Medical Student thinking of applying to Advanced Residency Position as a PGY-2 in Internal Medicine: Thoughts?

[TorturedSoul]

Disclaimer: So first of all, I would like to start by saying that a very similar question to mine has been asked in the past, but that person had a different situation than mine so I wanted to hear your thoughts on my specific situation. Thank you.


So guys so I just found out that I did not match into my desired advanced specialty.. To be honest, I did actually consider that something like this would happen and so I dual-applied with IM and ended up matching into a university-affiliated program. There are, I think, two main reasons why I ended up not matching: not enough research/extra-curriculars in the field and a low STEP I score of 21x (STEP II was okay, but not amazing, at 24x). Thankfully those are two things I think I can improve on. Correct me if I am wrong I think it is feasible to start doing research as an intern by the halfway point or maybe even a little bit before. And in regards to STEP, ideally I would like to start studying for STEP 3 ASAP and be ready to show improvement on it like I did for STEP II (aiming for 235+, maybe even 24x). With those two things and obviously very good LOR/evals from my PD and attendings at the internal medicine program I would be attending, I think I would show improvement in my application. As such I would like to start applying into the match process at the beginning of PGY-2. That way, if I matched, I would not cause unnecessary tension with my PD by leaving a vacant spot and if I did not then I would still graduate and if nothing else be a board certified internist and maybe possibly look into doing fellowship (although I know Cards and GI, which are the only two fellowships I have a real interest in, are super competitive as well so I do not know what my chances of matching into those are either).

Anyway, so I know that this is a super weird plan and not at all common, and, of course, the problem of funding comes into play. But I just wanted to get the input of other people as to if this would even be feasible or if I am just daydreaming plans for myself that don't realistically make sense. I just really can't see myself letting go of the opportunity of doing my dream specialty.

---

Members don't see this ad.

 

[ThoracicGuy]

Disclaimer: So first of all, I would like to start by saying that a very similar question to mine has been asked in the past, but that person had a different situation than mine so I wanted to hear your thoughts on my specific situation. Thank you.


So guys so I just found out that I did not match into my desired advanced specialty.. To be honest, I did actually consider that something like this would happen and so I dual-applied with IM and ended up matching into a university-affiliated program. There are, I think, two main reasons why I ended up not matching: not enough research/extra-curriculars in the field and a low STEP I score of 218 (STEP II was okay, but not amazing, at 242). Thankfully those are two things I think I can improve on. Correct me if I am wrong I think it is feasible to start doing research as an intern by the halfway point or maybe even a little bit before. And in regards to STEP, ideally I would like to start studying for STEP 3 ASAP and be ready to show improvement on it like I did for STEP II (aiming for 235+, maybe even 24x). With those two things and obviously very good LOR/evals from my PD and attendings at the internal medicine program I would be attending, I think I would show improvement in my application. As such I would like to start applying into the match process at the beginning of PGY-2. That way, if I matched, I would not cause unnecessary tension with my PD by leaving a vacant spot and if I did not then I would still graduate and if nothing else be a board certified internist and maybe possibly look into doing fellowship (although I know Cards and GI, which are the only two fellowships I have a real interest in, are super competitive as well so I do not know what my chances of matching into those are either).

Anyway, so I know that this is a super weird plan and not at all common, and, of course, the problem of funding comes into play. But I just wanted to get the input of other people as to if this would even be feasible or if I am just daydreaming plans for myself that don't realistically make sense. I just really can't see myself letting go of the opportunity of doing my dream specialty.

You're not likely to be able to put together much good research as an intern along with all the stresses and job requirements for the job.

It would probably help to let us know what advanced specialty you are considering to be able to get advice more tailored to your situation.

 

[TorturedSoul]

You're not likely to be able to put together much good research as an intern along with all the stresses and job requirements for the job.

It would probably help to let us know what advanced specialty you are considering to be able to get advice more tailored to your situation.

Thank you for the feedback on research. I thought that this might be the case, but I think it would also help to see how I could handle the workload and also see what opportunities I would have available.

I'm interested in Radiology.

 

[deleted480308]

Thank you for the feedback on research. I thought that this might be the case, but I think it would also help to see how I could handle the workload and also see what opportunities I would have available.

