Tag: Step 2 CK

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Top Blog Posts for Medical Students

I recently came back from a trip to Barbados where I gave the incoming first semester class of Ross University some advice on how to succeed in med school. Here’s a summary of my top med school blog posts broken up into various categories:

Med School Study Tips

Med School Study Resources

USMLE resources

Clinical Rotations

Should You Go To a Caribbean Med School

Discusses the discrepancy in the match rate between US-IMG’s and US MD and DO graduates

Residency Tips for Med Students

Residency Tips for Residents

Ross University Specific

Interviews with Residents in Various Specialties

Interview with Fellows in Various Specialties

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How To Prepare for Intern Year of Residency

One of the most frequently asked questions that I receive from medical students is about how to prepare for their first year of resident. It parallels one of the most common fears among medical students in that they will not be adequately prepared for day one of residency. It’s a valid concern because you will never truly be ready for intern year but if you’ve made it this far in your training then you are likely ready enough. Almost everything you learn intern year isn’t taught in medical school because you have to do actively do it to learn it. At least that’s what I thought until I came across OnlineMedEd.. It’s the only resource I’ve found that actually prepares medical students reasonably well for intern year. Again, nothing is going to make you fully prepared but this is as close as you’re gonna get.

 

I started using OnlineMedEd during third year of medical school

OnlineMedEd is an amazing resource with videos that help explain complicated topics that overlap real world experience with the textbook. They do an amazing job of translating all of that USMLE step 1 material into actual practical knowledge so you can look sharp on all of your third year rotations. I would watch a few before each rotation started and it showed. Dustin and the OnlineMedEd team also drill home all of the important facts that are frequently tested on step 2 CK. Sure, nothing will ever replace UWorld but OnlineMedEd gives it a run for it’s money. Start using OME early and often.

 

A curriculum for fourth year medical students

Your fourth year of medical school is a magical time especially after interview season is over and your rank list is finalized. You’re basically just waiting to graduate and planning your vacation to South East Asia. It is all to easy to fall into a trap of laziness and forget that you are going to be a full fledged doctor in 6 short months (well technically you’ll be an intern but a doctor nonetheless). If you dedicate yourself to the structure of OnlineMedEd during your fourth year you will have a dedicated curriculum that keeps you fresh and sharp on the wards. Sure, you’re still gonna forget a lot before intern year starts but at least OnlineMedEd will get you into some good habits.

 

It prepares you for intern year

My advise to all of my fourth year medical student is always the same- go home because life is too short to be spent in the hospital watching me type notes and at least one of us should see the sun today. I also tell them that the best way to be a good intern is to develop good habits while you are still in medical school. The dirty truth about residency is that you don’t need to be all that intelligent to be a good intern. You simply need to be efficient, thorough, and work hard. The sooner you develop habits that enable you to work smarter, and not harder, the better off you will be. OnlineMedEd has developed a fantastic Intern Boot Camp that helps you do exactly that. If I could do my fourth year all over again I would use the Intern Boot Camp and test out what does and does not work for me while I was still on the wards in the hospital. That way when I show up day one of residency I at least had a system that I knew worked for me. It’s like when I had to learn how to actually study in medical school- I wish I didn’t have to go through the process of figuring out what works best for me. I wish I knew how to study more efficiently back in undergrad. Likewise, take the time to learn the ropes of what it takes to be an intern while you are still a medical student.

 

Start studying for step 3

Ugh I know. Sorry for bringing up the USMLE’s again but you have to get it over with eventually. I’ve written extensively about when you should take USMLE Step 3 as well as how to study for USMLE step 3. If you use OnlineMedEd during your fourth year of medical school you will get a head start on it. You don’t need to use OnlineMedEd as your primary study aid but it will certainly help cement concepts in your head and make it easier for you once you start your dedicated step 3 study period as you transition from medical student to resident.

