Category Archive: How to match in….?

How to Match into a Great Emergency Medicine Residency

Categories:

Choosing a Specialty, Emergency Medicine, Emergency Medicine Rotation, How to match in....?

July 13, 2015

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Emergency_room

An Emergency Medicine Attending Physician's Perspective:

From an interview with an Emergency Medicine physician in Colorado. 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 Emergency Medicine match?

Emergency Medicine has increased in competitiveness over the last 5-7 years, and seems to fluctuate somewhat in competitiveness. I personally think that competitiveness will maintain or increase as graduates are more attracted to specialties that compensate well while maintaining a good lifestyle (with minimal call), but that remains to be seen.

 

What must a student do to match into a great Emergency Medicine residency?

As with all specialties in the match, a good score on Step 1 is a must, but additionally a good Step 2 score is also important. EM program directors value this clinical-based test and your ability to perform in a clinical environment. Some say that this score is even more important than Step 1.

More important than either of those is your performance on clinical rotations, shelf exams, and letters of recommendation.  Emergency Physicians greatly value working with partners and colleagues who push themselves to be not only be great physicians, but team players who give the effort to help their fellow physicians. You have to go above and beyond with a solid knowledge base, evidence-based practice, and great interpersonal skills. 

The core 3rd year rotations are especially important (in addition to a sub-internship in EM) as our scope of practice really does encompass a significant portion of every other specialty.

 

What are residencies looking for in an Emergency Medicine applicant?

See the above – work ethic, integrity, clinical acumen, decisiveness, procedural competence, and being a team player.

 

What should students look for in an Emergency Medicine residency?

This will vary; you have to prioritize what is most important to you. Important considerations include location, reputation, research and leadership capability / opportunities, faculty, etc. Compensation is a consideration, but I think you (like me) will find that the variability is slight. Some programs offer coverage of meals while working, and some offer full health insurance benefits including dependents.  You will find a litany of differences – some of which may be deal breakers, some of which will only be perks – it's up to you to decide what's important.

Most programs have some subtle differences in their rotation schedule, which may make or break the decision for some, but I find that the differences are small, and many programs will provide excellent training. There are some programs which rise above the others for one reason or the other, but these reasons may be different for each applicant.  I found that focusing on subtle schedule differences created frustration, and got away from the more important consideration, which was fit.

In my opinion, the most important consideration is how you feel you fit with the program. Does your personality mesh well with your fellow residents and those of the faculty? If you have a family, will they be welcomed at events, or is every out-of-work gathering going to be held at a bar? What is your overall impression of the program, and how does that fit with your goals?

 

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

With regards to ranking programs, most of that in my opinion is answered above. It's important to make a list of priorities and stick to it. As for the application, LORs, and personal statement: LORs should be obtained from practicing Emergency Physicians who know you and can speak to your clinical skills as well as personal attributes. Having an impersonal letter from a "big name" in Emergency Medicine is not nearly as important as one from someone who can write a strong letter touting your abilities as a provider as well as a person.

Your personal statement should be concise (no more than a page) and clearly demonstrate WHY you are going to be a rock star EP. However, you should not explicitly write all that out. Find a case that will grab the attention of the reader, demonstrates why you think EM is a no-brainer choice and why you are committed to it, and also showcasing your talents and skills.  This is your chance to express how you stand out from your peers, so you need to do that without sounding egotistical.  This is not a time for straight humility, but you must represent yourself with quiet confidence.

 

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

Be familiar with the results of the match from recent years, and discuss with your faculty mentors how many programs you need to apply to / interview with.  Currently, 9-12 interviews is likely sufficient for the average applicant, but that may vary in coming years, and depending on the applicant. Interviews can be expensive, so consider your top picks ahead of time, but don't be afraid to adjust that list as you visit programs and formulate your impressions. You will likely be surprised about which programs stand out, or which will fall in their rank (I know I was…).

 

What other advice do you have for students applying for Emergency Medicine residency?  

