Tag: NRMP

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I Didn’t Match In Radiology! What Do I Do?

match

Question:

Thank you for providing great information. I have been utilizing it throughout my residency application process and have found it to be an invaluable resource. Currently, I am in the process of SOAPing (Supplemental Offer And Acceptance Program) to match into a position and was hoping to get your input on applying for research fellowships in radiology as an alternative to SOAPing into an undesirable program/alternative specialty. I am a US MD 4th year with a 230-240 range for both USMLE1&2 and with previous research experience in genetics and interventional radiology.
Thank you for your time and consideration,
A Worried SOAPer

Answer:

Sorry to hear about having to try to SOAP into a position. I would continue to try to get into a slot in radiology if you can. Getting a residency slot in a marginal program is better than not getting anything if radiology is your chosen field. I believe that you can always make the most of your experience regardless of the residency that accepts you.
However, I would imagine that there are not that many empty slots in the SOAP this year. (Only ten programs did not fill as of the time I am publishing this article). So, if you do not match into an opening, I think doing a radiology research program would be a great way to make yourself more desirable the next time you apply. I would probably opt to find a clinical program this year first as well (if you have not done so already), so you have that clinical year that you need under your belt. But, getting a research year afterward would be an excellent way to stay immersed in the field. It is the closest you can get to remain in radiology without completing a residency year.  It will also demonstrate your interest in the programs when/if you reapply.
Good luck with the SOAP,
Barry Julius, MD
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You Are Not Right: Radiology Is Less Competitive This Year!

less competitive

Statement From A “Questionable Program Director”

Hi, I saw your post and talking to all the programs in the south this year, radiology was less competitive with our program receiving 60-80 fewer applications than last year. I state this because this year was not more competitive. But if you check the NRMP and look at the numbers instead of writing from your gut, you would not spread false information.

I will take a page from Barry and speak from my gut and say it is getting less competitive in the next few cycles with the horrors of taking candidates with no inclination for radiology via the SOAP to only fail the boards will start again.  In retrospect, I wish that I had interviewed more students because many have already been to 20-30 places with their prepared responses.

Fellow program director

________________________________________________________

Response From A “Real Associate Program Director”

Not quite sure if y0u are a real program director since you did not leave an email or another way to contact you. Most folks that are “real” will put their money where their mouth is. Additionally, the grammar was horrible (so I took the liberty to edit it a bit), and the note was challenging to read. (But that does not disqualify you from being a program director!) Regardless, I thought it would be fun to reply to this email in an ask the residency director format, now that we know our program has matched all four spots.  So, here we go!

Less Competitive This Year?

First of all, the NRMP has not released any of the numbers about the 2019 match. They are not yet available. Can’t say that I know what figures you are talking about from the NRMP. (another red flag regarding the credibility of your post!) However, I find it interesting that you reported having 60-80 fewer applications this year. That statistic flies right in the face of what our program has experienced for this year’s match. And, it also differs from what I have heard other programs saying. But, then again, we will find out the actual numbers of the match statistics when the real NRMP releases the stats for this year.

Second, my article called 2018-2019 More Competitive For Radiology? A Midyear Perspective is just a perspective. I based it on the hard and soft facts of what we saw at our program at the time of the article.  I use pieces of evidence to support the conclusion that this year was more competitive, not gut reactions. But again, we will see if my prediction bears out when we do get the final word from the NRMP.

Next, I want to put a pitch in for those folks that will be matching in the SOAP. What you are implying about the SOAP candidates could not be further from the truth.  Our former residents that matched through this process have been some of the most dedicated and fervent radiology residents that we have ever had. Most residents that match through the SOAP do not fail their boards. To the contrary, these residents perform extraordinarily during their four years and beyond.

And, finally, I am sorry to hear that you wish you should have been interviewing more students. (if you are real!) I think that says more about your program and your region of the country than the state of the radiology match this year.

Too-da-loo,

Barry Julius, MD

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A Common Rank Order Dilemma For Radiology Applicants

rank order

Question

Hello Dr. Julius,
I am an aspiring Radiologist who is currently preparing for the USMLE exams. In the future, I plan to apply for Radiology residency as well as Internal Medicine as a backup. However, I am a little worried and confused about submitting my NRMP Rank order list when the time comes. Specifically, I would like to ask if it is acceptable to apply for a Radiology position, preliminary position, as well as a full 3-year internal medicine residency position at the same program. How would my rank order list look?

Also, what would be an appropriate response to give interviewers if they know I have applied for both a prelim position and a full three year IM position? I am worried about being in a scenario where I would not match into any program at all due to the improper listing of my Rank Order List.

Thank you for your time,

Concerned applicant

Answer:

How To Rank Order For The Match

Good question! For confirmation about the process, I recently spoke with a few of my residents. Typically, you can tie the preliminary spots to the advanced radiology programs such that you need to match into a combination of the two or none at all. That can leave you with potentially hundreds of combinations and permutations depending on the number of programs you decide to rank. Furthermore, after you rank these tied together programs, you can then list the 3-year internal medicine programs. That way, you will rank any combination of a prelim and radiology programs more highly than a categorical three-year internal medicine slot. As you specified, you need to be careful to make the appropriate order when you create this rank order for the list. You may want to write down (on paper or electronically) the permutations before clicking the submit button!

Prelim Medicine And Three Year IM Programs Rank Issue

I would have to say that the other more controversial question to answer would be what to tell the Prelim and Three Year IM Programs to which you are applying at the same place. In this situation, I firmly believe that honesty is the best policy. Any other tact would make you seem a bit ridiculous since they already will know your motivations.

