Category Archive: Third Year

Best Books for the Emergency Medicine Rotation

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Third Year, Fourth Year, Emergency Medicine, Emergency Medicine Rotation

July 13, 2015

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This post is part of our series on the best books and resources to help you perform well on your third year rotations and shelf exams. Also check out our lists for clerkships in Internal Medicine, Family Medicine, OB/GYN, General Surgery, Neurology, Psychiatry, Pediatrics, and Emergency Medicine. You can also check out our complete list of "Best Books" lists for medical students here. 

Background: Clerkship Grades

At the beginning of each of these clerkship lists there are a few things I must say. First, your grade on clinical rotations will depend on both your clinical performance and your performance on a shelf exam at the end of the rotation. While it is true that how you work with your teams and patients will play into your evaluation, there is no denying that your knowledge of the subject matter is, by far, the most important part of your final grade because it directly affects both of these two areas of evaluation. As a resident, I currently find myself filling out medical student evaluations every week. There are very few 'incredible' medical students and very few 'terrible' medical students. The vast majority of you (~95%) fit into the "good and easy to work with" group; the only thing you have to set you apart from others is your knowledge base. You have no alternative but to study! First Aid for the Wards is a great resource to understand the dynamics of your clinical rotations, I highly recommend it.

Essential Resources

The resources I will describe in the clerkship lists are books and online question banks. From the onset let me point out two indespesible resources that I will not list for each rotation individually.

  • First, I consider a great online question bank essential. Both Kaplan and USMLE World are very good products. I highly recommend purchasing a one year subscription to one of these USMLE Step 2 question banks. As you complete your third year rotations, these question banks will prepare you for 1- your clinical duties, 2- your rotation shelf exam, and 3- the USMLE Step 2 during your fourth year.  
  • Second, online review materials (e.g. Medscape, UpToDate, etc.) are essential resources to prepare for your patients in the hospital. The books and question banks can never provide the type of in-depth detail about disease processes that you will need to learn how to properly take care of your specific patients. To be a great medical student, you must prepare more profoundly for the diseases you are encountering personally in the hospital.

Book Series for Third Year

Medical students are not all made the same; we are all very different learners. There are a number of companies producing review materials for third year medical students, each with a slightly different focus. Each of these companies produce a different book for each clerkship. Interestingly, some companies' books are rated higher in some clerkships than others. If you find a product that works for you, consider sticking with it during your third year even if that product is not 'rated' as highly for a specific clerkship. Below are a few of the review products and their features.

  1. The Case Files Series: A unique teaching model; the Case Files series introduces a number of important clinical cases and follows them up with clinical pearls and important concepts. For students who need vivid clinical situations to remember factoids and concepts, this is a great series. (Case Files Emergency Medicine)
  2. The PreTest Series: The PreTest series is a classic question bank format with questions and detailed explanations. As I previously mentioned, I believe there is no substitute for a great question bank. While an online resource (USMLE World or Kaplan) can be more robust and mobile, a good question book is still a great option. The PreTest series produces a couple fantastic question banks. (PreTest Emergency Medicine).
  3. The BluePrints Series: The BluePrints series has a beautiful format that is very easy to read. The text is laid out in a bulleted lists, but with more details and descriptions than the First Aid series with which most students are familiar. I think very highly of these review books. (Blueprints Emergency Medicine).
  4. First Aid Clerkship Series: The First Aid series well known to most students also produces review books for third year clerkships. The content is similar to what students are used to, bulleted lists of high yield information. While I highly recommend many of the First Aid review books for USMLE Step preparation, the books are not quite as widely read and recommended for clerkships. (First Aid Emergency Medicine).

Best Books for Emergency Medicine Rotation

So, we can agree that books are not sufficient for success on your clerkships, but they are still an incredible resource that you should tap into. Let's review the best books and resources for your General Surgery rotation. These lists come from both my experience and also from one medical school's annual survey of its 250 graduating medical students who try to detail which resources were the most useful on their rotations.

Most medical students will complete their Emergency Medicine clerkship in their fourth year, which means you will be well trained and there will be much expected of you. On the wards and operating rooms of your third year of medical school you rarely encountered medical emergencies; these are now the most important thing. While you know a lot about medicine now, you don't know much about the acute treatment of medical emergencies. When you are in the ED, you must change your mindset; you are no longer trying to cure disease, you are trying to stabilize patients so they can be transferred safely to the wards. The best way to change this mindset is to read clinical scenarios that put you in these situations. Also, don't forget to touch up on your EKG interpretation (Rapid Interpretation of EKG's), which will be highly relevant tot his rotation.

