What to do if you dont match???

I hate to be the one to start the negative talk but there is a chance that some of us wont match this year. I know people can do an intern year, research or what not. I thought we could get some opinions from attendings and staff as to what is the best course to follow to improve one's chance when entering the match next year.

If you don't match there are usually 2 options that most people consider: 1) Scrambling into a general surgery internship year or 2) Doing a year of research. Here are some of the pros and cons for each:

General Surgery Internship:
Pros - 1) Does not break up your training; 2) Can be advantageous if you're in a hospital which has an orthopaedic surgery residency and someone drops out; 3) Demonstrate your clinical acumen and proficiency to your mentors in general surgery who can then support you as a "known entity" in the clinical arena
Cons: 1) If you didn't match because of your "paper" application (low boards, few honors, not AOA, etc...) then doing a general surgery internship does not really "enhance" your application; 2) Related to #1 - you will not have an opportunity to do meaningful research and therefore cannot really change your application; 3) Does not guarantee matching the 2nd time around

Dedicated Research Year:
Pros: 1) Allows you to have appropriate time to perform meaningful research; 2) Allows you to enhance your application with presentations, posters, and publications; 3) For programs where your "paper" application failed to make the cut it may boost you.
Cons: 1) Unfortunately, for programs who take a hard line on number cut-offs, doing the year of research will not change their minds; 2) Obviously, no guarantee that taking a year to perform dedicated research will be enough for you to match the 2nd time around; 3) Takes you out of the clinical arena

Sum analysis - if you have an opportunity to spend a year in a laboratory that is well-known and respected (and has a track record of productivity for its members, including students,) it probably is the best way to go for reasons outlined above. If, on the other hand, your research opportunities are less desirable then the general surgery internship in a strategically placed position (if possible a good program in which there is a good orthopaedics program; even better, a good orthpoaedics program in which there are a large number of residents where there may be a history of turn-over).

Good luck to all - March 15 is close at hand!

wnl

Thank you the info on research vs. Gen Surgery prelim year. How does one find out about research opportunities after he or she doesn't match? Are the research postitions included in the scramble? I go to a medical school that does not have a strong research component, thus I am worried if I don't match it might be hard to find the reseach opportunities. Any advice?

If you don't match there are usually 2 options that most people consider]General Surgery Internship[/b]:
Pros - 1) Does not break up your training; 2) Can be advantageous if you're in a hospital which has an orthopaedic surgery residency and someone drops out; 3) Demonstrate your clinical acumen and proficiency to your mentors in general surgery who can then support you as a "known entity" in the clinical arena
Cons: 1) If you didn't match because of your "paper" application (low boards, few honors, not AOA, etc...) then doing a general surgery internship does not really "enhance" your application; 2) Related to #1 - you will not have an opportunity to do meaningful research and therefore cannot really change your application; 3) Does not guarantee matching the 2nd time around

Dedicated Research Year:
Pros: 1) Allows you to have appropriate time to perform meaningful research; 2) Allows you to enhance your application with presentations, posters, and publications; 3) For programs where your "paper" application failed to make the cut it may boost you.
Cons: 1) Unfortunately, for programs who take a hard line on number cut-offs, doing the year of research will not change their minds; 2) Obviously, no guarantee that taking a year to perform dedicated research will be enough for you to match the 2nd time around; 3) Takes you out of the clinical arena

Sum analysis - if you have an opportunity to spend a year in a laboratory that is well-known and respected (and has a track record of productivity for its members, including students,) it probably is the best way to go for reasons outlined above. If, on the other hand, your research opportunities are less desirable then the general surgery internship in a strategically placed position (if possible a good program in which there is a good orthopaedics program; even better, a good orthpoaedics program in which there are a large number of residents where there may be a history of turn-over).

Good luck to all - March 15 is close at hand!

wnl

Dr. Levine,

I'm going to revive this thread because I was hoping you could give me some advice on this situation. I didn't match despite >260 on Step 1/Step 2, several publications, top 10% of class, etc. I'm trying to decide between a general surg prelim year or a research year. I have a very research-strong home ortho department, so I would definitely be able to get out a fair number of publications. However, I'm not sure how much my paper application can be improved. I'd like to get hands on with some clinical medicine next year, but if more publications would significantly improve my application I'd be willing to go the research route. What would you recommend in this situation?

Thanks.

Spiff, I'm sorry to hear about your luck... but it certainly sounds like you have a most-enviable application already! Also, it looks like you got some great interviews this year (maybe TOO great... did you apply to some "lesser-name" programs?). No matter your choice, you'll do great again next year, I'm sure, no matter which path you choose.

Spiff 21,
I am sorry that you did not match - please email me directly at [url=mailto]wnl1@columbia.edu[/url] --

wnl

Thanks for the reply. Email sent.