darknebula Posted March 19, 2014 Report Share Posted March 19, 2014 so idk if this sounds obsessive and short-sighted, but location to me is perhaps the most important factor in chosing a residency. For a myriad of reasons, I dont really want to leave my current hometown for residency. I was thinking of setting up pre carms electives in 4 different specialties (all of which i like and would be ok with doing, even if i like 2 of them much more; these are: derm, internal med, rad and ophtho) and then ranking my current hometown (assuming i get interviewed) for my first 4 entries in the rank order list? Is this a good idea? Link to comment Share on other sites More sharing options...
keith_015 Posted March 19, 2014 Report Share Posted March 19, 2014 Unless you are in a SMALL city that ABSOLUTELY LOVES their own, your plan is career suicide. Having 3 very competitive specialities with minimal exposure in each shows you don't know what you want. Fields like that want to see commitment. If you really want Rads, Derm, Ophtho, then prepare to leave your hometown. The way your plan looks, there will be much more focused and competitive applicants than you that might beat you at your own school for the spot(s). Link to comment Share on other sites More sharing options...
Lactic Folly Posted March 19, 2014 Report Share Posted March 19, 2014 +1; what happens if you take a residency in something you're not as interested in just to stay for residency, and then when you graduate there is no opening in your hometown, and you have to move anyway? Link to comment Share on other sites More sharing options...
Nobodycirclesthewagons Posted March 19, 2014 Report Share Posted March 19, 2014 The above two posts make great points. Also, there's no guarantee you'll get a residency spot in your city, especially if you're applying for the specialties you mentioned. Ophtho, Derm are very competitive, and Radiology is also usually very competitive. Internal Med was a lot more competitive this past cycle, also. By your post history, it sounds like you go to UBC. I feel that Vancouver would be a competitive spot for Ophtho, Derm and Rads. I hear their IM program isn't amazing, but Vancouver as a city could be alluring to a lot of people. Splitting your electives across those four specialties would be a mistake and would probably not grant you many interviews. If location is that important to you, your best bet would probably be to gun for Family, Psych or Pathology. Even then, Family and Psych are becoming more competitive. Link to comment Share on other sites More sharing options...
hkmedic Posted March 19, 2014 Report Share Posted March 19, 2014 so idk if this sounds obsessive and short-sighted, but location to me is perhaps the most important factor in chosing a residency. For a myriad of reasons, I dont really want to leave my current hometown for residency. I was thinking of setting up pre carms electives in 4 different specialties (all of which i like and would be ok with doing, even if i like 2 of them much more; these are: derm, internal med, rad and ophtho) and then ranking my current hometown (assuming i get interviewed) for my first 4 entries in the rank order list? Is this a good idea? Yes, ditto everyone else. This is not a good strategy. You're spreading yourself too thin, especially among the ultra competitive specialties. You have to do some honest reflecting. Are you competitive in any of the specialties you listed? Have you been involved with research, etc.? There's no such thing as 'home school advantage' or 'guarantees' with those specialties; you won't be granted an interview just because it's your own school. Maybe IM, but definitely not the others. Link to comment Share on other sites More sharing options...
infamyofinternal Posted March 19, 2014 Report Share Posted March 19, 2014 Short sighted,not everyone is lucky enough to match in their desired area. Link to comment Share on other sites More sharing options...
ralk Posted March 19, 2014 Report Share Posted March 19, 2014 How plausible would a location-first strategy be if you relaxed the conditions a bit? Say, not a highly sought-after city, going for specialties that were less competitive (and specialties with greater overlap in scope). I know nothing would be guaranteed when trying to get the right location, but would there at least be a way to increase those chances to a reasonable level? Link to comment Share on other sites More sharing options...
5th time the charm Posted March 19, 2014 Report Share Posted March 19, 2014 The above two posts make great points. Also, there's no guarantee you'll get a residency spot in your city, especially if you're applying for the specialties you mentioned. Ophtho, Derm are very competitive, and Radiology is also usually very competitive. Internal Med was a lot more competitive this past cycle, also. By your post history, it sounds like you go to UBC. I feel that Vancouver would be a competitive spot for Ophtho, Derm and Rads. I hear their IM program isn't amazing, but Vancouver as a city could be alluring to a lot of people. Splitting your electives across those four specialties would be a mistake and would probably not grant you many interviews. If location is that important to you, your best bet would probably be to gun for Family, Psych or Pathology. Even then, Family and Psych are becoming more competitive. It may be best to narrow down your career choice so you improve your chances. Year over year its hard to know but you don't want to see yourself after all these years of medical school not matching. I didn't know that psychiatry is getting more competitive too so it sounds like students really have to make their decisions soon on in med school and do what they can to have favourable applications for residency spots, irregardless of their specialty choice. Link to comment Share on other sites More sharing options...