 

1. Emergency Medicine Secrets:

The most well-respected text by medical students for the Emergency Medicine clerkship; Secrets provides high yield bulleted lists and clinical scenarios. I highly recommend this book.


 

2. Case Files Emergency Medicine:

Case Files is a great addition when preparing for the Emergency Department and the EM shelf exam. By now, many of you know this series well and know what to expect from this well-regarded series of clinical scenarios.

3. An Introduction to Clinical Emergency Medicine:

A great introduction to clinical EM, this book is often provided to medical students. This would also be a great reference in a general practice clinic, so you will likely refer to it over and over again even if you are not going into emergency medicine.


 

4. Tintinalli's Emergency Medicine Just the Facts:

The Tintinalli name is well known in Emergency Medicine. This book is small text made specifically for the EM clerkship. It has a clean format and is well received by most medical students. 


 

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Top Ten Books for Surgical Interns

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General Surgery, General Surgery Rotation

May 4, 2015

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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.

The surgical internship is unique in that you will care for the full spectrum of patients: acute surgical patients, post-operative patients, patients with chronic illness, and very sick patient in the ICU. The surgical intern is truly a "Jack-of-all-trades" physician and must be able to reconcile huge med lists, manage diabetes, identify an acute abdomen, and take care of acute electrolyte changes in the ICU.

These are tall orders for a newly minted doctor. And don't forget, after 7am you will likely be the only one on the floor while the rest of your team heads to the operating room. Having the right books is one easy way to calm some of the inevitable anxiety. After much discussion with interns and residents at my last two hospitals, I have compiled the following Top Ten Books for Surgical Interns. These books are also great resources for preliminary surgery residents, or other surgical supspecialistis completing a general surgical internship. Most of the general surgery residents I spoke to agree that this list remains the same into their entire residency. Good Luck!

  • Updated May 2015

1. The Mont Reid Surgical Handbook:

The Mont Reid Handbook is a great reference tool to keep in your pocket or on your phone. It was written by a group of surgical residents and is very high yield. It will cover the majority of issues you run into while managing the floors during a surgical internship. It is also great for reviewing for OR cases…if you get to see any during your first year.

2. Surgery On Call:

Surgery On Call is another great pocket reference. The goal of this book, however, is more in the initial evaluation and treatment of surgical patients. The quick-reference format is great for a quick consultation. Some interns also suggest Surgical Recall , which has a similar format but is geared more towards 3rd and 4th year medical students. 

3. A Textbook: Cameron, Current Surgical Therapy:

Every surgery resident, even surgical interns, will benefit from a great surgery text. Many of you will be provided a text at the start of residency, so ask your department before investing hundreds in one of these books. Cameron's Current Surgical Therapy is the highest rated by surgical residents. However, there are other great options. Greenfield's Surgery is well-regarded and cheaper than Cameron's. There are also many people who swear by the Sabiston Textbook of Surgery. 

4. Tarascon Pocket Pharmacopedia:

While we all have access to online pharmaceutical indexes during residency, I agree with most interns and residents that a pocket manual like this great Tarascon book is far faster and more reliable than most online resources.

5. The ICU Book:

You really should get an ICU book. You can get through your first month as an intern in the SICU or MICU without one of these books, but they make your life so much easier that it is just not worth it. Even if you just read through it a few weeks before starting in the ICU, the information will be fresh on your mind and will help you a lot. This is the ICU book I used, it addresses both medical and surgical intensive care issues. Many residents also like The Little ICU Book. 

6. The Washington Manual Internship Survival Guide:

This is a lesser-known internship manual written by the same people who developed the highly rated medication reference, The Washington Manual of Medical Therapeutics. Not as well known as the Mont Reid manual, this is a book from a similar mold with a small but vocal cult-following.  

7. Zollinger Atlas of Surgical Operations:

A surgical atlas is the best way to learn the anatomy and prepare for pimping in the OR. A great surgical atlas will become one of your most important references during residency. If you are a general surgery resident, Zollinger's is the go-to atlas for most residents. 

8. Operative Dictations in General Surgery:

Dictating operative notes is a necessary evil. It has to be done, and it has to be done well for documentation purposes. As the low man on the totem pole, the job of dictation will fall on you. This is a highly recommended book to help interns and residents early in their career. I have a number of procedure note templates available on this website.

