Tag: Residency

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The Most Frequently Asked Questions on Residency Interviews…by Medical Students

It’s my first interview season as a resident and I am loving the free lunches. Uh, I mean…meeting all of the applicants. It’s kind of strange being on the other side of things because I remember asking the exact same annoying inquisitive questions that all of you are asking. However, I’m realizing most of my answers are not specific to my program and I end up giving general residency advice like how to survive your intern year and how to create your residency rank list. Here’s what I tell the prospective fourth years:

 

 

What’s your favorite part of your residency program

My co-residents. It’s annoyingly corny but true. This is a highly sensitive test for weeding out unhappy residency programs. Residency sucks but you should at least be able to get along with the people you are stuck in residency with because the only thing worse than going through residency is going through residency alone.

 

 

If you could change one thing about your program what would it be?

Daily free lunches, a personal assistant, and a raise would be nice. Otherwise, well…every residency program has there bugs but the tell of a good program is that the administration will listen to their residents and make appropriate changes. A better question to ask is ‘what are the most recent changes that were made to your program based on complaints or concerns raised by residents’. Ask that. You’ll look like, really smart.

 

 

Why did you choose this program?

It was a gut feeling. Every program I interviewed at had essentially the same things. Maybe some had more or less research, was in a bigger or smaller city, had a bigger or smaller residency class size, or had varying degrees of fellowship opportunities. But you will likely be a successful doctor wherever you end up. The question you have to ask yourself is ‘will I be happy in this city at this hospital if I match here’. And the answer to that question depends a lot on you (and your family’s) priorities.

 

 

What stood out about your top choice residency programs compared to the rest on your list?

The program director’s leadership and enthusiasm when meeting us (despite likely giving the same speech and presentation hundreds of times before), the impressive amount of teaching that occurs during morning report (yes, it’s like this every morning), and my interactions with the other applicants and residents . Again, these residents and fellow applicants are the people you’re going to be stuck with for the next three years. If you can’t enjoy an afternoon with these people then that residency program likely isn’t a great fit for you. My favorite interview days were ones with the best lunches. And also when I got along well with the other residents and applicants. But also lunch.

 

 

So lunch is really important to you, huh?

It’s all about the little things. When a program would take us to their cafeteria for lunch it made me feel like they weren’t even trying to impress us. Sure, maybe they have an amazing cafeteria and all of the residents eat there everyday. Except it ends up coming across like a cheap date who forgot their wallet at home. It would never be a reason to rank a program higher or lower but it consistently served as a surrogate marker for other things that may be awry. Like someone who wears ankle socks with dress pants. Judged.

 

 

So you get along well with your residency class?

I enjoy hanging out and working with most of my co-interns and residents. You find your people early on and you go through hell with one another. Working on the same floor together for a month builds some pretty strong bonds. Especially if chased with tequila. Just recognize you aren’t going to get along with everybody and that’s okay. Hopefully the bell-curve is skewed towards positivity and most attendings, fellows, and residents there aren’t jerks. Again, big red flag if lots of people within the residency program don’t like one another.

 

 

Are you involved in any research at the moment?

I’m currently four months into residency. I finally have my feet underneath me and I can navigate the hospital system pretty well. Don’t get me wrong, I’m still a bumbling intern but I am more efficient bumbling intern compared to July 1st. I now feel comfortable pursuing research projects and am currently getting involved in a QI project. However, I’m waiting to take step 3 before I jump into some bench research going on in my hospital. Just beware, the only thing worse than not performing any research is getting involved in research and dropping out because you weren’t available or weren’t interested. It’s unprofessional, word will spread, and people will be less willing to offer you future research opportunities.

 

 

When are you taking step 3?

ASAP! More specifically the middle of December. Many of my friends in OB/GYN and pediatrics have already taken and passed step 3. Internal medicine constitutes a large proportion of the exam so there isn’t a huge rush for IM residents to take step 3 because you’re going to learn the majority of what’s on the exam during your training anyway. However, non-medicine residents are often advised to take the exam as soon as possible so they can get it out of the way. Personally, I’m taking a middle ground approach and will be taking it six months into my residency. It really depends on your schedule. Mine is lighter early on so I have time to finish UWorld (yes, it is the only resource I am using. Will confirm that it was a good decision once I pass). Getting step 3 out of the way also let’s you finally focus on the more important things in residency. Like research and not killing your patients.

 

 

Should I take step 3 before starting residency?

Only if you have an insane amount of time prior to residency. Otherwise, go enjoy your life and follow up on my next blog post about what to do the summer before residency! You can also check out my two blog posts on this exact subject:

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Spotlight Interview: DO graduate earns OB/GYN residency

Tell us a little about yourself. What are your career goals in medicine? Who are you outside of medicine?

I’m Maureen. I’m 27 and originally from California. The first question people ask me when they learn that is “why did you leave beautiful sunny California to come to gross Philadelphia?” but I actually really love it here. I guess you could say I’m more of an east coast, fast paced type of person…probably part of why I love OB/GYN. I hope to be an adolescent gynecologist but I’m sure I will change my mind in the next four years. Outside of medicine, I love to cook, travel, and hang out with my friends with a glass of cab.

 

 

What should fourth year medical students do the summer before medical school? What did you do?

