Tag: Interviews

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Intern Interview Spotlight Update- The Life of a Pediatrics Intern

Prior to starting intern year I interviewed Zack Manier about the residency application and interview process. Today he is six months into his intern year, the first year of his pediatrics residency at The Children’s Hospital at St. Peter’s University Hospital in New Brunswick, NJ. I sat down with Dr. Manier to find out what it’s like to be a freshly minted medical doctor.

Thanks for taking the time to let me interview you again. I introduced my readers to you a few months ago before we both started residency in an interview about the residency application and interview process. Fast-forward to today and we’re a little more than six months into intern year. What’s it like being a doctor?

Ummmmm…so many feels. Important, accomplished, nerve-wracking, busy, overwhelmed, stimulated, stressed, anxious, lost, rewarding, powerful, prolific…shall I go on?

 

That sounds like the all too familiar. So what’s the most rewarding part of being a pediatrician?

Honestly, the gratitude from the parents. Hearing parents (and even adolescent patients) compliment me or compliment me to an attending saying things like “best doctor we’ve had” (yes, that’s happened…I’m not just bragging) is so amazing. It makes all the times I feel completely stupid and useless worth it. Also, definitely having parents ask to specifically have me as their child’s doctor and come to my Thursday afternoon office hour. Clearly my competence (or confidence) is showing, and that is just as rewarding.

 

 

To contrast that story what has been the most frustrating part of residency?

Continuing to be at the bottom of the totem pole. “Yay, I’m a doctor now and no longer a student! I’ve moved up in the ranks!” Wrong. You’re back on the bottom. You’re just the intern. And yes, interns still do [female dog] work. Definitely not as much as when I was a student, but it happens. Oh, and overnight nursery pages. It’s frustrating, but hey…that’s the way the cookie crumbles, right? Now I want a cookie…

 

 

Ah, answering pages. Grey’s Anatomy made it always seem like every page was life and death. Turns out its more often that the patient is having too few or too many bowel movements. So what about residency do you find most challenging?

Trying to be confident with my decisions and not just looking to my senior for everything I’m unsure of (even though they are the best and are always happy to help). I’m not a student anymore. I’m not supposed to just ask my senior to do everything. I have to do it. It’s on me now. I make the phone calls. I order the medications. I call the attendings in the middle of the night. I tell the parents that Child Protective Services is taking their child away. I decide a baby’s respiratory status is improved enough to discontinue oxygen. And if that baby decompensates? It’s on me now. That’s something that you have to realize from day one…you’re a doctor now. This is the start of the rest of your career.

 

 

Our jobs can indeed be quite humbling and terrifying at times. Can you speak on what your biggest fear going into intern year was? 

 Probably what I just discussed above…that even though, yes, you have your seniors…you have to make your own decisions and become a self-sufficient physician. It was hard a first, but I quickly realized I didn’t have a choice. I couldn’t be passive (not that I am that type of person anyway). You have to. That made that fear dissolve within the first two months.

Also, one fear that I’m sure everyone shares…feeling incompetent. You’re going to enter feeling like you know nothing, especially when you’re put on the spot. I imagine that’s what tabula rasa feels like. But magically, somehow…from somewhere…the answers pop out. Your hand starts writing the corrects words. You’re entering medications like you’ve been doing this for years, and you start to realize you know more than you think. The knowledge is there…you just have to apply it.

Thankfully, my co-interns were/are all in the same boat. Having them around and spending time outside of the hospital with them to talk and vent (and drink) have helped to depress those fears.

 

 

Ah your co-interns. As corny as it sounds, I’ve found that they truly are the best part of any residency program. You spend so much time with them in the hospital that it’s nice to enjoy their company too. Speaking of hours, what are yours like? What’s a typical day for a pediatric intern?