9. The ABSITE Review (FISER):

Many surgical interns will complete residencies in specialties other than general surgery. For those of you moving on the general surgery after your internship, you should start studying for your ABSITE early. I know you are incredibly busy in the hospital, but when you have a minute you should keep an ABSITE review book and/or question book handy. The Fiser review comes highly recommended. Another book that many residents recommend is ABSITE Slayer.

10. Old-School and Out-of-Print:

After discussing books for surgical internship and residency with many people, there were two books that were mentioned many times but are no longer in print: The Cleveland Clinic Guide to Surgical Patient Management and The Surgical Intern Pocket Survival Guide . These two books come as high or more highly recommended than every other book on this list. Some residents say these were the most used books in their white coats. Unfortunately, you can no longer buy either of them new, but there are many used options.  

 
 
 

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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 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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Spotlight Interview: Why did you choose OB/GYN?

Categories:

Choosing a Specialty, OB/GYN, OB/GYN Rotation, Why did you choose....?

June 1, 2012

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An OB/GYN Resident’s Perspective: From an interview with an obstetrics and gynecology resident at Banner Good Samaritan, in Phoenix, Arizona.

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 OB/GYN?

I enjoyed the opportunity of working with women over the course of their lifetime health care needs.  From adolescent to geriatric patients you can develop life-long relationships with your patients and families.  Labor and Delivery is exciting and fun to be a part of.  Delivering patients was rewarding and the patients generally are very appreciative of your service. I also enjoyed working with the type of people who typically choose Ob/gyn as a career. I tried to talk myself out of it because of what others had to say, but throughout 3rd year medical school, every subsequent rotation came back to how much I enjoyed Ob/Gyn and I realized that I wouldn’t have been happier in any other specialty.

 

  • Describe an OB/GYN typical work day?

Usually it starts early (to the hospital before 6 most days, this will get better after residency), postoperative and postpartum rounding on patients in the hospital then usually clinic 3-4 days per week.  Most Ob/Gyn’s will have one full day of surgery per week.  Depending on the group you practice with, you’ll be on call about every 4th night for deliveries and one weekend a month.  Clinic may be interrupted by deliveries but they are usually quick.

 

  • What type of lifestyle can an OB/GYN expect?  

It is highly variable, if you choose to be on call for all of your patient deliveries, you can expect to be interrupted frequently as babies are born at all hours.  However most practices will share call amongst the group and with other groups.  Usually Ob/Gyn’s will be on call every 3rd-4th night and maybe one weekend a month.  That is typically home call and you come in for deliveries only. Many Ob/gyn’s are working parents and often female with a relatively normal home and family life.

 

  • What is the average salary of an OB/GYN?

Salary is highly variable based on call schedule and region but most will typically start in the low 200’s initially for most urban areas.  Rural regions tend to start much higher but the call schedule can be more demanding as well.  It is not unusual to increase significantly, again based on call schedule and delivery volume.

 

  • What is the job market like for OB/GYN?

Great! As long as people keep having babies!  There is a projected shortage in all aspects of medicine and Ob/Gyn is no different.  You can typically find a job close to any area where you may want to live.

 

  • What can you tell us about OB/GYN Sub-specialties?

All subspecialties are three year fellowships: Gynecologic oncology, Maternal Fetal medicine, Reproductive endocrinology and infertility and urogynecology.  Salaries and lifestyles are generally improved with all of those specialties to varying degrees and there is always a market for them.

 

  • What are the potential downsides of OB/GYN that students should be aware of?

Like I mentioned before, babies are born at all hours, especially at 3 o-clock in the morning.  However you can make the schedule what you want, if you join a large group you’d have to take less call but you’d likely be busier during those call nights.  Malpractice insurance and lawsuits are a well known downside to the field. As long as you understand this going into it and it is not a surprise, it will not be a problem.

 

  • What else would you tell medical students who are considering OB/GYN?

In the end you choose a specialty that you really enjoy. Don’t choose solely based on lifestyle or salary.  Don’t try to fool yourself either though, those things are important but if you hate your job, it makes for a miserable lifestyle.

 

 

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: Matching in OB/GYN

Categories:

Choosing a Specialty, How to match in....?, OB/GYN, OB/GYN Rotation, The Match

June 1, 2012

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An OB/GYN Resident’s Perspective:  From an interview with an obstetrics and gynecology resident at Banner Good Samaritan Hospital in Phoenix, Arizona.

