Monthly Archive: June 2012

Top Ten Books for the USMLE Step 1

Categories:

Preclinical Years, Books, Step 1

June 7, 2012

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This list is part of a series of articles about the best books for medical students. Click on the Med School Books Main Page to see other lists including the best books for each year in medical school, the best books for each clinical rotation, and the best books for USMLE Steps 1, 2, and 3.

Before I plunge into the Top 10 books for Step 1 let me first explain that books were only the second best resource for me while studying for Step 1.  I found question banks to be the most efficient means of studying for Step 1. In order to do well on an 8 hour test, you need to be accustomed to doing hundreds of questions in a day.  Doing well on Step 1 is not just a question of learning the info in the books I list below, but also a question of developing the stamina to say focused on the 349th question of the day….it is like preparing for a marathon. USMLEworld and the Kaplan Q-bank in my opinion are the best resources for preparing for Step 1, but you can not do questions for 1 month straight, you need to spend some time in books. Now for the books…

  • Updated April 2015

1. First Aid for the USMLE Step 1:

I don't know how they do it, but the First Aid people have an unbelievable ability to know exactly what is important to the people who write board questions.  First Aid is reprinted each year. I suggest buying one copy early in med school and study from it while you study for your other classes. Then, purchase the new copy when you are studying for Step 1.  First Aid is not sufficient for Step 1, but it should be required reading for all students as it highlights the stuff that you absolutely must know. Some students also recommend Kaplan's MedEssentials for the USMLE Step 1

2. BRS Pathology:

Another required book for Step 1 is a pathology review book. The two most commonly used books are BRS Pathology and Goljan's Rapid Review Pathology (#3). I prefer the BRS book because it is a no-nonsense text with a few pictures and tables but mostly focused on simple and clear text.  You should browse through both books before deciding which one you will use.

3. Rapid Review Pathology:

The other famous pathology review text for Step 1. This book is written by Dr. Goljan of "Goljan Lectures" fame. (If you do not have these lectures, see my article and links about the subject because they are fantastic). The content is similar to the BRS Pathology text but the delivery is quite different. This text is more visually appealing with colors, images, and many tables. Pick your poison.

4. BRS Physiology:

A broad physiology text is another book that most students use when studying for USMLE Step 1. It is unlikely that you will learn anything new when ready a physiology text. However, a physiology text will help you cement concepts in your mind. A great understanding of physiology will help answer the difficult Step 1 questions. I found that reading the physiology text for one organ system, then the pathology text and First Aid for the same was great preparation for questions on that subject.
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5. High Yield Biostatistics:

You can not forget the small categories that are tested on Step 1. Biostat/epidemiology is one of these areas. I am sure I had 10-15 questions on these topics. The High Yield book is quick and easy; you can get through it in just a few hours. Don't go into the test without knowing all forms of bias and all calculations of a two-by-two table.

6. BRS Behavioral Science:

The behavioral sciences will also take up at least 5-10 of your Step 1 questions. These are hard to study for but you must find a way to do it. There are a few books options in this category, the great asset of the BRS book are about 15-20 questions at the end of each chapter. Many students swear by High-Yield Behavioral Science. This book is also very good, more concise, and easy to read. It does not have questions.

7. MicroCards:

Flashcards will give you a nice break from question banks and books. MicroCards have a ton of information. It may seem like some of the information is superfluous, but after taking the exam you will realize that many Step 1 questions ask very specific questions about bacterial anatomy and antibiotic targets.  I will never forget that on my Step 1 they wanted me to know the treatment for sporothrix schenckii.  So, yea, get some microcards.

8. PharmCards:

This is another set of flashcards that you can use in the bus, at night on the bed, during lunch, etc. Like MicroCards, these cards have a ton of information. However, you will be asked some very specific questions. One example I still remember is being asked the mechanism of action of ethosuximide.  Even though it is "Step 1" they will still ask pharm quesions.

9. First Aid Cases for USMLE Step 1:

You will find a common theme here: find something to break up the books and question banks. Though questions and the first 4 books will be your main ammunition to study for Step 1, you can not do that for a whole month. Flash cards and cases will help break things up while still learning and picking up some questions. The First Aid case book is very good and highly recommended by all. I used case books when my mind was tired of memorizing, and I think they helped me pick up a few questions. Most of you are also familiar with Kaplan's USMLE Step 1 QBook in print format, which is another great distraction of texts and computer questions.

10. USMLE Step 1 Secrets:

I did not use this book. I had heard good things during medical school, but it never made it into my bag. Since I wrote this post I have had numerous students write to me and explain that book became a foundation for them. As the book states in its Preface, it is not a stand-alone resource. The book aims to add clinical context to the data you will glean from texts and First Aid. I place it tenth on my list only because I do not know its true power. After reading through the book after-the-fact, I am convinced that I would have used it quite frequently during my study time.

 
 
 

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Spotlight Interview: How to Match in Anesthesiology (Emory Resident)

Categories:

Residency, Anesthesia, Choosing a Specialty, How to match in....?, The Match

June 4, 2012

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An Anesthesia Resident’s Perspective:  From an interview with an anesthesia resident from Emory University in Atlanta, Georgia.

Part of an interview series entitled, “Specialty Spotlights“, which asks medical students’ most burning questions to physicians of every specialty.  See what doctors from every specialty had to say about why they chose their specialty and how to match in their residency.

 

  • How competitive is the Anesthesiology match?

Comfortably in between family practice and plastic surgery.  Overall, it would probably be considered medium competitiveness.  Interestingly, the competitiveness of anesthesia has varied quite a bit over the years (higher board scores, lower match rate, etc). The numbers seem to be about average right now though.

