Category Archive: Residency

The Most Recruited Medical Specialties

Categories:

Residency, Choosing a Specialty, Dermatology, Emergency Medicine, Family Medicine, General Surgery, Internal Medicine, Neurology, Ophthalmology, Pediatrics, Psychiatry, Radiology, The Match, Urology

April 25, 2012

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Now that I am in the first year of residency I am beginning to think about landing that first real job.  As a Transitional Year resident I am heavily involved with the Internal Medicine residents at my hospital.  I found out very quickly that these internal medicine residents are HIGHLY sought after. In fact, many of them receive job offers on a weekly, or even daily basis.  The jobs that are in highest demand for internists are outpatient primary care and inpatient hospitality.  Many of my senior residents are being offered salaries between $200,000 and $300,000 along with many benefits including loan repayment. There are even some offers higher than $300,000 for less desirable locations! This is in a stark contrast to the ophthalmology job market that I will face, where starting salaries are low and it is terribly difficult to get your foot in the door.

Recently, I came across the Merritt Hawkins database.  Merritt Hawkins obtains information about starting salaries and benefits for newly graduated residents. I speak about their great physician salary database in my Ultimate Guide to Physician Salaries. However, their database also contains a list of the 20 most recruited specialties in medicine. The list may shock you!  The ability to find a well paying job right out of residency is NOT AT ALL correlated with the competitiveness of the specialty.  Case in point: family physicians and general internists are the two most highly recruited specialists in medicine!

From Merritt Hawkins

 

This list represents the Top 20 most ‘requested physician searches by medical specialty.’ The numbers represent the number of times Merritt Hawkins was used to recruit a person from the respective specialties (Merritt Hawkins full PDF including physician compensation data is available here for free). So, when you are deciding on a specialty, don’t forget that competitive does not equal good job placement.  In fact, many of the least competitive specialties are very high on this list (pediatrics, psychiatry, family medicine)

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Preparing for USMLE Step 1

Categories:

Step 1, The Match

April 24, 2012

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I recently read a great article about preparing for the USMLE  board exams an another great medical student website called Medical Student Insider. The author is a soon-to-be psychiatry resident from UCLA name Mike Frazier.  Any time you hear or read advice about studying for boards you should always take it with a grain of salt; this is because we all study and learn differently. However, after scoring above a 250 of Step 1, soon-to-be Dr. Frazier's words pack quite a punch!

Highlights from the Medical School Insider Article:
  1. USMLE Step 1 is the most important factor in determining your competitiveness in the match.
  2. USMLE World is KING. I totally agree! After completing 2,000+ USMLEWorld questions, I sat down at the real Board exam and felt like I was just doing more USMLEWorld questions. They prepared me perfectly.
  3. First Aid for the USMLE Step 1 is a priceless book.  Buy it early, use it your first two years, and then devour it while studying for Step 1.
  4. Set a Goal!
  5. Create a study schedule to help you achieve your goal.

Read the full article to see what else Mike Frazier says about studying for Step 1.  

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Spotlight Interview: Matching in Family Medicine (Ohio Resident)

Categories:

Family Medicine, How to match in....?, The Match

April 5, 2012

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A Family Medicine Resident’s Perspective:

From an interview with a family medicine resident from Columbus, OH

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?

Not so much.  If you want to go out West you'll need a higher score on USMLE Step 1, but matching in Family Medicine is much less stressful than some fields.  It's more focused on determing where you fit well in terms of residency.

 

  • What are residencies looking for in a family medicine applicant?
Good work ethic, intelligence, compassion, and passion for the field they've chosen.

 

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

Family Medicine interviews are more like wining and dining.  Residency programs have one real goal, and that is to figure out if you would be a good fit for their program.  With this in mind, the best thing you can do is be yourself.  Wherever you interview, ask yourself, "Would I be happy living here and working with these people for the next three years?"

 

  • What should students look for in a family medicine residency?