Before medical school, I took a vacation. I stopped working about two months before med school started to travel with friends and reset my mind. I also had to move from San Diego to Philadelphia, so I road tripped across the country with my dad. I wouldn’t suggest anything else. Relax. Don’t study. Spend time with family and friends. Work on your friendships because free time will be compromised.

 

 

Where did you go to medical school?

I went to PCOM—the Harvard of DO schools! I only applied to DO school. I had a 33 MCAT, but my GPA was only a 3.2. I knew I wasn’t competitive for MD schools in locations I wanted to live (California, Philadelphia, NYC). PCOM was the first school I interviewed at, in the beginning of October. I got my acceptance October 31st. I went to one other interview and cancelled the rest. I knew PCOM was the right place for me.

 

 

What advice would you give to pre-med applicants about applying to medical school?

I would tell pre-med students to do well on their MCAT and to not neglect their GPA. Scores get you in the door—a theme that will ring true again for residency. Nothing else will guarantee interviews like solid numbers.

 

 

So for those of us who don’t know, what’s the difference between a DO and an MD medical school?

At DO schools you learn osteopathic manipulative medicine (OMM). It means 1-2 extra lecture hours a week along with one 90-minute lab session to practice the techniques. It means taking a different board examination. Otherwise, I don’t think there are any differences—but I am a little biased.

 

 

Do you plan on continuing to use OMM in practice?

Unfortunately it’s not realistic to use OMM in residency. You just don’t have time. If I end up in private practice then I will 100% use OMM. It really does help patients with musculoskeletal issues. If you learn to bill correctly, it can also be extremely lucrative. I spent two months of my fourth year working in my school’s OMM department so I was able to see what consistent treatment can do for a patient with low back pain or carpal tunnel. I probably have a bigger appreciation for OMM than most other current DO students.

 

 

Let’s fast forward to fourth year of medical school. How many OBGYN programs did you apply to? Any backup specialties?

I applied to 59 programs. Philadelphia, New Jersey, and NYC. I didn’t apply to any backup specialties. I got around 20ish interviews and stopped counting. I really wanted to be in either Center City, Philadelphia or NYC, so I cancelled most of my NJ interviews when I had a few in Philadelphia. I went on 9 interviews—much less than the average candidate. I would say most people did 15-20 at least. I also took a big risk and only ranked 6 programs. I honestly just had a hard time picturing myself being happy at any program outside of my top 4. It was a hard decision but I risked it. Luckily, I got my first choice and it’s been 6 weeks and I haven’t cried yet. Complete success.

 

 

Do you think you had an advantage or disadvantage applying to residency as a DO?

Definite disadvantage in a few areas. First, certain schools do not accept you. Waste of money to apply. Second, some sites, especially those tied to Caribbean schools, do not allow you to rotate there. Which takes away the chance to do sub-internships there which are important for almost every specialty. I definitely got asked awkwardly on interviews “What is a DO?” and it sucked.

 

 

Every potential applicant is probably dying to know, so what were your step scores? Did anything on your resume separate you from the crowd?

  • COMLEX level 1: 629
  • COMLEX level 2: 627
  • USMLE step 1: 233
  • USMLE step 2: 251

Those scores definitely helped me land interviews at solid allopathic university programs like Drexel, Temple, SUNY- Downstate who have a paucity of DO’s in their resident pools. I was often the only DO or one of a handful on interview day. I also did research between first and second year of med school and got a paper published in Menopause. I think my research my scores are 100% what got me interviews. I also was president of PCOM’s OB/GYN club, served as a class representative in our student government, and taught gymnastics during first and second year.

 

 

What advice do you have for someone who wants to apply to OBGYN but didn’t score that well on step 1 and/or step 2?

Apply early and broadly for sub-I’s and show up and work your ass off. That’s the single best, and in some cases only, thing you can do to get an interview.

 

 

What were OBGYN interviews like? Any advice on how to succeed on interview day?

Lots of women, ha. I actually made some great friends on the interview trail. It was really comforting. Know your application, know your research, know where you want to be in five years. Have questions ready—my favorite was “how do you hope to see the program improve in the next 5 years?” Know where the program director trained. Otherwise, just be friendly. Talk to the residents about their personal lives. Ask if they residents hang out together—if the answer is anything other than “oh yeah! We’re all friends!” you know that program probably isn’t very social. Really try to see how you fit with the residents. That’s the most important thing. Who do you want to be stuck on 15-hour nights, 6 nights a week with?

 

 

What should current applicants look out for in an OB/GYN program? (besides free food on interview day)

They should look how they fit in with the residents. Go to the pre interview dinners and talk to them about how they feel about the program. Interviews will get very cumbersome by the end so you will cancel a few. Rationalize it in that you’re opening the door for someone else who might really want that spot. Figure out your non-negotiables and make your rank list from there.

 

 

Any other advice that you’d want to give fourth year medical students currently applying for the match?

Breathe!

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Gift Ideas for Someone in Medicine

With the holiday season approaching I wanted to update this blog post with my newest favorite gift ideas for someone in medicine. These are some of my favorite gift ideas for anyone with a loved one going into dentistry, medical school, residency, fellowship training, nursing school, PA school and everything else in between.

 

Professional lapel pins- perfect for any specialty

 

 

 

 

Dr. VOROBEV

This is probably one of my favorite Etsy stores I’ve found. They’ve got everything. From podiatry, surgery, orthopedics, pharmacy, and more. Whatever specialty your loved one goes into you can definitely find something for them. These are some of my favorites:

 

 

 

 

 

Stethoscope Heart necklace

Cardiology: Anatomical Heart Pendant

Rod of Asclepius

Orthopedic surgery: Tree of Andry
Pharmacist: Bowl of Hygieia
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What happens when you don’t match

What happens to medical students who don’t match? Here’s what one unmatched psychiatry applicant had to say.

