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Interventional radiology is a very competitive field of medicine to match into. If you did not match into IR (aka are considered “unmatched”) or only partially matched, this resource was created for you. We hope that it gives you some insight into what steps you can take to improve your chances of matching for the next cycle. The responses below are summarized insights from SIR residents who have previously faced similar situations along with perspectives shared by IR program directors.

Scenario #1- Partial match 

I partially matched at a great institution for my prelim year after unsuccessfully matching into IR/DR or DR during my initial application cycle. I would like to know what I can do to increase my chances of matching into IR. 

General advice: Here are some tips to optimize success in this case. 

1. Communicate with your program director 

Partially matching is a tough blow to handle, but it is simultaneously a great opportunity to bolster your reapplication as you now have a foot in the door. We highly recommend reaching out to your preliminary year program director as soon as possible to let them know of your situation, and gauge how willing and able they are to help you match to IR/DR. This not only establishes early rapport between you and your program director but can open the door to early engagement in any research opportunities at the hospital and connect you with radiology faculty. Between March and September there are 6 months, so why wait until you show up in July to begin making moves with your program director and radiology department? Call your program director soon after you partially matched. Take initiative in creating opportunities and establishing the support you will need come ERAS submission time.

2. Work hard and be a stellar intern 

This is the most important thing you can do to help your application. The fact you partially matched remains a successful feat, as it inherently infers that you are hirable as a medical doctor. If you want your program director to write you the greatest letter of recommendation of all time, be the best intern possible by exhibiting a solid work ethic during clinical duties. Maintain humility in your work by pitching in wherever needed, supporting nurses, caring for patients with compassion, and doing what is right. Your attendings and senior residents are in more contact with the program director than you think, and often their input is included in the program director’s letter of recommendation. You do not need to be the brightest or most skillful intern, but you should be the hardest working. 

3. Find strong and supportive mentors

This year will be difficult, more so with the additional stress of re-applying, and ergo it is important to find mentors. Unfortunately, not everyone can understand the difficulties and unique situational stresses you might face as a partially matched intern, and it is vital that you can recognize those who can support your career and cut out those who do not demonstrate such concern. Fortunately, professional mentors can be anyone you look up to, including co-residents or chief residents, as well as attendings both in and outside of radiology. Begin by seeking mentors within your existing circle before reaching out to individuals outside your network. 

4. Curriculum Vitae boosters

There are 6 months between match day in March and the submission deadline in September. Here are some ways to add more to your CV in this short time span.

• Contact your program director early to inquire about research opportunities within the institution. Whether in surgery, internal medicine, or another specialty, you can contribute to a project as it doesn’t have to be limited to radiology. More often than not, they are more than happy to give you recognition if you participate and help out with the project.

• Have completed projects on your application by late September. Projects after this point are of questionable benefit as it is unclear if programs will recognize that you have completed these projects after your ERAS application has been submitted. 

• Ask your program director about other IRs in the radiology department and if they can put you in touch. Speak to them and make it clear you partially matched and are determined to do what you can do to be successful in your reapplication. Many people don’t realize that in addition to research, you can get involved in Quality Improvement (QI) projects. Research can sometimes be started before you arrive in July, but for QI projects you usually need to be there already. 

• Speak to doctors and support staff in the radiology department and see what issues exist in their workflow, for example. Or maybe organize IR or DR clinical education sessions for your co-interns with support from your mentor. These are amazing ways to show you contribute to your work environment and are a team player as well as leader. They are also major talking points in any letter of recommendation. 

• Get involved as a volunteer for the Society of Interventional Radiology (SIR)! Listed are few common ways for medical students and trainees to get involved as a volunteer. Only join projects/committees that you are passionate about, have the time to complete and do not detract from your clinical opportunities.

• The MSC Reserves is a year-round opportunity that provides short-term projects to those looking to get more involved with IR. 

• Those with some more advanced IR experience can get involved with the RFS Reserves, which is another year-round opportunity that has short term projects that are IR focused. 

• While you could apply to join a 1-year term committee geared towards medical students and residents, note that the annual application is open from October - January annually and volunteer terms don’t begin until the spring. 

These are great talking points in future interviews as ways you are staying involved in IR during your preliminary year.

• Join committees in your hospital or preliminary program. For example, run to be a representative for your intern class. There are numerous different hospital committees you can join and list on your application. Again, this shows you’re not only an incredible intern, but that you can also contribute to the growth of your current and future program.

• By late September (assuming you are starting projects in the intern year), it could be feasible to have a poster submitted to radiology conferences such as SIR, International Symposium on Endovascular Therapy (ISET), Society of Interventional Oncology (SIO), American College of Radiology (ACR), American Roentgen Ray Society (ARRS) or Association of Academic Radiology (AAR). You can research when conferences submit and present. Note that most conferences have submissions in the fall, with presentations in spring. Research days are another avenue for presentations but may not happen until mid or end of year. Publications are also great but take time to submit, and unless you are given a publication to submit, it may not be a possible addition to your CV by application time. 

