You-Know-What

Okay, the topic of the post might sound misleading to most, but those who are aware of it, might agree.

I am taking about the San Francisco Match (or the SF Match, as we call it affectionately). There seems to be a surprising lack of resources for more information about this match and how it works. I have yet to see another website besides the official site (which is quite informative for a beginner) that has some information on the system.

First things first, this is NOT a match for match in California! In fact, it has absolutely nothing to do with location whatsoever. A lot of people ask about whether you need a SSN or PTAL for this match. And the answer is NO.

This is just the same as the NRMP/ERAS match, except for the fact that its for certain fixed sub-specialties, and takes place earlier in the year.
Now since I matched for Child Neurology, that is what I'll talk about (even though the SF match also caters to other sub-specialties like NDD, Ophthalmology, Plastic Surgery etc)

Three Years of Child Neuro include one year of Adult.

What is Child Neurology and why am I talking about  it here?
Well to answer the latter first. I MATCHED! And want to spread the love! (Especially for IMGs who don't have a med school advisor, and rely on seniors and forums for all information!)

To answer the former, read on..

When can you get into it?
WHENEVER YOU WANT! (..Well almost!) There are a couple of separate pathways to get into Pedi Neuro. To make sure I don't give a wrong message, let me quote from the website:

"Prerequisite Training: The training can be initiated following one of three options:
(1) 2 years of residency training in pediatrics in the United States or Canada;  

(2) one PG-1 year (as described in the Program Requirements for Residency Education in Neurology**) and 1 year of residency training in pediatrics; or 

(3) 1 year of pediatrics plus 1 year of basic neuroscience training.

The program director must review and determine the acceptability of these initial two years of training."

** (Excerpt from the Neurology RRC Program Requirements (ACGME): 'Those that provide 4 years of residency training, the first year of which training (accredited in the United States or Canada) must include a broad clinical experience in general internal medicine. This year must include at least one of the following: (a) 8 months in internal medicine with primary responsibility in patient care or (b) 6 months in internal medicine with primary responsibility in patient care and a period of at least 2 months total time in pediatrics or emergency medicine or both. Residents must spend no more than 2 months in neurology during this year.'  

I am taking the first pathway, by entering Child Neurology as PGY-3 in 2013. (Does that clear it up a little?)

So, wait, its a Residency after residency, or a Fellowship ..or what? Huh?

Child Neurology, while technically is a fellowship level thing since you do it after a Peds Residency; it is considered a Residency by the Board. So basically, if you do Peds  then Child Neurology-- and end up taking both Boards-- you can be 'Double Board Certified' with 'Certification in Pediatrics' and 'Certification in Neurology with Special interest in Child Neurology'.
The Neurology Certification means you can practice adult neurology too (since you do have to spend one-third of your Child Neurology Residency in the Adult Year)
Then there's the opportunity to pursue a fellowship, in one of the many fields of interest like Epileptology, Neuromuscular disorders, Sleep medicine etc.


The Timeline:
Its an early match.
How early? Well, the process of submission of documents starts in June (as opposed to September, for ERAS).
- You mostly have interviews ranging from late-October and should finish by late-December (though I met someone who was finishing in mid-Jan, so that's how far it can go!)
- Then you submit the rank list by mid-Jan.
- And Match Day is usually in the last week of Jan. (It was January 27th this year!)


How many programs? 
There are not as many programs for Child Neurology as are for Pediatrics (doh!!). There are about 70 odd programs (--they give you the comprehensive list once you register for the match) . I applied to twenty five programs, and received interviews from thirteen places.

Most of the programs via the SF Match are for the three year Child Neurology i.e. beginning as a PGY-3. But programs prefer if their residents do both- Peds as well as Peds Neuro-- from their place, so they *usually* try to co-ordinate with the Peds Department. This means while they might try to interview you for Pediatrics as well (if you apply there via ERAS), it is NOT an obligation.
Now some places like Cleveland Clinic, Rainbow Babies etc have a dedicated five year track. Which means, if you get in the Child Neurology part of the track, you mostly get in for Pediatrics as well (again, through NRMP!)


Match Data:
While people might think that the competition is less in Pedi Neuro, let me assure you-- its a MYTH! There are about 1-3 spots per year per program. So the ratio for candidates per spot boils down to the same thing. Here is a link to last year's match data from the SF Match. So last year 69% IMGs matched, which is more than the average NRMP match percent, but definitely involves more of a commitment!

I know some IMGs might be tempted to apply just for the heck of it.

If that is your plan, then DON'T!

Here's a scenario:
Assuming, you apply for about 30 Child Neuro programs and a hundred-ish Peds programs. (I did.. since I wasn't sure I would be able to make it in Pedi Neuro this year). If you end up getting interviews in Pedi Neuro, then quite possibly your credentials are good enough and therefore you will get interviews for 'just-Pediatrics' as well.
Now, if you aren't sure if you want to go for Peds Neuro, then you might be in a fix since the match date is earlier. Your rank list is divided between the programs that invited you for both Peds/CN and the ones that have only Peds!
You might end up going to a specialty you aren't sure about (Pedi/Neuro) without giving a specialty you might love (eg Peds or IM) a chance!
[Basically what I'm trying to say is, applying to Peds Neuro is not like applying to say Family Med or Peds as a back up that I've seen a lot of Internal Medicine people do! Its a different ball game altogether]

Apply to the field only if you LOVE it! Since if more than just five years of your life.

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I tried to cover everything that sporadically kept coming up in my head. More questions are welcome. I'll try to write another post if I have some common queries, or answer questions in comments.

Good luck!
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PS: Hugs to one absolutely fantastic CN intern I met during my away rotations. She patiently helped me out a lot through the whole process, when I didn't know squat about You-Know-What! Thanks, S. x