 

They also have great study products

Last thing I’ll mention are their study aides. The Intern Guide Book and the Quick Tables Book are great study tools for medical students. They succinctly provide you with a ton of well organized material. You have to fill in the blanks and annotate it just like any guide book. But if you are going to use OnlineMedEd then these books are essential as they go hand in hand with some of the videos. Just like any resource, the more you use it the more results you get from it!

 

So if you are interested in using OnlineMedEd check them out here: OnlineMedEd.

 

*Full disclosure: sponsored content. That being said, I only support brands that I believe in.*

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How To Learn More, Faster in Medical School

It’s been awhile since I used Picmonic. It was my go to medical school resource when I was a first and second-year med student and was even more valuable while I was studying for USMLE step 1 and step 2 CK.  The more I used it, the more valuable it became. It is still to this day one of my three favorite medical school resources, which is why I was so excited to team up with Picmonic to help spread the word!

 

 

What is Picmonic?

Picmonic is an online app that helps make studying easier, more efficient, and a little bit more fun. Let’s face it; medical school challenges you with a relentless barrage of information that requires absolute dedication to memorizing. And the worst part about studying in medical school is a simple fact that some stuff doesn’t make sense. You just have to memorize it. I’m talking about subjects like biochemistry, nutritional deficiencies, pharmacology, and microbiology. That’s why Picmonic is so amazing. It uses vivid pictures, stories, and wordplay to get all of that expensive medical school facts that you just have to know into your brain!

 

 

Let me just show you what I’m talking about

Each subject has a unique Picmonic ‘card’ that uses visual storytelling and pictures as mnemonics to help you remember more. They’re even better than flashcards! This is the Picmonic card for erythema nodosum, and I still remember it and use it to this day during residency. Inevitably during morning report, noon conference, patient presentations, or when I’m teaching my medical students this subject pops up. And my co-residents are just as shocked as my friends in medical school were when I rattle off the disease associated with erythema nodosum, represented by the Nodosaur with red bumps on its legs.

 

What I also love about Picmonic is that its cast of characters stays consistent throughout the Picmonic universe. For instance, take a look at the erythema nodosum card again down below. You’ll see a ‘cock (rooster) at sea’ representing coccidiomycosis circled in red.

 

 

Now check out the card for coccidioidomycosis. It’s the same rooster at sea, again circled in red.

 

 

Now take a second look at the coccidiomycosis card, but this time check out the granny-llama representing granulomatous inflammation, circled in yellow below. Now check out the same granny-llama circled in yellow on the Picmonic card for granulomatosis with polyangiitis (Wegeners).

 

 

And again, we see the same granny-llama representing granulomatous inflammation on the card for granulomatosis with polyangiitis (Wegeners).

 

 

 

Buy Picmonic Now!

Ultimately, I wholeheartedly believe that Picmonic helped me pass and succeed in medical school and helped me ace USMLE Step 1 and USMLE Step 2 CK (and even bails me out every once in awhile during residency). The more esoteric and difficult to memorize a subject is the more Picmonic flexes its muscles.

 

 

So if you’re tired of reading about Picmonic and ready to try it out, here is what you should do:

  1. Go to https://www.picmonic.com/redeem and enter KittyKatzFree for 2-weeks of free access to Picmonic!
  2. Once you’re ready to purchase: use my link to get 30% of any fixed term subscription!

 

 

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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: Joey from Brooklyn lands a PM&R residency

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

 

 

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

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

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

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

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

 

 

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

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

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

So I applied to both PM&R and EM.

 

 

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

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

 

 

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

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

 

 

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

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

 

 

How did you end of ranking your programs?

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

 

 

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

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

 

 

Any crazy stories from the interview trail?