This is obviously institution-dependent, but I guess I’ll give you a little snapshot into mine…

It all depends on the rotation. ER is just 18 shifts/month, and we basically make our own schedule— clutch. Lighter rotations like nursery and neurodevelopment as well as outpatient electives are typical M-F 8-5, with weekend floor calls here and there. Floor sucks. Floor sucks everywhere. Sign-out is at 6:30am, and intern sign-out to the oncoming evening intern is at 7:00pm. Yes, that’s 12+ hours a day, usually 6 days/week. Morning report every morning from 8-9am, noon conferences daily from 12-1pm, grand rounds from 9:30am-10:30am every Thursday, and my office hours (or continuity clinic) Thursday afternoons.

Oh, and nights…nights are great. We specifically do 3 sets of 2 weeks of nights as interns, which are 7pm-9am Sunday-Thursday. Which means weekends off (for the most part). Lovely.

My institution is (amazingly) different in a way…interns get every Friday night off. Every one. For the entire year. All eight of us. Those nights…we drink and complain. I also usually get at least one entire weekend off per month, and use that time to get the hell out of New Brunswick for sanity purposes.

 

 

Speaking of sanity, what do you do outside of the hospital to keep it? 

I guess I covered a lot of that above. But yes…relax, drink, travel…in that order. I need it. We all do. Get close with your interns. Go out when you can. If not to drink then for dinner. Vent. Complain without your seniors around. Even if you think you’re in the most amazing place at the start (which I did), you will start to realize the flaws as you become familiar with the inner-workings and the politics. Every institution has them. And you need close people to talk about it with. That’s what we do. I can’t stress enough how important it is to be close with your co-interns, or as in my case, even your second (and sometimes third) years. Also, I get away when you can. I have friends and family all over, and getting out of the little hospital bubble with all your (likely) hospital friends is necessary to stay sane. Plus, I’m in the cold…I hate the cold. Winter sucks. I go to Miami every chance I get.

 

 

That’s great advice. How about exercising? How often do you find yourself exercising compared to before residency started?

This will be a short one. I don’t. I exercise the same amount as before, because I didn’t. Should I? Definitely. Quite honestly though, my feet hurt (I hate dress shoes). And after the day is over, I want to be horizontal. In my bed. Am I complaining? Yes. Do I plan to change this soon? Yes! You can’t be a doctor (especially a pediatrician) promoting health and wellness when you don’t do it yourself.

 

 

How often are you able to see your family or significant other?

This is something I struggle with daily. My family is in one city, my SO is in another, and I’m in a third. So when I get the chance, where do I go? To see my SO. It’s a hard decision, but I’m used to being away from my family…I went to college out of state, medical school internationally, and I haven’t lived at “home” in almost 10 years. It’s difficult being apart from my SO, and we need frequent visits to maintain our relationship, just like all long-distance relationships. Thankfully, we see each other at least monthly (whether I go there or he comes here), and Facetime is a live-saver. Since I moved to NJ in June, I haven’t been back home. My family did come visit for Thanksgiving, and I’m currently writing this on the plane home for Christmas. Holidays and occasions…that’s been pretty typical for seeing my family over the past years.

 

 

How are you handling the debt?

Debt? What’s that? Oh, right…I mean, the cronies automatically take money from my account monthly, and I don’t think about it. And that’s all I have to say about that.

 

 

When do you plan on taking step 3? 

Bleh. Adult medicine. I don’t want to study it. It’s like, I want to take it and get it over with so I never have to study adult medicine again, but at the same time…I don’t want to start studying adults again. But alas, I must. I’m either taking it mid-February or end of April, as those are the times that work with my lighter rotations. I’m getting UWorld for Christmas (yay, adulting), so I’m about to start on that. Mainly, I don’t want to spend the $900 or whatever is it to take the exam. I’d rather spend it on drinks. Medicine is a damn money pit, ya know?

 

 

What’s it like having the responsibility of teaching medical students?

I love it. It’s great. I’ve tutored in the past and was a head anatomy TA in medical school, so it’s something I enjoy. It’s also nice to have attendings tell me that medical students compliment me and enjoy working with me. They don’t think I’m dumb! However, it is sometimes hard to give them full attention as the intern…especially on floor when it’s super busy and I have one million things to do. That’s what the seniors and attendings are for.

