Applying to Multiple Specialties

[ihsh]

Hello,

As a first-year medical student, I am still in the process of exploring the different specialties. I am wondering, though, whether it is common/feasible for people to apply to 3 or more specialties. My understanding is that the limited electives time can make it difficult if the specialties are seemingly unrelated (and you don't want to appear to be "backing up"), but I just wanted to double check.

The following are some sample combinations that I thought of:

Example 1:  neurology (priority),  internal medicine and family medicine?

Example 2:  Radiology (priority)+ Anatomical pathology+ hematological pathology+general pathology

Example 3: Urology (priority)+ general surgery + internal medicine

Thanks!

 

 

[doc_doc_doc]

So while it's possible...there's many reasons its not recommended:

1) Most schools give you 8 - 12 weeks of elective time before CaRMS reference letters are due. Most electives are 2 weeks. That means you have 4 -6 chances to get a reference letter. You need 3 reference letters per specialty. It's also preferred if the letters are from staff that are in the specialty you're applying to (so urology letters from urologists, etc). To do the combos you want - that would be really difficult! It would require you to have a huge variety of electives, which leads me to:

2) Having a bunch of electives in a bunch of competitive things makes you look indecisive and doesn't convey that you really know what you're interested in. How is a urologist going to believe that you want to do urology for the rest of your life if you've spent only 2 weeks in the specialty and seem pretty torn between a bunch of other things? Even if the specialties are "related" - its pretty hard to sell yourself to urology programs when they're assessing other applicants and they have 10 full weeks in the specialty. It's just not going to make you a strong applicant to be spread so very thin and in this day and age, where others have often dedicated not only 10 full weeks but a lot of time in pre-clerkship to these specialties, that really doesn't work.

3) Logistically, you need to write a 45 personal letters if you're going to apply to 3 specialties broadly. You also need to find time to attend 45 interviews. It's hard enough to attend all the interviews in ONE specialty - and remember that the programs in one specialty do talk to try and make the interview tour reasonable. Hitting up 3 different specialties would be really really hard just in terms of physically making it to all the interviews. And you'd need a lot of interviews, since you'd be lower ranked on most people's list given the fact that you don't seem overly committed to any one specialty with that sort of strategy.

So basically - its far and few in between to see people going for more than 2 things. I also advice you that your back up plan be reasonable. General surgery is pretty competitive these days, even for people doing a full 10 week CaRMS tour. It's not really an effective back up - for instance, there was zero second round spots left in it last year! Internal medicine too is no longer a safe backup, considering the growing interest and the fact that there was very very few second round English internal spots left. 

You're still in first year - it's good to have this broad idea of what you like. But I would really work on figuring out what path you want in the next 2 years, since it's very risky and difficult to go into CaRMS with the idea of spreading yourself thin over 3 specialties. 

[ihsh]

Thank you so much for such a detailed and insightful response!

[indefatigable]

.

[HappyAndHopeful]

How common is it for people to apply to a few specialties in just one geographical location, due to family commitments? Does it often work out for them? 

[Bambi]

6 hours ago, HappyAndHopeful said:

How common is it for people to apply to a few specialties in just one geographical location, due to family commitments? Does it often work out for them? 

That’s precisely what I did. I applied to 3 fields in 1 geographical location, got my 3 interviews, would have been happy in any of the 3, and was accepted in a surgical specialty. I was prepared not to match as I realized I was taking a chance, but was not prepared to compromise on location. I do recommend this approach provided you are adaptable on the field you will match to.

[Epona]

nil

[ralk]

On 10/19/2017 at 11:41 PM, HappyAndHopeful said:

How common is it for people to apply to a few specialties in just one geographical location, due to family commitments? Does it often work out for them? 

It's common enough and it does work out more often than not, but it is certainly a risk. Depends somewhat on location as well. Every year we hear about people set on the GTA and GTA alone who fail to match, even when having a low-competitiveness specialty like Family in the mix. For smaller centres, it's easier to be preferential about location.

Being flexible about location is usually an easier path to matching that being flexible about specialty, for better or worse, but if you're stuck on location, specialty flexibility becomes a near-must.

[LeBronto2019]

Thoughts on this with respect to 3 non-competitive specialties? Main interest is in addictions medicine (clinical and research) but not sure whether to do it through family med, psychiatry or even PHPM. Doing longitudinal FM clerkship + 2 weeks FM, 6 weeks electives for each of the others. 

