Monday, February 13, 2017

Geography is Giant

When I was a medical student applying for emergency medicine residency programs, a well-meaning dean gave me some bad advice. I was determining the order of my rank list and was particularly concerned about one program that had an excellent reputation but was in a city I didn’t like. The dean told me, “You’ll be so busy during residency it won’t matter where you live.” Luckily, the advice rubbed me the wrong way, and I wholeheartedly disregarded it. As I've said in a recent blog entry (and others in the past), where you live for your medical training - medical school, residency, or fellowship - is as important as the quality of your training program. The reasons are several-fold:

1. Medical training is extremely time-consuming, and you want to be in a city you can enjoy fully when you’re able to blow off steam.

2. Medical training is extremely stressful, and you want to be in a city where you have social support.

3. Medical training is not completed in a vacuum. Your personal life continues. If you’re single you may meet someone and end up staying in the city where you have trained for the rest of your life (gasp!). If you’re in a long-term relationship you may decide to have children or may already have them. Down the road you may not want to relocate your family.

Not everyone gets the opportunity to go to medical school or train in residency and fellowship programs in a city s/he likes. But you can make choices that will increase your chances.

Monday, February 6, 2017

After Your Residency or Medical School Interview: What's the Value of the Second Look?

After interviews - if permitted by the institution - there are several ways you can communicate with a medical school or residency. My favorites are brief thank you notes and well-written letters of interest.

But what about the "second look?" I've had many mentees ask me if re-visiting a school or training program after the interview day is valuable. Unfortunately, there may not be a definitive answer to this question because how a second look is perceived varies by institution.

The cons of the second look are cost and time. And perhaps even worse, there is the risk that you are imposing on the school or program. You don't want your request for a second look to work against your candidacy. On the other hand, the pros of a second look are that demonstration of interest and enthusiasm that many schools and programs are seeking.

If you are a pre-med and are wait listed at a medical school, I would generally recommend a second look if you can swing it. After all, you have every right to visit the institution you may be attending. If you go for a second look in this scenario, make sure to do a formal visit: Let the admissions office or dean's office know you would like to spend the day and ask if you might have an opportunity to meet with students and even an admissions officer to support your candidacy.

If you are a residency applicant, it's hard to say if a second look will help or not. A residency director friend of mine says that a visit from someone who travels from far away might improve a candidate's standing by a few slots on the rank list at her program. That sounds like a tepid endorsement at best... If you are considering a second-visit, make sure to speak to the program coordinator. S/he might advise you against it or, on the contrary, let you know it's appreciated by the residency director.

As we all know, the residency and medical school interview scene is already stressful and expensive, so unless you are a wait listed pre-med - with all other things being equal - I generally would not push yourself hard to do that second look.

Monday, January 30, 2017

Your Residency Application: What to Prioritize When Creating your Rank List

Creating your Match rank list can be challenging. Below, I briefly note a few considerations when making your list:

1. Make sure you understand how the NRMP algorithm works. See my previous blog post regarding errors to avoid at all costs. The key is to rank in the order you want - first goes first, second goes second, etc.

2. Consider your happiness and life balance. Blasphemy perhaps, but I would argue that they are more important than the strength of the training program.

3. Reflect on the culture, geography, size, and even maturity/age of the program. Think about whether you will fit in.

4. Consider whether you could spend your whole life at the institution or in that program's location. It's a lot to grapple with, but many residents graduate and stay for the rest of their careers.

5. Decide whether you liked the program director, chairperson, and faculty generally. They could make or break your happiness and success.

6. Realize that most programs will train you well if you work hard. Their prestige and quality may be more similar than you think. For that reason, note that your personal preferences and intuitions are paramount.

Monday, January 16, 2017

Thank You Notes

Clients ask me what's the best way to send post-interview thank you notes - email versus snail mail. I advise the latter, sending hand-written notes. Email can be viewed as less labor-intensive or thoughtful.

You can still get the notes in quickly: Put them in the mail the morning after you've completed your interview. Some applicants even bring blank thank you notes to the interview day, complete the cards after their interviews, and leave them with the program coordinator.

Your thank you notes should be written on plain cards and sent to every faculty member you conversed with one-on-one. If the residency coordinator helped you with a difficult scheduling issue, for example, writing to him/her would be wise too. Within reason and if written cordially, a thank you note cannot hurt you (unless you have been expressly asked not to communicate after the interview day).

