More Residency Slots Proposed

There was a well-reasoned op-ed in the NYT this past week on an amendment being proposed to Congress to add fifteen thousand medical residency slots to the hundred thousand residencies the federal government now finances. The point the writers make is that increasing the supply of physicians across the board is much less strategic than training primary care physicians (PCPs) specifically and remunerating those PCPs such that they continue to practice. The piece is written by Shannon Brownlee, the author of “Overtreated: Why Too Much Medicine Is Making Us Sicker and Poorer” and David Goodman, a professor at the Dartmouth Institute for Health Policy and Clinical Practice. Here is the article.

Happy Holidays

I'm taking a brief respite during the holiday season. Have a healthy, happy new year!

Doctors Seeking Management Training

Here's an interesting article on MDs who get MBAs or go through other management training programs to improve their administrative skills in the hospital.

Medical School Reapplicants and International Schools

International schools can be a good option for medical school applicants whose grades or MCATs are not at a satisfactory level for US medical schools. But ensure you do your research first: The schools can be very expensive, so be certain you can afford the tuition before you waste your time on an application. Other options: Doing a post-bacc year to increase your science GPA or considering some DO schools that have less rigorous admissions requirements.

Getting started early with a strategy session can make a difference in your medical school application. Contact me.

Scary

Here's a recent article on medical student needle sticks that's a bit disturbing. Worth a read.

Interviews: Third Eye

With regard to interviews, I remind applicants that sitting up straight, speaking slowly and looking an interviewer in the eyes conveys confidence and honesty. Although it might sound silly, if you feel too awkward, you can imagine a third eye on the bridge of the interviewer's nose and focus there. This technique helps some shier applicants.

For assistance with your interviews, contact me.

What constitutes BCPM?

Which courses count for AMCAS' BCPM (Biology, Chemistry, Physics, and Mathematics) classification versus their AO (All Other) category for GPA calculation?

The assignment is based on the course's primary content and is determined by the applicant. However, if AMCAS considers the classification inaccurate, they will adjust the GPA calculation. Applications aren't returned in these cases, so there should be no delay in processing, but one's estimated GPA would be different than anticipated.

If an applicant disagrees with the adjustment, s/he can submit an Academic Change Request, including the course description found in the course catalog so that AMCAS can verify the primary content of the course.


Contact me for pre-med advice - the earlier the better for 2011 medical school applications.

Happy Thanksgiving!

Have a healthy, happy holiday. I'll resume the blog next week.

Thank you notes: Be swift

See my previous blog entries on thank you notes. The bottom line: They can't hurt and might help. Ensure you send your note immediately after the interview (day of or next day), as your candidacy will likely be discussed soon after your visit.

Contact me for mock interviews, and please see my testimonials page for some new comments about my work.

AMSA Featured Speaker

I've been invited to be a featured speaker at AMSA's 60th Annual Convention to be held in Anaheim this spring. I'm scheduled to speak on Saturday, March 13, 2010 at 11:30am. In the past the American Medical Student Association's national meetings have been the largest annual gatherings of medical students in the United States. I'll be offering an interactive lecture called "Getting Into Residency: An Insider's Tips."

Contact me for personalized application assistance.

To Address or Not to Address (Deficiencies in Your Application): That is the Question

Whether to address weaknesses in your application during the interview is a difficult topic. Generally, what I recommend is as follows:

1. If you have a mild weakness (one mediocre grade/evaluation), there is no need to bring it up with the interviewer.

2. If, on the other hand, you have a major weakness (very low MCAT/failed the USMLE, large chronological gap, etc.) then you are better off addressing the issue head on. Think of the politicians who are caught in scandals: Those that 'fess up early manage their problems. Those that don't let the press interpret them. (I'm not saying that a weakness in one's application is equivalent to some politicians' misconduct; I'm just using this as an analogy.) If you have a glaring problem, go ahead and confront it head on. It will demonstrate integrity and will allow you to mold the admission committee's perception.

For individualized mock interview assistance, contact me. I am booking 2-3 weeks in advance, but I try to squeeze in clients sooner when I'm able.

Inquiring About Your Status

Please see my previous blog entry about contacting institutions regarding your status. When you call you can gently say, "I'm attempting to make some travel arrangements and was wondering if you could give me an update on my status." As long as you are polite, you won't hurt your candidacy. (Of course, if an institution specifically requests on their website or brochures that you not call, I would advise against it.)

Medical School Competition

United States medical school enrollment is up for the eleventh consecutive year, according to the Association of American Medical Colleges. Check out this short article on the topic.

