I disagree with your assessment. I have received different information from a PD at a hospital in Boston that stated that as an FMG one should be prepared to have a back up plan. Different PD view things differently. I was told by one that research improved your application slightly, while the other told me it will help you tremendously stand out from the rest of the applicant pool. One said board scores are heavily weighted, the other said that the overall application (not so much emphasis on scores alone) was looked at (including input from residents during the interview process).

I will be happy at either specialty, I also have different circumstances than most individuals that come into play to with choosing to have a back up plan. Even with good USMLE scores, you are still at an disadvantage applying for residency with American grads, and applying from SMU. This was made quite clear to me on my interview at Synergy. I choose to have a back up plan, and if I end up in FM, so be it, I won't be disappointed. I think one should really think it through when applying to just one residency. You must be willing to go through the scramble, or miss matching that year (again this depends on many factors, including board scores, the applicant pool, your overall application). If you are willing to risk staying out a year to achieve your dream for EM, good for you. That is not an option for me, and for others who aren't sure if they are willing to wait a year, putting all eggs in a basket can prove to be a horrible mistake. I have seen people upset over making the mistake of thinking they were sure to match into EM to only miss the match and scramble into a prelim program in IM, one even missing the scramble.

Thanks for wishing me luck.

__________________
Juni

how exactly will they know, unless you apply to the different specialties at the same institution or tell them (they aren't suposed to ask)

and if EM ans FM are so different, why is there a combined program that is EM/FM?

I know in smaller towns, FM docs work the ED- so they can't be that far off.

__________________
Graduation -May 3rd!!![ ]
Diploma Received [ ]
ECFMG Certified [] took 12 days
Training License []
Orientation []
PGY-1 (OMG!) []
Move Complete []

Juni- I think you are missing my point.

Usually, one works hard through medical school and decides they want to be an X physician. When the match comes, you are usually concerned in where you will match (what state, what program you are going to, city, etc). However, if you choose more than two specialties, YOU ARE LETTING THE SYSTEM tell you what kind of doctor you will be.

You said that it doesn’t bother you being an IM, EM, or FM, which is good. However, for those students shooting for X and SETTLING for Y (a back up) is just a receipt for living a horrible life. You are really settling for your second or third choice.

Think about, you really want to be a lawyer, but the system is telling you will be a cook, engineer, etc…so in essence you are not in control (you can do so much with the ranking etc) but once the computer tells you will go to x place for x specialty that is where you will go.

What you are trying to say, and we all agree is that as an IMG, we have a harder time in certain competitive specialties. We need to be smart of what specialty we choose. However, my point is: you should not let a computer decide what type of doctor you will be. That is your decision.

By the way, I am not interested in EM.

__________________
The three leading causes of Death in America:
3) Cancer 2) Heart Disease 1) Chuck Norris

Family Medicine (X) Surgery (X), IM (X), OBGYN (X), PEDS (X), IM/PEDS (X), Psychiatry (X), Cardiology (X), Neurology ( ), Nuero-Surgery ( ), AI Neurology ( ), Pediatric-Neurology ( ), Family Medicine ( )

so are you saying you are going to lie when, if, the PD ask you?

and, if you are so set in two specialities, why not apply to the same program? deception? what are you trying to hide?

if your heart is set on two specialities, perhaps, like juni, there is nothing wrong to applying to multiple specialties....just tell that to the PD.

__________________
The three leading causes of Death in America:
3) Cancer 2) Heart Disease 1) Chuck Norris

Family Medicine (X) Surgery (X), IM (X), OBGYN (X), PEDS (X), IM/PEDS (X), Psychiatry (X), Cardiology (X), Neurology ( ), Nuero-Surgery ( ), AI Neurology ( ), Pediatric-Neurology ( ), Family Medicine ( )

how about this scenario...

you're a caribbean student and have your heart set on plastic surgery. you want it so bad you can't think about anything else. you have a 83 on step 1, and a 81 on step 2. pass on cs. you are dead set on getting into plastics... and you don't apply to any other specialty as this would be diverting your attention from what you really want to do.

i will tell you, this person might waste 10 years applying over and over again for plastics. you ain't gunna get it. sorry. that's life. you minus well do something else less competitive, and at least you'll still be a doctor.

i wanted to be an astronaunt when i was a kid. i guess i settled.

looking at all carribean stats...youll most likely end up in FM.
I say go for wyckoff heights FM.

