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I am matched to an advanced program but did not find any PGY1 position. The program PD tried very hard but nothing worked out. What should I do now? I am so depressed.
nightmare. No PGY1 year
- Thread starter neuronwangyu
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Hopefully a prelim spot will open up somewhere for you before July 1. If not, you probably will have to give up your advanced spot and reapply in the match in the next cycle.
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it seems that a few of us are in the same situation, matched into advanced (especially with neuro) and no prelim. def contact the PD from the neuro program to whcih you have matched and speak to them, hopefully they will be able to help. other than that keep checking each day for open spots, keep searching and keep your head up.
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What's going on this year? I have heard several stories of people matching into advanced sports but not getting a PGY-1 spot. Is this year just an anomaly, or is this typical for neuro spots?
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If this is true it would be interesting to see if the ROAD specialties are becoming increasingly competitive with more applicants, which would partly explain why neuro applicants may be finding it more difficult to find a prelim spot. Definitely would be an argument for neuro programs to push for categorical status.
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+1, I don't know why more programs haven't gone this route already? Maybe it is the politics involved at certain programs, especially if neuro doesn't have a lot of sway?
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I also agree. Categorical status ended up being a big factor in how I ranked the programs on my list. It's just a lot nicer to know you will be in the same place for all 4 years--no moving twice in two years. Plus, if all neuro programs went to categorical, it would save a lot of money for applicants who wouldn't have to apply to so many prelim spots. I sat through way too many internal medicine program director power point presentations. Just my two cents.
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That is awesome!! It makes me happy when programs go out of their way to help make things work! I sure hope I match at a program that is willing to do this for its future residents. +1 for them (whoever they are).
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same here. I tried to contact a few IM programs but every one said filled.
I guess if I have to apply next year, I will definitely consider categorical programs favorable. Post-match searching is like hell.
I guess if I have to apply next year, I will definitely consider categorical programs favorable. Post-match searching is like hell.
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I heard from one PD that IM program does not like neurology to dictate the selection of their candidates.
Conversely I ranked all the advanced programs ahead of categorical because I really wanted to stay where I'm at for one more year. The highest I had a categorical only program was 8th on my list.
I think the best option most programs are moving toward is having most of their spots be categorical with 1 or 2 advanced positions. The only downside is if the categorical spots end up being much more appealing you could be left with an open slot or a less desirable candidate in the advanced position. I'm not sure how many applicants really need the flexability of doing their first year elsewhere.
It is unfortunate that prelim spots are getting so tough to come by. At my home insitution there were a lot more students that wanted to stay than spots, though everyone ended up somewhere. In fact on match day in some ways I was more worried about where I would match from prelim than for neuro.
Depends on where you live, but to play it safe I would apply to several regional prelim spots. If they are within driving distance you can fit in the prelim interviews whenever you have a chance between neuro interviews. Plus, if they are within the same city as where you currently live you will still "only have to move once" prior to starting neuro.
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This is similar to my experience as well. I was much more worried about getting a prelim spot, since I was much more geographically constrained for prelim due to personal reasons. Moreover, the other prelim applicants all seemed to be ROAD specialties with ultra-competitive grades, AOA, etc. Plus there was fairly poor prelim application advising and lack of "going to bat" at my institution (which itself got rid of its prelim medicine program!). I feel lucky to have matched for prelim in my desired geographic area--but it was a VERY close call.
Not to fan the flames of panic (for 99% of students it works out fine), but there are super stud IMGs that you are competing against too. I was interviewing at a very good Midwest prelim program and most of the applicants there interviewing were super star applicants from England, India, and Germany that in many cases had already completed advanced specialty training in their home country and were looking at strong U.S. prelim programs as a way to buff their application prior to applying for a US residency after their PGY1 year. In general, strong IMG candidates are making the match tougher each year and have turned the scramble from tough to impossible in some cases.
This prelim thing is indeed a tricky issue with a lot of variability from place to place. Had things not worked out at my home institution there weren't many other options that were close. Neuro programs with numerous advanced slots really need to be proactive about helping their students secure prelim positions. Many places are. This year Penn and Partners stick out in my mind as being really helpful about helping students get spots.
