Second round, Second thoughts

[BlackJack]

I didn't match in round one, hence the obvious title.

 

I've applied for some things in the 2nd round, but I am having serious doubts as to whether my heart is in these backup fields. Whereas my classmates have some excitement for starting their respective residencies, I am entirely ambivalent. Maybe I'll grow to like the work, but maybe I won't and will be stuck with my decisions indefinitely. That would be miserable.

 

I've always been told never to match to something you could not see yourself doing, but I don't think I have the liberty to abstain from matching. I have no money, my family has no money, I have an extreme debt-load, and I have no job-ready skills to put to use in this jobless economic climate.

 

Should I just say screw it, suck it up, and take some residency position somewhere just so that I have one, even though I might not have any inspiration to do it? Or should I take another kick at the can next year, and also apply to the USA? I really don't know what to do.

 

 

I'm not going to say what I'm applying to so that I preserve confidentiality.

[yellow]

I say just do it BlackJack. I'm sure it's a huge pain to do something you don't want to do. But try to look past the haziness and find something you could remotely like. You never know, but you might actually like what you end up choosing. (it's possible...don't shake your head)

 

 

Also at the same time, it's not the end of the world. I've heard many stories about how people have switched post match. Even though it may be frowned upon, or the contract may be "binding" who gives a crap; life happens. It's your career - advocate for yourself, pick a program director that will look out for you, and start making good contacts with people who will advocate for you.

[pilotgirl]

Hey BlackJack,

 

I think your concerns are definitely understandable. People have always said not to match to something unless you see yourself doing it in the future. If you find yourself doing this anyway, the outcomes might include:

 

1) You grow to like it

2) You switch out and do something you like more -- this has gotten easier because you take the funding along WITH you...so the recipient program usually has no problems as long as they have the room for you in their training program. It's easier to switch to a five-year program from a five-year program because of funding.

3) You do it for a few years, hate it, apply for residency again

4) You marry rich.

 

For me, I could live with any of these options. Ultimately, it comes down to what you're willing to put up with in the meantime. Hey, I once met a dude who completed a residency in neuropathology, found out that he didn't like it, did yet another residency in neuroradiology and is happy as a clam.

 

Good luck!

[BlackJack]

I don't know which program directors would actually look out for me. I've phone interviewed with a few, but they don't know me, and I can't gauge someone without actually meeting them. Who is to say that they'd actually be fine with losing a resident should I decide to switch out in the future? That puts a lot of burden on the other residents in their program. Sure its fine if you can find someone else to switch in and take your place, but there weren't really any positions in the second-round this year that had that kind of "leverage".

 

Do PDs expect their 2nd draft picks to want to switch? Do they tend to make things more difficult for them, or do they want to see the resident be content elsewhere? I know its hard to generalize...

 

This may be province-specific, but I've always been led to believe that your funding only stays with you in the province to which you matched. If you want to go to another program outside of your province, it becomes many orders of magnitude more difficult because your funding doesn't go with you. Is there any truth to this?

 

Would you say that trying to match to a 5 year program is essentially the right thing to do, just to get the funding if I need it to switch? So, I should put things like family (2yrs) and internal (3yrs) down near the bottom of the rank list?

 

One more thing: if I match at all, in anything, I'll never again be able to do first round of CaRMS, which severely decreases my residency choices. Some places have "re-entry" positions, but these are few and far between, and very limited in options. That's another reason for me to not enter the 2nd round, but I don't think I can afford it. If I wasn't so uncertain about my financial future, I would without hesitation bow out of the 2nd round.

[pilotgirl]

Disclaimer: the following represents my own opinion. Please take it with a grain of salt!

 

I don't know which program directors would actually look out for me. I've phone interviewed with a few, but they don't know me, and I can't gauge someone without actually meeting them. Who is to say that they'd actually be fine with losing a resident should I decide to switch out in the future? That puts a lot of burden on the other residents in their program. Sure its fine if you can find someone else to switch in and take your place, but there weren't really any positions in the second-round this year that had that kind of "leverage".

 

Personally, I would say that ALL PDs have a certain level of suspicion...they're certainly less naive than we are. The key is having a reason why you want to do specialty 'x'. Practice your "spiel", make it believable. The more truthful you can make it, the more convincing it is. I hate lying but anyone who interviewed for more than two specialties had to do it. Others called it "playing the game".

 

Ideally, you match to a specialty that you can live with. It may not be your first choice but you might grow to love it.

 

Do PDs expect their 2nd draft picks to want to switch? Do they tend to make things more difficult for them, or do they want to see the resident be content elsewhere? I know its hard to generalize...

 

I don't know if they expect them to switch but I would think that they're on the look-out for them.

 

This may be province-specific, but I've always been led to believe that your funding only stays with you in the province to which you matched. If you want to go to another program outside of your province, it becomes many orders of magnitude more difficult because your funding doesn't go with you. Is there any truth to this?

 

I have no idea. Do you have a career counselor that you can ask? PAIRO?

 

Would you say that trying to match to a 5 year program is essentially the right thing to do, just to get the funding if I need it to switch? So, I should put things like family (2yrs) and internal (3yrs) down near the bottom of the rank list?

 

Hah! I don't know if it's the "right" thing to do. When it comes to CARMS, it's not black or white, just shades of grey.

 

Would you rather do family or internal, or would you rather have that glimmer of hope that you'll be able to switch? That's for you to really think about and decide.

 

One more thing: if I match at all, in anything, I'll never again be able to do first round of CaRMS, which severely decreases my residency choices. Some places have "re-entry" positions, but these are few and far between, and very limited in options. That's another reason for me to not enter the 2nd round, but I don't think I can afford it. If I wasn't so uncertain about my financial future, I would without hesitation bow out of the 2nd round.