Also, pro-tip: get the medical students to follow your patients. That’s what I do. Why? Because on floor rounds, the student presents and gets pimped, not me.

 

 

In retrospect, with the knowledge that you have now, are there any questions you would recommend to medical students to ask during their interviews? 

Other than all of the medical knowledge, you mean? I don’t think there is anything that I now wish I had asked…I pretty much knew what I was getting into, and I feel like it’s on par with my expectations. The most important thing is to ask the resident’s if they’re happy. We won’t lie. We really do tell it like it is. And definitely ask how they feel they attendings are and what their relationships are with the attendings. It will make a world of difference. I’m fortunate enough to have amazing attending physicians. It’s something I have been bragging about to all the interviewees this season. Like, you know how in medical school or residency even there are those physicians that people are “scared” to work with or grumble about being placed with? Yeah, we don’t have any. None. I would say 90-95% of ours are absolutely amazing, and the rest are good but ever-so-slightly more intimidating. That might be the best part of my residency. Definitely ask about that.

 

 

Speaking of medical students, do you strongly feel that there is anything you wish you did differently while you were in medical school that would have better prepared you for residency?

My one and only regret is not taking USMLE Step 3 prior to residency. I was going to, but I ended up drinking and traveling instead. (A common thread here, clearly) So, if you have time, seriously consider taking it. It will save you a load of stress and annoyance later, when that is the last thing you have on your mind or want to deal with. Otherwise, just be proactive. Act like a resident on rotations, not a student or a shadow. Ask to do procedures, to see extra patients, to write notes, to have your H&Ps checked and reflected on, to stay later, to make phone calls. These are all things you have to do as a resident, and the sooner you start, the better. These are all things I did, and not only did it get my outstanding grades and letters of recommendation, but it also significantly prepared me for residency. If you have all of these things (mostly) down before starting, you can focus on expanding your knowledge and being the best provider for your patients you can be.

 

 

For the current medical students reading this, what general advice do you have regarding residency?

First and foremost, the last line I just said. Be the best provider you can be FOR YOUR PATIENTS. That’s what it’s really about, and why (most) of us all are in this profession. It’s for the patients. Check your egos at the door. This isn’t about you, it’s about them. The rest…the knowledge, the fearlessness, the confidence, the competence…that will come with time. But your patients always come first, no matter what.

 

 

Zack, thank you so much for taking the time to let me interview you. I appreciate your words of wisdom and motivation.

Check back next week for my next intern interview update. And as always subscribe so you don’t miss out!

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Spotlight Interview: a family medicine resident who failed step 1

Emily Chan is a Ross University graduate who successfully matched into her top choice residency program. However, it wasn’t an easy route to residency. As a Canadian citizen she could only apply to programs that would sponsor her visa. Oh and she also failed USMLE step 1. Here’s her story.

As a close friend, I know you pretty well. Can you tell my followers a little bit about yourself? Who are you professionally? Who are you outside of the hospital?

I’m from the beautiful area of Niagara Falls, Canada. True to stereotype, I am polite, love maple syrup, and say “eh” often. I received my Bachelor’s in biomedical sciences at the University of Montréal – in French.

Professionally, I am a hard worker and a team player. I show up to the office or the hospital with a smile and do my best. People have described me as a problem solver because I will come up with quick solutions for anything.

Outside of the hospital, I indulge in my hobby of cooking and baking. Nothing makes me happier than sharing good homemade food with friends. I also attempt, with varying degrees of success, to justify my paid gym membership even though I hate working out.

You matched into your top choice family medicine program. That’s an amazing accomplishment. Why did you choose to apply to family medicine?

Thank you! It is the most amazing feeling. I knew since I was 12 years old that I wanted to be a family doc. I’ve always loved talking to people and listening to stories about themselves, their families, and their lives. I believe that every personality fits in a certain branch of medicine. How will you know? Trust me, you’ll just feel it, you’ll know. Family medicine was my perfect fit.

Where are you from originally? Did you want to match in the US or Canada? Did you experience any extra hardships trying to match in American programs as a Canadian?

