Thursday 9 August 2012

Applying to Programs in Another Specialty as Backup: Key Concepts

An interesting question was posed by one of the readers of the blog yesterday. The essence of the question was if you are a above average applicant, then will applying to FM be counterproductive as programs may suspects that you are using FM as back up? This is a very good question and I want to break it down into individual components and discuss each issue separately. 

There is a general thought that some specialties are easier to apply than others. The answer to this is yes and no. Yes because there are specialties like FM which seem easier to apply to because they are not as rigorous in their criteria for selecting applicants for interview. Many community hospital based family medicine programs do interview applicants with low scores on exams, old year of graduation, gaps in CV and have lower expectations in form of scores. What they lose in the above criteria they more than make up in other ways, making subjects like FM equally competitive. Family medicine programs often require evidence of commitment to the specialty in the form of prior experience in family medicine, clinical experience, and letters of recommendation from family practice physicians. They also look at the general background and aptitude of the applicant, because it takes a different kind of physician to be trained at least superficially in a variety of distinct medical specialties including obstetrics, pediatrics, internal medicine, surgery, gynecology etc. Thus the concept that family medicine is easier to get into is not straightforward and is compounded by the fact that there are fewer positions in family medicine residency as compared to internal medicine and pediatrics.

If you are applying to family medicine or pediatrics as back up, there are certain things you have do to ensure that your application is not obviously considered as a ‘plan B’ and discarded. You have to show commitment to the specialty that you are applying and this is true even for back ups. If you have an application that is geared for internal medicine including a internal medicine related letters or recommendation, personal statement and on day of application you choose a few programs in FM or psych. Then this may not go well with programs, because out of the blue applications will stand out as “just in case as back up” applications and will be viewed negatively. 

There are many ways you can convince programs of your commitment to specialty of choice, these have been discussed in depth in the article in the past. Briefly, 
  1. Having hands on clinical experience in field helps 
  2. Observerships in back up specialties also are favored. 
  3. Try to satisfy the requirement of many programs which needs a letter of referral from a physician who is doing the backup specialty. 
  4. Doing research is a big plus especially for fields like neurology or psychiatry 
  5. Publications in specialty specific journals (Am. Fam physician, Annals of family med., J of clinical Psych etc), are a big big plus 
  6. Finally, if you are applying to back up specialties, make sure you make a distinct personal statement that is tailored to that field. Rehashing the same PS for multiple specialties will be an obvious give away when it comes to genuine versus back up applicants.
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  1. but is there anyway that program will find out you are applying to back up specialty in the same hospital

    1. As far as I know, there is no way that PDs will know through ERAS that you have applied to another specialty in same institution. The only way this could happen is by plain old type of networking (faculty meetings PD to PD chit chat, word of mouth etc), the chance of which is pretty darn real but exceptionally small.


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