This is a great specialty and profession. While we tout fun procedures, fast-paced shifts, and a great lifestyle, you should make no mistake and know that we work hard. Very hard. We do work that no one else does, and that many shy away from. We are not experts in every field of medicine, but we are masters of resuscitation, emergent airway management, trauma, and critical care. You will hear some people bash Emergency Medicine for not being "experts" in their specific area of expertise – that's by design! I was never trained to be an OB/GYN, but I am trained to recognize and treat OB and GYN related emergencies, referring those non-emergent cases for outpatient follow-up.  This does not give us room to slack and provide substandard care, but rather excellent care of urgent and emergent problems, leaving more obscure and less urgent problems to the specialist. Emergency medicine is awesome, enjoy 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 Physical Medicine and Rehabilitation

Categories:

Choosing a Specialty, How to match in....?, PM&R, The Match

May 30, 2015

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PM&R Vintage

 

A Physical Medicine and Rehabilitation (PM&R) Resident’s Perspective:  From an interview with a PM&R resident from 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 PM&R match?

Matching in PM&R is not as competitive as some fields, such as radiology, neurosurgery, dermatology, etc. However, it also used to be a relatively unknown specialty. Medical student exposure to PM&R has improved and the number of applicants seems to be steadily increasing, so it is becoming more competitive.

 

  •  What must a student do to match well in PM&R?

A student looking to match well in PM&R should focus on the same things students would pursuing other specialties. Like any specialty, doing well on boards is important. Most programs have now instituted board score cut-offs for applicants, which are around 200-220 for USMLE Step 1. In general, students should perform well on their clinical clerkships throughout medical school, and a rotation is PM&R is preferred. Strong supportive letters of recommendation, including one from someone in PM&R, is preferred. At least some exposure to or participation in research is also a plus.

 

  • What are residencies looking for in a PM&R applicant?
PM&R residencies look for all the usual strengths in an applicant like good board scores and academic performance, good clinical performance on your clerkships, research exposure, etc. In my experience, PM&R residencies also tend to appreciate individuals with additional interests like sports and music. There are many in PM&R who followed non-traditional paths to medicine and may have had other careers first. Personality is also very important, as it takes pretty caring and compassionate people to be providers for individuals with disabilities as well as an ability to work with a multi-disciplinary team. In addition to a student's application, their interview day with a residency program will be very important

 

  • What should students look for in a PM&R residency?

If you are pursuing PM&R but not yet sure whether you want to do a fellowship, look for a well-rounded PM&R program with opportunities for exposure to the subspecialties. I looked for a program with a good balance of inpatient and outpatient clinical duties and wanted exposure to all the major areas: Sports/MSK, stroke, TBI (traumatic brain injury), SCI (spinal cord injury), amputation and pediatric rehab. I also looked for programs that had an ultrasound curriculum, as well as plenty of exposure to procedures including electrodiagnosis (EMG), botox, interventional spine and baclofen pumps. Beyond curriculum, the deciding factor in residency programs for me was finding a good “fit.” I paid close attention to interactions with residents, students, fellows and faculty on interview days to try and get a feel for whether this was a place I would like to train or not. 

 

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

Like any other specialty, having a well-rounded application is important. Although board scores are important and used as a screening tool, residencies want to see much more than that. Do at least one rotation in PM&R, even if you have to arrange an away rotation. Also try and have at least one Letter of Recommendation from someone in PM&R. I looked for well-rounded programs to rank, but ultimately my rank list came down to finding a good fit on my interview day. Pick a program where you can see yourself being both well trained and happy for 4 years

 

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

Although I did a lot of practice interview questions before my interviews, one question I didn’t have a great answer for was “So what is a Physiatrist?” I struggled with this question because the scope of our field is pretty broad, but having a decent answer will help guide your personal statement and save you the embarrassment if asked on the interview trail

 
  • What other advice do you have for students applying for PM&R residency?  

People like to say “plenty of money and relaxation,” and although the lifestyle is good there are long days and hard days. We take care of very sick patients, many of which have experienced something catastrophic, and as their physiatrist we can be their greatest advocate or on some days just their cheerleader. In PM&R, you have to be willing to wear many different hats. Also, make sure you write “PM&R” NOT “PMNR,” and know how to pronounce “Physiatrist.”  