As a Canadian, I knew the odds were not in my favour across the board. Many factors influenced my choice to not pursue a Canadian residency. Canada made it very difficult for me to apply (poor matching stats, inconvenient availability of mandatory tests, and difficulty to obtain Canadian electives). I felt that if my own country made it so challenging for me to come back, then I wasn’t going to put up a fight. Instead, I concentrated all my energy to match in the US. I am very glad my strategic gamble paid off. Yes, you face discrimination because as a resident you will require a visa. I was ineligible to apply to many programs because they did not want to deal with the headache of visas. Disappointing, sure, but I don’t blame them.

Speaking of hardships, I remember the day that we all received our step one scores. You and I, along with three close friends of ours, were living together in Florida. I remember the moment when you came downstairs from your room and told us what every medical student dreads to even think of. That you failed step one. What happened? Why do you think you failed? Were you doing poorly in school? Did it come as a shock to you?

Oh that dreadful day… It was awful! I was so glad to be surrounded by friends like you when I found out I failed. You all rallied around me in a big group hug and reassured me that everything was going to be ok.

Failing Step 1 was a huge blow and I did not expect it at all. Granted, I’m not the strongest student so by no means did I expect to have a stellar score. I just expected to pass. So when I learned I was a few points shy of passing, I was crushed. I had done fine in school up to that point. I never failed any tests on the island, never repeated a semester, and I even passed the comp on the first try. Everything suggested that I’d be fine.

In hindsight, I realized what I thought was enough preparation for the test ended up being insufficient. To tackle Step 1 a second time around, I had to prepare more than ever before.

What was step 2 CK like for you? What steps did you take to make sure you didn’t make the same mistakes again?

Step 2 CK was definitely better than Step 1. I will say, all the self-doubting and insecurities resurfaced when I was prepping for Step 2. I spent 6 months studying and even delayed my test till October – meaning I applied to match without a CK score. As anyone and everyone will tell you, it’s best to apply to match with a full and complete application but mine lacked the CK. It was a risk I was willing to take. I absolutely could not afford to fail a second USMLE exam. Aside from doubling the time I dedicated to study, I got weekly tutor help to go over questions on UWorld that I got wrong. I also made sure that I took plenty of practice tests.

How many programs did you end up applying to? How many categorical? How many preliminary? How many interviews did you end up going on?

I applied to every single FM program in the US for which I was qualified. All categorical, no prelim. I spent a little over $3,100 on my 140+ applications. In the end, I only had 2 interviews. Yes, you read that right, two interviews. One interview was where I did all my core rotations in 3rd year. I got the other interview because I clicked well with residents from that program while attending the AAFP National Conference. I knew from the get go that on paper I was less than stellar so I worked hard on networking. I attended family medicine residency fairs like it was going out of style. In 12 months, I attended 3 residency conferences.

What was match day like for you?

Every medical student will tell you that match day is a nerve-wracking day, and for me, it was no different. I was hoping to match but I also mentally prepared myself that there was a good chance I would not match. When I learned that I successfully matched, I cried tears of joy and relief. Knowing that I beat the odds was the most incredible feeling. It validated all the people along the way who believed in me and said I would make it. I now had proof that outside people (not just family and friends) believed I was worthy of pursuing this profession.

I know we’ve talked a lot about a major weakness in your application but what do you think were your greatest strengths about your application? What set you apart from the other applicants?

Academia has never been my forte. I knew clinical years were my time to shine. It’s what I do best; it’s where I feel most comfortable. I worked diligently and was rewarded with A’s in all my core and elective rotations, except surgery. I genuinely connected with my attendings and they wrote me beautiful letters of recommendation. My strong LORs were undoubtedly a key component to my match success. I’ve always been a people person so interviews came naturally to me. When applying to medical schools, I had 4 interviews and was accepted to all 4. I knew I had strong interview skills. I harnessed that same energy and left my 2 residency interviews feeling confident.

The fact that you failed step one, the proverbial kiss of death to any applicant’s dream of obtaining a residency, but still managed to match into your top choice family medicine program is quite an accomplishment. In closing, what advice would you give to a medical student who failed or didn’t do well on step one?

