. On the other hand once you're done with intern year, PGY-2 in IM is much better and you'll do more actual medicine and less scut.
 
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I thought about it a lot. Radiology is what I want to do 100%. That is why I told my PD that I want to switch. However, as a response PD decided not to renew my contract. Regardless of PGY2 being better than PGY1, I do not want to do IM. I want to do Radiology. I just don't know what to do at this point. Would it have made my situation any better if I stick through and finished IM and reapplied? Wouldn't it make it worse by using up the entire GME funding? The real issue here is not me convincing myself. Even though I realized what is a better fit for me, I am in a very bad situation and lost.

So if you don't find something for next year, you'll be out of a job?
 
I thought about it a lot. Radiology is what I want to do 100%. That is why I told my PD that I want to switch. However, as a response PD decided not to renew my contract. Regardless of PGY2 being better than PGY1, I do not want to do IM. I want to do Radiology. I just don't know what to do at this point. Would it have made my situation any better if I stick through and finished IM and reapplied? Wouldn't it make it worse by using up the entire GME funding? The real issue here is not me convincing myself. Even though I realized what is a better fit for me, I am in a very bad situation and lost.
You need backup plan B and C if you don’t get radiology. 8 years ago at the bottom of the competitiveness, you have a good shot with your stats. Today, I give you less than 10% chance. Radiology has been getting more competitive every year. Those kids who were initially interested in EM and RadOnc see dumpster fires right now and are making a bee line to radiology.
 
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Correct. I will be out of a job


why do the Radonc people make a bee line to radiology?
Horrible job market due to residency expansion, among other issues
 
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i dont want to settle with job that i do not want to do. I want to do radiology. I am jobless after june. how can i increase my chances of securing radiology position next cycle? i dont want to use up my GME funds by doing a residency that I dont want. Wouldnt that make my situation a lot worse?
It's all relative. You are an IMG applying to an increasingly competitive and popular field (momentum again) as a reapplicant from an IM program. That's a terrible starting point. Frankly, "a lot worse" situation is not having a job as a doctor in America at all from where I'm sitting, not worrying about radiology. I guess you really need to reflect on if there is any possible way you can fix this situation by finding a niche in medicine available in IM. You only have 2 years left before you control your life as an attending. There is flexibility there. It might not be rads but it can still be a great life!
 
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Apply for the 'Physician' positions, which start PGY-2 the year of the match. There are about 30 such positions a year.
 
i dont want to settle with job that i do not want to do. I want to do radiology. I am jobless after june. how can i increase my chances of securing radiology position next cycle? i dont want to use up my GME funds by doing a residency that I dont want. Wouldnt that make my situation a lot worse?
I can't imagine a worse situation than the one you're in right now. To give further advice - do you have family or friends who can take you in, or previous work experience that will get you a job outside of medicine, or do you have to worry about becoming homeless?

If that's on the table, I would advise moving to a state that gives you a physician license after one year of residency, so at least you can have a roof over your head and food to eat. I know Missouri also will let you work as an assistant physician without finishing residency, so that's at least one place that you can get a job while applying for rads next year.
 
I would be begging my IM program director to renew the contract and then finish out IM and do an IM fellowship. You are at high risk of not matching into radiology. If you don’t, you may be driving an Uber in the future.

To give you reference, I interviewed one FMG candidate who had 260-270’s on steps 1 & 2 and had decent application. Spoke English fluently. We are ranking him near the bottom of the rank list because we prefer to have few or none FMG’s and DO’s in our class. Don’t hate the player. Hate the game.
 
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I would be begging my IM program director to renew the contract and then finish out IM and do an IM fellowship. You are at high risk of not matching into radiology. If you don’t, you may be driving an Uber in the future.

To give you reference, I interviewed one FMG candidate who had 260-270’s on steps 1 & 2 and had decent application. Spoke English fluently. We are ranking him near the bottom of the rank list because we prefer to have few or none FMG’s and DO’s in our class. Don’t hate the player. Hate the game.
Eh, you can hate both.
 
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Where did you apply first time around? If you apply only to bottom tier programs and maybe buff up your app with research or something over the next year, I think you have a chance.
 