The Early Bird

For all of those pre-med students who are reading my blog in preparation for their future applications to medical school, here's a reminder: Start early. One of my clients from this application season has already been admitted to two top medical schools. As I've mentioned before, medical school admissions are rolling. You can increase your odds by getting your AMCAS in during June and July.

Dress for Success

A few simple rules regarding clothes and interviews:

1. Do not be noticed for your clothing. You do not want to be the "guy with the Bugs Bunny tie." This is not the time to be creative, unfortunately.
2. Be professional but comfortable. You may have to walk a mile between interviews. I still remember a miserable ten minutes in a Manhattan winter, getting from one building to another.
3. Pack carry-on. I won't forget the embarrassed applicant who came to our institution in jeans when his suitcase was lost by the airline.


Contact me for mock interview assistance soon.

Don't Beg

There are a lot of good points in my colleague Ann Levine's book The Law School Admission Game: Play Like An Expert. In particular, I want to point out her advice regarding avoiding pleas for acceptance. I notice many applicants make this error at the end of personal statements for medical school, residency and fellowship. Here's Ann's take, which I think is very useful:

"Your personal statement should convince the reader to admit you based on the strength of your experiences and perspective. No begging at the end. None of this, "I truly hope for the opportunity to prove myself" nonsense..." (p.91).

Remember: If you make yourself a distinctive candidate through your accomplishments, you won't feel the need to address your reader in this manner.

Distress in Medical Training

Here's more on the difficulties associated with training to be a physician. This isn't new news; it's just getting more attention as of late.

Match Violations

This WSJ article refers to a PGY-1's experience last year with Match violations.

I was asked multiple inappropriate (and illegal) questions when I was interviewing. (I was later told that one of my interviewers was taken off the roster because of his routine practice of asking unprofessional questions.) One thing I review with my clients in residency mock interviews is how to best answers these questions. I am currently scheduling mock interviews into the end of October, so please contact me soon if you are interested in my assistance.

Business School Applications

There's a recent NYT article on the lessening interest in business school compared to years past. The decline is not severe, but I suspect that competitive candidates who considered business school in the past may now consider medical school, as being a physician is seen as a stable career choice in these uneasy times. As I've mentioned before, I think the poor economy may make medical school admissions rougher.

Medical Students Posting Profanity

Check out the recent article in the NYT regarding a JAMA study that demonstrates a surprisingly high number of medical students who post profanity online. It's kind of a strange research question, but makes for some good conversation.

Law School Admissions

My friend and colleague Ann Levine recently published a comprehensive book called The Law School Admission Game: Play Like an Expert. Although the book targets a different applicant pool, medical school, residency and fellowship candidates may find the sections on writing an excellent personal statement and getting the best letters of recommendation helpful. Check out Ann's book here.

Interview Strategies: Why Did You Interview at this Time?

Most medical school, residency and fellowship applicants schedule their interviews according to convenience and cost, but you may be asked why you arranged your interview so early or so late in the season. The real concern behind this question is that you are interviewing early because you are using the institution for a practice session or that you are interviewing late because you had considered leaving the institution to the end in case you wanted to cancel.

Reassure the interviewer that you are serious about the program. If you are interviewing early you might say, "As soon as I was offered an invitation I took the opportunity to visit because I am very enthused about this institution." If late, you might say, "I wanted to maximally prepare for this interview because I am very interested in being here."

Contact me soon for mock interview assistance. I am scheduling two to three weeks in advance.

Updated Web Site

Please take a look at the latest updates to my testimonials page. As usual, for help with your medical school, residency, fellowship or post bacc application contact me here or email me at insidermedical@gmail.com .

Secondary Essays: A Blessing and a Curse

The number of secondaries some medical school applicants receive can be overwhelming. Some institutions send out secondaries to almost all of their applicants; remember that the process is a money-maker for schools. To lessen the time sink, try to use the same essay for several secondaries. With some small changes an essay may be used for multiple purposes.

Contact me for editing help.

Scheduling Mock Interviews

For those of you who will be seeking mock interviews please email me as soon as you receive your first invitation so that we can schedule a slot. Although it is early in the season, I am already booking two to three weeks in advance. Giving me as much notice as possible is really helpful. My email: insidermedical@gmail.com .

Nursing Home Life for Medical Students

There's a charming article in the NYT on University of New England medical students who temporarily live in a nursing home to experience what their patients do. About three-quarters down the first page there are statistics on geriatric fellowships. (Please see my other blog entry on this topic.) Geriatrics is a field that has traditionally been unpopular; but I think that will change as the population continues to age.

Contact me now for help with your fellowship application.

Appropriate Letters of Recommendation

For residency applicants, remember that beyond getting strong letters of recommendation, you want to get appropriate ones. You need at the very least one letter in your field and other letters from associated specialties; a psychiatry letter for a general surgery residency is going to be almost worthless.

