What you need for a top heme/onc program

[scarletgirl777]

I'm still an MS3 but I have some questions about onc fellowship. First of all I apologize bc IM fellowship apps are a big black box to me, but since I'm 100% sure that I would not want to do general internal medicine I have some questions about it. What kind of things help someone get into a top academic heme/onc program? What matters most on your app? How much do things from medical school count? Are evaluations from your time as a PGY-1/PGY-2 an important part of the process? How competitive is onc compared to other IM fellowships?

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[gutonc]

I'm still an MS3 but I have some questions about onc fellowship. First of all I apologize bc IM fellowship apps are a big black box to me, but since I'm 100% sure that I would not want to do general internal medicine I have some questions about it.

What kind of things help someone get into a top academic heme/onc program?

The same kinds of things that matter to get into a top academic IM program. Research, LORs,research, evals, research, board scores, research.

What matters most on your app?

Nothing matters the "most." Lots of things matter a lot.

How much do things from medical school count?

Research counts. So does AOA. Nobody cares about anything else.

Are evaluations from your time as a PGY-1/PGY-2 an important part of the process?

Insofar as they affect the letter your PD and other LOR writers will send, they matter quite a bit. But you're not getting graded in residency the way you are in med school.

How competitive is onc compared to other IM fellowships?

Not quite as competitive as cards or GI but close. More competitive than the rest (ignoring A&I here since that's a pretty niche specialty).

 

[Nadir]

Where you come from matters for the top places. Dana Farber famously almost exclusively takes their own, Sloan-Kettering takes from everywhere but gives Cornell a lot of their slots. MD Anderson takes from everywhere without much preference to any one program. Other places like UW, Penn, Hopkins, are also diverse but have a clear bias towards graduates of strong IM programs.

Letters are important--both who they are from (one of the perks of a "name brand" residency program) and what they say about you.

If you are coming from the right program (or I suppose "tier" or program), research matters insofar as you need something to talk about on interviews, but it does not need to be much. You can match at a top place and not have published. I think conventional wisdom is that you should at least have a project going when you interview so you can tell people about it and demonstrate some academic curiosity.

Of course, a lot of this doesn't apply if you are an FMG, or coming from a smaller IM residency..with any of those, you'll have to kick up your application couple notches to be taken seriously.

 

[Danbo1957]

For academics you need strong research, good to high Step scores, and a recognised ability to teach (a good recommendation of your R3 work).

MDAnderson does take from everywhere, they want clinical exellence first. But, they also always have several instate fellows on their current roster.

 

[twocentnews]

I'm an OMS-1 but I have always been interested in Heme/Onc. When you guys say research, when are we supposed to get that? I applied for some summer research opportunities, but those are always super competitive and if I don't get them, I don't know what else or when we are supposed to try to earn that part of the application? Is it during clinical years? Rotations?

Thanks for the help, really appreciate it. I guess even as a med student, I am still not fully sure how to go about becoming what I want to become...

 

[scarletgirl777]

Thanks to everyone for all the helpful replies!

 

[Nadir]

All you really need is some sort of clinical research project during residency. Again, doesn't have to be much. Obviously the more the better.
Anything you do beyond that...basic science, summer research during medical school etc, can only help, but I wouldn't get too worked up about it. That kind of thing will help with residency placement though, which in turn is pretty important.

 

[DrVanNostran]

OOC, how many places do people typically apply and interview at?

 

[gutonc]

OOC, how many places do people typically apply and interview at?

Definitely fewer than for residency but it varies. I applied to 10 and interviewed at 8, I have colleagues who interviewed at as few as 1 (crazy IMHO) and up to 20.

 

[Robot Skeleton]

I have a related question--how important is it to train at a top hem/onc program if your goal is to eventually work in private practice? That is to say, would you face significant hurdles in landing a good job if you don't come from a top notch program?

 

[carrigallen]

That is to say, would you face significant hurdles in landing a good job if you don't come from a top notch program?

While it may carry some name-brand value for the practice, it isn't critical. Actually most top notch programs don't want to train private practitioners, and doing 1 year of research at that program may be a waste of time for both you and them.

 

[DrVanNostran]

I have started to hit my OMG I do not have enough to match phase. I'm coming from a mid-tier IM program and a mid-tier med school. I have 1 accepted abstract during my IM residency and maybe 1 submitted publication which I should be 1st/2nd author. Step scores >240 and should have some decent LORs. The dream is obviously MDACC (I love Texas, sorry Gutonc), but I know thats a shot in a million. After my malignant heme rotation, I think I am leaning liquids.

Questions:
1. Would applying to 60 programs (including the name brands) be to much; if so how many? I plan on applying to a mix of community and academic programs to get an idea of the training programs.
2. In these last 6 months before the application goes out, anything else I can do?

 

[visari]

I have started to hit my OMG I do not have enough to match phase. I'm coming from a mid-tier IM program and a mid-tier med school. I have 1 accepted abstract during my IM residency and maybe 1 submitted publication which I should be 1st/2nd author. Step scores >240 and should have some decent LORs. The dream is obviously MDACC (I love Texas, sorry Gutonc), but I know thats a shot in a million. After my malignant heme rotation, I think I am leaning liquids.

Questions:
1. Would applying to 60 programs (including the name brands) be to much; if so how many? I plan on applying to a mix of community and academic programs to get an idea of the training programs.
2. In these last 6 months before the application goes out, anything else I can do?

