Billy Terrell MS-43/02/09

Goals for YOU -- the MS3Develop knowledge and skills to be a great Clinician

Perform AWESOME your 3rd yearGet into your dream Residency Program

Go to where you’ll be the happiest, best for your career.Have average to high average GPA and Step ScoresHave an attractive applicationHave letters that are truly personalBe genuine

Start NowDo NOT procrastinateStart Career planning NOW, begin work on application in

late Spring.Your Application takes weeks of solid work to assemble

Personal Statement – 2 weeksLetters of Recommendation - could take a month or moreCompiling Extracurricular activities

Research Community Service Medical School Sponsored Activities Hobbies (be genuine)

Choose your specialtyYes, it is hard! Requires soul searching and realistic

appraisal of yourself.3rd year rotations

Interested in the common patient complaint?Does your personality fit?

Patient population Clinician, Clinician-Surgeon, Academia Lifestyle

Iserson’s Getting Into a Residency (copies in library)**NRMP Charting Outcomes in the Match

http://www.nrmp.org/data/chartingoutcomes2007.pdf

Away RotationsGain exposure to complicated scenarios.Get to know inner workings of the program.Allow the faculty to evaluate you.Get to know the city.Can really make/break interview experience.Get Letters of Recommendation from faculty.Visiting Student Application Service (VSAS)

http://www.aamc.org/programs/vsas/students/start.htmOther Institutions – Apply through Med school Website

MentorGuide you to away rotations.Help guide/review your personal statement.Write you an awesome letter of recommendation.Develop contacts for you in the field.

This is VITAL!

Ask MS-4s going into field! Learn from us!Find out which faculty are connected.

ApplyingDecide on a general geographic area.Apply to all schools in that area.Use ERAS Program List (includes program website links)

https://services.aamc.org/eras/erasstats/par/index.cfmSchools are viewed on arbitrary Tiers.

Apply based on your qualificationsEx: Apply to a few top Tier, many middle, and a few low tier.

If needed, apply to institutions in a “backup” field.Consider especially for high competitive fields.

Use NRMP Charting Outcomes.pdf to know if your field is competitive.Double the work!

What makes a good programAsk Faculty who went there!

Expect some BiasSee Linda Holmes for list of graduates in a specialty.

Ask MS-4s going into that specialty!Freida

Specialty Training StatisticsStudentDoctor.net

http://forums.studentdoctor.net/US News Best Hospitals

http://health.usnews.com/sections/health/best-hospitals

Residency PositionsCategorical: Resident enters a program with the

objective to complete the entire program. Length varies with specialty.

Preliminary: Positions for residents who have already been accepted into another specialty, but who are completing pre-requisites for that specialty.

Transitional: 1st year of residency designed to provide a program of multiple clinical disciplines. Typically used to fulfill pre-requisite for a specialty.

Fellow: Post residency sub-specialty training.

ERASTransmits Your Application to Residency Programs

Electronic Residency Application Servicehttp://www.aamc.org/students/eras/start.htmKaren Bledsoe will give you your login “Token”

Electronic Form that is basically your med school CV.Type ALL sections in Word then copy/paste into form boxes.

Select Schools to apply to through your personal application page.Uses Application Document Tracking

Tab within your ERAS site that allows you to see which schools have received/viewed/downloaded your application.

Receiving interview notification via this website Message tab and email.

Fee: 60$ for 10 schools, 8$/school 11-20.

ERAS TimelineJuly 1st – Application website OpensSeptember – Applicants may begin applying.

Send Karen Bledsoe a digital photo of yourself.Acquire transcripts from undergrad / med school.

Interviews – Begin in November, continue through JanuaryNovember 1st – Dean’s Letters (MSPEs) are released to

programs. ERAS automatically distributes this.2nd Look opportunity– December, JanuaryNRMP:

January/February – Programs assimilate RANK listsMid February – Rank lists due

NRMPMatches You to your Dream Residency

Provides a uniform date of appointment to Residency.Provides uniform rules for appointment.

Historically, recruitment occurred even as a MS-2!Applicant’s / Program Rank lists compared via computer

algorithm .Applicant Registration Fee: 40$ (2009)

In Summary: ERAS helps you set up interviews with programs, NRMP helps you match with a program via a fair process.You MUST register for both!