I want people reading this to say to themselves, if she can match her top choice in her dream specialty with a 203 Step 1 score, a 215 Step 2 score, and only 2 interviews, I can do it too. One failure does not define you. You will encounter people along the road who will encourage you to quit medicine (one of my Ross professors counseled me to pursue non medical careers) or take time off (I was strongly encouraged to delay my graduation date and my match by a year) or give up all together. Take all that advice as fuel to prove them wrong.

Thank you Emily for bravely sharing your inspirational story. You are proof that it is possible to fail USMLE step 1 and still earn a residency. I’m sure it was an emotionally tumultuous path and taught you a lot about yourself along the way.

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UPDATE: Unfortunately due to the high volume of requests to speak with Dr. Chan I can no longer forward her private email. If you have questions for her please comment below. After sufficient questions have been posted we plan to release an updated blog post with the most frequently asked questions. Thank you for your understanding.

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Spotlight Interview: matching in Canada from a Caribbean medical school

Dana is a Ross University School of Medicine graduate from Toronto. She went through both the US and Canadian matches and successfully matched into her top choice Canadian program. I interviewed Dana about her experience going through the match and the difficulties she encountered along the way. Here’s what she had to say:

 

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

If I could describe myself professionally I would use the words inquisitive and dedicated. For as long as I can remember I have had a constant need to know how and why things work the way they do (growing up this was often to the annoyance of my parents). I’ve always strived to excel in any position I hold so I believe my dedicated nature has really found its niche in medicine. Outside of the hospital, I would describe myself and adventurous and thoughtful. I love to travel, try new things and for the most part view the world as limitless. I also don’t make hasty decisions and I place significant value on the relationships in my life.

 

How many programs did you apply to? How many categorical? Prelim? How many in the United States? How many in Canada?

Originally I applied to approximately 100 IM categorical US programs. I did not apply to any back up programs or prelim spots, against my medical school’s advice. I spoke with other colleagues and was aware that they applied to 150-200 programs on average, but my plan was to stay in large cities or close to the Canadian border. After only receiving 4 interviews in the first 3 weeks I applied to the remaining 150 IM categorical programs available in the US (this was a humbling and expensive lesson). The Canadian match was a few months later and after my experience in the US I applied to every Canadian IM program, I believe there’s 7, as well as a dozen Family Medicine programs.

 

What as the most difficult part of applying to both the Canadian and the American match?

I think the most difficult part was that each system uses a completely different application. This meant that I couldn’t just use the same documents twice. I had to rewrite statements of interest and reformat resumes, which is an enormous task. The letters of recommendation could be the same but I had to bother my preceptors twice to use two different uploading systems.

 

Roughly, how does the Canadian match work? Can you end up with both a Canadian and an American residency?

Luckily CaRMs (Canadian Residency Matching Service) match date is about two weeks before the US match date. This is great since your chances of getting into a Canadian program are much poorer than a US program so ideally you would want to try this route first and use the US match as a backup if it doesn’t work out. If you match into CaRMs you are automatically withdrawn from the US match. You are also never able to find out how you were ranked in the US match.

 

How did you end up ranking your programs? Would you have rather gone to your least favorite Canadian program over your top American program?

It was a difficult choice deciding how to rank my programs since being close to home, Toronto, was important to me but also the quality of the program. In the end I ended up ranking my first choice US program as the one that I believed was the best place to be academically, which happened to be the second closest geographically to my home in Canada. When I submitted my rank list for CaRMs I reluctantly ranked a program that was across the country, but did so based solely on the fact it was in Canada. If I would have matched at this program I would have been automatically withdrawn from the US match, as I mentioned earlier, so I knew that would mean giving up my first choice US program. This was definitely the most difficult decision I had to make in all of my ranking.

 

How many interviews did you go on in the end? How many in the US? In Canada?

In the end I was invited to 7 interviews in the US and 2 interviews in Canada. Some of these interviews were in very undesirable locations for me, but I felt it was good practice to keep all my options open since I was not invited to a lot of interviews. In the end I ranked them all.