 

Thanks for letting me interview you Steven. You have a pretty unique story that my readers would love to hear about but before we delve in can you tell us a little bit about yourself? Who are you professionally? Did you go straight from undergrad to Ross? Who are you outside of the hospital?

My pleasure, Marc. I appreciate the opportunity to share my story as I feel people can learn from any experience in this process, both good and bad. I graduated from NYU in 2010 with a Bachelor of Arts in Mathematics. After graduation, I had about six months before starting with Ross University’s MERP (Medical Education Review Program) and I knew I needed to make money. So I took a job that any medical school bound person takes – working in the jewelry and diamond industry. I did mostly bookkeeping but I also prepared orders for a wholesale company that dealt with Macy’s, JcPenney, Sears, HSN, QVC, etc. It taught me a lot about dealing with large staffs and it was a nice break away from the science and math world I had spent so much time with in undergrad.

Professionally, I’m the one making jokes in the office but I focus on the patient when I’m in the room. I like to be a reason people enjoy coming to work, because they know it’ll be fun and productive. On the same token, I’m also someone who isn’t afraid to call someone out for their BS because I expect someone to do the same to me if I ever act out of line. I also am one of the first people to teach someone how things run in the office, how to order labs, do procedures, etc. Not only do people feel comfortable if it’s a peer teaching them but it helps me better my skills as well.

 

 

What specialties did you apply for? How many programs in each specialty? What was your reasoning for that number of programs?

I applied to psychiatry, internal medicine, and internal medicine-psychiatry combined. For psychiatry, I applied to 76 programs. For internal medicine, I applied to 10. And for IM-psych, I applied to all 9 programs in the country. My step scores weren’t that competitive and there are only 196 psychiatry programs in the country. I went through each program on FREIDA and checked to see if I matched their step requirements. If I did, I tried to see who the residents were. If there were zero or one Caribbean grad in all the PGY positions, then I didn’t apply as I felt that that one particular Caribbean grad may have had a connection there or had stellar scores. Plus, why would I spend money on programs that were going to outright reject me?

For IM, I applied to where I had rotated and since I could apply up to 10 for one fee, I applied to some hospitals in the NY/NJ area (which is where I’m from). And for IM-psych programs, there were only 9 so it made the most sense to apply to all of them.

 

 

How many interviews did you end up receiving? How did you feel your chances were at matching?

Formally, I received three interviews, but in total, I ranked four positions. I received 2 for psychiatry and I was taken off the waitlist for 1 IM-psych program. All of them were university-based programs. At the IM-psych program, I had mentioned that I had also applied for a psychiatry categorical position at the same place and I wanted to know if I had to come back for another interview, which I was totally willing to do. Ten minutes after that mini-interview, I had an impromptu meeting with the program director of psychiatry and she told me that she will see what the other four interviewers had to say about me from that day and she would let me know if I needed to come back or not. Two weeks later, I’m notified that she had enough to consider me for a position. Throughout the next two months prior to match day, I had received several emails about how the psychiatry program is expanding and there’s new facilities and all these wonderful things. I didn’t think I was a shoo-in but I felt that maybe I had a great shot.

 

 

So, it’s Monday, March 14th. The day applicants find out if they matched. You open the e-mail and find out that you did not obtain a residency. What’s going through your head?

Before that day, I told myself whatever happens, happens. I actually slept well the night before! I was driving in Fort Lauderdale and taking care of some errands and I happened to look at my phone. For five seconds, I was completely numb. And then it hit me. My biggest fear came true. All that work, all that money, all the stress, and for what? Nothing.

*cue Kim Kardashian ugly crying*

I can honestly say that it is one of the most devastating experiences and I would not even wish it upon an enemy. The e-mail just says “you did not match”. Not even a “good morning” or “hey girl!” Just one line that says you’re not good enough to continue in your career. After quickly doing my errands and a few snot-filled tissues later, I sped home passing several cops on the way and began on SOAP.

Most of us aren’t familiar with the SOAP, or the Supplemental Offer & Acceptance Program. Can you walk us through your experience with it? (Here’s a link to the SOAP schedule for my readers)

SOAP is a chance for unmatched applicants to apply to unfilled spots in all fields of medicine. However, this means that you will have to come up with new personal statements in the matter of hours, which is exactly what I had to do for family medicine. As Markus said in a previous posting, the website was down and no one could send in applications (because like LOL, heaven forbid the ERAS website works when it needs to).

I spoke with a friend who match into IM the year before through SOAP and she guided me through the process while she was at work. She told me to apply to the IM prelim, IM categorical, and family med programs that had the MOST open spots. I had only 45 spots to pick from and I used 5 of them on psychiatry programs that were unfilled. Then I went through family medicine and internal medicine. In retrospect, I could’ve used those 5 on family medicine or IM spots but what’s done is done.

 

 

So on Monday you found out that you didn’t match. Then during the week you went through the SOAP.  Friday comes along and you find out that you didn’t SOAP into a residency. How did that feel?