San Francisco MatchThe “Early” Match

http://www.sfmatch.org3 Specialties Participate via SF Match

Ophthalmology Plastic Surgery (However most participate in ERAS instead)Child Neurology

Not electronic service!Centralized Application Service (CAS)

Every Document must be in print. (Type app in Word first )Letters of Rec. – Sealed Envelopes w/ writer Signature on SealOriginal Transcripts – Notarized, in envelope.Gather ALL required docs – mail Next Day Air as one package.

100$ Registration Fee (2009), 60$ first 10, 10$/school 11-20Is the combined ERAS/NRMP equivalent for these specialties.Still must apply for PGY-1 via ERAS/NRMP

SF TimelineJune 1st – Application Process open August 1st – Few school deadlines (Mayo, Bascom

Palmer)September 1st – Application DeadlineInterview Offers start – End of September, all by mid

October.Rank List Due – early JanuaryMatch – mid January

The Urology MatchHosted by the American Urological Association

http://www.auanet.org/content/residency/residency-match.cfm

Applicants apply for interviews via ERAS.Similar to service provided by NRMP.

Some programs require NRMP for PGY-1 Surgery.Registration Fee: 75$ (2009)Timeline:

Rank list submission: Beginning of JanuaryMatch: End of January

Medical Student Performance EvaluationAn assessment of a student’s performance relative to his

or her peers throughout the first three years of medical school.

An assessment of the student’s academic performance AND professional attributes.

It is NOT a letter of recommendation.Standardized format since ~ 2002.Release date of November 1.

How is the MSPE Prepared?Each student completes a Dean’s Letter Questionnaire to

be available on the Student Affairs webpage.Each student has a meeting with Dr. Veitia in July or

August.Students review their MSPE to correct factual

information.Students cannot revise evaluative statements.

The Six Sections of the MSPEIdentifying Information Unique CharacteristicsAcademic History (matriculation dates, explanation of gaps in educational

program, information about repeats or remediations, information about adverse actions)

Academic ProgressPre-clinical/ basic science course workPerformance in clinical clerkships (grade, narrative)

Summary Summative assessment of the student as compared to his or her peersSchool-specific categories to differentiate studentsProfessionalismAppendices

What Residency Directors WantBe yourself! Impossible to be the perfect applicant.NRMP Program Director Survey

http://www.nrmp.org/data/programresultsbyspecialty.pdfStep Scores – Predict performance on Specialty Board Exam.Characteristics of Ideal Candidates (from MSPE Comments)

KnowledgeTeamworkStrong MotivationWorking at intern levelGenuine InterestPatient advocacyGreat communication skillsOwning ProblemsIntegrityHonestyNo Personality Issues

Letters of RecommendationGoal: Attain PERSONAL letters that exude what RDs want to see!Plan and do a rotation with someone. Ask them EARLY in rotation.Start asking EARLY! Pick people with contacts.ASK them if they can write you a great letter.

Do not submit one that you think is lukewarm.Ask their office staff/MS-4s if they are quick on getting letters out.

(this can be important).Typically one is from the dept. Chair of the field of interest.One letter is from a separate but related field.One is from a physician in your field who knows you well.

Personal StatementHave a faculty member who reads personal statements as

part of the residency committee read your final draft.Depending on specialty – some programs spend 12 minutes

per ENTIRE application, 1° care may spend an hour per application.

Take Home Point: You must craft your application to describe your strong points across various sections of the application.

Personal Statement Do’s/Don’ts

Do’sBe honest and Genuine!Present yourself as a mature professional.Make it easy to read (excellent flow, flawless grammar).Convey:

What makes you unique (makes you stand out) What makes you a good fit for the specialty. Both what motivates you, and your future goals. If necessary, only negatives that can be positively explained.

Don’tsDon’t rehash your curriculum vita.Don’t use quotes.Don’t waste space (i.e. Why I wanted to become a Dr…).

AdviceBe aware of BAD advice!Talk with program directors here.

They read 100’s of applications every season.Use people who went to the school of your interest!

