Interviewed but planning not to rank !

[Immunoonco]

I am having a lot of stress regarding the following topic and I would appreciate any insight from experienced people or anyone who would like to provide an opinion

I had several interviews for hem/onc this year (first time going to the match). However, most of the places are not academic institutions or university hospitals with very minimal research. I am very interested in pursuing academic hem/onc in the future with heavy focus on clinical research and I don’t believe any of the places where I am interviewing fulfill this goal for the short term. I am in a dilemma on whether I should just go with what I have and rank the places or not rank any program thus no match this year and then look for a Hospitalist job in an academic top tier hospital and do research before applying again in the near future. The only problem is that I am an IMG graduated a long time before coming to the states to start residency. My USMLE scores are mediocre and I am concerned that later even with more research experience this won’t help much in pursuing a competitive fellowship. The other thing that I tell myself is that maybe I can start fellowship now in any program and then probably later try to put a feet in an academic institution which seems unlikely.

I would appreciate any input on your thoughts as I am really confused at this point on what to do.

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[Suprep]

its possible that you become academic hospitalist and work 2-3 years and then apply and potentially match in a strong program. but absolutely no guarantee to that. if you need visa, you are at huge disadvantage to begin with. I would urge you to rank programs that you interviewed and join somewhere, build connections and work your way in academics in the future.

 

[Immunoonco]

its possible that you become academic hospitalist and work 2-3 years and then apply and potentially match in a strong program. but absolutely no guarantee to that. if you need visa, you are at huge disadvantage to begin with. I would urge you to rank programs that you interviewed and join somewhere, build connections and work your way in academics in the future.

I do not need a visa. I am starting to realize that medical school where you come from, residency program and fellowship program really matter for future affiliation with big academic institutions. My concern is that I don’t match and then not find a job ( like BMT Hospitalist) in a program where I can grow my research knowledge.

 

[gutonc]

If you want to be an oncologist, rank every program you interviewed at this year. If you are happy being a hospitalist or PCP, your strategy is sound.

 

[IM_applicant]

Your dilemma is tough. Your chances at an academic career definitely depend on where you do fellowship, but that, in turn, depends on where you did residency and what you've accomplished so far and what your chances are in getting into an academic fellowship down the line.

What are you referring to with heavy clinical research? How do you see your day-to-day ideally? And what are the programs?

 

[rokshana]

I am having a lot of stress regarding the following topic and I would appreciate any insight from experienced people or anyone who would like to provide an opinion

I had several interviews for hem/onc this year (first time going to the match). However, most of the places are not academic institutions or university hospitals with very minimal research. I am very interested in pursuing academic hem/onc in the future with heavy focus on clinical research and I don’t believe any of the places where I am interviewing fulfill this goal for the short term. I am in a dilemma on whether I should just go with what I have and rank the places or not rank any program thus no match this year and then look for a Hospitalist job in an academic top tier hospital and do research before applying again in the near future. The only problem is that I am an IMG graduated a long time before coming to the states to start residency. My USMLE scores are mediocre and I am concerned that later even with more research experience this won’t help much in pursuing a competitive fellowship. The other thing that I tell myself is that maybe I can start fellowship now in any program and then probably later try to put a feet in an academic institution which seems unlikely.

I would appreciate any input on your thoughts as I am really confused at this point on what to do.

Bird in the hand...
Not hem/onc, but as competitive as hem/onc is, you should be thankful for the interviews you got...

You can always work within the fellowship you get to get your cv to be attractive to academic centers...this may mean doing an extra research year or 2...doing a sub fellowship after hem/onc, etc...to work your way up to academics...would it be easier coming from a big name place or a big name fellowship...sure, but it’s not impossible from a low tier program.

 

[Immunoonco]

Your dilemma is tough. Your chances at an academic career definitely depend on where you do fellowship, but that, in turn, depends on where you did residency and what you've accomplished so far and what your chances are in getting into an academic fellowship down the line.

