Apply for pgy1 or pgy1?

[flumazenil92]

Hi Guys,

Just want to get your advice going forward. I'm an IMG and went unmatched in the recent match season and nothing came through in SOAP either. However, a month after match day I was offered a Prelim position (I consider myself lucky) at one of the places which I had applied to during SOAP.

My creds are as the following:
Step 1: 241
Step 2: 245
Step 2 CS: Pass (first attempt)
Step 3: 234
Canadian citizen (no American status)
6 months worth of US/Canadian Electives

Considering that getting paid is better than nothing, I accepted the offer. However, this is only a prelim position meaning I will have to find a categorical position in the incoming match.

I wanted to get your guys advice on how should I proceed forward. Originally I wanted (and had applied for) IM categorical but it seems I can change to another specialty now that I am in a prelim position. But, all my electives have been in IM and have no experience or letters from any other specialty. With this all in mind I have the following questions/concerns:

1) If I want to stay in IM categorical should I reapply for PGY1 in the match or PGY2? If PGY2, where do I find an open position (is there a centralized way to apply for these)?

2) If I want to try for anesthesiology or radiology (or even other), how do I go about getting a rotation and subsequently a letter while in a prelim position?

Appreciate your advice. Thanks in advance guys!

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[bannie22]

1) do both
2) ask ur PD

 

[AdmiralChz]

1) If I want to stay in IM categorical should I reapply for PGY1 in the match or PGY2? If PGY2, where do I find an open position (is there a centralized way to apply for these)?

2) If I want to try for anesthesiology or radiology (or even other), how do I go about getting a rotation and subsequently a letter while in a prelim position?

Getting your foot in the door (even with a prelim PGY-1 year) is the first step so nice work there! Your next priority is to strive for excellent performance during your intern year. Work your butt off and show them that you belong there.

1) If you want to stick with IM, you should probably do both. Having solid early performance in PGY-1 year could set you up with a couple strong domestic letters which will help your application. There is absolutely some attrition which leaves open PGY-2 spots, I do not know of any centralized service but it has been discussed quite a bit around here in the last year - do a search around the forums and see where. Your best bet is to try to work something out with your PGY-1 program, but to do so you'll need sustained excellent performance.

2) I don't know the details of your application beyond the above, but your numbers seem at least reasonable. That being said you failed to match for IM which is an order of magnitude less competitive than Anesthesiology or Radiology. You might be able to request a rotation during your prelim year (probably not if it is IM-based rather than a true transitional year), but honestly I would focus on IM performance and applications as this is likely your best shot in the states. You can certainly reach out to the PD of the Anes/Rads program at your PGY-1 institution (if there's a program) after you get there for a second opinion, but it's going to be a tough sell.

Others might have different perspectives, but honestly I think your best bet is to keep on track for IM.

 

[NotAProgDirector]

Most IM programs will want you to continue as a PGY-2. Your PD should be able to help you find a spot. There's always a chance a spot will open at that program.

 

[flumazenil92]

Thank you all for your insight!

 

[flumazenil92]

Most IM programs will want you to continue as a PGY-2. Your PD should be able to help you find a spot. There's always a chance a spot will open at that program.

I assume you're a program director or have the general know how of the administration side of things. Have another question for you, if my program did decide to keep me for pgy2, when would I expect to hear a about an offer from them (helps me plan for the future - eg. attending interviews, whether to submit a ROL or not, etc). Let me know. Thanks.

 

[NotAProgDirector]

There isn't a clear answer. In general, PGY-2 openings occur later in the year -- someone's not doing well and drops/fails out, a PGY-1 decides to transfer to another program, etc. This tends to happen between Jan and March, but can happen at any time.

What I'd recommend is show up, work hard, do well. If you decide to apply in the match (not an unreasonable choice), you'll need an LOR at the end of August, so you'll meet with your PD then and explain your plan, also mention that you're interested in a PGY-2. They can help you apply both for PGY-1 (or PGY-2 advanced/reserved) in the match, and also PGY-2 outside the match. If you're interested in staying there, they will determine whether they have room and whether they want to keep you.