Rheum rotations

[Balo]

Hi, wanted to know what people's opinions were. I have a particular geographical location I prefer that is far from my current location and am considering doing an away there, but a lot of those programs would probably be deemed "reach" or highly desirable due to university name brand and thus highly competitive. I likely will have 4 weeks each for 2 away rotations. Would it be better to rotate at a seemingly less prestigious program even though the location is not my preference or would it be better to rotate at my desired location even though the competition is likely stiffer? I will probably do one rotation at one of those nearby fellowships but then I have an open slot for either a competitive away in a place I would like to live long-term or a more community kind of program in a place I wouldn't normally consider (will apply broadly).

I'm not a very competitive applicant at this time but would like to shoot my shot. Am working on a case report that isn't published yet. Also planning on going to a conference. I have a benchwork paper from med school in a different field. Have a QI project in a different field as well although it is clinic-based. Volunteered in sports med as well. I will likely be able to get 1-2 rheum letters and a letter from PD; I may also ask PCP for a letter if that helps speak towards my clinical ability out-patient. Passed all levels, no STEP.

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[Legend of Link]

Hello. if you have a good app I think your chances of matching at your desired locale is high. Also if you can get a letter from those high reach places it will boost your app more. However, if you think your app is not strong, I would rotate at the less competitive places since that will expose your face more to those faculties and you will have high chance of getting interviews/ matching there. I would split up your 4 weeks as 2 weeks at high reach place and try to get a letter and 2 weeks at the less known place so they get to know you and you can try to get a letter there as well.
Aside from that, just wondering what made you choose rheumatology over other specialties? I'm a pgy-1 trying to figure out between allergy vs. Rheumatology vs. Endo (was thinking heme onc before but gave up on that cause I'm tired of the rat race of matching a competitive fellowship)

 

[dozitgetchahi]

Rheumatologist here.

Not sure it really matters that much. It’s hard to excel on this type of rotation if you’re not affiliated with the institution and don’t know the ropes of how the hospital works, the EMR, etc.

I was a fellow at one of those “name brand” institutions and we had a number of these away rotators come through during my fellowship. The faculty generally said they weren’t all that impressed with these rotators, although I’m not sure that was because of any specific deficiency in them - more that it’s just hard to look good in a 4 week period at an institution you’ve never been to before.

Rheum is more competitive than it used to be, although not extremely so. When I applied I had only done a rheum rotation two months before the app deadline - just then, I decided I liked it. I had no rheum research but I had a couple of good letters. I was a DO, came out of a mid tier academic IM residency and did pretty well as a resident. I went to a very good rheum program in my desired locale. So it worked out.

 

[anaphyrelaxed]

Hello. if you have a good app I think your chances of matching at your desired locale is high. Also if you can get a letter from those high reach places it will boost your app more. However, if you think your app is not strong, I would rotate at the less competitive places since that will expose your face more to those faculties and you will have high chance of getting interviews/ matching there. I would split up your 4 weeks as 2 weeks at high reach place and try to get a letter and 2 weeks at the less known place so they get to know you and you can try to get a letter there as well.
Aside from that, just wondering what made you choose rheumatology over other specialties? I'm a pgy-1 trying to figure out between allergy vs. Rheumatology vs. Endo (was thinking heme onc before but gave up on that cause I'm tired of the rat race of matching a competitive fellowship)

If you want to get out of the rat race (get a fellowship with little to no work) consider endo, sleep, or just do general IM.

Allergy was the third most competitive speciality for IM last year based on NRMP match data (match rate 72%), right behind GI/Cards. Heme/Onc had a 77.5% match rate. All four had >99% fill rate. To highlight doz’s point, Rheum had a 77.9% match rate, the same as Heme/Onc. Allergy seems to be getting more competitive, last year was particularly tough, though it’s unclear if this trend will persist or not where in the past, heme/onc has been more competitive.

Either way, if you want a desirable specialty in IM, you’re gonna have to do some amount of work/grind for it. ID, Nephro, Sleep, Geri/Pali (>90% match rate) are the specialties you can walk in to, but for obvious reasons.

 

[Residentdoc86]

Second @dozitgetchahi, it is hard to show your stuff in 2-4 weeks, especially if you don't have access to their EMR.

Rheumatology is getting very competitive. I'm finishing from a "name brand" institute. I applied after working 4+ years as a PCP. I had strong Rheum LORs because I schmoozed with the Rheum department at my PCP job and got to work on a book chapter and meta-analysis that later became an ACR abstract after I matched. Also did various volunteer stuff for my local and national ACP. I will say the 2 classes that came after me had much more impressive stats and publications, and most were in-house MD-PHD residents. This is your competition for "name-brand" programs. I was the only non-in-house applicant accepted in my year.

Does your current program have affiliated outpatient rheum attending you can work with? If so I say try to secure a 4-week rotation at the "name brand" institute, impress a couple of attendees, make sure they know you are applying, and pray they write you a LOR. 1-2 strong LORs from the name brand will help.

Try to present a poster, research, or thieves market at ACR or even CCR (Clinical Congress of Rheumatology). It's a good experience and a lot of PD are there and may remember you. I went to CCR last year and the current president of EULAR and queen of Lupus were both there. Great place to "schmoozed".

Shoot your shot!

 

[NewYorkDoctors]

sleep is a decent backdoor for PCCM . just saying dark horse pathway.