I got your point, and agree with you. I'll use myself for an example, IM is not what I really want. I really want EM, but apply to both, and get into IM. Yes that is a recipe for disaster if I really don't want IM, and end up there.

Now my point is if you want EM, and only EM great. Just make sure you are okay with having to wait a year if you don't match. I have seen people who were only set on EM, but when match time came around, and they did not match, and adding that there were only three spots in the scramble (which were taken up quickly I may add), then what options they had? They thought, oh I would wait out a year if I have to. I have seen people quickly change and decide that they should have had a back up plan. If you are willing to wait out a year, then great. Some people think they can but when they are confronted with the scenario of not matching they go crazy. I seen three people go through this (two made the scramble, one did not). The two that made the scramble aren't too happy with their picks and are currently reapplying for another residency. They were dead set on their choices and were inflexible, which could be a double edge sword. My point is that I think having a back up, at least a prelim as a backup, wouldn't hurt, since that would give you the opportunity to apply again the next cycle. Then you can at least work while you wait for the next cycle.

__________________
Juni

great point about the prelim...a good back up would indeed be a prelim (IM or Surg) but not another specialty.

how is the interviews going?

__________________
The three leading causes of Death in America:
3) Cancer 2) Heart Disease 1) Chuck Norris

Family Medicine (X) Surgery (X), IM (X), OBGYN (X), PEDS (X), IM/PEDS (X), Psychiatry (X), Cardiology (X), Neurology ( ), Nuero-Surgery ( ), AI Neurology ( ), Pediatric-Neurology ( ), Family Medicine ( )

ok, so you don't match and you "sit out" a year.

In that year are you then:
1. no longer on any type of loans
2. do not qualify for health insurance
3. will have to begin repaying student loans afetr 6 months of final term
????

Am a crazy in thinking that there just might be an SMU MD working at Jamba Juice or Starbuck's to make ends meet and to get health insurance?

Also, given the fine print of Health Expess, these loans are not deferred until after residency correct? i.e. You must factor in this repayment
into your budget for residency.

Any education or experience on this would be greatly appreciated.

first off, having a back up is a good idea for most people. for one thing they are only one year contracts you can try again for your "dream" specialty next year without having to sit out a year. if you do sit out a year finances are rough, research positions are mainly non paying so everyone has their reasons for going with a back up or not and i don;t see anything wrong with either approach

you are being WAY too narrow minded and letting the name of a specialty define your work life. what you do in practice after you graduate is linited only in what you want to do. for example if you are a FP and want to work in ER there are two options,

1)get board certifed in ER as a family doc (different board exam than EMB) then work in an ER. of course its not going to be at a university ER that may want a ER residency and boards but you have most community hospitals, many with med school affiliations, and a buffet table of smaller city and rural ERs to chose from.
2)work in an urgent care center. the vast majority of urgent care centers are basicallt ER's with the same patient population, compplaints, diseases except for major trauma. some of the bigger ones even have xray/CT/mri/lab facilities in them. my firend who is a FP doc works at one georgia

once you get out in practice and have a couple of years experience you can pick and choose what you want to treat. want to be a dermatologist? i know people who are FPs 5 years out of practice and all they do is skin diseases. want surgery, GI, Cardio but couldn't get in? there are FPs that do appendectomies, cholecystectomies, colonoscopies, and everything cardio except caths.

you can use the same above for most specialties because to some extent you have choices of what you want to do even in subspecialties

__________________
OBGYN PGY II
I see light at the end of the tunnel!!!...wait a minute its just another freakin tunnel!