1. If you don't have anything bad on your application (low scores, need Visa, Caribbean grad...etc), applying to 60 programs is way too much IMHO. Let's say you have a realtively good application and you apply to 60 programs. You'll probably get around 20-25 interviews! Will you have enough time and money to go to all these places as a PGY-3?
If you don't have a red flag on your application (not having a ton of published research is not a red flag BTW), narrow your list down to ~30 programs that you can imagine yourself doing a fellowship at. Applying to program X that is mid-tier and located in a boring city that you have never visited and don't know anyone around a 100 miles radius of it is probably a stupid idea. Don't panic looking at some of the outstanding applicants here at SDN. It's a very biased sample of the population. While your application might not be enough for MDACC, it should be fine for a lot of good places.
Also, if your goal is academia why would you apply to community programs?! You can always go to PP regardless of where you train, but you can't go the other way around.

2.Continue working on your research. Don't kill patients.

 

[gutonc]

I have started to hit my OMG I do not have enough to match phase. I'm coming from a mid-tier IM program and a mid-tier med school. I have 1 accepted abstract during my IM residency and maybe 1 submitted publication which I should be 1st/2nd author. Step scores >240 and should have some decent LORs. The dream is obviously MDACC (I love Texas, sorry Gutonc), but I know thats a shot in a million. After my malignant heme rotation, I think I am leaning liquids.

Questions:
1. Would applying to 60 programs (including the name brands) be to much; if so how many? I plan on applying to a mix of community and academic programs to get an idea of the training programs.
2. In these last 6 months before the application goes out, anything else I can do?

Based on what you've shared here previously about your CV, you're going to be a solid mid-tier applicant and get more than enough interview offers. 60 programs is insane. 20-30 should be more than enough but it's your money so do what you want. No reason not to apply to dream/reach programs but be sure to spread your app broadly (which I know you'll do).

And there's not a whole heck of a lot, besides getting that pending publication submitted, that you can do between now and then to increase your chances.

 

[DrVanNostran]

Based on what you've shared here previously about your CV, you're going to be a solid mid-tier applicant and get more than enough interview offers. 60 programs is insane. 20-30 should be more than enough but it's your money so do what you want. No reason not to apply to dream/reach programs but be sure to spread your app broadly (which I know you'll do).

And there's not a whole heck of a lot, besides getting that pending publication submitted, that you can do between now and then to increase your chances.

Thanks

People at my program did 2 things: either apply only Chicago or ~50 programs. I may end up in the latter. I am starting to really want to go out west or down south.

 

[visari]

Thanks

People at my program did 2 things: either apply only Chicago or ~50 programs. I may end up in the latter. I am starting to really want to go out west or down south.

The questions is where would you find 50 good programs in the west or south? there is not even half of that number out there.

One of the main reasons the match is getting difficult and more competitive (from residency throughout fellowship) is that good applicants are applying broadly and cherry-picking later instead of doing some homework before applying. Everyone thinks he/she is being smart and playing it safe, but actually this is getting back at everyone in the end. Programs are getting more applications (a good number of them is from really good applicants who have very little interest in the program) and have to send a limited number of interviews. Some applicants with "real" interest are being screened out and put on waiting lists, and the whole thing is getting messy. Regular applicants used to interview at 5-10 places, but now PhDs/AOA are applying to 30-40 programs and going to 10-15 interviews. I'm not trying to blame you here, because if everyone is doing that you can't be the wise one or you will be screwed. Ideally, applying broadly and randomly to >25 programs should be something that only an IMG/DO/carribean grad/zero research exp./community residency/crappy scores/3 years away from residency kind of applicant does.

Very unfortunate this ERAS panic that is going around!

 

[DrVanNostran]

The questions is where would you find 50 good programs in the west or south? there is not even half of that number out there.

One of the main reasons the match is getting difficult and more competitive (from residency throughout fellowship) is that good applicants are applying broadly and cherry-picking later instead of doing some homework before applying. Everyone thinks he/she is being smart and playing it safe, but actually this is getting back at everyone in the end. Programs are getting more applications (a good number of them is from really good applicants who have very little interest in the program) and have to send a limited number of interviews. Some applicants with "real" interest are being screened out and put on waiting lists, and the whole thing is getting messy. Regular applicants used to interview at 5-10 places, but now PhDs/AOA are applying to 30-40 programs and going to 10-15 interviews. I'm not trying to blame you here, because if everyone is doing that you can't be the wise one or you will be screwed. Ideally, applying broadly and randomly to >25 programs should be something that only an IMG/DO/carribean grad/zero research exp./community residency/crappy scores/3 years away from residency kind of applicant does.

Very unfortunate this ERAS panic that is going around!

I hear what you are saying. I am pretty confident that I am "over" applying but I feel like I have to. IMO, since a majority of applicants do, I think we essentially get the same interviews and match where we would, we just are giving the system more of our money.

 

[IM2GI]

I hear what you are saying. I am pretty confident that I am "over" applying but I feel like I have to. IMO, since a majority of applicants do, I think we essentially get the same interviews and match where we would, we just are giving the system more of our money.

Better to over-apply and cancel/politely decline than under-apply and wish you had. Never know how the interviews will shake out if you can afford it. You will get a sense of how competitive based on the interviews you start to get back. I ended up not getting invited to that many of my "safety" programs because they probably didnt want to waste their time. Programs know the type/region of applicants that they typically match with. Numbers are much smaller for fellowship.