 

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 neurosurgery

Categories:

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

May 30, 2015

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Recklinghausen neurosurgery

 

A Neurosurgery Resident’s Perspective:  From an interview with a neurosurgery resident from a top program in the Midwest.

 

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 neurosurgery match?

Neurosurgery is among the very competitive specialties. Still though, I think that 80% of U.S. grads match somewhere.

 

 

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

All students should rotate at their home institution as well as at least one away rotation (almost everyone in my medical school class did at least two away rotations).  Boards are important.  Research and publications are very well looked on, as is performance on the sub-internship.  Being a good sub-intern is not about how much you know, but rather how hard you work, how willing you are to be at the hospital constantly, and how easy to get along with you are.

 

  • What are residencies looking for in a neurosurgery applicant?
The answers are the same as what I mentioned earlier. As a resident, I want someone who’s going to work their tail off on service and not let down the rest of the team.  

 

  • What should students look for in a neurosurgery residency?

Make sure the fit of your personality matches the department.  Seven years is a long time to be miserable if you don’t like the people, no matter how prestigious the place. 

 

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

Letters of recommendation should be from neurosurgeons (it’s a very small world), or research mentors. Perhaps other types of surgeons can write your letter of recommendation if you’ve worked with them a lot.   Other letters really won’t count for anything.  You should get one from the chair at the places where you rotate.  It doesn’t matter if you didn’t really work with them at all; they will solicit feedback from the residents and staff you did work with and their letter serves as a summary of your time there.  

 

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

It’s well worth it to interview at a lot of places and get a “tour” of neurosurgery.  It really is a small world and you’ll run into people over and over.  

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

It’s an awesome privilege to be able to do this stuff. Good luck!  

 

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 ENT

Categories:

Choosing a Specialty, How to match in....?, Otolaryngology

May 11, 2015

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Ear Exam

 

An Otolaryngology Resident’s Perspective:  From an interview with an ENT resident from the Midwest

 

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 Otolaryngology match?

The match is very competitive, recently it has been otolaryngology matched applicants with the highest average Step 1 score.   

 

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

Generally applicants need to have good test scores, and strong research and extracurricular features in their CV to be ensured an interview.  However, the programs are small- and personality conflicts are hard to avoid, so the interview becomes crucial to actually matching.  Programs have many qualified applicants and interviews are important for finding people who will be a good fit.  Also, the field is small, a well-connected chairman seems to know all the ENT's in the country, so your letters of recommendation (specifically who wrote them) is vitally important to where you match.  

 

  • What are residencies looking for in a Otolaryngology applicant?
Residencies are looking for someone who they get along with, someone they can trust to tell them the truth when staffing a consult in the middle of the night (not just what they want to hear).  Big academic centers are looking for hard-working and successful researchers with a record of being able to get a project to publication as a student.  Of course, any concerns that the resident will have professionalism or personal coping issues during training will flag them to fall way down the rank list.  (Programs are generally 2-3 people per year/ 5 year program, losing one resident means losing 10% of the residency).

 

  • What should students look for in a Otolaryngology residency?

Students should pay attention to what graduates  have been doing.  If everyone is going into fellowship and becoming chairman somewhere- you can be sure that there is some unstated expectation that matched applicants will continue that trend.  On the flip-side, if everybody goes into general practice and you want an academic job, there may not be mentors or support for you to get there.  Think honestly about what you ultimately desire- then come up with a politically correct way to convey those career goals to discuss in interviews.  

Another thing to look for is representation of all the subspecialties.  It can be hard for academic programs to retain facial plastic surgeons. If you hope to treat cleft lips, make sure there is someone to learn it from.  

Observe the general happiness of the residents.  If you match, you will join that small cohort of people and spend more time with them than your spouse.  Watch for anything that might be intolerable.