Dear OP,

I want to thank you for sharing and want commend you for realizing what is important to you and acting on it. I was in a similar (possibly worse) situation so hopefully I can share my experience that could help if anything offer hope. I was in a surgical specialty for 4 years and was placed on resident probation. Ultimately my contract was not renewed and I was without a job starting July 1, 2020. As you can imagine it was not a good time to be unemployed, however I found a job through social connections in medical education and applied to rads. I applied to both PGY1 and PGY2 positions, but all of the PGY2 spots were locations that I didn't really care to be. Ultimately I interviewed and matched in a PGY1 position at a very well known academic residency. I ended up just continuing my job a second year instead of doing an intern year. Hopefully my story can help be motivation to you. You brought up some great questions and hopefully I can answer them.

1. GME funding for residency - Don't worry about this. This is the job of the program to worry about. GME does fund residency positions for a few years but not all spots are GME funded. Some are funded by the department or the VA hospital that don't have the same requirements.

2.Unemployment - I have a medical license and found part time employment at Signify Health doing home visits for insurance companies. You will make more than you did in residency. Check it out if you are looking to pay the bills.

3. Vacant PGY2 programs - It's like the Wild West. Some programs post their openings and others don't. You can look at this website Residency Positions Available or aunt Minnie for openings but there aren't many. Some spots may be filled through the match as with the filter "physician only". However most are word of mouth. I recommend emailing programs you are interested in to let the know you are available if a PGY-2 spot should open up. Also try to get your PD to leverage the rads department to get you a spot at your local institution if they have program.
 
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OP I am sorry you have found yourself in this situation. As someone going through this process now, but from a much more favorable starting position, I think you need to be more careful. Pulling the ripcord without backup plans was perhaps a hasty decision. I would try to make amends with your IM program and stay in the pipe or find another IM PGY2 spot. From the PDs I have spoken to gap years outside of medicine are usually frowned upon once you begin residency. Medicine is a very conservative field in that applicants who are outside the standard process are often ignored. Why take a risk on someone outside the pipe when there is a sea of qualified candidates that raise no questions? As mentioned above, you have a lot of things stacked against you, and IM residency gets much better after intern year. Finishing an IM residency will make you a more desirable candidate while also leaving you with the ability to still practice medicine and generate a good income if radiology doesn't work out. Regarding funding, while some programs wont look at candidates who don't bring their funding with them, most programs have plenty of money and don't care as much about the GME funding.

The fact that you got no interviews this cycle is a big red flag. Also if you applied to rads this year without first informing your IM program that's a match violation. I don't know how it played out, but that could have contributed to their decision to not renew your contract. There are a lot of unknowns here. To add, the fact that you had time to apply via ERAS this cycle tells me you had, at most, 4 months of IM wards/clinic before making this decision. Had you considered radiology as a medical student or done any radiology rotations as an intern? These are the questions PDs will be asking themselves. Speaking of PDs, you should be reaching out to the radiology program at your institution if there is one- that will be your best bet for getting a spot and their perspective will be the most valuable to you. However, that too is complicated by your lack of current relationship with your medicine program. No radiology PD will consider you without a positive recommendation from your current program.

Finally, your language makes it sound like you might be struggling with some depression and that might be affecting your decision making. I would advise you to seek some help, both with these decisions and perhaps with a professional for yourself if you can find the time/money. Many medical schools have GME career counseling services as well as mental health services. That might be a good place to start.
 
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I can't imagine a worse situation than the one you're in right now. To give further advice - do you have family or friends who can take you in, or previous work experience that will get you a job outside of medicine, or do you have to worry about becoming homeless?

If that's on the table, I would advise moving to a state that gives you a physician license after one year of residency, so at least you can have a roof over your head and food to eat. I know Missouri also will let you work as an assistant physician without finishing residency, so that's at least one place that you can get a job while applying for rads next year.
That "AP" license in Missouri has not taken off well from what I heard.

I dont know any state except for Puerto Rico (or maybe Minnesota) that would give an IMG a medical license after only 1-yr post grad training.
 
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