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 OB/GYN match?

The overall competitiveness of OB/GYN is about average. The average board score for Step 1 is usually in the low to mid 220s. There are many more female applicants than male applicants right now.

 

  •  What must a student do to match well in OB/GYN?

Audition rotations in programs you are interested in can be very helpful but you have to impress people during the rotation. It is very easy to do a rotation and just coast through it.  They are called audition rotations for a reason.  Do well on Step 1, show improvement on Step 2 if needed and get letters of recommendation from people who really know you, not just big names

 

  • What are residencies looking for in an OB/GYN applicant?
Programs are looking for someone who is motivated, works hard and helps those around them.  Intelligence is obviously important but strong work ethic goes much farther.

 

  • What should students look for in an OB/GYN residency?

Look for a program where the residents are happy.  Well trained and well taken-care-of residents are happy residents and it is obvious on interview day which residents are happy.  It is important to note not just what the residents tell you but how they say it.  Every one of them will say they are happy and pleased with the program but it is easy to see those that are truly happy.

Editor’s Note: I remember a number of resident’s giving me similar advice throughout medical school. I must admit, I was skeptical. Anyone can fake it during an interview day, right? How can I learn in residents are happy during an 8 hour interview? The reason everyone will keep telling you to pay attention to this is because it is ABSOLUTELY tangible if the residents are happy or not. If you are paying attention, there is no way they can fool you. Happy residents are excited to see each other, they speak to their attendings when they see them and have ongoing friendships with them, they have lives outside of work, they don’t have to think long about why they love their program, they are quick to explain what features of their program set it apart. You may not think this is a big deal now, but I assure you that the temperament of a residency program will make or break the next 3-7 years of your life.

 

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

Get letters from doctors who know you well, not just big names. As a fact, personal statements are cheesy but try to minimize cliché terms. Rank programs on gut feel taking all things into consideration.

 

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

I prepared well. Just read as much as you can about the match and be prepared to ask questions during your interviews.

 

  • What other advice do you have for students applying to OB/GYN residency?

Do what you enjoy, you’ll be training in this specialty and working in it for the next 35 years so make sure you like what you do and the type of people you’ll be working with.

 

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 General Surgery

Categories:

Choosing a Specialty, General Surgery, General Surgery Rotation, How to match in....?, The Match

May 31, 2012

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A General Surgery Resident’s Perspective:  From an interview with a general surgery resident at Orlando Health in Orlando, FL

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 general surgery match?

Moderately difficult. The average USMLE Step 1 score is usually in the high 220s, but higher for the sought after programs.

 

  •  What must a student do to match well in general surgery?

Your USMLE Step 1 score is the most important factor. Letters of Recommendation are very impotant and some should come from surgeons you have worked closely with. If you are interested in a research institution then research publications and presentations are very important.

 

  • What are residencies looking for in a general surgery applicant?
They are looking for someone who is Intelligent; they use Step 1 scores to establish this. They are also looking for someone who is passionate and hard-working; they can learn this through the activities you list and from the things mentioned in your letters of recommendation. It is important to be easy to work with, you can show this to programs during your interview.

 

  • What should students look for in a general surgery residency?

From a training standpoint, I think that surgical simulation experiences and structured education lectures/curriculum are something that every applicant has to be aware of. These experience are paramount in your surgical training. As you probably know, operative experience volume and variety is one of the most important factors (i.e. how many mastectomy vs whipple cases). You should know these statistics about each of your programs of interest.

 

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

Letters of recommendation should be from faculty that can speak to your strengths in clinical decision-making and surgical skills. Personal statements should not be about how you always wanted to be a surgeon, but why you decided to be a surgeon. Rank programs that provide you with a high operative experience and well-defined simulation/education curriculum

 

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

Be sure to prepare your  letters of recommendation early. Plan to interview at about 10-15 programs. If you plan to interview at highly competitive programs, you might need to plan on a bit more interviews.

Editor’s Note: I 100% agree with preparing your LOR early.  Many of the attendings are extremely busy and 1 month notice may not be enough. Start asking at the end of your third year if you find individuals who could write great letters.

 

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

The best advice I ever received about deciding to do general surgery was “If you can’t do anything but general surgery and be happy as a physician then you should do surgery. Otherwise do the other specialty”. General surgery is a much more family-friendly specialty than it used to be. The egos and personalities that used to predominate the specialty are gone, surgeons are expected to be calm and mild-mannered today and exist well with their non-surgical counterparts. The best part of being a surgeon is being able to diagnose and treat the problems our patients face. When all other options fail and other specialties are uncertain what to do they will consult a surgeon to help, so you will be the go-to person where-ever you practice

 

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: Why did you choose general surgery?