 

Any crazy stories from the interview trail?

At the end of one of my interviews I realized my middle button of my blouse was undone. No idea how long that was like that for.

 

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

The days were way more exhausting than I expected them to be. The travelling combined with the anxiety about the day really gets to you after a while. A couple of my interviews started at 7am for morning rounds and didn’t end until 3 or 4pm. These days were long enough without having to also roll out my charm for 8 hours straight.

 

Do you feel that coming from a Caribbean medical school hindered your chances to match back home in Canada?

Yes, but I don’t think my chances would have been any better coming from a US or European school. The Canadian match first and foremost ensures all of its Canadian graduates have a residency. There are designated spots for international medical graduates (IMG’s) in the CaRMs match, but they are very few for very many.

 

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

I believe my work experience prior to Ross University was a strong point of my application; most programs asked about this during the interview process. I also made it a priority in my personal statement to express the hardships that came along with studying in a third world country and in constantly relocating during clinical years. In the end I believe that the impression I left on the staff during an elective rotation is what set me apart from the other applicants.

 

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

A big weakness in my application was my USMLE Step 1 score. I was having personal troubles and knew going into the exam I was not as prepared as I should be. In hind sight I also wish I spent more time on my personal statement. I left it until the last minute and did not allow time to have people proof read it and critique it.

 

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?

My USMLE Step 1 score was a full standard deviation below average, which I am disappointed with and believe negatively affected my interview invitations. I worked hard to redeem myself on USMLE Step 2 CK and scored 30 points higher, which I am very pleased with. On the Canadian version of the USMLE, the Medical Council of Canada Evaluation Examination (the MCCEE) I received two standard deviations above the average, which is the score I’m most proud of.

 

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

I would tell other Canadians that if they want a residency in Canada to just try! I heard countless times along the way that it’s impossible as an IMG to get a residency in Canada. For this reason I was preparing the whole time to get rejected, but I worked really hard and was one of the lucky ones. If things would have gone the other way I was very excited for my US residency programs and looking forward to spending more time with our lovely neighbors to the south. Either way I would recommend that you keep all your options open; being an IMG does not mean you cannot have the residency you want.

 

Thank you Dana for sharing your experience with the Canadian and US match process. Going through the Electronic Residency Application Service (ERAS) was frustrating enough for me at times so I can only imagine what it was like to do it twice. I wish you the best during your internal medicine residency and hope to hear more from you soon.

Next in the spotlight series is an interview with a family medicine resident who failed step 1. Subscribe so you don’t miss out!

 

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What is ‘The Match’?

Are you in medical school? Sick and tired of explaining the process of step exams, clinical rotations, the interview process, and the dreaded match algorithm to your friends and family? Send them this post before you go home for the holidays and hopefully everyone will have a better idea as to when they can start calling you doctor if they haven’t done so already.

First let me recap the med school timeline for you so we’re all on the same page. The first two years of medical school are the basic sciences. It’s the classic classroom experience where we learn all of the science behind the medicine. This takes roughly two years and culminates with step 1 of the US Medical Licensing Exam (USMLE). Or the COMLEX (Comprehensive Osteopathic Medical Licensing Examination of the United States) level 1 if you are in an osteopathic school.

Now if you have a friend, family member, cousin, or are simply Facebook friends with a med student then you have likely heard of these exams. Or at least heard us complaining about studying for them. So what can possibly make these tests so important that we take months off to study for them? Although stellar board scores alone won’t secure you an interview they can certainly ‘pose a problem when they are significantly below the mean. Board scores have become ‘a threshold that must be achieved in order to receive an invitation for an interview’ (3). It’s a way to weed out thousands of applicants to a smaller pool of hundreds of interviewees to a handful of residents depending on the program and specialty.

