Withdrawing from ERAS and Changing Specialty

[unsurenow1]

Long time lurker.

I'm currently applying to specialty X (won't reveal which one here), but after doing my sub-Is, I just don't know if it's the right specialty for me anymore. I feel like I wouldn't be that happy in this field. I'm an overall good applicant (Step 1 > 250 and several honors during 3rd year), and I've been getting a lot of interviews, so application strength/number of interviews aren't factoring in to these doubts I've been having.

Basically, I was wondering if it would be okay to withdraw from ERAS and the Match this cycle and apply again next fall to another specialty? I wouldn't finish my 4th year requirements, so I would still be classified as an MS-4 for the Match. I was considering switching to IM or anesthesiology, and I would use the rest of this year to do research before doing sub-Is in the new specialty next summer. Would I be at a disadvantage if I withdrew from this ERAS cycle and applied next year to IM or anesthesiology? If I were to do this, any tips to help myself do well in next year's application cycle?

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[ThoracicGuy]

Long time lurker.

I'm currently applying to specialty X (won't reveal which one here), but after doing my sub-Is, I just don't know if it's the right specialty for me anymore. I feel like I wouldn't be that happy in this field. I'm an overall good applicant (Step 1 > 250 and several honors during 3rd year), and I've been getting a lot of interviews, so application strength/number of interviews aren't factoring in to these doubts I've been having.

Basically, I was wondering if it would be okay to withdraw from ERAS and the Match this cycle and apply again next fall to another specialty? I wouldn't finish my 4th year requirements, so I would still be classified as an MS-4 for the Match. I was considering switching to IM or anesthesiology, and I would use the rest of this year to do research before doing sub-Is in the new specialty next summer. Would I be at a disadvantage if I withdrew from this ERAS cycle and applied next year to IM or anesthesiology? If I were to do this, any tips to help myself do well in next year's application cycle?

What is giving you doubts about X? What led you decide on X in the first place? I'm not sure why hiding the field would be particularly helpful, but it hurts us to be able to give the best advice.

 

[AdmiralChz]

Long time lurker.

I'm currently applying to specialty X (won't reveal which one here), but after doing my sub-Is, I just don't know if it's the right specialty for me anymore. I feel like I wouldn't be that happy in this field. I'm an overall good applicant (Step 1 > 250 and several honors during 3rd year), and I've been getting a lot of interviews, so application strength/number of interviews aren't factoring in to these doubts I've been having.

Basically, I was wondering if it would be okay to withdraw from ERAS and the Match this cycle and apply again next fall to another specialty? I wouldn't finish my 4th year requirements, so I would still be classified as an MS-4 for the Match. I was considering switching to IM or anesthesiology, and I would use the rest of this year to do research before doing sub-Is in the new specialty next summer. Would I be at a disadvantage if I withdrew from this ERAS cycle and applied next year to IM or anesthesiology? If I were to do this, any tips to help myself do well in next year's application cycle?

What would your plan be for the intervening year? It's definitely late, but you could consider adding prelim medicine applications - it would definitely be possible to transition over to an open PGY-2 spot somewhere the next year for IM. You could do the same for A/R Anesthesia spots, but they are getting more and more rare each year and it's getting late.

I'd consider talking with some people at your home institution about this if you have some contacts you trust. That's probably your best and most logical shot at changing fields.

 

[unsurenow1]

I chose X because it seemed interesting at first but after doing a couple sub-Is in that field, it just seems routine and not as interesting anymore. The lifestyle that their attendings have isn't appealing to me, and I felt more and more exhausted after my shifts as my sub-Is went on.

The plan for the intervening year would be to do research until July when I can do a sub-I for that new field and prepare for the next ERAS cycle. Is doing something like this unheard of/disadvantageous?

 

[rokshana]

I chose X because it seemed interesting at first but after doing a couple sub-Is in that field, it just seems routine and not as interesting anymore. The lifestyle that their attendings have isn't appealing to me, and I felt more and more exhausted after my shifts as my sub-Is went on.

The plan for the intervening year would be to do research until July when I can do a sub-I for that new field and prepare for the next ERAS cycle. Is doing something like this unheard of/disadvantageous?

its not unusual...its why you do sub-is to begin with...but realize that EVERY specialty is going to become routine and not as interesting...you think that CP or new a fib is an exciting w/u for the cardiologist...or that a GI doctor has the same enthusiasm for colonoscopies as he did when he did his first one? or the surgeon is over the moon about doing an appy?

why would you wait until July to do the sub i? what if you learn then you don't like it?
do the subi - early.

and lifestyle (after residency/fellowship) is what you make of it...