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

May 31, 2012

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A General Surgery Resident’s Perspective: From an interview with a general surgery resident at Orlando Health, in Orlando, Florida.

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 General Surgery?

I appreciate the combined operative and medical management of patients. Surgeons make definitive management of patient issues. There is a great variety of operative procedures. As a general surgeon I am able to care for both long and short term patient management scenarios. There is a great deal of job opportunities and availability. I enjoy team-based patient management.

 

  • Describe a General Surgeon’s typical work day?

I usually wake up at 0400,I am at hospital by 0500 to round on patients until about 0700. I will be in the OR from 0700 until about 1600 with intermittent 30-60 minutes breaks between cases to eat, follow-up on patients, and see new consults. From 1600-1800 we follow-up on outstanding patient issues and setup for following day. On good days, I return home and from 1800-2000 I study for following day cases and current patient problems. On non-operative days, simply change the OR times  to clinic from 0800-1600.

 

  • What type of lifestyle can a General Surgeon expect?  

As a general surgeon I work weekends at least 2-3 times per month. The amount of free time you will have is extremely dependent on your sub-specialty choice. Private practice surgeons enjoy significantly more free time while surgeons in academic practice spend more time with research and have less operative/clinic time generally. Call is usually taken for 24 hours periods and you will be working most of the day and night. Some surgeons have a tendency to scheduling elective cases during their call days, but this depends on how difficult your call is.

 

  • What is the average salary of a General Surgeon?

The overall salary of a surgeon is highly variable amongst sub-specialties, typically  between $250,000-$500,000.

 

  • What is the job market like for General Surgeon?

There is no lack of general surgery positions. I would say they are extremely available for both private practice and academic positions. There is some variability among sub-specialties. However, overall, we are one of the most high recruited specialties.

 

  • What can you tell us about General Surgery Sub-specialties?

Residency for general surgery is 5 years mandatory and more commonly 1-2 years research years during PGY2 or 3. Therefore, many general surgery residencies last 6-7 years before fellowship. Fellowships typically last 1-2 years. Subspecialties have more call and higher salary. Additionally, sub-specialties are generally in more demand than general surgeons.

 

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

The schedule is less flexible due to emergent surgical problems. Surgical shift hours are not reliable and typically cases will be delayed or run over and require staying at the hospital beyond a call or shift. This leads to a schedule that can be variable. Training programs are not as “intense” as they were historically, although there are still high expectations of surgical residents. There are not many other residents/doctors who work as hard as general surgeons.

 

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

One thing students should realize is that there is more peri-operative management being handled by hospitalist services for elective surgical problems. Therefore, some of the duties and responsibilities of a surgeon 20 years ago and being placed in the hands of non-surgeons. Additionally, surgical critical care services are beginning to  limit the medical management requirements of general surgeons.

 

 

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: Matching in Psychiatry

Categories:

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

May 31, 2012

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 A Psychiatry Resident’s Perspective:  From an interview with Dr. Frazier a psychiatry resident at UC Irvine Medical Center in Irvine, 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 psychiatry match?

Overall, it is not a very competitive specialty.

 

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

Mainly, you must show interest in the field. Let people know you’re interested when you’re in your rotation. Doing some research also helps you know if you like the field. Research may also help to get a good letter from someone at your university.

 

  • What are residencies looking for in a psychiatry applicant?
Solid letters of recommendation, a good personality (more important here than in many other specialties), to a lesser extent good board scores (not as important, but they will definitely help you!)

 

  • What should students look for in a psychiatry residency?

Look for a program that trains physicians in what you want to do. Are you interested in research? Choose a program that supports that. Are you interested in clinical work? Choose one that focuses more on that. Also, make sure you get along with the residents. I recommend an away rotation to your top school(s) if you can.

 

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

Identify your letter writers early on. A few from psychiatry, one from medicine, one from family medicine or something else. For ranking, just choose the place that you want the most. Don’t try to game the system!

 

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

Interviews are generally very laid back. Still prepare, but don’t stress them too much. Have a few questions for the interviewers.

 

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

Again, identify letter writers early. They mean a lot for residency in general, but maybe even more for psychiatry. Other than that, enjoy your career!

 

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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