[GrouchoMarx]

i would strongly recommend against applying to more than one moderately competitive specialty.

from my experience in reviewing the applications from canadians who didnt match and are stuck backing up with path in the second round, i have noticed that a considerable number of them were splitting their electives and their interests between two competitive or moderately competitive fields (examples include radiology and urology, derm and plastics, plastics and ENT, radiology and emerg), only to end up with neither in the end. 

now they are in family, psych, or path. i dont know if theyre happy or not. probably not. settling for something you dont want is unpleasant.

[mononoke]

People apply to derm and plastics??  I thought you had to do all your electives in plastics to even get interviews...how did their guidance counsellors not advise them about that?

[brady23]

Most schools don't let you do more than 6 weeks of electives in one particular specialty, so is it still bad to split electives between two specialties? 

It is kind of unfortunate for people who are torn between two specialties coming across as they are "undecided".

[LeBronto2019]

On 1/21/2018 at 4:16 PM, GrouchoMarx said:

now they are in family, psych, or path. i dont know if theyre happy or not. probably not. settling for something you dont want is unpleasant.

Two out of three of those is what I'd like so maybe I should take a chance with this strategy  

[GrouchoMarx]

On 1/21/2018 at 6:46 PM, mononoke said:

People apply to derm and plastics??  I thought you had to do all your electives in plastics to even get interviews...how did their guidance counsellors not advise them about that?

admins are sometimes not very bright.

[Organomegaly]

On 1/31/2018 at 10:57 PM, GrouchoMarx said:

admins are sometimes not very bright.

 

Many people also don't listen or refuse to attend the appointments so they don't hear something they don't want to hear. 

[ralk]

59 minutes ago, Organomegaly said:

 

Many people also don't listen or refuse to attend the appointments so they don't hear something they don't want to hear. 

Bit of both I think. Students don't pay attention, but partially because admin communication or advice is inconsistent, non-existent, or poorly delivered that students aren't receptive when the good advice comes.

[MDLaval]

I know someone who applied to Gen Surg, Vascular and Plastic. Nothing else. The person is a very strong candidate (for sure in QC since you don't need to do all your electives in one single specialty to be competitive), but still, no backup and you never know what will actually happen.

I also know someone who only applied to Anesthesiology, no backup.

[Med Life Crisis]

On 10/19/2017 at 10:36 PM, marrakech said:

That's part of the fun of training within Quebec - you can be limited by typically 4-week electives and also must have variety of electives, so the choices become simpler   All before core rotations too!

Sorry if this is stupid, but how does that change anything? And how does it make the choice simpler?

[MDLaval]

13 minutes ago, Med Life Crisis said:

That's part of the fun of training within Quebec - you can be limited by typically 4-week electives and also must have variety of electives, so the choices become simpler   All before core rotations too!

Sorry if this is stupid, but how does that change anything? And how does it make the choice simpler?

1

Before core rotations? Not at Laval. You have 2 x 3-weeks electives in 3rd year and 3 x 4-weeks (one of them you can split into 2 x 2-weeks rotation) during 4th year. 

You start clerkship in August and your 1st elective doesn't take place until April/May. 

[Med Life Crisis]

18 minutes ago, MDLaval said:

I know someone who applied to Gen Surg, Vascular and Plastic. Nothing else. The person is a very strong candidate (for sure in QC since you don't need to do all your electives in one single specialty to be competitive), but still, no backup and you never know what will actually happen.

I also know someone who only applied to Anesthesiology, no backup.

Please update us on what happens to them! My interests are similar.

[indefatigable]

37 minutes ago, Med Life Crisis said:

Sorry if this is stupid, but how does that change anything? And how does it make the choice simpler?

A lot of places allow/encourage 2 weeks electives which effectively doubles the number of places that people go to.  Also having core rotations first is better since you get experience BEFORE the crucial electives which are where you get an opportunity to show your suitability for a specialty.  If you do your electives first it may be more difficult to demonstrate your strength as a starting clerk since you probably won't know as much.  

26 minutes ago, MDLaval said:

Before core rotations? Not at Laval. You have 2 x 3-weeks electives in 3rd year and 3 x 4-weeks (one of them you can split into 2 x 2-weeks rotation) during 4th year. 