 

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

It is a competitive match so seek a mentor who is well-connected in the field.  They will help you with curating experiences to put on your CV and where to get letters of recommendation.  This may mean looking outside your institution.  Successful research is sought and will be discussed at all interviews.   Letters of recommendation are almost all positive, so it becomes important WHO wrote the letter.  If you have your heart set on a specific program, make sure your letter writers know the chair/program director.  Be proactive without being annoying in the process.  One of my co-residents was not offered an interview here, but she called and politely discussed her situation with the coordinator and program director.  She got an interview and ended up matching.  The corollary is that if you are rude to the secratary managing interviews, they can mention it to the committee and get you off the rank list.  Be professional!  Rank lists are deeply personal and involve many factors- but basically rank where you WANT to go. 

 

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

I wish I knew how small the field is.  Fortunately my letter writers were well known- to my benefit.  In a competitive specialty like this one, small things matter- if you are professional and hard-working it will show. 

 

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 Interviews: What is a Transitional Year Residency?

Categories:

Residency, Anesthesia, Choosing a Specialty, Dermatology, How to match in....?, Neurology, Ophthalmology, Radiology, The Match, Why did you choose....?

September 11, 2012

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A Transitional Year Resident's Perspective: An interview with a transitional year resident from the Ann Arbor, Michigan.

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 is a transitional year residency?

Transitional Year (TY) residencies might be the least well known residency option after medical school. The TY is a one year residency with a general focus which prepares recent graduates for advanced residencies. To understand where a TY fits in, you must understand that there are a number of residency programs that do not start specialty training until the 2nd year after medical school graduation (i.e. PGY2). These specialties include anesthesia, dermatology, neurology, physical medicine and rehabilitation, radiology, radiation oncology, and ophthalmology.

Each of these residencies begin their specialty training after a resident's intern year. Many of these residency programs will combine the intern year (PGY1) with the advanced specialty training. In these cases, the resident will remain in the same residency throughout their training and there is no need to complete a transition year residency. However, there are programs in each of these specialties that do not start training their residents until the second year after medical school (PGY2). These programs require their residents to complete an approved intern year prior to beginning specialty training. Approved intern years include a year of preliminary medicine, preliminary surgery, preliminary pediatrics, or a transitional year residency.

 

  • How is a transitional year residency different from other intern years?

The goals of training are basically the same among all intern years; we all learn hospital based patient care. Surgical interns take care of patients before and after surgery in the hospital, medicine interns take care of medical patients in the hospital, pediatric interns take care of kids in the hospital. A transitional year resident will take care of all of the above. The transitional year aims to be a broad hospital-based training. TY residents will spend various months working on medicine, surgical, OB, pediatric, outpatient, ED, ICU, and elective rotations. The great asset of a TY is that it provides more flexibility, allowing residents to focus on their interests. I am interested in research and was able to complete two months of intense research during my intern year: something no one from an internal medicine, surgery, or any other residency could say.

 

  • Are Transitional Year Residencies easy?

Not all TYs are made equally. It is a well known fact that there are some pretty cush TY residencies out there. However, there are also some very difficult TYs. To illustrate this fact, last year I interviewed at a number of TY residencies of varying difficulties. The easiest one had 4 required inpatient months, one outpatient month, one ED month, and 6 electives. Sign out during inpatient months was 3pm. When you were in the ICU you covered 2-3 patients, and you were NEVER on call the entire year. In contrast, I interviewed at a big hospital TY where there were two MICU months where you covered 15 patients, 6 required inpatient medicine months, 2 surgery months, a busy ED month, terrible call, and three 'electives' which were all time consuming. In general, however, the answer to this question is yes. Transitional years are FAR easier than prelim surg residencies and quite a bit easier than prelim medicine residencies as well.

 

  • Is the training as good at a Transitional Year Residency?

Absolutely, if you choose the right place. Many months this year I have more free time than I did in medical school. I have found that with the free time I am actually reading and studying a ton. I think that you MUST take call to learn how to be a doctor during your intern year. I am not sure how you can become a 'well trained' doctor if you never take call during your intern year. Being on call at night is when you really have to make decisions and you really learn a ton. You don't need 11 months of inpatient work to become a great radiologist or a great ophthalmologist. However, 6 solid months of medicine/surgery will certainly prepare you for your next level of training. Then you can spend the other half of the year becoming great at something else: research, pediatrics, surgery, golf, sleeping, etc etc

 

  • Describe a typical transitional year schedule?