For help with your residency application please contact me as soon as possible.

Personal Statement for the Preliminary Year

Candidates who apply to certain fields - Radiology, Dermatology, in some case Emergency Medicine - need a preliminary year of training before initiating their specialty residency. I've been asked about submitting the same personal statement for both the desired specialty and the prelim year.

It is appropriate to use the same essay with modifications. Ensure you explicitly address why a prelim year in - let's say Internal Medicine - will advance the rest of your career. Of course, you can be honest about what your professional goals are; the reader knows you are applying for a one -year position, but it is important to include a paragraph that focuses on how the prelim program will help you.

The season is in full swing. Contact me asap if you would like editing services.

Personal Statement: Avoiding Writers' Block

A few years ago a client told me she had more trepidation about writing her residency personal statement than taking her USMLE boards. Writers' block - experienced either before starting the essay or before working on a revision - is normal but aggravating.

I recommend two tactics:

1. Make an outline. This advice might sound like something your fourth-grade teacher would tell you, but it works. Start with a five-paragraph template (which can be changed but is a nice place to begin) and jot down each paragraph's thesis (or main point).

2. Give yourself enough time to work on the PS. The season is already progressing, so this is something to note. Writing an excellent essay in a few days is difficult. Sometimes you'll need a few days' break between revisions just to get yourself back on track.

Please contact me for help with your medical school, residency, fellowship or post bacc essays. The sooner the better. Here are updated comments about my work.

The Early Bird

Most medical school admissions are rolling, and there is an advantage to early application to residency and fellowship programs as well. If you are interested in my editing services, please consider submitting your written materials to me as soon as possible. The season has heated up already and will get even busier.

Safety Schools

Whether you call me a pessimist or a realist, I am an advocate of having a large number of safety schools on your list when applying to medical school.

I have some clients with good GPAs and mediocre MCATs and vice versa. Ensure that your safety schools include those whose averages are the same and lower than your weakest numbers. In other words, if you have a strong MCAT but a weaker GPA, pick safety schools that reflect the GPA.

Remember: You can always decline a medical school's offer of admission; you do not want to be without options.

Letters of Recommendation: Mediocre = Bad

I've been advising a lot of clients lately regarding letters of recommendation both for medical school and residency. Remember that your letters have a big impact on your application, and a mediocre letter can bomb your candidacy. Always ask your potential letter writers if they will write you a "strong letter" of recommendation. If they say no, hesitate or tell you they are too busy think of their negative responses as a favor.

For help with application strategy please contact me. The earlier in the season the better.

CNN article

Cnnmoney.com published this article on the dearth of medical students committed to primary care. I'm quoted about half-way through the piece. Enjoy!

Optimally Wording Your Non-Academic Time

I've noticed a few medical school and residency applicants using the term "year off" in their personal statements when, in fact, they've spent their time completing research, international community service or other worthwhile endeavors. Saying you "took a year off" belittles your accomplishments. Ensure you avoid language that inadvertently subtracts from your application.

Letters of Recommendation: Applying in More than One Specialty

For pre-residency candidates who are applying in more than one specialty, I recommend being up front with your letter of recommendation writers. A few clients have asked me if they should ask recommenders to compose letters for different specialties or one letter that's more generic. The former is your better bet. First, your letter writers will be appreciative if you are honest with them. Second, you'll get more appropriate, and thus stronger, letters.

Applying to more than one field - especially if one of them is competitive - is not that uncommon. There's no reason to be embarrassed.

Contact me for help with your application. 'Tis the season.

AMCAS questions? Call AAMC

For those applying to medical school who have general questions about the AMCAS, I strongly recommend calling AAMC, as I've had a lot of success with rapid responses from them. I've had less success with email but perhaps that's because of my spam filter. Here's their info:

Association of American Medical Colleges
2450 N Street, NW
Washington, DC 20037-1123

E-mail: amcas@aamc.org

Phone: 202-828-0600

Hours of Operation

Monday-Friday:
9 a.m. - 7 p.m. ET

Please note:
AMCAS representatives will be unavailable on Thursdays from 2 p.m. - 4 p.m. ET for staff meetings.

Personal Statement: Show. Don't Tell.

Compare the following:

"I am a compassionate person with a lot of resolve who wants to help people through medicine."

"My four years of clinical work in a low-income clinic, taking vital signs and translating for Spanish-speaking patients, has strengthen my resolve to become a physician."

See the difference?

A quick reminder: In your personal statement it's critical to demonstrate your points with examples, rather than just state your thoughts. Show. Don't just tell because anyone can say s/he is good with patients, kind-hearted and hard-working. Only a few excellent candidates can prove that.