 

  •  What must a student do to match well in Anesthesia?

You need to find great references from anesthesiologists.  This can be accomplished in the standard ways but most importantly is to demonstrate interest by performing well in an anesthesiology rotation.

 

  • What are residencies looking for in an Anesthesiology applicant?

Residencies are most interested in a well-rounded medical student that can think well on his/her feet.  The same positives from other professional arenas apply to anesthesia – personality, humility, empathy, etcs.

 

  • What should students look for in an Anesthesia residency?

There are a few things you need to be aware of. First, you need to know the number of cases completed by residents at each of your interviews. You need to be ready to hit the ground running, so # of cases and variety is important. You will be able to learn about the satisfaction of current residents while on your interviews. You should also consider georgraphic fit with family, and your career goals in general (academics vs. private among other questions). Ask where past residents have ended up – fellowships?  Jobs?  What are the employment statistics?

 

  • Do you have any advice on the application, letters of recommendation, personal statements, or how to rank programs?

The best 20-30 programs essentially all offer the same things.  Everyone gets jobs, or has fellowship options.  Go where you have the best fit, where the geography/hospital best suits the interest of your family (or yourself).

 

  • What do you wish you knew before application/interview season?  

Calling programs once or twice is not seen as “nagging” – a friendly, professional follow-up to applications will oftentimes turn into an interview offer so long as you do it early in the process.

 

  • What other advice do you have for students applying to Anesthesiology residency?

Whether you apply to anesthesia, emergency medicine or ophthalmology – you need to be honest with yourself about your career aspirations.  Try and get past the notion that you “need to be a neurosurgeon or your life was for naught.”  Accept that there are many specialties and many places where you can be a very successful, happy professional.  Remember to mind your spouse/significant other and ask for their input – your decision will affect more lives than your own.

 

Editor's Note: Applying for residency or preparing for your interviews? I highly recommend First Aid for the Match, The Successful Match: 200 Rules to Succeed in the Residency Match, and The Residency Interview: How To Make the Best Possible Impression .


 

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Spotlight Interview: Why Did You Choose Anesthesia? (Emory Resident)

Categories:

Anesthesia, Choosing a Specialty, Why did you choose....?

June 4, 2012

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An Anesthesia Resident’s Perspective: From an interview with an anesthesia resident from the Emory University in Atlanta, Georgia.

Part of an interview series entitled, “Specialty Spotlights“, which asks medical students’ most burning questions to physicians of every specialty.  See what doctors from every specialty had to say about why they chose their specialty and how to match in their residency.

 

  • What attracted you to Anesthesia?

A couple of things stand out to me.  First and foremost, I was attracted to its pace & acuity.  I learned pretty quickly in medical school that I was not destined to manage a wide variety of chronic problems.  I have always been the type of person that prefers high-pressure situations and quick decision-making.  Secondly, I felt I had a lot in common with the other anesthesiologists I met.  There is most certainly a “personality type” that seems to gravitate toward the field – usually personable, outgoing but quietly knowledgable physicians.  Most importantly, they are the type of doctors that underscore doing a great job by staying out of the limelight.

 

  • Describe an Anesthesiologist’s typical work day?

A typical day for a general OR anesthesiologist involves the following – Arriving at the hospital around 615 am to prepare your rooms, see your patients, start any necessary IVs, lines etc.  Cases are ready to go around 7:15 at most hospitals.  As a resident you will typically stay with your patients for the duration of their case.  On a typical OR day with bread and butter abdominal surgery you oversee 4-5 cases a day.  At the end of the day you are relieved to go pre-op the next day’s patients (physical exam, brief H&P).  As an attending, the field is shifting to more of a perioperative & Anesthesia Care Team model.  This usually involves a physician overseeing the anesthesia to 3-4 cases simultaneously.  Nurses or residents work directly beneath the attending at the patient’s bedside.

 

  • What type of lifestyle can a Anesthesiologist expect?

Anesthesiology is far from a “lifestyle” specialty – busy practices will necessitate call (usually a weekend a month, or one night in seven as “first call”).  That being said, anesthesia has the perk of more defined hours than many other specialties.  When cases are done in your operating room, you are free to go home.  There are no follow up visits in clinics, floor management or chronic care with which to be concerned.

 

  • What is the average salary of a Anesthesiologist?

Typically new graduates will make around $250,000 average, depending on geographic location.  After a few years of practice (or with partnership) salary typically rises closer to $330-$350k per year.

 

  • What is the job market like for Anesthesiology?

There are always jobs for anesthesiologists.  Availability is geographically dependent, however.   If you are dead-set on working in midtown Manhattan you will have to take a pay cut, and your  job search will be a bit more labored.

 

  • What can you tell us about Anesthesiology Sub-specialties?

Typically the sub specialists will spend one extra year as a fellow (PGY5, five years total).   There are only a handful of ABA-recognized fellowships at this time.  Pain medicine, critical care medicine, cardiovascular anesthesia and pediatric anesthesia.  Experts predict there will soon be board-certification in obstetrics, neuro, and local anesthesia.

 

  • What are the potential downsides of Anesthesiology that students should be aware of?

I am always asked about the political climate of anesthesia, and the supposed “take over” by nurses.  This is something to consider before entering the field – the role of the anesthesiologist is always evolving, we are seeing a shift towards perioperative management and an “anesthesia care team” model being emphasized so physicians can manage multiple cases at the same time.  No one can predict what legislation will mandate in the future.  It goes without question that a physician-trained anesthesiologist will always be a necessity at major medical centers – and the need for good physicians will always be greater than the supply.

