Last minute backup with family

[garlic]

Was feeling confident about matching to my first choice specialty anywhere across the country this year, and so wasn't planning to backup. But as the carms deadline gets closer, I find my anxiety about going unmatched skyrocketing. I've now decided to put in a last minute app for family but have no idea how to go about this, with only 1 month left to gather sufficient reference letters.

For context, I have 4 weeks pre-carms of IP urban family and 1 med ed family project on my CV (not published or presented). My electives and research are completely geared towards another specialty that has no overlap with family in terms of scope/practice model/etc.

My letters for family will not be of great quality and will all be from third year. So there is likely no point applying to places like UBC/Toronto/Calgary. I was wondering what are some programs where I have a decent shot, without being in the middle of nowhere? 

Any advice would be really appreicated, as my school's advisors have not been helpful AT ALL and most of my friends are either going for surgical specs or family/IM 

[ArchEnemy]

My two cents: apply first and decide later.

You can choose not to rank the FM programs if you change your mind after interviews, but not the other way round. The downside is that you lost a few hundred dollars (nbd).

Good luck!

[JohnGrisham]

Would you rather do family, than re-apply the following year to the speciality? Thats a question you should ask yourself, because obviously you spent a lot of time and energy to that field. You can always apply to those family programs the following cycle if you really would be okay with them, rather then unmatched a 2nd time. 

if the answer to the question is yes, then do what archenemy said and apply to some FM programs this year. If not, i dont think its worth spreading yourself even further thin to programs you wouldn't be happy with (based on what you said about middle of nowhere), acknowledging that you would rather be in "UBC/toronto/calgary" but feel you wouldn't have a strong app for them and not apply this current year.

[Lactic Folly]

Given you said there is no overlap between FM and your specialty of choice, is there any other reasonable backup specialty, even if your CV is not geared towards that field? Is FM genuinely your second choice of career?

I can't advise on programs, but as you said, FM programs in popular locations will be competitive. There are other less competitive specialties from which it might be easier to transfer into FM than the other way around.

With regards to applying to something that is obviously not your interest on paper, I was told once that you can make the point in your personal statement "yes, I like {my first choice}... and I also like FM." Probably our FM posters could comment more on how effective this is likely to be.

[1D7]

Your best shot is at your home school. Despite having absolutely horrendous applications for FM for our home school, most of the specialty students who didn't match to their first choice discipline were able to back up into it at our home school. Almost all the few remaining unmatched ones were able to find 2nd round spots. Most of these people had at most 2 weeks of electives in FM.

I advise ranking all programs though still since you can usually transfer into FM—and hey, maybe you'll end up liking the specialty you originally wanted (unless it's a terrible lifestyle specialty, cuz if you don't like it now you're probably going to hate your life as a R1).

In terms of extra spots I'd advise checking out the 2nd round availabilities in the last 2 years.

[Intrepid86]

Can't speak for others, but if I saw an application where applying to FM seemed to be an afterthought, I would give it the same amount of consideration that the applicant gave us (i.e., not much).

[JohnGrisham]

21 hours ago, 1D7 said:

Your best shot is at your home school. Despite having absolutely horrendous applications for FM for our home school, most of the specialty students who didn't match to their first choice discipline were able to back up into it at our home school. Almost all the few remaining unmatched ones were able to find 2nd round spots. Most of these people had at most 2 weeks of electives in FM.

I advise ranking all programs though still since you can usually transfer into FM—and hey, maybe you'll end up liking the specialty you originally wanted (unless it's a terrible lifestyle specialty, cuz if you don't like it now you're probably going to hate your life as a R1).

In terms of extra spots I'd advise checking out the 2nd round availabilities in the last 2 years.

I think this is school by school basis. Certainly at the more popular programs like UofT, UBC and UofA, this will not be easy to back up into FM.

[JohnGrisham]

4 hours ago, Intrepid86 said:

Can't speak for others, but if I saw an application where applying to FM seemed to be an afterthought, I would give it the same amount of consideration that the applicant gave us (i.e., not much).

Definitely a common sentiment, but some FM programs in "less desirable" provinces will definitely still rank to fill.

[IMislove]

What if you have an elective or two in a rural FM Ontario program, and you wanna do the rural sites, sure it's backing up but are your odds good? I would not be interested in the more urban programs. Plus rural fam med career is more appealing to me for personal reasons.

[JohnGrisham]

On 10/20/2019 at 9:37 PM, IMislove said:

What if you have an elective or two in a rural FM Ontario program, and you wanna do the rural sites, sure it's backing up but are your odds good? I would not be interested in the more urban programs. Plus rural fam med career is more appealing to me for personal reasons.

Everyone says rural FM is appealing to them hah.  Rural spots in desirable provinces are still reasonably competitive due to having so few seats. 2 seats at a program isnt a whole lot, especially if those programs have feeder students from longitudinal clerkships, students who grew up in that region (automatic boost often) etc. 

If you add spots in less desirable, poor weather, minimal amenities rural training sites then odds are probably okay. 

 

Hard to sell loving IM which is predominantly big city specialty centre training versus boonies in Saskatchewan rural FM, but many rural sites that are less desirable will rank to fill.

 

 

[IMislove]

2 hours ago, JohnGrisham said:

Everyone says rural FM is appealing to them hah.  Rural spots in desirable provinces are still reasonably competitive due to having so few seats. 2 seats at a program isnt a whole lot, especially if those programs have feeder students from longitudinal clerkships, students who grew up in that region (automatic boost often) etc. 

If you add spots in less desirable, poor weather, minimal amenities rural training sites then odds are probably okay. 

 

Hard to sell loving IM which is predominantly big city specialty centre training versus boonies in Saskatchewan rural FM, but many rural sites that are less desirable will rank to fill.