Consider them low-hanging fruit.

Monday, January 9, 2017

Check Yourself Before you Wreck Yourself: Your Residency Application

As we approach the time to submit your rank order list, it's imperative that you understand how to organize your list.

Don't try to outsmart the algorithm by putting programs with more residency slots higher on your list or by prioritizing those that have given you good feedback over those that haven't. None of those factors is relevant in creating your rank order list, and you will harm your chances if you pursue those strategies!

Your first choice should be first. Second should be second, etc. Here's an explanation of the algorithm if you're interested.

Take a look at this under-one-minute Guru on the Go video for further clarification.


Monday, January 2, 2017

Your Residency Application: What to Do if You Receive No or Few Interview Invitations?

1. Don't panic.

2. Try contacting - in a professional manner - all institutions to which you have sent your ERAS. You can send an email and call. When you call, be calm, respectful, and enthusiastic. Do not demand to speak to the program director. Let the person who answers the phone know that you are very interested in the program and would appreciate the opportunity to interview. Offer to be on an interview wait list if necessary.

3. Prepare for the Supplemental Offer and Acceptance Program (SOAP). Note that SOAP is not a separate program from the residency Match. So a) your main residency Match user status must be active and b) your credentials must be verified by the Rank Order List Deadline in order to participate in SOAP. Here is more information on SOAP. 

4. Make a plan for what you will do if the Match and SOAP don't work out for you. What will you do next year? How will you improve your written materials, interview skills, and overall candidacy? If heaven forbid, you do not have success in either the Match or SOAP, please consider getting help from me or someone else who is experienced. The sooner the better to improve a candidacy and prepare for a re-application.

Monday, December 26, 2016

Understanding How the Match Works is Critical for Succeeding in the Process

Improving written materials and interview skills is important, but all of that work can go to waste if applicants do not understand basic strategies for the Match. In November of last year the NRMP published an article called, "Understanding the Interview and Ranking Behaviors of Unmatched International Medical Students and Graduates in the 2013 Main Residency Match" in the Journal of Graduate Medical Education. The data is especially important for IMGs who represented the majority of unmatched candidates.

Sadly, the authors found that some applicants made strategic errors including the below:

- Not attending all interviews, thus failing to capitalize on every opportunity to market themselves.

- Declining to rank all programs at which they interviewed or not ranking all programs they would be willing to attend.

- Misunderstanding the Match and ranking programs at which applicants did not interview.

- Failing to rank programs based on true preferences or ranking programs based on the perceived likelihood of matching.

It kills me to read about these mistakes :(. Here is a simple explanation of the Match algorithm. If you do not understand how the Match works, it is absolutely critical that you learn about it to avoid destructive errors.

Monday, December 19, 2016

A Great Opportunity: American Association for the Advancement of Science (AAAS) Science News Writer Internship

Looking for something different to do this spring and summer? The American Association for the Advancement of Science (AAAS) is offering a paid six-month internship (April through September) with Science Magazine in Washington, D.C.

As some of you know, I was an AAAS Mass Media Fellow in 1995. The program was truly fantastic and life-altering.

In terms of qualifications for the Science News Writer Internship, applicants need to have completed their undergraduate education or be in their senior year of college. They should have interest (and preferably experience) in writing about science for lay people. According to the AAAS, preference will be given to candidates who have published science journalism articles, worked at other science news publications, and/or completed a journalism or science writing program.

The AAAS suggests you visit their job information website to get more information. Applications are due by January 2nd, so get moving!

Monday, December 12, 2016

Your Residency Application: What Do Program Directors Really Want?

If you were a program director (PD), you'd be trying to avoid two big headaches as you assessed a residency candidate:

1) Will this person be competent and collegial? A PD does not want to get complaints from patients, faculty, or other services about his/her residents.

2) Will this person leave the program prematurely? A PD does not want to scurry around to fill an open call schedule/ residency slot.

As you approach your interviews, consider how you can demonstrate your competence and collegiality, as well as your commitment to the field and the residency program. For the former, ensure you showcase academic successes, extra curricular activities that demonstrate teamwork, and - if asked - hobbies and reading materials that demonstrate your personality. For the latter, highlight research projects in the specialty, sub-internships, and knowledge about the program and city.

Making sure the PD knows you are not going to cause him/her headaches is half the battle.