 

  • What else would you tell medical students who are considering Anesthesiology?

Spend time following anesthesiologists in the hospital setting.  If you know any anesthesiologists privately, try and assess how happy they are with their career choice.

 

Editor's Note: For more help choosing a specialty in medicine, I highly recommend one or both of these two great books. I found both very useful.

 

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Spotlight Interview: Why Did You Choose Urology? (USC Resident)

Categories:

Choosing a Specialty, Urology, Why did you choose....?

June 4, 2012

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A Urology Resident’s Perspective: From an interview with a urology resident from the University of Southern California (USC) Medical Center in Los Angeles, California.

Part of an interview series entitled, “Specialty Spotlights“, which asks medical students’ most burning questions to physicians of every specialty.  See what doctors from every specialty had to say about why they chose their specialty and how to match in their residency.

 

  • What attracted you to Urology?

Many factors attracted me to Urology…

1) Surgery – If you are interested in surgery then definitely consider urology. Urology has a very broad range of surgeries ranging from microsurgery to complex open abdominal cases with extensive reconstruction. If you are into technology, urology is often on the forefront of new surgical modalities such as robotic surgery.

2) Clinic – Many urologic issues are often dealt with in an outpatient clinic. There is definitely continuity of care as many urologic issues aren’t resolved with one clinic visit. Whether it is a patient with recurrent kidney stones that needs a metabolic work up, or a post surgical cystectomy patient for bladder cancer that you are surveying.  Also many urologic procedures can also be done in an office setting such as cystoscopy, ureteral stent placement, vasectomy, prostate biopsies, plus much more.

3) People – Your work environment and colleagues are an important factor in choosing a specialty. Although it is a stereotype, it is often true; urologists are known to be fun, down to earth, and happy surgeons. Also, urology is a small field. You will find when you go on interviews, you will get to know the majority of your interviewing cohort by the end of the interviewing season. Similarly, most academic urologists know the other academic urologists across the whole country. Everyone is familiar with one another and this lends to a tight knit group of specialists.

4) Lifestyle/Flexibility – This is definitely a factor to consider when choosing a specialty. Not only are urologists relatively well compensated as it is a surgical specialty, the field also lends itself to a relatively nicer lifestyle if that is what you are looking for. Although training is rigorous, once you are practicing there are generally very few urologic emergencies. Urology also allows you to be flexible with how you want to practice. You could do very well practicing as a general urologist. You can also choose to sub-specialize by pursuing one of a number of fellowships. These include urologic oncology, endourology/stone disease, pediatric urology, transplant, reconstruction, female/neuro urology, minimally invasive surgery, and andrology/infetility.

  • Describe a Urologist’s typical work day?

This can vary widely depending on if you are in academics or private practice, but in general urologists operative 2-3 days a week. The rest of the week is split between research and clinic.

 

  • What type of lifestyle can a Urologist expect?  

Few urologic emergencies lend to a nicer lifestyle for urologists. The field is flexible and you can generally choose to be as busy as you would like. Because it is a surgical field you can still expect relatively early mornings.

 

  • What is the average salary of a Urologist?

See the excellent positings on this blog for average salaries. [Link from the Editor: The Ultimate Guide to Physician Salaries]

 

  • What is the job market like for Urology?

In general, very good. Very few urologists are trained each year (approximately 270). This leads to a shorter supply for a growing field. Definitely keep in mind that in more desirable locations, jobs may be more difficult to find, and you will take a substantial pay cut than if you practiced in a more rural setting.

 

  • What can you tell us about Urology Sub-specialties?

Urologic oncology – 1-3 extra years of fellowship (accredited vs non accredited). Lifestyle is more varied as your patients are, in general, more sick. Variety of surgery from robotics to massive abdominal surgery.

Endourology/stone disease – 1-2 years of fellowship. Master endscopic/percutaneous management of stone dsease.

Female urology – 1-2 years of fellowship. Nice lifestyle, very good job market as they are in high demand.

Neurourology – 1-2 years of fellowship. Urodynamic evaluation of patients with voiding disorders.

Infetility/Andrology – 1-2 years of fellowship. Very few fellowship spots available. Very nice lifestyle, more competitive job market.

Pediatrics – 2-3 years of fellowship. Also competitive job market especially for major cities.

Transplant – 1-2 years of renal transplant fellowship. Varied lifestyle depending on seniority/call schedule.

Reconstruction – 1-2 years of fellowship. Nice lifestyle.

 

  • What are the potential downsides of Urology that students should be aware of?

It is not a field to go into if you are not into surgery. The surgical training is very rigorous. Most programs are 5-6 years in length, and you can expect early mornings and late evenings. Although times are changing, urology is still a male dominated field which can be a deterrent to many women who may be interested. The good news is that there is a rise in female applicants each year and there is a growing need and demand for urologists who are female.

 

  • What else would you tell medical students who are considering Urology?

If you are at all interested in surgery, definitely consider exposing yourself to urology by doing a rotation in medical school. Most medical students have little to no exposure to urology and much of this exposure is all in the classroom setting. Many people (including patients, medical students, and practicing physicians) have little knowledge of the field and what we do. Although it is a unique specialty, you can tailor your practice to your own wishes and desires: more clinic, more in-office procedures, more big whacks, etc.. Definitely check out www.urologymatch.com, which is surely the best resource for medical students and has many articles as well as an active message board. Also check out the official American Urologic Association at www.auanet.org.