What are you referring to with heavy clinical research? How do you see your day-to-day ideally? And what are the programs?

I am interested in a career involving patient care and clinical research (phase I-III). I would love to have 70% of my time dedicated to research.
The problems I’m facing is that I don’t have good scores with an attempt in USMLE, IMG graduate from a while ago >5 years. I have very robust research experience without much publications but I believe if I am put in a place where there is a lot of opportunity for research I will be able to demonstrate my competency and ability to be a competitive person. Still I am really confused and don’t know what to do at this point.

 

[Suprep]

another option is doing extra year of fellowship after hem onc in a big name institution and get into academics that way. Those 1 year fellowships are no where as competitive as hem onc is.

 

[MD46]

I am interested in a career involving patient care and clinical research (phase I-III). I would love to have 70% of my time dedicated to research.
The problems I’m facing is that I don’t have good scores with an attempt in USMLE, IMG graduate from a while ago >5 years. I have very robust research experience without much publications but I believe if I am put in a place where there is a lot of opportunity for research I will be able to demonstrate my competency and ability to be a competitive person. Still I am really confused and don’t know what to do at this point.

I mean just breaking it down for you..

Things working against you:
1. Attempt in USMLE
2. Relatively older IMG graduate
3. Research experience with no significant publications to show for?
4. You didnt mention any presentations or posters etc at any major conference
5. Coming from a low tier program
6. expecting a place will give you 70% time for research given your profile

Things working in your favor:
1. You know what you want and want to do research


A friend did heme onc 3yr fellowship from a low tier program, heck it only started like 5 years ago
Did mostly clinical research during fellowship, tried to present at ASCO, ASCH, AACR and NCCN.
Had posters, abstracts and some good pubs as well.
Did lots of meta-analysis as well.

Ended up in MD Anderson Phase 1 program : after 2 yrs has an academic assistant professor appointment there.

Anything is possible
If heme onc is what u wana do, just go ahead and rank where u think they at least offer some opportunity for you to research.

just my 2 cents

 

[IM_applicant]

I am interested in a career involving patient care and clinical research (phase I-III). I would love to have 70% of my time dedicated to research.
The problems I’m facing is that I don’t have good scores with an attempt in USMLE, IMG graduate from a while ago >5 years. I have very robust research experience without much publications but I believe if I am put in a place where there is a lot of opportunity for research I will be able to demonstrate my competency and ability to be a competitive person. Still I am really confused and don’t know what to do at this point.

If most of what you want to do is clinical trials than what is your 70% research time going to look like? You are going to have to see a lot of patients to maximize the number of patients you can enroll.

Like @MD46 and @Suprep suggested, you can make your way up in research as an oncologist during/after fellowship and you have several things working against you that are not going to change. I don't think getting a hospitalist job will help you that much, and significant research when you're working a full-time job is very tough to accomplish. Old grad taking even more time off may not necessarily work in your favor.

Practically: You can talk with top-tier academic hospitals right now. Places are already interviewing/have interviewed for heme/onc hospitalists in major academic programs. If you send out emails in the next few days/weeks for the type of position you want and don't get a very positive response, I would rank the programs you interviewed at. Ask them specifically if they think they can improve your chances of getting into an academic fellowship. The worse thing is finding out after you didn't rank programs, that you are not competitive for academic positions at what you consider top tier hospitals.
Second, reach out ASAP to faculty and to other IMGs, especially from your country, that are where you want to be. They can likely give you better advice because obviously there is much more to you than the few details you shared here. They can also give you honest and non-anonymous advice about your chances.

Take my advice with a grain of salt as you should anyone's. Just my 2 cents based on what you wrote. Good luck!

 

[Immunoonco]

I mean just breaking it down for you..