Each specialty can be loosely broken down into highly competitive, moderately competitive, and less competitive specialties based on information obtained from previous residents who matched into each one respectively. Highly competitive specialties including dermatology, neuro surgery, orthopedic surgery, plastic surgery, radiology/oncology, radiology, urology, opthalmology, and otolaryngology. Moderately competitive specialties include emergency medicine, OB/GYN, and general surgery. Less competitive specialties include family medicine, internal medicine, neurology, pathology, and psychiatry (3). One of the important pieces of data used to signify each fields competitiveness is the average board score of matched applicants into those respective fields. More competitive fields can use a higher cutoff. So again, a high board score doesn’t guarantee you anything but a low board score can filter you out of the process.

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For instance, The following graph is taken from the 2014 National Resident Match Program (NRMP) data that is available online here.

step 1

This chart “displays the step 1 scores for matched US seniors and independent applicants by specialty. The horizontal bars are median values for successful applicants and the vertical lines show the interquartile ranges (the top and bottom scores of applicants). Scores are generally higher for more competitive specialties, but there is still substantial overlap when specialties are compared” (1). The same thing goes for step 2 scores. You have to do well and, on average, everyone does better on step 2 than step 1. In 2014, the average step 1 score for matched applicants was 230 and the average step 2 score was 243 (1). Here’s the step 2 chart:

step 2 scores

And if you were wondering to yourself, ‘what the hell is an independent applicant’ the answer is anyone who isn’t graduating from a US allopathic medical school. That includes students from Caribbean schools and also American D.O. programs (1)

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Okay, so you finished your first two years of medical school, wrote your step 1 exam, finished your third year of medical school, and wrote your step 2 exam. Now what? At this point you start applying for residencies. A survey performed by the American Medical Association (AMA) of 1,000 fourth year medical students from US allopathic programs from the showed that students applied to an average of 36.4 programs.

apply

This is where the dichotomy between ‘US senior applicants’ and ‘independent applicants’ is really staggering. Caribbean medical students are known to apply to upwards of 100 programs. Personally, I applied to 144 programs for internal medicine. So what’s so important about interviews these interviews? To answer that question we go back to the NRMP match data which shows that the greater the number of interviews you have the greater chance you have to match (and not be unemployed come July 1st).

contiguous rank list

This chart for internal medicine shows an applicants probability of matching based on the number of contiguous ranks. Contiguous ranks means that when it comes time for an applicant to rank programs, that the programs on an applicants match list is in the same specialty. Meaning that programs that you rank one through five are all in internal medicine. Not internal medicine and pediatrics. And in order to get that contiguous rank list you need interviews.

10 interviews seems to be the magic number that most students strive to surpass. What’s the probability of matching if an ‘independent applicant’ like myself gets 12.3 interviews? It’s still above 90% and I’d take those odds any day in Vegas. So 10 interviews seems to be the magic number that most students strive for. That still means that there are students out there who have 10 interviews and don’t match but your likelihood increases with the more interviews that you get.

So how does ‘the match’ work? It’s a complicated computer algorithm similar to what sororities use during rush (you know, minus the computer algorithm). Applicants make a list of the programs they want to go to, each program makes a list of which applicants they want, the information goes into a computer algorithm, and the algorithm spits out the match. Watch this 2-minute video to really understand it:

 

 

So in summary, get good board scores so you aren’t filtered out, score at least 10 interviews, don’t be a weirdo on the interview, and hope that you match. On Monday, March 14th applicants find out IF they matched. This gives unmatched applicants a week to participate in the SOAP (supplemental offer and acceptance program) and attempt to fill unmatched residency spots. Then on Friday, March 18th applicants across the country find out WHERE they matched. Then come July 1st, new interns start nationwide. Happy holidays!July 1st

 

 

1- Charting Outcomes In The Match. Characteristics Of Applicants Who Matched To Their Preferred Specialty In The 2014 Main Residency Match. 5th ed. Washington, DC: NRMP, 2014. Web. 23 Dec. 2015.

2- LWW,. “Going “Fourth” From Medical School: Fourth-Year Medical Stu… : Academic Medicine”. N.p., 2015. Web. 23 Dec. 2015.

3- Katta, Rajani, Samir P Desai, and Samir P Desai. The Successful Match. Houston, Tex.: MD2B, 2009. Print.