 

Editor's Note: For more help choosing a specialty in medicine, I highly recommend one or both of these two great books. I found both very useful.

 

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Spotlight Interview: How to Match in Urology (USC Resident)

Categories:

Choosing a Specialty, How to match in....?, The Match, Urology

June 3, 2012

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A Urology Resident’s Perspective:  From an interview with a urology resident from the University of Southern California (USC) in Los Angeles, California

Part of an interview series entitled, “Specialty Spotlights“, which asks medical students’ most burning questions to physicians of every specialty.  See what doctors from every specialty had to say about why they chose their specialty and how to match in their residency.

 

  • How competitive is the Urology match?

It is considered a competitive specialty to match into. The website www.auanet.org has some statistics that can help you out. In general there is an approximately 70-80% match rate for students coming directly out of medical school. This number is substantially lower for graduates that did not match the first time around, graduates that took time off after medical school, and international medical graduates. The good news is the number of positions are increasing each year, while the number of applicants has stayed approximately the same. This does vary year by year.

 

  •  What must a student do to match well in Urology?

Be very well rounded. Step 1 scores aren’t everything, but many programs will use this score as a screening tool to offer you an interview. Unlike most other specialties, urology does not publish data on average Step 1 scores of matched applicants. There is a generalization that scores above 230 are considered competitive and will get you interviews at most places except for possibly top tier institutions. There are definitely exceptions, and unfortunately these date are not publicized by institutions. Research is not a must, but can definitely set you apart from others, especially if you have presented the research at a meeting or as a published article. This will give you more to talk about during your interviews. Great letters of recommendations from urologists are also important. Having a letter from a well known urologist can really help your application and increases your chance of matching well. Urology is a small field, and most academic urologists know each other well, so a strong letter of recommendation from a leader in the field can take you far.

 

  • What are residencies looking for in a Urology applicant?
Stong work ethic. Personable applicants. Great board scores. Strong letters of recommendations. Great clinical knowledge.

 

  • What should students look for in a Urology residency?

Satisfaction – how happy are the residents? Operative experience – do the residents get autonomy when they operate or are they mainly assisting attendings? There are some programs where you will be assisting even as a chief resident. Research – is there a research year built into the program? What opportunities are there for clinical/translational/basic science research? do the residents publish? Location/Social life – although you will be busy, the days you are free you want to be able to have something to do. Do the residents have fun outside of the hospital? Staff – how are they to work with?

 

  • Do you have any advice on the application, letters of recommendation, personal statements, or how to rank programs?

1) Submit your application early! If possible this means the day ERAS is open for application submission (For the 2013 match this date is September 15th, 2012). You can fill out the majority of ERAS ahead of time. Also make sure all your letters of recommendation’s are ready by the time you can finalize and submit your ERAS.

2) In general, only obtain letters of recommendations from urologists. 3 is enough. One is usually from the chairman of your urology department (and often the most important letter), and the rest are from either away institution urologists or a particular attending you worked with extensively and knows you well.

3) The personal statement is more likely to hurt you then to help you. Very rarely do personal statements stand out, and if they do stand out it may not be a good thing. In general be sincere, honest, and to the point in your personal statement.

 

  • What do you wish you knew before application/interview season?  

1) If you know you have a possible interest in urology, do a rotation as early as possible in your 3rd year. This will give you time to get to know the urology department at your university and will help you find a research project. Also, meet with your school’s dean regarding your competitiveness. Start talking with the urology residents at your institution and their experiences with applying.

2) Away rotations are important for urology. Not only does it give you an opportunity to see what other programs are like, this is also your chance to show them what can’t be expressed on your application. Start researching the programs where you might want to do an  away rotation early on, as applications for away rotations are generally due by February/March of your 3rd year. Importantly, an away rotation can help you just as much as it can hurt you. Think of it as a month long interview. While the month can be extremely stressful, it can also give you the best chance of matching at an institution you might not have thought you had a chance at. Most urology applicants do 1-2 away rotations.

3) If your USMLE Step 1 score is not as strong, consider taking Step 2 early. A substantial increase in your step 2 score can definitely help you.

4) Keep in mind that as of the 2012 match, the urology match is still an early match and it is separate from the regular match. This means that you need to expedite your application as well as letters of recommendation. As soon as your application can be finalized and submitted on ERAS (generally beginning of September), do this. This means your letters have to already be uploaded at this time. Many programs start offering interviews within a week of application submission. Interviews in general start at the end of September and last through mid December. The peak of interviews is during the month of November. On the bright side, all this hard work also means that you also get to match mid-January.

5) Spend lots of time on www.urologymatch.com. There is plenty of good information that can help prepare you for every aspect of urology.

6) Take everything you read on www.urologymatch.com with a grain of salt. The best way to really get to know a program is gathering information from multiple sources (first hand experience with an away rotation, talking to the residents/attendings, reading various opinions online).

 

  • What other advice do you have for students applying to Urology residency?

After your interview season is over, consider doing a second look if you have the time/money. A second look is a 1 or 2 day return visit to a program so that you can see first hand what they are all about. This is definitely not a must, however it can help you with making your match list. I suggest this particularly for programs that you think you will rank high, as this will allow you to experience first hand what the program is like. If you really like a program, try to find out during your first interview if second-look day is something that many people do. Again as much as a second look can help you with how you rank a program,  remember that it is the second-look at your for the program as well.  Do a second look if you really want to discover more about a program, not to show a program you’re really interested.

 

Editor's Note: Applying for residency or preparing for your interviews? I highly recommend First Aid for the Match, The Successful Match: 200 Rules to Succeed in the Residency Match, and The Residency Interview: How To Make the Best Possible Impression .