By that point, I had already gone through the five stages of grief. Denial set in when I was in the car. Then anger when I was cursing at anyone on the road that was slowing me down from getting home (which is what I do on a regular basis and I’ve been trying to work on but YOU try driving on I-95 in Fort Lauderdale and Miami and tell me you don’t have road rage, but I digress…). Bargaining was SOAP. Depression set in when the 5th round of SOAP happened and I hadn’t received any offers. It continued for a week when all I saw on Facebook were my friends posting that they matched at their number one or number two choices. It wasn’t that I wasn’t happy for them. Every single one of us had a unique journey and even the people I didn’t like, I respected them enough in a professional sense to be proud that they get to continue their journey. It was more about the fact that I didn’t get to continue my journey with them.

Several months had passed and I hadn’t reached the acceptance stage of grief. It wasn’t until I went to the AAFP National Conference in Kansas City at the end of July that I had realized that I had been in the wrong field all this time. I realized within the first hour of the conference that I had such a wrong idea as to what family medicine and primary care entailed. There are so many opportunities for me as a family medicine doctor, whether it be to provide medical care for a whole family, work as a hospitalist, deal with mental health issues, or even perform procedures. After I didn’t match, I had told myself that something big was in store for me, and I finally believed it. Networking at the expo hall with the residency programs made me realize that I was a perfect fit for family medicine and that there are programs out there that WANT me. As I’m writing this, I can definitely say that I wasn’t supposed to match into psychiatry because I realized that I was meant to match into family medicine (I’m hoping). It feels good to be in that acceptance part of grief!

 

 

Why do you think you didn’t match? What were your step scores? Was your application particularly weak in any one specific area?

I had thought about not giving exact numbers here, but in all honesty, who cares? Step 1 was a 208, and step 2 CK was a 209 (yes, the EXACT passing score). Step 2 CS was a pass and everything was on the first try. I expected my Step 1 score but my CK was an absolute miracle. I had worked harder for CK than I did for step 1 and yet, I was not getting anywhere with my studying. I took a UWorld assessment two days before just to get more questions in and I had about 179. So in two days, my score JUMPED 30 points. (This is NOT a plan I recommend to ANYONE, by the way.) I know I’m a terrible test taker and that in rotations, I shined and my letters of recommendation reflected that.

In addition, I had failed one course in basic sciences, and THAT was a reason why a program didn’t take me. They were too worried that I may not pass step 3 (which I’ll go into below) and therefore, not be able to be licensed. However, my scores were good enough to get some interviews at university programs so I must have done SOMETHING right.

 

 

Do you think the fact that you attended a Caribbean medical school played a factor?

Not at all. The places I had interviewed at were very IMG friendly, as were the residencies I spoke with at the AAFP National Conference.

 

 

What do you plan to do while you wait to apply for the 2017 match?

I am currently a Clinical Teaching Fellow for Ross University. Some of my colleagues know it as “junior faculty” but teaching fellow is the formal title and you better believe I am using that on my CV. For those who don’t know what that is, my role is to act as a standardized patient for the incoming 3rd year medical students and assist other junior faculty in teaching how to handle difficult patients and certain common primary care cases, as well as how to begin to formulate an efficient style of medical interviewing. I also assist in Ross’s Ambulatory Care Competencies elective, where we prep the 4th year students for Step 2 CS by presenting cases and critiquing their notes.

Outside of Ross University, I tutor for Huntington Learning Center (which I have been doing since 4th year of med school), where I mostly do SAT/ACT math and high school subject tutoring in math as well. In addition, I’m getting my MBA in Health Services Management through Keller Graduate School of Management, which is one of the sister schools of Ross University. What’s great about that is that they have an “MD to MBA” program where I was able to get credit for 5 out of the 16 courses, so now I only need to complete 11 of them. In addition to working, I plan on taking Step 3 by the end of October. Needless to say, I only know one speed and it is full speed ahead.

 

 

How are you handling your loan debt?

Some of my loan debt could not be deferred or put into forbearance, so I have been paying that off. However, since starting grad school, I’ve been able to defer most of my loans while taking out more. Thanks, Uncle Sam!

 

 

What words of wisdom would you give to someone knowing what you know now?

Have plans A through Z ready to go from the jump. You don’t want to rely on them, but you want them ready if you have to execute them.

Go to as many networking conferences as you can. I know those things can cost money, but at the very least, go to the big ones run by the specialties to which you are applying.

But most importantly, it’s not a matter of “if” you become a resident, but rather it’s a matter of WHEN. 2016 was not my time and I realize that now. However, come 2017, I will be a better applicant and in a better frame of mind to continue on in the next chapter.

 

 

Thank you Steven for an informative and entertaining interview. I look forward to finding out where you match in 2017.

 

Next week I interview a Ross University graduate who matched into a categorical general surgery position. Be sure to subscribe to my blog, like me on Facebook, and follow me on Twitter so you don’t miss it!

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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!

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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.

—

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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What I Learned During My First Week of Residency

In the United States July 1st marks the start date for the majority of residency programs. My residency program however starts one week early, a trend that many are adopting. It gives us one ‘extra’ week of vacation prior to the start of our second year of residency. So for all of my friends and the rest of you strangers out there on the interweb, here’s what I’ve learned after my first week of my internal medicine residency.