For help with your personal statement for medical school, residency, fellowship or post bacc programs contact me.

Medical School Reapplicant Advice

The number one mistake I see in clients who come to me for help as re-applicants to medical school is that their original list of schools is not congruent with their GPAs and MCATs.

In choosing schools for reapplication (or for first-time submission) ensure that you have at least ten to twenty schools whose average MCAT scores and GPAs are lower than or the same as your numbers are. Having no "safety schools" is - as it were - not safe. Check out this summary of the MSAR for a quick reference. Consider international schools if your numbers are lower than those on the MSAR summary.

Step 2 Deadline

I recently received a notification from the Education Commission for Foreign Medical Graduates regarding the step 2 deadline. For those planning to apply for the 2010 Match please note the following testing deadline information per ECFMG:

...As indicated in the 2009 Schedule for Reporting Step 2 CS Results, if you do not take Step 2 CS
by December 31, 2009, your result will not be available in time to
participate in the 2010 Match.

At the time of this writing, the earliest available test date at any
test center was in September 2009. Demand for the Step 2 CS examination
is already heavy for test dates in the latter part of 2009.
Additionally, test sessions at all test centers may be subject to
scheduling restrictions that limit the number of test dates available to
you.

All test sessions for the remainder of 2009 have been opened and no new
test sessions will be added through the end of the year. To maximize
your chances of obtaining a 2009 test date,

- Apply for Step 2 CS now, provided you meet the eligibility
requirements.

- Once registered, schedule your testing appointment immediately.

- If you cannot obtain a testing appointment at your preferred test
center, check for availability at other test centers.

Registering and scheduling now offer a number of benefits:

- Applicants registered for Step 2 CS can schedule immediately if a
preferred testing appointment is available.

- Applicants who schedule a testing appointment can change the testing
appointment without cost, provided they give more than 14 days' notice.
See Rescheduling in the ECFMG Information Booklet.

If you are planning to take Step 2 CS but are not planning to
participate in the 2010 Match, please consider scheduling a Step 2 CS
testing appointment that is after December 31, 2009. This will maximize
the number of testing appointments available for those who must take
Step 2 CS by December 31, 2009 to obtain their results in time to
participate in the 2010 Match.

Updated information on Step 2 CS scheduling will be posted to the ECFMG
website as it becomes available. Individuals planning to take Step 2 CS
should monitor the ECFMG and USMLE websites for the latest information.

Physician-in-Training Wellness

There's an article by Pauline Chen, M.D. in the NYT regarding the need for doctors-in-training to take better care of themselves. The piece is touching, but I think a major point is missed. A good part of the caregiver burnout that Chen talks about is related to lack of sleep,which is not addressed in the article. Take a look.

AMCAS Sequencing Activities: My Error

I want to apologize for a large error I made. The AMCAS cannot be sequenced in a preferred order despite the - apparently outdated - information I gave in a previous entry. If the applicant attempts to reorder, AMCAS will force a chronological order. I spoke to AMCAS and they indicate there is no way around this. Great apologies for my error.

Alternatives to Overscheduling the Doctor

There's an interesting NYT article on the lack of time doctors have to see their patients and alternative systems to alleviate the problem. These systems may be the wave of the future for physicians.

AMCAS: Brevity is the Soul of Wit

The AMCAS application consists of a maximum of fifteen work/activity descriptions, all of which must be maintained within a 1325 character requirement (including spaces). Do not fall into the trap of trying to fill the space. A brief, streamlined AMCAS is much more likely to be read - not scanned.

Imagine yourself as an admissions committee member who has scores - maybe hundreds - of AMCAS to review. You start to review an AMCAS that fills all of the allotted space. You are not going to look upon this favorably! You are seeking well-written, brief summaries of applicants' accomplishments.

For help with your AMCAS descriptors please contact me. Showcasing your accomplishments optimally is essential.

NRMP 2009 Data

The NRMP has published data from the 2009 Match, including "PGY-1 Match Rates" and "Number of PGY-1 Positions Offered and Filled for Selected Specialties." It's almost too much information for future residency applicants, but candidates can look through the doc to see what interests them most.

Here's it is: "Results and Data: 2009 Main Residency Match."

Physician Work Hours - Maybe Not So Bad... Eventually

Check out this comforting article about work-life balance. I've only had a label for my posts called "physician dissatisfaction," but now I'm adding "physician satisfaction." This article begs the question, though, of how much more competitive medical school admissions will become as bright students flee business.

Personal Statement - What Makes You Distinctive?

I have been receiving a lot of med school and post bacc personal statements lately and with them a lot of questions about how to best write a medical application essay. Here is a listing of all of my PS blog entries. Remember: The key is to write about what makes you a distinctive applicant and how your accomplishments have afforded you skills that make you an exceptional candidate.

