Tag: EM

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Spotlight interview: Joey from Brooklyn lands a PM&R residency

I know him as Joey from Brooklyn and had the pleasure to rotate with him before he was Dr. Seldin. Here’s what he had to say about his journey to landing a Physical Management & Rehabilitation (PM&R) residency.

 

 

Tell us a little bit about yourself. Who are you professionally? Who are you outside of the hospital? What was your path to medicine?

The best way to tell about myself is to start from where my family is from. My father is from Brooklyn and my Mother is from Queens. I grew up on Long Island and my wife is from the Bronx. And its not hard to tell when you talk to me, my accent says it all.

I went to college to the University of Buffalo and received a BS in Psychology. During this time I became very interested in Fitness and Nutrition, performed in Body Building Shows, and learned from one of the greatest Trainers in Buffalo John Schweikhard. This love for fitness and nutrition pushed me in the direction of perusing a masters degree in nutrition from Columbia University. While earning my Master’s I lived in Washington Heights and would spend my free time on the Upper West Side (UWS). One Friday in June of 2008 I was in a Bar on the UWS of Manhattan at a place called Burbon St. I was there early and she walked in, I looked at her and said “yo legs come over here” and we hit it off. At the end of the Summer, July 28, 2008 I was in a bad accident and lost my right eye. This was hard time for me. I finished my masters thesis a few months later. 90% of the people I studied with at Columbia went right into medical school all over the country.

I lost my flow, this was the first time in my life that I wasn’t in school anymore and didn’t have a job and didn’t know what to do. After a year and a half, when I had more confidence after loosing my sight and multiple surgeries, I fell back on my fitness and nutrition knowledge and decided to professionally train people. At the same time my little brother starting to box and I put a lot of effort into helping him train. I would make his meals and slept on his couch in return. Then I came to a point when I realized I needed to really go for what I wanted my whole life which was a to become a doctor. At this time I was professionally training several doctors and one of them who was a cardiologist said, ‘if you want it then go for it’. I took the MCAT and honestly very did poorly. So I took it again, and again and again. Finally I was at a party and this kid who was shadowing at one of my client’s offices was like, ‘I’m going to Ross’. I didn’t know anything about this school and said to myself it is worth a try.

Outside the hospital I am a family man, I had my son two weeks before the start of my 3rd year of medical school. It was hard to give time from my family and study but I pushed through. I had my 2nd child 6 weeks ago. She was due the day before we started residency but she arrived early. It was perfect timing because it gave me a chance to get to know her.

 

 

What specialties did you apply to? How did you come to choose them?

Before I started medical school, I came to know this field called PM&R, Physical Medicine and Rehabilitation. While I was training clients I came to build a lot of great relationships. One of them worked at North Shore LIJ hospital system and he helped me volunteer at their hospital in the PM&R division. I didn’t know it at the time but this small step may have gotten me the career I have today.

So I knew in my head before I started medical school that this may be the field for me. What most people don’t know is, I kept an open mind during my 3rd year of medical school and really enjoyed all of my rotations. The closest thing to PM&R for me was emergency medicine. I also met the best attending physician there who really inspired me and peaked my interested in that field too.

So I applied to both PM&R and EM.

 

 

So going into PM&R means you have to do a transition year. Did different programs have different requirements for that transition year?

Most programs require you to complete a preliminary year in either internal medicine, family medicine, surgery, or a transitional year (this is like 5th year medical school- you rotate in surgery, OB/GYN, medicine, the ICU, EM, and some electives). Some programs have a categorical position, meaning you do your first year in that program as a medicine resident. Medicine is the most relevant in my opinion. The thing I didn’t know was that internal medicine preliminary spots are very hard to get. See, the ophthalmology, dermatology, radiology, and anesthesia guys and gals are going for IM prelim spots as well. So they’ve got the top step scores and they are US students. Where I am just in the top of the scores applying as an international medical graduate.