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

 

 

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

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

 

 

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

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

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

 

 

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

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

 

 

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

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

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

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

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

 

 

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

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Spotlight Interview: 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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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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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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Best Resources to Destroy USMLE Step 2 CK

*Disclaimer: Below are my favorite resources with associated links. If you like my blog please use the links to buy any books on Amazon or services (Picmonic, OnlineMedEd) as I receive a small referral fee that helps me keep this blog up and running! I only listed products I trust or and/or used*

Question Banks

The purpose of doing practice questions is to find your weaknesses in order to guide your study process and  to get you inside the head of question writers. Hopefully you figured this out already since you most likely already took step 1. However, I found studying for step 2 CK to be more difficult than step 1 because of the other obligations that MS3 requires. Question banks are also great on the go. Long subway to your friend’s apartment on the upper east side? Do a question set on the train. Bored in between lectures? Practice questions. Lost your resident and don’t feel like going back to the floor? Practice questions. Practice questions? Practice questions! Here are the practice questions I used.

USMLE World

Still the gold standard when it comes to practice questions. There is no way around it. You can read the message boards on Student Doctor Network and they all reiterate what I find to be true. That UWorld is the end all and be all when it comes essential resources for Step 2 CK. Some students will argue that UWorld and a review book are the only resources you need for step 2 CK and for the most part that is true. I completed UWorld in its entirety once. Then I completed all of the questions I got wrong (which was nearly half of them). Then I continued to do full question sets until test day so I ended up doing UWorld two and a half times. I highly suggest it.

Kaplan

Kaplan is the other major question bank out there. I used to do Kaplan questions with my friend who preferred not to ‘waste’ UWorld when he studied for his clinical clerkship exams. Just like step 1, a major advantage of Kaplan to UWorld is that they tell you exactly where this topic or subject is located in the most popular review books. I enjoyed using Kaplan but chose not to invest more money in another review book when I could borrow my friends’ PreTest books instead. That being said, I haven’t heard terrible things about Kaplan.

PreTest

I took step 2 during the second week of my first elective rotation in cardiology. So the bulk of my serious step 2 studying was done during my 8 week surgery core and subsequent 4 week surgery elective. I took a practice test and I did terribly. Like embarrassingly bad. And my worst subject was surgery. I had completed all of the UWorld surgery questions and ran through them all a second time. I wasn’t being lazy either. I read through and studied the answers to each question but I just wasn’t making any progress. My friend suggested I try pre-test and I loved it. Pre-test gives you over a thousand questions for each clerkship exam. In some regards they go into far too much detail than you actually need for your step exam and cover a much wider scope of subjects than UWorld alone…but that’s exactly why I used it. You can finish all of the UWorld or Kaplan questions for the smaller subjects like psych and pediatrics quite quickly. These books expose you to a lot more pathology that other qbanks don’t cover. I highly suggest using this resource for in between lectures, after you finish a specific section of UWorld, or if you just want more high quality practice questions. Just beware that they are not NBME format. So I would shy away from them when it comes closer to test day

Practice Tests

The purpose of practice tests are to find your weaknesses and to exploit them in order to maximize your score. Basically, study what you suck at! That’s the point of doing practice questions and that’s the point of doing a practice exam. So you can tell if your study process is working or not. For instance, after I started dedicating more and more time to study my weakest subject, surgery, my score began to creep up. I found that the number of questions I got wrong in other subjects continued to stay relatively stable but I was able to decrease the number of surgery questions I got wrong from 20, then to 12, then to 8, and on my last practice test I literally got zero surgery questions wrong. My point is that you can’t just keep taking practice tests to see what score you would get on step 2. That’s great and you should do that but you have to remember that the purpose of taking a practice test is to evaluate your weaknesses and to strategically focus on them. Okay, now I can get off my soap box.

NBME

NBME is the gold standard because they are written just like the real test. You have to use these wisely because there are only a limited number of them. Additionally, I believe that it is worth the ten extra dollars to purchase the expanded feedback. This option grants you the ability to see which questions you got wrong. Annoyingly, they don’t tell Sure you can screen shot every single question if you really want to (unlike UWorld Self Assessment) but this is so much easier and also doesn’t mess with your ability to recreate test day.