 

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Radiology: “Don’t Choose Something You Hate”

Categories:

Choosing a Specialty, Compensation, How to match in....?, Radiology, The Match, Why did you choose....?

June 3, 2012

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A Radiology Resident’s Perspective: An interview with a radiology resident who has asked to remain completely anonymous for reasons you may soon understand.

Part of an interview series entitled, “Specialty Spotlights“, which asks medical students’ most burning questions to physicians of every specialty.  See what doctors from every specialty had to say about why they chose their specialty and how to match in their residency.

 

  • What attracted you to Radiology?

The money.  Choosing a specialty for its salary is considered an anathema in the medical community.  Because the discussion of salary is taboo, many medical students have taken to talking about a specialty’s “lifestyle.”  In reality, lifestyle and salary/work ratio are near synonymous.  With the notable exceptions of radiation oncology and dermatology, radiology is unquestionably at the top of the heap.  Factoring in vacation, hours, and salary the average private practice (PP) radiologist made nearly twice as much per hour as a general surgeon.  If you are going to sacrifice your youth to medical education then you should be lucratively rewarded.

As I learned more about radiology, I realized that the specialty has all sorts of unique advantages.  Without a patient base, a radiologist is free to move about the country at will.  They can work from home or from anywhere in the world with teleradiology.  This mobility, free of the fetter of patient care, continues to drive radiologist’s salaries higher. Radiologists tend to practice longer than any other specialty (except pathology) presumably due to the relaxed work environment.  However many radiologists retire early, which is silly because radiology differs little from retirement.

When I began my clinical rotations, I made a very important and life altering discovery.  Clinical medicine sucks.  I hated the whole experience.  I agonized at having to pick between such awful choices.  People kept telling me, “Just do what you love!”  I have different advice, “Don’t do what you hate!”  Radiology is unique in that we have an integral role in patient care without having to be dragged into any of patient care’s unpleasantries.  I am no longer screamed at by patients at 2 am because they think nexium is causing back pain.  I no longer have to hold a screaming child for a shot or calm down a sundowning gomer.  If you have the opportunity to save lives from a distance, I highly recommend it.

 

While the lifestyle is enviable, radiology is anything but easy.  Radiology is an intellectually rigorous specialty that encompasses the entire breadth of medicine.  The training requires extensive study of anatomy, pathology, physics, and treatment.  In emergencies, films must be read quickly and accurately.  Entire medical treatment plans are sometimes based on a radiologist’s dictation.  Medical imaging continues to be at the forefront of modern medicine. Technology advances rapidly and a radiologist should expect to spend most of his or her career keeping up with current technology.

 

  • Describe a Radiologist’s typical work day?

The typical radiologist comes to work and reads films in the dark for the majority of the day.  The work day in punctuated by phone calls, administrative responsibilities, and procedures (thoracenteses, liver biopsies, chest tubes, barium swallows, etc.).  Contrary to popular belief, these procedures are performed by general radiologists with no special “interventional” training.

 

The Radiologist’s Dilemma: This radiologist can’t decide which LED TV to buy. A common problem…

  • What type of lifestyle can a Radiologist expect?  

Based on information on the ACR website, job postings, and anecdotal experience the average radiologist works about 50 hours a week.  Generally this is a 7am-4pm M-F with one short call until 9pm and 1-2 weekend days per month.  Work schedules are flexible.  It is also possible to rearrange the work schedule in many different ways with your partners.  Our work schedule isn’t tied to patient management so we can divide it anyway we wish.  PP radiologists average 10 weeks of vacation per year, a figure that makes teachers envious.

  • What is the average salary of a Radiologist?

Based on the most recent Merrit Hawkins salary scan the average radiologist makes $417,000(1).  Andrew has compiled the entire source of physician salary data into one easily searchable article.  The Ultimate Guide to Physician Salaries. I highly recommend it.

 

  • What is the job market like for Radiology?

The job market is somewhat tight at the moment, though this is not unique to radiology.

 

  • What are the potential downsides of Radiology that students should be aware of?

My specialty is perfect.

 

  • What else would you tell medical students who are considering Radiology?

Don’t do what you hate.  Kill the boards and standardized tests.  Keep your options open.

 

  • How competitive is the Radiology match?

Radiology is a very competitive specialty.  The average USMLE STEP 1 is 240(2).  26% of successfully graduates are inducted into AOA.  Most have some research.  Luckily, radiology is a surprising large specialty.  With nearly 1000 positions per year, there are plenty of spots to go around.  More residency positions are created every year.  For this reason, radiology is less competitive than dermatology, radiation oncology, plastic surgery, orthopedics, otolaryngology, or ophthalmology.  Clinicians actively try to dissuade medical students from going into radiology.

 

  • What are residencies looking for in a Radiology applicant?

Personality, 3rd year grades, board scores, research.  In that order.

 

  • What else would you tell medical students who are considering Radiology?

I wish I knew how fat I would get on pre-interview dinners.  Radiology interviews are great.  If I could do it again, I would.