It depends on if you know what type of Family Physician you want to be.  If you want to practice OB when you're finished with residency you should find a program that emphasizes OB/GYN training.  If you want to work in a rural area than a rural FM residency would likely be a good fit because that's where you'd be most likely to be "the only doc in town."  Location is a very important consideration and should not be discounted either.  You need to find a place where you will be happy living.

 

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

Be excited.  Family Medicine is a great field that will provide you with incredibly rewarding experiences on an almost daily basis.  You will also be able to make a very respectable living and have a great lifestyle.  What more could you ask for?

 

 

 

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: Matching in Radiology

Categories:

How to match in....?, Radiology, The Match

April 5, 2012

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From Hartford Hospital

 
 
A Radiology Resident’s Perspective:

From an interview with an radiology resident from New York City, NY

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 radiology match?

Last year (2011) it wasn’t even specified as “competitive” by the NRMP. However, in general, radiology is a popular choice. I considered myself a consistent but average medical student, and had no trouble getting plenty of interviews. Be realistic with your choices, and don’t think about of the cost of your application. If you are feeling insecure, cast a wide net and spend some time asking yourself what really matters in a program.

 

  • What are residencies looking for in a radiology applicant?
Well first of all, board scores. It is the first screen they put all candidates through. But you were already going to do your best, weren’t you? Once you have the interview, just try to be amiable and show good communication skills. Don’t be too forward, arrogant, or serious. This is all opinion but I don’t think your potential as a radiologist can be divined by an interview. They are just looking for someone they wouldn’t mind sharing space with for 4 years! Try to relax and enjoy it.

 

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

If you know you are going to rank a place at the bottom of 10 or more programs, consider cancelling your interview.

 

  • What should students look for in a radiology residency?

I will only mention what is most important: Find the residents, talk to all of them, and ask yourself if you would enjoy seeing them every day. Sure, the upper levels will be gone by the time you get there, but the environment you see will not be much different.

 

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

You have made the right choice. You will match. Anyone who says anything different (e.g. co-interviewees) knows nothing about it and is probably just trying to get inside your head for petty reasons. Don’t let them succeed… spend your time talking with positive, supportive friends and family. Use advisors. If yours is unhelpful or cannot answer your questions, find an ‘unofficial advisor’ who can cheer you on. They need not be radiologists. They should not be hard to find, the good ones are usually very involved with students.

 

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: Matching in Ophthalmology (Hopkins Resident)

Categories:

General, How to match in....?, Ophthalmology, The Match

April 5, 2012

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An Ophthalmology Resident’s Perspective:

From an interview with an ophthalmology resident at Johns Hopkins University

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 ophthalmology match?

Ophthalmology is pretty competitive. It is not as bad as plastic surgery, but it is one of the most difficult matches right now.

 

  • What are residencies looking for in a ophthalmology applicant?
The top programs are all academic institutions, so a good research foundation definitely helps. The field is small and well informed, they like to see early and/or definite commitment to the field.

 

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

I did not know about the postings on studentdoctor network. If you go online to the studentdoctor network website during interview season you will see that there is a place where people post interview dates and times as soon as they get them.  There is usually also a calendar with all the interview dates listed.  If you can not find a calendar, make your own.  Often you will get interview invites and if you respond in more than a couple hours there are no more interview spots left. Check email every 3 minutes, you just have to do it. Respond to interview invitations within minutes of receiving email.

EDITOR’S NOTE:  I cannot agree more with this advice.  Click here to go to the main SDN ophthalmology page. Click here to see the link to the ophthalmology interview thread from 2011.

 

  • What should students look for in a ophthalmology residency?

You will have to decide for yourself what options you prefer, but here are some of the most important questions when evaluating a program because they represent major differences and distinctions: location, small vs. large program (i.e. 3 residents per year vs. 8 per year), front loaded work and call vs. evenly distributed, home vs. in-house call, research faculty/area/time devotion/expectations, strength and notoriety of the faculty, training style (autonomy vs. faculty guidance), facility and equipment (new slit lamps? teaching scopes? etc), is there a VA, is the VA hours away or in another state, is the VA clinic resident run.  In my opinion, a strong resident run VA clinic is a must.