IMGs: 2009 NRMP Results

The ECFMG has published stats about this year's Match for IMGs. The data is not significantly different from 2008, which means it's still not great news: In 2009 only 47.8% of U.S. citizen IMGs obtained first year positions through the Match. Of those IMGs who were not U.S. citizens, only 41.6% matched. Of course, high board scores and excellent LORs are extremely helpful. It's also important to ensure your ERAS and personal statement are optimal for submission. Contact me for help earlier rather than later please, so I can assist you best.

Mama's Rules

I strongly recommend a charming piece recently published in the Annals of Emergency Medicine written by Emergency Physician Arthur Kellermann. Most of us go into medicine for the right reasons, but it's amazing how quickly we get bogged down by exhaustion, especially during residency.

Medical School Financial Aid Options

I've have several clients who were admitted to medical school this season and may not be able to go secondary to difficulty securing tuition. Remember that getting a Federal GradPlus or other type of loan is difficult now, and that will likely continue at least through next year. Start to think now about how you will finance your education and whether you are a good risk for a loan. If not, consider what family member might co-sign a medical school tuition loan for you. The AAMC has a section on their site called Financing Your Medical Education, which is a good starting point in considering these issues.

Post Baccalaureate Pre-Medical Application Help

I've been offering help to post bacc applicants informally (with great success; my last client got into Penn). But now I've added a post baccalaureate page with a list of my services for clients. Take a look at my first blog entry on searching post baccaluareate programs for help deciding where to apply.

Physician Shortage

Here's an interesting NYT article focusing on the predicted U.S. physician shortage. It's worth a read particularly because it describes how residency slots are funded, something many people don't understand.

Calculating your GPA

I have found this document very helpful for applicants who are computing their GPAs for AMCAS. And once you've calculated your numbers, take a look at my blog entries on deciding where to apply to medical school.

Contact me for application help at Insider Medical Admissions.

Quick Tip: Step 2

I was just advising a client about when he should take his Step 2. The answer to this question is different depending on a medical students' step 1 scores, how competitive her/his specialty choice is, etc. I can make one suggestion to everyone, though:

On the ERAS form you can check a box to ensure that your Step 2 scores are not automatically released to residency programs. I recommend this. If your score is poor, you can hold it from programs to which you are applying indefinitely. If it is good, you can choose then to release it with very little delay. This move keeps your options open.

Contact me for a strategy session now - before the application season starts. I can assist with decisions about rotation scheduling, the need for research, letters of recommendation, etc.

Quick tips: Sub-i Success

Now is the time that many third year medical students are starting their sub-internships. Here are some quick tips on how to succeed:

1. Read before starting your rotation. You don't have to be ready for board-certification but knowing something about the field from the beginning will impress.
2. Be on time and eager.
3. Don't be annoying. No one likes a gunner.
4. Consider teaming up with an attending to write a case report if you're involved in an interesting case.
5. Don't complain at the hospital. At home you can punch your pillow or cry to your significant other, but at the hospital be cheerful.
6. Attend optional events (if invited) - conferences, morbidity and mortality, luncheons, grand rounds.
7. Be nice to everyone a) because it's the right thing to do and b) because you never know if you might run into someone again.

Contact me for strategy session help now. It's much better to get on top of things early. Also, check out my updated testimonials page.

Quick tip: CVs

Don't assume your CV (curriculum vitae) is being read just because you submitted it to letter of recommendation writers, admissions committees or professional recruiters. There are several pitfalls that can turn a reader off, so here are some quick tips to get your foot in the door:

1. Ensure the formatting is simple. This is one of the biggest mistakes I see: No need for multiple font changes, etc. Half the battle is readability.
2. Ensure the CV is streamlined. (This is where I help the most.)
3. Ensure you briefly describe any activity that will not be familiar to the reader so you get "full credit." For example if you won a local award, list how you were selected and out of how many other candidates. This way the reader will understand the weightiness of the honor.

Contact me for help with your CV. Having an excellent CV early is useful - not only for current needs. It also allows you to simply add accomplishments as they come throughout your medical career.

Getting Clinical Experience

How can a pre-med get clinical experience that demonstrates to admissions officers that the applicant knows what being a practicing doctor entails? Here are three ideas:

1. Work in an Emergency Department, particularly one that is academically-associated. (Doing so can offer the opportunity to get a letter of recommendation from a better-known physician. See my blog entry called "Selecting Your Letter of Recommendation Writers.")
2. Volunteer at a clinic. Volunteering at a low-income clinic often affords the opportunity to take vital signs and patient histories and assist those in need.
3. Work at a veterinarian's office (a client's great idea): This is an excellent way to get real hands-on experience that you cannot get with humans as a pre-med.