 

 

Not a lot of actual medicine

Most of what I’ve learned this past week is the process of being an intern like where documents are located, how to put in orders, and how to use the phone/paging system. Exciting stuff…I know.  It’s everything that you didn’t learn in med school because its the stuff that you can’t be taught in a classroom and don’t really do as a med student. You really just have to learn by doing. So, even though you are going to ignore these words of wisdom just like I did when someone told me don’t stress about the little things because theres nothing you can really do to prepare yourself for it.

 

 

Your residents and attendings don’t expect much from you

I was rounding on the weekend with my attending on my third day of residency. He asked me a simple question that any medical student can tell you without much thought. He asked, ‘what is the reversal agent for Warfarin?’. I put my notes in my pocket, crossed my arms, and struck a confident pose and loudly answered, ‘potassium’. Now for you non-medical people, the correct answer we were looking for was Vitamin K. My brain somehow spat out the electrolyte whose elemental symbol is ‘K’. And that’s basically my first week of residency in a nutshell. Looking stupid but being really confident about it.

 

 

I fucking hate fax machines

fax machine

Seriously, why are these still a thing?

 

 

And that 80 hour work weeks are exhausting

michael bluth tired

I guess I’ve never really had a full time job before but this can’t be normal. Your shift might only be 10 hours but you only get to leave when your work is done. Which is why late admissions are the worst. They’re the equivalent of someone sitting down for dinner at a restaurant right before the kitchen is about to close. Except we won’t spit in your food. Probably.

 

 

You can still make a little bit of time for yourself

One of my biggest concerns going into residency was the notion that I wouldn’t have the time or energy to continue to exercise and stay relatively healthy. I mean my body can’t be all down hill from here, right? Well if you never worked out prior to starting residency I doubt that this will be the time to begin for you. However, you certainly have enough time during the week to find a few days here and there to do whatever makes you happy whether its working out, playing basketball, reading, or just binge watching Game of Thrones (what a great finale).

 

 

Lastly, shout out to the med students

I used to hate the stupid menial labor of med school like finding out if the nurse is aware of the orders we   put in or calling down to radiology to find out when our patient was getting scanned. But now I realize that if it wasn’t for you then I would be the one doing it. Every small task is actually tremendously helpful. At least it is for me. And I always trade menial labor for knowledge (yes, believe it or not I’m actually kinda smart. I’m just really good at playing dumb). So next time your resident asks you to fax a hospital to get records just realize that you are going to be that person doing it when you’re the intern. Yeah, sucks to suck

screaming internally

 

Good luck to all of my fellow newly minted interns! And for everyone else, remember to stay out of the hospital in July or else I might be your doctor.

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Spotlight Interview: a pediatric resident who also applied to OB/GYN

I sat down with Zack Manier, a Ross University School of Medicine graduate from St. Louis, who will be starting the first of his three year pediatrics residency at The Children’s Hospital at St. Peter’s University Hospital in New Brunswick, NJ. He is the first interview in a series of blog posts that will shine a light on the match process.

 

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

Let’s see…I grew up in a typical Midwest suburb outside of St. Louis, MO. I was one of those 4.5 GPA kids who could study the morning of with little effort and get an A and was in every AP class you could think of. I was a big band and orchestra nerd (hey, it was the cool thing at my school! We had football players in marching band, okay?) but a beach bum at heart. I love the sun and the sand, and can’t get enough of the ocean. I got out of the Midwest and moved to the Sunshine State for undergraduate, completing my BS in psychology at the University of Central Florida in Orlando.

Professionally, I feel like I’m empathic and relatable with my patients, and definitely a good listener. I consider myself more common-sense and witty knowledgeable than book smart, and am most definitely not a gunner. I am not afraid to speak out when I know something and will not back down if I know I am correct, but I am a team player and refuse to make others look bad for personal gain, as so many do (you will come to unfortunately find out).

 

How did you end up at Ross University?

That last-minute study mentality caught up to me in my science classes in college, causing me to not be accepted to medical school the first time I applied (study hard, kids!). I had not considered nor heard about Caribbean schools and was looking into go down unda’ to Australia for school, when I discovered the “big three” Caribbean schools. Because they accepted year-round applications, and I did not want to delay starting medical school another year, I decided to apply. I applied in April, interviewed in May, and was accepted to all three in June for the August class. I went with my gut and chose Ross University, and I couldn’t be happier with my decision. My eternal wanderlust and love of the tropics had me going to the right place.

 

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

Pediatrics and OB/GYN and I ended up matching into pediatrics. It was always pediatrics from the start, and my core rotation confirmed that. I was actually dreading OB/GYN (as most medical students do). It was my last core rotation; my attending told me, “You’re not going to be a pediatrician. I’m going to make you an OB/GYN by the end of this.” I highly doubted her, but she was right. She was amazing, and working side-by-side with her opened my eyes to the world of OB/GYN. I think it completely depends on your core experience…I had a friend who had a HORRIBLE OB/GYN core, so she hated it. I probably would have never come to love OB/GYN if I was in her situation. I can fully say that Dr. McDonald at AMC single-handedly kindled my love for OB/GYN.

So I ended up applying to both because I had a genuine interest in both. I would have been happy with either. Neither was a backup.