On the plus side prelim programs love neuro residents versus other specialities because they know neuro residents tend to be pretty gung ho about inpatient management and general medicine stuff. That is not always the case with ROAD applicants that sometimes look at the prelim year as something bad "they just have to get through."
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Amos makes all excellent points. I don't want to scare anyone, but applicants should be aware that while some prelim programs claim they love neuro applicants as opposed to ROAD applicants, this does not necessarily translate into them ranking you to match. In my experience, there are several people from my graduating class doing ROAD specialties who matched at programs I had ranked highly but didn't match at. This seemed to be particularly true at community programs in my geographic area, even ones in which interviewers seemed impressed with my credentials and told me point blank that they love neuro applicants.
I think the bottom line is that if you are applying to advanced programs, it is important to apply more broadly to prelims than you may initially think you should, including several out of your target geographic areas. Particularly if the programs are competitive (i.e. highly desired for geographic, academic,or limited total number of competing programs in the area reasons, or that receive a large number of applications from highly competitive applicants).
I think also that for the purposes of prelim medicine programs, if your application comes across as research-heavy, as mine did, it is important to emphasize your clinical accumen and devotion to taking care of patients. I tried to highlight those features of my application, but I get the feeling that I probably still came across as too research-focused for the likes of many prelim programs. This is where I believe that clinical honors during 3rd year and AOA are two important (and IMO unfortunate) tools for "proving" your clinical credentials and being competitive with ROAD applicants. Also important is the Dean's letter which assigns you the "adjective" and states all the Honors you acquired during clerkships--this is the rather shorthand way many people who read applications assess your clinical ability. Finally, I came away from the experience feeling as though the personal statement also should be written in two very different versions for prelim and advanced programs. I modified my advanced one slightly, which I now feel was a mistake not to modify it more significantly (i.e. don't mention that you want to be a physician-scientist; rather focus mostly on your clinical experiences and interests to show why you love taking care of patients and want to learn general medicine).
I could be wrong about the points in the last paragraph, but those are just my gut feelings coming away from the whole prelim application process.
Word.
It's always hard to go wrong with demonstrations of clinical skill. That's why it's usually better to have letters of recommendation from people that know you well and can relate clinical anecdotes vs. chairmen types that just fill in your name on a form letter. It's also why you should pursue getting elected to humanism societies (such as the Gold society) or explore other ways of showing your commitment and skill in patient care. Free medical clinics, teaching in the community, patient service awards etc. Personally I think applicants get too caught up in the AOA thing. It's a nice piece of recognition, but at least in neurology it is not that high on people's wish list.
I don't want to get too caught up in personal anecdotes, but I had a good friend who graduated a couple years ago who assumed he was golden because he was one of a handful of students that got elected to AOA during his M3 year, vs. the M4 year like most students where I train. Anyway, he was a great guy, but he wasn't really very involved in much outside getting honors in most of his courses and some research he did in the ENT department for a couple summers. He ended up matching at his 10th choice for ENT and was pretty unhappy on match day.
This doesn't relate to all applicants, but some good advice I got from someone regarding MD-PhDs or those with a lot of research experience is:
"Program directors are going to be most concerned with different issues for different types of applicants. For research folks, however, they are thinking about:
1) Is the applicant still interested in academics, or are they burned out on research and are going straight to private practice?
2) Can the applicant care well for our patients on the floor, or are they all thumbs when it comes to people skills and just belong in a lab somewhere."
Im not sure about modifying your personal statement for prelim vs. advanced (I was kind of out of ERAS energy at that point), but it is key to mention during your interviews that while your long term goal is X, right now you are totally committed to learning as much as possible about patient care.
As one last point (can you tell Im an M4 with nothing to do this afternoon) one way to interview at programs outside your geographic area is to apply to prelim programs in the same cities as some of your preferred advanced programs. Then fly in a day early and interview for medicine, then hit neuro the next day. Sort of annoying, but as an added bonus it helps you learn more about the hospital in general and the institutional atmosphere of your preferred advanced programs.