Please consider contacting me early for your med school applications. Remember the admissions are rolling at most institutions.

Interview Strategies: Advice from the Non-Medical World

There's a column in the NYTs written about interviewing for the many Americans who are currently seeking employment. I found part of it useful for medical school, residency and fellowship interviews and thought I would share that section below. Ms. Safani to whom the journalist refers is Barbara Safani, owner of Career Solvers, a career management firm.

Some people “believe that talking in generalities is the way to go,” Ms. Safani said, but hiring managers usually prefer specifics — especially examples of how you executed a project or solved a problem. Otherwise, you don’t differentiate yourself and you become a mere blur, she said.

In addition to these “stories of success,” candidates need to be able “to communicate in 30 seconds what they’re all about and how they’re going to add value to that organization,” Ms. Safani said.

If you are questioned about your weaknesses, “be authentic without being damaging,” Ms. Safani said. Be ready with an example of a weakness that is not centered on the core competencies of the job you are seeking, she said.

And, of course, be prepared to ask questions yourself — ones that show you have done research about the company. Ms. Safani recommends asking some questions that go beyond the particular job you are applying for, and that cover the direction of the company as a whole.

All of the above points are topics I discuss with my clients during their one-on-one mock interviews.

Get started early on your application for this coming season: www.InsiderMedicalAdmissions.com .

Who is fit to become a doctor?

There's a weird situation that's created a storm in Sweden: A convicted murderer was accepted to medical school. The NYT's article about the episode is worth a read, bringing up issues about what kind of person is fit to be a physician and how bad doctors can harm the reputation of the entire profession.

Contacting programs

I recommend that if you have not heard from a medical school, residency or fellowship program to which you applied that you contact the institution to inquire about your status. (The Match has passed, so, of course, this will no longer work for residency applicants for this year.)

This week I received an email from a client who told me that this technique served her well in getting a fellowship interview. The applicant had not been invited to interview at a particular program, and I suggested she call to ask about her status. By phone she was offered an interview. Two medical school applicant clients told me about similar experiences when they called schools.

Of course if the school or program explicitly asks in their written materials that you don't contact them about your status then calling is not a good idea.

Check me out: www.InsiderMedicalAdmissions.com . I am already assisting applicants for next year.

Match Results: Good News

I haven't heard back from all of my residency applicants yet, but so far the news looks very good with many of my clients matching to their top first or second choices. These include clients who applied in competitive specialties like orthopedics and ophthalmology. Congratulations!

What factors are most important in your residency application?

The results of the 2008 NRMP Program Director Survey are currently available on-line. According to the NRMP website, data are reported for nineteen specialties and include: (1) factors used for granting interviews and ranking applicants, (2) use of USMLE exam scores and (3) the percentage of interview slots filled prior to the November 1 release date of the MSPE (medical student performance evaluation).

Many applicants will find this information valuable in determining what program directors are currently using to evaluate applicants. Note that personal statement and interview performance are highly valued even in surgical fields. This demonstrates how important it is a) to submit excellent written materials and b) to be well-prepared for residency interviews.

This is - in part - why my application assistance has such a high impact for my clients. Contact me for assistance: InsiderMedicalAdmissions.com .

Match Day

Today is Match Day. Results are available at 1 pm EST.

Resident Work Hours

I was pretty disappointed with the responses Dr. Thomas J. Nasca, the executive director of the ACGME (Accreditation Council for Graduate Medical Education), made in a recent interview with Pauline Chen from the New York Times about resident work hours.

Dr. Nasca's point is that physicians in training need to put their patients' needs over their own, being prepared to suffer extended work hours. Of course professionalism dictates that the patient's well being is paramount but not at the expense of the doctor's safety. Doctors' incidence of needle sticks and motor vehicle accidents increase after extended work hours.

Furthermore, we know that someone who is excessively tired cannot make good judgments, and lack of sleep has been likened in psychological studies to intoxication. Yes, pass offs are a high risk time, but two alert physicians can communicate clearly with one another. If I were a patient, I would always prefer a new physician who had slept well over an original one who was debilitated with fatigue.

Dr. Nasca highlights a resident who was put in the position to either leave her dying patient or stay and lie about the hours she had worked. From my experience, the lies have been in the other direction: One friend at a New York program told me that one resident schedule was created for public consumption (demonstrating that the residents were working within the work hour limitation guidelines) while the real schedule was followed.

Furthermore, Dr. Nasca reports that teaching hospitals have been shown to give better care than private hospitals, but that is in spite of the long resident hours, not because of them. I recall a surgical resident who told me that on his service, after being on call, the residents were rewarded by being allowed to operate the next day. Would you want your family member to be a reward for an exhausted doctor?