 

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

I applied to 75 pediatrics programs and 50 OB/GYN programs, so 125 total. Some may say that’s a small number, especially within the individual specialties…they’re probably right. I felt I was less competitive for OB/GYN, hence the lower number of programs. Basically, I went to every program’s site and added it to my list as long as I met their requirements listed. I then removed any programs I knew I definitely did NOT want to go to, whether based on location or other things I found on their sites. That landed me at roughly 125. I’m also super anal/obsessive-compulsive, so applying to 126 or 124 would have driven me nuts (aka not a rounded number). I know, maybe that’s not the time to act that way, but I can’t help it. So I may have tacked on or removed one here or there. In the end, I was comfortable with that amount of programs and amount of money I was spending. I never once felt I over- or under-applied.

 

How many interviews did you receive in each field?

I received six pediatrics interviews and four OB/GYN interviews. Whoa! That’s not very many! No, it’s not (see below). But hey, they say if you have 10 interviews, you’ll basically match. Checkmark. Plus, I know people who matched with way less than me and people who didn’t match with more than me. Don’t let it get you down.

Of note—I only ended up going to 9/10 interviews. The more I looked into one of them, the more I felt it wasn’t for me. Yeah, canceling an interview when I had so few may be crazy, but hey…why spend extra money and time on a program you have no interest in? How do you know you don’t like a program? I can’t tell you that…you just do. It’s just a feeling you get. I was confident enough with how my interviews had been going that I didn’t think I needed that one.

 

How did you end up ranking the programs? (looking at the perspective of why you ranked a pediatric program higher or lower than an OB/GYN program)

I sincerely ranked my programs based on the programs themselves (and partly based on location). I was not going in ranking one specialty higher or lower. As soon as I returned from an interview, I inserted it into a list appropriately based on comparison with previous interviews. You just get a “feeling” when you’re there.

One program was already lacking in pre-interview communication, so I already had a bad taste, and ten minutes into the interview, I knew it was not for me. It was so bad that I considered not ranking it at all. I ended up ranking it just because I really felt I would not end up there (and I didn’t), but I ranked it very last, and even that was a struggle.

My top choice happened to be OB/GYN (so I obviously didn’t match my top choice), but that was solely because it was a new program that I felt was amazing, and it was in the south (no snow, hell yeah!). It was Atlanta, to be exact, where I had done my cores and a city I fell in love with.

One program was pretty amazing, but the location was so rural that I didn’t think I would even enjoy any free time I did get. It just didn’t meet my lifestyle needs. Even the residents said that they flew somewhere every chance they got, even if it was just a weekend. I ranked it lower on my list because of that.

If you must know, they ended up ob—ob—peds—peds—peds—ob—peds—peds—ob. Completely mixed, like I said. That’s based on things like program directors, attendings, residents, schedules, various opportunities, and the overall feeling I had at each program.

At the end of the day, I said I would be happy if I matched within my top five, which I did. I am excited about the future, and feel like I ended up exactly where I was meant to be. (But we can follow up on this in a year lol)

 

What was the most challenging aspect of applying to two different fields?

Definitely writing two personal statements! This is so critical…you can’t really even tweak one to fit the other specialty. Okay, maybe you could for internal medicine and family medicine, but definitely not my two specialties. It was a lot of extra time.

Keeping track of what type of program I was at was also key. There are two ways you can go about it…the honest, “I’m applying to [insert specialty] also,” or the not-so-honest “I love [insert specialty] and am only applying to it.” I went with the latter. I was confident enough that my interviews were not going to overlap or affect each other, so why put any doubts in a program’s mind? As far as I’m concerned, treat each program you interview at like it’s your top choice and you are so excited to be there, and give everyone you meet that same impression.

Originally, there was also the concern of “What if I get interviews for both specialties at the same hospital?” I decided I would deal with that if/when the time came, but, fortunately for me, that never happened. I can’t give any advice on what to do there except to go with your gut and be prepared to deal with the consequences, whether good or bad…you don’t want to get caught in a lie.

 

Any crazy stories from the interview trail?

So, one OB/GYN program (that awesome but rural one), we were each supposed to have three 30 minute interviews. Someone cancelled last minute, so a few of us got an extra interview. Lucky me, I ended up with four 30 minute interviews. TWO HOURS OF INTERVIEWS?! I thought that was crazy. To top it all off, one of them had me suture during the interview, and another had me do laparoscopy WHILE asking me interview questions. Good thing I can multi-task! Side note, we were also given an article about REI ahead of time and told to read/be prepared to discuss it…only the program director was asking about it, and I didn’t have an interview with him. So I basically read it just for fun.

I was also told in advance that one pediatrics program I was interviewing at basically just pimped the entire time and that several people came out crying. Although I did hear that some people were asked medical questions depending on the interviewer while I was there, I was not. So, do not believe everything you hear or get worked up/nervous in advance over something. Just be confident with yourself. I did have two interviewers there though…one lasted 45 minutes, and she just grilled me on if I think Caribbean schools are akin to US schools, and whether or not our USMLE step scores reflect that. Okay? Whatever. My second interview was the assistant program director and basically told me my file looked good and she would be happy to have me, and I was done in five minutes, no questions asked.

The program I said I almost didn’t rank? Basically, everything was bad. Too much to type. But let’s just say that it was an OB/GYN program, and the resident who was giving us the tour had wanted pediatrics, but ended up in OB/GYN (don’t ask me how that happened). On our tour, we passed the pediatrics group, and he said, “Hey peds, have fun! It’s a great program…unlike the OB/GYN program.” Um…ok. That sealed the deal. If your own residents are bad-mouthing your program to prospective residents…not a good sign.