 

 

What was it like applying and interviewing for both of them?

I truly enjoyed the interview process and anyone who knows me also knows I am a talker. And when it comes to interviews, I thought to myself this is probably the only time I can get away with talking about myself all day. Another thing about applying to specialty fields is you don’t get interviews until October and until late December. It was mid October and I had like 4 interviews. My buddy applying to IM had like 20 by the end of September. Then all of a sudden I was bombarded with them.

 

 

How many programs did you end up applying to? What was your reasoning for that number of programs? How many interviews did you receive for each respectively?

I applied to 129 programs but I didn’t break the bank like other people I know. It ended up costing about $1,600. I applied to 10 transitional, 39 PM&R, 55 EM, and 25 IM programs. I got 10 PM&R, 10 IM Prelim, 6 EM, 1 TY interview for a total of 27 interviews. Of these interviews, 6 of these interviews I got by bugging programs to interview me and one of them is where I matched.

 

 

How did you end of ranking your programs?

My ranking was not an easy task. I went on a lot of interviews and honestly there a few things to consider for you rank. Some people rank based on location, academics, specialty, and other things. For me the most important was location. Staying in NY and being close to both my wife’s family and my family meant a lot.

 

 

What was the most challenging aspect of applying to PM&R?

There are not a lot of programs and in many programs are only 2-4 spots per year. I think there is only like 116 spots in the whole northeast.
For EM the IMG is non-existant these days. The programs are big into US students. There was lots of spots, lots of programs but I got only a few interviews.

 

 

Any crazy stories from the interview trail?

So SUNY Downstate PM&R pre-interview social, was at a bar in the village. It was open bar with top-notch drinks. The kicker was that we had to drink a certain amount to get a discount. So the residents had us downing beers and shots. I drank 6 Chimays and Duvels and downed a glass of Jonny Walker Blue. Then I had the interview the next day…good thing it wasn’t until 12pm.

 

 

What do you think were your greatest strengths about your application?

I applied locally. There are by far the most programs in NYC and having ties to an area can boost your ranking. I also scored very well. It is a special feeling when you go on an interview and pretty much know you probably have better scores then most of the people sitting next to you. If you go to Ross you know how hard it is to make it off that island and you know how hard you can work. I know I can work harder than anyone out there. I had a child right before my 3rd year of school and still was able to go up 17 points on step 2.

 

 

In contrast, what were your greatest weaknesses about your application?

The medical school I attended I would say was the greatest weakness. But is only the limiting factor for getting interviews. 80% for sure if you get an interview, they really want you otherwise they wouldn’t interview you.

My first interview was at Stony Brook PM&R, the director said, hey you go to Ross, great school. I laughed hard in my mind. Turns out that a resident many years ago at Stony Brook was a super star. On the flip side, there are hurdles with advanced match. See you can score a PM&R place on match day but that is only years 2-4 for your residency. You still need to also match in prelim as well. Now I matched in both of course otherwise I wouldn’t be talking to you about it. But sometimes a programs ranks someone in PM&R and the person doesn’t secure a prelim spot, and can’t soap into a spot either. Pretty much just fucked.

 

 

How did you do on the USMLE’s? What were your step scores? Do you think your step scores negatively/positively affected the number of interviews your received?

Step 1 242 and Step 2 257. They definitely helped me and I looked up the average scores on the ERAS stats list. No one scored as high as I did in 2014 in PM&R on Step 2. I know if my scores weren’t as good I would not have gotten close to the number of interviews I had.

 

 

What advice would you give to other Caribbean and/or American medical graduates who want to apply to PM&R?

Take every interview you can get. Also make sure you can rotate at a place that will let you go on your interviews during your rotation. On one of my electives I went on 4 interviews in one week and they didn’t give me any shit about it, which was great.