5. Get to know your radiology department

Try and spend as much time as you can in the radiology department. If you have a patient undergoing an IR procedure, try and get involved in the case. Read out any interesting imaging you came across with the radiologists. Get that face time and show your interest. If possible complete as much elective time as possible in the radiology department prior to resubmitting in September. This will allow the IR/DRs to work with you and get to know you well. If your intern year hospital has a radiology residency program, this can be your best chance at making a great impression, showing your talent and getting that interview.

6. Letters of Recommendation and Personal Statement

You must receive a strong letter of recommendation from your program director. Aside from this, it is highly encouraged to get letters of recommendations from mentors in the radiology department. Aim for 1-2 letters of recommendations from IRs who can attest to your strengths, interest, research or QI projects you were involved in, initiatives you took etc. You can also get letters of recommendations from surgeons or any other specialists than can attest to your character and clinical capabilities. 

A reasonable letter of recommendation layout can be 1 program director, 2 IR/DRs, 1 attending from your program. Ask that they specifically mention that you are interested in IR/DR in their letters of recommendation. Edit your personal statement to highlight how your intern year has strengthened you to become a better candidate. Address the previous non-match directly and explain the steps you are taking to ensure a successful outcome this time. Have mentors review it and edit it as much as possible. Limit it to 1-page max.

7. Improve your test scores 

• Step 3: If your board scores are not competitive, you can consider taking Step 3 early. Particularly if your scores were not strong, taking Step 3 (+/- an in-service exam) and doing well is another point you can add to your application. See what is realistic for you as the main challenge is that it may be difficult to take Step 3 immediately after graduation and before the intern year, assuming you graduate in May/June and start the intern year in July, due to the limited number of available testing spots.

• In-service exam: Performing well on the medicine or surgery in-service exam could be another way to show your academic/clinical capabilities. The medicine in-service exam is usually early September, while the surgery one is around January. The only caveat, it is important to be sure you are able to take either exams at a time when you can study and maximize your results. If you don’t perform well you do not need to add it to your application.

8. Apply broadly

Apply as broadly as you can in the application cycle. We do not necessarily recommend that you reapply to places you had applied and interviewed at previously, as they may not interview you again in the upcoming cycle, unless you have a substantial reason that you might receive another invitation. You could consider reapplying to programs that did not interview you previously, but we caution repeating your prior application list as you need to optimize the numbers of interviews you receive. For your main geographic preference, signal programs and locations on the supplemental application, these are the most important factors in securing an interview at an institution based on ERAS data. Of course, the cost is higher the more programs you apply to but view it as an investment, not a cost. 

9. Brush up on your interview skills 

If possible, see if you can figure out why you may not have successfully matched in the previous cycle and identify any aspects you may be able to improve. Practice answering interview questions and having the best virtual interview set up that makes you look professional and polished. Practice makes perfect, even if you believe you are an amazing interviewee, complete practice interviews with mentors so you can answer the toughest of questions with poise and grace.

10. Check for open R1 spots 

Check the SIR vacancies page regularly for open R1 spots or the SIR Connect Open Forum. Since you partially matched, you may be eligible to apply for any R1 positions that become available throughout the year. Let your network know you’re reapplying as you never know when a contact might alert you to an opening.

Scenario #2 - Did not match or aka “unmatched”

I was not successful in the match. I do not have a prelim nor a residency. I am planning to reapply again this year. What can I do to increase my chances of a successful interview day, and hopefully matching into IR and a prelim year?

General advice: This is a difficult situation. Take the time to reflect on what may have hurt you this past cycle and review the tips provided above for the partially matched section as many of the current tips apply to this situation. 

Questions for reflection: Were there any red flags on your application? Did you apply broadly? Did you get many interviews? If so, perhaps you need to work on your interviewing skills.

In summary here is what we advise: 

1. Review your application and past couple of months with mentors you trust and try to find what you can realistically work on for your reapplication. If you did interview at programs, try reaching out to program directors and asking for any constructive feedback on your application. 

2. In the interim, you could consider completing a research year while reapplying as a means of demonstrating academic productivity during this forced gap year.

• Some students choose to defer graduation to maintain their status as medical students. During this time, they often complete additional away electives and engage in research at their home institution throughout the following year or application cycle. 
• Some prefer to graduate and take on a research role of higher time commitment at an academic center.
• Some like to mix research with any clinical work such as ED scribing or working as an assistant in a clinic so they are able to maintain an income during the year.          

 Ultimately, you want to be doing something that you can add to your CV and speak about in your personal statement and interviews. Letters of recommendation are also very important, so consider this before committing to any role. 

3. Make sure whoever is supervising you is aware of your situation and wants to help you succeed. This can also help create connections. For example, if you present at a research conference you will meet plenty of people in the field who may be able to help you.

4. Lastly, check online for vacancies on the SIR website or the SIR Connect Open Forum for available preliminary positions as there are often openings you can apply to off-season. This can get your foot in the door, and you can use the many tips in the scenario above to optimize your chances at matching. 

Final thoughts 

Review featured resources that have been created by passionate students and trainees from SIR’s Resident, Fellow and Student (RFS) Section. Many of these resources provide specific advice from IR mentors from various career stages regarding away rotations, how to match into IR, research tips and more on their webpage. 

We are confident you have the resilience to succeed in this reapplication cycle and ultimately reach your professional goals. No matter the circumstances, we believe you have what it takes to become an outstanding physician. Stay positive and keep moving forward!