Anesthesia SOAP advanced vs wait for physician only (R) Spot

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Hi all,

Recently I found out that I did not match into ophthalmology. I am now looking towards anesthesiology. This isn't the worst thing ever, as I was having some regrets about ophthalmology even during the interview process. I have taken the anesthesiology rotation and have given anesthesia as a future career considerable thought. I know that there is the chance I could do a research year or something to get into ophthalmology, but at this point I actually would prefer to pursue anesthesiology.

It is too late for the normal match on ERAS. My question is, should I SOAP, or wait and apply for a physician only (R) spot during PGY1? Obviously the SOAP would mean that I would find out sooner and presumably would be less stressful than waiting to apply during PGY1. On the other hand, the spots listed on the SOAP are likely very undesirable (at least based on past years) while there are many spots at excellent programs listed on ERAS as physician only "R".

Right now, I am favoring waiting until PGY1 and applying for "R" spots, unless of course there are decent programs in the SOAP. Somewhere middle tier would be perfectly ok at this point since I'm not in a position to choose. Does this plan seem reasonable?

Stats:
Top 40 US school. School doesn't rank. Not AOA
Step 1: 249, Step 2: scores pending
4 clerkship honors
10+ pubs/abstracts, all in ophtho or basic science
Confirmed with PD yesterday that application has no red flags
Currently working on making connections in anesthesia department and hopefully will be able to take advanced rotation in anesthesia

Appreciate any advice!

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You should do a prelim, and apply to anesthesia next year or soap into an anesthesia position this year. I think you will be fine if you do okay on Step 2.
 
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You should also talk to your home Anesthesia program, and any programs that they are associated with. They might interview you and rank you.
 
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I served several years on the residency recruitment committee for my anesthesia program, the “R” spots are few and far between compared to categorical and advanced slots. We had one or two a year compared to 20 C/A spots, and we usually took military physicians transitioning out of their surgery positions. You have solid statistics to match in one, but there just aren’t very many of them.

I agree it would be best to discuss with your home anesthesia program. You might be able to land a categorical or at least an advanced position there - many programs have trouble getting interest in filling A slots (most programs are thus moving towards predominantly categorical positions), so you could get lucky.
 
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I have contacted my home program and another program in the state. If that doesn't work out I will try my luck in the SOAP.

Thanks everyone. I couldn't find very many threads discussing "R" spots, so your advice is very helpful.
 
Is it appropriate at this time to send emails out to lots of programs asking if they have interview slots? Is there any way to easily find out which programs still have not completed interviews?
 
Is it appropriate at this time to send emails out to lots of programs asking if they have interview slots? Is there any way to easily find out which programs still have not completed interviews?

Can’t hurt to ask, at this point. It’s very late in the game so I’d probably only ask nearby programs - we usually had some last minute openings, especially at the end of interview season as applicants that had plenty of interviews cancelled their last ones to save $$.
 
I did physician only match. You would be surprised how competitive they are. Many people had completed a residency or had several years of experience and had very compelling reasons for wanting to do Anesthesiology.

Also there are only something like 25 programs out there that do this. They are usually good programs but take a look at the list (available on ERAS) and make sure you see at least 10 you'd be ok with.

Long story short, do your best now to get a position you are satisfied with. It can't hurt. But if you find the only opening is unsatisfactory, you might want to consider rolling the dice a bit on the physician only. Just don't be surprised when you're sitting next to a PGY-5 CCM fellow who wants to add Anesthesia to his/her repertoire come interview day.
 
Hey, thanks a lot for your response. This is good information.
 
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