If you have shit scores, plan for back ups. Don’t be foolish. And if your scores suck, make sure you can relate to the field you are going for and kill it on the interview. I know one guy (and if he reads this will know who he is) has bad step one scores, but improved on step 2 but still under the average and landed a great residency. The reason is he related to the field and in the end of the day you only need one place to rank you (or two places if you’re going into PM&R…one prelim and one advanced spot). Even if it was your last rank, it’s better than nothing.

Take your test seriously. In June during my last 3rd year rotation I took a practice NBME and got a 220. I took another NBME one month later and got a 225. I finished 3rd year and had 4 uninterupted weeks to study. I took my 3rd NBME and got a 235. Took another 1 week later and got a 236. I wasn’t too happy at this point. But had got a lot down in the last 2 weeks of studying. 1 week before my exam, I took the USMLE World self-assessment got a 256 and was happy. 1 week later and got a 257. Holy shit was I happy.

Don’t worry about how many hours you will work as a resident in one field or anther. Before I started I didn’t know if I could really do this. But I did know I can push myself hard. Honestly I am up at 5 am every day, get to hospital 6-6:15am and finish about 5-6pm on a regular day. Not to mention short call and weekends. But I never feel like I can’t do it. You will do it. You’re so busy that the day flies by. You know your job is awesome when I go in on a Saturday at 6:30am and look at my clock and its 5pm and I need to get these last few notes done before sign-out. You can do it too I promise. I really can say that I love my job.

 

 

Thank you Joey for giving us a candid look at your application process. Be sure to subscribe so you don’t miss my second interview with an unmatched psych applicant.

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Spotlight interview: from California to the Carribbean, an emergency medicine resident shares his advice

Tell us a little bit about yourself. Who are you professionally? Who are you outside of the hospital?

Well hello there everyone! My name is Ami, pronounced Ah-mee.

I’m an easy going but sometimes intense guy from Los Angeles, California (cough cough the best city in the world). I grew up in the suburbs or “the valley.” I went to UC-Irvine for my undergrad and double majored in International Studies and Biology, but mostly spent my time surfing… hence my atrocious bio GPA, average MCAT that eventually led me to Ross like many other people. As I answer these questions I’ll give a line of advice from my experience thus far.

There is a small caveat before Ross University where I decided to get serious towards the end of senior year of college (too late to take the “correct” path to med school). I graduated, then took some bio classes at UCLA, did some research in the ER at Children’s Hospital in LA (CHLA) and got EMT certified to boost the résumé. This still wasn’t enough.

Now bear with me because the story below has a lot to do with the next 5 years of my life.

The story: I had been surfing the same spot in North LA for around 5 years at the time and there was always this guy in the water, who was there so often, I just figured he was some surf bum with no job. So I start talking to this guy and I ask him “well what do you do?” and he causally answers, “Well, I’m a doctor…” I actually laughed out loud and said, “No, really what do you do?” He’s like “no, seriously.”

So at this point I’m intrigued and ask “well, what type of doctor are you and where do you work?” And to my surprise, he says “I’m an Emergency Medicine doctor and I work at UCLA for the past 15 years” So we talk more in depth about how I’m trying to go to med school and he tells me how he just started this Med-tech company and because I’m used to taking tests, “why don’t you come over to the office and do some quality assurance/beta testing on the ultrasound simulator…”

Thus begins my mini, 1 year career working for SonoSim, Inc. Being in that start-up environment where 9-5 is unheard of and 1 position equals 5, was the best experience of my life. It taught me how to actually work hard and made me responsible for the progression of a company where others depend on you and if you fail, the entire team/business fails. All this combined with a lot of ultrasound scanning made for the best med school prep I could’ve hoped for. It also gave me a close look into the world of emergency medicine, which is likely why I went for EM over Surgery in the end.

***Advice #1: Always say yes to new opportunities, the smallest door can change your life.

 

 

What specialties did you apply to? What attracted you to emergency medicine and surgery?

