Year off vs. Straight through for internal competition?

[socal1234]

Hi All, was hoping for some advice? I'm in a residency program (pretty reputable) and there will be 15-20 people applying to cardiology this upcoming cycle (with some chiefs). I think the fact that I wont be able to stay has been making me upset and I don't know if its worth taking a year off to maximize chances at other big programs? I want to be an academic sub sub specialist and want to ideally end up in one of the big Boston/East Coast programs or West Coast. I am probably in the mid level of those 20.

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[drk]

if you decide to sit out this cycle, you will still be applying for fellowship at the very end of your third year/beginning of your off year.

How much will you gain? Likely nothing. Your off year production will not be seen until two match cycles later.

At the same time, there will always be more competitive applicants coming up.

 

[Eyeaboutthat]

since you're ok with ending up in either coast, why not just apply broadly. you'll probably get enough interviews to end up in the top half of your list

 

[cardsguy2017]

I'm not sure I quite follow, but it seems you think you currently aren't competitive and were hoping your home program would still take you anyway. That's not how it usually works. Programs will take the best candidates period. What's your app look like now? Any research so far? You may very well be competitive enough to apply now. Nevertheless those big time academic coastal programs are very competitive, partly due to location too. You may not even match after a year off. What are you career goals? There's nothing wrong with going to non-coastal program or a lesser program and still pursuing or making it big in academics.

 

[socal1234]

Competitive overall(published several times in med school, top 10 medicine program), but home program has a lot of internal competition (chief, fast trackers) limiting the likelihood of being able to stay. Hope to stay in imaging research. The idea of starting over in a new city also scares me.

 

[cardsguy2017]

I'd apply and see what happens. You'll likely match somewhere. The year off may or may not help much, I'd lean towards the latter. It's opportunity cost waiting another year. It's up to you how much it's worth improving your chances or how much you feel the need to be at a certain program. But it may only be more competitive next year. IMO, doing fellowship at a different program you get to see how different people/hospitals practice medicine, it's an opportunity for learning and growth.

 

[deleted980918]

Unless you are dead set on staying in your home program, I would apply given your competitive application. An extra year likely won't add much and may even hurt if you are not productive research-wise or not doing a chief year instead.

 

[thecalccobra]

I would go ahead and apply. If you’re a competitive applicant from a top 30 IM program, you’ll match well regardless of how many people from your class are applying.

To give you an example, CCF had 20+ people match into Cardiology at pretty decent programs.

 

[MyTachyBradyHeart]

Competitive overall(published several times in med school, top 10 medicine program), but home program has a lot of internal competition (chief, fast trackers) limiting the likelihood of being able to stay. Hope to stay in imaging research. The idea of starting over in a new city also scares me.

I would go ahead and apply. If you’re a competitive applicant from a top 30 IM program, you’ll match well regardless of how many people from your class are applying.

To give you an example, CCF had 20+ people match into Cardiology at pretty decent programs.

CCF isn't considered a top-10 IM program. To OP, you should definitely apply. You have a strong application already and will get looks at a lot of top programs. Delaying a year will not help your chances at your home institution. In fact, if my guess of your home institution is correct (top 10, lots of cards, fast-trackers/chiefs, only takes ~3 in-house applicants, etc), your chances will not increase an iota if you take a year off.

On a side note, while moving to a new city and new hospital system is daunting, there is the advantage of 1) learning in a different environment/culture, which makes you a better doctor and 2) there's always the chance that you'll like your new city.

 

[DreamDoc305]

I say apply this cycle and apply broadly.

 

[socal1234]

Do you think not having much scholarly work from residency would change things on that year off decision? (only one abstract) but its hard to make time for research when you're working 90 hours a week...ugh.

 

[shouldigomd]

You are working 90 hours a week... that is malignant as heck or you are doing something very wrong...

How are you so convinced you want an academic research based career without having done any research during residency?

Just apply and if the quality of the programs don't meet your standards than you can rank vs not rank.