A surgical colleague told me of the time she left work after extended hours, was driving home during daylight and next found herself on the side of the freeway in the dark. Apparently, she had fallen asleep at the wheel, but not before she drove her car to a safer spot. Pretty creepy.

Ooops

I want to apologize for the erroneous blog entry that went out today about Match Day. I had prewritten the notice and had scheduled it to go out appropriately, but I guess there was a glitch with blogger.com . Match Day is Thursday, March 19 (next week).

I've deleted the mistaken blog entry.

Pharmaceutical Companies and HMS

There's a provocative debate going on at my alma mater Harvard Med (HMS). A group of students is leading the fight against pharmaceutical influences on HMS teaching faculty. Another group of students says that drug company money is necessary for the vitality of Harvard.

I can say that as a student at HMS in the 90's, I was rather oblivious to the influences that are delineated in a recent NYT article on the topic. The NYT piece is worth a read.


Michelle
www.InsiderMedicalAdmissions.com

The Scramble

The Scramble starts this year on Tuesday, March 17 at noon EST. The Scramble represents the two-day period, ending when Match results are published on March 19 at noon EST, in which unmatched applicants and unfilled programs "find each other." During the Scramble, unmatched candidates can send up to thirty applications to ACGME-accredited programs to which they have not applied previously and up to fifteen to those to which they have applied.

Here are two links to more detailed descriptions of the Scramble process: The ERAS Preparing for the Scramble page and an on-line document called Post-Match Scramble Information for ERAS 2009 IMG Participants .

There are companies that will fax applicants' materials to unfilled programs. If you think you may need to participate in the Scramble, I recommend researching the quality and professionalism of those companies now - prior to the chaos of the Scramble period.

Although I can assist candidates who want to enhance their written materials for the Scramble, I do not offer services to fax applicants' paperwork to unfilled programs. If you think you may need to participate in the Scramble and need to improve your written materials, please contact me right away: www.InsiderMedicalAdmissions.com .

Post Baccalaureate Premedical Programs

For those considering an application to post baccalaureate premedical programs, I'd recommend the AAMC searchable database. The search options are comprehensive, including degree type and special program focus.

With regard to program focus, it's important to consider the courses you've completed before applying to a post baccalaureate program because some are intended to offer science curriculum to those who have not had it, while others act as academic-record enhancers. Along those lines, remember that not all courses in a program may be classified as BCPM (biology, chemistry, physics and math) by AMCAS so ensure you review a post bacc program's classes and their classification before applying.

Most post baccalaureate programs require an updated resume and essay. I've had experience editing written materials for post bacc applicants and am happy to help more candidates: InsiderMedicalAdmissions.com .

Being a physician: A recession-proof job?

According to a recent study, despite the recession, physician salaries increased by 4.4% for specialists and 4% for primary care physicians in 2008. Sullivan, Cotter and Associates is a compensation and human resource management firm that utilized surveys of 257 health care organizations employing more than 41,000 physicians to publish their findings.

Nursing and other health care jobs (physician assistant, home health aide) are also being seen as good careers in this economy. Newsweek.com listed these in their recent photo montage called "Recession-proof jobs."



Check me out at www.InsiderMedicalAdmissions.com .

Thank you notes: Goofy but gracious

My feeling about post-interview thank you notes is that they can't hurt. In theory it seems a little funny that a candidate would thank a faculty member in writing for an obligatory interview. But when I was interviewing candidates at Harvard, it really was nice to receive a note from an applicant.

My suggestions regarding thank you notes:

1. Hand write - no emails.
2. Send the note in a timely manner (the next day).
3. Keep it brief.
4. If there was something particularly noteworthy about the interview (a common interest) mention it.
5. Be formal in your tone.

Good luck,
Michelle
www.InsiderMedicalAdmissions.com

Away rotations

Some medical schools are currently requiring their students to plan their spring and summer rotations. The question I am asked is what my thoughts are on the utility of away rotations. Here we go:

1. They are either really good or really bad. Never in between. If you think you are going to shine then consider being away. If you are just revving up then don't go. The last thing you want is to spend a month away only to have the institution rule you out early. (If you have a strong application that is even more reason not to go away.)
2. Consider the financial cost. Unless you have free housing, being away can get very expensive.

I have a few clients who are strategically contacting me early - now during their third years - for strategy sessions. It's a good idea to get professional advice now and not be blindsided later about weaknesses you could have improved.

Early Bird Special

I'm using this blog entry to alert my blog readers that effective February 13 at noon PST, I will be implementing a price increase in some editing services. In gratitude for your blog reading patronage, I am alerting you as a courtesy to allow you or any friends you wish to refer the opportunity to purchase services at the current "Early Bird" rates. Please see my payment page for details regarding the changes.