USMLE World- Self Assessment

The only reason this resource isn’t above the NBME practice exams is because there is only one USMLE World Self Assessment (UWSA). Both the NBME’s and the UWSA are only half as long as the real thing but the advantage of the UWSA is that they are like UWorld question sets. You are given full UWorld style explanations of each question, both the questions you get correct and incorrect alike. I chose to make this my last practice test because I was able to utilize these four individual question sets like they were new questions that I was able to review afterwards.

Review Books

I encountered a few problems when I chose which review book to utilize. My ideal review book would have everything in it already. Explanations from UWorld, differential diagnosis categorized by both chief complaint as well as pathophysiology, best initial test, most accurate test, best initial therapy, maintenance therapies, and alternative therapies. I never found that type of book. So go to the book store and check them out for yourself before you buy them.

Master the Boards (MTB)

I liked MTB for the same reason why I disliked it. Its brevity is nice when you just want a quick and dirty answer but it leaves you hanging at times when you want more detailed UWorld style explanations (seriously, why can’t someone just put UWorld in a book format already?!). Between UWorld and MTB you are guaranteed to pass step 2 because they cover all of the high yield stuff but be prepared to annotate the shit out of it. Bonus tip: use MTB for step 3 instead of the step 2 CK version. It’s got a few extra gems in there and it’s really not all that different from it’s step 2 cousin. This way you won’t have to start all over again for your next step.

First Aid for the USMLE Step 2 CK

First Aid was my step 1 bible but I didn’t use it for step 2 CK and I regret that decision. I borrowed this book a few times from my friends and I liked it. It mimics the step 1 version quite well. Again, I did not use this as a primary resource but I would encourage you to check it out.

Step Up to USMLE Step 2 CK

I used Step Up to Medicine (SU2M) for internal medicine only and did not use Step Up To USMLE CK because I disliked SU2M so much. If MTB has too little information then this is the complete opposite side of the spectrum. It has long winded explanations of every subject in bullet format. Some people liked that but it wasn’t for me.

Lecture Material

Lectures were less valuable to me for step 2 than for step 1. I just didn’t have enough time to sit down and watch video lectures. My favorite way to study was to simply review whatever disease my patients had that day. Every once in a while however I just didn’t know something and needed someone to spell it out for me. These are the resources I used for those moments.

Online MedEd

This is by far my new favorite resource that I utilized for step 2. Online MedEd uses a reverse classroom style of teaching with whiteboard based lectures. Lecture videos range in length and subject matter but are amazing resources for both step 2 and for the wards. For instance, one day I was feeling a little lost about fluid management so I went to the library and threw on the fluid management videos. I went back to the floors with a better grasp of what I was doing and didn’t feel like such an idiot. I especially liked the algorithmic way of thinking they employ. I watched every video and would do it again in a heart beat.

Doctors in Training (DIT)

I loved DIT for step 1 but it just didn’t do it for me for step 2. I didn’t have hours and hours to watch videos everyday, nor did I have the energy for it (that’s why I liked OnlineMedEd a little bit more because their videos were short and to the point). What I still loved about DIT was that they remind you of what you may have forgotten. The pre-lecture and post-lecture quizzes are gold. It wasn’t for me but doesn’t mean you shouldn’t at least check them out. Not to mention they’re great guys to follow on Twitter.

Kaplan Lecture Videos

I got my hands on these videos and they were fantastic. Conrad Fischer at his best. If you liked Kaplan for step 1 then you will like them for step 2.

 

Miscellaneous

The other stuff that doesn’t fit into a pretty category like the stuff I already mentioned.

The Successful Match: 200 Rules to Succeed in the Residency Match

This book is pure gold and I highly recommend it to anyone and everyone going through the match process. It provides analytical data on the match. The author provides objective data on a subjective subject like what characteristic traits different program directors like to see in their candidates the most in each respective specialty. This book provides advice on everything from writing your personal statement, the most commonly asked interview questions and the best way to answer them, what type of programs you should be applying to, who you should be asking for letter of recommendations from, and so much more. It was my most valuable resource before and during interview season. You won’t regret this investment. In fact, your friends are going to want to borrow it. Mine did.