 

[NotAProgDirector]

From an application standpoint, this is perfectly fine. You withdraw your application, withdraw from the match, reapply next year. You will have no problems, and no programs will care / hold this against you. All will be fine.

You could still try to apply this year, but it's late and your options may be limited. Your home program would likely consider you. You could also stay in the match and see what's available in SOAP. Either there will be a great program in there, or not. If so, you apply and see what happens (although in this case, you'd need to stay on track to possibly graduate on time).

Extending your 4th year into 2 years is certainly a possibility. It would give you time to explore both IM and Anesthesia. You should do rotations in them now, not leave it solely for next year. If your school allows you to split your 4th year at "no charge", then this is a great idea. If your school is going to charge you for a 5th year of tuition, you should consider just doing the IM and Anesthesia SubI's now, graduate, and then work for a year and save the tuition. The usual concern is that when you look at the NRMP data, that fresh grads do better in the match than prior US grads. But that data is biased -- most US grads that don't match are people who had problems with their applications, so it's not a surprise that after failing to match, they have more trouble matching. You will do fine whether a fresh grad or a prior grad -- although if all things are equal, I'd extend your 4th year.

 

[unsurenow1]

From an application standpoint, this is perfectly fine. You withdraw your application, withdraw from the match, reapply next year. You will have no problems, and no programs will care / hold this against you. All will be fine.

You could still try to apply this year, but it's late and your options may be limited. Your home program would likely consider you. You could also stay in the match and see what's available in SOAP. Either there will be a great program in there, or not. If so, you apply and see what happens (although in this case, you'd need to stay on track to possibly graduate on time).

Extending your 4th year into 2 years is certainly a possibility. It would give you time to explore both IM and Anesthesia. You should do rotations in them now, not leave it solely for next year. If your school allows you to split your 4th year at "no charge", then this is a great idea. If your school is going to charge you for a 5th year of tuition, you should consider just doing the IM and Anesthesia SubI's now, graduate, and then work for a year and save the tuition. The usual concern is that when you look at the NRMP data, that fresh grads do better in the match than prior US grads. But that data is biased -- most US grads that don't match are people who had problems with their applications, so it's not a surprise that after failing to match, they have more trouble matching. You will do fine whether a fresh grad or a prior grad -- although if all things are equal, I'd extend your 4th year.

I was looking at what you said- I would plan to extend my 4th year into 2 years, and it wouldn't cost me anything extra since my school charges tuition by semester. I would do research until I resume 4th year in fall of 2018, although I am wondering if there are other things I could do that could also be worthwhile.

So if I do withdraw, change specialties, and reapply next year, the most I would have to do would be explain why I switched, right? I wouldn't be disadvantaged at all, and I would still have a chance at top programs provided my stats are good?

 

[NotAProgDirector]

Yes, that's the way I see it. The only trouble you could run into is 1) people assuming that you actually tried to match into X and didn't, and now are applying next year into X and IM/Gas as a backup; or 2) this is all a smokescreen for a bigger issue. The first point is easily addressed -- you'll want one LOR from your mentor in X telling your story -- that you were applying in X, changed your mind, withdrew, now applying to IM (or anesthesia) only. Your X mentor will only write that if true.

The second point, well, there's no defense against that.

 

[Apollyon]

2) this is all a smokescreen for a bigger issue.

On SDN? Well, I never!!

 

[NeurologyHopeful2018]

I agree with aprogdirector. Extend your 4th year. My friend is doing a prelim year since he did not match into a competitive specialty and is now applying to a lesser competitive specialty.

He is going through hell right now trying to take time off during inpatient heavy internship year to travel to interviews - and he is getting not many invites despite superior stats because they all correctly assume he is damaged good that did not match.

 

[HomeSkool]

I'm having a little trouble with the whole "IM vs anesthesiology" thing. Did you mean EM? IM is a very different brand of medicine from anesthesiology. If you're truly undecided between the two, I'm concerned that you're applying for residency without knowing where you belong.

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[Gastrapathy]

Talk to your home program about doing a medicine prelim. Leaves both paths open.