Finally, you will run into “talkers”—people who talk themselves up way more than they should just to feel good about themselves and make you feel worse. Ignore them. You can tell who they are. I had heard about one girl who I had not yet had the pleasure of meeting yet on the trail, until I finally ended up at an interview with her. I knew right away it was her. She poopooed on anyone who went to a foreign school and acted like she came from the Ivy League, even though she was simply at an average run of the mill Midwest med school. She was also reapplying, as she didn’t match her first time applying to OB/GYN. She was gloating about how she now had over 60 interviews but couldn’t find the time. “I had a program call me last week and say they really want me but just don’t have an interview slot.” Bullshit. That’s how you know. You don’t go from not matching to 60+ interviews in your year off. You’re not Mother Teresa. Ignore those people, please.

 

What were your greatest weaknesses about your application?

My biggest weaknesses, I felt, were my step scores, without a doubt. I was actually surprised at how many interviewers told me my scores were just fine, but who knows if they were just saying that. I didn’t really get grilled about them at all. I found most people want to get to know you for you…they’re already past what is on paper. So focus on that in your interviews. I did feel, however, that my scores limited me in the application phase, as I didn’t meet score requirements for some programs here and there. That’s when scores really matter…they will get you more interviews.

 

In contrast, what do you think were your greatest strengths about your application?

My biggest strengths? Everything else. I had all A’s in my cores and electives (which led to a strong MSPE), and I had STRONG letters of recommendation. Almost every (if not all) program complimented me on my letters. Those rec letters are so important…scores/grades are just numbers on a page, but letters tell the program who you are and how you work. I also feel that I’m a strong writer, and I was pretty pleased with my personal statements. I was only asked about them occasionally. Finally, thankfully I had a pass on CS and I improved from Step 1 to Step 2, which are both critical, especially with weaker scores.

 

You’ve already given a lot of great advice but many of my readers will still ask, 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?

I kind of touched on this above, but as for the scores: 217 on Step 1, 222 on Step 2, and first-time pass on CS. Why? I don’t think I put as much effort into studying for them as I should have. Based on my school’s exams/shelf exams/GPA, most would’ve thought I would’ve done much better. I expected higher scores and was disappointed with them, but there’s nothing you can do at that point except make sure the rest of your application is strong, which I did. I do think it affected the number of interviews I received…I obviously would have received more with higher scores. Many programs filter initially solely on Step 1 scores…even though you may meet their online requirements, they eventually have to filter out people once they receive so many applications. My saving grace was CS and the score improvement between steps, no matter how small the jump. Just don’t go down!

 

Lastly, what advice would you give to other Caribbean and/or American medical graduates who want to pursue a career in pediatrics?

Obviously you want to do well in your pediatrics core, but don’t slack in the others! An A in pediatrics and a B in everything would be the same as a B in pediatrics and an A in everything else. You need to be well rounded. Pediatrics is basically all the adult specialties combined into one, just for little people.

Strive for an A in your pediatrics rotation, and go above and beyond to make sure you can get a STRONG letter from your attending. However, if you end up having a bad pediatrics core, do not let that deter you from pediatrics or make you feel like you have to choose another specialty. Just make up for it in pediatrics electives.

Speaking of electives, take pediatrics electives and take them early. Get letters from each attending, even if you think you have enough…you can never have too many! Your application is due in September, so only electives up until then will appear on your application. I made sure to take my pediatrics and OB/GYN electives prior to that. After I submitted my application, I just took easy/blah electives so I could focus on interview season…they don’t really matter THAT much, after all (especially when you just can’t wait to be done with school).

Think long and hard about why you want to go into pediatrics. Convey that in your personal statement. Don’t lie. The most common interview question is “Why [insert specialty]?” You need to be able to convey to the interviewers that pediatrics is where you belong and what you’re meant to do. Don’t half-ass anything.

Join the American Academy of Pediatrics, and try to go to a conference. I didn’t make it to one because of my schedule, but even membership shows interest and dedication, and you’ll be ahead of the game.

Finally, try to get some inpatient experience. Many foreign schools don’t have a lot of inpatient pediatrics opportunities, so if not in your core, try to find an inpatient elective…a non-affiliate if necessary. I’m going in with only one week of inpatient experience, and that was in the NICU. I was questioned about it twice (I think) throughout my interviews, but I had a good answer/explanation prepared, and my interviewers seemed to like my response. I’ve been reading and studying a lot, but I can only imagine inpatient experience will only help better prepare you for residency.

 

Wow, thank you Zack for sharing your story about your route to a pediatrics residency. I look forward to hearing about your intern year in the months to come.

Next in the Spotlight Series will be an interview with an unmatched surgical applicant. Scroll down and subscribe below so you don’t miss out!

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The Residency Interview- like dating, but worse!

Residency interviews are like a series of first dates only worse. Unfortunately, you can’t have your friend call you to bail you out because you’re not enjoying yourself. You have to sit through each powerpoint presentation on why each residency program is far superior to all the rest and pretend like you haven’t heard the same spiel from every other program. Here’s some advice on how to excel on your residency interviews.

 

 

1. Be the best version of yourself

When I asked my dad for advise before my first interview he said, ‘just be yourself’. I looked back at him incredulously and he corrected himself by adding, ‘maybe just tone it down a little bit’. This could also easily be titled ‘hide the crazy’. Be yourself but don’t come on too strong. Be the person your dog thinks you are.