I double applied to Emergency Medicine and General Surgery, no back ups in Internal Medicine/Family Med etc. I’m an ADD, instant gratification, need challenges type of guy and I know that I would never find happiness in other specialties. I also love using my hands so I needed a specialty that was heavy on procedures. As many of my friends and wonderful girlfriend can attest to, I struggled immensely deciding between Surgery and EM. I applied to both realizing that I would love both for different reasons: EM would provide enough procedures and diagnostic challenge with great lifestyle. Surgery would be all procedures and the fulfillment of definitive care. Also, I still personally believe Surgery is slightly more intellectually stimulating/challenging than EM (says the EM resident lol).

***Advice #2: Introspection, knowing yourself, is the key to every life decision.

 

 

How many programs did you end up applying to? How many EM? Categorical? Prelim? What was your reasoning for that number of programs?

I applied to every single Emergency Medicine program in the country, some 180+ programs. I applied to about 100 general surgery programs and every prelim position at those programs as well. It cost upwards of $6,000 JUST. TO. APPLY.

Was it worth it? YES. For most, you are already in debt; the only thing that matters is that you give yourself the best chance possible to get a residency. Obviously, be realistic about your résumé, scores, personality, etc.

***Advice #3: You end up in the place your supposed to be. Trust the process.

 

 

How many interviews did you go on for each specialty?

EM: 8, Gen Surg: 3, Pre-lim: 2. I went to every interview I got, it was logistically difficult and expensive. I flew across the country about 5 times. Again, you’re a “foreign” graduate; you have to take every opportunity possible. The statistics and amount of people applying for certain specialties are in flux every year, so advice doesn’t hold true year-to-year. My interview excel sheet is below.

***Advice #4: You are never too good for a certain place or program. Be humble.

 

 

How did you end up ranking the programs? (Surgery higher than EM? Better the program the higher it went regardless of surgery or EM?)

It’s a combination of things. I really wanted to be close to home in California so I ranked those programs first, it was just a bonus that those programs had everything I wanted as well. UConn had everything the California programs had and I absolutely loved the leadership and residents, more than any other place I went.

Jackson Memorial was a gamble because the program is brand new, but you can’t beat the patient pathology/experience. The Detroit programs are amazing, well established programs, also with great patient pathology. I was really impressed with Detroit and would have been grateful to go there as well. I only ranked one Surgery program higher than some EM because I would’ve been happier with those people doing surgery than the others doing EM. Like everyone says, it’s a feeling during the interview that really sets your decision.

Below is the excel sheet of my interviews/dates/ranks

I ranked them:

1) Stanford Univ: EM

2) UCSF-Fresno: EM

3) UConn: EM

4) Jackson Memorial: EM

5) St. John: EM

6) DMC-Sinai Grace: EM

7) Cleveland Clinic – Florida: Gen Surg

8) Crozer Chester: EM

9) Lehigh Valley: EM

– The rest of Gen Surg

– Prelims

***Advice #5: Trust your gut.

 

 

Any crazy stories from the interview trail?

Noone I interviewed with ever passed out or threw up, but I heard one good story.

Apparently the year before at one of the hospitals an applicant for Emergency Medicine got so drunk at the meet-n-greet the night before, he blacked out, got alcohol poisoning and ended up in the hospital. The kicker is that the next morning when the applicants were getting the tour of the Emergency Department, he was passed out in one of the ED beds with an IV, recovering…

Needless to say, don’t be that guy.

***Advice #6: Don’t let your insecurities steer you into bad decisions.

 

 

What did you find to be the most frustrating part of the interview process?

Simply the cost. It’s hard to justify applying to so many places. A lot of people hedge their bets and apply only to places with a history of taking foreign grads, but you just never know. I pulled every string I could, called acquaintances, went to conferences to network, and tried everything I could. Now I’m at a program that usually never took Ross grads and I had interviews in places I would’ve never expected.

It’s a numbers game in the end; you want your face and résumé in as many hands as possible.