 

It sounds like you're determined to enter the 2nd round then. Hang in there! Only a few more days to go!

 

Good luck!

[Lactic Folly]

This may be province-specific, but I've always been led to believe that your funding only stays with you in the province to which you matched. If you want to go to another program outside of your province, it becomes many orders of magnitude more difficult because your funding doesn't go with you. Is there any truth to this?

 

I've heard this as well...

[JCTulip]

I do not fully understand your financial hardship, but if you can find some way to make it through next year, I'd say apply again to both US and Canada in the specialty you want, not the back up you may or may not like for the rest of your career.

 

3 cases from UBC who did not match in their respective competitive specialty, and all ended up in radiology the next year

 

(1) Indianna radiology (top 20 program)

 

(2) UPenn radiology (top 10 program)

 

(3) a radiology program in Canada in the following year's CaRMS.

 

Hence it can be done to match into a competitive specialty the next year.

[BlackJack]

I do not fully understand your financial hardship, but if you can find some way to make it through next year, I'd say apply again to both US and Canada in the specialty you want, not the back up you may or may not like for the rest of your career.

 

3 cases from UBC who did not match in their respective competitive specialty, and all ended up in radiology the next year

 

(1) Indianna radiology (top 20 program)

 

(2) UPenn radiology (top 10 program)

 

(3) a radiology program in Canada in the following year's CaRMS.

 

Hence it can be done to match into a competitive specialty the next year.

 

Your post shows that it is indeed possible. However, all of these applicants came from UBC, which is a school that is visible to the Americans. The school I go to is not UBC, nor is it Toronto or McGill. Ian mentioned in a previous post that applying to the USA from a Canadian school that is not a "name" school may make securing a residency spot far more difficult since the schools do not want to gamble on an unknown person with an unknown education.

 

I'm very very close to hitting the "withdraw from match" button, but I do not have a reasonable back-up plan if I do.

[JCTulip]

Your post shows that it is indeed possible. However, all of these applicants came from UBC, which is a school that is visible to the Americans. The school I go to is not UBC, nor is it Toronto or McGill. Ian mentioned in a previous post that applying to the USA from a Canadian school that is not a "name" school may make securing a residency spot far more difficult since the schools do not want to gamble on an unknown person with an unknown education.

 

I'm very very close to hitting the "withdraw from match" button, but I do not have a reasonable back-up plan if I do.

 

I agree to a certain degree.

 

Though I doubt that UBC is a well-known school in the US, and question the importance of reputation of Canadian schools in the match process.

 

I think though, the decision weighs more on your confidence and commitment to do the following:

 

(1) do well on USMLE step 1 and 2 (I'd say >240 on the exams)

(2) build up a strong CV quickly from now until Sep

(3) secure better letters of reference

 

and

 

(4) find the money to make it through the process - as it is awefully expensive to apply broadly to the US programs. With exams, applications, and interviews, I am roughly estimating that you'll probably need to gather 10-15K just for the application.

 

All at the same time, keep in mind that statistics show re-applicants don't do well in the CaRMS match in general for a variety of reasons discussed above and in other threads.

 

It is definitely a huge gamble of your time, money and mental health - and the worst case scenario is that you end up exactly where you are today, one year from now, going into round 2.

 

Personally, I am a risk taker and would exhaust all possible means before settling for something else. But that's just me.

 

I wish you luck!

[Ian Wong]

Hi there,

 

Just wanted to comment on a couple of the points that have been discussed. I think that UBC is not particularly well-known in the US outside of the west coast.

 

It is still possible to match into the US for radiology coming out of a "not so famous" med school. At this time, I know of Canadian citizens doing US radiology programs who have come out of U of A and U of M, currently in university programs in the US. I have one Canadian citzen friend currently in a strong community radiology program in the US who graduated from an Irish medical school. Granted, the two university programs are not necessarily the strongest ones out there, but if you are willing to apply very broadly, and IF you can do very well on the USMLE Step 1 exam, you have a reasonable chance of matching into a US radiology program.

 

One factoid that I would mention is that this year was one of the most competitive years to match into radiology in the US since the 2003-2004 cycle (ironically, the year that I applied). There were many US med students who either slid much further down their rank lists than is typical, or who didn't match outright. You can see the discussions regarding this on Auntminnie.com, which has interactive forums populated by med students, and to a lesser degree, by residents, fellows, and attendings.

 

I really don't know how to advise you. If you feel extremely passionate about a given field, and are willing to burn a year, and the corresponding finances for it, it may be worth spending that year upgrading your application, and then pan-applying in Canada and the US. This will cost you a significant chunk of money, and has no guarantee of success. However, the day you match into that specialty is a day that has no better feeling associated with it.

 

I took the year off, but I had my family's backing in order to do so. It took a lot of extra cash to afford to live for that year, as well as pay for the massive costs of interviewing and travelling. This doesn't even include the fact that you are de facto forfeiting a year of attending-level salary, as you are delaying your entry into the work-force (that 1 year of salary compounded over your career adds up to a LOT of money).

 

On the other hand, if there is another specialty you could see yourself doing, or if taking that year off is simply not a feasible option for whatever reason, then I vote taking the spot that comes, and doing whatever you can to either learn to love or at least appreciate that alternate specialty. However, you don't want to stick yourself into a specialty that you can't tolerate, because you may not be able to switch out of it with any ease.

 

I wish you the best of luck in your decisions. I don't envy your position; it's a tough choice either way.

 

Ian