 

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

It’s early match so somehow you need to try out the rotation and decide early.  Once make a decision, you need to starting getting your application packet together early. Remember, they want to know that you are committed, this is hard to do because your application is due near the beginning of your 4th year.

 

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: Matching in Ophthalmology (OSU Resident)

Categories:

How to match in....?, Ophthalmology, The Match

April 4, 2012

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An Ophthalmology Resident’s Perspective:

From an interview with an ophthalmology resident at The Ohio State University

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 ophthalmology match?

Extremely competitive.  For foreign medical graduates (FMG) and second time applicants, chances of match are very slim. The overall match rate for ophthalmology is about 75%.

 

  • What are residencies looking for in a ophthalmology applicant?
They are looking for genuine interest in the field of ophthalmology demonstrated by rotation evaluations, Ophthalmology research, volunteering etc, and a highly competitive applicant. Outstanding applicants with high board scores and numerous class honors do not necessarily have to have as much ophthalmology related extracurricular involvement or research. However, if you are not a stellar applicant, early and evident interest is very important.

 

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

I wish I knew which programs I was realistically competitive for. Other than the top 15-20 programs it is difficult to know where a program ranks and how good they are or aren’t without interviewing there.  Ask people who recently applied or find a faculty member who is willing to discuss these types of things.

 

  • What should students look for in a ophthalmology residency?

One of the most important things for me was finding attendings who enjoy teaching and enjoy resident interaction. A program that will help put you in a position to match in your desired fellowship is also very important. Learning about a residency’s job and fellowship placement is very important. Clinical and surgical experience, above all, are something that you must weigh. Surgical numbers should be above the national averages and especially above the minimum required amount.

 

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

Academic ophthalmology is a small world. A great letter from a prominent ophthalmologist is invaluable.

 

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: Matching in Dermatology

Categories:

Dermatology, How to match in....?, The Match

March 31, 2012

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A Dermatology Resident’s Perspective:

From an interview with a dermatology resident at Wayne State University in Detroit, 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.

 

 

  • How competitive is the dermatology match?

Very. There are not a lot of training programs as compared to otherspecialties. On top of that, each program may only have 2-3 spots yearly. As you can imagine, this creates a competitive atmosphere in the Dermatology match.

 

  • What are residencies looking for in a dermatology applicant?
There are rumors about Dermatology i.e. You must do research, you must have 250+ on Step 1, etc. Although these will help in the match, each applicant has their own characteristics that may impress a program (i.e leadership,Clinical experiences). In general, a well-rounded student will be very competitive. Honors in third year clerkships will be very helpful. Dermatology programs particularly look at the Internal Medicine clerkship as a strong indicator. 

 

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

Since Dermatology is competitive, it is important to apply broadly across the country. The application and travel expenses can be costly so prepare wisely.

 

  • What should students look for in a dermatology residency?

Important aspects of Dermatology training include a diverse patient population, wide variety of training in all Dermatology subspecialties (Pathology, Pediatrics, Procedural, Mohs and Cosmetics) and learning environment (clinic vs. inpatient; large program vs small program)

 

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

It is important to immerse yourself in the field of Dermatology. Performing well in a Dermatology clerkship will be very helpful. Away rotations are helpful to show a program how well you can fit in at that program AND will give you the opportunity to get a strong letter of recommendation from  Program director at your away rotation.

 

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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Pre-operative Clearance Checklist

Categories:

Residency, Family Medicine Rotation, General Surgery Rotation

February 6, 2012

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A frequent question in the outpatient setting is whether or not a patient is optimized for surgery. There are a number of things that a physician must check in order to properly send a patient back to a surgeon with a gold star. I recently used the Johns Hopkins Internet Learning Center (HopkinsILC) to study the basic pre-operative evaluation and I highly recommend it (requires access from your school or hospital, many hospitals have access, ask your librarian).  There is a great review pdf available from HopkinsILC which details some of the highlights of the lesson.  Below I will summarize some points from the pdf. To learn more, you should ask for access to HopkinsILC, it is a great resource.