***Advice#7: Never give up because the feeling of comfort can be dangerous.

 

 

Do you feel that coming from a Caribbean medical school hindered your chances to match in one of the more competitive specialties?

Absolutely, 100% yes. It’s just the reality of the situation and you have to make the best of it. Interviewing in California as an IMG, likely means I would have easily been accepted as a US-grad. Everyone will ask on interviews “Why Ross/Caribbean and how was your experience?” The answer is always “It made me more resilient, hardworking and appreciative.”

I was very bitter about this fact for a long time, if you’re like me, my advice is to just let it go. You have to make peace with this because people will feel your animosity and energy during the interview, which will never end well. If you’ve made it into the match, then by definition you have worked your butt off and don’t let anyone make you feel any different.

***Advice #8: Be a politician. Being able to spin your story might make or break you. Practice.

 

 

What do you think were your greatest strengths about your application? What set you apart from the other applicants?

I think my work experience and ultrasound research were really the 2 things that set me apart. I had really great letters of rec for Emergency med. I even had my old boss before med school write me a letter, remember he’s an ER doc at UCLA so his input was relevant. Besides the other 2 SLOEs (specific EM letters you need to apply in EM) I had the Ob/Gyn Program Director who I did ultrasound research with during my 3rd year write me a letter as well.

Letters of Rec are extremely important; on almost every interview people mentioned the letters. Its one of the only ways for programs to get an idea of who you really are, your work ethic, your personality, etc. For surgery, I had few interviews and I think this is a direct correlation to weaker more generic letters of rec in surgery. I was also only able to do 1 real surgery sub-I before applications, which hurt as well.

***Advice #9: Tell your story, figure out what part of your story is interesting, and let others give you feedback.

 

 

In contrast, what were your greatest weaknesses about your application?

I think my greatest weakness was the places I did Sub-I’s and away rotations. All my EM rotations were within the Ross network: 2 in Chicago at Mt. Sinai, and 1 in LA at California hospital. I would have had more interviews if I had set up better away rotations. It’s important to do Non-affiliate rotations. I have friends from other foreign med schools with similar scores and resumes that had 15+ interviews because they did a lot of away rotations and set them up early. Most places will give you a curtsy interview, but if you do well there, they will definitely consider you for a real spot. Again, you have to spin your story: I had great experiences from my rotations, inner city ED’s are very similar and an important exposure to have.

***Advice #10: Be informed about the process and plan ahead.

 

 

How did you do on the USMLE’s? What were your step scores? Do you think your step scores negatively/positively affected the number of interviews your received?

Step 1: 237, Step 2: 252, CS: Pass

Clearly these scores are critically important. For EM, 220 range might keep your application from going in the trash. But remember, the program coordinators are just clicking check boxes for criteria. If you call a program with any legitimate reason that you want to go there (i.e. spouse, family, I like snow, you guys look cool, my grandma’s brother’s daughter’s dog can’t live without me, whatever) they will pull your application out of the trash and look, hopefully. Have people make calls for you and never be afraid to call yourself and ask.

***Advice #11: Nothing beats a personal touch to create an empathetic connection. People will work harder for you if they feel connected.

 

 

What advice would you give to other international medical graduates who want to pursue residency in emergency medicine?

Work and study hard. Do many non-affiliate away rotations. Get your SLOEs in early. Go to ACEP and SAEM and get at least 3 program directors emails. Follow up! This is not the time to be shy but of course there is a balance and “business etiquette.” Be direct and if possible a little playful and funny. In the end, and maybe most importantly, these people have to like you and want to work with you.

***Advice #12: Regardless of what happens (match, no match, prelim or dream job) it’s a life long journey in medicine and you will end up in the right place.

 

 

Wow Ami (Ah-mee), thanks for a great interview and some amazing advice.

 

Subscribe and check back next week for an entertaining interview with another Caribbean graduate who matched into Physical Management & Rehabilitation!