Make sure to make it known that you enjoy medicine as well as radiology. And, tell the interviewers that you will perform exceptionally no matter which program you attend. Program directors most want to know that the folks beginning in their program will make it through to the completion of their residency. So, this strategy should satisfy the program director’s biggest concerns.

Hope that allays your concerns,

Barry Julius, MD

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Radiology Residency And The SOAP Match

It’s the middle of March, and every 10 minutes, you are checking your email to see if you have matched in one of the most competitive specialties out there; maybe it was dermatology or radiation oncology. You can’t eat or drink. Your mouth is dry. Suddenly, you get the dreaded email- “You have not matched for the ‘blank’ specialty in the regular match.” All these years of work, and what do I have to show for it? A wave of depression sets in. You want to stick your head in the sand.

Unfortunately, every year this scenario plays out. Each year the dynamics of matching in competitive specialties becomes more challenging due to increasing numbers of medical schools/American MD graduates and stagnant American residency positions. (1) Not everyone gets their first choice of specialty during the standard NRMP initial match. Since this time of the year is about to arrive, I thought it was essential to give you some guidelines/tips on approaching the issue if you are one of these residents.

Wash That Fit of Depression Away

It is crucial to get into game mode. The SOAP process can be time-consuming and exhaustive from both an applicant’s and a program director’s perspective. But, to be a viable applicant, you need to move on. As an associate radiology residency director, one of my biggest turnoffs in the SOAP process is interviewing miserable residents that do not show a bit of enthusiasm for their new specialty choice. It is not the end of the world, and it is a sign of mental toughness and grit if you can adapt to the unique circumstances. Things don’t always go our way!!!

If you are in this situation, it is also important to remember that you are not alone. Numerous qualified medical students don’t match. Often the overall quality of the applicants is better than the initial match. So, don’t take this as a sign that you are going to make a horrible resident. It’s just not true.

Think About Your Options

Residency is a long, arduous process. So, this decision should be well thought out, and all applicants need to step back. Don’t rush into applying to a specialty if you are not convinced that you have an interest. If you are not sure, there are other options, such as applying for a transitional or prelim year and then reassessing the application during the year of residency. Only apply for the specialty of radiology if you are genuinely interested!

Most Applications In The SOAP Are From Different Specialties

We often get former applicants from matches of the most competitive specialties. Presently, these would be radiation oncology, dermatology, and some of the surgical subspecialties. For many years these specialties are entirely matched with no slack. So, your two choices are to reapply another year after completing a year of preliminary medicine or surgical internship. Or, you can change specialties entirely. You take a risk either way. If you reapply, you may not match the following year unless there is a significant change in your credentials. On the other hand, if you decide to match in the SOAP for another specialty such as radiology, you may be matching in an area that you may or may not genuinely interest you. You will need to make that hard choice in a very brief amount of time.

Significant self-reflection and analysis are critical at this juncture. Sometimes, the right choice is to apply to another specialty. I believe that medical schools underexpose students to many different subspecialties. Frequently, the best fit for a prospective resident is different from the specialty he/she initially applies. So, think about the possibility of applying to another specialty than you initially chose.

Don’t Fret About Application Items Not Geared To Radiology

Don’t worry if some of your recommendations, personal statements, and application are not entirely “radiology-centric.” The program directors usually understand the predicaments of the applying residents at this point. However, the applicant should develop reasons for his/her newfound interest in radiology during the interview since enthusiasm for the specialty is critical. Make sure you have a logical argument prepared for the phone or “in-person” interview for why you would be interested in radiology. It will go a long way toward securing a spot in a radiology program.

The Early Bird Gets The Worm

Joining the SOAP right away is probably one of the most critical factors in the residency SOAP match process. If you are not early in the draw, you are going to miss out on the spot. Make sure your application is submitted to your SOAP specialty of interest as early as possible. Often, we find out about outstanding candidates only out after the SOAP match ends. Don’t let that be you!!!

Try To Schedule Onsite Interviews If Possible

In the SOAP process, it is a significant advantage to match the face to the application. Although it is not always possible due to distance or other circumstances, if you are interested in a position and want to maximize your chances of acceptance during the SOAP process, an onsite interview shows your interest and ups your chances of obtaining a spot. (although not as critical in the times of Covid!) I always would rather deal with the known vs. the unknown entity. You get a better feel for the applicant, usually when he/she is sitting in front of you (or on Zoom!) rather than in a phone interview conversation. We have accepted applicants over the phone, but your chance of acceptance “in person” is higher. Try to get to the interview if possible physically.

Use Your Connections

Any connection to the SOAP match program of interest is of significant help. We value the known vs. the unknown quantity when we are looking at SOAP applicants. So, if you have any connection to the program of interest, it will give you a leg up in the process. It could be a resident you met at some point earlier in your medical school training, a former mentor, or a friend of a relative. It doesn’t matter. Any connection is often better than no relationship. Use it!!!!

This Too Shall Pass

The SOAP process is short-lived but very stressful for all parties. Applicants and programs that did not match the first try will often find a happy end to this story. Be enthusiastic, get past your depression, put time and effort into the SOAP process, and, often, the SOAP process will handsomely reward you. Don’t take it seriously, be depressed about not matching into your initial specialty, or take a lazy approach and you won’t. Good luck with the match!!!

(1) http://www.usnews.com/education/best-graduate-schools/top-medical-schools/articles/2013/07/11/aspiring-med-students-face-growing-residency-competition