IR Aways

[Bbroush]

I looked for a thread on this but all of them were from a while back. I'm an M2 at a newer med school in the Midwest that doesn't have a radiology residency (or IR) so I'm worried that without an away elective I could be at a disadvantage (either in another region or even here). How important are away electives?

Yes I know IR is crazy competitive this year. Just thought I'd ask. Hope the interview season is going well for everyone.

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[irwarrior]

If you want to do an IR residency, you likely need at least one if not a few IR sub internships under your belt.

 

[IRorBustguy]

If you want to do an IR residency, you likely need at least one if not a few IR sub internships under your belt.

Nah - just do one at a strong IR program and get decent letters. I did only my home program and am doing just fine

 

[IR4thewin]

Also at a newer school, no home rads residency, did one away at a good place, have gotten plenty of interviews, probably would not have been taken seriously except for the away and getting a good letter from that away pd


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[Naijaba]

I did a home sub-internship and two away rotations. I chose a lower-tier program and a top-tier program for my aways. I didn't ask for a letter from either program as my goal was to meet the faculty and residents, and to show that I was a good fit for their programs. In retrospect, I would've done my home program and a single away at the more competitive program.

In the competitive surgical disciplines (plastics, neurosurgery, cardiothoracic, etc.) away rotations will vastly improve your chances at that particular program. I was interested in neurosurgery, and a few program directors said that they always matched at least one applicant who had done an away at their program. Yale went so far as to say that everyone they matched in the past 5 years had done a sub-internship at Yale. Now that's for neurosurgery. I suspect IR will be less competitive because of the alternative pathways to IR. You don't have to do an away rotation, but I think a single away at your top-choice could be helpful. I think your goal during an away should be to find a faculty member with whom you "click" really well. This person can advocate for your application and mentor you down the road.

 

[Bbroush]

Thanks everyone for your responses so far! I realize that this is a newer and very competitive residency but I appreciate your help. I started doing research in medical school in an IR adjacent field (vascular surgery PAD research) and I'll have at least 3-4 pubs from that, which is how I learned about IR in the first place. I've been able to get involved in SIR medical student council and also via a symposium at a nearby program I got involved in research with an attending there. So I feel like if I can do all the other things + get some away electives I should have a decent shot.

Also at a newer school, no home rads residency, did one away at a good place, have gotten plenty of interviews, probably would not have been taken seriously except for the away and getting a good letter from that away pd


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How was/is the rest of your application? Congrats on the success with interviews

 

[IR4thewin]

You should be in a great spot as far as research goes. I did not have any pubs, just some posters and oral presentations, which I think is probably below average, but had a PD tell me he was impressed with my research lol, so I don't know what to think anymore. Step 1/2 were above average for rads but not by much. AOA and good clerkships, don't minimize the importance of third year grades. If you do well on the shelf exams then many schools will out your national percentile in the deans letter, perhaps another way to stand out if your step 1 is at IR below average. But yeah, as long as you meet the cutoffs (no one know where they are set, maybe 220 step 1), then doing always and getting to know people through your activities will be very helpful and you should be golden.


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[irwarrior]

It is hard to assess how competitive IR will be in the upcoming years. But, you should try to be prepared. I agree early involvement in IR is helpful. IR research is a plus as is involvement in the SIR medical student council. I am hearing of more and more students doing 2 or 3 IR electives during the 3rd and 4th year of medical school so that may be considered. Also, going to the national IR meetings and IR symposium also are ways to showcase the students interest in IR. The IR PD wants to make sure that you are aware of what you are getting yourself into as this is an extremely busy patient driven specialty and far different in its day to day existence from diagnostic radiology. The IR program directors are a tight group and they will often call one another to ask about medical student applicants.

Step scores, AOA status (3rd year honors)/class rank are quite important as well.

 

[Bbroush]

thanks @irwarrior and @IR4thewin. I'm not sure how feasible AOA will be currently, but 3rd year honors should definitely be doable. With IR are there certain clerkships where an honors is more important/focused on?

Also the point about SIR meetings is good to know. I definitely am trying to figure out how to get to DC for SIR in march.

Obviously Step is important, my school doesn't have us take it until late 3rd year, so hopefully I can do well.

If anyone else has any input it would be much appreciated. Thanks!

 

[IR4thewin]

Anecdotally, IR docs I've worked with or met on the trail are very respectful of vascular surgeons, so if you can nail surgery then get a good letter from vascular attending that won't hurt. Easier said than done at some institutions I could imagine with the personalities you may get in vascular, but I lucked out with my attending who was awesome.


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[IR4thewin]

You can keep anonymity and don't have to say if you go to FIU, but I know they take step 1 after 3rd year. If that is where you go, I would try very hard to set up some time, formal or informal at Miami cardiac and vascular institute. They are very highly regarded and a strong letter from someone there could be very helpful. Work as long hours as they do, be friendly, smile, and learn everything you can. If MCVI says you are a hard worker and smart, I think a lot of places would respect that.


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[Bbroush]

You can keep anonymity and don't have to say if you go to FIU, but I know they take step 1 after 3rd year. If that is where you go, I would try very hard to set up some time, formal or informal at Miami cardiac and vascular institute. They are very highly regarded and a strong letter from someone there could be very helpful. Work as long hours as they do, be friendly, smile, and learn everything you can. If MCVI says you are a hard worker and smart, I think a lot of places would respect that.