Talk with FACULTY in your field of interestTalk with MS-4s going into that field!

Rule of Thumb: You do not want your personal statement or interview attire to “stand out.”

You want the total package to “stand out.”

Something to Remember…Program Directors or Residents of programs to which you

are applying may “Google” you or look you up on Facebook or MySpace.

Clean it up, or keep your profile Private!Google will find you Blog!

In Summary: Give them nothing other than you application / interview to judge you by.

Scheduling InterviewsSignificantly better Interviewee with experience

Schedule your dream schools after a “trial run”Available interview dates

Depend on when you receive interview offerDepend on competitiveness of program

Respond to interview offers IMMEDIATELY. (24hrs)Competitive fields are first come first serve for spots.

Re-schedule/ Cancel Goal: Notify at least 1 wk prior.

What to WearMen

Black or Grey Suit – this is not the time to be cheap!White ShirtWindsor Tie – Yellow, Red, Blue – Power colorsBlack dress shoes – CLEAN, NO SCUFFS! (cited by RDs)Buy Chap stick (also cited by RDs—interview season is winter time!).

WomenMore variable – Black or Grey skirted suit still most commonBlouse – nothing flashy.No flashy jewelry – use your judgment on nose piercing.Natural hair colors only.

Carry black leather folder w/ case presentation, CV, spare photos, and your list of questions to ask! (You’ll be nervous and forget them!) Carry a nice pen, do NOT use a drug pen or another institution's pen (d’oh).

Photo: Wear your interview attire for photo, mid-chest up. (passport size)

Questions to ExpectPart 1

Research Programs before Interview! Use Program Website – Read Everything

YOU MUST SELL YOURSELF!Be prepared for 3-on-1 & Panel (8+) interviews (Relax)

Tip: Scan room periodically while speaking to engage all interviewers.Be prepared to explain ANY areas of your record.

Some suggest pre-emptive discussion of weaknesses.Be prepared to discuss current events!

Read Wall Street Journal in airport/plane.Tell me about yourself? (Difficult ice breaker)

Variant Question: What are your strengths/weaknesses?Answer: Explain what motivates you and include strengths.

What accomplishment are you most proud?What is the most difficult thing you have done?Not mentioning family, who are your heroes?

Questions to ExpectPart 2

What do you do in your spare time?Why should I choose you over the other applicants here today?Where do you see yourself in 10 years?Describe something unethical that has happened in your career.Which patients do you find difficult to deal with?Why do you want to go into this specialty?Why did you apply to this program?Tell us about a patient you learned to most from? (BE prepared for a

case presentation!) (Competitive- absolutely necessary)Where else have you interviewed?Can you think of anything else you would like to add?Be prepared to discuss common patient complaints/diseases!Competitive Surg Field - Do NOT get flustered by Dexterity tests.

Questions to ASK FacultyALWAYS ask Questions- This conveys your interest in the programFaculty:

Strengths/Weaknesses of Program?Changes do you anticipate in next few years?What do most of your graduates pursue p/ graduation?How are the residents evaluated?How do your graduates perform on the board exam?Opportunity for research? Is attendance to national conferences encouraged?What is the Lecture schedule?Local VA Hospital? Location of all clinic sites? Is there a Resident run Clinic? If so, is there an attending on staff?What aspect of the program do residents find most difficult?

Finally, ask for contact information (for p/interview)

Questions to ASK ResidentsResidents:

Strengths/Weaknesses of the ProgramCall Schedule, who is my backup? Is there initial buddy Call?What is the patient load?What attracted you to the program?Would you come here again?Do the residents get together outside of work? How often?How are the lecture series?Do you feel the program prepares you for the boards?Any initial lecture series/ training?Fellows helpful? Do they teach? Do they share cases?Local Housing?Specialty Exposure?Equipment provided (Books, surgical tools i.e. Loupes)How much time off do you have?What is the relationship between faculty and residents?

Illegal QuestionsAny questions concerning childbearing!

What are your family plans? – “Answer that you plan to have children at the end of your residency. My training comes first.”

What is your corrected vision? What medications do you use?How much EtOH do you drink/wk?How many days were you sick last year?Any specific rank order questions!