Everyone must do: 1 month in the ICU, 1 month ED, 1 month outpatient, 2 months general medicine. I believe the rest is up to the residency program. Most programs end up giving 3-5 months of electives.

 

  • What are the potential downsides of a Transitional Year?

Not many! More free time, less stress, more fun…what's not to like. I guess one downside is that it closes some doors if you choose to switch specialties. For example, if you were doing a preliminary medicine year at an academic center and decided you wanted to do medicine instead of anesthesia, the switch would be easier. After completing a TY year you can only go into the specialties I listed above.

 

  • How competitive is the Transitional Year match?

It is actually very competitive. There are not many spots, and they are all coveted because they represent less work, more free time, more electives, and a much easier year. Also, imagine all the applicants trying to get spots: future radiologists, ophthalmologists, radiation oncologists, dermatologists. This is not a list of ordinary applicants. Matching into a TY is about as hard as matching into radiology or ophthalmology.

 

  • What are residencies looking for in a Transitional Year applicant?

I asked my TY program director this exact question and this was his response: "We know we will only have you for one year. However, during that year the TY class will take care of about 50% of all the patients in this hospital. So, it is in the hospitals best interest to have someone who 1- will work hard without being asked, and 2- will maintain the great patient care that we have at the hospital." I think those two things are exactly what all programs want. I think item #2 may touch on competency a little bit, but is mostly referring to your interpersonal skills.

 

  • What should students look for in a Transitional Year residency?

Whatever you want to look for in a TY year. That sounds cliche, but as I said above, not all TYs are made equally. Do you want a chill year at the risk of missing out on training? You can find that. Do you want to do pediatrics as well as medicine and surgery? You can find that.

 

  • Is there anything you wish you knew before application season?

I interviewed at a few places that had both TY years as well as preliminary medicine years but the curriculum was exactly the same. In other words, if you match into the preliminary medicine year, you still have the flexibility that the TY residents at the same program have. All of these programs will let you apply to both the TY and the prelim med year after your single interview. These are great programs to find because even though there is no difference at all in the curriculum, the preliminary medicine years are a bit easier to get into.

 

  • What other advice to you have for students applying to a Transitional Year?

Good luck, intern year is exhilarating, fantastically rewarding, difficult, and very very short. Enjoy it. Read The House of God (amazon link), there is no better time than intern year. Also, watch the first season of Scrubs where the characters are interns…it is incredibly realistic!

 

 

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: An Orthopaedic Surgeon’s Job Description

Categories:

Residency, Choosing a Specialty, How to match in....?, Orthopedic Surgery, The Match, Why did you choose....?

August 18, 2012

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An Orthopedic Surgery Resident's Perspective: An interview with an orthopedics resident from the West Coast

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 Orthopedic Surgery?

I feel like you can learn a lot about a specialty based on what you see in the attending physicians of that specialty. The orthopedic attendings, for the most part, seemed happy. There are many sub-specialties in Ortho and was interested in nearly all of them. The patients' prognoses in many cases were very good. Patient’s lives were improved dramatically by Orthopedic intervention.

 

 

  • Describe an Orthopedic Surgeon's typical work day?

Long. Orthopedic Surgery is no place for individuals looking for a structured 8 to 5 job. Attendings often work harder than residents. First and foremost, the patient comes first and your day ends when the work is done.

 

  • What type of lifestyle can a an Orthopedic Surgeon expect?  

It's not dermatology. Call and nights vary between sub-specialties, but generally if you are asking this question, Orthopedic Surgery may not be the right choice for you.

 

  • What is the average salary of an Orthopedic Surgeon?

Also varies from specialty to specialty. Generally speaking Orthopedic Surgeons are some of the best compensated surgical specialists, but that should only be a perk. Don’t go into Orthopedic Surgery for the money, times are changing.

 

  • What is the job market like for Orthopedic Surgery?

The market varies amongst subspecialties. Hand Surgery and Sports Medicine are amongst the most competitive now, but are also rather saturated. Generally speaking, our aging population bodes well for our job security for the next couple of decades at least.