You start clerkship in August and your 1st elective doesn't take place until April/May. 

I guess this was a feature of the old UdeS curriculum.  Fortunately, it seems to have changed.  

[Med Life Crisis]

1 minute ago, marrakech said:

A lot of places allow/encourage 2 weeks electives which effectively doubles the number of places that people go to.  Also having core rotations first is better since you get experience BEFORE the crucial electives which are where you get an opportunity to show your suitability for a specialty.  If you do your electives first it may be more difficult to demonstrate your strength as a clerk since you won't know as much.  

I guess this was a feature of the old UdeS curriculum.  Fortunately, it seems to have changed.  

Haha ok, so it was sarcastic  

I guess being limited by 1 elective is technically a good thing for someone who wants to explore different specialties, instead of gunning for 1 competitive specialty and putting all the electives into that.

[indefatigable]

Just now, Med Life Crisis said:

Haha ok, so it was sarcastic  

I guess being limited by 1 elective is technically a good thing for someone who wants to explore different specialties, instead of gunning for 1 competitive specialty and putting all the electives into that.

Yes/no - since it's hard to be competitive outside of QC.  

[humhum]

On 1/21/2018 at 3:16 PM, GrouchoMarx said:

i would strongly recommend against applying to more than one moderately competitive specialty.

from my experience in reviewing the applications from canadians who didnt match and are stuck backing up with path in the second round, i have noticed that a considerable number of them were splitting their electives and their interests between two competitive or moderately competitive fields (examples include radiology and urology, derm and plastics, plastics and ENT, radiology and emerg), only to end up with neither in the end. 

now they are in family, psych, or path. i dont know if theyre happy or not. probably not. settling for something you dont want is unpleasant.

It is absolutely practical to pursue 2, and sometimes 3, parallel paths into CaRMS and come out competitive for all of them. For those that didn't match to either, who is to say they would have matched if they had pursued one interest? There also always the story of last minute epiphanies, who end up matching to relatively competitive fields with no more than a single electives. Then there are the handful of PDs at very competitive programs that actively reject applications of purist gunners in favor of someone who has an actual interest in general medicine.

Some of it depends on the school, where they have a ton of elective time. Some of it depends on the depth of interest demonstrated through the earlier years with research or outreach, or sometimes just the right letter from the right person. It just might take twice as much work. That said betting on either Derm or Emerg is probably not the best way to go, but something like Rad and Neuro, or Peds and General surgery, etc, should be doable.

[GrouchoMarx]

18 minutes ago, humhum said:

It is absolutely practical to pursue 2, and sometimes 3, parallel paths into CaRMS and come out competitive for all of them. For those that didn't match to either, who is to say they would have matched if they had pursued one interest? There also always the story of last minute epiphanies, who end up matching to relatively competitive fields with no more than a single electives. Then there are the handful of PDs at very competitive programs that actively reject applications of purist gunners in favor of someone who has an actual interest in general medicine.

Some of it depends on the school, where they have a ton of elective time. Some of it depends on the depth of interest demonstrated through the earlier years with research or outreach, or sometimes just the right letter from the right person. It just might take twice as much work. That said betting on either Derm or Emerg is probably not the best way to go, but something like Rad and Neuro, or Peds and General surgery, etc, should be doable.

since elective time seems to matter A LOT, and elective time is a limited resource, splitting electives between two or more fields reduces the chances of matching to any of them. 

people like to talk about things that help people match, but the most consistent one that i have seen is that they dedicated their important elective time to only the field they wanted.

last minute epiphanies are notable because theyre against all odds victory stories. the people who have last minute epiphanies and fail probably arent speaking out but i bet they outnumber the former. survivorship bias.

nobody cares about generalism. thats just med-ed gobbledygook. good letters, good elective performance, and maybe research will do someone just fine. i have not seen pds to reject gunners. i have seen plenty reject 'generalists'

rad neuro is fine because neuro is not competitive. peds gen surg might be a harder sell but still not impossible (surgeons might think peds is too soft, peds might think surgery is too hard, so the student is never considered high enough in rank lists for either field)

the new paradigm is pick a specialty early, give it all you got, and back up with the states. if it doesnt work then, prepare an application to family countrywide for the next year.