Ttoronto Posted March 19, 2014 Report Share Posted March 19, 2014 everyone above make great points. If you are from UBC, ubc is known for taking their own students but when applying you got to accept the risk of not matching there. Usually 50% of UBC grads match outside of BC! Link to comment Share on other sites More sharing options...
A-Stark Posted March 19, 2014 Report Share Posted March 19, 2014 Not an idiot, but this is an extremely risky strategy. Your best bet to matching at a particular program is to perform strongly on an elective there, perhaps a bit later in the fall of your application. Do at least a few other electives in the same specialty elsewhere. If possible, get letters from your core rotations from your home school too. If you have a backup in mind, it should be family or psych or *maybe* IM if you're already a good applicant for it. But all these specialties are actually getting more competitive, and it is always competitive to get particular locations regardless of the specialty. Think about your top choice specialty and whether you will be a competitive applicant. Do one or two electives at your home program in that specialty, have 2-3 elsewhere, and some mix of other disciplines too. Link to comment Share on other sites More sharing options...
darknebula Posted March 19, 2014 Author Report Share Posted March 19, 2014 Abort. bad idea lol. Thank you for the replies everyone! Link to comment Share on other sites More sharing options...
GrouchoMarx Posted March 19, 2014 Report Share Posted March 19, 2014 Not an idiot, but this is an extremely risky strategy. Your best bet to matching at a particular program is to perform strongly on an elective there, perhaps a bit later in the fall of your application. Do at least a few other electives in the same specialty elsewhere. If possible, get letters from your core rotations from your home school too. If you have a backup in mind, it should be family or psych or *maybe* IM if you're already a good applicant for it. But all these specialties are actually getting more competitive, and it is always competitive to get particular locations regardless of the specialty. Think about your top choice specialty and whether you will be a competitive applicant. Do one or two electives at your home program in that specialty, have 2-3 elsewhere, and some mix of other disciplines too. There is always pathology. It is still not competitive, yet is very interesting, challenging, and has a great lifestyle and income potential. Anyone considering applying to a competitive field should think of backing up with pathology. Link to comment Share on other sites More sharing options...
Tonto Posted March 19, 2014 Report Share Posted March 19, 2014 Also the difference bw derm, rads, optho is beyond miles. It doesn't matter how much you like your hometown, if your someone who doesnt like sitting in the dark staring at a computer screen the entire day with very little human interaction, you will be miserable in Rads. Same goes with if you enjoy putting a sharp minature scalpel to someones eye and operating through a microscope as in optho. These fields are vastly different. Now if you wanted, you could take electives in all these to see if you like em. I can gaurantee one of those options you listed you will realize you could not do it your entire life. Its just how it is. Link to comment Share on other sites More sharing options...
dan0105 Posted March 20, 2014 Report Share Posted March 20, 2014 Just throw down Family Medicine at the end of your rank-order-list. Problem solved. Default to family. And as a bonus, because you did one of every specialty, they will be confused with what you are actually into and think you like everything, hence why you are choosing family medicine... the system works. Link to comment Share on other sites More sharing options...
spontaneouscombustion Posted March 20, 2014 Report Share Posted March 20, 2014 ^About the only chance he would have would be family (and IM i guess), since I doubt anyone of rads/derm/optho would touch him with such a scattered elective schedule. Even family would be wary, particularly if you were more heavy on the rads/optho/derm electives. Sounds like a surefire way to go unmatched. Link to comment Share on other sites More sharing options...
burrb Posted March 20, 2014 Report Share Posted March 20, 2014 ^ would not match to the desired IM programs such as Toronto, Mac. It's risky making IM a backup specialty unless you applied across country. Link to comment Share on other sites More sharing options...
jasmineblossom Posted March 20, 2014 Report Share Posted March 20, 2014 Just throw down Family Medicine at the end of your rank-order-list. Problem solved. Default to family. And as a bonus, because you did one of every specialty, they will be confused with what you are actually into and think you like everything, hence why you are choosing family medicine... the system works. "Defaulting" to family medicine is not a guarantee that an applicant will be able to stay in his/her hometown if it is a highly desired city, such as Vancouver. The UBC Family Medicine program is huge, but the # of spots in Vancouver is only 30 for CMGs (12 in Vancouver-Fraser, 12 in St. Paul's, and 6 in Surrey). Those 30 spots are actually competitive. Compare that to 67 in the city of Calgary and 115 in the UofT GTA stream. Family Medicine is becoming more and more popular, as people realize that the job outlook for some other specialties is bleak. I would caution against thinking of family medicine as a "default" program. If one is willing to relocate, then Family Medicine is not a very difficult match to obtain. However, there have been cases of people going unmatched for family medicine when they were not willing to relocate outside of the most popular cities. Link to comment Share on other sites More sharing options...