 

  • What can you tell us about Orthopedic Surgery sub-specialties?

Residencies currently range from 5-6 years with 1 year fellowships available in: Shoulder, Hand, Spine, Tumor, Joints, Sports Medicine, Pediatrics, Trauma… About 85% of current residency graduates are going onto Fellowship training.

 

  • What are the potential downsides of Orthopedic Surgery?

Be prepared to work hard and not complain.

 

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

With a good work ethic and the right motives, Orthopedic Surgery will offer a rewarding lifetime of challenge and service.

 

  • How competitive is the Orthopedic Surgery match?

Very, with the caveat that interpersonal and personality traits cannot emphasized enough.

 

  • What are residencies looking for in an Orthopedic Surgery applicant?

You will need to reach a certain threshold of competency/test scores (different programs weight each of these differently). The rest is studying and hard work. Away rotations are usually weighted pretty heavily and should be considered a month long job interview. Dress appropriately, prepare for cases/clinic, show up early, etc.

 

 

  • What should students look for in an Orthopedic Surgery residency?

I would want to feel fairly comfortable with the people you interact with. You will be spending a good chunk of your life with them. Also, ask them the appropriate, but difficult questions. I always appreciated programs that seemed to be up front and honest.

 

 

  • Do you have any advice about the residency application?

Spend plenty of time on your personal statement and have it proofread by several different people. Another thing that I found useful was to offer to draft letters for those you ask…chances are good they are probably busier than you are.

 

  • Is there anything you wish you knew before application season?

Give every day your best shot. Otherwise stop worrying. The rest takes care of itself. No amount of worry will do anything but shorten your life span.

 

  • What other advice to you have for students applying to Orthopedics?

Good luck! It is a stressful, but dynamic time in life.

 

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 Anesthesiology (Pittsburgh Resident)

Categories:

Residency, Anesthesia, How to match in....?, The Match

July 8, 2012

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An Anesthesia Resident’s Perspective:  From an interview with an anesthesia resident from the University of Pittsburgh School of Medicine in Pennsylvania.

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?

The anesthesia match is moderately difficult.  However, the answer to this question really depends on how you look on paper and in person. Our match is not as difficult as plastic surgery, but there are always a few people in the country who do not match. You should speak with one of the deans of your medical school if you have concerns.

 

  • What are residencies looking for in an Anesthesiology applicant?

The most important factors initially are a student's performance in anesthesia rotations and letters of recommendation.  Board scores do matter, but need not be sky high.  Mostly, anesthesiologists are laid back and are looking for someone they can work easily with.  You also need to show initiative and be able to make decisions quickly and respond to crises effectively. I am not sure exactly how one portrays these qualities, but the interview certainly can help.  Have answers in your mind to questions that you will almost certainly get asked (examples: Why have you chosen anesthesia?,Can you tell me an example in your life of problem solving?, Where do you think the specialty is going in next 10-25 years?, etc.).

 

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

I did not have much exposure to FREIDA. I would recommend researching program statistics on FREIDA prior to applying, you will learn some interesting things about programs and may even choose not to apply to one and to apply to a different program.  Also, the ASA (American Society of Anesthesiologists) annual meeting is in October (right before interview season) and there are a number of medical student specific programs that include an opportunity to meet and talk with many program directors (this event occurs on the weekend portion of the meeting).  I would try to attend if it is at all financially possible to do so.

 

  • What should students be looking for in an Anesthesia residency program?

Use FREIDA and your other tools to determine what size program you want to be part of. Large and small programs each have their positives and negatives. Look for residencies that fit into the program size and 'level of prestige' that fits what you're looking for in the work/life balance and where you want to go with your future career.  You will also find that more prestigious schools at big research universities also have positives and negatives.

 

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

Start early and get everything submitted ASAP, most programs filter through the applicant pool once and then fill all interview spots. Furthermore, spots fill quickly, so have your email forwarded to your phone/pager and don't be afraid to excuse yourself from your rotation to set up an interview; 4 hours later may be too late.  It is not uncommon for programs to send out more invites than they have interview spots.

 

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 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: 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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