 

UpToDate

Most medical schools provide this for you and it was easily my most often used resource during my third and fourth year of medical school. It’s like Wikipedia for medicine when Wikipedia doesn’t do a good enough job at explaining something. Or when someone points out that Wikipedia isn’t ‘a reliable resource’. Anyway, it’s amazing and I love it. Bonus tip: click the ‘summary and recommendations’ tab to get a quick snapshot of the article you’re checking out.

Picmonic

If you used Picmonic for step 1 then you should keep using it for step 2. I talked about Picmonic before and it still rings true. Every time I thought about brain tumors, tumors of the bone, any vasculitis, developmental disorder, and everything from biochemistry my Picmonic note cards would pop into my head. I’ll probably be that one resident who puts a Picmonic mnemonic in the presentation slides for morning report. I don’t ‘like like’ Picmonic. I love them.

*Use my link to get 30% off your Picmonic subscription!

Blueprints

Blueprints is like PreTest because they are good for shelf exams but not so much for dedicated step 2 CK studying. I highly disliked Blueprints because it was so long but others liked it for that exact same reason. Each chapter gives you a few bolded key words, tables and figures and explains the topic in great detail (again, too much detail in my opinion). The book ends with 100 NBME style questions with long explanations. I liked PreTest more because of how succinct it was but I have friends who, again, had the complete opposite opinion. To each his or her own.

Tablet > smart phone

If you don’t have a tablet already I would highly recomend purchasing one. If you are short on cash you do not need to purchase an iPad. There are tablets out there for under $100. Sure they aren’t as pretty but all that you realy need them for is accessing UWorld. Yes, you can simply use your smartphone instead of buying another piece of technology but unfortunately every time you have your phone out people will think you are texting. I remember once when I was on my phone doing a UWorld question set while I waited for the operating room to be cleaned and a nurse called me out for ‘texting instead of taking care of my patient’. Said patient was actually sitting next to me in her bed on her phone playing ‘2048’. She was trying to beat my high score and was failing miserably. Anyway, my patient kindly told the nurse to ‘kindly fuck off’. She was one of my favorite patients ever. Moral of the story: if you are on your phone people will think that you are texting no matter if you are using it to cure cancer or are actually texting.

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Test Taking Strategies: how to maximize your score

Your USMLE step 1 and step 2 scores are the most important pieces of information in your residency application. However, acing your board exams isn’t just about knowing the science but also about having strong test taking skills. At the end of the day, your score is a combination of how smart you are multiplied by how hard you work divided by your test taking skills. Here are my test taking strategies to maximize your score on test day.

 

Find your weaknesses

It’s hard to improve your test taking skills if you don’t know where to start. So do a question set of UWorld or two and while you are reviewing your answers figure out why you got the question wrong in the first place. In my mind, there are two broad categories of why you get questions wrong. The first is that you straight up didn’t know the answer because you didn’t know the science or medicine behind the question at hand. The second category of incorrect answers is due to poor test taking skills.  So if you get a question wrong because you didn’t remember the auto-antibody that correlates with autoimmune hepatitis then don’t stress out about it. Just go study that subject material. However, did you fluster over this answer choice for five minutes? Did you eat up all of your time trying to remember the answer? That’s a test taking strategy and is something you have to work on.

So first, (1) figure out if you got the answer wrong because of a lack of knowledge versus poor test taking skills. Next, (2) continue to jot down the reasons why you got these questions wrong. Eventually, you might (3) find patterns in why you get questions wrong.