 

  • What should students look for in a Radiology residency?
  1. A balance of case volume and teaching:  There are “work” residencies and “study” residencies.  “Work” residencies focus on learning to read films and dictate efficiently but can lack structured educational activities such as lectures and research.  If case volume is too high, you may be trained to be a transcriptionist instead of a radiologist.  On the other hand, at certain programs the residents are underworked and spend a large portion of their day studying and researching.  While these residencies sound cushy, it is embarrassing for residents to have to fight each other for cases.  One should look for a program where the residents do not have to compete with fellows for films/cases.
  2. “View-box” teaching:  The ideal situation is that the resident reads a film independently, checks out with the attending who teaches and answers questions, and then the resident dictates a report.  The suboptimal way is that the resident types a brief preliminary report which is later finalized by an attending with no face-to-face contact.  (Though the latter situation is appropriate for senior residents reading basic films.)
  3. Modern Equipment:  Radiology is a rapidly changing field.  Don’t be behind in the technology before you even start!
  4. Residents and Faculty:  Go someplace where you will fit in and feel comfortable.
  5. Facilities:  Palace or dump?
  6. Food:  You are what you eat.
  7. Fitness:  For something to do with all your free time.

 

  • What other advice do you have for students applying to Radiology?

I met an old southern radiologist when I was a medical student.  He looked like a colonel in the Civil War.  Grizzled and wizened, he looked me straight in the eye and asked, “Son, what is it ya wanna do with yo life?”

“Radiology, sir.”

He said, ”Well that shows remawkable judgment and good sense.”

You are choosing a career for LIFE.  Choose a specialty that you will enjoy when you’re 64.  Most people have the same specialty longer than they are married.  Treat your specialty choice with the same careful consideration as you would with any major life decision.  Or don’t, and go into ER.  What do I care?  Peace.

 

MYTH OR FACT:

Physicians from all specialties frequently switch to radiology after realizing their mistake

  1. Radiology is going to be Outsourced! – A favorite MYTH of surgeons, foreign doctors, and the ignorant.  First and foremost, as long as radiology is considered to be medical practice, then it will require aUS medical license.  Credentialing is increasingly difficult and the notion that any hospital would credential an unknown inRanipet,India is absurd.  Second, general radiologists now perform far too many procedures to not have a physical presence at a hospital.  And third, there is no way to sue that physician in Ranipet.
  2. Radiology doesn’t have enough patient contact  – MYTH.  Radiology has as much patient contact as you want.  At any time, I can put down my mocha latte and go talk to my patients.  I don’t, but I could.  Radiology requires a one year internship that is designed to shatter any delusions medical students still have about patient contact.
  3. Radiology has turf wars with other specialties.  – This is FACT, but it is not unique to radiology.  The most notable radiology turf war is with cardiologists over cardiac imaging.  Clinicians reading their own films is grossly inappropriate.  Clinicians are 4 times more likely to order a film if they are reading it themselves3.  Beyond the unscrupulous avarice, the radiation from unnecessary studies causes direct harm to patients.
  4. Radiologists sit in the dark all day – FACT, but there is nothing stopping me from turning the lights on while I read films.

 

Editor's Note: For more help choosing a specialty in medicine, I highly recommend one these great books about choosing a specialty. If you have already decided on radiology, I recommend the First Aid for the Match to help you get ready for interviews.

 

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Spotlight Interview: Why Did You Choose Urology? (OSU Resident)

Categories:

Choosing a Specialty, General Surgery Rotation, Urology, Why did you choose....?

June 1, 2012

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A Urology Resident’s Perspective: From an interview with a urology resident The Ohio State University Medical Center  in Columbus, Ohio.

Part of an interview series entitled, “Specialty Spotlights“, which asks medical students’ most burning questions to physicians of every specialty.  See what doctors from every specialty had to say about why they chose their specialty and how to match in their residency.

 

  • What attracted you to Urology?
I knew that I was attracted to surgery, but I was not interested in living a “surgeon lifestyle.”  Many doctors, including surgeons in other specialties, recommended during medical school that I check out urology.  Urology was not on my differential and the thought of dedicating my life to the urinary tract did not seem appealing.  I was convinced to do a 2 week surgery subspecialy rotation in urology.  I was amazed at the breadth of surgical procedures they performed.  I also enjoyed all the different equipment (or toys) that they utilized.  There was also a lot of variety in clinic between medicine and office procedures.  I appreciated the fact that urologists worked hard, but most days were still done at a reasonable hour.   This allowed the urologists to maintain a healthy balance between work and life outside the hospital.  Probably, the deciding factor was how genuinely happy the urologists were and when asked, all of them stated they would choose urology if they had to do it all over again.

 

  • Describe a Urologist’s typical work day?

The work week is usually split fairly evenly between clinic and OR.  I would say that most urologists have around 2 OR days and 3 clinic days, although many clinic days may have time dedicated to office procedures.  Obviously, the clinic days are going to be more routine office hours.  OR days vary a lot depending on what type of cases you perform.  Most procedures are outpatient and relatively short.  If you plan to do a lot of cancer surgery then you will do some longer cases and therefore will have some evenings spent operating.

 

  • What type of lifestyle can a Urologist expect?  

It is still a surgery field which means you still have early rounds due to early OR cases.  I feel that residency hours are comparable to other surgery fields, with the main difference maybe being home call for urology versus in-house call for many other fields.  I feel there is a light at the end of the tunnel though.  In practice, most days will have office-hours type of schedule.  A lot depends on what types of cases you decide to do and how the call is split up.  In general, there are less emergent surgeries in urology than most other fields.  If you are at a busy hospital there still may be ER consults and inpatient catheter issues that will need to be addressed in the middle of the night.  I think that most nights, even on call, you can expect to get a decent amount of sleep.  Relative to some surgery fields, you should have adequate time to spend with family and doing hobbies during the evenings and weekends.

 

  • What is the average salary of a Urologist?