I'm interested in Radiology.

I’m going to suggest you just work on being a good intern, sure radiology is possible but it’s maybe more likely you get to be an IM doc now

 

[TorturedSoul]

I’m going to suggest you just work on being a good intern, sure radiology is possible but it’s maybe more likely you get to be an IM doc now

Of course, and like I said,"worst case scenario" I do not match and continue on my medicine training. That is why I decided to dual apply into medicine, because I knew I would be okay with doing it.

What I was just asking is what are my chances of getting into radiology residency in the way I described.

 

[deleted480308]

Of course, and like I said,"worst case scenario" I do not match and continue on my medicine training. That is why I decided to dual apply into medicine, because I knew I would be okay with doing it.

What I was just asking is what are my chances of getting into radiology residency in the way I described.

The worst case scenario is you announce you are applying out, your program makes your life hard, doesn’t resign you and you end up without a job in a year

I hope you end up happy with something

 

[TorturedSoul]

The worst case scenario is you announce you are applying out, your program makes your life hard, doesn’t resign you and you end up without a job in a year

I hope you end up happy with something

I am sorry I think you misunderstood me, I would definitely not be applying out. That is why I mentioned it would be to an advanced specialty. If I were to apply as a PGY-2 and I matched I would not start until after internal medicine residency was over.

However, I do appreciate your concern, and I also hope I end up happy regardless of whether I match or not. Thank you for your responses!

 

[GoSpursGo]

Wouldn’t it make more sense to go hard to make yourself competitive for cards or GI? The odds of you managing to do rads related research in an IM program, and also solving the funding issue of a rads program taking you after you’ve already completed a residency program, seems like an incredible long shot.

 

[NotAProgDirector]

This has been done before, in both directions. I've had a very small number of residency grads who go on to another residency, and I've taken a few interns who completed another residency first.

If you apply as a PGY-2 to advanced programs, you'd be able to finish your IM residency before you would start radiology. However getting time to do enough interviews as a PGY-2 can be difficult. A better plan IMHO is to apply as a PGY-3. That's when everyone who is applying to fellowship will be applying, so your ask will fit right in. You could apply for "R" positions and start radiology right at the end of your PGY-3 and apply for A positions and have a gap year -- where you could work as a hospitalist.

The main problem, as already hinted, is that it may be difficult to "have it all". Getting a Cards or GI fellowship requires research and networking in those fields, and you're unlikely to be able to do both that and radiology. You could try for an overlap with cardiac imaging -- if you did research on cardiac MRI, you could (theoretically) spin that into both applications. But realistically you'd want to use a bunch of your elective time working in your field of choice, and you'll have to choose between the two.

Probably your best choice is to plan for Cards/GI. You could apply for Radiology in your PGY-2 and see what happens. Your best chance may be at your home institution. If that leads nowhere, then you continue with Cards/GI. This assumes that your Univ allfiated program has a history of placing people in those fields -- if not, then you would need a serious push to get a spot in one of these fields, and should not mess around.

Best of luck.

 

[DarkHorizon]

Are you a USMD or USDO? Chances of this happening are much higher if USMD. Also, you should have matched the first time if USMD if you targeted the right programs.

 

[TorturedSoul]

Are you a USMD or USDO? Chances of this happening are much higher if USMD. Also, you should have matched the first time if USMD if you targeted the right programs.

USMD, it seems this year was much more competitive than years before. I know people who had much better scores than me who ended up not matching either.

 

[TorturedSoul]

Thank you everyone for taking the time to respond!

I really just wanted to know if it was possible. It seems like it is, but just very difficult, which is understandable. I guess I'll take it one step at a time and see how intern year goes and take it from there to decide (and see what the opportunities I would have available) to pursue cardiology, GI, or rads.

Thank you!

 

[deleted480308]

I am sorry I think you misunderstood me, I would definitely not be applying out. That is why I mentioned it would be to an advanced specialty. If I were to apply as a PGY-2 and I matched I would not start until after internal medicine residency was over.

However, I do appreciate your concern, and I also hope I end up happy regardless of whether I match or not. Thank you for your responses!

Correct, I didn’t catch that part of the post. My apologies