 

 

Luckily I am not GTA and live close to some of the rural programs hence my interest. Good to know, I’ll keep that in mind when clerkship rolls around and see if my path changes more to fam.

[Edict]

On 10/20/2019 at 4:05 PM, Intrepid86 said:

Can't speak for others, but if I saw an application where applying to FM seemed to be an afterthought, I would give it the same amount of consideration that the applicant gave us (i.e., not much).

Yet judging from past experience, very few programs do this apart from maybe UofT or UBC family. OP definitely should backup if they can see themselves doing family over being unmatched. You probably won't have the strongest application but have a reasonable chance of matching somewhere. Just apply broadly. My advice is to apply broadly, you never know and honestly 40 bucks is way cheaper than the opportunity cost of waiting it out another year. 

[blah1234]

I would always recommend to my learners to backup and apply broadly. You may not get the field you are passionate about, but the consequences of being unmatched are too high these days. Even if you hate FM at least you are a licensed individual practitioner and have access to many jobs that require it. Many unmatched students have very few options moving forward which is a tragedy. 

[garlic]

Thanks for the feedback guys. I've perseverated over nothing else for the past week hahah. Going to give family a go...guess I'm not as big a gambler as I thought. It's a bad fit but probably a better idea than backing up with Gen Sx (which I could spin my CV for). 

On 10/19/2019 at 7:51 PM, 1D7 said:

Your best shot is at your home school. Despite having absolutely horrendous applications for FM for our home school, most of the specialty students who didn't match to their first choice discipline were able to back up into it at our home school. Almost all the few remaining unmatched ones were able to find 2nd round spots. Most of these people had at most 2 weeks of electives in FM.

I advise ranking all programs though still since you can usually transfer into FM—and hey, maybe you'll end up liking the specialty you originally wanted (unless it's a terrible lifestyle specialty, cuz if you don't like it now you're probably going to hate your life as a R1).

In terms of extra spots I'd advise checking out the 2nd round availabilities in the last 2 years.

Been going over data from the past 5 years but it's been so variable, especially with the surge of unmatched students and some ?UGME-PGME dealings last year. Like, what happened to Ottawa with 31 seats after first round last year?? And am I misinterpreting the point when I conclude Western is a safer bet compared to, say, Alberta which has only had 0-4 empty spots each year recently?

[IMislove]

25 minutes ago, garlic said:

nothing else for the past week hahah. Going to give family a go...guess I'm not as big a gambler as I thought. It's a bad fit but probably a better idea than backing up with Gen Sx

As I think I may be in similar boat as you in a few years, curious why gen sx is not something your considering if you got surg spec as your primary? Lifestyle reasons or other? Thank you!

[Arztin]

Don't get fooled by the empty seats after first round. 

Ottawa FM is known to not rank a whole lot of applicants, and the fact that it isn't filled isn't because they don't have enough applicants.

There are FM programs that don't rank people at all from their home med school if they felt like you want a specialty other than FM.

For now, apply first then decide later.

My 2 cents: it's better to be matched in a rural FM program than getting unmatched.

[LittleDaisy]

On 10/25/2019 at 12:29 AM, Arztin said:

Don't get fooled by the empty seats after first round. 

Ottawa FM is known to not rank a whole lot of applicants, and the fact that it isn't filled isn't because they don't have enough applicants.

There are FM programs that don't rank people at all from their home med school if they felt like you want a specialty other than FM.

For now, apply first then decide later.

My 2 cents: it's better to be matched in a rural FM program than getting unmatched.

I second Arztin. I had friends who were strong FM candidates, who didn't get invited into Ottawa FM programs. 

FM programs don't have to rank all the candidates and invite all of them to interviews, if they feel that you are not a good fit. 

To OP, I would back up with FM programs. Going through second round or being unmatched carries a lot of stigmatization. Depending on your medical school, the support may be there to do a 5th year or not. I won't risk your future career and take CaRMS cautiously. 

Just my two cents

[garlic]

I appreciate your input! 

Understandably FM programs don't want to waste their time with people who are obviously backing up. That's totally fair!
But on the flip side, how are we weak FM candidates supposed to figure out which places we actually have a shot at, if the carms data is kind of falsely reassuring (as in the case of Ottawa)?? Are we just supposed to find out by word of mouth? 

As a corollary, are our chances better applying to smaller locations with 4 seats, or bigger locations like Edmonton that have >50 seats? A lot of the smaller ones ask for reasons for choosing/ties to the area, which I just don't have.

I agree that it's too big a risk to not back up --- but I also don't want to shotgun everywhere and spread myself thin for a basically 0 chance at some sites...

 

 

[garlic]

On 10/24/2019 at 7:58 PM, IMislove said:

As I think I may be in similar boat as you in a few years, curious why gen sx is not something your considering if you got surg spec as your primary? Lifestyle reasons or other? Thank you!

Nice! A lot of big decisions coming your way in the next little bit!

My case is a bit different so YMMV. My first choice specialty isn't a surg spec. It just happened along the way that I got invited onto a few projects by various gen sx staff. Did an elective in it this year just because I enjoy the scope, ended up getting two letters offered (albeit for my main specialty...likely would not have impressed them enough had I been a gen sx hopeful lol). After that I genuinely considered gen sx, and asked residents for their candid advice. Most R1s were still excited but the R3/4s were kinda more "you gotta love the job more than anything and anyone else". One girl was living in a basically empty apartment without furniture since she never went home anyway. Another guy missed his anniversary and kids' birthdays for the past 3 years in a row. Etc etc. Ultimately knew I could not handle the lifestyle...and anyway 4 weeks is not enough to compete with people going for the specialty imo!

I kind of rambled but hopefully you found some of it helpful. Or at least mildly entertaining