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Nah, there are a bunch of schools that do 3rd year step 1 now. I wish I was that far south

Anecdotally, IR docs I've worked with or met on the trail are very respectful of vascular surgeons, so if you can nail surgery then get a good letter from vascular attending that won't hurt. Easier said than done at some institutions I could imagine with the personalities you may get in vascular, but I lucked out with my attending who was awesome.


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Great advice! Yeah would having my PI who's a vascular surgeon be the best letter? I figured it would but I thought I'd ask.

 

[m3db01]

To piggyback on this question, whats the best approach to getting a letter from a vasc surgeon when your intention is IR? My program has attendings that are ALL about recruiting med students into vasc surg...I wonder if they will want to write a letter for a guy who is choosing IR over vasc lol. I will be rotating with them in January

 

[RadsFTW123]

Why are all these new med schools being opened? Medicine is a saturated profession in almost all desirable fields, once these new med schools open their own residencies, it'll be the end for sure

 

[IR4thewin]

It sounds like you are a little bitter, but do you understand how acgme development works at these new schools? Our school has a 10-year plan that does not include rads or derm or Ortho or any of the 'desirable fields.' These new schools mainly develop primary care/gen surg residencies, or associate themselves with existing residencies by bringing them under an academic roof. Yes, more medical schools means the match is more competitive, but do you realize how much better we have to do than you folks at established schools just to get some recognition for interviews?


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[IRorBustguy]

It sounds like you are a little bitter, but do you understand how acgme development works at these new schools? Our school has a 10-year plan that does not include rads or derm or Ortho or any of the 'desirable fields.' These new schools mainly develop primary care/gen surg residencies, or associate themselves with existing residencies by bringing them under an academic roof. Yes, more medical schools means the match is more competitive, but do you realize how much better we have to do than you folks at established schools just to get some recognition for interviews?


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No offense but what is your school going to do to keep students from applying to the competitive fields? 10-year plan to get them into primary care whilst charging 50k a year? Great plan you got. Unless your school makes you sign a binding contract stating you wont apply to anything but the primary care fields, I'd be willing to bet the % of your classmates that end up applying to the more competitive fields mirrors that of other US schools.

 

[IR4thewin]

The 10-year plan I was referring to is an ACGME development plan, which is totally different from LCME and undergraduate medical education. You mentioned new schools popping up and 'once these new med schools open their own residencies, it'll be the end for sure.' I was merely stating that most of these new schools are not starting residencies in the competitive fields. Yes, they are creating more med students which makes the residency match more comptetitive, but if students at the top tier schools think they should get whatever residency they want just because they went to school x, and don't feel like you should have to work as hard as I do and get the scores that we do in order to even be considered by top places, then I say suck it up and quit being entitled. If I get the same scores, research, extracurriculars, etc as an HMS student, a residency will take someone from Harvard over me anyway. My point is that we have to work a lot harder to move up the ladder, so quit whining.


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[Bbroush]

lol @IR4thewin you're right. Also my school was made around existing residency programs and 3rd/4th year teaching hospital system. SOOOOOO anyway......

To piggyback on this question, whats the best approach to getting a letter from a vasc surgeon when your intention is IR? My program has attendings that are ALL about recruiting med students into vasc surg...I wonder if they will want to write a letter for a guy who is choosing IR over vasc lol. I will be rotating with them in January

I really would love to know the answer to this as well. Also my original question before the derail: Is a letter from my PI who is a vascular surgeon a good letter? Better than, for example, someone from a clerkship?

 

[IR4thewin]

I think only you can answer that. The PI can be helpful especially if you are wanting to end up at a research oriented institution and if the research was significant. Clinician can be good to, you ideally want someone to say that they loved you so much they tried to convince you to go vascular surgery but couldn't draw you away from your love of IR. Anyone like me who is going through the match now doesn't have the greatest perspective, would be nice if you can talk with someone older who went through it, or if you do an away, ask the program director which would be better in their opinion. Most PD's are there to help students get into IR and would be honest with you


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[IR4thewin]

Last piece of advice, ask both the PI and the clinician to write one and upload. Doesn't mean you have to use it. But a) one letter writer may not upload it as soon as you want and you would have a backup. B) you could assign the PI to academic places and the other to more clinically focused places.


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[Bbroush]

Last piece of advice, ask both the PI and the clinician to write one and upload. Doesn't mean you have to use it. But a) one letter writer may not upload it as soon as you want and you would have a backup. B) you could assign the PI to academic places and the other to more clinically focused places.


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Thanks for the advice. I'd be happy matching anywhere, but that's good to know. Also it's good to know I should be planning on 2-3 aways.

One other question: what is the latest during 4th year that I should do aways? (either for a LOR or in general.)




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[IRrads10]

i'm going to deposit this here ( http://rfs.sirweb.org/wordpressnstall/2016/06/02/5595/ ) as this may be helpful !

 

[Naijaba]

One other question: what is the latest during 4th year that I should do aways? (either for a LOR or in general.)

A good rule is to finish the rotation before they send interview invites out. I did my two-weeks at Stanford October 17th-October 28th, and they sent out invites the following week. I'd suggest starting even earlier (e.g. October 1st at the latest).