 

Recognize patterns concerning why you are getting questions wrong

So at this point you should have completed a few question sets and collected some data concerning why you are getting questions wrong. Maybe you are a great test taker and you just need to study the science a little more. If that’s you then stop reading this blog post and go study! If you’re like me, you might need to make a plan moving forward concerning how to improve your test taking skills. Some reasons why I got questions wrong in the past were because:

  1. I wasted time on ‘easy’ questions and had to rush through questions near the end
  2. I changed my answer choices
  3. I would be thinking about question number 1 while I was reading question number 2
  4. Test taking anxiety
  5. Stupid mistakes

Next, I will go into how I overcame these test taking weaknesses of mine and hopefully you can mimic what I did and overcome your deficiencies.

 

Overcome minor anxiety by simulating test day

A soccer coach I once knew used to hate when we took practice shots from a stand still. He felt that during a game you rarely had the opportunity to take a shot when the ball wasn’t already moving. It didn’t simulate the game realistically. Likewise, you need to prepare for the exam by answering practice questions against the clock. It will simulate the anxiety of test day and, hopefully, make you more comfortable when answering questions in the hot seat. This helped me get over my minor test taking anxiety. Those butterflies in my stomach.

Power poses are also a great subconscious confidence booster. Long story short, if you have positive, confident posture it will translate into a slight increase in real life confidence. That goes for test day too. Check out this TED talk that goes into more depth on the topic.

As an aside, this post is mainly for test taking strategies. Minor tweaks that can improve your score. Which means that if you have severe anxiety to the point where it is truly inhibiting your ability to take tests then please seek professional help. There is no shame in speaking to a psychiatrist about your test taking anxiety and they are much better equipped to help you flourish come test day. Same thing goes for people whose attention span could use a little artificial endurance.

 

Don’t overthink it and stop changing your answer choices

I recently tried this new ice-cream place in Brooklyn called Ample Hills Creamery (if you live in the area you NEED to go there). Looking at the menu I instantly saw the words ‘Salted Crack Caramel’ and knew what I wanted to try. Except then I saw other delicious looking options like ‘The Munchies’ and ‘Mexican Hot Chocolate’ and I started second-guessing myself even though I knew what I wanted to get. Likewise, when it comes to test day don’t overthink your answer choice. If you think you know the answer then click the bubble and move on to the next one. JUST CLICK THE BUBBLE AND MOVE ONE! Your first inclination is often your best guess…especially if you aren’t sure why you think it’s the correct answer choice (sometimes your gut is smarter than you and not just with regards to ice-cream).

UWorld also has a great tool to see where you are making your mistakes. I found that I had a greater number of answers that I changed from correct to incorrect that the other way round. By making a ‘click and move on’ rule I increased the number of questions I got right. It might only get you one or two questions right in each question set but they add up quickly. Especially when step 1 and step 2 are 7 and 8 question sets long respectively.

The only exception to this rule is if I went back to my question and found that I completely missed something. Oh, the patient had a myocardial infarction because he did cocaine! I’m gonna change my answer from beta-blocker to calcium channel blocker. Boom. Science bitch!

 

Once you eliminate the impossible, whatever remains, no matter how improbable, must be the truth

There were a lot of easy questions on step 2. Things that everyone gets right like ‘give IV fluids’ or ‘compare to old chest x-ray’. Then there are the cluster of questions that make me wonder if I forgot everything or if I just straight up never learned it. For example, on step 1 I remember a question on neurofibromatosis type I but I forgot that it is also often called von Recklinghausen Disease. At the time, I wasn’t sure if von Recklinghausen Disease was the same thing as neurofibromatosis type I or not. Instead of ruling IN the correct answer I simply ruled OUT the incorrect ones. With this approach I was left with only one possible answer choice and ended up picking the right one.

Ultimately, this isn’t anything new or groundbreaking that you haven’t heard before but its worth hearing again. When it comes to these standardized tests every question is worth an equal number of points. I hope that these test taking tips will help you get a few more questions right and help bump up your score because every little bit counts. Happy studying!