When a decision is going to impact your future, it is always better to be practical. While applying to US medical residency programs, this may mean keeping your search diversified enough to include multiple specialties. If you are a medical student planning to apply for more than one specialty due to career path uncertainty or the overall competitiveness of the Matching system, here's what you need to know.
As per the year 2018 data from the National Resident Matching Program, it depends on the type of applicant. On average, allopathic senior medical students are less likely to rank multiple specialties. This particular group's average number of specialties ranked in 2018 was 1.2 for matched US seniors and 1.6 for unmatched seniors. These numbers are almost the same for senior students from osteopathic medical schools. Around 1.2 specialties were ranked by those who matched, and unmatched candidates ranked 1.5.
Matched international medical graduates (IMGs) who were citizens of the US ranked 1.5 specialties, and those members of the same demography who didn't match ranked more or less a similar number. Meanwhile, matched IMGs who weren't US nationals ranked 1.3 specialties compared to 1.4 from those who didn't match.
Considering the abovementioned data, the main driver of ranking more than one specialty for medical students, apparently, is their desire to Match. Allopathic seniors matched at a 94% clip in 2018, and almost three-quarters of these students got their top choice. Conversely, osteopathic seniors' matching rate was 81.7% for natives and 57.1% for IMGs.
The specialty's competitiveness also plays a role in this regard. For example, in 2018, matched seniors whose preferred specialty was integrated interventional radiology applied for more than one specialty. In six specialties offering 30 or more spots, around 90% of the spots were filled with allopathic seniors in 2018. Integrated interventional radiology was the top specialty in this category.
Hence, as far as your applicant profile is concerned, it is a good idea to rank more than one specialty. But, do remember that the application process may differ. You will need different personal statements for every specialty. You will need letters of recommendation from different people as well, ideally from those who are more suitable for that particular specialty. Furthermore, you will have to ensure that you take the appropriate sub-internships for each specialty you have applied to.
If you are applying to many specialties, things can get complicated quite easily. Specialty selection is a crucial decision for a future physician. Here are a few tips to help you make an informed decision:
Start exploring your options earlier in medical school, such as through informational interviews or shadowing, which can help eliminate those specialties that aren't suitable for you. It is definitely good to take every opportunity, even those you aren't interested in.
The best strategy would be to avoid the pressure to decide in your senior years and determine your options as soon as possible. This approach will help you become a competitive applicant for medical residency because there will be different demands and things related to every specialty, and you must prepare adequately.
For instance, emergency medical residency applicants need to provide SLOEs (standard letters of evaluation). A SLOE is just like a traditional letter of recommendation, but it is specific to emergency medicine. You can become a stronger competitor if you provide the SLOE. Ideally, students must firmly decide on a specialty no later than the middle of their third year.
Medical students with exceptional grades who intend to opt for primary care residency usually are told to match into a more competitive specialty because it is a mistake to choose a specialty based on your grades. Instead, choose a specialty you are more passionate about. Grades and test scores play a vital role in receiving interview requests from medical residency programs. However, program directors are interested in well-rounded applications.
Matching is determined by many more aspects than grades and scores. Even if your grades are slightly below the required average for your desired specialty, it is possible to strategize wisely to become a competitive applicant. Such as you can get involved in research and activities valued by a particular specialty.
If you are confused about the right specialty, we won't recommend that you complete a rotating internship for the sake of buying more time. If you start the internship in July, the next year's Match's registration will be roughly three months later in September. If you intend to apply for residency by September, the internship won't change much for you.
Students thinking about internships should first consider what this step will change for them the next year and develop a specialty focus. Graduated physicians will have a more challenging time with matching. According to the year 2018 Match data, only 44% of medical school graduates could match a first-year residency position while about 94% of medical school seniors matched for the same position. The residency process is fiercely competitive, so you have to make the right decision at the right time.
Med school is the perfect time for you to explore diverse fields and specialties in medicine. So, it's imperative to stay true to your interests and preferences. Every specialty has its fair share of pros and cons. You must start to plan early on and make a list of your desired specialties' pros and cons as you are exposed to them. Moreover, consider where you want to reside in the future and what type of practice you intend to have. There are specific needs of different specialties, which should factor into your final decision.
Still, if you are conflicted between several specialties, try to spend more time on rotations with the doctors. One last advice- never hesitate from consulting your advisor and doctor as they are valuable sources of information.