Overall, probably between $200,000 and $600,000 with starting salary between $200,000 to $400,000.  A lot has to do with private practice versus academics and how saturated the specific market is.  I think most academic urologists will make between $200,000 to $300,000, but with certain bonus/incentive packages may eventually make more.  If you are starting off in a bigger practice in a more competetive location, you will likely start off closer to the $200,000 range, but with time can build up your practice and eventually be making greater then $500,000.  There has also been a trend towards hospital employed urologists.  These hospitals will often provide higher starting salaries (e.g. closer to $400,000), but may have more of a ceiling on how much you can earn from there.

 

  • What is the job market like for Urology?

Most of the big, destination type cities are relatively saturated.  Having said that, you can likely get a job just about anywhere but you may just have to take a big pay cut.  There are many relatively rural hospitals that are desperate for urologists and will pay good money to lure you out there.  I would say in general that the job market is good, but you may need to have some flexibility on where you want to end up practicing.

 

  • What can you tell us about Urology Sub-specialties?

Urology fellowships are 1-2 years.  As opposed to the trend in many other surgical fields, you definitely do not need a fellowship to get a good job.  Most residents will only do a fellowship if they want to do academics or if there is a specialty field that they feel they did not get adequate exposure to during residency and they desire extra training in.  In some big cities, fellowships may give you a marketable skill, but most fellowship trained urologists will still practice general urology with maybe a slant towards that specialty.  If you really just want to do one specialized field and not other parts of urology, then academics is likely your best option.

 

  • What are the potential downsides of Urology that students should be aware of?

Urology is a tough surgical residency.  With any type of surgery comes complications and stress.  Although call may be better than some surgery fields, there are still going to be emergent cases or patients crashing in the middle of the night and on weekends.  You are dedicating yourself to the urinary tract which means a lot of bloody urine and prostate exams.  Everytime you tell people what field you’re in you have to answer the question, “why urology?”

 

  • What else would you tell medical students who are considering Urology?

If you want variety and enjoy being busy then this is a good field to consider. Compensation is definitely on the higher end which is a bonus!

 

Editor's Note: For more help choosing a specialty in medicine, I highly recommend one or both of these two great books. I found both very useful.

 

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Spotlight Interview: How to Match in Urology (OSU Resident)

Categories:

Choosing a Specialty, How to match in....?, The Match, Urology

June 1, 2012

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A Urology Resident’s Perspective:  From an interview with a urology resident from The Ohio State University in Columbus, Ohio

Part of an interview series entitled, “Specialty Spotlights“, which asks medical students’ most burning questions to physicians of every specialty.  See what doctors from every specialty had to say about why they chose their specialty and how to match in their residency.

 

  • How competitive is the Urology match?

Urology is one of the more competitive fields.  I think it’s similar to neurosurgery and ENT.  More competetive than general surgery but probably not as competetive as ortho, plastics, or dermatology.

 

  •  What must a student do to match well in Urology?

The usual stuff like high board scores, honors in your clinical clerkships, and AOA are very common amongst the residents matching in urology. Lacking in one or more of these areas, though, is not a deal breaker.  If you can show programs that you are passionate about field and a hard worker then you still have chance of matching.  This is done with good letters, research in the field, and possibly away rotations (as long as you impress on the away rotation).

 

  • What are residencies looking for in a Urology applicant?
They are looking for someone who is smart, hard-working, and passionate about urology.   Urology used to have a reputation of being an “all male” club, but that is definitely not the case anymore.  Many females are now going into urology.   Many programs seem to have a lot of residents that are regional, but this may be just due to them receiving more applications from regional medical schools.  This also may be due to the fact that faculty will know regional faculty members better and so letters of recommendations from these faculty members may be more meaningful.

 

  • What should students look for in a Urology residency?

In general, most people feel that all urology residency programs are going to give you adequate training.  There are some programs that are 6 years versus 5 years.  The 6 year programs either have an additional year of general surgery (so 2 years altogether) or else a year of research.  If you dread doing an extra year of general surgery or research then this is something to consider.  Because it is competetive and there are not a million programs, you do have to be willing to go to programs or cities that you maybe would not consider if you were applying to a less competitive residency.  I think most urology applicants have the “I’m just happy I matched” attitude.

 

  • Do you have any advice on the application, letters of recommendation, personal statements, or how to rank programs?

With the early match, you have to start early.  Unlike other fields, many urology applicants are trying to squeeze in urology rotations and letters out of end of 3rd year and early 4th year.  Make sure you schedule away rotations early, because some fill up, especially in the Summer and early Fall.  At the beginnning of each away rotation let the chair know that you intend to get a letter of recommendation.  It may actually look bad if you do an away roatation and do not get a letter of recommendation out of it.  You do not necessarily have to send the same letters and other information to every program.  I think you are allowed 3-4 letters in your official application, but you can have different letters available to different programs.  So for instance if you have a letter from a former resident at a program, make sure to include that letter to that program.  There are also tricks to get extra letters sent directly to the program if you think that would be beneficial.  Do not hesitate to mail updated CV’s or research information after the application has been sent out directly to programs.  It gives them more information about you and also shows some extra dedication and interest in their program.  I would rank as many programs as you interview with, unless you truly would rather not match than go to a certain program.

 

  • What do you wish you knew before application/interview season?  

I wish I knew what I was getting into.  Letters, applications, interviews, traveling…there is no way to understand the best way to do it until you actually do it.  Good Luck.

 

  • What other advice do you have for students applying to Urology residency?

Bring it!

 

Editor's Note: Applying for residency or preparing for your interviews? I highly recommend First Aid for the Match, The Successful Match: 200 Rules to Succeed in the Residency Match, and The Residency Interview: How To Make the Best Possible Impression .