 

  1. If the patient has any active cardiac issues, surgery should be postponed.  This includes…
    1. Recent myocardial infarction (<30 days)
    2. Active cardiac disease (unstable angina or worse)
    3. An uncorrected arrhythmia
    4. Severe aortic stenosis

 

  1. The patient must be able to complete 4 or more ‘metabolic equivalents of task’ (METS).  This includes
    1. Climbing a flight of stairs
    2. Walk for 30 minutes
    3. Play tennis, bowling, or other more intense sports
    4. Able to vigorously clean a house (scrub floor, move furniture)

 

  1. There are a few medications that must be stopped prior to surgery. Some examples (not an exhaustive list) include…
    1. If the patient is on blood thinners (coumadin) or anti-platelet drugs (plavix, lovenox, etc) these may have to be stopped and the surgeon will have to be part of the discussion
    2. Diuretics, ACE-inhibitors, and ARBS are usually held
    3. Oral hypoglycemics are usually held for 1-2 days
    4. Insulin is usually decreased by 50%
    5. Sedatives are usually held

 

Again, here is the link to the pdf explaining the above points. And here is the link to the HopkinsILC website.

 

 

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American College of Radiology: Appropriateness Criteria

Categories:

Residency, All Rotations, Radiology, eResources

February 6, 2012

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Have you ever wondered what imaging test should be ordered for your patient? What radiologic test would be most beneficial in this situation? What imaging test should I order first? If a patient comes in with a painful knee, should I get an x-ray or go straight to MRI?  If a woman comes in with a non-tender breast mass should I get an ultrasound before the mammogram?  These are difficult questions; luckily The American College of Radiology (ACR) has our back! The ACR publishes a fantastic online resource they call the “Appropriateness Criteria” which details the best imaging tests for nearly every presentation.

http://www.acr.org/ac

They website allows the user to choose between a variety of organ systems (e.g. women’s health, urology, gastrointestinal).  In each organ system the user can then choose a specific complaint (e.g. breast mass, hematuria, dysphagia). For each complaint, the ACR then allows the user to choose what specific patient presentation is occuring (e.g. 35 year old woman with a new breast mass vs. 35 year old woman with a mass seen on mammogram vs. 70 year old woman with a new breast mass). In each circumstance, the ‘Appropriateness Criteria” explains what is the best radiologic test to help diagnose the patient’s problem.  They explain in detail the advantages and disadvantages of each test (MRI, CT scan, ultrasound, x-ray, etc) for each specific problem.

The criteria are updated every few years, the most recent data comes from 2009. One of the best parts about the ACR Appropriateness Criteria can be found at the end of each section. Not only do they make suggestions about which tests will be most useful in diagnosis, they also provide a literature review for EVERY SINGLE patient complaint which outlines what research and studies they are using when making their suggestions.

I HIGHLY RECOMMEND this website. In fact, there are few resources that I can recommend higher. I have used this many times and they intricacies and precision of the criteria still surprise me.  There is NO BETTER RESOURCE available to determine which imaging tests are indicated for a specific patient presentation.

 

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U.S. Residency Programs Under Probation

Categories:

Residency, Choosing a Specialty, Specialties, The Match

November 15, 2011

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The ACGME is incharge of accrediting U.S. medical and surgical residencies. There are three decisions that can be made: Accreditation, probationary accreditation, or withdrawl of accreditation. The ACGME compiles an up-to-date list of residency programs under probation or with withdrawn accreditation in all specialties. I had previously reported on the list for 2012, but many of these programs have either dissolved or have been able to regain good standing with the ACGME. Rather than list all the current institutions on probation, a list which is always in flux, it is best to search the database yourself. You can search for all specialies, or by a single specialty. This is probably a very good thing to do when deciding where to apply.

Click here to search for programs under ACGME probationary accreditation 

Click here to search for programs whose accreditation has been withdrawn

 

 

 

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