bbqsauce Posted March 20, 2014 Report Share Posted March 20, 2014 "Defaulting" to family medicine is not a guarantee that an applicant will be able to stay in his/her hometown if it is a highly desired city, such as Vancouver. The UBC Family Medicine program is huge, but the # of spots in Vancouver is only 30 for CMGs (12 in Vancouver-Fraser, 12 in St. Paul's, and 6 in Surrey). Those 30 spots are actually competitive. Compare that to 67 in the city of Calgary and 115 in the UofT GTA stream. Family Medicine is becoming more and more popular, as people realize that the job outlook for some other specialties is bleak. I would caution against thinking of family medicine as a "default" program. If one is willing to relocate, then Family Medicine is not a very difficult match to obtain. However, there have been cases of people going unmatched for family medicine when they were not willing to relocate outside of the most popular cities. If you take a look at the carms site, there were actually 120 spots for CMGs and 36 for IMGs for UBC Family Medicine. https://phx.e-carms.ca/phoenix-web/pd/main?mitid=1201 Link to comment Share on other sites More sharing options...
supafield Posted March 20, 2014 Report Share Posted March 20, 2014 If you take a look at the carms site, there were actually 120 spots for CMGs and 36 for IMGs for UBC Family Medicine. https://phx.e-carms.ca/phoenix-web/pd/main?mitid=1201 30 for Vancouver, not UBC. I think you can also add the 4 coastal spots to that potentially. Link to comment Share on other sites More sharing options...
bbqsauce Posted March 20, 2014 Report Share Posted March 20, 2014 Sorry about that, read it too fast. My mistake. Link to comment Share on other sites More sharing options...
carazadie Posted March 20, 2014 Report Share Posted March 20, 2014 Agree with the above advice. These days it feels like those of us who apply to more than one specialty are shooting ourselves in the foot. Programs want to see a genuine commitment. You can't back up effortlessly with family or psych these days, unless you are willing to go to a less desirable location. I am genuinely interested in two (not overly competitive) fields and would like to apply to both. I have split my electives evenly between the two. My fear is that both specialties will think that I am backing up with them, and no one will want me. But that's a risk I am willing to take in order to keep my options open over the next year. Being rushed into premature career decisions is probably one of the worst parts of the carms process, for me. I simply didn't feel, half-way through third year, that I had enough experience to make a final decision about my preferred specialty. Yet that is the reality of what the current system asks us to do, in order to be competitive. Sorry to hijack with my experience, but there it is. /feelings Link to comment Share on other sites More sharing options...
medicine man Posted March 20, 2014 Report Share Posted March 20, 2014 Its difficult to know why you risking your entire career and dictating what you do for the rest of your life for just 5 years of your residency. Unless its for legitimate family reasons (family member ill, need to stay close by to see children etc..), you have to be willing to move. Pick one career with maybe one backup. From the specialties you mentioned, they're quite random with very little to do with one another other than being competitive and specialties making a lot of money. Examine why you like certain specialties and then perhaps you can come away with a legitimate backup. If you like plastics, it could make sense you like PM&R or ENT etc..If you like Rads, Path may provide that diagnostic no patient interaction career. One option if all you really want to stay on the westcoast, as many from there do, is to apply to the states. You can apply in all of California, Washington and Oregon. Unfortunately you would have to write both your USMLEs fairly quickly but thats another option if thats you're only reason for wanting to stay in Vancouver. Link to comment Share on other sites More sharing options...
Talon01 Posted March 20, 2014 Report Share Posted March 20, 2014 Where do you live that's so bad ass? I need to visit! Link to comment Share on other sites More sharing options...
EuclidsGeometry Posted March 22, 2014 Report Share Posted March 22, 2014 Hey, if you really like where you live, back up with family medicine instead. If you spread yourself between 3 really competitive programs (int med is becoming popular too), it shows me that you do not really care about either specialty. Link to comment Share on other sites More sharing options...
synch Posted March 23, 2014 Report Share Posted March 23, 2014 These days it feels like those of us who apply to more than one specialty are shooting ourselves in the foot. Programs want to see a genuine commitment. I'm not sure I totally agree with that. I applied to two E-ROAD specialties and family medicine, and was fortunate to get interviews in all three and match to one of the E-ROADs. I really think the idea that we have to commit ourselves to a single competitive specialty has become overblown common "wisdom". I distributed my electives favouring one of the specialties, but I still managed to get all the interviews I applied for in the second specialty. I did research, but in neither of the specialties I applied for. I was cautioned that applying to two competitive specialties would mean I got neither, but clearly that wasn't the case. I think people are making a bigger deal of the need to specialise early than is really warranted. Link to comment Share on other sites More sharing options...
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