Things working against you:
1. Attempt in USMLE
2. Relatively older IMG graduate
3. Research experience with no significant publications to show for?
4. You didnt mention any presentations or posters etc at any major conference
5. Coming from a low tier program
6. expecting a place will give you 70% time for research given your profile

Things working in your favor:
1. You know what you want and want to do research


A friend did heme onc 3yr fellowship from a low tier program, heck it only started like 5 years ago
Did mostly clinical research during fellowship, tried to present at ASCO, ASCH, AACR and NCCN.
Had posters, abstracts and some good pubs as well.
Did lots of meta-analysis as well.

Ended up in MD Anderson Phase 1 program : after 2 yrs has an academic assistant professor appointment there.

Anything is possible
If heme onc is what u wana do, just go ahead and rank where u think they at least offer some opportunity for you to research.

just my 2 cents

Sorry that I didn’t explain my research experience. I did a research in a top tier program. Unfortunately no abstracts or publication from that project only because I had to leave very early. I had a couple of abstracts at national cancer society meeting (all first author). A number of publications of review articles , case reports, meta analyses and book chapters (all as first author). I am also still currently working on a couple of projects ( all I’ve mentioned is in hem/onc).
I totally get what you are saying and I am trying to be reasonable and realistic but again I really feel motivated for academic work and think I have the potential.

 

[Immunoonco]

If most of what you want to do is clinical trials than what is your 70% research time going to look like? You are going to have to see a lot of patients to maximize the number of patients you can enroll.

Like @MD46 and @Suprep suggested, you can make your way up in research as an oncologist during/after fellowship and you have several things working against you that are not going to change. I don't think getting a hospitalist job will help you that much, and significant research when you're working a full-time job is very tough to accomplish. Old grad taking even more time off may not necessarily work in your favor.

Practically: You can talk with top-tier academic hospitals right now. Places are already interviewing/have interviewed for heme/onc hospitalists in major academic programs. If you send out emails in the next few days/weeks for the type of position you want and don't get a very positive response, I would rank the programs you interviewed at. Ask them specifically if they think they can improve your chances of getting into an academic fellowship. The worse thing is finding out after you didn't rank programs, that you are not competitive for academic positions at what you consider top tier hospitals.
Second, reach out ASAP to faculty and to other IMGs, especially from your country, that are where you want to be. They can likely give you better advice because obviously there is much more to you than the few details you shared here. They can also give you honest and non-anonymous advice about your chances.

Take my advice with a grain of salt as you should anyone's. Just my 2 cents based on what you wrote. Good luck!

Thank you for the information. Is there any way to find out who to contact and where to start from to apply for hem/onc Hospitalist job ?

 

[IM_applicant]

Thank you for the information. Is there any way to find out who to contact and where to start from to apply for hem/onc Hospitalist job ?

Not that I know. I think you just have to look it up online / call / ask contacts. I think some of them don't advertise the positions because they are filled based on word of mouth. Maybe your research mentor at the top tier program could help? BTW if their letter is very strong, not having published from that experience shouldn't be that detrimental to your application. Another thing that you could do is ask your mentor to have the fellowship director at the institution review your application and walk you through what your weaknesses are and if your hospitalist plan is a good idea.

 

[MD46]

Sorry that I didn’t explain my research experience. I did a research in a top tier program. Unfortunately no abstracts or publication from that project only because I had to leave very early. I had a couple of abstracts at national cancer society meeting (all first author). A number of publications of review articles , case reports, meta analyses and book chapters (all as first author). I am also still currently working on a couple of projects ( all I’ve mentioned is in hem/onc).
I totally get what you are saying and I am trying to be reasonable and realistic but again I really feel motivated for academic work and think I have the potential.

Sounds like u have a solid chance to get into and academic based position later in your career.

from what i remember: beth israel in boston, barnes jewish st louis, university of IOWA had hematology oncology hospitalist programs. look into it

 

[cabergoline2]

it's not hard to get x academics once u are already a oncologist... you may not get academic appointment str8 from fellowship but there will be easy paths of getting the same... rank everything and hope you match and do well in the fellowship... things will be set..