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After you rank each Rad Onc program in the match, you create a supplemental list for that Rad Onc program, indicating which preliminary or ty programs you want to go to, and in which order, if you were to match at that Rad Onc program.
So, there are two ways to approach the match:
1. Just rank Rad Onc programs in your primary list (and include prelims only in your supplemental lists). This is what I did. This means, if you do not match to a Rad Onc program, then you will not match to a prelim/TY program.
This strategy worked for me in that I was free to do a year of research.
However, it also does make it a lot harder to scramble, because you have
to scramble into two different programs.
2. Rank all of your Rad Onc programs, and then "bottom out" your primary list with some prelim programs.
Makes it easier to scramble, and to pick up spots throughout the year (This year, I know there have been at least 4 different openings, not to mention the 5 real scramble spots last year).
But you can't do a year of research, obviously.
As far as finding a research spot, I found that the majority of the people I talked too were receptive to the idea. Really, its a good situtation for them, because you will be providing support in projects that they are already interested in. A win-win situation. And if you can bring in outside funding, they are even more excited.
I found out, before the match, that my home school had funding for year-out research, and that the research didn't have to be done at my home school. That was a big advantage. I also applied to the Doris Duke year-out program (you don't have to accept a spot there until just after the match, which is good timing. But some Doris Duke sites didn't like the fact that I was applying as a "backup" plan).
I talked to people at my home department, and some were interested and some were not, and someone at a top 10 program where I had done an away, who was interested. I did try to contact some "big names" who I thought I would like to work with, and didn't get a positive response from any, but I only contacted a couple. In the end, I ended up going away from my department (mid-to-low tier per the rankings on this forum) to another department (mid-to-higher tier).
One final point, if at all possible, I think it is best not to graduate if you do a year out. The advantages are:
1. You are then eligible for year-out medical school programs like Doris Duke, or local programs at your school.
2. You are covered by your medical school's liability poilicy, so you can still interact with patients (if you were a MD not in a training program, I was told this would be expensive/hard to arrange?)
3. You would be eligible to take out more student loans in case you can't find a research position that is funded.
4. Less interest accrual on your student loans (a smaller point).
I was able not to graduate because I didn't take a final, one-week, required course at my medical school. I will take it this year. Perhaps similar caveats are available at other places.
One issue I wasn't sure how to deal with was if and how to bring up the topic of doing a year-out with a faculty at a program you are trying to match to. I did do this with one faculty (during our interview, no less!). I don't know if this had a negative impact.
so if one does not match, is there a way to prevent graduation from medical school to retain benefits of residency application to the next app cycle? or can a medical school force you to graduate if you already have all your course requirements and USMLE 2s done?