 

 

2. Know what you want…and share the important details

I wanted a residency program with a strong cardiology program in a big city in the northeast. Sure, I left out the ‘northeast’ part when I interviewed in Pittsburgh and Miami. And it was a little awkward when I mentioned my interest in pursuing cardiology to the one program that didn’t have my desired fellowship. Kind of like the time I met a Tinder date at my favorite Brooklyn hipster bar only to learn that she ‘doesn’t drink’. My point being that you should know what is important to you and know what is a deal breaker. Just don’t shoot yourself in the foot in the process.

 

 

3. Have interests outside of medicine

It really doesn’t matter what hobbies you have. You can be a tequila aficionado, coffee connoisseur, or an amateur chef. Sure, on a medical residency interview its good to mention your interests and long-term goals in medicine but it gets old after a while. Just think how many other applicants talk about how much they love saving lives. We get it. You want to be a doctor. Just remember to show them who you are outside of what is inside your application.

 

 

4. Prepare for the most commonly asked questions

This shouldn’t have to be mentioned but I’m going to do so anyway. Your interview day should not be the first time you think of your answer for the most frequently asked questions like (1) tell me about yourself, (2) where do you see yourself in 10 years, (3) what would you have done in life if you didn’t pursue medicine, (4) why this specialty, (5) what are your biggest weaknesses/strengths. Talk these out with your friends. You don’t need to memorize your answer. In fact, don’t. It will sound memorized. Just make a few bullet points about things you want to mention.

 

 

5. Use every question as an opportunity to sell yourself

I’m not sure if you knew this or not but sometimes during the presidential debates the candidate doesn’t always answer the question they were asked. They use the question as an opportunity to talk about something important that they want to convey. You should do the same with your interview. For instance, on one interview I was asked ‘if you could be any type of animal, what type of animal would you be?’. There wasn’t one right answer but there are certainly wrong answers. I said, ‘a bee’. After the interviewer looked at me funny I explained ‘bees are intelligent animals proficient at fulfilling their individual tasks for the betterment of the hive much like how in medicine each specialty must work together and communicate effectively for the betterment of the patient’. This specific answer might be catered to internal medicine and the primary specialties so it might not go over so smoothly on an orthopedic surgery interview but you get the idea.

 

 

6. Make them remember what you said, not how you dressed

How you dress is kind of like your personal statement. You just want it to keep you par with the other applicants. You have very little to gain by being risky with both your personal statement and how you dress but unfortunately a lot to lose by trying to show off. Blend into the background of black and grey suits or skirts and laugh when the program director makes  the old joke ‘oh wow, a colorful bunch!’.

 

7. Send a ‘thank you’ after the interview

Many programs told me about a study that showed many applicants changed their rank order list based on post-interview communications. As such, most programs have a strict ‘business only’ communication after the interview. This means that they will answer questions that you have about their program but shouldn’t tell you much more than that. Regardless, send a thank you e-mail. Hand written letters are okay too. After each interview remember to write down something memorable that you talked about so you can include ‘I enjoyed discussing what we would do with our lottery winnings. Do you mind sharing with me where that elephant sanctuary was in Thailand that you recommended?’ (Yes, this actually happened. The interview went pretty well).

 

8. Take notes after the interview and keep a running rank list

Each program begins to blend together after each interview. Make note of important things you like and dislike about each one. You’d be surprised at how good/bad some hospital cafeterias are.

 

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Categorical vs Preliminary

After med school comes residency where young doctors learn how to actually be doctors. But not all residencies are the same. In general, there are two types of residencies that students can apply for, ‘categorical’ and ‘preliminary’ positions. Categorical spots offer full residency training for their specific field of choice in order to become board certified. Preliminary positions only offer one or two years of training.

Categorical positions are a guaranteed job and it’s what every applicant shoots for. Earning a categorical position means that your application process is over until you apply for jobs or fellowships in order to further specialize after you complete your residency. Each residency training program has different lengths. Internal medicine, family medicine, and pediatrics are three years a piece. General surgery, and otolaryngology are five years. Psychiatry, pathology, and obstetrics and gynecology are all four years.  Technically dermatology, anesthesia, neurology, opthalmology, diagnostic radiology, and radiation oncology are also four years. However, these residencies are actually three years long in their respective specialty after completing a one year preliminary year.

One might apply for a preliminary position for a few reasons. The biggest being that some advanced residencies require a preliminary year, such as those mentioned earlier. For instance, most anesthesia residencies require one preliminary year before a young doctor finishes their final three years of residency specifically training in anesthesia. The other big reason students apply for preliminary positions is as a backup. Prelim positions secure you one year’s worth of paid experience. For instance, a student might apply for both categorical and preliminary positions in their respective specialty depending on the strength of their application. Surgery is a notoriously competitive field so even a strong applicant might go unmatched. Thus, many students apply to both categorical and prelim positions in the hopes that if they don’t match into a categorical position that they will at least have one year to figure out their next move.

But a prelim spot at a program doesn’t secure you a categorical spot next year. Most residencies and programs don’t have second or third year prelim positions and you need a categorical position to finish residency. So if I apply to internal medicine only and receive a prelim spot I would be happy because I have a definite job for one more year but I would still be anxious because my future would not be certain. I would have to go through the match one more time to earn a categorical position somewhere.

If you’re looking for more information on this subject Wash U explains the basics pretty well. So do Doctors in Training (DIT). But my favorite post on this subject is from RK MD- a tech savvy anesthesia resident.