Post InterviewWrite down info about each program immediately!Try to Rank programs as you go.Send Thank You Note/Email within a few days.

Thank ALL faculty with ONE letter to Program Director2nd look Interview – scheduled with program personally

Allows you to further narrow down your top 3.Common among certain specialtiesDo not expect to be with program director (i.e. no re-

interview)Email Residents p/ interview with new questions/criteria as

you mature along the trail.

Writing the Thank-you NoteThank the PD (obviously) for the opportunity

Be FlatteringAsk the PD to thank the other faculty for you

Convey your interest in the programList specific factors (their strong points)

State your specific reasons for wanting to be at that program

Re-iterate your strong pointsWhy you are a better choice over other applicants!

Be concise!

Questions you need to answerWill this Residency Program provide me with strong

training?**Does this program offer an environment that will allow

me to reach my full potential?How did I feel when I visited the program?Will I feel comfortable at this program?Will I enjoy working with the faculty/staff there?Could I live and work in this city for the next several

years?

Making your Rank ListNational Resident Match Program (NRMP)

http://www.nrmp.org/Both Residency and Fellowship MatchRegister on-site before December (discount price)Certify Your List (Green) –Confirmation Email

SF Match – PDF form fill in, submit electronicallyConfirmation Email

In general, Rank at least 6 schoolsUse whatever criteria you feel is important

Always trust your gut feeling!Do NOT Rank a program because they told you they would

rank you High!

How the Rank WorksNRMP:

http://www.nrmp.org/res_match/about_res/algorithms.html

It is not that complicated. Just Rank IN ORDER OF YOUR PREFERENCE!

Basically, the system is in your favor if you rank a program 1!A program’s Rank list is used as a tie breaker between 2

students that have Program X ranked #1.The un-matched student goes to 2nd choice, process repeats

as if that school is their #1.Summary: There is NO reason to not Rank a competitive

program as #1, if you do not match there it is as if that program was never on your list!

Common Errors Made Not giving enough thought to your Rank ListCreating too Short a Rank listRanking a program you have serious doubts about

You are committing yourself if you rank them!Ranking programs based on where you will get accepted.

You will only match to the program you want if you put it at the top of your list!!!!

Do NOT reciprocate because a program told you they would Rank you High.

Criteria I used to Vet ProgramsI Literally had all categories on a spreadsheet

Match!NRMP: Occurs in middle of MarchNRMP: Outcome announced via email / Web on Monday

Informed of un-match status same day.List of un-filled programs posted Tuesday at Noon.NRMP Results: Disclosed at Match Day, posted NRMP

website at 1pm ET.SF Match: Occurs in middle of JanuarySF Match: Disclosed on Match date to you and residency

program.

Avoid the Scramble!The “scramble” for unfilled positions occurs p/ Match.Scramble version of ERAS available on Tuesday of Match

Week.This is not your opportunity to get into a competitive

specialty.2,000 US Graduates PLUS 7,000 FMGs use the scramble

**Factors that often lead to Scramble:Poor candidate interviewsDid not Rank enough Institutions

Revise your applicationAlter Personal Statement if needed, Update CV to present.

Application Document Tracking – same as traditional ERAS.

But if you Scramble…http://www.aamc.org/students/eras/info_scramble/start.htm

Process lasts 2 DaysTuesday Noon- NRMP Dynamic List available

Use program ID code to search for program on ERAS.During Scramble, you can apply to a maximum of 30 new programs

and 15 programs to which you’ve already applied free of charge via ERAS Scramble edition.

Have all App Documents Ready to Fax to non-ERAS programs.http://www.efax.com

Contact Program Directors DIRECTLY! There will be a phone Interview.Some programs will accept you on phone, others wait. Find A Resident Service (Post-Match AAMC Service)

http://www.aamc.org/students/findaresident/For unsuccessful Match via NRMP and Scramble

Good Luck!Know this! Programs are as terrified as you are! They

want you to like them!You determine your success in the Match.Take Initiative, this is your future career!

Medical School was just a stepping stone.The Odds are in your favor!

Around 95% Match in their preferred specialty!

PLEASE fill out the Survey!