 

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Spotlight Interview: How to Match in Family Medicine (Oregon Resident)

Categories:

Choosing a Specialty, Family Medicine, Family Medicine Rotation, How to match in....?, The Match

June 1, 2012

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A Family Medicine Resident’s Perspective:  From an interview with a family medicine resident at the Oregon Health Science University Hospital in Portland, Oregon.

Part of an interview series entitled, “Specialty Spotlights“, which asks medical students’ most burning questions to physicians of every specialty.  See what doctors from every specialty had to say about why they chose their specialty and how to match in their residency.

 

  • How competitive is the Family Medicine match?

Family medicine is not very competitive. I was offered interviews at every school I applied. I ended up turning down many of the interviews I received. I interviewed at 11 residencies and got my first choice.

 

  •  What must a student do to match well in Family Medicine?

The usual stuff, good board scores, good clerkship grades, some research. Interviewing well may be even more important in FP because the specialty is so focused on personal relationships. Networking can be helpful as well, so you should try to get to know people early.

 

  • What are residencies looking for in a Family Medicine applicant?
I really think they are looking for just two things: 1- competency: they need to know you can do the work, w- personality fit: they are going to be working with you for 3+ years, they need to know you will fit in.

 

  • What should students look for in a Family Medicine residency?

A program that is interested in allowing you to be sane and healthy.

 

  • Do you have any advice on the application, letters of recommendation, personal statements, or how to rank programs?

Most people rank according to geography and then dive into specifics. Family medicine residencies are very different from one another, even more so that other specialties. For instance, at one program where I interviewed, the interns do 5 months of surgery their first year! That is kind of weird.  Because the field is so broad (peds, surgery, OB/GYN, hospital, outpatient) there is a great diversity in training programs.

 

  • What do you wish you knew before application/interview season?  

The Northwest is probably the best place to do family medicine. Lots of space, lots of prestige for family medicine residents and a great place to live.

 

  • What other advice do you have for students applying to Family Medicine residency?

Feel out the resident “culture” as much as possible, it wil have a significant effect on your health.  

 

Editor's Note: Applying for residency or preparing for your interviews? I highly recommend First Aid for the Match, The Successful Match: 200 Rules to Succeed in the Residency Match, and The Residency Interview: How To Make the Best Possible Impression .


 

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Spotlight Interview: Why Did You Choose Family Medicine? (Oregon Resident)

Categories:

Choosing a Specialty, Family Medicine, Family Medicine Rotation, Why did you choose....?

June 1, 2012

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A Family Medicine Resident's Perspective: From an interview with a family practice resident at Oregon Health Sciences University in Portland, OR.

Part of an interview series entitled, "Specialty Spotlights", which asks medical students' most burning questions to physicians of every specialty.  See what doctors from every specialty had to say about why they chose their specialty and how to match in their residency.

 

  • What attracted you to Family Medicine?
Autonomy. Mobility. I wanted the sense that I was choosing a specialty that would allow me to work as much or as little as I wanted and that would allow me to place my family in a town of our choosing (likely a small town).
 
I also love the tradition in family medicine of trying to manage a patient by yourself as much as possible. There are a lot of efficiencies and preventative virtues in this approach to care. I feel like so much can be done in a small community that keeps thousands of people from ever having to be admitted to a hospital.
 
I love the intellectual challenge of receiving a patient into my office and managing all of their complaints. The situation demands that I be fluent on a variety of medical topics and able to comment on the current state of the medical literature. I really enjoy the challenge to read broadly and competently on a range of medical issues, it allows me to possess a synthesized view of medicine and patient care, to be sure I am not engrossed in too many minute details.

 

  • Describe a Family Physician's typical work day?

Most days will start at 8:00 am. We see patients until 11:00 and then break for Lunch until 12:30. We see patients after lunch until 4:30. A large number of family docs will have a half-day on Friday.

 

  • What type of lifestyle can a Family Doctor expect?  

Your lifestyle will be pretty good. Weekends are virtually always free if you do not do hospital work. You will have regular call, but you rarely have to go in.  Most problems while you are on call are resolved over the telephone.

 

  • What is the average salary of a Family Practice Physician?

There is a great range of earning potential in FP.  The average salary is around $150,000.  However, you can see fewer patients in a day, or work fewer days in a week and earn less than this. If, however, you see patients quickly, become medical director of a nursing home or two, work extra on the weekends, etc, it is very possible to make much more than this.

 

  • What is the job market like for Family Medicine?

Honestly, it couldn't be better. Family docs can go anywhere they want. Lots of recruiters will call you throughout your residency. There is a great need of primary care docs in every corner of this country.

 

  • What can you tell us about Family Medicine Sub-specialties?

There are a few options as a family medicine physician. Some of the fellowships include hospital medicine (i.e. become a 'hospitalist'), geriatrics, adolescent care, and Sports medicine. For the most part, fellowships are one year in length. Sports medicine doctors end up making a bit more money than a generalist and the other sub-specialties.

 

  • What are the potential downsides of Family Medicine that students should be aware of?

In family medicine there is a lot to the business side of things. You will be responsible for managing much of the business side. If you are not a good businessperson, not organized, or dislike that type of thing, this part of the job could be a real drain. The salary is on the lower end for physicians, but it is still a very good living.

 

  • What else would you tell medical students who are considering Family Medicine?

If you want to do outpatient care in a small community, this is a great field.

 

 

Editor's Note: For more help choosing a specialty in medicine, I highly recommend one or both of these two great books. I found both very useful.

 

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