My pricing reflects my commitment as an experienced admissions officer to helping my clients get ahead. Every applicant gets my personal attention. Every edit is done solely by me. With my services my clients can feel confident that they get what they pay for.

Thank you! Michelle

Letters of Intent: What They Should Include

A few applicants have emailed me asking me how to write a letter of intent (LOI), whose goal is to get the attention of a medical school and get off the wait list. Here are my recommendations:

1. Keep it short. More than one page will very likely be left unread.
2. Keep it formal.
3. Clarify your enthusiasm. If the school is your number choice say so.
4. Summarize your accomplishments (briefly) and what makes you a distinctive candidate.
5. Update your application.

I have helped numerous clients with LOIs and am, of course, always available for editing assistance: InsiderMedicalAdmissions.com .

The recession hits AMSA

Bad news: I got word this week that AMSA is being forced to cancel my lecture at the national convention for lack of funding.

Per my contact, the poor economy affected several groups that would typically support a medical student professional advancement lecture. It's unfortunate but I look forward to giving my lecture in the future.

The blog will take a brief break while I am on vacation!

What if I haven't heard about my status?

My recommendation for applicants who haven't heard from institutions is to get on the phone and ask. I've had two clients who have done this and have consequently been invited for interviews at those institutions. One applicant was told she was missing a letter of recommendation (which doesn't really make sense since the process is computerized). The other was invited on the spot on the phone. Additional tips:

1. Be polite. Do not be pushy.
2. Advise the person who answers the phone that you have been offered other interviews (if you have) and that you are trying to make travel plans. (This is honest, and most people are sympathetic to the aggravation and cost involved with organizing travel.)
3. Do no call institutions if their web sites or other materials directly advise you not to call regarding your status.

For help with mock interviews please contact me at insidermedical@gmail.com . After we had practiced together, one of my clients was recently offered a medical school spot by phone within 24 hours of her interview!

Your favorite institution

A few people have asked me whether it's wise during the interview, in thank you notes or in letters of intent to tell an institution that it's your favorite. I say, "Sure, if it's true." On the other hand, it's not wise - as some applicants do - to tell all institutions that they're your first choice. I can assure you from experience that admissions committee members across the country speak to one another. And you may see these selection committee members again.

I remember an applicant who told our institution that we were his first choice. He was ranked to match but didn't because he had ranked another residency over us. After that, my colleagues were pretty clear that they wouldn't forget this deceptive behavior if they interacted with him professionally in the future (seeking a job, seeking a committee position).

Check me out: InsiderMedicalAdmissions.com .

GI physician shortage predicted

For my blog-followers who are either currently applying to an Internal Medicine (IM) residency or who are already in their first year of an IM training program, there's an interesting article on a predicted GI physician shortage. The GI folks I have talked to seem to enjoy their work, feel they are mostly fairly remunerated but have worries about how technologies (like CT imaging) might infringe on their subspecialty. This article may diminish some of those worries about GI's future.

Scheduling Interview Practice: Think Early

For those of you who are planning to contact me for mock interviews please think early. I have had a few clients requesting emergency sessions. Giving me as much notice as possible is really helpful. My email: insidermedical@gmail.com .

The East Coast - West Coast Conundrum

If you are from either coast and are interviewing on the opposite side of the country, it's really important that you make clear that you are willing to move. There is a prejudice - especially in the West Coast to East Coast direction - that applicants may not be serious about a cross-country institution.

Don't be afraid to come out and tell your interviewer that you would like to try the other coast - experience something new. Or if you have family in the institution's area mention that. Institutions want to know that you are serious about them before making an offer.

For help with your interviews contact me through InsiderMedicalAdmissions.com .

MCAT: More Timeline Questions

As a follow up to my last blog, another question that often comes up is how far back schools recognize and credit MCAT scores. There's not a definitive answer. Most schools require that scores not be more than two to three years old, but this time frame varies from school to school. If you have concerns it's worth contacting the institution.

Check me out: www.InsiderMedicalAdmissions.com

MCAT scores: How far back can schools see?

I've had a few nontraditional candidates ask me whether med schools can see very old MCAT scores. Here's the scoop: The Medical College Admission Test folks follow what they call their Full Disclosure policy, which means all scores from exams taken since April 2003 are automatically released to AMCAS and the schools that the applicant specifies. If the applicant tested prior to April 2003, s/he has the choice of whether to send those scores.

For help with your application please contact me via www.InsiderMedicalAdmissions.com . I am scheduling mock interviews up to four weeks in advance so email me soon.

Happy new year!